bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomized controlled trial demonstrates novel tools to assess patient outcomes of Indigenous cultural safety training
Authors: Smylie Janet , Rotondi Michael A. , Filipenko Sam , Cox William T. L. , Smylie Diane , Ward Cheryl , Klopfer Kristina , Lofters Aisha K. , O’Neill Braden , Graham Melissa , Weber Linda , Damji Ali N. , Devine Patricia G. , Collins Jane , Hardy Billie-Jo 
Published: January 2024

Abstract
Background
Health care routinely fails Indigenous peoples and anti-Indigenous racism is common in clinical encounters. Clinical training programs aimed to enhance Indigenous cultural safety (ICS) rely on learner reported impact assessment even though clinician self-assessment is poorly correlated with observational or patient outcome reporting. We aimed to compare the clinical impacts of intensive and brief ICS training to control, and to assess the feasibility of ICS training evaluation tools, including unannounced Indigenous standardized patient (UISP) visits.

Method
Using a prospective parallel group three-arm randomized controlled trial design and masked standardized patients, we compared the clinical impacts of the intensive interactive, professionally facilitated, 8- to10-h Sanyas ICS training; a brief 1-h anti-bias training adapted to address anti-Indigenous bias; and control continuing medical education time-attention matched to the intensive training. Participants included 58 non-Indigenous staff physicians, resident physicians and nurse practitioners from family practice clinics, and one emergency department across four teaching hospitals in Toronto, Canada. Main outcome measures were the quality of care provided during UISP visits including adjusted odds that clinician would be recommended by the UISP to a friend or family member; mean item scores on patient experience of care measure; and clinical practice guideline adherence for NSAID renewal and pain assessment.

Results
Clinicians in the intensive or brief ICS groups had higher adjusted odds of being highly recommended to friends and family by standardized patients (OR 6.88, 95% CI 1.17 to 40.45 and OR 7.78, 95% CI 1.05 to 58.03, respectively). Adjusted mean item patient experience scores were 46% (95% CI 12% to 80%) and 40% (95% CI 2% to 78%) higher for clinicians enrolled in the intensive and brief training programs, respectively, compared to control. Small sample size precluded detection of training impacts on clinical practice guideline adherence; 100% of UISP visits were undetected by participating clinicians.

Conclusions
Patient-oriented evaluation design and tools including UISPs were demonstrated as feasible and effective. Results show potential impact of cultural safety training on patient recommendation of clinician and improved patient experience. A larger trial to further ascertain impact on clinical practice is needed.

Trial registration
Clinicaltrials.org NCT05890144. Retrospectively registered on June 5, 2023.
Multifaceted roles for BCL3 in cancer: a proto-oncogene comes of age
Authors: Seaton Gillian , Smith Hannah , Brancale Andrea , Westwell Andrew D. , Clarkson Richard 
Published: January 2024

AbstractIn the early 1990’s a group of unrelated genes were identified from the sites of recurring translocations in B-cell lymphomas. Despite sharing the nomenclature ‘Bcl’, and an association with blood-borne cancer, these genes have unrelated functions. Of these genes, BCL2 is best known as a key cancer target involved in the regulation of caspases and other cell viability mechanisms. BCL3 on the other hand was originally identified as a non-canonical regulator of NF-kB transcription factor pathways – a signaling mechanism associated with important cell outcomes including many of the hallmarks of cancer. Most of the early investigations into BCL3 function have since focused on its role in NF-kB mediated cell proliferation, inflammation/immunity and cancer. However, recent evidence is coming to light that this protein directly interacts with and modulates a number of other signaling pathways including DNA damage repair, WNT/β-catenin, AKT, TGFβ/SMAD3 and STAT3 – all of which have key roles in cancer development, metastatic progression and treatment of solid tumours. Here we review the direct evidence demonstrating BCL3’s central role in a transcriptional network of signaling pathways that modulate cancer biology and treatment response in a range of solid tumour types and propose common mechanisms of action of BCL3 which may be exploited in the future to target its oncogenic effects for patient benefit.
Mitigating role of financial inclusion on the perceived difficulties, concerns, and borrowing for medical expenses in Saudi Arabia
Authors: Al-Hanawi Mohammed Khaled , Al Rahahleh Naseem 
Published: January 2024

