bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of low-dose esketamine on perioperative neurocognitive disorder and postoperative depressive symptoms in elderly patients undergoing major elective non-cardiac surgery for malignant tumors: A randomized clinical trial
Authors: Cuifang Huang , Xianlong Xie , Yubing Liang , Huijun Dai , Xiangren Chen , Linghui Pan 
Published: October 2023

Abstract

Background: Research on the impact of small-dose esketamine on perioperative neurocognitive disorder and postoperative depressive symptoms in elderly patients is limited. This study aimed to assess whether administering perioperative small-dose esketamine intravenously would reduce the incidence of perioperative neurocognitive disorder and postoperative depressive symptoms in elderly patients with malignant tumors undergoing elective non-cardiac major surgery.
Methods: This trial included 209 patients aged 65 to 86 years undergoing tumor resection who received esketamine (Group E) or not (Group C) during and after surgery. Cognitive function was evaluated using neuropsychological tests as well as the telephone interview for cognitive status-modified (TICSm), and symptoms of depression were assessed using the 17-item Hamilton Depression Rating Scale (HAMD-17).
Results: There was no significant difference in postoperative delirium incidence between patients who received esketamine during surgery and those who did not at 1-5 days post-operation. Group E had 12.0% incidence (13 out of 108 patients), while Group C had 10.9% (11 out of 101). Group E showed significantly better results than group C regarding less time required for the trail making test (Part B) during neuropsychological testing, lower incidence of depression, and lower Hamilton depression score at 3, 7, and 90 days post-surgery.
Conclusions: Small doses of eketamine given perioperatively improved postoperative depression in elderly patients with malignant tumors. Adverse reactions were not significantly increased. It did not significantly affect postoperative delirium and cognitive function, but it facilitated the recovery of social executive abilities.
Trial registration: The study was registered on clinicaltrials.gov.cn on 10/3/2023 (NO. ChiCTR2300069249).
Phleum pratense-pollen adaptive variations and pollen microbiome investigation under different climatic regions and prospects of allergenicity
Authors: Humayun Muhammad , Naseem Saadia , Goodman Richard E , Ali Zahid 
Published: October 2023

Abstract
Phleum pratense is an allergenic grass that pollinates in spring. Databases Allergenonline.org and Allergen.org record ten P. pratense allergens and their isoforms. Phl P 1, Phlp 5 and Phl p 11 are major P. pratense-pollen allergens with demonstrated basophil activity and skin test reactivity. Little is known about P. pratense pollen adaptive variations in different climatic regions and pollen associated microbial diversity. In this study, we collected P. pratense-pollens in the spring season 2022, from three climatic regions (R1, R2 and R3) in Pakistan having difference in mean annual air temperature, mean annual precipitation and elevation. The morphology of pollens was observed by light microscopy, scanning electron microscopy (SEM), biochemical fingerprint analysis and composition of pollens were investigated by fourier-transform infrared spectroscopy (FTIR). The pollen-associated bacterium was identified through Biolog GEN III microplate system. The pollen water-soluble proteins were isolated and stabilized in phosphate buffer saline (PBS) and tested for allergenicity response through dot blots and western blots analysis. Morphological study found difference in pollen biochemical composition. Biolog identified Brevibacterium epidermidis from P. pratense pollens. Protein extracts quantification and sodium dodecyl sulfate-poly acrylamide gel electrophoresis (SDS-PAGE) gel found decreased protein expression in R1 region pollens in comparison to R2 and R3 regions pollens. Allergenicity studies found differential expression of beta-expansin and profilin (allergens) in pollens obtained from three regions. Beta-expansin and profilin were suppressed in R1 pollens, and expressed in R2 and R3 pollens. This is the first study to identify B. epidermidis growth on P. pratense pollen. A variable allergen expression in P. pratense pollens has also been observed in different regions. An increase in mean annual temperature and decrease in mean annual precipitation affected pollen biochemical composition, and inhibited beta-expansin and profilin expression involved in pollen growth and development. Therefore, the findings of the research are unique, which enhances basic knowledge and understanding of P. pratense-pollen associated microbiota and climate change impacts on the pollen allergen expression.
Patients’ experience during vaginal examination and transvaginal ultrasound in a tertiary hospital in Singapore- A Qualitative study
Authors: Lee Jean-Jasmin ML , Cheong Xinyi , Tan Tse Yeun , Zhong Yuting , Chua Caroline SL , Goy Raymond WL , Ang Seng Bin 
Published: October 2023

