bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of factors associated with unmet healthcare needs in people with disabilities before and after COVID-19: a nationally representative population-based study
Authors: Lee Sujin , Park Han Nah , Nam Hye Jin , Kim Bohye , Yoon Ju Young 
Published: January 2024

Abstract
Background
People with disabilities, who require numerous healthcare services, are vulnerable to unmet healthcare needs. This study aimed to investigate and identify the factors that influence unmet healthcare needs among people with disabilities and to compare these factors before and after the COVID-19 pandemic in South Korea.

Methods
A propensity score matching analysis was conducted using two datasets from the National Survey of Disabled Persons collected in 2017 and 2020. The participants were matched based on variables known to influence healthcare utilization. Based on the Andersen model, logistic regression was performed to analyze the key characteristics of the factors associated with unmet healthcare needs, including predisposing, enabling, and need factors.

Results
Propensity score matching resulted in the inclusion of 1,884 participants in each group: an experimental group and control group. Before COVID-19, factors associated with unmet healthcare needs included sex, age, marital status, and education level (predisposing factors), instrumental activities of daily living dependency, satisfaction with medical staff’s understanding of disability, satisfaction with medical institutional facilities and equipment (enabling factors), subjective health status, and depressive symptoms (need factors). After COVID-19, factors included physical disability, instrumental activities of daily living dependency, and discrimination (enabling factors), and subjective health status, chronic diseases, depressive symptoms, and regular medical care (need factors). No significant predisposing factors affecting unmet healthcare needs were identified after COVID-19.

Conclusions
This study compared the factors affecting unmet healthcare needs among people with disabilities before and after COVID-19. Recognizing the different factors associated with unmet healthcare needs before and after COVID-19, (e.g., sex, type of disability, satisfaction with medical staff’s understanding of disabilities, medical institutional facilities and equipment considering the disabled, discrimination, chronic diseases, and regular medical care) may help governments and policymakers establish strategies to reduce and prevent unmet healthcare needs during and a future crisis.
Non-pharmacological labor pain relive methods: utilization and associated factors among midwives and maternity nurses in Najran, Saudi Arabia
Authors: Elgzar Wafaa T. , Alshahrani Majed S. , Ibrahim Heba A. 
Published: January 2024

Abstract
Background
Traditionally, pharmacological pain relief methods have been the most acceptable option for controlling labor pain, accompanied by numerous adverse consequences. Non-pharmacological labor pain relive methods can reduce labor pain while maintaining an effective and satisfying delivery experience and delaying the use of pharmacological methods. This study explores the utilization of non-pharmacological labor pain relive methods and its associated factors among midwives and maternity nurses.

Methods
A cross-sectional research was conducted in Maternal and Children Hospital/Najran, Saudi Arabia, from April to May 2023 and incorporated a convenience sample of 164 midwives and maternity nurses. The data was collected using a self-reported questionnaire composed of five sections; basic data, facility-related factors, non-pharmacological labor pain relive utilization and attitude scales, and knowledge quiz. A logistic regression was used to determine the associated factors with non-pharmacological labor pain relive utilization.

Results
The results revealed that 68.3% of participants utilized non-pharmacological labor pain relive methods. The midwives and maternity nurses helped the parturient to tolerate labor pain by applying the non-pharmacological labor pain relive methods, including; positioning (55.5%), breathing exercises (53.7%), comfortable and relaxing environment (52.4%), therapeutic communication (47%), positive reinforcement (40.9%), relaxation (40.2%), and therapeutic touch (31%). In addition, working unit, providers-patient ratio, working hours, non-pharmacological labor pain relive training, years of experience, and non-pharmacological labor pain relive attitude were significant determinants of non-pharmacological labor pain relive utilization (P < 0.05).

