bluuebunny/crossref_metadata_2025_split huggingface dataset:
Similar proteome expression profiles of the aggregated lymphoid nodules area and Peyer’s patches in Bactrian camel
Authors: Cheng Yujiao , Ren Yan , Wang Wenhui , Zhang Wangdong 
Published: October 2023

Abstract
Background
The presence of Aggregated Lymphoid Nodules Area (ALNA) is a notable anatomical characteristic observed in the abomasum of Bactrian camels. This area is comprised of two separate regions, namely the Reticular Mucosal Folds Region (RMFR) and the Longitudinal Mucosal Folds Region (LMFR). The histological properties of ALNA exhibit significant similarities to those of Peyer’s patches (PPs) found in the gastrointestinal system. The functional characteristics of ALNA were examined in relation to mucosal immunity in the gastrointestinal system.

Results
We used iTRAQ-based proteomic analysis on twelve Bactrian camels to measure the amount of proteins expressed in ALNA. In the experiment, we sampled the RMFR and LMFR separately from the ALNA and compared their proteomic quantification results with samples from the PPs. A total of 1253 proteins were identified, among which 39 differentially expressed proteins (DEPs) were found between RMFR and PPs, 33 DEPs were found between LMFR and PPs, and 22 DEPs were found between LMFR and RMFR. The proteins FLNA, MYH11, and HSPB1 were chosen for validation using the enzyme-linked immunosorbent assay (ELISA), and the observed expression profiles were found to be in agreement with the results obtained from the iTRAQ study. The InnateDB database was utilized to get data pertaining to immune-associated proteins in ALNA. It was observed that a significant proportion, specifically 76.6%, of these proteins were found to be associated with the same orthogroups as human immune-related genes. These proteins are acknowledged to be associated with a diverse range of functions, encompassing the uptake, processing and presentation of antigens, activation of lymphocytes, the signaling pathways of T-cell and B-cell receptors, and the control of actin polymerization.

Conclusions
The experimental results suggest that there are parallels in the immune-related proteins found in ALNA and PPs. Although there are variations in the structures of LMFR and RMFR, the proteins produced in both structures exhibit a high degree of similarity and perform comparable functions in the context of mucosal immune responses.
COVID-19 risks in private equity nursing homes in Hesse, Germany – a retrospective cohort study
Authors: Evers Janis , Geraedts Max 
Published: October 2023

Abstract
Background
Private-equity-owned nursing homes (PENH) represent the strongest form of profit orientation in the nursing care market. Private equity firms aim to increase the profitability of nursing care facilities, which often leads to cost-cutting measures and the use of less qualified staff. Our study aims to fill the existing knowledge gap by examining the association between private equity ownership and COVID-19 related infections and deaths among residents and staff during the COVID-19 pandemic.

Methods
We analyzed outbreak and mortality data for the period from 20/03/2020 to 05/01/2022 from 32 long-term care facilities in the Federal State of Hesse, Germany, which included 16 PENH that were propensity score matched on regional population density and number of beds with 16 non-PENH. We used logistic regression to determine the odds ratios (OR) for above-median values for the independent variables of PENH-status, number of beds, proportion of single rooms, registered nurses' ratio, and copayments.

Results
PENH had substantially fewer outbreaks in number, but longer and larger outbreaks among nursing home residents, as well as a markedly increased proportion of deceased residents. The odds of the outcome "infections & deaths" were 5.38 (p <. 05) times higher among PENH compared to non-PENH.

Conclusions
The study indicates a need for further research into the quality of care in PENH to inform evidence-based policy decisions, given the higher infection and death rates. Improved documentation and public visibility of PENH is also recommended, in line with existing practices for for-profit and non-profit nursing homes in Germany. Given our findings, regulatory bodies should closely observe PENH operational practices.
The associations of gestational weight gain and midpregnancy lipid levels with placental size and placental-to-birth weight ratio: findings from a chinese birth cohort study
Authors: Zhang Kangdi , Jia Xiaomin , Yu Wenjie , Cheng Xin , Li Yingqing , Wang Xinqiang , Wang Jie , Li Zhenhua , Mao Yicheng , Zhao Jiawen , Li Tao , Chen Maolin , Gao Guopeng , Hu Chengyang , Yan Shuangqin , Zhang Xiujun 
Published: October 2023

Abstract
Background
The placenta serves as the sole maternal organ responsible for transmitting nutrients to the fetus, playing a crucial role in supporting standard fetal growth and development. To date, only a small number of studies have investigated the impact of maternal gestational weight gain and lipid concentrations on placental development. This study aimed to explore the influence of weight gain during pregnancy and lipid levels in the second trimester on placental weight, volume, and the placental weight ratio.

