bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishment of a risk prediction model for Aromatase Inhibitor-Induced Arthralgia in breast cancer patients: a retrospective cohort study in high-altitude regions
Authors: Zhao Ju , Shen GuoShuang , Li Meng , Zhao Fuxing , Wei Yingyuan , Xiao Wenjun , Cai Yanqiu , Ren Dengfeng , Zhao Jiuda , Zhao Yi , Wang Miaozhou 
Published: December 2023

Abstract
Background:
Aromatase inhibitor-induced arthralgia (AIA) is a common and debilitating adverse event in breast cancer patients receiving aromatase inhibitors (AI) treatment. One of the reasons why breast cancer patients discontinue AI treatment prematurely. However, the risk factors and predictive models specific to high-altitude regions are lacking. This study aimed to develop a predictive model for AIA in breast cancer patients in high-altitude regions.
Methods:
A retrospective cohort study was conducted in a high-altitude region at Qinghai University Affiliated Hospital from June 2021 to October 2023. This study involved a total of 315 breast cancer patients undergoing AI treatment. Participants were randomly assigned to either a training set (n=220) or a validation set (n=95) in a 7:3 ratio. Variable selection was carried out using the Least Absolute Shrinkage and Selection Operator (LASSO) regression, coupled with 7-fold cross-validation. A multivariate logistic regression analysis was performed on the training set to identify independent risk factors for AIA, leading to the establishment of a nomogram based on these risk factors. The model's performance was assessed using calibration plots, Receiver Operating Characteristic (ROC) curves, and Decision Curve Analysis (DCA).
Results:
Out of the 14 variables analyzed, five predictors were selected for the development of the predictive model. These included prior chemotherapy, years since the last menstrual period (LMP), menopause mode, stage, and psychological factors. The incidence rate of AIA in the cohort was 58.41%. The multivariate logistic regression analysis identified several significant independent predictors for AIA in high-altitude regions. These included previous use of taxane chemotherapy (Odds Ratio [OR] = 10.174, 95% Confidence Interval [CI] = 2.008-62.69, P=0.008), LMP (OR = 0.175, 95% CI = 0.052-0.494, P=0.002), drug-induced menopause (OR = 3.834, 95% CI = 1.109-14.13, P=0.036), stage (OR = 10.423, 95% CI = 4.114-32.15, P < 0.001), and psychological factors (OR = 25.108, 95% CI = 8.430-87.95, P<0.001). The developed nomogram exhibited a strong predictive capacity, with an area under the Receiver Operating Characteristic (ROC) curve value of 0.971. The calibration curve demonstrated a high degree of consistency between predicted probabilities and observed values. Decision Curve Analysis (DCA) underscored the clinical utility of the nomogram.
Perceptions of Breast Reconstruction Among Native American Women: A Qualitative Analysis
Authors: Marquez Jessica L , Tausinga Telisha , Scott Kaylee , Tuncer Fatma Betul 
Published: December 2023

Abstract
Background
Despite having a high incidence of breast cancer, Native American/American Indian (NA/AI) women have among the lowest rates of breast reconstruction (BR). While NA/AI women are often racially miscategorized, little is known as to why reconstruction rates remain low. This study investigates cultural factors, values, and perceptions of held by NA/AI that might impact BR rates.
Methods
Individual, semi-structured interviews utilizing open-ended questions prompting for insight into barriers to care, cultural values, body image, and reconstructive preferences were conducted. All interviews were audio-recorded and transcribed. Qualitative content analysis was performed, which allowed for inductive themes to be drawn from the raw data.
Results
Fifteen NA/AI women who underwent surgical treatment for breast cancer were interviewed. Emerging themes included acceptance, privacy, humility, wholeness, self-image, negative perceptions of plastic surgery, naturality, fear, and cultural contraindication of ADM use. All women discussed their reconstructive options with a breast surgeon, but only 3 chose to reconstruct. Most women suggested that reconstruction with autologous tissue was a more culturally congruent choice than implant-based reconstruction. Reconstructive surgery was often viewed as strictly cosmetic. All women unanimously opposed ADM use in BR due to cultural beliefs surrounding the use of tissue from deceased individuals.
Conclusions
This is the first study to investigate culture-specific perceptions of BR. Our results suggest that culture specific factors and preferences may contribute to low rates of BR. Results from this study can be used to improve cultural competency in addressing BR in NA/AI women.
Bending and Buckling Analysis of Porous 2D Functionally Graded Beams with Exponential Material Property Variation
Authors: Adıyaman Gökhan , TURAN Muhittin 
Published: December 2023

