bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis of primary vitreoretinal lymphoma masquerading infectious retinitis by retinal biopsy
Authors: Nguyen Nam V. , Khan Farid , Cannon Andrew , Huang Ye , Kim Lucas , Xu Rena , Rishi Pukhraj , Conrady Christopher D. , Greiner Timothy C. , Yuil-Valdes Ana , Yeh Steven 
Published: February 2024

Abstract
Purpose
To report a case of primary vitreoretinal lymphoma masquerading as infectious retinitis that was diagnosed via a retinal biopsy.

Observations
A 72-year-old female patient was referred to our ophthalmology clinic for evaluation of retinitis and vasculitis in the right eye (OD). On examination, best-corrected visual acuities (BCVAs) were hand motions OD and 20/20 in the left eye (OS). Fundus examination revealed optic disc edema and diffuse retinal whitening superior to the superotemporal arcade OD. Given the high suspicion of infectious retinitis, the patient was treated with intravitreal foscarnet, systemic acyclovir, and oral prednisone and underwent a comprehensive uveitis workup, which was unremarkable for viral and autoimmune entities. Given the patient’s history of diffuse large B cell lymphoma with cutaneous involvement, vitreoretinal lymphoma was suspected, prompting pars plana vitrectomy with a retinal biopsy. Biopsy and immunohistochemistry results were consistent with B-cell lymphoma, and the patient was treated with high-dose methotrexate and rituximab. At 5-month follow-up, BCVAs were hand motions OD and 20/30 OS, and fundus examination demonstrated disc edema with resolution of retinal whitening OD. She responded well to the treatment with regression of vitreoretinal lymphoma on examination and is being monitored closely for lymphoma recurrence.

Conclusions and importance
Although uncommon, patients with vitreoretinal lymphoma may masquerade as infectious retinitis, and vitreoretinal lymphoma should be suspected when refractory to antiviral therapy and in the setting of a negative workup for viral etiologies. Vitrectomy with retinal biopsy may be considered to aid the diagnosis of vitreoretinal lymphoma although careful consideration of the risks and benefits is warranted.
Expression of the immune checkpoint molecules CD226 and TIGIT in preeclampsia patients
Authors: Li Cui , Liu Haiyan , Duan Zhongliang 
Published: February 2024

Abstract
Background
Imbalanced immune responses are involved in developing preeclampsia (PE). We wish to explore the expression and potential changes of immune checkpoint molecules TIGIT, CD226 and CD155 in PE patients.

Methods
The expression of the immune checkpoint molecules TIGIT, CD226 and CD155 in different lymphocyte subpopulations was determined by flow cytometry in 24 patients with PE and compared to 24 healthy pregnant women of the same gestational age as the controls.​Serum CD155 was detected by ELISA in the patients with PE compared to controls.

Results
The percentages of CD4+ and CD8+ T lymphocytes in the peripheral blood of PE patients were not significantly different from those of the controls, whereas the regulatory T cells (Tregs) in PE patients were significantly lower than those in controls (6.43 ± 1.77% vs. 7.48 ± 1.71%, P = 0.0420). The expression of TIGIT and CD226 showed different percentages on CD4+ T cells, CD8+ T cells and Treg cells. However, the difference in the percentages of TIGIT, CD226 on these T cells between the two groups was not statistically significant. The level of CD155 in peripheral serum of PE patients was 6.64 ± 1.79 ng/ml, which was not significantly different from that in the control group 5.61 ± 1.77 ng/ml, P = 0.0505. The present results demonstrate that TIGIT, CD226 and CD155 are not present at altered immune conditions in the peripheral blood of patients with PE, compared with normal pregnant women.

Conclusion
The immune checkpoint molecules TIGIT, CD226 and CD155 are not abnormally expressed in PE patients.
Health-related physical fitness, physical activity and its correlates among school going adolescents in hilly state in north India: a cross sectional survey
Authors: Kumari Ranjeeta , Nath Bhola , Singh Yogesh , Mallick Rupsha 
Published: February 2024

Abstract
Introduction
Health-related physical fitness, which includes body composition, cardiorespiratory fitness, muscular endurance, flexibility, power, and strength are associated with risks of chronic diseases and promote good health and wellness. There have been reports of increasing levels of physical inactivity among children and adolescents, leading to increasing rates of obesity and decreased physical fitness. The present study was conducted among school going adolescents to estimate the levels and correlates of PF for timely intervention.