Methods
This birth cohort study encompassed 1,358 mother-child pairs. Placental data for each participant was gathered immediately post-delivery, and the study incorporated data on gestational weight gain throughout pregnancy and lipid profiles from the mid-trimester. A linear regression model was employed to assess the correlations between gestational weight gain, mid-trimester lipid levels, and metrics such as placental weight, placental volume, and the placental-to-birth weight ratio (PFR).

Results
In the study groups of pre-pregnancy underweight, normal weight, and overweight, the placental weight increased by 4.93 g (95% CI: 1.04–8.81), 2.52 g (95% CI: 1.04–3.99), and 3.30 g (95% CI: 0.38–6.22) per 1 kg of gestational weight gain, respectively. Within the pre-pregnancy underweight and normal weight groups, the placental volume increased by 6.79 cm^3 (95% CI: 3.43–10.15) and 2.85 cm^3 (95% CI: 1.31–4.39) per 1 kg of gestational weight gain, respectively. Additionally, placental weight exhibited a positive correlation with triglyceride (TG) levels (β = 9.81, 95% CI: 3.28–16.34) and a negative correlation with high-density lipoprotein (HDL-C) levels (β = − 46.30, 95% CI: − 69.49 to − 23.11). Placental volume also showed a positive association with TG levels (β = 14.54, 95% CI: 7.69–21.39). Conversely, PFR demonstrated a negative correlation with increasing HDL-C levels (β = − 0.89, 95% CI: − 1.50 to − 0.27).

Conclusions
Gestational weight gain was significantly correlated with both placental weight and volume. This association was especially pronounced in women who, prior to pregnancy, were underweight or of normal weight. Additionally, TG and HDL-C levels during the mid-trimester were linked to placental development.
Association between disease activity of rheumatoid arthritis and maternal and fetal outcomes in pregnant women: a systematic review and meta-analysis
Authors: Lv Jiamin , Xu Li , Mao Shuhui 
Published: October 2023

Abstract
Background
A meta-analysis has compared the pregnancy outcomes between women with and without RA, while the effect of disease severity on pregnancy outcomes within women with RA has not been explored. Therefore, we performed a systematic review and meta-analysis to assess the association between disease activity of RA and pregnancy outcomes.

Methods
Four English databases (Pubmed, Embase, Cochrane Library, and Web of Science) and three Chinese databases (China National Knowledge Infrastructure [CNKI], VIP, and Wan Fang) was searched for eligible studies up to August 13, 2023. Cochran’s Q test and the I2 statistic were used to assess the heterogeneity of the included studies. The odds ratio (OR) (for counting data) and weighted mean difference (WMD) (for measurement data) were calculated with 95% confidence intervals (95%CIs) using random-effect model (I2 ≥ 50%) or fixed-effect model (I2 < 50%). Subgroup analysis based on study design and regions was used to explore the sources of heterogeneity. Sensitivity analysis was performed for all outcomes and the publication bias was assessed using Begg’s test.

Results
A total of 41 eligible articles were finally included. RA women had higher odds to suffer from preeclampsia, gestational diabetes, spontaneous abortion, and cesarean delivery (all P < 0.05). The infants born from RA mother showed the higher risk of stillbirth, SGA, LBW, congenital abnormalities, diabetes type 1, and asthma (all P < 0.05). The high disease activity of RA was significantly associated with the higher risk of cesarean delivery (OR: 2.29, 95%CI: 1.02–5.15) and premature delivery (OR: 5.61, 95%CI: 2.20–14.30).

