bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nurse management of minor problems in primary care emergencies: a non-randomized controlled trial
Authors: Estarlich-Corominas Jordi , Soler-Abril Neus , Casanellas-Chuecos Anna , Becerra-Corzo Sara , Bianco Andrea Sofia , Torán-Monserrat Pere , García-Sierra Rosa 
Published: January 2025

Abstract

Background
Health systems must implement strategies to adapt to the high demand in primary care caused by social changes. Since 2009, the Catalan Institute of Health has been expanding the Nurse Demand Management programme through which nursing autonomously addresses minor health problems. This study aims to analyse whether this programme is a factor in improving the efficiency and quality of care in a primary care emergency centre. The results come from a non-randomised controlled experimental study that tested the implementation of the programme applied to an experimental group treated by nurses versus a control group treated by doctors. The study was approved on 14 July 2022 by the Research Ethics Committee of the Jordi Gol University Institute following the guidelines of the TREND statement.

Results
A total of 312 patients were included in the study, all of whom came to the emergency centre with five types of minor problems. Exactly half (156) were seen by nurses and half were seen by doctors. The experimental group had an average waiting time of 15.1 min and the control group 33.25 min. There was no significant difference in the assessment of the quality of care received and there were no differences in the total number of consultations for the same problem. There were fewer prescriptions given out by nurses, with an average of 1.79 medicines per participant versus 2.26 medicines prescribed by doctors. The results of the study suggest that the Nurse Demand Management programme was a factor in improving the efficiency and in the emergency centre. Nurse resolution capacity, after applying algorithms, offered quality care, with fewer prescriptions and good patient satisfaction without increasing the total number of consultations due to the same problem.

Trial registration
The protocol for the current study was registered at Clinicaltrials.gov, with identification NCT06298240, retrospectively registered February 29, 2024.
In-home work environment for home care workers in Northern Sweden before and during the Covid-19 pandemic
Authors: Norström Fredrik , Bölenius Karin , Sahlén Klas-Göran , Zingmark Magnus , Pettersson-Strömbäck Anita 
Published: January 2025

Abstract

Background
The in-home work environment is the main work environment for home care workers, but it has only been sparsely studied. Our aim was to investigate the in-home work environment for home care workers by exploring challenges that arise regardless of a pandemic and by investigating Covid-19–specific challenges.

Methods
Two cross-sectional studies were conducted, one before (2017) and one during the pandemic (2021/2022) in three Swedish regions (Jämtland/Härjedalen, Västerbotten and Västernorrland), in which 1,154 (58%) out of 2,000 and 629 (33%) of 1,900 invited home care workers participated, respectively. Participants responded to a questionnaire asking about 10 problems associated with the in-home work environment as well as Covid-19–related challenges. Comparisons were conducted between regions and between study years using univariable analyses.

Results
Daily problems with the in-home work environment were common before the pandemic, and they increased statistically significantly during the pandemic for, among other things, non-ergonomic beds (29% vs. 37%), impractical bathrooms (40% vs. 50%), indoor smoking (24% vs. 31%), and pets (19% vs. 25%). There were major concerns about the risk of getting infected with Covid-19 for both staff (42%) and the home care recipients (50%). There were statistically significant differences between regions, e.g. many problems were more common in the Västerbotten region than in the other two regions during the pandemic, while challenges with protective equipment was most common in the Västernorrland region.

Conclusions
In-home work environment problems are common for home care workers and worsen in a more strained situation. Efforts are needed to strengthen the work environment for home care workers.
Social-structural barriers to primary care among sex workers: findings from a community-based cohort in Vancouver, Canada (2014–2021)
Authors: Harris Miriam T. H. , Shannon Kate , Krüsi Andrea , Zhou Haoxuan , Goldenberg Shira M. 
Published: January 2025

Abstract

Background
Due to social-structural marginalization, sex workers experience health inequities including a high prevalence of sexually transmitted and blood-borne infections, mental health disorders, trauma, and substance use, alongside a multitude of barriers to HIV and substance use services. Given limited evidence on sex workers’ broader primary healthcare access, we aimed to examine social-structural factors associated with primary care use among sex workers over 7 years.