Abstract
Background
Vaginal digital examination and transvaginal ultrasound are routinely for clinical assessment. Many women find these procedures uncomfortable, embarrassing, and stressful. Negative experiences increase anxiety and discomfort experienced during subsequent examinations. Emotional distress and fear of pain result in women avoiding gynaecological screening and follow-up. This study uses qualitative methods to evaluate the experience of patients who have undergone both vaginal digital and transvaginal ultrasound examinations, collectively called pelvic examinations (PE) in the outpatient setting of a tertiary hospital in Singapore.
Methods
Qualitative semi-structured interviews were conducted on twelve participants aged 30–57 years. Interviews were audio-recorded, transcribed, audited, and analysed iteratively based on grounded theory. Emergent themes were first externally validated and finalized after rounds of deliberations amongst the investigators. This included descriptions and concepts reflecting the most important matters experienced by participants.
Results
Majority of participants found PE unpleasant and uncomfortable especially when providers were perceived to have poor communication and examination skills. Factors that improve their experience include a conducive environment i.e., privacy, dim lights, and warm lubricant. Having adequate information before and during the procedure was important especially for first time.
Conclusion
Patient-centred care ensures a positive experience in relation to the themes found in this study. Gaps in HCP training on communication and procedure skills should be addressed. Efforts should be made improve the clinic environment and provide adequate information to patients.
Visualization of cristae and mtDNA dynamics and interactions with super-resolution microscopy
Authors: Xi Peng , Ren Wei , Ge Xichuan , Li Meiqi , Sun Jing , Li Shiyi , Shan Chunyan , Gao Baoxiang 
Published: October 2023

Abstract
The dynamic interaction between the mitochondrial inner membrane (IM) and mitochondrial DNA (mtDNA) remains elusive due to the limitations in spatiotemporal resolution offered by conventional microscopy and the absence of suitable in vivo probes specifically targeting the IM. Here, we have developed a novel fluorescence probe called IMMBright660, characterized by exceptional photostability, fluorogenicity within lipid membranes, and low saturation power. Leveraging these features, we successfully employed time-lapse stimulated emission depletion microscopy (STED) at low power to visualize the IM, despite that mitochondria is highly photo-sensitive. By utilizing dual-color imaging of the IM and mtDNA, we have uncovered that mtDNA tends to habitat at mitochondrial tips or branch points, exhibiting an overall spatially uniform distribution. Notably, the dynamics of mitochondria are intricately associated with the positioning of mtDNA, and mitochondrial fusion consistently occurs in close proximity to mtDNA to minimize pressure during cristae remodeling. In healthy cells, >66% of the the mitochondria are Class III (with lengths longer than 5 μm or more than 12 cristae), while it dropped to <18% in ferroptosis. Mitochondrial dynamics, orchestrated by cristae remodeling, foster the even distribution of mtDNA. Conversely, in conditions of apoptosis and ferroptosis where the cristae structure is compromised, mtDNA distribution becomes irregular. These findings, achieved with unprecedented spatiotemporal resolution, reveal the intricate interplay between cristae and mtDNA and provide insights into the driving forces behind mtDNA distribution and expansion.
A novel technique for one-lung ventilation in children with unilateral atelectasis
Authors: Bai Ke , Zhou Fang , Huo Junming , Wan Rui , Liu Chengjun 
Published: October 2023

Abstract
It is very difficult to perform differential lung ventilation (DLV) in children with unilateral atelectasis, especially small children. We aimed to introduce a novel technique, one-lung ventilation with a single-lumen tube with a side hole (SH-SL-OLV), to perform DLV in this setting. This retrospective, observational, and analytic study enrolled 21 children with unilateral atelectasis admitted to the PICU. The children were treated with one-lung ventilation with a single-lumen tube (SL-OLV) or SH-SL-OLV.A total of 8 children underwent 45 SL-OLV sessions, and 13 children underwent 23 SH-SL-OLV sessions. Before treatment, no significant between-group difference was present in FiO2, P/F ratio, and PCO2. However, during OLV, FiO2 and PCO2 were significantly lower, while the P/F ratio and the duration hours of OLV were significantly higher in the SH-SL-OLV group than in the SL-OLV group. SH-SL-OLV is an innovative technique for the treatment of unilateral atelectasis in children. SH-SL-OLV can improve atelectasis and reduce the risk of hypoxemia and hypercapnia during OLV.
Communication barriers faced by pharmacists when managing patients with hypertension in a primary care team: A qualitative study
Authors: Tan Reuben , Kawaja Ariffin , Ooi Swee Phaik , Ng Chirk Jenn 
Published: October 2023

