bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigation on the association between serum lipid levels and periodontitis: a bidirectional Mendelian randomization analysis
Authors: Chen Zhihong , Song Jukun , Tang Liszen 
Published: November 2023

Abstract
Objective
Several research has considered the potential correlation between periodontitis and serum lipids. However, serum lipid profiles correlation with periodontitis remains largely unknown. The investigation objective was to examine periodontitis correlation with serum lipid levels using a bidirectional Mendelian randomization (MR) analysis.

Methods
The study employed a bidirectional MR analysis with two samples, utilizing a freely accessible genome-wide association study (GWAS). Furthermore, the primary analysis employed the inverse variance weighted (IVW) method. To determine whether the lipid profiles were associated with periodontitis, a variety of sensitivity analyses (including MR-Egger regression, MR-PRESSO, and weighted median), as well as multivariable MR, were employed.

Results
MR analysis performed by IVW did not reveal any relationship between periodontitis and low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), or total cholesterol (TC). It was also found that LDL, HDL, TG, and TC were not associated to periodontitis. Furthermore, the MR estimations exhibited consistency with other MR sensitivity and multivariate MR (MVMR) analyses. These results show that the correlation between serum lipid levels and periodontitis could not be established.

Conclusion
The finding indicates a negligible link between periodontitis and serum lipid levels were identified, despite previous observational studies reporting a link between periodontitis and serum lipid levels.
Translation and cultural adaptation of the Greek integrated palliative care outcome scale (IPOS): challenges in a six-phase process
Authors: Anagnostou Despina , Katsaragakis Stylianos , Panagiotou Irene , Patiraki Elisabeth , Tserkezoglou Aliki 
Published: November 2023

Abstract
Aim
To translate and culturally adapt IPOS to the Greek population.

Methods
A four phases- sequential study, which included verification of conceptual equivalence, double forward- backward translations and conceptual cognitive debriefing. Focus group interviews used ‘think aloud’ and ‘verbal probing’ techniques. Interviews were audio-recorded, transcribed verbatim and thematically analyzed using predefined categories. Purposely sampled from two oncology and palliative care units in Athens.

Results
The Integrated Palliative Care Outcome Scale was well accepted by both patients and health professionals. Overall comprehension and acceptability of the scale were good. The comprehension and judgement challenges identified in the pre-final version were successfully resolved in the cognitive interviewing phase. Five out of the seventeen translated items of the scale were modified after cognitive debriefing. Comprehension difficulties were identified with specific terms (e.g., energy/feeling depressed) and with some answer options. Severity of symptoms and not their impact was a common difficulty. A judgement challenge was reported in relation to 7-days recall and fluctuation of symptoms. Layout concerns in relation to length of questions were also stated. All questions were considered important and none as inappropriate.

Conclusion
This study demonstrated face and content validity and acceptability of the Integrated Palliative Care Outcome Scale in the Greek context. Cognitive Interviewing proved valuable in refining concepts within the specific cultural context.

Clinical implications
The IPOS outcome measure tool is now being used routinely in a palliative care service in Athens and is currently used to evaluate service outcomes.
Neurophobia among medical students and resident trainees in a tertiary comprehensive hospital in China
Authors: Han Fei , Zhang Yao , Wang Ping , Wu Dong , Zhou Li-Xin , Ni Jun 
Published: November 2023

Abstracts
Background
Medical students and residents have been revealed to have extraordinary difficulties in managing patients with neurological complaints. However, specific information on Chinese trainees is scarce. Herein, we aimed to uncover the presence of, contributing factors for, and potential solutions to neurophobia among medical students and resident trainees in China.

Methods
Questionnaires were administered to the medical students of Peking Union Medical College and residents of the Internal Medicine Residency Training Program at Peking Union Medical College Hospital. We asked about perceived difficulty, knowledge, interest, and confidence in neurology in contrast to six other specialties. The reasons why neurology is regarded as difficult and approaches for improving neurological teaching have been appraised.

