bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient factors associated with conveyance decision-making by Emergency Medical Services professionals in patients with a syncope: a cross-sectional factorial survey design
Authors: Ort B. Bastiaan A. , uit het Broek Lucia G. , de Bruin Harm , Akkermans Reinier P. , Goosselink Ben , Vermeulen Hester , Ebben Remco H.A. , Vloet Lilian C.M. , Berben Sivera A.A. 
Published: October 2023

Abstract
Background
The clinical decision-making of non-conveyance is perceived as complex and difficult by emergency medical services (EMS) professionals. Patients with a transient loss of consciousness (TLOC) based on syncope constitute a significant part of the non-conveyance population. Risk stratification is the basis of the clinical decision-making process by EMS professionals. This risk stratification is based on various patient factors. This study aimed to explore patient factors significantly associated with conveyance decision-making by EMS professionals in patients with a TLOC based on syncope.

Methods
A cross-sectional vignette study with a factorial survey design was conducted. Patient factors were derived from the “National Protocol Ambulance Care”, and all possible combinations of these factors and underlying categories were combined, resulting in 256 unique vignettes (2*4*4*4*2 = 256). Patient factors presented either low-risk or high-risk factors for adverse events. Data were collected through an online questionnaire, in which participants received a random sample of 15 vignettes. For each vignette, the respondent indicated whether the patient would need to be conveyed to the emergency department or not. A multilevel logistic regression analysis with stepwise backward elimination was performed to analyse factors significantly associated with conveyance decision-making. In the logistic model, we modelled the probability of non-conveyance.

Results
110 respondents were included, with 1646 vignettes being assessed. Mean age 45.5 (SD 9.3), male gender 63.6%, and years of experience 13.2 (SD 8.9). Multilevel analysis showed two patient factors contributing significantly to conveyance decision-making: ‘red flags’ and ‘prehospital electrocardiogram (ECG)’. Of these patient factors, three underlying categories were significantly associated with non-conveyance: ‘sudden cardiac death < 40 years of age in family history’ (OR 0.33, 95% CI 0.22–0.50; p < 0.001), ‘cardiovascular abnormalities, pulmonary embolism or pulmonary hypertension in the medical history’ (OR 0.62, 95% CI 0.43–0.91; p = 0.01), and ‘abnormal prehospital ECG’ (OR 0.54, 95% CI 0.41–0.72; p < 0.001).

Conclusion
Sudden cardiac death < 40 years of age in family history, medical history, and abnormal ECG are significantly negatively associated with non-conveyance decision-making by EMS professionals in patients with a TLOC based on syncope. Low-risk factors do not play a significant role in conveyance decision-making.
Large common bile duct stones in high-risk elderly patients: Immediate endoscopic stone removal or elective stone removal? A single-center retrospective study
Authors: Meng Ke , Zhang Da-ya , Chen De-xin , Liu Wen-jing , Fang Kai-xuan , Chen Shengxin , Wu Lang , Li Ming-yang 
Published: October 2023

Abstract
Background and objective
For high-risk elderly patients with chronic diseases, endoscopic stone removal for large common bile duct stones is associated with a high risk of adverse events and incomplete stone removal. The aim of this study was to investigate whether the treatment strategy of short-term biliary plastic stent placement followed by elective endoscopic stone removal is more effective and safer than immediate endoscopic stone removal.

Methods
The data of 262 high-risk elderly patients who received endoscopic retrograde cholangiopancreatography (ERCP) for large common bile duct (CBD) stones from 2017 to 2022 were retrospectively analyzed. The patients were divided into group A (immediate stone removal) and group B (stent drainage + elective stone removal). The baseline data of the 2 groups were matched 1:1 by propensity score matching. The stone clearance rate, ERCP procedure time, total hospital stay, and procedure-related adverse events were compared between the matched groups. In group B, stone size before and after stent placement, hospital stay, procedure time and adverse events of two ERCPs were compared.