AbstractAccess to convenient quality healthcare at all times is considered a basic human right; however, many countries are still striving to achieve this goal for their populations. The persistent rise in healthcare expenditure remains a significant obstacle in achieving universal health coverage on a global scale. The aim of this study was to investigate the role of financial inclusion in addressing the financial hardship related to health and medical expense concerns in the Kingdom of Saudi Arabia. Probit models were applied to analyse nationally representative data from the Global Financial Inclusion (Global Findex) database. The results showed that financial inclusion had a significant impact on reducing the hardship associated with obtaining money for emergency expenses within 30 days as indicated by a significant coefficient of -0.262. Additionally, Financial inclusion substantially increases the likelihood of borrowing money for health or medical purposes in the past 12 months, with a coefficient of 0.585. Moreover, correlations were identified between low income levels and decreased likelihood of borrowing for health/medical purposes, increased difficulty in obtaining money for emergency expenses, and heightened concern regarding the ability to afford medical costs in the event of serious illness or accidents. These findings highlight the need for policy makers and health providers to prioritize financial inclusion and support programs for low-income individuals to achieve equity in health treatment for all in Saudi Arabia.
Extracellular vesicle therapy for obesity-induced NAFLD: a comprehensive review of current evidence
Authors: Zhang Jiali , Ma Baochen , Wang Zixu , Chen Yaoxing , Li Chengzhong , Dong Yulan 
Published: January 2024

AbstractNon-alcoholic fatty liver disease (NAFLD) as a chronic disease especially in Western countries, is still a tough question in the clinical therapy. With the rising prevalence of various chronic diseases, liver transplantation is expected to be the most common therapy after the next 10 years. However, there is still no approved drug for NAFLD, and targeted therapy for NAFLD is urgent. Exosomes as a kind of extracellular vesicle are cell-derived nanovesicles, which play an essential role in intercellular communication. Due to complex cell–cell interactions in the liver, exosomes as therapeutic drugs or drug delivery vesicles may be involved in physiological or pathological processes in NAFLD. Compared with other nanomaterials, exosomes as a cell-free therapy, are not dependent on cell number limitation, which means can be administered safely in high doses. Apart from this, exosomes with the advantages of being low-toxic, high stability, and low-immunological are chosen for targeted therapy for many diseases. In this review, firstly we introduced the extracellular vesicles, including the biogenesis, composition, isolation and characterization, and fundamental function of extracellular vesicles. And then we discussed the modification of extracellular vesicles, cargo packing, and artificial exosomes. Finally, the extracellular vesicles for the therapies of NAFLD are summarized. Moreover, we highlight therapeutic approaches using exosomes in the clinical treatment of NAFLD, which provide valuable insights into targeting NAFLD in the clinical setting.
Graphical Abstract
The cell cycle, autophagy, and cell wall integrity pathway jointly governed by MoSwe1 in Magnaporthe oryzae
Authors: Li Lin , Zhu Xue-Ming , Bao Jian-Dong , Wang Jiao-Yu , Liu Xiao-Hong , Lin Fu-Cheng 
Published: January 2024

AbstractThe cell cycle is pivotal to cellular differentiation in plant pathogenic fungi. Cell wall integrity (CWI) signaling plays an essential role in coping with cell wall stress. Autophagy is a degradation process in which cells decompose their components to recover macromolecules and provide energy under stress conditions. However, the specific association between cell cycle, autophagy and CWI pathway remains unclear in model pathogenic fungi Magnaporthe oryzae. Here, we have identified MoSwe1 as the conserved component of the cell cycle in the rice blast fungus. We have found that MoSwe1 targets MoMps1, a conserved critical MAP kinase of the CWI pathway, through protein phosphorylation that positively regulates CWI signaling. The CWI pathway is abnormal in the ΔMoswe1 mutant with cell cycle arrest. In addition, we provided evidence that MoSwe1 positively regulates autophagy by interacting with MoAtg17 and MoAtg18, the core autophagy proteins. Moreover, the S phase initiation was earlier, the morphology of conidia and appressoria was abnormal, and septum formation and glycogen degradation were impaired in the ΔMoswe1 mutant. Our research defines that MoSWE1 regulation of G1/S transition, CWI pathway, and autophagy supports its specific requirement for appressorium development and virulence in plant pathogenic fungi.
cGAS-STING, inflammasomes and pyroptosis: an overview of crosstalk mechanism of activation and regulation
Authors: Liu Jingwen , Zhou Jing , Luan Yuling , Li Xiaoying , Meng Xiangrui , Liao Wenhao , Tang Jianyuan , Wang Zheilei 
Published: January 2024