Results
A total of 351 surveys were completed by 218 medical students and 133 residents. The response rate exceeded 70% in both groups. The prevalence of neurophobia was 66.1% and 58.6% among medical students and residents, respectively. Respondents declared that greater difficulty was observed in neurology than in other specialties, and the management of patients with neurological problems was the least comfortable (p < 0.0001). Neurophobia has various perceived causes, and neuroanatomy is regarded as the most important contributor. Nearly 80% of medical students felt that improvements in neurology teaching could be achieved through further integration of preclinical and clinical neurological teaching.

Conclusions
The findings of the first survey on neurophobia in China are in accordance with those of previous studies. Neurophobia is highly prevalent in Chinese medical students and residents. Strategies to improve teaching, including enhanced integration of teaching and more online resources, are needed to prevent neurophobia.
Knowledge and practices of private pharmacy auxiliaries on malaria in Abidjan, Côte d’Ivoire
Authors: Bedia-Tanoh Valérie A. , Angora Étienne K. , Miezan Sebastien A. J. , Koné-Bravo Estelle D. M. , Konaté-Touré Abibatou , Bosson-Vanga Henriette , Kassi Fulgence K. , Kiki-Barro Pulchérie C. M. , Djohan Vincent , Menan Hervé E. I. , Yavo William 
Published: November 2023

Abstract
Background
The emergence of resistance to artemisinin derivatives in Southeast Asia constitutes a serious threat for other malaria endemic areas, particularly in Côte d’Ivoire. To delay this resistance, the application of the control measures recommended by the National Malaria Control Programme (NMCP) for a correct management, in the private pharmacies, is a necessity. The purpose of this study was, therefore, to assess the level of knowledge and practices of private pharmacy auxiliary in Abidjan about the management of malaria.

Methods
A descriptive cross-sectional study was conducted from April to November 2015. It included auxiliaries of private pharmacies in Abidjan. Data collection material was a structured an open pretested questionnaire. Data analysis was carried out using Package for Social Science (SPSS) software version 21.1. Chi square test was used to compare proportions for a significance threshold of 0.05 for the p value.

Results
A total, 447 auxiliaries from 163 private pharmacies were interviewed. It was noted that the auxiliaries had a good knowledge of clinical signs of uncomplicated malaria (99.1%), biological examinations (54.6% for the thick film and 40.7% for rapid diagnostic tests (RDTs) and anti-malarial drugs (99.3% for artemether + lumefantrine, AL). The strategies of vector control (long-lasting insecticide-treated mosquito nets (LLITNs, Repellent ointments, cleaning gutters, elimination of larvae breeding site and intermittent preventive treatment with sulfadoxine–pyrimethamine (IPTp-SP) in pregnant women were also known by the auxiliaries, respectively 99.8% and 77.4%. However, the malaria pathogen (25.1%) and the NMCP recommendations (e.g. use of AL or AS + AQ as first-line treatment for uncomplicated malaria and IPTp-SP in pregnant women) were not well known by the auxiliaries (28.2% and 26.9% for uncomplicated and severe malaria). Concerning the practices of the auxiliaries, 91.1% offered anti-malarial drugs to patients without a prescription and 47.3% mentioned incorrect dosages. The combination artemether + lumefantrine was the most recommended (91.3%). The delivery of anti-malarial drugs was rarely accompanied by advice on malaria prevention, neither was it carried out on the result of an RDT.

Conclusion
The epidemiology and the NMCP recommendations for the diagnostic and therapeutic management of malaria, are not well known to auxiliaries, which may have implications for their practices. These results show the need to sensitize and train private pharmacy auxiliaries, and also to involve them in NMCP activities.
Recent advancements in nanomaterial-laden contact lenses for diagnosis and treatment of glaucoma, review and update
Authors: Baghban Roghayyeh , Talebnejad Mohammad Reza , Meshksar Aidin , Heydari Mojtaba , Khalili Mohammad Reza 
Published: November 2023