Abstract
Background
As primary care pharmacists take on an increasingly important and collaborative role in managing patients with chronic diseases, communication barriers with patients and healthcare colleagues have emerged. This study aimed to explore the communication barriers faced by pharmacists when managing patients with hypertension in a primary care team.
Methods
Twelve pharmacists working in five government primary care clinics were interviewed by a researcher using a topic guide. The interviews were audio-recorded, transcribed verbatim and subjected to thematic analysis.
Results
Pharmacists’ management of patients with hypertension was found to be affected by communication challenges at three different levels: between pharmacists and patients, pharmacists and doctors, and doctors and patients. Barriers to communication between pharmacists and patients include language barrier, physical disabilities, medication brand changes, and specific challenges faced during video consultations. Barriers to communication between pharmacists and doctors include lack of access to patient information across institutions on the electronic medical records (EMR), inadequate and inappropriate documentation by doctors, and disruptive and ineffective phone calls by pharmacists to doctors. Barriers to communication between doctors and patients had a spillover effect on pharmacists; these barriers included language barrier, patients not discussing medication nonadherence with doctors, and conflicting advice given by doctors and pharmacists.
Conclusions
The communication barriers pharmacists faced when managing patients with hypertension involved multiple stakeholders. Many of the challenges resulted in patients having difficulty understanding and adhering to their management plan. Effective interventions to foster stronger interprofessional relationships and create a conducive platform of communication should be developed to address these communication barriers.
Accumulation of docosapentaenoic acid (n-3 DPA) in a novel isolate of the marine ichthyosporean Sphaeroforma arctica
Authors: Yan Qiang , Liu Yingchun , Barrett Christa , Ryan Kelly , Seeler Daniel , May Oliver , Zirkle Ross 
Published: October 2023

Abstract
The n-3 long-chain polyunsaturated fatty acids (LC-PUFAs) are important for human nutrition as structural components of cell membranes as well as functioning in various cell signaling pathways. Currently, docosapentaenoic acid (n-3 DPA, C22:5) is not considered in the omega-3 index and is less studied than its counterparts eicosapentaenoic acid (EPA, C20:5) and docosahexaenoic acid (DHA, C22:6) due in part to a lack of a consistent, highly enriched source. In this work, we screened microorganisms in our culture collections with the goal to isolate a strain with high levels of n-3 DPA. We isolated a strain of Sphaeroforma arctica that produces up to 11% n-3 DPA in total fatty acid and has a high n-3 DPA to DHA/EPA ratio. The cell growth of the isolated strain was characterized using microscopy imaging and flow cytometer technologies to confirm the coenocytic pattern of cell divisions previously described in S. arctica. Our novel isolate of S. arctica grew more robustly and produced significantly more n-3 DPA compared to previously isolated and described strains indicating the uniqueness of the discovered strain. Overall, this work reports a first isolate n-3 DPA producing microorganism and establishes the foundation for future strain improvement and elucidation of the physiological function of this LC-PUFA for human nutrition and health.
Doping Prevalence Among Elite U.S. Athletes
Authors: Davoren Ann Kearns , Rulison Kelly , Milroy Jeff , Grist Pauline , Fedoruk Matthew , Lewis Laura , Wyrick David 
Published: October 2023

