bluuebunny/crossref_metadata_2025_split huggingface dataset:
Noise and silver nanoparticles induce hepatotoxicity via CYP450/NF-Kappa B 2 and p53 signaling pathways in a rat model
Authors: Belji Kangarlou Marzieh , Khavanin Ali , Nadri Farshad , Goodarzi Zahra , Karami Esmaeil , Rashidy-Pour Ali , Kiani Mehrafarin , Hashemi Habybabady Raheleh 
Published: February 2024

Co-exposure to noise and nanomaterials, such as silver nanoparticles (Silver-NPs), is a common occurrence in today’s industries. This study aimed to investigate the effects of exposure to noise and the administration of silver-NPs on the liver tissue of rats. Thirty-six adult male albino Wistar rats were randomly divided into six groups: a control group (administered saline intraperitoneally), two groups administered different doses of Silver-NPs (50 mg/kg and 100 mg/kg, 5 days a week for 28 days), two groups exposed to noise in addition to Silver-NPs (at the same doses as mentioned before), and a group exposed only to noise (104 dB, 6 hours a day, 5 days a week for 4 weeks). Blood samples were taken to assess hepatic-functional alterations, such as serum ALP, ALT, and AST levels. Additionally, biochemical parameters (MDA, GPX, and CAT) and the silver concentration in the liver were measured. Histopathological analysis, mRNA expression (P53 and NF-κB), protein expression (CYP450), and liver weight changes in rats were also documented. The study found that the administration of Silver-NPs and exposure to noise resulted in elevated levels of ALP, ALT, AST, and MDA ( p < .01). Conversely, GPX and CAT levels decreased in all groups compared with the control group ( p < .0001). There was a significant increase ( p < .05) in liver weight and silver concentration in the liver tissues of groups administered Silver-NPs (50 mg/kg) plus noise exposure, Silver-NPs (100 mg/kg), and Silver-NPs (100 mg/kg) plus noise exposure, respectively. The expression rate of P53, NF-κB, and cytochromes P450 (CYPs-450) was increased in the experimental groups ( p < .05). These findings were further confirmed by histopathological changes. In conclusion, this study demonstrated that exposure to noise and the administration of Silver-NPs exacerbated liver damage by increasing protein and gene expression, causing hepatic necrosis, altering biochemical parameters, and affecting liver weight.
Exploring Barriers and Facilitators for Human Milk Donation and Acceptance Among Donors and Recipients
Authors: Chaudhari Vaishali , Aiyer Sheila 
Published: February 2024

Background There is no ideal alternative to mother’s own milk. In circumstances where an alternative is required, donated human milk is the best available option. To promote the establishment of more human milk banks, it is necessary to know the current attitude and awareness of the general population toward human milk donation as well as its acceptance. Methods This is a qualitative study including focused group discussions and in-depth interviews. Results Major barriers found to the donation of milk were fear of the insufficient amount of milk remaining for her baby, inconvenience due to stitch pain after lower segment caesarean section, not willing for pre-donation laboratory testing, the donation process being time-consuming, misconceptions like fear of disease transmission, and so on. Factors facilitating milk donation were breast engorgement and altruism. The facilitator for the acceptance of donated human milk was the belief that donated human milk was the best available option at that time. Barriers to acceptance of donated milk were fear of transmission of infections, prevalent misconceptions about donated human milk, and a lack of awareness regarding the process of pasteurization. Conclusion Barriers to the donation of milk are related to inadequate knowledge, fear, and low awareness regarding human milk banking. Most mothers were encouraged to donate milk due to excess milk. A lack of knowledge about the process of pasteurization appears to be a significant barrier to the acceptance of donated milk. Pasteurized donated milk, being the only available superior option, made donated milk acceptable among the recipient’s relatives.
Lived Experiences Among Critically Ill and Near-Death Survivors Relating to the COVID-19 Infection: A Phenomenological Study
Authors: Kusoom Wichitra , Krongyuth Sununta 
Published: February 2024