Results
A total of 57 pairs of patients were successfully matched between the 2 groups. The stone clearance rate in group B was higher than that in group A (89.5% vs. 75.3, P = 0.049). The total hospital stay in group B was longer than that in group A (11.86 ± 3.912 d vs. 19.14 ± 3.176 d, P<0.001). The total adverse event rate in group A was higher than that in group B (29.8% vs. 12.3%, P = 0.005). The incidence of cholangitis/cholecystitis after ERCP was significantly higher in group A than in group B (7.0% vs. 0.9% P = 0.029). There was no significant difference in the incidence of post-ERCP pancreatitis, bleeding, pneumonia, and cardio-cerebrovascular events between the 2 groups. There were no perforation cases in either group. After plastic biliary stent placement in group B, the stone size was significantly smaller than before stent placement (1.59 ± 0.544 cm vs. 1.95 ± 0.543 cm, P < 0.001), and there was no significant difference in the total adverse event incidence between the two ERCP procedures (18.8% vs. 10.9%, P = 0.214).

Conclusion
For high-risk elderly patients with large CBD stones, the treatment strategy involving temporary placement of plastic stent and elective endoscopic stone removal is safer and more effective than immediate stone removal.
Study of some potential biomarkers in Egyptian hepatitis C virus patients in relation to liver disease progression and HCC
Authors: Baraka Kholoud , Abozahra Rania R. , Badr Eman , Abdelhamid Sarah M. 
Published: October 2023

Abstract
Background
Egypt has the greatest prevalence of hepatitis C worldwide according to the WHO reports, accounting for 13% of the global HCV infections. HCV is a substantial precursor for fibrosis, cirrhosis, and hepatocellular carcinoma. This study aimed to investigate the potential relevance of some cytokines, miR-122 and miR-221 for the diagnosis of liver disease progression associated to HCV infection.

Methods
One hundred and twenty blood samples were collected from patients with chronic liver disease, HCC, and healthy individuals. Total bilirubin, alanine aminotransferase, aspartate aminotransferase, platelet count, albumin, and creatinine were measured. Serum level of selected cytokines was conducted by ELISA. Serum miRNA expression was detected by RT-PCR.

Results
IL-2R was higher among HCC patients and the mean concentration of both TNF-αRII and IL-6R was higher among cirrhotic patients. The expression of miRNA-122 showed a little fold decrease in all studied groups; the highest level was observed in HCC patients. The expression of miRNA-221 showed a significant fold increase in HCC and cirrhotic groups.

Conclusions
This study revealed that there is no difference in liver disease progression in patients regarding sex and age. Routine liver function tests performed poorly in terms of early diagnosis of liver disease progression; however, serum total bilirubin gave somewhat useful guide for discrimination between fibrotic, cirrhotic and HCC cases. IL-2R showed a significant consistent increase in its level with disease progression. The miR-221 serum level showed significant fold increase with liver disease progression. Therefore, making miR-221 a potential non-invasive biomarker for liver disease progression in the diagnostic setting is recommended.
Modified Naples prognostic score for evaluating the prognosis of patients with obstructive colorectal cancer
Authors: Gu Junnan , Deng Shenghe , Jiang Zhenxing , Mao Fuwei , Xue Yifan , Qin Le , Shi Jianguo , Yang Jia , Li Huili , Yu Jie , Liu Ke , Wu Ke , Cao Yinghao , Cai Kailin 
Published: October 2023

Abstract
Background
Inflammatory, immune, and nutritional status are key factors in obstructive colorectal cancer (OCRC). This study aims to investigate the value of modified Naples prognostic score (M-NPS) in evaluating OCRC prognosis.

Methods
A total of 196 OCRC patients were retrospectively analyzed to construct M-NPS based on serum albumin (ALB), total cholesterol (CHOL), neutrophil:lymphocyte ratio (NLR), and lymphocyte:monocyte ratio (LMR), and then they were divided into three groups. The Kaplan–Meier (KM) method and Cox proportional hazard regression analysis were performed for overall survival (OS) and disease-free survival (DFS) of OCRC patients.

Results
Patients with high M-NPS had worse OS and DFS (P = 0.0001, P = 0.0011). Multivariate COX analysis showed that M-NPS was an independent prognostic factor for OCRC patients. Patients in the M-NPS 2 group had significantly worse OS (hazard ratio [HR] = 4.930 (95% confidence interval [95% CI], 2.217–10.964), P < 0.001) and DFS (HR = 3.508 (95% CI, 1.691–7.277), P < 0.001) than those in the 0 group.