Conclusions
High non-pharmacological labor pain relive utilization was significantly associated with nurses' older age and higher education, working in the delivery room, lower nurse-patient ratio, lower working hours, in-services training, increased years of experience, and positive attitude. The study sheds light on the importance of handling the pre-mentioned factors to enhance non-pharmacological labor pain relive utilization.
Structural connectome alterations between individuals with autism and neurotypical controls using feature representation learning
Authors: Jang Yurim , Choi Hyoungshin , Yoo Seulki , Park Hyunjin , Park Bo-yong 
Published: January 2024

AbstractAutism spectrum disorder is one of the most common neurodevelopmental conditions associated with sensory and social communication impairments. Previous neuroimaging studies reported that atypical nodal- or network-level functional brain organization in individuals with autism was associated with autistic behaviors. Although dimensionality reduction techniques have the potential to uncover new biomarkers, the analysis of whole-brain structural connectome abnormalities in a low-dimensional latent space is underinvestigated. In this study, we utilized autoencoder-based feature representation learning for diffusion magnetic resonance imaging-based structural connectivity in 80 individuals with autism and 61 neurotypical controls that passed strict quality controls. We generated low-dimensional latent features using the autoencoder model for each group and adopted an integrated gradient approach to assess the contribution of the input data for predicting latent features during the encoding process. Subsequently, we compared the integrated gradient values between individuals with autism and neurotypical controls and observed differences within the transmodal regions and between the sensory and limbic systems. Finally, we identified significant associations between integrated gradient values and communication abilities in individuals with autism. Our findings provide insights into the whole-brain structural connectome in autism and may help identify potential biomarkers for autistic connectopathy.
Comprehensive review of dibenzocyclooctadiene lignans from the Schisandra genus: anticancer potential, mechanistic insights and future prospects in oncology
Authors: Jafernik Karolina , Motyka Sara , Calina Daniela , Sharifi-Rad Javad , Szopa Agnieszka 
Published: January 2024

AbstractCancer remains one of the leading causes of mortality worldwide. The search for novel and effective anticancer agents has been a significant area of research. Dibenzocyclooctadiene lignans (DBCLS), derived from the Schisandra genus plants like: S. chinensis, S. sphenanthera, S. henryi, S. rubriflora, S. grandiflora, S. propinqua, and S. glabra, have been traditionally used in various medicinal systems and are known for their myriad health benefits, including anticancer properties. This comprehensive review aimed to collate and critically analyse the recent literature on the anticancer properties of DBCLS, focusing on their mechanistic approaches against different cancer types. An exhaustive literature search was performed using databases like PubMed/MedLine, Scopus, Web of Science, Embase, TRIP database and Google Scholar from 1980 to 2023. Peer-reviewed articles that elucidated the mechanistic approach of these lignans on cancer cell lines, in vivo models and preliminary clinical studies were included. Studies were assessed for their experimental designs, cancer types studied, and the mechanistic insights provided. The studies demonstrate that the anticancer effects of DBCLS compounds are primarily driven by their ability to trigger apoptosis, arrest the cell cycle, induce oxidative stress, modulate autophagy, and disrupt essential signaling pathways, notably MAPK, PI3K/Akt, and NF-κB. Additionally, these lignans have been shown to amplify the impact of traditional chemotherapy treatments, suggesting their potential role as supportive adjuncts in cancer therapy. Notably, several studies also emphasise their capacity to target cancer stem cells and mitigate multi-drug resistance specifically. DBCLS from the Schisandra genus have showcased significant potential as anticancer agents. Their multi-targeted mechanistic approach makes them promising candidates for further research, potentially leading to developing of new therapeutic strategies in cancer management.
Genomic and phenotypic analysis of invasive Streptococcus suis isolated in Spain reveals genetic diversification and associated virulence traits
Authors: Uruén Cristina , Fernandez Ana , Arnal José Luis , del Pozo Mateo , Amoribieta Maria Casas , de Blas Ignacio , Jurado Paula , Calvo Jorge Hugo , Gottschalk Marcelo , González-Vázquez Luis Daniel , Arenas Miguel , Marín Clara M. , Arenas Jesús 
Published: January 2024