AbstractDespite the existence of numerous eye drops in the market, most of them are not sufficiently effective because of quick clearance and the barriers within the eye. To increase the delivery of the drugs to the eye, various new formulations have been explored in recent decades. These formulations aim to enhance drug retention and penetration, while enabling sustained drug release over extended periods. One such innovative approach is the utilization of contact lenses, which were originally designed for cosmetic purposes and vision correction. Contact lenses have appeared as a promising formulation for ocular drug delivery, as they can increase the bioavailability of drugs in the eye and diminish unwanted side effects. They are specifically appropriate for treating chronic eye conditions, making them an area of interest for researchers in the field of ophthalmology. This review outlines the promising potential of nanomaterial-laden contact lenses for diagnosis and treatment of glaucoma. It classifies therapeutic approaches based on nanomaterial type, summarizes diagnostic advances, discusses improvement of contact lenses properties, covers marketing perspectives, and acknowledges the challenges of these innovative contact lenses for glaucoma management.
Injectable hydrogel loaded with lysed OK-432 and doxorubicin for residual liver cancer after incomplete radiofrequency ablation
Authors: Cao Yanyan , Sun Tao , Sun Bo , Zhang Guilin , Liu Jiayun , Liang Bin , Zheng Chuansheng , Kan Xuefeng 
Published: November 2023

Abstract
Objective
To investigate the efficacy of an injectable hydrogel loaded with lysed OK-432 (lyOK-432) and doxorubicin (DOX) for residual liver cancer after incomplete radiofrequency ablation (iRFA) of hepatocellular carcinoma (HCC), and explore the underlying mechanism.

Materials and Methods
The effect of OK-432 and lyOK-432 was compared in activating dendritic cells (DCs). RADA16-I (R) peptide was dissolved in a mixture of lyOK-432 (O) and DOX (D) to develop an ROD hydrogel. The characteristics of ROD hydrogel were evaluated. Tumor response and mice survival were measured after different treatments. The number of immune cells and cytokine levels were measured, and the activation of cGAS/STING/IFN-I signaling pathway in DC was evaluated both in vitro and in vivo.

Results
LyOK-432 was more effective than OK-432 in promoting DC maturation and activating the IFN-I pathway. ROD was an injectable hydrogel for effectively loading lyOK-432 and DOX, and presented the controlled-release property. ROD treatment achieved the highest tumor necrosis rate (p < 0.001) and the longest survival time (p < 0.001) compared with the other therapies. The ROD group also displayed the highest percentages of DCs, CD4+ T cells and CD8+ T cells (p < 0.001), the lowest level of Treg cells (p < 0.001), and the highest expression levels of IFN-γ and TNF-α (p < 0.001) compared with the other groups. The expression levels of pSTING, pIRF3, and IFN-β in DCs were obviously higher after treatment of lyOK-432 in combination with DOX than the other therapies. The surviving mice in the ROD group showed a growth inhibition of rechallenged subcutaneous tumor.

Conclusion
The novel ROD peptide hydrogel induced an antitumor immunity by activating the STING pathway, which was effective for treating residual liver cancer after iRFA of HCC.
Implementing harm reduction kits in an office-based addiction treatment program
Authors: Shang Margaret , Thiel Brent , Liebschutz Jane M. , Kraemer Kevin L. , Freund Ariana , Jawa Raagini 
Published: November 2023

Abstract
Background
The rising rates of drug use-related complications call for a paradigm shift in the care for people who use drugs. While addiction treatment and harm reduction have historically been siloed in the US, co-location of these services in office-based addiction treatment (OBAT) settings offers a more realistic and patient-centered approach. We describe a quality improvement program on integrating harm reduction kits into an urban OBAT clinic.

Methods
After engaging appropriate stakeholders and delivering clinician and staff trainings on safer use best practices, we developed a clinical workflow for universal offering and distribution of pre-packaged kits coupled with patient-facing educational handouts. We assessed: (1) kit uptake with kit number and types distributed; and (2) implementation outcomes of feasibility, acceptability, appropriateness, and patient perceptions.

Results
One-month post-implementation, 28% (40/141) of completed in-person visits had at least one kit request, and a total of 121 kits were distributed. Staff and clinicians found the program to be highly feasible, acceptable, and appropriate, and patient perceptions were positive.

