bluuebunny/crossref_metadata_2025_split huggingface dataset:
Afzelin induces immunogenic cell death against lung cancer by targeting NQO2
Authors: Xia Lei , Xu Xiaoqing , Li Meijun , Zhang Xinyue , Cao Fang 
Published: October 2023

Abstract
Background
Lung cancer is one of the most common malignant cancers worldwide. Previous studies have shown that Afzelin, a flavonoid, possesses anticancer activity. The aim of this study was to explore Afzelin’s effect on lung cancer cells and delineate potential anti-cancer mechanism.

Methods
The effect of Afzelin on cell viability, proliferation, and apoptosis of lung cancer cells i.e., A549 and H1299 cells, was studied. The targets for Afzelin in lung cancer were predicted using SwissTargetPrediction, Next, the GO analysis and pathway enrichment were analyzed using String. For in vitro studies, the overexpression plasmid of NQO2, the identified target of Afzelin, was transfected into Afzelin-treated cells to verify the regulatory role of Afzelin on its target and signaling pathway.

Results
In in vitro studies, Afzelin markedly inhibited cell viability, proliferation, and raised apoptotic rate of A549 and H1299 cells. In addition, Afzelin activated endoplasmic reticulum (ER) stress and increased ATP, HMGB1, and CRT levels in lung cancer cells, indicating that Afzelin induced immunogenic cell death (ICD). SwissTargetPrediction identified NQO2 as a target of Afzelin. Further, Afzelin markedly inhibited NQO2 protein expression and in turn, overexpression of NQO2 attenuated the effect of Afzelin on A549 and H1299 cells.

Conclusion
Afzelin inhibits lung cancer progression by targeting NQO2, in turn, activating ER stress and inducing ICD.
UK health researchers’ considerations of the environmental impacts of their data-intensive practices and its relevance to health inequities
Authors: Samuel Gabrielle 
Published: October 2023

AbstractBackgroundThe health sector aims to improve health outcomes and access to healthcare. At the same time, the sector relies on unsustainable environmental practices that are increasingly recognised to be catastrophic threats to human health and health inequities. As such, a moral imperative exists for the sector to address these practices. While strides are currently underway to mitigate the environmental impacts of healthcare, less is known about how health researchers are addressing these issues, if at all.MethodsThis paper uses an interview methodology to explore the attitudes of UK health researchers using data-intensive methodologies about the adverse environmental impacts of their practices, and how they view the importance of these considerations within wider health goals.ResultsInterviews with 26 researchers showed that participants wanted to address the environmental and related health harms associated with their research and they reflected on how they could do so in alignment with their own research goals. However, when tensions emerged, their own research was prioritised. This was related to their own desires as researchers and driven by the broader socio-political context of their research endeavours.ConclusionTo help mitigate the environmental and health harms associated with data-intensive health research, the socio-political context of research culture must be addressed.
Facilitators and barriers of appropriate and timely initiation of intravenous fluids in patients with sepsis in emergency departments: a consensus development Delphi study
Authors: Kabil Gladis , Frost Steven A. , Hatcher Deborah , Shetty Amith , McNally Stephen 
Published: October 2023

Abstract
Background
Sepsis is a life-threatening medical emergency in which appropriate and timely administration of intravenous fluids to patients with features of hypotension is critical to prevent multi-organ failure and subsequent death. However, compliance with recommended fluid administration is reported to be poor. There is a lack of consensus among emergency clinicians on some of the determinant factors influencing fluid administration in sepsis. Thus, the aim of this study was to identify the level of consensus among key stakeholders in emergency departments regarding the facilitators, barriers, and strategies to improve fluid administration.

Methods
The modified Delphi questionnaire with 23 statements exploring barriers, facilitators, and strategies to improve fluid administration was developed from the integration of findings from previous phases of the study involving emergency department clinicians. A two-round modified Delphi survey was conducted among key stakeholders with managerial, educational, supervision and leadership responsibilities using a “Reactive Delphi technique” from March 2023 to June 2023. The statements were rated for importance on a 9-point Likert scale. The RAND/UCLA Appropriateness Method (RAM) was used to identify the level of consensus (agreement/disagreement).

