bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of social support, physical and psychological performance on sleep outcomes in Iranian older adults: a case-control study
Authors: Salehi Zahra , Pasha Hajar , Hosseini Seyed Reza , Kheirkhah Farzan , Bijani Ali 
Published: December 2023

Abstract
Background
Sleep quality is one of the most important factors to improve the quality of life in older adults and physical and mental health plays an essential role in better sleep quality. This study aimed to determine the impact of social support, and physical and psychological performance on sleep outcomes in Iranian older adults.

Methods
In this case-control study, 400 elder people, who were exposed to sleep problems, and 400 people without sleep problems were randomly selected during 2016–2017 in Amirkola, Iran. Subjects in the case and control groups were matched in terms of gender and age. The demographic characteristics, Duke Social Support Questionnaire (DSSI), Physical Activity Scale for the Elderly (PASE), Activity of Daily Living (ADL), Instrumental Activity of Daily Living (IADL), Mini-Mental State Examination (MMSE), and Pittsburgh Sleep Quality Questionnaire (PSQI) questionnaires were used to collect data. T-test, Chi-square, Pearson Correlation coefficient, and multiple Logistic regression were used for data analysis.

Results
The mean score of DSSI and its domains including social interaction (DSSI.Int) and social satisfaction (DSSI.Sat) were 28.15 ± 3.55, 9.31 ± 1.23, and 18.84 ± 2.88 in the case group and 28.87 ± 3.20, 9.48 ± 1.10, and 19.83 ± 2.44 in the control group, respectively. In this study, the mean scores of MMSE, PASE, ADL, and IADL were 25.36 ± 3.95, 101.71 ± 56.99, 13/97 ± 0.37, 20.59 ± 2/79; respectively. There was a significant inverse correlation between poor sleep quality with DSSI score (rho = -0.165, P < 0.0001), DSSI.Int (rho = -0.113, P < 0.001), DSSI.Sat (rho = -0.160, P < 0.0001), PASE (rho=-0.160, P < 0.0001), and IADL (rho = -0.112, P < 0.001) score. Therefore, more social support and physical activity improved the quality of sleep. There was a significant negative relationship between DSSI, and its domains with sleep quality in terms of gender. DSSI (rho = 0.25, P < 0.0001), DSSI.Int (P < 0.0001, rho=-0.18), and DSSI.Sat (P < 0.0001, rho=-0.22) was significant in men but not in women. The results of the adjusted logistic regression revealed a significant association between sleep quality problems and DSSI (p < 0.045, OR = 1.40), the use of hypnotic drugs (p < 0.0001, OR = 7.56), and occupation (p <0.03, OR= 12.66).

Conclusions
The results of the present study suggest that low social support and all its domains, PASE, IADL, and using hypnotic drugs may play a role in the development of sleep problems. It can be used as an effective, safe, and low-cost strategy for promoting sleep quality in older adults.
HIV assisted partner services (aPS) to support integrated HIV and hypertension screening in Kenya: a pre-post intervention study
Authors: Wamuti Beatrice , Sambai Betsy , Magambo Christine , Ndegwa Margaret , Macharia Paul , M.Temu Tecla , Farquhar Carey , Bukusi David 
Published: December 2023

Abstract
Background
People living with HIV (PLWH) have a higher risk of developing hypertension compared to HIV uninfected individuals. HIV assisted partner services (aPS), where PLWH are assisted by a healthcare provider to disclose their status to sexual and / or drug injecting partner(s), offers an opportunity for integrated HIV and hypertension screening. We evaluated the feasibility of the aPS model in supporting integrated HIV and hypertension screening at the Kenyatta National Hospital, Kenya.

Methods
Between August 2019 and December 2020, we conducted a pre-post intervention study. We enrolled women receiving HIV testing services (HTS) with confirmed hypertension (female index clients) and traced their male relatives for HIV and hypertension screening and reviewed management at 3-months. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg, diastolic blood pressure (DBP) ≥ 90 mmHg, and/or use of antihypertensive medication.