Conclusions
High disease activity of RA was associated with the high risk of adverse pregnancy outcomes, suggesting that it was important to control disease for RA women with high disease activity who prepared for pregnancy.
Role of multi-strain probiotics in preventing severity and frequency of recurrent respiratory tract infections in children
Authors: Khan Laghari Imran , Nawaz Tahira , Mustafa Sultan , Jamali Abid Ali , Fatima Sanober 
Published: October 2023

Abstract
Background
Respiratory tract infections are among the most common infections in the pediatric population throughout the globe. Globally around 20% of all deaths in children below 5 years of age are secondary to acute respiratory infections, mostly pneumonia. Probiotics are live microorganisms that when administered in adequate amounts confer a health benefit on the host. Their mechanism in preventing respiratory tract infections is not known but it is thought that probiotics act by modulating the immune system. This study was conducted to find out whether using probiotics is effective in decreasing the severity and frequency of recurrent respiratory tract infections or not.

Methods
A Quasi-experimental study was conducted at the Pediatric Medicine Department of Abbassi Shaheed Hospital Karachi during 2021–2022. The study was approved by the institutional ethical review committee i.e. advanced studies and research board (ASRB). The sampling technique was non-probability consecutive sampling and the sample size was 70 patients with recurrent respiratory tract infections, aged six months to 12 years of age. All enrolled children were given probiotics containing Bifidobacterium, Lactobacillus Acidophilus for two weeks. Data were analyzed by using SPSS version 22. A p-value of < 0.05 was considered statistically significant.

Results
Out of 70 children with recurrent respiratory tract infections, 39 (55.71%) were male and 31 (44.29%) female. Around 75% of the children were below five years of age. The most common presenting complaint was fever (72.86%), followed by cough (68.57%), wheezes (45.71%) and nasal discharge/sneezing (32.86%), respectively. The most common RRTI was infectious rhinitis (30% of the cases), otitis media (24%) and pharyngitis/tonsillitis (21%). After giving probiotics for two weeks most significant decrease was found in recurrent infectious rhinitis (p-value 0.02), recurrent otitis media (p-value 0.03) and recurrent bronchiolitis (p-value 0.05) over the next six months.

Conclusion
The results of our study indicate that the administration of probiotics reduces recurrent respiratory tract infections among children. This six months trial has demonstrated that there was a significant decline in respiratory symptoms among study participants. This study also observed a significant decrease in respiratory diseases during the follow-up.
Lifestyle risk factors of self-reported fibromyalgia in the Norwegian Women and Cancer (NOWAC) study
Authors: Benebo Faith Owunari , Lukic Marko , Jakobsen Monika Dybdahl , Braaten Tonje Bjørndal 
Published: October 2023

Abstract
Background
While the aetiology of fibromyalgia syndrome (FM) remains unknown, lifestyle factors have been linked to the disorder. However, there are few studies on the association between lifestyle factors and FM, thus we examine the risk of self-reported fibromyalgia given selected lifestyle factors.

Methods
We used data from 75,485 participants in the Norwegian Women and Cancer study. Information on FM and the lifestyle factors body mass index (BMI), physical activity level, smoking status/intensity, and alcohol consumption were obtained from baseline and follow-up questionnaires. We used Cox proportional hazards model to calculate hazard ratios (HRs) with 95% confidence intervals (CIs).

Results
After a median follow-up time of 10 years, we observed 2,248 cases of self-reported fibromyalgia. Overweight (BMI 25-29.9 kg/m2) and obese (BMI ≥ 30 kg/m2) women had a relative risk of 1.34 (95% CI 1.21–1.47) and 1.62 (95% CI 1.41–1.87), respectively, compared to women with normal weight (BMI 18.5–24.9 kg/m2). Very low physical activity level (1–2) was associated with a 31% higher risk of self-reported fibromyalgia (HR 1.31, 95% CI 1.09–1.57) when compared to moderate physical activity level (5–6). There was a strong dose-response relationship between smoking status/intensity and self-reported fibromyalgia (p for trend < 0.001). Compared with moderate alcohol consumption (4.0–10 g/day), the risk of self-reported FM was 72% (HR 1.72; 95% CI 1.45–2.03) higher among teetotallers, and 38% (HR 1.38, 95% CI 1.23–1.54) higher among those with low consumption (0.1–3.9 g/day).