Results
Of the 21 panellists who completed Round 1 survey, 18 (86%) also completed Round 2. The panellists rated 9 out of 10 (90%) barriers, 3 out of 4 (75%) facilitators and all 9 (100%) improvement strategies as important. Out of the total 23 statements, 18 (78%) had agreement among the panellists. Incomplete vital signs at triage (Median = 9, IQR 7.25 to 9.00) as a barrier, awareness of importance of fluid administration in sepsis (Median = 9, IQR 8.00 to 9.00) as facilitator and provision of nurse-initiated intravenous fluids (Median = 9, IQR 8.00 to 9.00) as an improvement strategy were the highest rated statements.

Conclusion
This is the first Delphi study identifying consensus on facilitators, barriers, and strategies to specifically improve intravenous fluid administration in sepsis in Australia. We identified 18 consensus-based factors associated with appropriate and timely administration of intravenous fluids in sepsis. This study offers empirical evidence to support the implementation of the identified strategies to improve patient outcomes.
Postabortion care availability, readiness, and accessibility in Niger in 2022: results from linked facility-female cross-sectional data
Authors: Thomas Haley L. , Alzouma Souleymane , Oumarou Sani , Moreau Caroline , Bell Suzanne O. 
Published: October 2023

Abstract
Background
Postabortion care (PAC), which is an essential element of emergency obstetric care, is underresearched in Niger. The study aims to assess the availability, readiness, and accessibility of facility-based PAC services in Niger.

Methods
This study uses female and facility data from Performance Monitoring for Action Niger. The female data include a nationally representative sample of women aged 15–49 (n = 3,696). Using GPS coordinates, these female data were linked to a sample of public and private facilities (n = 258) that are expected to provide PAC. We assessed PAC availability and facility readiness to provide basic and comprehensive PAC using the signal functions framework, overall and by facility type. We then calculated the distance between women and their closest facility and estimated the proportion of women living within five kilometers (5 km) of a facility providing any PAC, basic PAC, and comprehensive PAC, overall and by women’s background characteristics.

Results
Only 36.4% and 14% of eligible facilities had all basic and comprehensive PAC signal functions, respectively. Oxytocics and laparotomy were the most missing signal function for basic and comprehensive PAC, respectively. Private facilities were the least ready to provide the full range of PAC services. While 47% of women lived within 5 km of a facility providing any PAC services, only 33.4% and 7.9% lived within 5 km of a facility providing all basic and all comprehensive PAC signal functions, respectively. Women who were divorced/widowed, had higher levels of education, and were living in urban areas had increased odds of living within 5 km of a facility with any or basic PAC. Women who were never married had increased odds of living within 5 km of a facility with comprehensive PAC, while urban residence was fully predictive of living within 5 km of a facility with comprehensive PAC.

Conclusions
This study found PAC availability and readiness to be insufficient in Niger, with inadequate and disparate accessibility to facilities providing PAC services. We recommended stakeholders ensure stock of essential commodities and availability of PAC services at primary facilities in order to mitigate the negative maternal health repercussions of unsafe abortion in this setting.
Investigating the quality of hemovigilance process using the first two steps of Six Sigma model: a cross-sectional study
Authors: Molaahmadi-Hassanabadi Fatemeh , Mehrolhassani Mohammad Hossein , Rahimisadegh Rohaneh 
Published: October 2023

Abstract
Background and purpose
Hemovigilance is a set of monitoring methods that covers the blood transfusion chain, from collecting blood and blood products to monitoring the blood recipients. To this end, any error in this process can have serious and irreparable consequences for patients. The present study aimed to investigate the quality of hemovigilance process in Iran, using the first two steps of Six Sigma model.

Methods
This was a quantitative cross-sectional study that was conducted over 6 months (from August 20, 2021, to February 20, 2022) at Afzalipour Hospital in Iran, using the first two steps of Six Sigma model. The study population comprised of all inpatients who needed blood or blood product transfusion in various departments of Afzalipour Hospital, among whom 477 patients were selected via stratified sampling in three shifts (morning, evening, and night). The datasheet was used to record errors in the three shifts. This research was conducted, using the DMAIC cycle’s “define” and “measure” steps.

Results
In the define step, the hemovigilance process at Afzalipour Hospital was divided into two categories of normal process and emergency process. Each of these processes consists of several sub-processes, including “phlebotomy,“ “requesting blood and blood products from the department,“ “preparation of application by the blood bank,“ " sending a request from the blood bank to the blood transfusion center,“ “transfusing blood and blood products,“ and “returning the blood and blood products to the blood bank and waste disposal.“ In the measure step, the quality of hemovigilance process was evaluated based on sub-processes and labels at morning, evening and night shifts. The sub-process of sending a request from the blood bank to the blood transfusion center had the highest error rate with a sigma level of 1.5. Also, the evening and night shifts had a sigma level of 1.875, and the clinical and registration labels had a sigma level of 1.875. The overall sigma level of hemovigilance process was calculated to be 2.