Methods
Data were derived from An Evaluation of Sex Workers Health Access (AESHA), a community-based open prospective cohort of women (cis and trans) sex workers in Metro Vancouver, from 2014 to 2021. Descriptive statistics were used to summarize the proportion of primary care use in the past six months and to assess primary care trends over time from 2014–2021. We used multivariate logistic regression with generalized estimating equations (GEE) to identify social-structural factors associated with primary care access (seeing a family doctor in the last six months), after adjusting for confounders.

Results
Amongst the 646 participants, most (87.4%) accessed primary care at some point during the study period, and primary care use in the last 6 months was relatively stable (ranging from 60–78%) across each follow-up period. At first available observation, participants faced a high burden of sexually transmitted and blood-borne infections (STBBIs) (48.0%, 11.5%, and 10.4% were HCV, HIV, or STI seropositive, respectively), 56.8% were diagnosed with a mental health disorder, 8.1% had recently overdosed, and 14.7% were recently hospitalized. In multivariable GEE analysis, exposure to intimate partner violence was associated with reduced primary care use (Adjusted odds ratios (AOR) 0.63, 95% Confidence interval (CI): 0.49—0.82), and limited English fluency was marginally associated (AOR 0.76 CI: 0.51—1.14).

Conclusions
This study characterized primary care use and its social-structural determinants among sex workers over 7 years. Participants faced a high burden of STBBIs and other health disparities, and a proportion faced gaps in primary care utilization. Scale-up of trauma-informed, culturally and linguistically tailored, sex worker-friendly primary care models are needed, alongside structural interventions to decriminalize and destigmatize sex work and substance use.
Clinicopathological study and molecular subtyping of muscle-invasive bladder cancer (MIBC) using dual immunohistochemical (IHC) markers
Authors: Vaithegi R. , Pai Kanthilatha , Calicut Kini Rao Anuradha , Monappa Vidya , Prabhu Swathi , Suvarna Nischitha 
Published: January 2025

Abstract

Background
Muscle-invasive bladder carcinomas (MIBCs) exhibit significant heterogeneity, with diverse histopathological features associated with varied prognosis and therapeutic response. Although genomic profiling studies have identified several molecular subtypes of MIBC, two basic molecular subtypes are identified - luminal and basal, differing in biological behaviour and response to treatment. As molecular subtyping is complex, surrogate immunohistochemical (IHC) markers have been used to determine the molecular subtypes with good correlation to genomic profiling.

Methods
We analysed the clinicopathological features of 66 cases of MIBCs received over a 5-year study period. IHC expression was determined using GATA3 and CK5/6 to classify MIBC into luminal, basal and double-negative subtypes. The association between clinicopathologic variables and molecular subtypes were analysed using Chi-square test.

Results
The mean age at diagnosis of MIBC was 65.91 years with a male predominance. Based on IHC expression of GATA3 and CK5/6, MIBCs were classified into luminal, basal and double negative subtypes in 62.1%, 30.3% and 7.6% respectively. The luminal subtype occurred at an older age and showed predominantly conventional urothelial carcinoma with papillary morphology. Basal subtype occurred at earlier age, showed greater association with smoking and was more commonly associated with urothelial carcinoma with non -papillary morphology and exhibiting divergent differentiation as well as pure squamous cell carcinoma on histopathological examination. The double-negative subtype was found exclusively in males and exhibited a non-papillary morphology. Notably, all diagnosed neuroendocrine carcinomas were classified as double-negative type. While there was no statistically significant difference in tumour stage in cystectomy specimens between the molecular subtypes, lympho-vascular invasion and lymph node metastasis was more commonly associated with the basal type (p < 0.05) There was no significant difference in recurrence rates, metastasis and death between luminal and basal subtypes.