Results
One hundred female index clients (median age: 55 years; interquartile range (IQR): 47–65) mentioned 165 male relatives (median: 49 years; IQR: 40–59) of whom 35% (n = 58/165) were enrolled. Of the male relatives, 29% had hypertension (n = 17/58), 34% had pre-hypertension (n = 20/58), and none were HIV-positive (n = 0/58). Among the female index clients, there was a statistically significant decline in SBP (pre: 156 mmHg, post: 133 mmHg, p-value: < 0.0001) and DBP (pre: 97 mmHg, post: 80 mmHg, p-value: < 0.0001), and increase in antihypertensive medication uptake (pre: 91%, n = 84/92; post: 98%, n = 90/92; X2: 4.3931, p-value: 0.036) relative to baseline. Among the male relatives, there was a statistically significant increase in antihypertensive medication uptake among those with hypertension (pre: 13%, n = 6/46; post: 17%, n = 8/46; X2: 32.7750, p-value: < 0.0001) relative to baseline.

Conclusion
HIV aPS holds promise for integrated HIV and hypertension screening among at-risk clients and their families. Twenty-nine percent of the male relatives had hypertension, higher than the national prevalence (24%), while one-third had pre-hypertension. We observed relatively high participant retention, reductions in blood pressure, and increase in antihypertensive medication uptake among those with confirmed hypertension. Future research expanding the aPS model to other non-communicable diseases through larger studies with longer follow-ups is required to better assess causal relationships and optimize integrated service delivery.
Understanding gender differences of people with HIV newly diagnosed or returning to care with advanced HIV disease in Malawi: a qualitative study
Authors: Katirayi Leila , Maphosa Thulani , Chilikutali Lloyd , Chamanga Rachel K , Petersson Josephine , Khatib Sarah , Munthali Boswell , Nyirenda Rose , Matiya Eddie , Nyirenda Laywell , Tiam Appolinaire , Denoeud-Ndam Lise 
Published: December 2023

Abstract
Background
Despite tremendous progress in improving antiretroviral therapy (ART) access, advanced HIV disease (AHD) still remains a challenge globally. Reasons for delayed presentation to care and ART adherence may be affected by gender. We present qualitative study findings on gender differences in decisions for HIV testing and ART initiation/adherence in adults with AHD in Malawi.

Methods
We used a qualitative study design, interviewing 16 men and 16 women aged 18 years and above diagnosed with AHD in sites implementing an optimized package of AHD care, from December 2021-February 2022. We included study participants receiving AHD services for at least two months. We also interviewed 16 lay workers and 16 health care workers supporting people living with AHD. In-depths interviews (IDIs) were conducted in English or Chichewa by trained research assistants using semi-structured interview guides. A short-answer analysis was conducted, and findings were interpreted according to thematic areas.

Results
Both men and women reported stigma as a main barrier influencing their decision to test for HIV and to initiate and adhere to ART. Fear of side effects, insufficient food, and the need for more information were other barriers reported among men and women as well as perceived as barriers by HCWs. Men appear to have tested later for HIV and stated that they were waiting until experiencing significant symptoms before testing. According to clients and HCWs, men were also less inclined to initiate ART after a HIV diagnosis, whereas women were motivated to start treatment to remain healthy and care for the family. Both genders reported that treatment could be delayed if they were feeling healthy. Treatment fatigue was reported among all groups as the main reason to discontinue treatment.

Conclusions
There were similarities and differences between genders in decision-making about HIV care. Concerns about stigma were important reasons for delay in HIV care in both genders. Motivations for accessing HIV treatment and care were different among men and women, pushing the need for gender-tailored counseling services and community messaging that educate both men and women on the benefits of initiating ART early, in turn reducing the number of people presenting with AHD.