Conclusion
The results of this study showed that the quality of hemovigilance process at Afzalipour Hospital was poor. By employing the first two steps of Six Sigma method, we identified the existing errors in the hemovigilance process of Afzalipour hospital in order to assist hospital managers to take the necessary measures to improve this process.
Genetic polymorphisms of GGT1 gene (rs8135987, rs5751901 and rs2017869) are associated with neoadjuvant chemotherapy efficacy and toxicities in breast cancer patients
Authors: Sun Lu , Wu Ziping , Lin Yanping , Xu Shuguang , Ye Yumei , Yin Wenjin , Zhou Liheng , Lu Jingsong 
Published: October 2023

Abstract
Background
Our previous study illustrated the predictive value of serum gamma-glutamyl transpeptidase (GGT) for neoadjuvant chemotherapy (NAC) sensitivity in breast cancer patients. In this study we aim to determine whether single nucleotide polymorphisms (SNPs) in the gamma-glutamyltransferase 1 (GGT1) gene are related to the NAC response and adverse events and to find out a genetic marker in predicting NAC sensitivity.

Methods
Three SNP loci (rs8135987, rs5751901, rs2017869) of GGT1 gene were selected and tested among breast cancer patients reciving NAC. Four genotype models were used in SNP analysis: co-dominant model compared AA vs. Aa vs. aa; dominant model compared AA vs. Aa + aa; recessive model compared AA + Aa vs. aa; over-dominant model compared AA + aa vs. Aa. Chi-squared test and multivariable logistic regression analysis were performed between SNP genotypes, haplotypes and pathological complete response(pCR), adverse events as well as serum GGT level.

Results
A total of 143 patients were included in the study. For SNP rs8135987 (T > C), the TC genotype in over-dominant model was inversely related with pCR (adjusted OR = 0.30, 95% CI 0.10–0.88, p = 0.029) as well as the risk of peripheral neuropathy (adjusted OR = 0.39, 95% CI 0.15–0.96, p = 0.042). The TC genotype in dominant model was significantly associated with elevated serum GGT level (OR = 3.11, 95% CI 1.07–9.02, p = 0.036). For rs2017869 (G > C), the occurrence of grade 2 or greater neutropenia (OR = 0.39, 95% CI 0.08–0.84, p = 0.025) and leukopenia (OR = 0.24, 95% CI 0.08–0.78, p = 0.017) were both significantly reduced in patients with CC genotypes. For rs5751901(T > C), the CC genotype could significantly reduce the risk of grade 2 or greater neutropenia (OR = 0.29, 95% CI 0.09–0.96, p = 0.036) and leukopenia (OR = 0.27, 95% CI 0.09–0.84, p = 0.024) in recessive model.

Conclusions
The GGT1 gene SNPs might be an independent risk factor for poor response of NAC in breast cancer patients, providng theoretical basis for further precision therapy.
Dual roles of myocardial mitochondrial AKT on diabetic cardiomyopathy and whole body metabolism
Authors: Chen Yu-Han , Ta Albert P. , Chen Yumay , Lee Hsiao-Chen , Fan Wenjun , Chen Phang-Lang , Jordan Maria C. , Roos Kenneth P. , MacGregor Grant R. , Yang Qin , Edwards Robert A. , Li Junfeng , Wang Ping H. 
Published: October 2023

Abstract
Background
The PI3K/AKT pathway transduces the majority of the metabolic actions of insulin. In addition to cytosolic targets, insulin-stimulated phospho-AKT also translocates to mitochondria in the myocardium. Mouse models of diabetes exhibit impaired mitochondrial AKT signaling but the implications of this on cardiac structure and function is unknown. We hypothesized that loss of mitochondrial AKT signaling is a critical step in cardiomyopathy and reduces cardiac oxidative phosphorylation.