Abstract

The bending and buckling analysis of porous two-directional (2D) functionally graded (FG) beams was conducted using a higher-order shear deformation theory (HSDT). The introduction of exponential functions to depict changes in material properties is a novel approach in the static analysis of 2D FG beams. Three distinct porosity distribution functions were taken into account. The governing equations were formulated through the application of Lagrange’s principle. During the numerical analysis, a finite element comprising two nodes and eight degrees of freedom (DOFs) was utilized. This choice facilitated accurate and efficient solutions, even for shorter beams, without the need for a shear correction factor. Notably, the obtained shear stresses aligned with actual values, registering as zero at both the top and bottom of the beam. The obtained results of the study were validated against findings reported in the literature. A parametric study was carried out to investigate the effects of porosity, porosity distributions, gradation parameters, slenderness, and boundary conditions on the non-dimensional deflections, stresses, critical buckling loads, and buckling mode shapes. It was found that both porosity and the distribution of porosity have noticeable effects on the static analysis of the beams.
Hyper-recombination in ribosomal DNA is driven by resection-independent RAD51 loading
Authors: Gál Zita , Boukoura Stavroula , Korsholm Lea Milling , Oxe Kezia Catharina , Nieto Blanca , Dulina Ekaterina , Rasmussen Anna Vestergaard , Dahl Christina , Galanos Panagiotis , Lin Lin , Guldberg Per , Bartek Jiri , Luo Yonglun , Larsen Dorthe Helena 
Published: December 2023

Abstract
Ribosomal DNA (rDNA) encodes the ribosomal RNA genes and represents a genomic region that is intrinsically unstable. Despite decades-long awareness of rDNA instability, the underlying mechanisms and implications for genome integrity remain elusive. Here, we use Bloom Syndrome (BS), a rare genetic disease characterized by DNA repair defects and hyper-unstable rDNA, to investigate the mechanisms leading to rDNA instability. We find that in BLM proficient cells the homologous recombination (HR) pathway in rDNA bear resemblance to that of nuclear chromatin; initiated by resection, RPA loading and BRCA2-dependent RAD51 filament formation. However, we show that BLM deficiency compromise RPA-loading and BRCA1/2 recruitment to rDNA, but intriguingly not RAD51. RAD51 accumulation at rDNA occurs despite depletion of resection nucleases but display increased dependency on BRCA1 in BLM deficient cells. Furthermore, we show that rDNA repair intermediates result in micronuclei formation in the absence of BLM. Our findings suggest that rDNA is permissive to RAD51 loading in the absence of BLM, leading to micronucleation and potentially global genomic instability.
Access to Essential Medicines for Diabetes Care: Availability, Price, and Affordability in Central Ethiopia
Authors: Deressa Hachalu Dugasa , Abuye Habtamu , Adinew Alemayehu , Ali Mohammed K. , Kebede Tedla , Habte Bruck Messele 
Published: December 2023

Abstract
Background
Diabetes is a major global public health burden. Effective diabetes management is highly dependent on the availability of affordable and quality-assured essential medicines (EMs) which is a challenge especially in low-and-middle-income countries such as Ethiopia.
Methods
A cross-sectional study was conducted in 60 selected public and private medicine outlets in central Ethiopia from January to February 2022 using the World Health Organization/Health Action International (WHO/HAI) standard tool to assess access to EMs. We included EMs that lower glucose, blood pressure, and cholesterol as these are all critical for diabetes care. Availability was determined as the percentage of surveyed outlets per sector in which the selected lowest-priced generic (LPG) and originator brand (OB) products were found. The number of days’ wages required by the lowest paid government worker (LPGW) to purchase a one month’s supply of medicines was used to measure affordability while median price was determined to assess patient price and price markup difference between public procurement and retail prices.
Results
Across all facilities, availability of LPG and OB medicines were 34.6% and 2.5% respectively. Only two glucose-lowering (glibenclamide 5mg, metformin 500mg) and two blood pressure-lowering medications (nifedipine 20mg and hydrochlorothiazide 25mg) surpassed the WHO’s target of 80% availability. The median price based on the least measurable unit of LPG diabetes EMs was 1.6 ETB (0.033 USD) in public and 4.65 ETB (0.095 USD) in private outlets, respectively. The cost of one month’s supply of diabetes EMs was equivalent to 0.3 to 3.1 days wages in public and 1.0 to 11.0 days wages in private outlets, respectively, for a typical LPGW. Thus, 58.8% and 84.6% of LPG diabetes EMs included in the price analysis were unaffordable in private and public outlets, respectively.
Conclusion
There are big gaps in availability and affordability of EMs used for diabetes in central Ethiopia. Relevant stakeholders should work to improve access to EMs.
Dry air compressor for car painting quality improvement
Authors: Waskito  , Putra Randi Purnama , Adri Junil , Yuvenda Dori , Jasman  , Irzal  
Published: December 2023