Trial registration
NCT05510973, first registration 22/08/2022.
Utility of needle biopsy in centrally located lung cancer for genome analysis: a retrospective cohort study
Authors: Kunimasa Kei , Matsumoto Shingo , Honma Keiichiro , Tamiya Motohiro , Inoue Takako , Kawamura Takahisa , Tanada Satoshi , Miyazaki Akito , Kanzaki Ryu , Maniwa Tomohiro , Okami Jiro , Matsumoto Yuji , Goto Koichi , Nishino Kazumi 
Published: December 2023

Abstract
Background
It is essential to collect a sufficient amount of tumor tissue for successful next-generation sequencing (NGS) analysis. In this study, we investigated the clinical risk factors for avoiding re-biopsy for NGS analysis (re-genome biopsy) in cases where a sufficient amount of tumor tissue could not be collected by bronchoscopy.

Methods
We investigated the association between clinical factors and the risk of re-genome biopsy in patients who underwent transbronchial biopsy (TBB) or endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and required re-genome biopsy in cases enrolled in LC-SCRUM Asia, a prospective nationwide genome screening project in Japan. We also examined whether the frequency of re-genome biopsy decreased between the first and second halves of the enrolment period.

Results
Of the 572 eligible patients, 236 underwent TBB, and 134 underwent EBUS-TBNA. Twenty-four TBBs required re-genome biopsy, and multivariate analysis showed that the risk of re-genome biopsy was significantly increased in lesions where the tumor lesion was centrally located. In these cases, EBUS-TBNA should be utilized even if the lesion is a pulmonary lesion. However, it should be noted that even with EBUS-TBNA, lung field lesions are at a higher risk of re-canalization than mediastinal lymph node lesions. It was also found that even when tumor cells were detected in rapid on-site evaluation, a sufficient amount of tumor tissue was not always collected.

Conclusions
For centrally located pulmonary mass lesions, EBUS-TBNA, rather than TBB, can be used to obtain tumor tissues that can be analyzed by NGS.
Modeling longitudinal oral health status and pneumonia risk: secondary data analyses of an integrated dental-medical cohort
Authors: Berg Richard L. , Glurich Ingrid , Panny Aloksagar , Scannapieco Frank A. , Miecznikowski Jeffrey , VanWormer Jeffrey , Acharya Amit 
Published: December 2023

Abstract
Background
Mounting evidence indicates potential associations between poor oral health status (OHS) and increased pneumonia risk. Relative pneumonia risk was assessed in the context of longitudinally documented OHS.

Methods
Electronic medical/dental patient data captured from 2007 through 2019 were retrieved from the integrated health records of Marshfield Clinic Health Systems. Participant eligibility initiated with an assessment of OHS, stratified into the best, moderate, or worst OHS groups, with the additional criterion of ‘no pneumonia diagnosis in the past 90 days’. Pneumonia incidence was longitudinally monitored for up to 1 year from each qualifying dental visit. Models were assessed, with and without adjustment for prior pneumonia incidence, adjusted for smoking and subjected to confounding mitigation attributable to known pneumonia risk factors by applying propensity score analysis. Time-to-event analysis and proportional hazard modeling were applied to investigate relative pneumonia risk over time among the OHS groups.

Results
Modeling identified associations between any incident pneumonia subtype and ‘number of missing teeth’ (p < 0.001) and ‘clinically assessed periodontal status’ (p < 0.01), which remained significant following adjustment for prior pneumonia incidence and smoking. The hazard ratio (HR) for ‘any incident pneumonia’ in the best OHS group for ‘number of missing teeth’ was 0.65, 95% confidence interval (CI) [0.54 − 0.79] (unadjusted) and 0.744, 95% CI [0.61 − 0.91] (adjusted). The HR for ‘any incident pneumonia’ in the best ‘clinically assessed periodontal status’ group was 0.72, 95% CI [0.58 − 0.90] (unadjusted) and 0.78, 95% CI [0.62 − 0.97] (adjusted).

Conclusion/clinical relevance
Poor OHS increased pneumonia risk. Proactive attention of medical providers to patient OHS and health literacy surrounding oral-systemic disease association is vital, especially in high-risk populations.
Nursing students’ learning flow, self-efficacy and satisfaction in virtual clinical simulation and clinical case seminar
Authors: Choi Hyein , Tak Sunghee H. , Lee Dayeon 
Published: December 2023

Abstract
Background
Virtual clinical simulations and clinical case seminar become widely utilized to address these constraints and help nursing students acquire clinical competencies as the limitations on practicum opportunities have been intensified by the COVID-19 pandemic. The purpose of this study was to examine learning flow, self-efficacy and satisfaction in virtual clinical simulation and clinical case seminar among nursing students.