Conclusion
A simple two-antibody panel using GATA3 and CK5/6 could help in classifying MIBC into basic molecular subtypes of MIBC with distinctive histopathological features that can provide insights into the corresponding molecular subtype. Greater association of lymphovascular invasion and lymph nodal involvement in cystectomy specimens in basal type and distant metastasis in the double-negative subtype suggests a more aggressive clinical behaviour of these, necessitating more intensive treatment.
A simple new method to determine leaf specific heat capacity
Authors: Zhang Jiayu , Kaiser Elias , Zhang Hanyi , Marcelis Leo F. M. , Vialet-Chabrand Silvere 
Published: January 2025

Abstract

Background
Quantifying plant transpiration via thermal imaging is desirable for applications in agriculture, plant breeding, and plant science. However, thermal imaging under natural non-steady state conditions is currently limited by the difficulty of quantifying thermal properties of leaves, especially specific heat capacity (Cp). Existing literature offers only rough estimates of Cp and lacks simple and accurate methods to determine it.

Results
We developed a non-invasive method to quantify k (the product of leaf thickness (lt), leaf density(ρ), and Cp), by fitting a leaf energy balance model to a leaf temperature (Tleaf) transient during and after a ~ 10 s light pulse. Cp was then estimated by dividing k by lt*ρ. Using this method, we quantified Cp for 13 horticultural and tropical plant species, and explored the relationship between Cp and leaf water content, specific leaf area and Tleaf response rate during the light pulse. Values of Cp ranged between 3200–4000 J kg−1 K−1, and were positively correlated with leaf water content. In species with very thick leaves, such as Phalaenopsis amabilis, we found leaf thickness to be a major factor in the temperature response to a short light pulse.

Conclusions
Our method allows for easy determination of leaf Cp of different species, and may help pave the way to apply more accurate thermal imaging under natural non-steady state conditions.
Cinnamic acid alleviates endothelial dysfunction and oxidative stress by targeting PPARδ in obesity and diabetes
Authors: Bai Yizhen , Tan Dechao , Deng Qiaowen , Miao Lingchao , Wang Yuehan , Zhou Yan , Yang Yifan , Wang Shengpeng , Vong Chi Teng , Cheang Wai San 
Published: January 2025

Abstract

Objective
Cinnamic acid (CA) is a bioactive compound isolated from cinnamon. It has been demonstrated to ameliorate inflammation and metabolic diseases, which are associated with endothelial dysfunction. This study was aimed to study the potential protective effects of CA against diabetes-associated endothelial dysfunction and its underlying mechanisms.

Methods
High-fat diet (HFD) with 60 kcal% fat was used to induce obesity/diabetes in C57BL/6 mice for 12 weeks. These diet-induced obese (DIO) mice were orally administered with CA at 20 or 40 mg/kg/day, pioglitazone (PIO) at 20 mg/kg/day or same volume of vehicle during the last 4 weeks. Isolated mouse aortic segments and primary culture rat aortic endothelial cells (RAECs) were induced with high glucose (HG) to mimic hyperglycemia and co-treated with different concentrations of CA.

Results
In DIO mice, four-week administration of CA, particularly at 40 mg/kg/day, diminished the body weights, blood pressure, fasting blood glucose and plasma lipid levels, and ameliorated endothelium-dependent relaxations (EDRs) and oxidative stress in aortas. The beneficial effects of CA were comparable to the positive control group, PIO. Western blotting results indicated that CA treatment upregulated the expression of peroxisome proliferator-activated receptor delta (PPARδ), and activated nuclear factor erythroid 2-related factor 2 (Nrf2)/ heme oxygenase-1 (HO-1) and AMP-activated protein kinase (AMPK)/ protein kinase B (Akt)/ endothelial nitric oxide synthase (eNOS) signaling pathways in mouse aortas in vivo and ex vivo. HG stimulation impaired EDRs in mouse aortas and inhibited nitric oxide (NO) production but elevated reactive oxygen species (ROS) levels in RAECs. CA reversed these impairments. Importantly, PPARδ antagonist GSK0660 abolished the vasoprotective effects of CA. Molecular docking analysis suggested a high likelihood of mutual binding between CA and PPARδ.

