bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality improvement interventions to prevent the use of hospital services among nursing home residents: protocol for a systematic review and meta-analysis
Authors: Basso Ines , Gonella Silvia , Bassi Erika , Caristia Silvia , Campagna Sara , Dal Molin Alberto 
Published: September 2023

IntroductionQuality improvement interventions are a promising strategy for reducing hospital services use among nursing home residents. However, evidence for their effectiveness is limited. It is unclear which characteristics of the quality improvement intervention and activities planned to facilitate implementation may promote fidelity to organisational and system changes. This systematic review and meta-analysis will assess the effectiveness of quality improvement interventions and implementation strategies aimed at reducing hospital services use among nursing home residents.Methods and analysisThe MEDLINE, CINAHL, Cochrane Library, Embase and Web of Science databases will be comprehensively searched in September 2023. The eligible studies should focus on the implementation of a quality improvement intervention defined as the systematic, continuous approach that designs, tests and implements changes using real-time measurement to reduce hospitalisations or emergency department visits among long-stay nursing home residents. Quality improvement details and implementation strategies will be deductively categorised into effective practice and organisation of care taxonomy domains for delivery arrangements and implementation strategies. Quality and bias assessments will be completed using the Quality Improvement Minimum Quality Criteria Set and the Joanna Briggs Institute Critical Appraisal Tools.The results will be pooled in a meta-analysis, by combining the natural logarithms of the rate ratios across the studies or by calculating the rate ratio using the generic inverse-variance method. Heterogeneity will be assessed using the I2or H2statistics if the number of included studies will be less than 10. Raw data will be requested from the authors, as required.Ethics and disseminationEthical approval is not required. The results will be published in a peer-review journal and presented at (inter)national conferences.PROSPERO registration numberCRD42022364195.
Statins exposure and acute pancreatitis: a retrospective cohort study using a large national insurance database
Authors: Ba Djibril M , Zhang Yue , Chinchilli Vernon M , Maranki Jennifer 
Published: September 2023

ObjectivesThe association between the use of statins and the incidence of acute pancreatitis (AP) has yielded inconsistent findings. While statins have been implicated as an aetiology for drug-induced pancreatitis, more recent studies have found statin use is associated with a reduced risk of pancreatitis. We sought to examine the association between the use of any statin medications and the risk of AP using large real-world data.DesignAll data were collected retrospectively, but individuals were prospectively followed forward in time to determine the outcome of interest using International Classification of Diseases, 10th Revision, Clinical Modification codes indicating a diagnosis of AP. A stratified Cox proportional hazards regression model was conducted to examine the association of statins use with AP.SettingsMerative MarketScan claims database 2017–2020.ParticipantsIndividuals who filled any statin prescriptions with at least 80% proportion of days covered between 1 January 2017 and 31 December 2017 and were continuously enrolled in the database from 2016 to 2020. We also identified non-users of statins and constructed multiple strata of individuals based on the 14 confounders of interest.ResultsAmong 1 695 914 individuals, 226 314 had filled their statins prescription during the study period. Unadjusted incidence rates of AP generally showed higher rates among statins users. The unadjusted incidence rate and 95% CI per 1000 person-years of follow-up was 0.63 (95% CI: 0.61 to 0.66) for non-statin users, versus 0.92 (95% CI: 0.86 to 0.98) for statins users. However, a stratified Cox proportional hazards regression analysis yielded a HR of 0.92 (95% CI: 0.84 to 1.01) for statins users, indicating no difference between the two groups.ConclusionsIn this large real-world analysis, use of statins was not associated with a higher risk of AP in this US healthcare setting.
Specific versus general exercise programme in adults with subacromial impingement syndrome: a randomised controlled trial
Authors: Gutiérrez Espinoza Héctor , Araya-Quintanilla Felipe , Pinto-Concha Sebastian , Valenzuela-Fuenzalida Juan , López-Gil José Francisco , Ramírez-Velez Robinson 
Published: September 2023