Conclusions
Overweight and obesity, very low physical activity level, smoking, and alcohol consumption were associated with an increased risk of self-reported FM.
Inclusion of person-centred care in UK postgraduate medical education curricula: Interviews and documentary analysis
Authors: Moore Heather L. , Watson Rose , Farnworth Allison , Giles Karen , Tomson David , Thomson Richard G. 
Published: October 2023

Abstract
Background
Person-centred care (PCC) involves placing people at the centre of their healthcare decision making to ensure it meets their needs, values, and personal circumstances. Increasingly, PCC is promoted in healthcare policy and guidance, but little is known about how this is embedded in postgraduate medical training. The aim of this research was to understand how PCC is embedded in UK postgraduate medical training and explore factors influencing inclusion of PCC in curricula content.

Methods
To explore this, we interviewed senior professionals with key roles in the curricula from four UK Royal Colleges (Psychiatrists; Physicians; Surgeons; and GPs) and used framework analysis on interviews and relevant curricula documents to identify themes.

Results
Legislation and professional/educational guidance influenced inclusion. PCC definitions and terminology differed and placement within curricula was variable. Royal Colleges defined the curriculum and provided training to ensure competence, but local deaneries independently implemented the curriculum. Trainer engagement was greater than trainee buy in. Quality assurance focused on feedback from trainers and trainees rather than patients, and patient and public involvement in curriculum development, teaching, and assessment was limited.

Conclusions
There is a need for cross-organisation collaboration to develop a PCC competence framework that defines the skills and level of competence required at different points in training, with clarity around the differences between undergraduate and postgraduate requirements. Greater auditing and quality assurance of programme delivery would help identify successful practices to share within and across Royal Colleges, while still maintaining the flexibility of local provision. Engagement with patients and the public in this work can only strengthen provision.
Instructional educational games in pharmacy experiential education: a quasi-experimental assessment of learning outcomes, students’ engagement and motivation
Authors: Dabbous Mariam , Sakr Fouad , Safwan Jihan , Akel Marwan , Malaeb Diana , Rahal Mohamad , Kawtharani Anwar 
Published: October 2023

Abstract
Background
This study aimed to determine the impact of implementing instructional educational games on attaining the intended learning outcomes mapped with the competencies of a pharmacy practice experience course, and to assess students’ attitudes towards motivation and engagement in this active learning activity.

Methods
This was a quasi-experimental study that utilized a pretest-posttest for the research groups. Students were divided into teams and challenged to answer different questions related to the case scenarios. Different gaming platforms as Gamilab, Wisc-Online, and Quizizz were accordingly used to create different questions that help students memorize medications’ brand names, and acquire the advanced community knowledge and skills. The attainment of the intended learning outcomes was assessed and compared between the experimental and control groups through the course total average of grades, and the subsequent averages of domains relating to the course competencies. Attitudes towards motivation and engagement in educational games activities were also assessed among the experimental group.

Results
A total of 233 students were enrolled in the study. The experimental group had significantly higher total posttest average compared to the control group (Beta = 7.695, 95% CI = 4.964–10.425, P < 0.001). The experimental group had also significantly higher averages of competency domains related to foundational knowledge (Beta = 1.471, 95% CI = 0.723–2.219, P < 0.001), pharmaceutical care (Beta = 1.650, 95% CI = 0.673–2.627, P < 0.001), essentials to practice and care (Beta = 1.838, 95% CI = 0.626–3.050, P < 0.003), and approach to practice and care (Beta = 2.736, 95% CI = 1.384–4.088, P < 0.001) averages. The experimental group reflected positive attitudes toward gamification engagement and motivation, with greater than 60% of the students recommend engage educational games to be part of the course.