Abstract
Background
Intracellular DNA-sensing pathway cGAS-STING, inflammasomes and pyroptosis act as critical natural immune signaling axes for microbial infection, chronic inflammation, cancer progression and organ degeneration, but the mechanism and regulation of the crosstalk network remain unclear.

Main body of the abstract
Cellular stress disrupts mitochondrial homeostasis, facilitates the opening of mitochondrial permeability transition pore and the leakage of mitochondrial DNA to cell membrane, triggers inflammatory responses by activating cGAS-STING signaling, and subsequently induces inflammasomes activation and the onset of pyroptosis. Meanwhile, the inflammasome-associated protein caspase-1, Gasdermin D, the CARD domain of ASC and the potassium channel are involved in regulating cGAS-STING pathway. Importantly, this crosstalk network has a cascade amplification effect that exacerbates the immuno-inflammatory response, worsening the pathological process of inflammatory and autoimmune diseases. Given the importance of this crosstalk network of cGAS-STING, inflammasomes and pyroptosis in the regulation of innate immunity, it is emerging as a new avenue to explore the mechanisms of multiple disease pathogenesis. Therefore, efforts to define strategies to selectively modulate cGAS-STING, inflammasomes and pyroptosis in different disease settings have been or are ongoing. In this review, we will describe how this mechanistic understanding is driving possible therapeutics targeting this crosstalk network, focusing on the interacting or regulatory proteins, pathways, and a regulatory mitochondrial hub between cGAS-STING, inflammasomes, and pyroptosis.

Short conclusion
This review aims to provide insight into the critical roles and regulatory mechanisms of the crosstalk network of cGAS-STING, inflammasomes and pyroptosis, and to highlight some promising directions for future research and intervention.
Dietary sulfur amino acid restriction in humans with overweight and obesity: a translational randomized controlled trial
Authors: Olsen Thomas , Stolt Emma , Øvrebø Bente , Elshorbagy Amany , Tore Elena C. , Lee-Ødegård Sindre , Troensegaard Hannibal , Johannessen Hanna , Doeland Beate , Vo Anna A. D. , Dahl Anja F. , Svendsen Karianne , Thoresen Magne , Refsum Helga , Rising Russell , Barvíková Kristýna , van Greevenbroek Marleen , Kožich Viktor , Retterstøl Kjetil , Vinknes Kathrine J. 
Published: January 2024

AbstractBackgroundDietary sulfur amino acid restriction (SAAR) improves metabolic health in animals. In this study, we investigated the effect of dietary SAAR on body weight, body composition, resting metabolic rate, gene expression profiles in white adipose tissue (WAT), and an extensive blood biomarker profile in humans with overweight or obesity.MethodsN = 59 participants with overweight or obesity (73% women) were randomized stratified by sex to an 8-week plant-based dietary intervention low (~ 2 g/day, SAAR) or high (~ 5.6 g/day, control group) in sulfur amino acids. The diets were provided in full to the participants, and both investigators and participants were blinded to the intervention. Outcome analyses were performed using linear mixed model regression adjusted for baseline values of the outcome and sex.ResultsSAAR led to a ~ 20% greater weight loss compared to controls (β 95% CI − 1.14 (− 2.04, − 0.25) kg, p = 0.013). Despite greater weight loss, resting metabolic rate remained similar between groups. Furthermore, SAAR decreased serum leptin, and increased ketone bodies compared to controls. In WAT, 20 genes were upregulated whereas 24 genes were downregulated (FDR < 5%) in the SAAR group compared to controls. Generally applicable gene set enrichment analyses revealed that processes associated with ribosomes were upregulated, whereas processes related to structural components were downregulated.ConclusionOur study shows that SAAR leads to greater weight loss, decreased leptin and increased ketone bodies compared to controls. Further research on SAAR is needed to investigate the therapeutic potential for metabolic conditions in humans.Trial registration: ClinicalTrials.gov identifier: NCT04701346, registered Jan 8th 2021,https://www.clinicaltrials.gov/study/NCT04701346
Autosomal dominant polycystic kidney disease with ectopic unilateral multicystic kidney: a case report
Authors: Amoah Yaw , Kyei Mathew Yamoah , Mensah James Edward , Palm Bridget , Adrah Henry Kwasi , Asiedu Isaac 
Published: January 2024