ObjectivesCurrent evidence on the clinical effectiveness about the different types of exercises in the subacromial impingement syndrome (SIS) remains controversial. This study aims to compare the short-term (at 5 weeks) effects of a specific exercise programme with a general exercise programme on shoulder function in adults with SIS.MethodsIn total, 52 adults with SIS were randomly allocated to 5 weeks to perform specific exercises (experimental group, n=26) or general exercises (control group, n=26). The primary outcome was change in shoulder function, it was assessed using the Shoulder Pain and Disability Index (SPADI) from baseline to 5 weeks. Secondary end points included changes in upper limb function (Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire), pain intensity (Visual Analog Scale (VAS)) and kinesiophobia (Tampa Scale of Kinesiophobia (TSK)).ResultsAll participants completed the trial. The between-group differences at 5 weeks were: SPADI, 13.5 points (95% CI: 4.3 to 15.6; ƞ2=0.22; p=0.001); DASH, 10.1 points (95% CI: 5.6 to 15.2; ƞ2=0.27; p<0.001); VAS at rest, 0.2 cm (95% CI: 0.1 to 0.3; ƞ2=0.07; p=0.553); VAS on movement, 1.7 cm (95% CI: 0.9 to 2.2; ƞ2=0.24; p<0.001); and TSK, 16.3 points (95% CI: 13.2 to 15.3; ƞ2=0.33; p<0.001). All differences favoured the experimental group and effect sizes were medium to large for most outcomes. Mediation analyses showed that the effect of the specific exercises on shoulder function was mediated by kinesiophobia (β=2.800; 95% CI: 1.063 to 4.907) and pain on movement (β= −0.690; 95% CI: −1.176 to −0.271).ConclusionIn adults with SIS, specific exercises may have a larger effect than general exercises. However, most differences did not reach the minimum threshold to be considered clinically important and the evidence to support exercise as standard treatment warrant further study.Trial registration numberBrazilian Registry of Clinical Trials UTN number U111-1245-7878. Registered on 17 January 2020 (https://ensaiosclinicos.gov.br/rg/RBR-4d5zcg).
SAPERO: a new tool for safety analyses in advanced radiotherapy
Authors: Giardina Mariarosa , Tomarchio Elio , Buffa Pietro , Ferrera Giuseppe , Abbate Boris Federico , Iacoviello Giuseppina , Marsala Laura , Carruba Giuseppe , Galeazzo Fabiola , Alfano Giuseppina Pia 
Published: September 2023

AbstractImproving safety standards in advanced radiotherapy technologies, where historical experience is not sufficient due to innovation aspects, raises the need to perform studies using new tools that follow a holistic view of the process chain. Such studies are useful to identify additional critical elements compared to safety analyses carried out by classic tools. In this field, SAPERO (La SicurezzA del PazientE: tecniche avanzate ed innovative per la valutazione del rischio di eventi indesiderati all'interno del percorso assistenziale nel settore RadioterapicO) is a new assessment tool that allows to use integrated of Hierarchical Task Analysis (HTA); Failure Mode Effects and Criticality Analysis (FMECA); Cognitive Task Analysis (CTA); Human Error Assessment Reduction Technique (HEART). The methodological approaches have been suitably modified to address their operating in the medical sector under study. Some improvements have concerned the application of the fuzzy theory in FMECA and the use of a linguistic approach in HEART. In this paper, SAPERO application on a case study related to treatment procedures in helical tomotherapy performed at the radiotherapy department of ARNAS Civico hospital, Italy, is described. The results have allowed to provide suggestions aimed to improve the examined process.
Transcriptional Heterogeneity Overcomes Super-Enhancer Disrupting Drug Combinations in Multiple Myeloma
Authors: Welsh Seth J. , Barwick Benjamin G. , Meermeier Erin W. , Riggs Daniel L. , Shi Chang-Xin , Zhu Yuan Xiao , Sharik Meaghen E. , Du Megan T. , Abrego Rocha Leslie D. , Garbitt Victoria M. , Stein Caleb K. , Petit Joachim L. , Meurice Nathalie , Tafoya Alvarado Yuliza , Fonseca Rodrigo , Todd Kennedi T. , Brown Sochilt , Hammond Zachery J. , Cuc Nicklus H. , Wittenberg Courtney , Herzog Camille , Roschke Anna V. , Demchenko Yulia N. , Chen Wei-dong D. , Li Peng , Liao Wei , Leonard Warren J. , Lonial Sagar , Bahlis Nizar J. , Neri Paola , Boise Lawrence H. , Chesi Marta , Bergsagel P. Leif 
Published: September 2023

