bluuebunny/crossref_metadata_2025_split huggingface dataset:
A cross-sectional study on the perceived barriers to physical exercise among women in Iraqi Kurdistan Region
Authors: Shabu Sherzad A. , Saka Mariwan H. , Al-Banna Dara A. , Zaki Sahar M. , Ahmed Hamdia M. , Shabila Nazar P. 
Published: October 2023

Abstract
Background
Limited research has investigated the barriers to physical exercise among women in Iraqi Kurdistan Region and other similar Muslim and Middle Eastern societies. This study aimed to determine the prevalence of perceived barriers to physical exercise among women and examine the associations of these barriers with the participants’ sociodemographic characteristics.

Methods
A cross-sectional study was carried out in Erbil, Iraqi Kurdistan Region, from December 2022 to January 2023. A self-administered online survey was designed using Google Forms. A convenience sample of 500 women and girls aged 18–65 years was selected for the study. A questionnaire was designed for data collection, including a list of 21 potential barriers to physical exercise developed based on literature review and experts’ opinions. The barriers were divided into three categories: interpersonal (8 barriers), social environment (8 barriers), and built environment factors (5 barriers). The participants were asked to indicate for each potential barrier whether it was “not really a barrier, somewhat a barrier, or a very important barrier.“ The statistical package for social sciences was used to estimate the prevalence of different barriers and assess their association with sociodemographic characteristics using the Chi-square test.

Results
The prevalence of physical inactivity among the study participants was 68.2%. The most prevalent interpersonal barriers to physical exercise included lack of time (47.4%), followed by fatigue (24%), and cost (22.4%). Regarding social environment factors, work (30.6%), harassment outside (22.2%), not having a friend or family member accompanying (19%), and not being allowed by family (15.4%) were the most prevalent barriers to physical exercise. Lack of footpaths, cycle lanes, or parks (34.4%), limited accessibility of gyms or other exercise facilities (25.8%), and environmental pollution (21%) were the most prevalent built environment factors as barriers to physical exercise.

Conclusion
Women in Iraqi Kurdistan Region experience many barriers to physical exercise. Women require family and social support and awareness about exercise benefits to overcome interpersonal and social environment barriers to physical exercise. Built environment factors are very important barriers and can be reduced by taking appropriate action and adopting necessary policies to provide the required infrastructure and facilities for physical exercise.
Advantages and pitfalls in utilizing artificial intelligence for crafting medical examinations: a medical education pilot study with GPT-4
Authors: E Klang , S Portugez , R Gross , R Kassif Lerner , A Brenner , M Gilboa , T Ortal , S Ron , V Robinzon , H Meiri , G Segal 
Published: October 2023

Abstract
Background
The task of writing multiple choice question examinations for medical students is complex, timely and requires significant efforts from clinical staff and faculty. Applying artificial intelligence algorithms in this field of medical education may be advisable.

Methods
During March to April 2023, we utilized GPT-4, an OpenAI application, to write a 210 multi choice questions-MCQs examination based on an existing exam template and thoroughly investigated the output by specialist physicians who were blinded to the source of the questions. Algorithm mistakes and inaccuracies, as identified by specialists were classified as stemming from age, gender or geographical insensitivities.

Results
After inputting a detailed prompt, GPT-4 produced the test rapidly and effectively. Only 1 question (0.5%) was defined as false; 15% of questions necessitated revisions. Errors in the AI-generated questions included: the use of outdated or inaccurate terminology, age-sensitive inaccuracies, gender-sensitive inaccuracies, and geographically sensitive inaccuracies. Questions that were disqualified due to flawed methodology basis included elimination-based questions and questions that did not include elements of integrating knowledge with clinical reasoning.

Conclusion
GPT-4 can be used as an adjunctive tool in creating multi-choice question medical examinations yet rigorous inspection by specialist physicians remains pivotal.
A study on the “community-hospital-community” model of community nursing practice teaching for undergraduate nursing students
Authors: Li Yuqing , Gui Jiaofeng , Wang Ying , Zhang Xiaoyun , Liu Haiyang , Guo Lei-lei , Li Jinlong , Lei Yunxiao , Li Xiaoping , Sun Lu , Yang Liu , Yuan Ting , Wang Congzhi , Zhang Dongmei , Wei Huanhuan , Li Jing , Liu Mingming , Hua Ying , Zhang Lin 
Published: October 2023

Abstract

Objective
To improve the quality of community nursing teaching practice and cultivate undergraduate nursing students who meet the quality accreditation standards of our nursing profession, and to explore the establishment of an undergraduate nurse practice model.