Conclusion
CA protects against endothelial dysfunction and oxidative stress in diabetes and obesity by targeting PPARδ through Nrf2/HO-1 and Akt/eNOS signaling pathways.
What contributes to consumer price inflation? A novel decomposition framework with an application to Austria
Authors: Schneider Martin 
Published: January 2025

Abstract
This paper introduces a novel approach to decomposing consumer price inflation. Expanding upon the established decomposition method for the value-added deflator, our methodology combines the cost structure of the consumption expenditures from the input–output table with quarterly national accounts data. This enables a detailed breakdown of HICP inflation, including imports. Applying this method to Austria from Q1 2019 to Q1 2023, we identify energy and non-energy imports as major contributors to inflation in 2022. Profits began contributing to inflation from H2 2022, while wage pressures remained minimal. The results of the analysis show that the decomposition can provide valuable insights for the conduct of monetary policy.
Treatment of peri-implant mucositis using an Er:YAG laser or an ultrasonic device: a randomized, controlled clinical trial
Authors: Bengtsson Viveca Wallin , Aoki Akira , Mizutani Koji , Lindahl Christel , Renvert Stefan 
Published: January 2025

Abstract

Purpose
The study assessed the clinical outcomes following treatment of peri-implant mucositis using Er:YAG laser or an ultrasonic device over six months. Patients' experience of pain, aesthetics, and Quality of life were further assessed.

Methods
One dental implant, per included patient, diagnosed with peri-implant mucositis underwent treatment with an Er:YAG laser (test) or an ultrasonic scaler (control) randomly. Treatments were performed at baseline and months three and six. At each session, oral hygiene was instructed after plaque registration, and the patient was guided in proper cleaning technique using a toothbrush and interproximal aids as needed. Full mouth bleeding on probing (FMBoP), full mouth plaque score (FMPS), implant bleeding on probing (BoP), implant mean graded bleeding (mBI), implant probing pocket depts (PPD), implant suppuration and bone levels were assessed. Oral health-related Quality of life (OHQoL) and visual analog scales (VAS), which reflect aesthetic satisfaction and pain of the treatment, were also evaluated.

Results
Forty-six patients were included. FMBoP was significantly reduced from 30.1 to 21.5% (test) (p < 0.001) respectively from 35.0% to 30% (control) (p < 0.01). FMPS showed significant reduction from 61.5 to 32.7% (test) (p < 0.001) and from 58.7 to 39.1% (control) (p < 0.001). At the implant BoP reduced from 89.0 to 55.7% (test) (p < 0.001) respectively from 94.9 to 63.7% (control) (p < 0.001). mBI was reduced from 1.3 to 0.6 (test) (p < 0.01) and from 1.9 to 0.8 (control) (p < 0.001). Distribution of “no bleeding” increased from 13 to 61% (test) (p < 0.05) and from 0 to 35% (control) (p < 0.05). At month three, statistically significant intergroup differences were shown for PPD ≥ 4 mm with 43.5% (test) respectively 73.9% (control) (p < 0.05). At month six, statistically significant intergroup differences, were shown for FMBoP 21.5% (test) respectively 30% (control) (p < 0.05) and for plaque score at the implant 4.0% (test) respectively 26% (control) (p < 0.05). Less pain was reported in the laser group at three days 0.08 (test) respectively 0.2 (control) (p < 0.05).

Conclusions
Treatment of peri-implant mucositis was effective regardless of whether the treatment was performed with an Er:YAG laser or an ultrasonic scaler. Fewer diseased sites were diagnosed at six months following laser treatment.

Trial registration: Registered at www.clinicaltrials.gov: study no, NCT05772299.
Causal association among smoking, bitter beverage consumption, and risk of osteoporosis: a two-sample mendelian randomization-based study
Authors: Wu Yanqian , Chao Jianqian , Bao Min , Zhang Na , Wang Leixia 
Published: January 2025

Abstract

Objectives
Two-sample MR methods were employed to analyze the impact of smoking and bitter beverage consumption on the risk of osteoporosis and osteoporosis with pathological fractures, in order to assess the causal association.