Methods
A descriptive cross-sectional study was used. Forty-two junior nursing students completed survey questionnaires after participating in computer-based virtual clinical simulation and clinical case seminar, which aimed at acquiring knowledge and care skills in geriatric nursing.

Results
Significant differences in two methods were found in learning flow which included challenge-skill balance (t = -2.24, p < .05) and action-awareness merge (t = -3.32, p < .01). There was no significant difference in learning self-efficacy (t=-1.52, p = .137) and learning satisfaction (t=-0.92, p = .365).

Conclusions
When there’s a mismatch between the perceived challenge and the students’ skill levels, it can hinder the learning process. Therefore, instructors should evaluate the clinical skill levels of their students and make necessary adjustments to the difficulty levels of simulation and clinical case seminar accordingly.
A patient’s perspective on care decisions: a qualitative interview study
Authors: Briedé S. , Brandwijk O. N. , van Charldorp T. C. , Kaasjager H. A. H. 
Published: December 2023

Abstract
Background and Objectives
Discussing treatment wishes and limitations during medical consultations aims to enable patients to define goals and preferences for future care. Patients and physicians, however, face multiple barriers, resulting in postponing or avoiding the conversation. The aim of this study was to explore an internal medicine outpatient clinic population’s perception on (discussing) treatment wishes and limitations.

Methods
Semi-structured interviews were conducted in two rounds with 44 internal medicine outpatient clinic patients at the University Medical Centre Utrecht, a tertiary care teaching medical centre in the Netherlands. Interviews were transcribed verbatim and thematically analysed with a phenomenological approach and inductive, data-driven coding.

Results
Four themes were identified, two (1–2) represent a deep conviction, two (3–4) are practically oriented: (1) patients associate treatment wishes and limitations with the end-of-life, making it sensitive and currently irrelevant, (2) patients assume this process leads to fixed choices, whilst their wishes might be situation dependent, (3) treatment wishes and limitations are about balancing whether a treatment ‘is worth it’, in which several subthemes carry weight, (4) the physician is assigned a key role.

Conclusion and practice implications
The themes provide starting points for future interventions. It should be emphasized that care decisions are a continuous, dynamic process, relevant at any time in any circumstance and the physician should be aware of his/her key role.
Predicting drug response from single-cell expression profiles of tumours
Authors: Pellecchia Simona , Viscido Gaetano , Franchini Melania , Gambardella Gennaro 
Published: December 2023

Abstract
Background
Intra-tumour heterogeneity (ITH) presents a significant obstacle in formulating effective treatment strategies in clinical practice. Single-cell RNA sequencing (scRNA-seq) has evolved as a powerful instrument for probing ITH at the transcriptional level, offering an unparalleled opportunity for therapeutic intervention.

Results
Drug response prediction at the single-cell level is an emerging field of research that aims to improve the efficacy and precision of cancer treatments. Here, we introduce DREEP (Drug Response Estimation from single-cell Expression Profiles), a computational method that leverages publicly available pharmacogenomic screens from GDSC2, CTRP2, and PRISM and functional enrichment analysis to predict single-cell drug sensitivity from transcriptomic data. We validated DREEP extensively in vitro using several independent single-cell datasets with over 200 cancer cell lines and showed its accuracy and robustness. Additionally, we also applied DREEP to molecularly barcoded breast cancer cells and identified drugs that can selectively target specific cell populations.