Abstract
Background
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disorder and the fourth cause of death of end-stage renal disease. The disease has a prevalence of 1:400–1:1000 accounting for 10% of patients on dialysis. In most ADPKD patients, bilateral kidneys are similarly affected, with numerous fluid-filled cysts arising from different nephron segments. Only a few cases of ADPKD with ectopic unilateral multicystic kidney have been reported. It has been observed that the deterioration of their kidney function seemed to be quicker than their age- and sex-matched controls and siblings especially when the ectopic kidney is dysplastic.

Case presentation
We report a case of a 46-year-old Ghanaian male patient who presented with left flank pain and hematuria with high BP and deranged renal function. Abdominal ultrasonography showed both kidneys to be larger than normal and had multiple cysts of varying sizes with the right kidney located in the right iliac fossa. Follow up Abdominopelvic computer tomographic scan (CT–Scan) without contrast showed enlarged kidneys with the renal parenchyma replaced by innumerable cyst of varying sizes. The right kidney was ectopically located in the right aspect of the pelvis. A diagnosis of ADPKD with right pelvic ectopic multicystic kidney was made. He was put on antihypertensives, analgesia for the left flank pain and to have follow up at the urology and nephrology departments.

Conclusion
In most ADPKD patients, bilateral kidneys are similarly affected. Only a few cases of ADPKD with ectopic unilateral multicystic kidney have been reported. It has been observed that the deterioration of their kidney function seemed to be quicker than their age- and sex-matched controls and siblings especially when the ectopic kidney is dysplastic.
Magnetization transfer ratio of the sciatic nerve differs between patients in type 1 and type 2 diabetes
Authors: Mooshage Christoph M. , Schimpfle Lukas , Tsilingiris Dimitrios , Kender Zoltan , Aziz-Safaie Taraneh , Hohmann Anja , Szendroedi Julia , Nawroth Peter , Sturm Volker , Heiland Sabine , Bendszus Martin , Kopf Stefan , Jende Johann M. E. , Kurz Felix T. 
Published: January 2024

Abstract
Background
Previous studies on magnetic resonance neurography (MRN) found different patterns of structural nerve damage in type 1 diabetes (T1D) and type 2 diabetes (T2D). Magnetization transfer ratio (MTR) is a quantitative technique to analyze the macromolecular tissue composition. We compared MTR values of the sciatic nerve in patients with T1D, T2D, and healthy controls (HC).

Methods
3-T MRN of the right sciatic nerve at thigh level was performed in 14 HC, 10 patients with T1D (3 with diabetic neuropathy), and 28 patients with T2D (10 with diabetic neuropathy). Results were subsequently correlated with clinical and electrophysiological data.

Results
The sciatic nerve’s MTR was lower in patients with T2D (0.211 ± 0.07, mean ± standard deviation) compared to patients with T1D (T1D 0.285 ± 0.03; p = 0.015) and HC (0.269 ± 0.05; p = 0.039). In patients with T1D, sciatic MTR correlated positively with tibial nerve conduction velocity (NCV; r = 0.71; p = 0.021) and negatively with hemoglobin A1c (r =  − 0.63; p < 0.050). In patients with T2D, we found negative correlations of sciatic nerve’s MTR peroneal NCV (r =  − 0.44; p = 0.031) which remained significant after partial correlation analysis controlled for age and body mass index (r = 0.51; p = 0.016).

Conclusions
Lower MTR values of the sciatic nerve in T2D compared to T1D and HC and diametrical correlations of MTR values with NCV in T1D and T2D indicate that there are different macromolecular changes and pathophysiological pathways underlying the development of neuropathic nerve damage in T1D and T2D.

Trial registration
https://classic.clinicaltrials.gov/ct2/show/NCT03022721. 16 January 2017.