Abstract
Background: Determining the prevalence of doping within an elite athlete population is challenging due to the extreme sensitivity of the topic, however understanding true doping prevalence is important when designing anti-doping programs and measuring their effectiveness. The objective of this study was to estimate the prevalence of doping among Olympic, Paralympic, World and National-level competitive athletes in the United States subject to the World Anti-Doping Agency (WADA) Prohibited List. This study used a web-delivered survey and direct questioning approach to collect data from athletes in the United States Anti-Doping Agency (USADA) Registered Testing Pool or Clean Athlete Program. For the first time, a prevalence survey of elite athletes used the WADA Prohibited List to assess prevalence in each specific category of banned substance / method.
Results: Of 1,425 respondents, overall doping prevalence among U.S. elite athletes in the 12 months prior to survey administration ranged from an estimated 6.7-9.2% depending on the method of calculation. Specific doping prevalence rates for each individual substance category ranged from 0.1% (diuretics or masking agents) to 4.1% for cannabinoids (in-competition).
Conclusion: By measuring doping prevalence down to specific performance enhancing substances and methods, as well as coupling with individual athlete personality characteristics such as attitudes, motivators and norms, a clearer picture of the use of specific prohibited substances in- and out of-competition, attitudes toward doping, beliefs about testing and most effective deterrents can be identified. By understanding doping prevalence, anti-doping programs can be tailored to increase deterrence and overall program effectiveness.
Attention-deficit/hyperactivity symptoms, mental health, and the strengths of the healthy adult self: an investigation of Bernstein’s Strengths Scale using a network approach
Authors: Miklósi Mónika , Vajsz Kornél , Oláh Stella , Nagy Vivien , Szabó Brigitta 
Published: October 2023

Abstract

Background
Bernstein’s heuristic model of personal strengths describes 16 positive attributes of the healthy adult self, grouped into four higher-order factors: self-directedness (identity, self-reflection, self-confidence, self-assertion, imagination/creativity), self-regulation (emotional balance, resilience, self-control, self-care, reality testing), connection (empathy, compassion, humour, responsibility), and transcendence (gratitude and wisdom). The study aimed to explore the factorial validity of Bernstein’s Strengths Scale developed for the assessment of these constructs. Furthermore, we explored the association of strengths with attention-deficit hyperactivity (ADHD) symptoms and mental health in a nonclinical sample using a network approach.
Methods
Five hundred and twenty-eight adults filled out an online questionnaire, including Bernstein’s Strengths Scale (BSS), the Mental Health Continuum – Short Form (MHC-SF), and the Adult ADHD Self-Report Scale (ASRS).
Results
After leaving out two items, our data showed an acceptable fit to the 16-factor model (CFI = 0.912, RMSEA = 0.050 [0.047–0.053], SRMR = 0.050). Because of low internal consistency, the Self-control subscale was excluded from further analyses. Principal component analysis revealed three instead of four second-order factors. In the network model, Self-confidence and Wisdom emerged as the most influential nodes. ADHD symptoms were negatively connected to responsibility, self-care, identity, emotional balance, self-confidence, and mental health, while they had positive edges with humor, self-reflection, and imagination/creativity. Mental health was positively related to several strengths, with the highest value of the edge connecting mental health with gratitude. Imagination/creativity, emotional balance, self-care, self-confidence, and identity bridged ADHD symptoms and mental health.
Conclusion
The BSS has acceptable factorial validity and is a reliable tool for assessing the personal strengths of the healthy adult self. ADHD symptoms in adults may be associated with deficits in personal strengths, but protective factors could also be identified. Addressing personal strengths in psychosocial interventions for ADHD in adults may improve patients’ emotional well-being and everyday functioning.
Arsenic Treatment of Acute Promyelocytic Leukaemia Affects Neutrophil Function in a Compensatory Manner
Authors: Thunström Anna , Urban Constantin Felix 
Published: October 2023

Abstract
Background: Arsenic (ATO) and retinoic acid (ATRA) are successfully used as chemotherapy-free regimens to treat acute APL. Compared to traditional chemotherapy approaches, this therapy evokes fewer haematological side effects, such as severe neutropenia and thrombocytopenia, but little is known about the impact of the treatment on neutrophil function.
Methods: We included three patients undergoing consolidation treatment for APL. To evaluate the functionality of neutrophils, we assessed chemotaxis and ROS production during different time points of the treatment and compared them with neutrophils from healthy donors.
Results: We revealed that the chemotactic ability of neutrophils isolated from APL patients was decreased before starting each cycle of treatment. However, there was an increase in chemotactic ability in the first week of treatment compared to other time points. Additionally, we observed increased ROS production at the start of the treatment cycle. In vitro exposure of isolated neutrophils from healthy donors to ATO led to decreased chemotaxis at high ATO concentrations exceeding those achieved in vivo, while ROS production was not affected. Chemotaxis and ROS production were not altered by exposure to ATRA in vitro.
Conclusions: Our study suggests that ATO and ATRA therapy alter neutrophil function by increasing chemotaxis and reducing ROS production. The effect on neutrophil function does not, however, seem to impact infection susceptibility in our patients, indicating that the enhanced functionality might compensate for the lowered neutrophil count.
Antifungal Activity of Human Antibodies against Candida albicans germ tubes (CAGTA) in Invasive Candidiasis: Implications for Diagnosis and Immunization
Authors: Carrano Giulia , Arrieta-Aguirre Inés , Díez-Villalba Ander , Bregón-Villahoz Marta , Fernandez-de-Larrinoa Iñigo , Moragues María-Dolores 
Published: October 2023