AbstractStreptococcus suis is a zoonotic pathogen that causes a major health problem in the pig production industry worldwide. Spain is one of the largest pig producers in the world. This work aimed to investigate the genetic and phenotypic features of invasive S. suis isolates recovered in Spain. A panel of 156 clinical isolates recovered from 13 Autonomous Communities, representing the major pig producers, were analysed. MLST and serotyping analysis revealed that most isolates (61.6%) were assigned to ST1 (26.3%), ST123 (18.6%), ST29 (9.6%), and ST3 (7.1%). Interestingly, 34 new STs were identified, indicating the emergence of novel genetic lineages. Serotypes 9 (27.6%) and 1 (21.8%) prevailed, followed by serotypes 7 (12.8%) and 2 (12.2%). Analysis of 13 virulence-associated genes showed significant associations between ST, serotype, virulence patterns, and clinical features, evidencing particular virulence traits associated with genetic clusters. The pangenome was generated, and the core genome was distributed in 7 Bayesian groups where each group included a variable set of over- and under-represented genes of different categories. The study provides comprehensive data and knowledge to improve the design of new vaccines, antimicrobial treatments, and bacterial typing approaches.
Dietary Insulin Index (DII) and Dietary Insulin load (DIL) and Caveolin gene variant interaction on cardiometabolic risk factors among overweight and obese women: a cross-sectional study
Authors: Amiri khosroshahi Reza , Mirzababaei Atieh , Setayesh Leila , Bagheri Reza , Heidari Seyedmahalleh Mohammad , Wong Alexei , Suzuki Katsuhiko , Mirzaei Khadijeh 
Published: January 2024

Abstract
Background and objective
Studies have shown that Caveolin gene polymorphisms (CAV-1) are involved in chronic diseases, such as metabolic syndrome. Moreover, the dietary insulin index (DII) and dietary insulin load (DIL) have been shown to potentially elicit favorable effects on cardiovascular disease (CVD) risk. Therefore, this study sought to investigate the effect of DII DIL and CAV-1 interaction on CVD risk factors.

Methods
This cross-sectional study consisted of 333 overweight and obese women aged 18–48 years. Dietary intakes, DII, and DIL were evaluated using the 147-item food frequency questionnaire (FFQ). Serum profiles were measured by standard protocols. The CAV-1 rs 3,807,992 and anthropometric data were measured by the PCR–RFLP method and bioelectrical impedance analysis (BIA), respectively. Participants were also divided into three groups based on DII, DIL score, and rs3807992 genotype.

Results
This comparative cross-sectional study was conducted on 333 women classified as overweight or obese. Participants with A allele for the caveolin genotype and higher DII score showed significant interactions with high-density lipoprotein (HDL) (P for AA = 0.006 and P for AG = 0.019) and CRI-I (P for AA < 0.001 and P for AG = 0.024). In participants with AA genotype and greater DII score, interactions were observed in weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, CRI-II, fat-free mass (FFM), and skeletal muscle mass (SMM) (P < 0.079). Those with higher DIL scores and AA genotype had higher weight (P = 0.033), FFM (P = 0.022), and SMM (P = 0.024). In addition, DIL interactions for waist/hip ratio (WHR), waist circumference (WC), triglyceride (TG), CRI-I, and body fat mass (BFM) among individuals with AA genotype, while an HDL interaction was observed in individuals with AG and AA (P < 0.066).

Conclusion
The findings of the present study indicate that people who carry the caveolin rs3807992 (A) allele and have greater DII and DIL scores are at higher risk for several cardiovascular disease and metabolic syndrome biomarkers. These results highlight that diet, gene variants, and their interaction, should be considered in the risk evaluation of developing CVD.
A promising natural killer cell-based model and a nomogram for the prognostic prediction of clear-cell renal cell carcinoma
Authors: Yao Qinfan , Zhang Xiuyuan , Wang Yucheng , Wang Cuili , Chen Jianghua , Chen Dajin 
Published: January 2024

Abstract
Background
Clear-cell renal cell carcinoma (ccRCC) is one of prevalent kidney malignancies with an unfavorable prognosis. There is a need for a robust model to predict ccRCC patient survival and guide treatment decisions.