Methods

Using the methods of literature review, survey, expert consultation, and discussion, we established the steps and contents of community practice teaching for undergraduate nursing students, and implemented them for the students of Grades 2014, 2015, and 2016, and evaluated the “community-hospital-community” practice model through various forms, such as student self-evaluation, faculty evaluation, exit examination, and evaluation by certified experts.

Result

A three-stage community nursing practice model of “community-hospital-community” was established for undergraduate nursing students. After three stages of practice, nursing undergraduates successfully passed the practical assessments and achieved excellent grades in each stage that met the requirements of the training program. In the first stage (community probation), community probation emphasizes a fundamental understanding of the community, using free clinics, health education, and home visits as entry points to effectively cultivate students’ job competence and proficiency in nursing operations and nurse-patient communication skills. In the second stage (internship in the hospital), through nursing internships in various systems, students are trained to integrate theoretical knowledge with practical skills and consolidate their understanding of fundamental knowledge, theory, and techniques. They are capable of preventing, diagnosing, intervening, and providing health education for common, frequent, urgent and critical complications in various clinical systems. They can formulate nursing plans and implement whole-person care. In the third stage (returning to the community for internship), students can master basic skills such as nursing operations and patient communication skills, and then they can enter the community internship.

Conclusion
The community nursing practice model of “community- hospital- community” for undergraduate nursing students can systematically train undergraduate nursing students’ ability to work in the community.
‘Beyond places of safety’ – a qualitative study exploring the implementation of mental health crisis care innovations across England
Authors: Foye Una , Appleton Rebecca , Nyikavaranda Patrick , Lyons Natasha , Dare Ceri , Lynch Chris , Persaud Karen , Ahmed Nafiso , Stuart Ruth , Schlief Merle , Huong Xia , Sevdalis Nick , Sheridan-Rains Luke , Rojas-Garcia Antonio , Stefan Martin , Clark Jeremy , Simpson Alan , Johnson Sonia , Lloyd-Evans Brynmor 
Published: October 2023

Abstract
Background
Mental health acute and crisis care consumes a large share of mental health budgets internationally but is often experienced as unsatisfactory and difficult to access. As a result, there is an increasing move towards developing innovative community crisis services, to improve patient experience and relieve pressure on inpatient and emergency services. This study aims to understand what helps and hinders the implementation of innovative mental health crisis care projects in England.

Methods
Using a qualitative approach, 18 interviews were conducted with crisis care service managers exploring their experiences and views of the development and implementation of their service developed with support from an English national capital funding programme. A framework analysis was conducted informed by implementation science.

Results
Key facilitators to implementation of innovative crisis services included bottom-up development, service user involvement, strong collaborative working, and leadership and management buy-in. Key barriers that affected the projects implementation included the complexities of crisis care, workforce challenges and resourcing issues.

Conclusion
There is a recognised need to improve, update, and innovate current crisis care offers. Results from this study suggest that a range of models can help address the heterogenous needs of local populations and that new approaches can be implemented where they utilise a whole-systems approach, involving service users and relevant professional stakeholders beyond mental health services in planning and developing the service.
Predictors of medicine redistribution at public healthcare facilities in King Cetshwayo District, KwaZulu-Natal, South Africa
Authors: Mabizela Sibusiso , Nakambale Hilma N. , Bangalee Varsha 
Published: October 2023

Abstract
Background
Effective pharmaceutical inventory management is essential for optimizing healthcare outcomes and supply chain performance. However, challenges such as stockouts, overstocking, and wastage can hinder this process. This study examines the interrelationships between overstocking, stockouts, and wastage in eight healthcare facilities in Northern KwaZulu-Natal, South Africa. It also explores the extent of these challenges and investigates the use of medicine redistribution as a strategy to address inventory management issues.