Methodology
School based cross-sectional study was done among students of class 8-11th in Government schools of Garhwal division of Uttarakhand. Multistage stratified random sampling was applied for recruitment of study participants. We recruited a final sample size of 634 students. Validated questionnaires and standard methods for assessment of physical fitness, physical activity levels and other variables such as waist circumference, hip circumference, BMI and hemoglobin estimation were done.

Results
Average and above average cardiorespiratory fitness score as per Harvard step test among boys (54.3%) was significantly higher as compared to girls (21.3%) (χ2 = 88.93, p < 0.001). There was a significant association between gender and dominant handgrip strength (χ2 = 8.02, p = 0.01) as well as between gender and Shoulder stretch test (SST) of dominant (χ2 = 17.5, p < 0.05) as well as nondominant arm (χ2 = 13.5, p < 0.05). Sit and reach test results also showed a significant association with gender (χ2 = 27.17, p < 0.001). Gender, hemoglobin level, BMI and PAL scores significantly predicted cardiorespiratory fitness scores (R2 = 0.188, F value of the model = 37.69, p =< 0.001)).

Conclusion
Physical fitness of school going adolescents in Garhwal division of Uttarakhand was better than other parts of India, with significant gender differences. Physical activity levels (PAL) were poor and are also a significant predictor of physical fitness. More emphasis needs to be paid on the health and fitness of girl students. School based policies to increase PAL among students through innovation and rewards may go a long way in improving the long-term health of the students.
Reduction by air purifier of particulate concentration during orthodontic procedures: a pilot study
Authors: Martín-Quintero Inmaculada , Cervera-Sabater Alberto , Cortés-Bretón Brinkmann Jorge , Aragoneses-Lamas Juan Manuel , Flores-Fraile Javier , Santos-Marino Juan 
Published: February 2024

Abstract
Background
The SARS-CoV-2 pandemic has raised awareness of the importance of air quality. This pilot study arose from the need to reduce the concentration of particulate matter in the dental office during orthodontic procedures. To evaluate the efficacy of using an air purifier during orthodontic care in the dental office to reduce the concentration of ambient particulate matter.

Results
Significant reductions in particle numbers were obtained for all particle sizes except the largest particles counted (10 μm) through use of the air filter. A marked association between higher humidity levels and higher particle counts was also observed.

Conclusions
Using an air purifier during dental care achieves a significant reduction in the concentration of ambient particles in the dental office. There is a correlation between higher relative humidity and higher particle concentration. The probability of obtaining a maximum particulate concentration level of 0.3 and 0.5 μm is 1000 times lower when using an air purifier.
Mediating effect of suicidal ideation in the association between child abuse and premenstrual syndrome among female adults
Authors: Kfoury Maya , Malaeb Diana , Moubarak Perla , Sakr Fouad , Dabbous Mariam , Hallit Souheil , Fekih-Romdhane Feten , Obeid Sahar 
Published: February 2024

Abstract
Introduction
Premenstrual symptoms encompass a range of physical, emotional, and behavioral changes that cyclically occur before menstruation. Childhood abuse has been associated with subsequent mental health challenges, yet its relationship with exacerbating premenstrual symptoms remains an understudied area. Furthermore, suicidal ideation often emerges from traumatic backgrounds such as child abuse, creating another layer of complexity. Given the rising suicide rates in Lebanon, and the concurrent increase in reported child abuse cases, this research focuses on the role of suicidal ideation as a mediator between child abuse and premenstrual syndrome.

Methods
This cross-sectional study involved 915 female university students in Lebanon. Participants completed an online questionnaire encompassing demographic details, health lifestyle, the Premenstrual Symptoms Screening Tool (PSST), Columbia-Suicide Severity Rating Scale (C-SSRS), and Child Abuse Self Report Scale (CASRS-12). The mediation analysis was conducted using PROCESS MACRO v3.4 model 4; three pathways derived from this analysis: pathway A from the independent variable to the mediator, pathway B from the mediator to the dependent variable, Pathway C indicating the direct effect from the independent to the dependent variable.