Conclusions
Incorporating kits in OBAT settings is an important step toward increasing patient access and utilization of life-saving services. Our program uncovered a significant unmet need among our patients, suggesting that kit integration within addiction treatment can improve the standard of care for people who use drugs.
Connections between health research systems and decision-making spaces: lessons from the COVID-19 pandemic in the province of Québec, Canada
Authors: Smits Pernelle , Cambourieu Caroline , Ouimet Mathieu 
Published: November 2023

AbstractThe coronavirus 2019 (COVID-19) pandemic allowed for exceptional decision-making power to be placed in the hands of public health departments. Data and information were widely disseminated in the media and on websites. While the improvement of pandemic management is still a learning curve, the ecosystem perspective – that is, the interconnection of academic health research systems and decision-making spaces – has received little attention. In this commentary, we look at the mechanisms in place, or not, in Canada for ensuring decision-making spheres can “speak” to academic research systems. We look at the thick walls that are still in place between health research systems and decision-making spaces. More precisely, we discuss three organizational flaws that we identified in the evidence-informed decision-making ecosystem of Québec and, more broadly, Canada. We introduce some inspiring measures that other countries have implemented to better link evidence and public health decision-making during health crises. The observed flaws and options are related to the vitality of early information sharing relays, the cross-sectional capacity to issue opinions, and the collection and integration of hard and soft data.
Estimating the cost-effectiveness threshold of advanced non-small cell lung cancer in China using mean opportunity cost and contingent valuation method
Authors: Peng Qian , Yin Yue , Liang Min , Zhao Mingye , Shao Taihang , Tang Yaqian , Mei Zhiqing , Li Hao , Tang Wenxi 
Published: November 2023

Abstract
Objectives
Monetizing health has sparked controversy and has implications for pricing strategies of emerging health technologies. Medical insurance payers typically set up thresholds for quality-adjusted life years (QALY) gains based on health productivity and budget affordability, but they rarely consider patient willingness-to-pay (WTP). Our study aims to compare Chinese payer threshold and patient WTP toward QALY gain of advanced non-small cell lung cancer (NSCLC) and to inform a potential inclusion of patient WTP under more complex decision-making scenarios.

Methods
A regression model was constructed with cost as the independent variable and QALY as the dependent variable, where the regression coefficients reflect mean opportunity cost, and by transforming these coefficients, the payer threshold can be obtained. Patient WTP was elicited through a contingent valuation method survey. The robustness of the findings was examined through sensitivity analyses of model parameters and patient heterogeneity.

Results
The payer mean threshold in the base-case was estimated at 150,962 yuan (1.86 times per capita GDP, 95% CI 144,041–159,204). The two scenarios analysis generated by different utility inputs yielded thresholds of 112,324 yuan (1.39 times per capita GDP) and 111,824 yuan (1.38 times per capita GDP), respectively. The survey included 85 patients, with a mean WTP of 148,443 yuan (1.83 times per capita GDP, 95% CI 120,994–175,893) and median value was 106,667 yuan (1.32 times the GDP per capita). Due to the substantial degree of dispersion, the median was more representative. The payer threshold was found to have a high probability (98.5%) of falling within the range of 1–2 times per capita GDP, while the robustness of patient WTP was relatively weak.

Conclusions
In China, a country with a copayment system, payer threshold was higher than patient WTP, indicating that medical insurance holds significant decision-making authority, thus temporarily negating the need to consider patient WTP.
Deciphering the molecular and cellular atlas of immune cells in septic patients with different bacterial infections
Authors: Sun Ping , Cui Mintian , Jing Jiongjie , Kong Fanyu , Wang Shixi , Tang Lunxian , Leng Junling , Chen Kun 
Published: November 2023

Abstract
Background
Sepsis is a life-threatening organ dysfunction caused by abnormal immune responses to various, predominantly bacterial, infections. Different bacterial infections lead to substantial variation in disease manifestation and therapeutic strategies. However, the underlying cellular heterogeneity and mechanisms involved remain poorly understood.

Methods
Multiple bulk transcriptome datasets from septic patients with 12 types of bacterial infections were integrated to identify signature genes for each infection. Signature genes were mapped onto an integrated large single-cell RNA (scRNA) dataset from septic patients, to identify subsets of cells associated with different sepsis types, and multiple omics datasets were combined to reveal the underlying molecular mechanisms. In addition, an scRNA dataset and spatial transcriptome data were used to identify signaling pathways in sepsis-related cells. Finally, molecular screening, optimization, and de novo design were conducted to identify potential targeted drugs and compounds.