Methods
A retrospective quantitative analysis was conducted using pharmacy inventory records from public healthcare facilities. Eight facilities, including hospitals and a community healthcare center in King Cetshwayo District, were purposively sampled. Linear regression analysis was used to examine the association between medicine redistribution as the outcome and the predictors - stockouts, overstocking, and wastage. Pearson’s correlation was utilized to evaluate associations between the predictors. Descriptive statistics were employed to quantify the levels and extent of overstocking, stockouts, and wastage related to expiry.

Results
The study included eight healthcare facilities with pharmacy warehouses managed by pharmacists. A total of 392 medicines were analyzed (49 per facility). Stockouts affected 85.6% of medicines, while overstocking and expiry-related wastage impacted 50.6% and 15.2% of medicines, respectively. The most common stock-out medicines were salbutamol 200mcg inhalant (4.0%), paracetamol 500 mg tablets (3.5%), and azithromycin 500 mg tablets (3.3%). Overstocking, stock with short-dated expiry, and expired medicines explained 68% of redistribution transactions to other facilities (r² = 0.68). A moderate, statistically significant correlation was observed between overstocking and expiry-related wastage (r² = 0.47, p-value = 0.020). Stockouts had a weak correlation with redistribution, accounting for only 4.5% (p-value < 0.01). A weak correlation was found between stockouts and overstocking (r = 0.10), as well as between stockouts and expired medicines (r = -0.20).

Conclusion
This study highlights significant challenges in inventory management, particularly regarding stockouts, overstocking, and expiry-related wastage in the evaluated healthcare facilities. Medicine redistribution emerged as a viable strategy to address these challenges. Improving inventory management practices and implementing targeted interventions are crucial for optimizing pharmaceutical supply chain performance and enhancing healthcare delivery outcomes in this setting.
Coexpression analysis of lncRNAs and mRNAs identifies potential regulatory long noncoding RNAs involved in the inflammatory effects of lipopolysaccharide on bovine mammary epithelial cells
Authors: Xia Xiaojing , Hou Jie , Ren Pengfei , Liu Mingcheng , Wang Lei , Wei Xiaobing , Teng Zhanwei , Kasianenko Oksana , Cheng Likun , Hu Jianhe 
Published: October 2023

AbstractBackgroundThe infection of bovine mammary glands by pathogenic microorganisms not only causes animal distress but also greatly limits the development of the dairy industry and animal husbandry. A deeper understanding of the host’s initial response to infection may increase the accuracy of selecting drug-resistant animals or facilitate the development of new preventive or therapeutic intervention strategies. In addition to their functions of milk synthesis and secretion, bovine mammary epithelial cells (BMECs) play an irreplaceable role in the innate immune response. To better understand this process, the current study identified differentially expressed long noncoding lncRNAs (DE lncRNAs) and mRNAs (DE mRNAs) in BMECs exposed toEscherichia colilipopolysaccharide (LPS) and further explored the functions and interactions of these lncRNAs and mRNAs.ResultsIn this study, transcriptome analysis was performed by RNA sequencing (RNA-seq), and the functions of the DE mRNAs and DE lncRNAs were predicted by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. Next, we constructed a modulation network to gain a deeper understanding of the interactions and roles of these lncRNAs and mRNAs in the context of LPS-induced inflammation. A total of 231 DE lncRNAs and 892 DE mRNAs were identified. Functional enrichment analysis revealed that pathways related to inflammation and the immune response were markedly enriched in the DE genes. In addition, research results have shown that cell death mechanisms, such as necroptosis and pyroptosis, may play key roles in LPS-induced inflammation.ConclusionsIn summary, the current study identified DE lncRNAs and mRNAs and predicted the signaling pathways and biological processes involved in the inflammatory response of BMECs that might become candidate therapeutic and prognostic targets for mastitis. This study also revealed several possible pathogenic mechanisms of mastitis.
Genetic implications of Th/U, Th/K, and U/K ratios for U mineralizations: A case study from El-Missikat and El-Erediya shear zones, Eastern Desert, Egypt
Authors: Abdel-Hakeem Mahmoud , El-Tahir Mohamed , Zeid Ehab Abu , Rageh Hassan 
Published: October 2023