The humidity used in the painting process greatly determines the result of painting the car body. This study aims to develop a dry air compressor that can be used to overcome car paint defects. This system consists of a 2 HP compressor engine for sucking air from the atmosphere, two air collection tubes where the first tube contains air obtained from the atmosphere and the second tube contains dry air obtained from the first tube. The inside of the first tube is given a copper coil measuring 5 mm in diameter which is connected to a 120-watt cooler while the second tube is not given a copper coil. Each tube has a diameter of 50 cm and a height of 100 cm. The addition of copper coil aims to separate air from water by means of the condensation process which is the development of this study. Testing of compressor performance is done by turning on the compressor with the exhaust valve closed. After 60 minutes, the air pressure in each tube increased from 0 Psi to 89 Psi, the humidity decreased from 52 % to 38 %, and the temperature decreased from 31.6 °C to 18.2 °C. To see the effect of cooling on the air, the exhaust valves on both tubes were opened. In the first tube there is water coming out, as much as approximately 100 ml while in the second tube there is no water coming out. The water that comes out of the first tube is caused by the condensation process that separates the air from the water and due to the influence of gravity the water falls to the bottom of the tube. The dry air contained at the top of the first tube is flowed into the second tube and is ready to be used for painting the car body. The painting results show that there are no more small holes or paint defects on the paint surface
Evidence of Clinical Efficacy and Pharmacological Mechanisms of Resveratrol in the Treatment of Alzheimer’s Disease
Authors: Jin Sian , Guan Xuefeng , Min Dongyu 
Published: December 2023

Background:
To evaluate the efficacy and pharmacological mechanisms of resveratrol in
Alzheimer’s disease (AD) patients.

Methods:
We conducted a thorough exploration of existing randomized controlled trials concerning
the treatment of Alzheimer's disease patients using resveratrol, utilizing accessible open databases.
Quantitative variables were represented as a standardized mean difference (SMD), accompanied by
a 95% confidence interval (CI). Additionally, we examined the potential targets and plausible pathways
associated with the impact of resveratrol on Alzheimer's disease using network pharmacology
techniques.

Results:
Our meta-analysis comprised five trials involving 271 AD patients, of whom 139 received
resveratrol treatment and 132 received placebo treatment. Compared with placebo therapy, resveratrol
treatment resulted in a significant improvement in Alzheimer’s Disease Cooperative Study—
Activities of Daily Living (ADAS-ADL) scores (SMD=0.51; 95% CI, 0.24 to 0.78) and cerebrospinal
fluid (CSF) Aβ40 (SMD=0.84; 95% CI, 0.21 to 1.47) and plasma Aβ40 levels (SMD=0.43; 95%
CI, 0.07 to 0.79). However, the improvement in the resveratrol-treated group compared with the
placebo treatment group on the Mini-Mental State Examination (MMSE) score, CSF Aβ42 and
plasma Aβ42 levels, and brain volume was not significant. There were no noteworthy statistical
variances in the occurrence of adverse effects noted between the two groups. The outcomes of network
pharmacology divulged that the principal enriched interaction pathway between resveratrol
and Alzheimer's disease is primarily concentrated within the PI3K signaling pathways. Resveratrol's
potential key targets for the treatment of AD include MAKP1, HRAS, EGFR, and MAPK2K1.