Conclusions
DREEP provides an in silico framework to prioritize drugs from single-cell transcriptional profiles of tumours and thus helps in designing personalized treatment strategies and accelerating drug repurposing studies. DREEP is available at https://github.com/gambalab/DREEP.
Coronary microvascular function in male physicians with burnout and job stress: an observational study
Authors: von Känel Roland , Princip Mary , Holzgang Sarah A. , Garefa Chrysoula , Rossi Alexia , Benz Dominik C. , Giannopoulos Andreas A. , Kaufmann Philipp A. , Buechel Ronny R. , Zuccarella-Hackl Claudia , Pazhenkottil Aju P. 
Published: December 2023

Abstract
Background
As a professional group, physicians are at increased risk of burnout and job stress, both of which are associated with an increased risk of coronary heart disease that is at least as high as that of other professionals. This study aimed to examine the association of burnout and job stress with coronary microvascular function, a predictor of major adverse cardiovascular events.

Methods
Thirty male physicians with clinical burnout and 30 controls without burnout were included. Burnout was assessed with the Maslach Burnout Inventory and job stress with the effort-reward imbalance and overcommitment questionnaire. All participants underwent myocardial perfusion positron emission tomography to quantify endothelium-dependent (cold pressor test) and endothelium-independent (adenosine challenge) coronary microvascular function. Burnout and job stress were regressed on coronary flow reserve (primary outcome) and two additional measures of coronary microvascular function in the same model while adjusting for age and body mass index.

Results
Burnout and job stress were significantly and independently associated with endothelium-dependent microvascular function. Burnout was positively associated with coronary flow reserve, myocardial blood flow response, and hyperemic myocardial blood flow (r partial = 0.28 to 0.35; p-value = 0.008 to 0.035). Effort-reward ratio (r partial =  − 0.32 to − 0.38; p-value = 0.004 to 0.015) and overcommitment (r partial =  − 0.30 to − 0.37; p-value = 0.005 to 0.022) showed inverse associations with these measures.

Conclusions
In male physicians, burnout and high job stress showed opposite associations with coronary microvascular endothelial function. Longitudinal studies are needed to show potential clinical implications and temporal relationships between work-related variables and coronary microvascular function. Future studies should include burnout and job stress for a more nuanced understanding of their potential role in cardiovascular health.
Identification of differentially expressed genes associated with the pathogenesis of gastric cancer by bioinformatics analysis
Authors: Abdolahi Fatemeh , Shahraki Ali , Sheervalilou Roghayeh , Mortazavi Sedigheh Sadat 
Published: December 2023

Abstract
Aim
Gastric cancer (GC) is one of the most diagnosed cancers worldwide. GC is a heterogeneous disease whose pathogenesis has not been entirely understood. Besides, the GC prognosis for patients remains poor. Hence, finding reliable biomarkers and therapeutic targets for GC patients is urgently needed.

Methods
GSE54129 and GSE26942 datasets were downloaded from Gene Expression Omnibus (GEO) database to detect differentially expressed genes (DEGs). Then, gene set enrichment analyses and protein-protein interactions were investigated. Afterward, ten hub genes were identified from the constructed network of DEGs. Then, the expression of hub genes in GC was validated. Performing survival analysis, the prognostic value of each hub gene in GC samples was investigated. Finally, the databases were used to predict microRNAs that could regulate the hub genes. Eventually, top miRNAs with more interactions with the list of hub genes were introduced.

Results
In total, 203 overlapping DEGs were identified between both datasets. The main enriched KEGG pathway was “Protein digestion and absorption.” The most significant identified GO terms included “primary alcohol metabolic process,” “basal part of cell,” and “extracellular matrix structural constituent conferring tensile strength.” Identified hub modules were COL1A1, COL1A2, TIMP1, SPP1, COL5A2, THBS2, COL4A1, MUC6, CXCL8, and BGN. The overexpression of seven hub genes was associated with overall survival. Moreover, among the list of selected miRNAs, hsa-miR-27a-3, hsa-miR-941, hsa-miR-129-2-3p, and hsa-miR-1-3p, were introduced as top miRNAs targeting more than five hub genes.

Conclusions
The present study identified ten genes associated with GC, which may help discover novel prognostic and diagnostic biomarkers as well as therapeutic targets for GC. Our results may advance the understanding of GC occurrence and progression.