Relevance statement
Magnetization transfer ratio imaging may serve as a non-invasive imaging method to monitor the diseases progress and to encode the pathophysiology of nerve damage in patients with type 1 and type 2 diabetes.

Key points
• Magnetization transfer imaging detects distinct macromolecular nerve lesion patterns in diabetes patients.
• Magnetization transfer ratio was lower in type 2 diabetes compared to type 1 diabetes.
• Different pathophysiological mechanisms drive nerve damage in type 1 and 2 diabetes.

Graphical Abstract
Patient, health professional and psychiatrist satisfaction with emergency department telepsychiatry during the COVID-19 pandemic: a pilot study
Authors: Dugas Erika N. , Bouhamdani Nadia , Poirier Martine , Lang Rino , Robichaud Martin , Aube-Pinet Julie , Godin Stéphane 
Published: January 2024

Abstract
Background
Emergency department telepsychiatry (EDTP) can improve healthcare delivery. However, no studies document implementation and overall satisfaction within the Canadian pandemic context. The objectives of this study were to (i) describe barriers associated with EDTP; and (ii) assess patients’, ED health professionals’, and psychiatrists’ perceived satisfaction with EDTP during the COVID-19 pandemic. Data were collected in three New Brunswick hospitals over 8-weeks in 2021. Psychiatrists (n = 6) completed a self-report questionnaire following each EDTP consultation, patients (n = 58) completed a telephone-administered questionnaire 1-week post EDTP consultation, and ED health professionals (n = 31) completed a single self-report questionnaire at the end of the study period.

Results
One-third of psychiatrists and two-thirds of ED health professionals encountered a barrier, respectively. The most common barriers related to problems linked to sound/video/connection, lack of experience and guidelines, or increased workload. Despite these barriers, high levels of satisfaction were reported by patients and psychiatrists (mean satisfaction score (sd): 4.2 (0.6) and 4.8 (0.4), respectively). ED health professionals reported lower satisfaction scores; however, most believed that EDTP was associated with healthcare delivery advantages.

Conclusions
These findings indicate moderate to high EDTP satisfaction. Additional training, guidelines, and change management strategies may be necessary to insure harmonious EDTP implementation for all health professionals.
Exploring the support needs of young adult caregivers, their issues, and preferences towards a web-based tool: a mixed-method study
Authors: Dang Srishti , Looijmans Anne , Sharma Nikita , Jansen Annemarie Braakman , Hagedoorn Mariët 
Published: January 2024

Abstract
Background
Young adult caregivers (YACs, aged 18–25) who take care of a loved one may juggle between caregiving responsibilities and other life areas such as education and social life, leading to an imbalance in their lives. The web-based tool ‘MantelzorgBalans’ aims to support informal caregivers (ICGs) in balancing caregiving tasks and activities in other life areas. However, this tool was designed to support ICGs of loved ones receiving palliative care and is not yet tailored to the needs of YACs. In order to do so, in this study we aim to explore (i) challenges and support needs of YACs in caregiving, (ii) their needs towards the content of the ‘MantelzorgBalans’ tool, and (iii) issues they encountered in using the tool and their preferences for adaptation of the tool.

Method
We conducted semi-structured interviews and usability testing with 13 student YACs in the Netherlands. Within usability testing, we used three approaches: (i) a thinking-aloud approach (verbalizing thoughts while using the tool), (ii) a task-based performance approach (scoring task completion rate), and (iii) questionnaires. We used thematic analysis to synthesize the qualitative data. For the quantitative data, we calculated frequencies and mean scores.

Results
Our findings suggest that the majority of YACs faced challenges in balancing caregiving with life areas such as education and social life. They needed support from healthcare professionals who could listen to them without judging them. With respect to the MantelzorgBalans tool, YACs needed more information on how to provide emotional support to their loved one and the emotional support that is available for them. In regards to the aesthetics, they preferred bright colours and more visuals in the tool. Overall, they were satisfied with the information presented in the tool, but they were neutral in their willingness to use it in the future.

Conclusion
From this study, we learn that YACs may experience specific challenges and needs in general, and towards a web-based tool in specific. In the near future, it will be important to develop digital tools to support YACs that match their specific needs. This may enable healthcare professionals to offer targeted and personalized digital support to YACs in future.