Conclusion
Incorporation of educational games into pharmacy practice experiences resulted in better learning outcomes. This kind of active learning appears to be acceptable and motivational for students, and is recommended for further research in didactic courses in the pharmacy curriculum.
Cost-effectiveness analysis of pembrolizumab versus chemotherapy as first-line treatment for mismatch-repair-deficient (dMMR) or microsatellite-instability-high (MSI-H) advanced or metastatic colorectal cancer from the perspective of the Chinese health-care system
Authors: Zhu Chen , Han Gang , Wu Bin 
Published: October 2023

Abstract
Background
Pembrolizumab is superior to chemotherapy as a first-line treatment for patients with mismatch-repair-deficient (dMMR) or microsatellite-instability-high (MSI-H) advanced or metastatic colorectal cancer (CRC), with a significant long-term survival benefit according to the KEYNOTE-177 trial. The current study aimed to determine whether pembrolizumab is a cost-effective treatment for patients with dMMR/MSI-H advanced or metastatic CRC in China.

Methods
A partitioned survival model (PSM) was developed to simulate patients with dMMR/MSI-H advanced or metastatic CRC based on progression-free survival (PFS), progressive disease (PD) and death. The model was designed using a lifetime horizon, a 6-week cycle, and a 5% discount rate. The patients in the model had metastatic dMMR/MSI-H CRC and had not previously received treatment; these characteristics were similar to those of patients in KEYNOTE-177, a phase 3, open-label randomized clinical trial. The health outcomes and utilities were based on the KEYNOTE-177 trial and published data, respectively. Costs were calculated based on local charges (2022) and published literature. A treatment was deemed cost-effective in China if the incremental cost-effectiveness ratio (ICER) value was less than U.S.$38,142.56 per quality-adjusted life-year (QALY). The robustness of the results was assessed via one-way deterministic and probabilistic sensitivity analyses.

Results
Baseline analysis revealed that pembrolizumab provided an additional 2.58 QALYs (3.00 life-year) at an incremental cost of U.S.$78,286.04, resulting in an ICER of U.S.$30,330.15 per QALY, which was below the willingness-to-pay threshold of U.S.$38,142.56 per QALY. When the patient assistance program (PAP) was considered, the ICER became U.S.$1,730.67 per QALY, manifesting absolute cost-effectiveness. The results of sensitivity analyses demonstrated that pembrolizumab was cost-effective in most cases.

Conclusions
Pembrolizumab is a cost-effective first-line treatment for dMMR/MSI-H advanced or metastatic CRC patients in China, especially considering the PAP.
Whole exome sequencing identifies novel variants of PIK3CA and validation of hotspot mutation by droplet digital PCR in breast cancer among Indian population
Authors: Kumar Rahul , Kumar Rakesh , Goel Harsh , Kumar Sonu , Ningombam Somorjit Singh , Haider Imran , Agrawal Usha , Deo Svs , Gogia Ajay , Batra Atul , Sharma Ashok , Mathur Sandeep , Ranjan Amar , Chopra Anita , Hussain Showket , Tanwar Pranay 
Published: October 2023

Abstract
Background
Breast cancer (BC) is the most common malignancy with very high incidence and relatively high mortality in women. The PIK3CA gene plays a pivotal role in the pathogenicity of breast cancer. Despite this, the mutational status of all exons except exons 9 and 20 still remains unknown.

Methods
This study uses the whole exome sequencing (WES) based approach to identify somatic PIK3CA mutations in Indian BC cohorts. The resultant hotspot mutations were validated by droplet digital PCR (ddPCR). Further, molecular dynamics (MD) simulation was applied to elucidate the conformational and functional effects of hotspot position on PIK3CA protein.

Results
In our cohort, PIK3CA showed a 44.4% somatic mutation rate and was among the top mutated genes. The mutations of PIK3CA were confined in Exons 5, 9, 11, 18, and 20, whereas the maximum number of mutations lies within exons 9 and 20. A total of 9 variants were found in our study, of which 2 were novel mutations observed on exons 9 (p.H554L) and 11 (p.S629P). However, H1047R was the hotspot mutation at exon 20 (20%). In tumor tissues, there was a considerable difference between copy number of wild-type and H1047R mutant was detected by ddPCR. Significant structural and conformational changes were observed during MD simulation, induced due to point mutation at H1047R/L position.

Conclusions
The current study provides a comprehensive view of novel as well as reported single nucleotide variants (SNVs) in PIK3CA gene associated with Indian breast cancer cases. The mutation status of H1047R/L could serve as a prognostic value in terms of selecting targeted therapy in BC.