Abstract

Multiple myeloma (MM) is a malignancy that is often driven by MYC and that is sustained by IRF4, which are upregulated by super-enhancers. IKZF1 and IKZF3 bind to super-enhancers and can be degraded using immunomodulatory imide drugs (IMiD). Successful IMiD responses downregulate MYC and IRF4; however, this fails in IMiD-resistant cells. MYC and IRF4 downregulation can also be achieved in IMiD-resistant tumors using inhibitors of BET and EP300 transcriptional coactivator proteins; however, in vivo these drugs have a narrow therapeutic window. By combining IMiDs with EP300 inhibition, we demonstrate greater downregulation of MYC and IRF4, synergistic killing of myeloma in vitro and in vivo, and an increased therapeutic window. Interestingly, this potent combination failed where MYC and IRF4 expression was maintained by high levels of the AP-1 factor BATF. Our results identify an effective drug combination and a previously unrecognized mechanism of IMiD resistance.

Significance:
These results highlight the dependence of MM on IKZF1-bound super-enhancers, which can be effectively targeted by a potent therapeutic combination pairing IMiD-mediated degradation of IKZF1 and IKZF3 with EP300 inhibition. They also identify AP-1 factors as an unrecognized mechanism of IMiD resistance in MM.
See related article by Neri, Barwick, et al., p. 56.
See related commentary by Yun and Cleveland, p. 5.
This article is featured in Selected Articles from This Issue, p. 4
Genetic Contribution to End-Stage Cardiomyopathy Requiring Heart Transplantation
Authors: Kim Yuri , Gunnarsdóttir Oddný Brattberg , Viveiros Anissa , Reichart Daniel , Quiat Daniel , Willcox Jon A.L. , Zhang Hao , Chen Huachen , Curran Justin J. , Kim Daniel H. , Urschel Simon , McDonough Barbara , Gorham Joshua , DePalma Steven R. , Seidman Jonathan G. , Seidman Christine E. , Oudit Gavin Y. 
Published: September 2023

Background:
Many cardiovascular disorders propel the development of advanced heart failure that necessitates cardiac transplantation. When treatable causes are excluded, studies to define causes are often abandoned, resulting in a diagnosis of end-stage idiopathic cardiomyopathy. We studied whether DNA sequence analyses could identify unrecognized causes of end-stage nonischemic cardiomyopathy requiring heart transplantation and whether the prevalence of genetic causes differed from ambulatory cardiomyopathy cases.

Methods:
We performed whole exome and genome sequencing of 122 explanted hearts from 101 adult and 21 pediatric patients with idiopathic cardiomyopathy from a single center. Data were analyzed for pathogenic/likely pathogenic variants in nuclear and mitochondrial genomes and assessed for nonhuman microbial sequences. The frequency of damaging genetic variants was compared among cardiomyopathy cohorts with different clinical severity.

Results:

Fifty-four samples (44.3%) had pathogenic/likely pathogenic cardiomyopathy gene variants. The frequency of pathogenic variants was similar in pediatric (42.9%) and adult (43.6%) samples, but the distribution of mutated genes differed (
P
=8.30×10
-4
). The prevalence of causal genetic variants was significantly higher in end-stage than in previously reported ambulatory adult dilated cardiomyopathy cases (
P
<0.001). Among remaining samples with unexplained causes, no damaging mitochondrial variants were identified, but 28 samples contained parvovirus genome sequences, including 2 samples with 6- to 9-fold higher levels than the overall mean levels in other samples.

Conclusions:
Pathogenic variants and viral myocarditis were identified in 45.9% of patients with unexplained end-stage cardiomyopathy. Damaging gene variants are significantly more frequent among transplant compared with patients with ambulatory cardiomyopathy. Genetic analyses can help define cause of end-stage cardiomyopathy to guide management and risk stratification of patients and family members.
Reduced Brain Cortex Angiogenesis in the Offspring of the Preeclampsia-Like Syndrome
Authors: Troncoso Felipe , Sandoval Hermes , Ibañez Belén , López-Espíndola Daniela , Bustos Francisca , Tapia Juan Carlos , Sandaña Pedro , Escudero-Guevara Esthefanny , Nualart Francisco , Ramírez Eder , Powers Robert , Vatish Manu , Mistry Hiten D. , Kurlak Lesia O. , Acurio Jesenia , Escudero Carlos 
Published: September 2023

BACKGROUND:
Children from pregnancies affected by preeclampsia have an increased risk of cognitive and behavioral alterations via unknown pathophysiology. We tested the hypothesis that preeclampsia generated reduced brain cortex angiogenesis in the offspring.