Results
We elucidated the cellular heterogeneity among septic patients with different bacterial infections. In Escherichia coli (E. coli) sepsis, 19 signature genes involved in epigenetic regulation and metabolism were identified, of which DRAM1 was demonstrated to promote autophagy and glycolysis in response to E. coli infection. DRAM1 upregulation was confirmed in an independent sepsis cohort. Further, we showed that DRAM1 could maintain survival of a pro-inflammatory monocyte subset, C10_ULK1, which induces systemic inflammation by interacting with other cell subsets via resistin and integrin signaling pathways in blood and kidney tissue, respectively. Finally, retapamulin was identified and optimized as a potential drug for treatment of E. coli sepsis targeting the signature gene, DRAM1, and inhibiting E. coli protein synthesis. Several other targeted drugs were also identified in other types of sepsis, including nystatin targeting C1QA in Neisseria sepsis and dalfopristin targeting CTSD in Streptococcus viridans sepsis.

Conclusion
Our study provides a comprehensive overview of the cellular heterogeneity and underlying mechanisms in septic patients with various bacterial infections, providing insights to inform development of stratified targeted therapies for sepsis.
Exploring the efficacy and beneficial population of preimplantation genetic testing for aneuploidy start from the oocyte retrieval cycle: a real-world study
Authors: Ma Shujuan , Liao Jingnan , Zhang Shuoping , Yang Xiaoyi , Hocher Berthold , Tan Jing , Tan Yueqiu , Hu Liang , Gong Fei , Xie Pingyuan , Lin Ge 
Published: November 2023

Abstract
Background
Preimplantation genetic testing for aneuploidy (PGT-A) is widely used as an embryo selection technique in in vitro fertilization (IVF), but its effectiveness and potential beneficiary populations are unclear.

Methods
This retrospective cohort study included patients who underwent their first oocyte retrieval cycles at CITIC-Xiangya between January 2016 and November 2019, and the associated fresh and thawed embryo transfer cycles up to November 30, 2020. PGT-A (PGT-A group) and intracytoplasmic sperm injection (ICSI)/IVF (non-PGT-A group) cycles were included. The numbers of oocytes and embryos obtained were unrestricted. In total, 60,580 patients were enrolled, and baseline data were matched between groups using 1:3 propensity score matching. Sensitivity analyses, including propensity score stratification and traditional multivariate logistic regression, were performed on the original unmatched cohort to check the robustness of the overall results. Analyses were stratified by age, body mass index, ovarian reserve/responsiveness, and potential indications to explore benefits in subgroups. The primary outcome was cumulative live birth rate (CLBR). The other outcomes included live birth rate (LBR), pregnancy loss rate, clinical pregnancy rate, pregnancy complications, low birth weight rate, and neonatal malformation rate.

Results
In total, 4195 PGT-A users were matched with 10,140 non-PGT-A users. A significant reduction in CLBR was observed in women using PGT-A (27.5% vs. 31.1%; odds ratio (OR) = 0.84, 95% confidence interval (CI) 0.78–0.91; P < 0.001). However, women using PGT-A had higher first-transfer pregnancy (63.9% vs. 46.9%; OR = 2.01, 95% CI 1.81–2.23; P < 0.001) and LBR (52.6% vs. 34.2%, OR = 2.13, 95% CI 1.92–2.36; P < 0.001) rates and lower rates of early miscarriage (12.8% vs. 20.2%; OR = 0.58, 95% CI 0.48–0.70; P < 0.001), preterm birth (8.6% vs 17.3%; P < 0.001), and low birth weight (4.9% vs. 19.3%; P < 0.001). Moreover, subgroup analyses revealed that women aged ≥ 38 years, diagnosed with recurrent pregnancy loss or intrauterine adhesions benefited from PGT-A, with a significant increase in first-transfer LBR without a decrease in CLBR.

Conclusion
PGT-A does not increase and decrease CLBR per oocyte retrieval cycle; nonetheless, it is effective in infertile populations with specific indications. PGT-A reduces complications associated with multiple gestations.