Introduction: The COVID-19 pandemic has resulted in severe illnesses worldwide. Around 655.5 million cases were having been confirmed, including 6.6 million deaths. The extreme cases experienced near death in the intensive care unit (ICU). This study explored the survivors’ experience of being near death while critically ill with the infection. Methodology: A descriptive phenomenological study was employed. Data were collected through in-depth interviews with 14 participants from Northeastern Thailand. Content analysis was applied by using Creswell’s strategy. Results: Four themes emerged: (a) anxiety and fear of dying alone, (b) environmental chaos, (c) using Thai Buddhist teaching in coping, and (d) returning from the brink of death. Moreover, the patients felt great gratitude and were grateful to the health care team. Discussion: Traumas experienced by patients in the ICU included physical and psychological distress, coping strategies, and an understanding of cultural awareness. Conclusion: Psychological and culturally congruent care should be implemented for patients in the ICU.
Accuracy and Reliability of Remote Categorization of Upper Limb Outcome After Stroke
Authors: Jordan Harry T. , Stinear Cathy M. 
Published: February 2024

Background There is an increasing need for motor assessments after stroke that can be performed quickly and remotely. The Fast Outcome Categorization of the Upper Limb after Stroke-4 (FOCUS-4) assessment remotely classifies upper limb outcome into 1 of 4 categories after stroke and was developed via retrospective analysis of Action Research Arm Test (ARAT) scores. Objective The aim of this study was to prospectively evaluate the accuracy and reliability of FOCUS-4 assessments for categorizing upper limb outcome after stroke when administered remotely during a videocall compared to an in-person ARAT. Methods Data were collected from 26 participants at 3 months post-stroke (3M), 27 participants at 6 months post-stroke (6M), and 56 participants at the chronic stage of stroke (>6M). Participants performed an in-person ARAT and a remote FOCUS-4 assessment administered during a videocall, and accuracy was evaluated by comparing the upper limb outcome categories. Participants at the chronic stage of stroke also performed a second remote FOCUS-4 assessment to assess between-day reliability. Results Overall accuracy of the remote FOCUS-4 assessment was 88% at 3M and 96% at 6M. Overall accuracy of the first and second remote FOCUS-4 assessments at the chronic stage was 75% and 79%, respectively. Reliability of the FOCUS-4 assessment at the chronic stage was 82%. The remote FOCUS-4 assessment was most accurate and reliable for participants with mild or severe upper limb functional impairment. Conclusions The remote FOCUS-4 assessment has potential to classify upper limb functional capacity or to screen possible participants for stroke trials, but external validation is required.
Chinese eSports Industry’s Boom and Recession: Evidence From Bubble Detection Framework
Authors: Li Xin , Li Zheng , Qin Meng , Zhang Weike , Su Chi-Wei 
Published: February 2024

This paper aims to explore whether the development of competitive computer gaming (eSports) industries is sustained in China. In doing so, we apply the Generalized Supremum Augmented Dickey-Fuller (GSADF) method to investigate when the bubbles originated and crashed in the Chinese eSports market from 2014 to 2021. Utilizing the data of the Chinese Electronic Sports Thematic Index (CESI), the empirical outcomes show that the Chinese eSports industry may deviate from its market value and that the industry witnesses bubble behaviors. The latent reasons might be attributed to government policies, economic growth, stock market crises, and venture capital investments. Therefore, to promote the stabilized and sustained development of the eSports industry in China, regulators and authorities should pay attention to the evolution of bubbles. Moreover, maintaining policy consistency and continuity may be beneficial in stabilizing investors’ expectations and reducing speculative investment behaviors. JEL Classification: G10, Z23, Z28.
Mentors Supporting Nurses Transitioning to Primary Healthcare Roles: A Practice Improvement Initiative
Authors: Rossiter Rachel , Robinson Tracy , Cox Rebekah , Collison Lisa , Hills Danny 
Published: February 2024