METHODS:
The preeclampsia-like syndrome (PELS) mouse model was generated by administering the nitric oxide inhibitor NG-nitroarginine methyl ester hydrochloride. Confirmatory experiments were done using 2 additional PELS models. While in vitro analysis used mice and human brain endothelial cells exposed to serum of postnatal day 5 pups or umbilical plasma from preeclamptic pregnancies, respectively.

RESULTS:
We report significant reduction in the area occupied by blood vessels in the motor and somatosensory brain cortex of offspring (postnatal day 5) from PELS compared with uncomplicated control offspring. These data were confirmed using 2 additional PELS models. Furthermore, circulating levels of critical proangiogenic factors, VEGF (vascular endothelial growth factor), and PlGF (placental growth factor) were lower in postnatal day 5 PELS. Also we found lower VEGF receptor 2 (KDR [kinase insert domain-containing receptor]) levels in mice and human endothelial cells exposed to the serum of postnatal day 5 PELS or fetal plasma of preeclamptic pregnancies, respectively. These changes were associated with lower in vitro angiogenic capacity, diminished cell migration, larger F-actin filaments, lower number of filopodia, and lower protein levels of F-actin polymerization regulators in brain endothelial cells exposed to serum or fetal plasma of offspring from preeclampsia.

CONCLUSIONS:
Offspring from preeclampsia exhibited diminished brain cortex angiogenesis, associated with lower circulating VEGF/PlGF/KDR protein levels, impaired brain endothelial migration, and dysfunctional assembly of F-actin filaments. These alterations may predispose to structural and functional alterations in long-term brain development.
Russia—a Re-emerging Donor in North Korea
Authors: Zakharova Liudmila , Burghart Sabine 
Published: September 2023

Abstract
Foreign aid has become an integral instrument of Russia’s policy towards North Korea since the 2000s. Based on quantitative and qualitative data this study systematically maps and discusses Russia’s aid disbursements to the DPRK in 2000–2020. It is shown that debt relief constituted the largest share and the significance of humanitarian assistance had increased. Unlike in the Soviet period when ideological motives prevailed in rendering foreign aid, the beginning of the 21st century saw a re-emerging of Russia’s international assistance mainly driven by pragmatic political and economic considerations without excessive obligations on both bilateral and multilateral levels. Although recipient need was considered in aid allocation, volumes were too small to solve North Korea’s food insecurity and malnutrition. This study contributes to a broader strategic picture of Russia’s policy towards North Korea.
Dispute Settlement in the Law of the Sea: Survey for 2022
Authors: Churchill Robin 
Published: September 2023

Abstract
This is the latest in a series of annual surveys in this Journal reviewing dispute settlement in the law of the sea, both under Part XV of the UN Convention on the Law of the Sea and outside the framework of the Convention. The most significant developments during 2022 were the award of an Annex VII arbitral tribunal relating to the preliminary objections of Russia in the Dispute concerning the Detention of Ukrainian Naval Vessels and Servicemen case and the judgment of the International Court of Justice on the merits in the Alleged Violations of Sovereign Rights and Maritime Spaces in the Caribbean Sea case.
Psychometric Properties of the Brief Coping Orientation to Problems Experienced Inventory Among Patients Pursuing Bariatric Surgery
Authors: Bartholomay Emily M. , Lilly Christa , Cox Stephanie , Tabone Lawrence , Szoka Nova , Abunnaja Salim , Aylward Laura 
Published: September 2023