Methods
To focus our investigation on the pathophysiological consequences of this mitochondrial signaling pathway, we generated transgenic mouse models of cardiac-specific, mitochondria-targeting, dominant negative AKT1 (CAMDAKT) and constitutively active AKT1 expression (CAMCAKT). Myocardial structure and function were examined using echocardiography, histology, and biochemical assays. We further investigated the underlying effects of mitochondrial AKT1 on mitochondrial structure and function, its interaction with ATP synthase, and explored in vivo metabolism beyond the heart.

Results
Upon induction of dominant negative mitochondrial AKT1, CAMDAKT mice developed cardiac fibrosis accompanied by left ventricular hypertrophy and dysfunction. Cardiac mitochondrial oxidative phosphorylation efficiency and ATP content were reduced, mitochondrial cristae structure was lost, and ATP synthase structure was compromised. Conversely, CAMCAKT mice were protected against development of diabetic cardiomyopathy when challenged with a high calorie diet. Activation of mitochondrial AKT1 protected cardiac function and increased fatty acid uptake in myocardium. In addition, total energy expenditure was increased in CAMCAKT mice, accompanied by reduced adiposity and reduced development of fatty liver.

Conclusion
CAMDAKT mice modeled the effects of impaired mitochondrial signaling which occurs in the diabetic myocardium. Disruption of this pathway is a key step in the development of cardiomyopathy. Activation of mitochondrial AKT1 in CAMCAKT had a protective role against diabetic cardiomyopathy as well as improved metabolism beyond the heart.
“That’s why we’re speaking up today”: exploring barriers to overdose fatality prevention in Indianapolis’ Black community with semi-structured interviews
Authors: Seo Dong-Chul , Satterfield Naomi , Alba-Lopez Leonardo , Lee Shin Hyung , Crabtree Charlotte , Cochran Nicki 
Published: October 2023

Abstract
Background
Opioid overdose deaths are of great concern to public health, with over one million lives lost since 1999. While many efforts have been made to mitigate these, Black communities continue to experience a greater burden of fatalities than their white counterparts. This study aims to explore why by working with Black community members in Indianapolis through semi-structured interviews.

Methods
Semi-structured one-on-one in-depth interviews were conducted in spring and summer of 2023 with Black residents (N = 23) of zip codes 46202, 46205, 46208, and 46218 in Indianapolis. Ten interview questions were used to facilitate conversations about opioid overdoses, recovery, fatality prevention tools such as calling 911 and naloxone, law enforcement, and racism. Data were analyzed using grounded theory and thematic analysis.

Results
Interviews revealed access barriers and intervention opportunities. Racism was present in both. Mental access barriers such as stigma, fear, and mistrust contributed to practical barriers such as knowledge of how to administer naloxone. Racism exacerbated mental barriers by adding the risk of race-based mistreatment to consequences related to association with substance use. Participants discussed the double stigma of substance use and being Black, fear of being searched in law enforcement encounters and what would happen if law enforcement found naloxone on them, and mistrust of law enforcement and institutions that provide medical intervention. Participants had favorable views of interventions that incorporated mutual aid and discussed ideas for future interventions that included this framework.

Conclusions
Racism exacerbates Blacks' mental access barriers (i.e., help-seeking barriers), which, in turn, contribute to practical barriers, such as calling 911 and administering naloxone. Information and resources coming from people within marginalized communities tend to be trusted. Leveraging inter-community relationships may increase engagement in opioid overdose fatality prevention. Interventions and resources directed toward addressing opioid overdose fatalities in Black communities should use mutual aid frameworks to increase the utilization of the tools they provide.
Precise placement of a triple-cavity drainage tube by guide wire exchange method for esophagojejunal anastomotic fistula after gastrectomy
Authors: Cao Yuning , Kong Xiangheng , Yang Daogui , Li Jianjun 
Published: October 2023

AbstractThis is a letter to the editor on a study by Ding et al. on the role of the three-tube method via precise interventional placement for esophagojejunal anastomotic fistula after gastrectomy. They suggest using transnasal insertion of abscess drainage catheter, jejunal decompression tube, and jejunal nutrition tube under fluoroscopy as a simple, minimally invasive, effective, and safe method for treating esophagojejunal anastomotic fistula. Compared to Ding et al.’s method, we presented a new procedure for the esophagojejunal anastomotic fistula. In this procedure, we precisely place a homemade triple-cavity drainage tube by guide wire exchange method near the esophagojejunal anastomotic fistula for continuous irrigation and negative pressure suction, which can provide adequate drainage and result in fistula’s self-healing. This procedure can also be performed at bedside without any anesthesia; therefore, it is a more simple, minimally invasive, effective, and safe treatment for esophagojejunal anastomotic fistula.
Traumatic coccydynia patients benefit from coccygectomy more than patients undergoing coccygectomy for non-traumatic causes
Authors: Kara Deniz , Pulatkan Anil , Ucan Vahdet , Orujov Said , Elmadag Mehmet 
Published: October 2023

Abstract
Purpose
Conservative treatment is the first step in the management of coccydynia. However, surgical treatment is required in cases where conservative treatment fails. The aim of this study was to compare the effect of traumatic and atraumatic etiologies on functional outcomes in patients who underwent coccygectomy for chronic coccydynia.