Introduction Effective primary healthcare services have been identified by the World Health Organization as the most equitable approach to enhancing universal healthcare. Robust models of mentoring for registered nurses (RNs) transitioning to primary healthcare roles have yet to be described in the Australian context. A robust mentoring model can support RNs to fulfill their potential, bridging the gap between theory and practice. In 2015, the peak body for nurses in primary health care (PHC) began developing a transition to practice program, including embedded mentoring to support newly graduated and more experienced registered and enrolled nurses. This quality improvement study reports the experiences and perspectives of nurses participating as mentors in two separate offerings of the program delivered between 2019 and 2021. Method A two-phase concurrent mixed methods evaluation utilized data from pre- and post online surveys and post program meetings. Quantitative items underwent descriptive analyses. Thematic analysis of free-text responses and comments was conducted independently by two researchers. Mentors voluntarily provided self-report data and were informed that data is routinely collected to support continuous quality improvement processes for all programs. An Information Sheet informed mentors of data usage, confidentiality, and options to withdraw without penalty from the program at any time. Results Seventy-nine mentors were recruited to support two groups of nurses ( N = 111). Mentor self-rated overall satisfaction with program participation was 86.67% (very or extremely satisfied). Mentors described being “witness to mentee growth,” “having facilitated access to learning” and receiving “unexpected benefits” including personal and professional growth and enhanced enthusiasm for their role in PHC. Conclusion The embedded mentoring reported in this article combined a focus on skills acquisition and professional identity with the provision of a range of resources and support activities. Sustainable mentoring programs will be an important mechanism for supporting the expanding roles required of nurses working in primary health.
Evaluation of Vascular Neurology Fellowship Websites in the U.S.
Authors: Tram Michelle T , Amory Colum , Tosun Kursad 
Published: February 2024

Objectives Due to the limitations of the Coronavirus disease pandemic, medical applicants have relied on remote means of information, such as a program's website, to decide where to apply. However, studies have shown that many residency and fellowship websites lack information. Vascular neurology fellowship websites have not yet been studied. This study evaluates the availability and accessibility of information on vascular neurology fellowship websites. Methods From 2021 to 2022, a total of 109 U.S. vascular neurology fellowship programs from the Fellowship and Residency Electronic Interactive Database were investigated to determine whether they had websites. Each website was evaluated on the immediate availability of 34 different criteria, which were deemed important by past studies. These criteria were reviewed under four categories: program overview, application information, fellow life, and curriculum. The comprehensiveness of the information among these different categories were analyzed. Programs were grouped by geographic region and electronic residency application service (ERAS)-participation status and comparisons were made within these groups. Results There were 107 programs with websites (98%). ERAS-participating programs fulfilled more criteria on average than non-participating programs ( P = 0.004). All websites provided information on general descriptions of their programs, but information on board exam pass rates, fellow testimonials, history of the fellowship program, responsibility progression, family and social events, parking availability, and application deadline were provided by less than 25% of websites. Conclusion This study found that there was a large lack of information on vascular neurology fellowship websites, which could be improved to attract more applicants.
Asymptomatic coronary artery disease in ischaemic stroke survivors: A systematic review and meta-analysis
Authors: Muthalaly Rahul G , Abrahams Timothy B , Nerlekar Nitesh , Nelson Adam J , Tan Sean , Chan Jasmine , Phan Thanh , Ma Henry , Nicholls Stephen J 
Published: February 2024

Background:Ischaemic stroke and coronary artery disease share risk factors and stroke survivors experience a high rate of cardiac events. Recent work suggests a high burden of asymptomatic coronary artery disease (CAD) in ischaemic stroke survivors. Thus, we performed this systematic review and meta-analysis to A) estimate the prevalence of CAD in ischaemic stroke survivors without known CAD and B) evaluate the association between coronary atherosclerosis and future major adverse cardiovascular events (MACE) in stroke survivors.Patients and Methods:We conducted a systematic review and meta-analysis according to the PRISMA statement. We included studies investigating acute ischaemic stroke or transient ischaemic attack where participants underwent anatomical assessment of all coronary arteries. For objective B) we included studies that reported an association between coronary atherosclerosis and MACE. Two reviewers used the Newcastle-Ottawa Scale to assess risk of bias. We used random-effects modelling for our analyses.Results:We identified 2983 studies of which 17 were included. These studies had a total of 6862 participants between 2008 and 2022. The pooled prevalence of any coronary atherosclerosis was 66.8% (95% CI 57.2%–75.1%) with substantial heterogeneity ( I2 = 95.2%). The pooled prevalence of obstructive (>50%) stenosis was 29.3% with substantial heterogeneity ( I2 = 91%). High-risk coronary anatomy (triple vessel disease or left main stenosis) was found in 7.0% (95% CI 4%–12%) with high heterogeneity I2 = 72%. One study examined high-risk plaques and found a prevalence of 5.9%. Five studies reported the association of coronary atherosclerosis with future MACE. The presence of obstructive CAD confers a HR of 8.0 (95% CI 1.7–37.1, p = 0.007) for future MACE.Discussion and Conclusions:Asymptomatic CAD is common in ischaemic stroke survivors. The presence and severity of asymptomatic CAD strongly associates with the risk of future MACE. Further evaluation of the benefits of routine coronary assessment in ischaemic stroke is warranted.
Monocytes in leukapheresis products affect the outcome of CD19–targeted CAR T-cell therapy in patients with lymphoma
Authors: Carniti Cristiana , Caldarelli Nicole M. , Agnelli Luca , Torelli Tommaso , Ljevar Silva , Jonnalagadda Sadhana , Zanirato Giada , Fardella Eugenio , Stella Federico , Lorenzini Daniele , Brich Silvia , Arienti Flavio , Dodero Anna , Chiappella Annalisa , Magni Martina , Corradini Paolo 
Published: February 2024