Results
The results of the mediation analysis showed that suicidal ideation mediated the association between all types of child abuse and the presence of PMS. Higher psychological (Beta = 0.21; p < 0.001), neglect (Beta = 0.02; p = 0.017), physical (Beta = 0.19; p < 0.001) and sexual (Beta = 0.20, p < 0.001) child abuse were significantly associated with higher suicidal ideation, which was significantly associated with the presence of PMS (Beta = 0.38, p = 0.001; Beta = 0.57, p < 0.001; Beta = 0.45, p < 0.001; and Beta = 0.50, p < 0.001) respectively. Finally, higher psychological (Beta = 0.17, p < 0.001), physical (Beta = 0.11, p = 0.024), but not sexual (Beta = 0.07, p = 0.198) child abuse was directly and significantly associated with the presence of PMS, whereas higher neglect (Beta = -0.06, p = 0.007) was significantly associated lower odds of having PMS.

Conclusion
This study highlights the mediating role of suicidal ideation in the complex association between different types of childhood abuse and premenstrual symptoms. The findings emphasize the need for trauma-informed care and tailored interventions to address the diverse impact of these factors. Recognizing the intricate relationships between child abuse, suicidal ideation, and PMS can aid healthcare providers in comprehensively addressing young women’s mental and reproductive well-being. Trauma-informed care, tailored interventions and awareness of potential connections between childhood maltreatment are essential in managing these complex challenges.
PRIME-nurse practitioner competency model validation and criterion based OSCE rubric interrater reliability
Authors: D’Aoust Rita , Slone Sarah E. , Russell Nancy , Budhathoki Chakra , Ling Catherine 
Published: February 2024

AbstractThe PRIME-NP (Professional-Reporter-Interpreter-Manager-Educator/Evaluation-Nurse Practitioner) Model is adapted from the RIME (Reporter-Interpreter-Manager-Educator) model used in medical education to guide medical student and resident education. The Delphi technique was used to validate the PRIME-NP Model. After two rounds of review by a group of experts in NP curriculum, the model was determined to be valid based on expert consensus. Agreement percent increase from the first round to the second round in all categories. Interrater reliability (IRR) was assessed using interclass correlation after instrument validation was completed for each of the five levels of the PRIME-NP model. Overall, the IRR of the instrument was found to be acceptable with some notable exceptions. No variance was noted in professional behaviors at any level. Variance was increased in management and educator/evaluator behaviors in higher/later course levels. The PRIME-NP Model and PRIME-NP OSCE Rubric is a valid and reliable instrument to assess NP student progression in objective structured clinical examinations. This instrument has the potential for adaptation for use in other types of health sciences education and settings.
The implementation of disaster preparedness training integration model based on Public Health Nursing (ILATGANA-PHN) to increase community capacity in natural disaster-prone areas
Authors: Sofyana Haris , Ibrahim Kusman , Afriandi Irvan , Herawati Erna 
Published: February 2024

AbstractIndonesia is at high risk of disasters. Therefore, nursing is expected to play a role in disaster risk reductions in communities. This study aimed to implement the Disaster Preparedness Training Integration Model based on Public Health Nursing (ILATGANA-PHN) to increase the Capacity of community in natural disaster-prone areas by assessing the preparedness level of families and communities in disaster-prone areas. The research method was developed in two stages, including the model preparation stage and the model implementation stage. This research was in the 2nd stage, namely the model impelementation stage. The research design, at the model implementation stage, used the one-sample pre-post test without control group design. The respondents were assessed before and after the ILATGANA-PHN training intervention. The sample size was calculated using the sample size calculation formula for the experimental research design without controls. The samples of the study were 78 people. The result of the research described the ILATGANA-PHN training concepts, including the instrument, curriculum, process, module, and maintenance patterns for the training process. The intervention had a significant effect on increasing the independent preparedness of the people in Kendeng Community, Sugih Mukti Village (ƿ 0.000 ≤ 0.005) in terms of four preparedness parameters, namely knowledge and attitudes about disasters (KA), disaster preparedness plans (PE), disaster warnings (WS), and resource mobilization community (RMC). Nurses have the opportunity to take responsibilities for empowering the community capacity in the disaster area through the implementation of ILATGANA-PHN training. The integrated training model for disaster preparedness based on Public Health Nursing (ILATGANA-PHN) is effective in increasing the community capacity, especially in disaster managements, in disaster-prone areas.
Prevalence of pressure injury on the medical wards of public general hospitals in Kuwait: a national cross-sectional study
Authors: ALFadhalah Talal , Lari Marjan , Al Salem Gheed , Ali Shaimaa , Al Kharji Hamad , Elamir Hossam 
Published: February 2024