Methods
RNA-seq data and clinical information of ccRCC were obtained from the TCGA and ICGC databases. Expression profiles of genes related to natural killer (NK) cells were collected from the Immunology Database and Analysis Portal database. Key NK cell-related genes were identified using consensus clustering algorithms to classify patients into distinct clusters. A NK cell-related risk model was then developed using Least Absolute Shrinkage and Selection Operator (LASSO) Cox regression to predict ccRCC patient prognosis. The relationship between the NK cell-related risk score and overall survival, clinical features, tumor immune characteristics, as well as response to commonly used immunotherapies and chemotherapy, was explored. Finally, the NK cell-related risk score was validated using decision tree and nomogram analyses.

Results
ccRCC patients were stratified into 3 molecular clusters based on expression of NK cell-related genes. Significant differences were observed among the clusters in terms of prognosis, clinical characteristics, immune infiltration, and therapeutic response. Furthermore, six NK cell-related genes (DPYSL3, SLPI, SLC44A4, ZNF521, LIMCH1, and AHR) were identified to construct a prognostic model for ccRCC prediction. The high-risk group exhibited poor survival outcomes, lower immune cell infiltration, and decreased sensitivity to conventional chemotherapies and immunotherapies. Importantly, the quantitative real-time polymerase chain reaction (qRT-PCR) confirmed significantly high DPYSL3 expression and low SLC44A4 expression in ACHN cells. Finally, the decision tree and nomogram consistently show the dramatic prediction performance of the risk score on the survival outcome of the ccRCC patients.

Conclusions
The six-gene model based on NK cell-related gene expression was validated and found to accurately mirror immune microenvironment and predict clinical outcomes, contributing to enhanced risk stratification and therapy response for ccRCC patients.
Preliminary identification of clinical cut-off of the vegetarian vegan eating disorder screener (V-EDS) in a community and self-reported clinical sample of vegetarians and vegans
Authors: McLean Courtney P. , Chen Zhibin , Fielding Joanne , Sharp Gemma 
Published: January 2024

Abstract
Background
The vegetarian vegan eating disorder screener (V-EDS) is an 18-item self-report screening tool designed to assess the unique elements of eating disorder symptomology in vegetarians and vegans. Previous results have suggested strong initial psychometric properties in non-clinical community samples of vegetarians and vegans. The present study sought to identify a preliminary threshold cut-off score to discriminate eating disorder pathology in a self-reported clinical and community sample.

Methods
This study involved secondary analysis using data collected in McLean et al. (Development and preliminary validation of a novel eating disorder screening tool for vegetarians and vegans: the V-EDS, 2023), comprising 599 non-clinical participants and 51 self-reported clinical participants. Receiver operating characteristic (ROC) curve analysis was used to compute possible cut-off values for the V-EDS. Results: ROC analysis indicated good performance of the V-EDS (area under the curve = 0.87), with integration of the Youden index demonstrating a global score of ≥ 18 to be optimal in predicting clinical caseness with good sensitivity (0.804) and specificity (0.843).

Conclusions
The present study fills an important gap as the first to investigate an optimal V-EDS score to discriminate level of impairment from eating disorder pathology in a sample of vegetarian and vegan community and self-reported clinical participants. We extend the utility of the V-EDS in discovering good discrimination power in classifying clinical caseness with a cut-off score of 18 shown to optimise the trade-off between sensitivity and specificity. Future research should focus on expanding the psychometric properties of the V-EDS in larger and more diverse participant groups, including gender, age, cultural identity, and eating disorder history.
PRESTO: A Phase III, Open-Label Study of Intensification of Androgen Blockade in Patients With High-Risk Biochemically Relapsed Castration-Sensitive Prostate Cancer (AFT-19)
Authors: Aggarwal Rahul , Heller Glenn , Hillman David W. , Xiao Han , Picus Joel , Taplin Mary-Ellen , Dorff Tanya , Appleman Leonard , Weckstein Douglas , Patnaik Akash , Bryce Alan , Shevrin Daniel , Mohler James , Anderson Daniel , Rao Arpit , Tagawa Scott , Tan Alan , Halabi Susan , Dooley Katharine , O'Brien Patrick , Chen Ronald , Ryan Charles J. , Eggener Scott E. , Morris Michael J. , Aggarwal Rahul , Shevrin Daniel , Tagawa Scott , Kim Charles , Taplin Mary-Ellen , Whang Young , Dakhil Shaker , Smith Raymond , Gartrell Benjamin , Fagbemi Seth , Mowat Rex , Farber Charles , Hashemi Neda , Humeniuk Michael , Ryan Charles , Ellerton John , Olsen Mark , Wang Jennifer , Dorff Tanya , Karina Pascual Sheila , Weckstein Douglas , Weckstein Douglas , Bryce Alan , Mohler James , Michael Randall James , Xiao Han , Patnaik Akash , King David , Picus Joel , Kilari Deepak , Monk Paul , Bitting Rhonda , Appleman Leonard , Eugenio Najera Jose , Rowland Kendrith , Hauke Ralph , Shehadeh Nasfat , Curti Brendan , Gupta Gopal , Tan Alan , Collins Timothy , Beer Tomasz , Tate David , Sheh Bryant , Basnet Alina , Conway James , Gross Howard , Goodman Michael 
Published: January 2024