Conclusion:
While having a high safety profile, resveratrol has efficacy in AD patients to a certain
extent, and more data are required to validate the efficacy of resveratrol for the treatment of AD in
the future. Suppression of the PI3K signaling pathways could hold significant importance in the
treatment of AD patients using resveratrol.
The Effect of Transcranial Photobiomodulation for Motor Performance
Improvement in Patients with Brain Disorders
Authors: Iravani Milad , Kalan Abbas Ebrahimi , Salimi Maryam Moghaddam , Jahan Ali 
Published: December 2023

Background:
Transcranial photobiomodulation (PBM) therapy has emerged as a
promising alternative therapeutic option for the management of neurological and psychiatric
disorders. However, the underlying mechanisms of PBM therapy and its effects on motor performance in brain disorders are not yet fully understood. The aim of this literature review is to
provide a more detailed and evidence-based explanation of the rationale and intent behind the
correlation between PBM therapy and its effects on motor performance in brain disorders.

Methods:
A literature search was performed in the databases "PubMed/Medline", "Scopus," and
"Google Scholar" for all relevant English language papers. A combination of different keywords
was used for the database search. Video articles, patents, review articles, book chapters, articles
using other transcranial methods, non-transcranial PBM, and case reports were excluded.

Results:
Out of the 2174 papers, 18 addressed the effect of PBM on motor performance. Among
these, four studies were on ischemic stroke models and individuals with stroke, six studies on
models associated with traumatic brain injury (TBI), five studies on models associated with neurodegenerative diseases and Parkinson's disease, and four studies related to models and patients
with central nervous system inflammation. All studies have shown that motor parameters improve with PBM. In two studies on healthy individuals, 65 showed improvement in motor function and 16 showed improvement in motor evoked potential. In most studies (n=10), the wavelength used was between 800 and 900 nm. Near-infrared or LED continuous light was used in
most studies. However, two studies compared the effects of pulsed and continuous waves and
found the superiority of pulsed over continuous waves.

Conclusions:
PBM therapy appears to be useful in brain injury, inducing changes at the behavioral, motor, cellular, and chemical levels. Recent studies suggest that PBM therapy may have
potential benefits in improving motor performance in brain disorders, including stroke, traumatic brain injury, Parkinson's disease, and demyelination. However, further research is needed to
determine the optimal parameters for PBM therapy and to investigate its effects on motor function in different brain disorders. Overall, PBM therapy appears to be a promising therapeutic
option for brain injury and warrants further investigation.
Species-specific Bioactivation of Morpholines as a Causative of Drug
Induced Liver Injury Observed in Monkeys
Authors: Gunduz Mithat , Argikar Upendra A. , Cirello Amanda L. , Brown Alan P. , Bonazzi Simone , Walles Markus 
Published: December 2023

Background:
Everolimus, an allosteric mechanistic target of rapamycin (mTOR) inhibitor, recently demonstrated the therapeutic value of mTOR inhibitors for Central Nervous System (CNS) indications driven by hyperactivation of mTOR. A newer, potent brain-penetrant analog of everolimus, referred to as (1) in this manuscript [(S)-3-methyl-4-(7-((R)-3-methylmorpholino)-2-(thiazol-4-yl)-3H-imidazo[4,5-b]pyridin-5-yl)morpholine,(1)] catalytically inhibits mTOR function in the brain and increases the lifespan of mice with neuronal mTOR hyperactivation.

Introduction:
Early evaluation of the safety of 1 was conducted in cynomolgus monkeys in which oral doses were administered to three animals in a rising-dose fashion (from 2 to 30 mg/kg/day). 1 produced severe toxicity including the evidence of hepatic toxicity, along with non-dose proportional increases in drug exposure. Investigations of cross-species hepatic bioactivation of 1 were conducted to assess whether the formation of reactive drug metabolites was associated with the mechanism of liver toxicity.

Method:
1 contained two morpholine rings known as structural alerts and can potentially form reactive intermediates through oxidative metabolism. Bioactivation of 1 was investigated in rat, human and monkey liver microsomes fortified with trapping agents such as methoxylamine or potassium cyanide.