Methods
Ninety-seven patients who underwent partial coccygectomy between October 2010 and December 2018 for the diagnosis of chronic coccygodynia were evaluated retrospectively. The patients were divided into two groups according to etiologies as atraumatic (group AT) and traumatic (group T). Concomitant disorders of the patients were recorded as psychiatric and musculoskeletal diseases. Visual Analog Scale (VAS) for low back pain, the Oswestry Disability Index (ODI) scale, Short Form-36 Physical Component Summary and Short Form-36 Mental Component Summary were used to evaluate the clinical outcomes pre- and postoperative at the last follow-up.

Results
The mean follow-up time was 67.3 ± 13.9 (range; 44–115) months. Group AT and group T included 48 (mean age 37.1 ± 11.3 and 36 (75%) female) and 49 patients (mean age 36 ± 11 and 35 (71.4%) female), respectively. The groups were statistically similar in terms of age (p = 0.614), gender (p = 0.691), body mass index (p = 0.885), tobacco usage (p = 0.603) and duration of pain (p = 0.073). However, the rate of musculoskeletal and total concomitant disorders was higher in the Group AT than in Group T (p < 0.05). The average preoperative SF-36 MCS and SF-36 PCS scores improved at the last follow-up from 43.3 ± 6.2 and 35.6 ± 4.9 to 72 ± 14.1 and 58.3 ± 10.9, respectively. The preoperative VAS and ODI decreased from 8 ± 1.4 and 39.8 ± 8.5 to 2.6 ± 1.8 and 13.4 ± 8.9 at the last follow-up, respectively.

Conclusion
Successful results were obtained with surgical treatment in chronic coccygodynia. In addition, functional outcomes in patients with traumatic etiology are better than in atraumatic ones.
Levels of evidence Level III; Retrospective Comparative Study.
Comparison of customized vacuum sealing drainage and vacuum sealing drainage in the treatment of diabetic foot ulcers: a retrospective analysis
Authors: Chen Qingling , Lu Minting , Liu Xueyan , Yu Yanmei , Li Jiaying 
Published: October 2023

Abstract
Background
The prevalence of diabetic foot ulcers, a common, more serious chronic diabetes-related complication, is increasing. Vacuum sealing drainage (VSD) constitutes an effective adjunctive treatment for diabetic foot ulcers. Factors, such as poor glycemic control, ischemia, and infection prolong wound healing time, and VSD products are expensive and unaffordable for many patients.

Objective
To compare the use of customized VSD and customized VSD in the treatment of diabetic foot ulcer.

Method
This retrospective study included 83 patients with diabetic foot ulcers in customized VSD (n = 44) and VSD (n = 39) groups. Baseline data, efficacy after 14 days, total treatment efficiency, final outcome (28 days after treatment, healing rate), average treatment cost, and hospitalization (days) of the two groups were compared. Factors affecting wound healing were analyzed.

Results
No significant intergroup differences in the baseline data were detected (VSD vs. customized VAD, p > 0.05). Treatment efficacy was higher in the customized VSD group than in the VSD group after 14 days (p < 0.05), although total treatment efficiency in both groups reached 100%. The final outcome in the customized VSD group was better (vs. VSD group, p < 0.05), and the wound healing rate was higher than in the VSD group (66.7% vs. 33.3%). The mean treatment cost and hospital days were greater in the VSD group (vs. customized VSD group; p < 0.05). Factors affecting wound healing include age, Wagner classification, HDL-C, and fasting C-peptide. Younger age, low Wagner classification grade, low HDL-C level, and high fasting C-peptide contribute to higher healing rate,

Conclusion
Efficacy and final outcome of customized VSD were better than that of VSD; the customized VSD device is simple and convenient to operate, and enables cost-effective treatment.