Abstract
CD19–directed chimeric antigen receptor (CAR) T cells can induce durable remissions in relapsed/refractory large B-cell lymphomas (R/R LBCLs), but 60% of patients do not respond or relapse. Biological mechanisms explaining lack of response are emerging, but they are largely unsuccessful in predicting disease response at the patient level. Additionally, to maximize the cost-effectiveness of CAR T-cell therapy, biomarkers able to predict response and survival before CAR T-cell manufacturing would be desirable. We performed transcriptomic and functional evaluations of leukapheresis products in 95 patients with R/R LBCL enrolled in a prospective observational study, to identify correlates of response and survival to tisagenlecleucel and axicabtagene ciloleucel. A signature composed of 4 myeloid genes expressed by T cells isolated from leukapheresis products is able to identify patients with a very short progression-free survival (PFS), highlighting the impact of monocytes in CAR T-cell therapy response. Accordingly, response and PFS were also negatively influenced by high circulating absolute monocyte counts at the time of leukapheresis. The combined evaluation of peripheral blood monocytes at the time of leukapheresis and the 4-gene signature represents a novel tool to identify patients with R/R LBCL at very high risk of progression after CAR T-cell therapy and could be used to plan trials evaluating CAR T cells vs other novel treatments or allogeneic CAR T cells. However, it also highlights the need to incorporate monocyte depletion strategies for better CAR T production.
Repositioning of ezetimibe for the treatment of idiopathic pulmonary fibrosis
Authors: Lee Chanho , Kwak Se Hyun , Han Jisu , Shin Ju Hye , Yoo Byunghun , Lee Yu Seol , Park Jeong Su , Lim Beom Jin , Lee Jin Gu , Kim Young Sam , Kim Song Yee , Bae Soo Han 
Published: February 2024

BackgroundWe previously identified ezetimibe, an inhibitor of Niemann–Pick C1-like intracellular cholesterol transporter 1 and European Medicines Agency-approved lipid-lowering agent, as a potent autophagy activator. However, its efficacy against pulmonary fibrosis has not yet been evaluated. This study aimed to determine whether ezetimibe has therapeutic potential against idiopathic pulmonary fibrosis.MethodsPrimary lung fibroblasts isolated from both humans and mice were employed for mechanisticin vitroexperiments. mRNA sequencing of human lung fibroblasts and gene set enrichment analysis were performed to explore the therapeutic mechanism of ezetimibe. A bleomycin-induced pulmonary fibrosis mouse model was used to examinein vivoefficacy of the drug. Tandem fluorescent-tagged microtubule-associated protein 1 light chain 3 transgenic mice were used to measure autophagic flux. Finally, the medical records of patients with idiopathic pulmonary fibrosis from three different hospitals were reviewed retrospectively, and analyses on survival and lung function were conducted to determine the benefits of ezetimibe.ResultsEzetimibe inhibited myofibroblast differentiation by restoring the mechanistic target of rapamycin complex 1–autophagy axis with fine control of intracellular cholesterol distribution. Serum response factor, a potential autophagic substrate, was identified as a primary downstream effector in this process. Similarly, ezetimibe ameliorated bleomycin-induced pulmonary fibrosis in mice by inhibiting mechanistic target of rapamycin complex 1 activity and increasing autophagic flux, as observed in mouse lung samples. Patients with idiopathic pulmonary fibrosis who regularly used ezetimibe showed decreased rates of all-cause mortality and lung function decline.ConclusionOur study presents ezetimibe as a potential novel therapeutic for idiopathic pulmonary fibrosis.
COPD: systemic proteomic profiles in frequent and infrequent exacerbators
Authors: Enríquez-Rodríguez Cesar Jessé , Casadevall Carme , Faner Rosa , Castro-Costa Ady , Pascual-Guàrdia Sergi , Seijó Luis , López-Campos José Luis , Peces-Barba Germán , Monsó Eduard , Barreiro Esther , Cosío Borja G. , Agustí Alvar , Gea Joaquim ,   on behalf of the BIOMEPOC group
Published: February 2024