Conclusion
M-NPS was an independent prognostic factor for OCRC patients; it might provide a potential reference for immunonutritional intervention in patients with obstruction.
Crisis and acute mental health care for people who have been given a diagnosis of a ‘personality disorder’: a systematic review
Authors: Maconick Lucy , Ikhtabi Sarah , Broeckelmann Eva , Pitman Alexandra , Barnicot Kirsten , Billings Jo , Osborn David , Johnson Sonia 
Published: October 2023

Abstract
Background
People who have been given a diagnosis of a ‘personality disorder’ need access to good quality mental healthcare when in crisis, but the evidence underpinning crisis services for this group is limited. We synthesised quantitative studies reporting outcomes for people with a ‘personality disorder’ diagnosis using crisis and acute mental health services.

Methods
We searched OVID Medline, PsycInfo, PsycExtra, Web of Science, HMIC, CINAHL Plus, Clinical Trials and Cochrane CENTRAL for randomised controlled trials (RCTs) and observational studies that reported at least one clinical or social outcome following use of crisis and acute care for people given a ‘personality disorder’ diagnosis. We performed a narrative synthesis of evidence for each model of care found.

Results
We screened 16,953 records resulting in 35 studies included in the review. Studies were published between 1987–2022 and conducted in 13 countries. Six studies were RCTs, the remainder were non randomised controlled studies or cohort studies reporting change over time. Studies were found reporting outcomes for crisis teams, acute hospital admission, acute day units, brief admission, crisis-focused psychotherapies in a number of settings, Mother and Baby units, an early intervention service and joint crisis planning. The evidence for all models of care except brief admission and outpatient-based psychotherapies was assessed as low or very low certainty.

Conclusion
The literature found was sparse and of low quality. There were no high-quality studies that investigated outcomes following use of crisis team or hospital admission for this group. Studies investigating crisis-focused psychological interventions showed potentially promising results.
Internet addiction and associated factors among undergraduate students of Jimma University; Jimma, South West Ethiopia, institutional based cross-sectional study
Authors: Amano Abdulkarim , Ahmed Gutema , Nigussie Kabtamu , Asfaw Henock , Fekadu Gelana , Hiko Ahmed , Abdeta Tilahun , Soboka Matiwos 
Published: October 2023

Abstract
Background
Internet addiction affects cognitive function, has a harmful impact on students’ academic performance, and increases their risk of experiencing psychological crises.

Objectives
Examining the prevalence of internet addiction and its contributing factors among regular undergraduate students at Jimma University in south-west Ethiopia.

Methods
An institutional-based cross-sectional study was conducted among study participants between August 1 and August 30, 2021. A total of 772 Participants were involved in the study using a multistage random sampling technique. Data was collected using pretested and structured questionnaires with self-administered techniques. The Young Internet Addiction Test (YIAT) was used to measure internet addiction. The data was entered into the computer using Epi Data version 4.6, and then it was exported to the Statistical Package for Social Science (SPSS) version 25 for analysis. The association between each independent variable and the outcome variable was examined using bivariate analysis. Variables with a p-value of less than 0.25 in bivariate analysis were included in the multivariate logistic regression model to determine how each independent variable affected the outcome variable.

Result
The prevalence of internet addiction among study participants was 53.6% (95% Confidence Interval (CI)) (49.99%, 57.15%). Findings from multivariate logistic regression analysis suggested a variety of related factors had significant associations with internet addiction. Being dissatisfied with a major study, having a cumulative grade point average of a promoted grade report, using the internet for entertainment, using the internet for Facebook, using the internet for telegram, depression, social anxiety, and poor social support.

Conclusion
This study revealed a comparatively high frequency of internet addiction among study participants. Internet addiction has been linked to psychosocial, academic, and purpose-related aspects of internet use. As a result, incorporating stakeholders’ efforts to improve the identified variables would be a helpful start toward lowering this high incidence.
Effect of non-surgical periodontal treatment on cytokines/adipocytokines levels among periodontitis patients with or without obesity: a systematic review and meta-analysis
Authors: Zhang Yuwei , Jia Ru , Zhang Yifei , Sun Xuefei , Mei Yukun , Zou Rui , Niu Lin , Dong Shaojie 
Published: October 2023

Abstract
Background
The objective of this systematic review and meta-analysis was to evaluate the effects of non-surgical periodontal therapy (NSPT) on inflammatory-related cytokines/adipocytokines in periodontitis patients with or without obesity.