AbstractThe current work is an attempt to reveal the possible utilization of the radiometric measurements to build-up a complete genetic scenario for magmatic, hydrothermal, and supergene uranium mineralization. For this purpose, ground gamma-ray survey was performed through the exploratory tunnels dug perpendicular to El-Missikat and El-Erediya shear zones, the Central Eastern Desert of Egypt. Contents of U, Th, and K were measured for the host pink granite (e.g., avg.15.94 U ppm, 35.62 Th ppm, and 6.63% K), alteration zones (brecciation, silicification, greisenization, kaolinization and hematitization) (e.g., avg. 124.01 U ppm, 63.67 Th ppm, and 3.13% K), and mineralized silica veins (e.g., avg. 312.65 U ppm, 92.22 Th ppm, and 2.62% K). All of these data were graphically represented as correlation plots of Th vs. U, Th/U vs. U, Th vs. K, and U/K vs. Th/K. The overall results indicate magmatic, hydrothermal, and supergene sources of El-Missikat and El-Erediya U mineralization. The magma-derived U contents are enclosed mainly in the pink granite that is mostly characterized by normal Th/U (2.5–5) and Th/K ratios (3–5*10–4). The hydrothermal processes through the alteration zones and mineralized silica veins are reflected by the weak correlation of Th with U (e.g. r = 0.13 and − 0.39), the strong negative correlation of Th/U ratio with U (e.g. r = − 0.82), 2.5˃Th/U˃0.1, Th/K˃5*10–4, Th/K < 3*10–4, and the strong positive correlation of U/K with Th/K (e.g. r = 0.91) as well as the occurrence of thorite, columbite, xenotime and hydrothermal zircon (0.5 > Th/U ≤ 0.1). Afterwards, the hydrothermal mineralization underwent some degrees of chemical weathering that resulted in supergene U mineralization whose fingerprints can be traced by the occurrence of secondary U minerals (e.g. kasolite and uranophane), Th/U ratios ≤ 0.1, and the weak correlation between Th/K and U/K (e.g. r = 0.39 and − 0.11).
Influence of diabetes mellitus on the pathological profile of aortic stenosis: a sex-based approach
Authors: Martín-Núñez Ernesto , Goñi-Olóriz Miriam , Matilla Lara , Garaikoetxea Mattie , Mourino-Alvarez Laura , Navarro Adela , Fernández-Celis Amaya , Tamayo Ibai , Gainza Alicia , Álvarez Virginia , Sádaba Rafael , Barderas María G. , Jover Eva , López-Andrés Natalia 
Published: October 2023

AbstractBackgroundDiabetes mellitus (DM) accelerates the progression of aortic stenosis (AS), but how their underlying molecular mechanisms interact is not clear. Moreover, whether DM contributes to clinically relevant sex-differences in AS is unknown. In this work we aim to characterize the sex-specific profile of major pathological mechanisms fundamental to aortic valve (AV) degeneration in AS patients with or without concomitant DM.Methods283 patients with severe AS undergoing surgical valve replacement (27.6% DM, 59.4% men) were recruited. Expression of pathological markers related to AS were thoroughly assessed in AVs and valve interstitial cells (VICs) according to sex and presence of DM. Complementary in vitro experiments in VICs in the presence of high-glucose levels (25 mM) for 24, 48 and 72 h were performed.ResultsOxidative stress and metabolic dysfunction markers were increased in AVs from diabetic AS patients compared to non-diabetic patients in both sexes. However, disbalanced oxidative stress and enhanced inflammation were more predominant in AVs from male AS diabetic patients. Osteogenic markers were exclusively increased in the AVs of diabetic women. Basal characterization of VICs confirmed that oxidative stress, inflammation, calcification, and metabolic alteration profiles were increased in diabetic VICs with sex-specific differences. VICs cultured in hyperglycemic-like conditions triggered inflammatory responses in men, whereas in women rapid and higher production of pro-osteogenic molecules.ConclusionsDM produces sex-specific pathological phenotypes in AV of AS patients. Importantly, women with diabetes are more prone to develop AV calcification. DM should be considered as a risk factor in AS especially in women.
Short-term exposure to PM2.5 and 1.5 million deaths: a time-stratified case-crossover analysis in the Mexico City Metropolitan Area
Authors: Gutiérrez-Avila Iván , Riojas-Rodríguez Horacio , Colicino Elena , Rush Johnathan , Tamayo-Ortiz Marcela , Borja-Aburto Víctor Hugo , Just Allan C. 
Published: October 2023

Abstract
Background
Satellite-based PM2.5 predictions are being used to advance exposure science and air-pollution epidemiology in developed countries; including emerging evidence about the impacts of PM2.5 on acute health outcomes beyond the cardiovascular and respiratory systems, and the potential modifying effects from individual-level factors in these associations. Research on these topics is lacking in low and middle income countries. We aimed to explore the association between short-term exposure to PM2.5 with broad-category and cause-specific mortality outcomes in the Mexico City Metropolitan Area (MCMA), and potential effect modification by age, sex, and SES characteristics in such associations.