AbstractBackgroundPressure injury is a severe problem that can significantly impact a patient’s health, quality of life, and healthcare expenses. The prevalence of pressure injuries is a widely used clinical indicator of patient safety and quality of care. This study aims to address the research gap that exists on this topic in Kuwait by investigating the prevalence of pressure injuries and preventive measures on the medical wards of the country’s public general hospitals.MethodsA cross-sectional research design was adopted to measure the point prevalence of pressure injuries on 54 medical wards in the public general hospitals. Data, including variables pertaining to hospitals, patients, pressure injuries and preventive practices, were collected using an online form. The data were processed and analysed using Microsoft Excel and SPSS 23 (α level = 0.05). Analysis provided an overview of patient, pressure injury characteristics and preventive measures, and the relationships between the patient and pressure injury characteristics and the prevalence of pressure injuries. A model for predicting the determinants of pressure injury prevalence was constructed from a linear regression analysis.ResultsThe mean national prevalence of pressure injury was 17.6% (95% CI: 11.3–23.8). Purely community-acquired pressure injuries represent the majority of pressure injuries nationally (58.1%). Regarding preventive measures, “pressure injury assessment on admission” has been provided to 65.5% of patients. Correlation analysis revealed that the only statistically significant correlation with the prevalence of hospital-acquired pressure injury was “pressure injury assessment on admission”, which was strongly negative (ρ = −0.857). Therefore, this was the only variable included in the regression analysis as a predictor of pressure injury prevalence (Beta = 0.839). The results showed many statistically significant differences between hospitals with respect to the variables studied.ConclusionsThe national pressure injury prevalence is high compared to the global rate. The higher percentage of purely community-acquired pressure injuries requires particular attention. Many risk factors for the development of pressure injuries are public health concerns, and effective mitigating strategies are needed. Further research is required to assess the knowledge, attitude, and behaviour of nurses with respect to pressure injuries, and to evaluate preventive and management practices.
Co-designing care for multimorbidity: a systematic review
Authors: Sumner Jennifer , Ng Celeste Wen Ting , Teo Kimberly Ee Lin , Peh Adena Li Tyin , Lim Yee Wei 
Published: February 2024

Abstract
Background
The co-design of health care enables patient-centredness by partnering patients, clinicians and other stakeholders together to create services.

Methods
We conducted a systematic review of co-designed health interventions for people living with multimorbidity and assessed (a) their effectiveness in improving health outcomes, (b) the co-design approaches used and (c) barriers and facilitators to the co-design process with people living with multimorbidity. We searched MEDLINE, EMBASE, CINAHL, Scopus and PsycINFO between 2000 and March 2022. Included experimental studies were quality assessed using the Cochrane risk of bias tool (ROB-2 and ROBINS-I).

Results
We screened 14,376 reports, with 13 reports meeting the eligibility criteria. Two reported health and well-being outcomes: one randomised clinical trial (n = 134) and one controlled cohort (n = 1933). Outcome measures included quality of life, self-efficacy, well-being, anxiety, depression, functional status, healthcare utilisation and mortality. Outcomes favouring the co-design interventions compared to control were minimal, with only 4 of 17 outcomes considered beneficial. Co-design approaches included needs assessment/ideation (12 of 13), prototype (11 of 13), pilot testing (5 of 13) (i.e. focus on usability) and health and well-being evaluations (2 of 13). Common challenges to the co-design process include poor stakeholder interest, passive participation, power imbalances and a lack of representativeness in the design group. Enablers include flexibility in approach, smaller group work, advocating for stakeholders’ views and commitment to the process or decisions made.

Conclusions
In this systematic review of co-design health interventions, we found that few projects assessed health and well-being outcomes, and the observed health and well-being benefits were minimal. The intensity and variability in the co-design approaches were substantial, and challenges were evident. Co-design aided the design of novel services and interventions for those with multimorbidity, improving their relevance, usability and acceptability. However, the clinical benefits of co-designed interventions for those with multimorbidity are unclear.
IGFBP3 induces PD-L1 expression to promote glioblastoma immune evasion
Authors: Zhao Leilei , Wang Yudi , Mu Peizheng , Zhang Xuehua , Qi Ruomei , Zhang Yurui , Zhang He , Zhu Xiao , Dong Zhouyan , Dong Yucui 
Published: February 2024

Abstract
Background
Glioblastoma (GBM) characterized by immune escape is the most malignant primary brain tumors, which has strong immunosuppressive effect. Programmed death ligand-1 (PD-L1) is a recognized immunosuppressive member on the surface of tumor cells, and plays a crucial role in immune evasion of tumors. Actually, little is known about the regulation of PD-L1 expression in GBM. Insulin-like growth factor binding protein 3 (IGFBP3) is upregulated in GBM and is related to poor patient prognosis. However, it remains unclear whether IGFBP3 plays a role in the regulation of PD-L1 expression in GBM.