Methods
We followed the preferred reporting items for systematic reviews and meta-analyses statement and registered the study (CRD42022375331) in the Prospective International Register of Systematic Reviews. We screened randomized-controlled trials and controlled clinical trials from six databases up to December 2022. Quality assessment was performed with RoB-2 and ROBINS-I tools for randomized trials and non-randomized trials, respectively. Meta-analysis was carried out using a random-effect model.

Results
We included seventeen references in the systematic analysis, and sixteen in the meta-analysis. Baseline results of pro-inflammatory biomarkers, including serum interleukin (IL)-6, serum and gingival crevicular fluid (GCF), tumor necrosis factor (TNF)-a, serum C-reactive protein (CRP)/hs-CRP, and serum and GCF resistin, were higher in obesity subjects than in normal weight subjects. The effect of NSPT with respect to levels of cytokines/adipocytokines, including IL-6, TNF-a, CRP/hs-CRP, resistin, adiponectin, leptin and retinol binding protein 4 (RBP4), were then analyzed in the systematic and meta-analysis. After three months of NSPT, serum (MD = -0.54, CI = -0.62 – -0.46), and GCF (MD = -2.70, CI = -4.77 – -0.63) levels of IL-6, along with the serum RBP4 (MD = -0.39, CI = -0.68–0.10) decreased in periodontitis individuals with obesity. NSPT also improved GCF adiponectin levels after three months (MD = 2.37, CI = 0.29 – 4.45) in periodontitis individuals without obesity.

Conclusions
Obese status altered the baseline levels of cytokines/adipocytokines (serum IL-6, serum and GCF TNF-a, serum CRP/hs-CRP, and serum and GCF resistin). Then NSPT can shift the levels of specific pro-inflammatory mediators and anti-inflammatory mediators in biological fluids, both in obesity and non-obesity individuals. NSPT can reduce serum and GCF IL-6 levels together with serum RBP4 level in individuals with obesity after 3 months, besides, there is no sufficient evidence to prove that obese patients have a statistically significant decrease in the levels of other cytokines compared to patients with normal weight. NSPT can also increase GCF adiponectin level in normal weight individuals after 3 months. Our findings imply the potential ideal follow-up intervals and sensitive biomarkers for clinical bioanalysis in personalized decision-making of effect of NSPT due to patients’ BMI value.
The effect of psychological contract on turnover intention among nurses: a meta-analytic review
Authors: Lu Xianying , Yang Jing , Bai Dingxi , Cai Mingjin , Wang Wei , He Jiali , Gong Xiaoyan , Hou Chaoming , Gao Jing 
Published: October 2023

Abstract
Background
The turnover intention (TI) of nurses is common, posing a threat to modern healthcare organizations. Psychological contract (PC) is a predictor of TI, affecting significantly nurse’s TI. However, the extent of the association between PC and nurse’s TI is unknown. We performed a meta-analysis to quantitatively analyze the relationship between PC and nurse’s TI.

Methods
We searched nine electronic databases from inception to July 2023. Observational studies were included using a retrieval strategy related to PC and TI. Meta-analyses of common effect and random effect models were performed using R software with Spearman or Pearson correlation coefficients. Meta-regression, subgroup analysis, publication bias, and sensitivity analysis were also carried out .

Results
Eighteen studies including 8,908 nurses were identified. Based on various PC-related perspectives, 16 studies explored nurses’ TI in terms of the content and three-dimensional structure of PC. Of these, 9 studies reported the negative direction of the correlation between PC and TI (r ranged from − 0.20 to -0.45), whereas 7 studies reported the positive direction of the correlation between PC and TI (r ranged from 0.32 to 0.50). The PC total and its dimensions were found to have moderately significant associations with TI, with the exception of the PCE and PCE-I. Additional, 2 studies reported the relationship between the outcome of PC and TI, the PCF, PCB, and PCV were powerful predictors of nurses’ TI. Meta-regression and subgroup analysis found that only nurses working in specialized departments might be the source of heterogeneity.