Abstract
Invasive candidiasis (IC) is a fungal infection caused by yeasts of the Candida genus, being Candida albicans the most frequently isolated species. These infections are associated with high mortality rates due to challenges in diagnosis, and pose a significant problem, especially for critically ill patients and those with immunosuppression or undergoing transplantation. To evaluate the activity of antibodies produced by patients with IC, particularly focusing on CAGTA that recognize specific antigens located on the cell wall surface of C. albicans germ tubes. We used sera from 29 patients with IC caused by either C. albicans or non-albicans Candida species. Whole serum IgG antibodies were divided into various fractions: anti-blastospores, CAGTA-enriched and purified CAGTA. The effect of these antibodies on C. albicans was assessed by XTT colorimetric assay to evaluate metabolic activity, CFU counts for viability assessment, and microscopy for growth, viability and morphological analysis. Compared with the anti-blastospores, the CAGTA-enriched IgG fraction was mainly responsible for reducing the metabolic activity and viability of C. albicans cells. Purified CAGTA (20 µg/ml) altered the cell wall surface of germ tubes, and DiBAC fluorescent staining revealed that they were fungicidal. In conclusion, antibodies produced in response to invasive candidiasis have antifungal activity against Candida albicans. Purified CAGTA altered the cell wall structure and induced cell death. These findings suggest the potential use of CAGTA and related antigens as diagnostic markers and the development of immunization protocols for protection against Candida infections.
Impact of healthcare-associated infections within 7-days of acute stroke on health outcomes and risk of care-dependency: a multi-centre registry-based cohort study
Authors: Fluck David , Fry Christopher h , Robin Jonathan , Affley Brendan , Kakar Puneet , Sharma Pankaj , Han Thang S 
Published: October 2023

Abstract
Healthcare-associated infections (HCAIs) in patients admitted with acute conditions remain a major challenge to healthcare services. Here, we assessed the impact of HCAIs acquired withing 7-days of acute stroke on indicators of care-quality outcomes and dependency. Data were prospectively collected (2014–2016) from the Sentinel Stroke National Audit Programme for 3,309 patients (mean age = 76.2 year, SD = 13.5) admitted to four UK hyperacute stroke units (HASU). Associations between variables were assessed by multivariable logistic regression (odds ratios, 95% confidence intervals), adjusted for age, sex, co-morbidities, pre-stroke disability, swallow screening, stroke type and severity. Within 7-days of admission, urinary tract infection (UTI) and pneumonia occurred in 7.6% and 11.3% of patients. Female (UTI only), older age, underlying hypertension, atrial fibrillation, previous stroke, pre-stroke disability, intracranial haemorrhage, severe stroke, and delay in swallow screening (pneumonia only) were independent risk factors of UTI and pneumonia. Compared to patients without UTI or pneumonia, those with either or both of these HCAIs were more likely to have prolonged stay (> 14-days) on HASU: 5.1 (3.8–6.8); high risk of malnutrition: 3.6 (2.9–4.5); palliative care: 4.5 (3.4–6.1); in-hospital mortality: 4.8 (3.8–6.2); disability at discharge: 7.5 (5.9–9.7); activity of daily living support: 1.6 (1.2–2.2); and discharge to care-home: 2.3 (1.6–3.3). In conclusion, HCAIs acquired within 7-days of an acute stroke led to prolonged hospitalisation, adverse health consequences and risk of care-dependency. These findings provide valuable information for timely intervention to reduce HCAIs, and minimising subsequent adverse outcomes.