Methods
The role of IGFBP3 in the glioma immune microenvironment was investigated using the CIBERSORT algorithm. The correlation between IGFBP3 and PD-L1 expression was analyzed using TCGA and CGGA databases. QRT-PCR, immunoblotting and RNA-seq were used to examine the regulatory effect of IGFBP3 on PD-L1 expression. Co-culture assay, cell counting kit (CCK-8), qRT-PCR, ELISA and flow cytometry were performed to explore the function of IGFBP3 in inducing immunosuppression. The biological role of IGFBP3 was verified using immunohistochemical, immunofluorescence and mice orthotopic tumor model.

Results
In this study, we analyzed immune cells infiltration in gliomas and found that IGFBP3 may be associated with an immunosuppressive microenvironment. Then, by analyzing TCGA and CGGA databases, our results showed that IGFBP3 and PD-L1 expression were positively correlated in GBM patients, but not in LGG patients. In vitro experiments conducted on different GBM cell lines revealed that the overexpression of IGFBP3 led to an increase in PD-L1 expression, which was reversible upon knockdown IGFBP3. Mechanistically, IGFBP3 activated the JAK2/STAT3 signaling pathway, leading to an increase in PD-L1 expression. Additionally, co-culture experiments results showed IGFBP3 overexpression induced upregulation of PD-L1 expression promoted apoptosis in Jurkat cells, and this effect was blocked by IGFBP3 antibody and PDL-1 inhibitors. Importantly, in vivo experiments targeting IGFBP3 suppressed tumor growth and significantly prolonged the survival of mice.

Conclusions
This research demonstrated IGFBP3 is a novel regulator for PD-L1 expression in GBM, and identified a new mechanism by which IGFBP3 regulates immune evasion through PD-L1, suggesting that IGFBP3 may be a potential novel target for GBM therapy.
The causal relationship between human blood metabolites and the risk of visceral obesity: a mendelian randomization analysis
Authors: Wang Zhaoxiang , Yang Qichao 
Published: February 2024

Abstract
Background
We aimed to explore the causal relationship between blood metabolites and the risk of visceral obesity, as measured by visceral adipose tissue (VAT).

Methods
Summary statistics for 486 blood metabolites and total, as well as sex-stratified, MRI-derived VAT measurements, adjusted for body mass index (BMI) and height, were collected from previous genome-wide association studies (GWAS). A two-sample Mendelian Randomization (MR) design was used. Comprehensive evaluation was further conducted, including sensitivity analysis, linkage disequilibrium score (LDSC) regression, Steiger test, and metabolic pathway analysis.

Results
After multiple testing correction, arachidonate (20:4n6) has been implicated in VAT accumulation (β = 0.35, 95%CI:0.18–0.52, P < 0.001; FDR = 0.025). Additionally, several blood metabolites were identified as potentially having causal relationship (FDR < 0.10). Among them, lysine (β = 0.67, 95%CI: 0.28–1.06, P < 0.001; FDR = 0.074), proline (β = 0.30, 95%CI:0.13–0.48, P < 0.001; FDR = 0.082), valerate (β = 0.50, 95%CI:0.23–0.78, P < 0.001, FDR = 0.091) are associated with an increased risk of VAT accumulation. On the other hand, glycine (β=-0.21, 95%CI: -0.33–0.09), P < 0.001, FDR = 0.076) have a protective effect against VAT accumulation. Most blood metabolites showed consistent trends between different sexes. Multivariable MR analysis demonstrated the effect of genetically predicted arachidonate (20:4n6) and proline on VAT remained after accounting for BMI and glycated hemoglobin (HbA1c). There is no evidence of heterogeneity, pleiotropy, and reverse causality.

Conclusion
Our MR findings suggest that these metabolites may serve as biomarkers, as well as for future mechanistic exploration and drug target selection of visceral obesity.