Results:
Our results suggest that bioactivation of the morpholine moieties to reactive intermediates may have been involved in the mechanism of liver toxicity observed with 1. Aldehyde inter-mediates trappable by methoxylamine were identified in rat and monkey liver microsomal studies. In addition, a total of four cyano conjugates arising from the formation of iminium ion intermediates were observed and identified. These findings may potentially explain the observed monkey toxicity. Interestingly, methoxylamine or cyano adducts of 1 were not observed in human liver microsomes.

Conclusion:
The bioactivation of 1 appears to be species-specific. Circumstantial evidence for the toxicity derived from 1 point to the formation of iminium ion intermediates trappable by cyanide in monkey liver microsomes. The cyano conjugates were only observed in monkey liver microsomes, potentially pointing to cause at least the hepatotoxicity observed in monkeys. In contrast, methoxylamine conjugates were detected in both rat and monkey liver microsomes, with only a trace amount in human liver microsomes. Cyano conjugates were not observed in human liver microsomes, challenging the team on the drugability and progressivity of 1 through drug develop-ment. The mechanisms for drug-induced liver toxicity are multifactorial. These results are highly suggestive that the iminium ion may be an important component in the mechanism of liver toxicity 1 observed in the monkey.
The Nurses-family Members’ Relationship at the Intensive Care Units in Jordan: A Phenomenological Study
Authors: Maharmeh Mahmoud , Bdair Izzeddin A. , Hamdan-Mansour Ayman M. , Nofal Basema , Darawad Muhammad W. 
Published: December 2023

Background:
Communication with patients’ families facilitates and creates a trustful relationship between nurses and patients' families and helps nurses to identify and understand patients' and families’ needs.

Aims:
This study aimed to explore Jordanian ICU nurses’ communication experience with patients’ families.

Methods:
A phenomenological approach was utilized to explore the nurses’ communication experience with family members of patients in the ICU. Participants were recruited from three ICU units in Amman, the capital of Jordan.

Results:
Eighteen critical care nurses were interviewed. Two major themes of nurses’ communication experiences were identified: Precarious relationships and disruptive communication patterns.

Conclusion:
To achieve high-quality care, participants recognized the importance of appropriate communication with family members. Results showed the importance of continuous improvement of communication skills with patients and their family members.
Insomnia among Intensive Care Unit Nurses in the United Arab Emirates and its Association to Work Productivity and Quality of Life
Authors: Mobarak Hassnaa Shaban , Ahmed Fatma Refaat , Al-Yateem Nabeel , Bani-Issa Wegdan , Alhosani Muna Ibrahim , AbuRuz Mohannad Eid 
Published: December 2023

Background:
A healthy workforce is essential for sustainable healthcare systems, disease control, and the provision of quality and safe healthcare services. Insomnia is a common problem among critical care nurses attributed to the hard nature of their work, long and irregular shifts, high levels of stress and tension, and exposure to traumatic situations associated with critical care environments. These issues compromise their professional and personal lives, have financial consequences for health organizations, and may reduce the quality of care provided to patients.

Aim:
To assess the prevalence of insomnia among ICU nurses and determine its impact on their Quality of Life (QoL) and work productivity.

Methods:
This cross-sectional study involved 430 ICU nurses working in three major governmental hospitals in the United Arab Emirates. Nurses were selected via convenient sampling. Data collected included nurses’ demographic characteristics, insomnia levels using the Athens Insomnia Scale, work productivity using the workability index, and QoL using the World Health Organization Quality of Life Scale-Brief questionnaire

Results:
Approximately 237 (55%) of participants reported moderate to severe levels of insomnia, and 195 (45.3%) had moderate productivity levels. However, the majority of participants reported low QoL levels in physical, psychological, social, and environmental QoL domains (61.4%, 60.2%, 47.2%, and 70.5%), respectively. Bivariate correlations demonstrated a significant negative relationship; correlation coefficient of -0.517, between participants' insomnia levels and work productivity levels. Additionally, significant negative relationships were found between insomnia levels and the QoL domains, with correlation coefficients of -0.629, -0.568, -0.469, and -0.485, respectively.

Conclusion:
This study found that insomnia has a negative relationship with ICU nurses’ work productivity and QoL. This may impact care delivery patient care and safety.Regular counseling sessions, better working hours, less overtime, and a better work-life balance may contribute to increased productivity and improved QoL among ICU nurses in the UAE.