Methods
We used a time-stratified case-crossover study design with 1,479,950 non-accidental deaths from the MCMA for the period of 2004–2019. Daily 1 × 1 km PM2.5 (median = 23.4 μg/m3; IQR = 13.6 μg/m3) estimates from our satellite-based regional model were employed for exposure assessment at the sub-municipality level. Associations between PM2.5 with broad-category (organ-system) and cause-specific mortality outcomes were estimated with distributed lag conditional logistic models. We also fit models stratifying by potential individual-level effect modifiers including; age, sex, and individual SES-related characteristics namely: education, health insurance coverage, and job categories. Odds ratios were converted into percent increase for ease of interpretation.

Results
PM2.5 exposure was associated with broad-category mortality outcomes, including all non-accidental, cardiovascular, cerebrovascular, respiratory, and digestive mortality. A 10-μg/m3 PM2.5 higher cumulative exposure over one week (lag06) was associated with higher cause-specific mortality outcomes including hypertensive disease [2.28% (95%CI: 0.26%–4.33%)], acute ischemic heart disease [1.61% (95%CI: 0.59%–2.64%)], other forms of heart disease [2.39% (95%CI: -0.35%–5.20%)], hemorrhagic stroke [3.63% (95%CI: 0.79%–6.55%)], influenza and pneumonia [4.91% (95%CI: 2.84%–7.02%)], chronic respiratory disease [2.49% (95%CI: 0.71%–4.31%)], diseases of the liver [1.85% (95%CI: 0.31%–3.41%)], and renal failure [3.48% (95%CI: 0.79%–6.24%)]. No differences in effect size of associations were observed between age, sex and SES strata.

Conclusions
Exposure to PM2.5 was associated with non-accidental, broad-category and cause-specific mortality outcomes beyond the cardiovascular and respiratory systems, including specific death-causes from the digestive and genitourinary systems, with no indication of effect modification by individual-level characteristics.
B7H3 targeting gold nanocage pH-sensitive conjugates for precise and synergistic chemo-photothermal therapy against NSCLC
Authors: Chen Bing , Zheng Kaifan , Fang Shubin , Huang Kangping , Chu Chengchao , Zhuang Junyang , Lin Jin , Li Shaoguang , Yao Hong , Liu Ailin , Liu Gang , Lin Jizhen , Lin Xinhua 
Published: October 2023

Abstract
Background
The combination of drug delivery with immune checkpoint targeting has been extensively studied in cancer therapy. However, the clinical benefit for patients from this strategy is still limited. B7 homolog 3 protein (B7-H3), also known as CD276 (B7-H3/CD276), is a promising therapeutic target for anti-cancer treatment. It is widely overexpressed on the surface of malignant cells and tumor vasculature, and its overexpression is associated with poor prognosis. Herein, we report B7H3 targeting doxorubicin (Dox)-conjugated gold nanocages (B7H3/Dox@GNCs) with pH-responsive drug release as a selective, precise, and synergistic chemotherapy-photothermal therapy agent against non-small-cell lung cancer (NSCLC).

Results
In vitro, B7H3/Dox@GNCs exhibited a responsive release of Dox in the tumor acidic microenvironment. We also demonstrated enhanced intracellular uptake, induced cell cycle arrest, and increased apoptosis in B7H3 overexpressing NSCLC cells. In xenograft tumor models, B7H3/Dox@GNCs exhibited tumor tissue targeting and sustained drug release in response to the acidic environment. Wherein they synchronously destroyed B7H3 positive tumor cells, tumor-associated vasculature, and stromal fibroblasts.

Conclusion
This study presents a dual-compartment targeted B7H3 multifunctional gold conjugate system that can precisely control Dox exposure in a spatio-temporal manner without evident toxicity and suggests a general strategy for synergistic therapy against NSCLC.