PURPOSE
Patients with biochemically recurrent prostate cancer (BRPC) after radical prostatectomy and a short PSA doubling time are at risk for distant metastases. Apalutamide, an androgen receptor antagonist, and abiraterone acetate plus prednisone (AAP) prolong survival in the metastatic setting. We evaluated whether intensification of androgen-deprivation therapy (ADT) improves outcomes in BRPC.

PATIENTS AND METHODS

PRESTO is a randomized phase III, open-label trial in patients with BRPC and PSA doubling time ≤9 months (ClinicalTrials.gov identifier:
NCT03009981
). Patients were randomly assigned 1:1:1 to receive a finite 52-week treatment course with ADT control, ADT + apalutamide, or ADT + apalutamide + AAP. The primary end point was PSA progression-free survival (PSA-PFS), defined as serum PSA >0.2 ng/mL after treatment completion.

RESULTS

Five hundred three patients were enrolled. The median PSA was 1.8 ng/mL (IQR, 1.0-3.6). At the first planned interim analysis, both experimental arms significantly prolonged PSA-PFS compared with the control arm (median, 24.9 months for ADT + apalutamide
v
20.3 months for ADT; hazard ratio [HR], 0.52 [95% CI, 0.35 to 0.77];
P
= .00047; median, 26.0 months for ADT + apalutamide + AAP
v
20.0 months for ADT; HR, 0.48 [95% CI, 0.32 to 0.71];
P
= .00008). Median time to testosterone recovery did not differ across treatment arms. The most common grade ≥3 adverse event was hypertension (7.5%, 7.4%, and 18% in ADT, ADT + apalutamide, and ADT + apalutamide + AAP arms, respectively).

CONCLUSION
Intensified AR blockade for a finite duration prolongs PSA-PFS with a manageable safety profile, without adversely affecting time to testosterone recovery. The addition of apalutamide to ADT should be considered in patients with high-risk BRPC.
MODERN LANGUAGES IN THE EDUCATION SYSTEM IN THE BALKANS IN THE XVIII – FIRST THIRD OF THE XIX CENTURIES (SOCIOLINGUISTIC ASPECT)
Authors: Razumova Lina V. 
Published: January 2024

Purpose. The article is devoted to the analysis of the formation of regional and local centers of teaching modern foreign languages in the Balkans in the XVIII-XIX centuries. The socio-historical conditions that were crucial in the formation of language education in this region and determined its character and main actors are investigated.
Methodology. The methodological basis of the study is a comparative historical method based on the cultural and historical interpretation of the data and systematization of the emerging linguistic situations and conditions on the territory of the studied areas.
Results. The analysis made it possible to determine that the poly-linguistic area under study, despite certain national differences in language education in the XVIII-XIX centuries, also reveals a number of common features. These include the rather late formation of language schools and educational centers. Another important feature is the mediating role of the Greek elite in the development of language education and the dissemination of Western European didactic samples in this territory.
Practical implications. The results of the research can be used in scientific and educational activities in the sections of historical sociolinguistics devoted to the analysis of the socio-historical conditions of the formation of national education systems, their didactic ideas and the social circumstances of their implementation.