BackgroundSome patients with COPD suffer frequent exacerbations (FE). We hypothesised that their systemic proteomic profile would be different from that of non-frequent exacerbators (NFE). The objective of the present study was to contrast the systemic proteomic profile in FEversusNFE. As a reference, we also determined the systemic proteomic profile of healthy controls (HC) and COPD patients during an actual episode of exacerbation (AE).MethodsIn the analysis we included 40 clinically stable COPD patients (20 FE and 20 NFE), and 20 HC and 10 AE patients. Their plasma samples were analysed by combining two complementary proteomic approaches: label-free liquid chromatography-tandem mass spectrometry and multiplex immunoassays. Gene Ontology annotation, pathway enrichment and network analyses were used to investigate molecular pathways associated with differentially abundant proteins/peptides (DAPs).ResultsCompared with HC, we identified 40 DAPs in FE, 10 in NFE and 63 in AE. Also compared to HC, pathway functional and protein–protein network analyses revealed dysregulation of inflammatory responses involving innate and antibody-mediated immunity in COPD, particularly in the FE group, as well as during an AE episode. Besides, we only identified alterations in the complement and coagulation cascades in AE.ConclusionThere are specific plasma proteome profiles associated with FE, which are partially shared with findings observed during AE, albeit others are uniquely present during the actual episode of AE.
Postural balance in COPD with obstructive sleep apnoea: a cross-sectional study
Authors: de Censo Caroline Maschio , Passini Viviane Vieira , Verri Bárbara Aparecida Teodoro Alcantara , Xavier Rafaella Fagundes , Carvalho-Pinto Regina Maria , Lorenzi-Filho Geraldo , Carvalho Celso R.F. 
Published: February 2024

ObjectiveThe aim of this study was to assess the postural balance in COPD patients with obstructive sleep apnoea (OSA). Physical activity, anxiety and depression symptoms, mood, and falls were also assessed in this population.MethodsModerate to severe COPD patients were assessed for laboratory and clinical postural balance (force platform and mini-balance evaluation systems test (Mini-BESTest)), physical activity (accelerometry), OSA (polysomnography), sleep quality (Pittsburgh Sleep Quality Index), sleepiness (Epworth Sleepiness Scale), anxiety and depression symptoms (Hospital Anxiety and Depression Scale), dyspnoea (modified Medical Research Council), clinical status (COPD Assessment Test) and mood (Brunel Mood Scale). Self-reported falls were recorded for 6 monthsviaphone calls.ResultsCOPD patients (n=70) were divided according to the polysomnography findings into the no OSA (n=30), mild OSA (n=25), and moderate to severe OSA (n=15) groups. Compared to patients with no OSA, those with moderate to severe OSA (msOSA group) presented median (interquartile range) increased path length (30.5 (23.9–34.5) cmversus39.0 (30.6–52.6) cm, anteroposterior displacement (1.89 (1.39–2.31) cmversus2.54 (2.06–2.83) cm and postural adjustment velocity (1.02 (0.80–1.15) cm·s−1versus1.30 (1.02–1.76) cm·s−1) (p<0.05). No differences were observed in the Mini-BESTest scores among the groups. The msOSA group presented a greater number of recurrent fallers in the first follow-up trimester. No association was observed between postural balance and age and pulmonary functionConclusionIndividuals with COPD and moderate to severe OSA present changes in postural balance, including broader oscillation, faster postural adjustments and a greater risk of falls than those with no OSA. Physical activity, anxiety and depression symptoms, and mood are similar between COPD patients with and without OSA.