Conclusions
To our knowledge, this was the first meta-analysis to quantitatively examine the relationship between PC and TI among nurses. The findings reaffirmed the necessity for healthcare administrators and the medical profession to valued nurse’ good interpersonal, social support, humanistic environment, and meet nurses’ psychological and spiritual needs in addition to their material demands. Moderators of the connection between PC and TI, based on meta-regression and subgroup analyses, should be carefully explored as they may aid in identifying nurses’ TI. Additional, longitudinal research, as well as mixed research, should be conducted to more comprehensively explore the relationship between PC and TI.
From a learning opportunity to a conscious multidimensional change: a metasynthesis of transcultural learning experiences among nursing students
Authors: Leyva-Moral Juan M. , Tosun Betül , Gómez-Ibáñez Rebeca , Navarrete Laura , Yava Ayla , Aguayo-González Mariela , Dirgar Ezgi , Checa-Jiménez Caterina , Bernabeu-Tamayo M. Dolors 
Published: October 2023

Abstract
Background
Several educational activities in nursing schools worldwide have been implemented to promote transcultural nursing and cultural competence. Despite the diversity of their experiences and outcomes, the available evidence has not been systematically reviewed and reinterpreted. This study aimed to review and reinterpret all rigorous qualitative evidence available, providing an opportunity to understand how students learn transcultural nursing and assisting faculties, researchers, managers, and practitioners in designing new interventions to improve transcultural training.

Methods
A meta-synthesis was conducted to review and integrate qualitative studies of these phenomena. English, Spanish and Portuguese articles were searched in Pubmed and Scopus databases. Only peer-reviewed journals in which qualitative approaches were used were included. Quality was assessed using the CASP qualitative version checklist. The metasynthesis technique proposed by Noblit and Hare was used to analyse the data.

Results
Twenty-nine studies were included in the analysis. Most studies used phenomenological approaches that were conducted in Australia and the United States of America, with international internships being the most popular learning method. The data revealed one central theme, “From learning opportunity to conscious multidimensional change,” and six subthemes. The transcultural nursing learning experience is not a simple or linear process. Instead, it appears to be a complex process formed by the interaction between a) self-awareness, b) reflective thinking, c) Cultural Encounters, d) cultural skills, e) Cultural Desire, and f) Cultural Knowledge.

Conclusions
Transcultural nursing learning is a multifaceted process that arises from specific learning opportunities. This process is still to evolving. Therefore, specific educational strategies should be implemented to encourage attitudinal change and promote reflective thinking.
The Golgi stacking protein GRASP55 is targeted by the natural compound prodigiosin
Authors: Berning Lena , Lenz Thomas , Bergmann Ann Kathrin , Poschmann Gereon , Brass Hannah U. C. , Schlütermann David , Friedrich Annabelle , Mendiburo María José , David Céline , Akgün Seda , Pietruszka Jörg , Stühler Kai , Stork Björn 
Published: October 2023

Abstract
Background
The bacterial secondary metabolite prodigiosin has been shown to exert anticancer, antimalarial, antibacterial and immunomodulatory properties. With regard to cancer, it has been reported to affect cancer cells but not non-malignant cells, rendering prodigiosin a promising lead compound for anticancer drug discovery. However, a direct protein target has not yet been experimentally identified.

Methods
We used mass spectrometry-based thermal proteome profiling in order to identify target proteins of prodigiosin. For target validation, we employed a genetic knockout approach and electron microscopy.

Results
We identified the Golgi stacking protein GRASP55 as target protein of prodigiosin. We show that prodigiosin treatment severely affects Golgi morphology and functionality, and that prodigiosin-dependent cytotoxicity is partially reduced in GRASP55 knockout cells. We also found that prodigiosin treatment results in decreased cathepsin activity and overall blocks autophagic flux, whereas co-localization of the autophagosomal marker LC3 and the lysosomal marker LAMP1 is clearly promoted. Finally, we observed that autophagosomes accumulate at GRASP55-positive structures, pointing towards an involvement of an altered Golgi function in the autophagy-inhibitory effect of this natural compound.

Conclusion
Taken together, we propose that prodigiosin affects autophagy and Golgi apparatus integrity in an interlinked mode of action involving the regulation of organelle alkalization and the Golgi stacking protein GRASP55.