The Brief COPE Inventory is a widely used scale that measures how a person copes with a specific situation. Despite its widespread use, the factor structure of this scale is somewhat unclear and has not been tested among patients pursuing bariatric surgery. We tested competing factor analytic models of the Brief COPE Inventory among patients pursuing bariatric surgery to identify the best fitting factor model for use in pre-surgical psychological evaluations. We also examined reliability and validity of the subscales from the best fitting model of coping. Participants included 1984 patients pursuing bariatric surgery ( Mage = 42.58 years, SD = 10.89, 81.39% female). The best fitting model of the Brief COPE Inventory among patients pursuing bariatric surgery was a three-factor model including interpersonal, intrapersonal, and maladaptive coping strategies. These results were replicated in a subset of the original sample and demonstrated appropriate convergent and discriminant validity with several key outcomes. The Brief COPE Inventory can be conceptualized as a multidimensional scale assessing interpersonal coping, intrapersonal coping, and maladaptive coping among patients pursuing bariatric surgery. Future work should examine how these subscales are related to surgical outcomes among people receiving treatment for excess weight.
Personal Health Planning in Adult-Child Former Caregivers of Parents Living With Dementia
Authors: Mroz Emily L. , Ali Talha , Piechota Amanda , Matta-Singh Tara D. , Abboud Anissa , Sharma Shubam , Monin Joan K. , Fried Terri R. 
Published: September 2023

Purpose To examine how former caregivers for parents living with dementia engage in personal health planning. Design An inductive, qualitative study. Setting Virtual, audio-recorded, semi-structured interviews. Participants Thirty-two midlife former primary caregivers for parents who died following advanced dementia 3 months to 3 years prior. Method Participants responded to a series of open-ended interview prompts. Interview recordings were transcribed and evaluated by a trained, diverse team to generate Consensual Qualitative Research (CQR) domains and categories. Results Caregivers developed health planning outlooks (ie, mindsets regarding willingness and ability to engage in personal health planning) that guided health planning activities (ie, engaging in a healthy lifestyle, initiating cognitive/genetic testing, maintaining independence and aging in place, ensuring financial and legal security). An agentic outlook involved feeling capable of engaging in health planning activities and arose when caregivers witnessed the impact and feasibility of their parents’ health planning . Anxiety-inducing and present-focused outlooks arose when caregivers faced barriers (eg, low self-efficacy, lack of social support, perception that parent’s health planning did not enhance quality of life) and concluded that personal health planning would not be valuable or feasible. Conclusion Caregiving for a parent living with dementia (PLWD) shapes former caregivers’ personal health planning. Interventions should support former caregivers who have developed low self-efficacy or pessimistic views on healthy aging to support them in addressing health planning activities.
Quality Control and Multi-targeted Therapeutic Approach of Nyctanthes arbor-tristris for Management of Hepatic Disease and Associated Complications
Authors: Salar Sapna , Sharma Pankaj , Gaurav  
Published: September 2023

Background Medicinal plants standardization is more concerning for its regulatory aspects based on safety, quality, and efficacy. Nyctanthes arbor-tristris is an Indian-origin medicinal plant that is used for numerous acute and chronic diseases. Due to the lack of an ethnopharmacological perspective based on biomolecular mechanisms, this study is associated to explore quality-based standardization and biomolecular mechanism of Nyctanthes arbor-tristris phytochemicals as a therapeutic application regimen in liver disease and associated complications. Materials and Methods 2,2-Diphenyl-1-picrylhydrazyl (DPPH) and iron chelating effect of prepared extract of Nyctanthes arbor-tristris was examined for antioxidant effect. High-performance thin-layer chromatography (HPTLC) and liquid chromatography and mass spectroscopy (LC–MS) qualitative and quantitative analysis was conducted to unravel metabolites of Nyctanthes arbor-tristris. Network pharmacology as well as insilico docking analysis were performed to examine molecular interaction of ligands and targeted genes that regulate liver malfunction. Results The results revealed that Nyctanthes arbor-tristris significantly ( p < 0.05) scavenge DPPH free radicals and iron chelating effect and thus exhibited an antioxidant effect. HPTLC and LC–MS analysis showed several major and minor metabolites Nyctanthes arbor-tristris the content of naringenin, ferulic acid, and caffeic acid was found to be 1.662 ± 0.027, 4.411 ± 0.201, and 4.846 ± 0.154, respectively. Network pharmacology and insilico docking analysis revealed the multi-targeted therapeutic effect of metabolites identified in Nyctanthes arbor-tristris against liver disease and associated pathophysiology’s via regulation in the expression of several genes such as nitric oxide synthase (NOS), tumor necrosis factor alpha (TNF-α), interleukins (ILs), toll-like receptors (TLRs) and serum aminotransferase. Conclusion The study concludes that Nyctanthes arbor-tristris play a multi-mechanistic and therapeutic action against liver-associated distortion and functional inability against oxidative and inflammatory stress, hepatocytes fibrosis, and apoptosis.