Methods
Publicly available genome-wide association study summary data were analyzed using MR methods. The exposures investigated were smoking (smoking per day, smoking initiation, and lifetime smoking index) and bitter beverages (coffee, tea, bitter alcoholic beverages, bitter non-alcoholic beverages, and total bitter beverages). The outcomes examined were the risk of osteoporosis and osteoporosis with pathological fractures. The inverse-variance weighted (IVW) method was used as the main statistical model. The stability and reliability of the results were verified by the Cochran’s Q test, the Egger-intercept test, and the leave-one-out analysis.

Results
Smoking per day was causally associated with the risk of osteoporosis OR = 1.417, 95% CI = 1.119–1.794, P = 0.003), and lifetime smoking index had a possible genetic causal association with the risk of osteoporosis with pathological fractures (OR = 4.187, 95% CI = 1.909–9.184, P < 0.001). No genetic causal association was found between smoking initiation or lifetime smoking index and the risk of osteoporosis (P > 0.05). No genetic causal association was identified between smoking per day or smoking initiation and the risk of osteoporosis with pathological fractures (P > 0.05). Total and bitter non-alcoholic beverage consumption showed a potential effect on the risk of osteoporosis (OR = 3.687, 95% CI = 1.535–8.858, P = 0.003 and OR = 3.040, 95% CI = 1.466–6.304, P = 0.002, respectively).

Conclusions
This study found smoking raises the risk of osteoporosis and osteoporosis with pathological fractures based on genetics. Certain bitter beverages are linked to an increased osteoporosis risk.
Utility of the C-Peptide/Insulin Molar Ratio for Distinguishing Type A Insulin Resistance Syndrome From Type 2 Diabetes
Authors: Nishikage Seiji , Hirota Yushi , Takayoshi Tomofumi , Yoshimura Kai , Takeuchi Takehito , Hamaguchi Tetsushi , Ueda Mariko , Yamamoto Akane , Sakaguchi Kazuhiko , Ogawa Wataru 
Published: January 2025

Abstract

Objective
Type A insulin resistance syndrome (IRS), characterized by impaired insulin receptor function due to variants of the insulin receptor gene, manifests as severe insulin-resistant diabetes. Differentiation of type A IRS from type 2 diabetes on the basis of hyperinsulinemia can be challenging. Given the association between insulin receptor dysfunction and reduced insulin clearance, we evaluated the potential of the circulating C-peptide reactivity (CPR)/immunoreactive insulin (IRI) molar ratio, a marker of insulin clearance, for distinguishing type A IRS from type 2 diabetes.

Methods
We retrospectively analyzed CPR and IRI levels measured during a 75-g oral glucose tolerance test (OGTT) in 18 individuals with type A IRS and 126 with type 2 diabetes. Receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic performance of the CPR/IRI molar ratio and IRI levels.

Results
IRI levels were significantly higher and the CPR/IRI molar ratio significantly lower in individuals with type A IRS compared with those with type 2 diabetes. The area under the ROC curve for the CPR/IRI molar ratio at baseline, 1 hour, and 2 hours after OGTT initiation was 0.997 (sensitivity 100%, specificity 99.2%), 0.999 (sensitivity 100%, specificity 97.6%), and 0.997 (sensitivity 100%, specificity 95.1%), respectively. The CPR/IRI molar ratio demonstrated robust diagnostic performance regardless of body mass index or hyperinsulinemia severity.

Conclusion
The CPR/IRI molar ratio, both at baseline and during OGTT, exhibited higher sensitivity and specificity than IRI levels alone for distinguishing type A IRS from type 2 diabetes. This ratio may serve as a reliable clinical marker for early and accurate diagnosis of type A IRS.
Acute Myocardial Infarction With Nonobstructive Coronary Arteries Across Endocrine Disorders: A Case Series
Authors: Roy Ayan , Patel Deepika , Merugu Chandhana , Kamalanathan Sadishkumar , Sahoo Jayaprakash , Naik Dukhabandhu 
Published: January 2025

Abstract
The endocrine and cardiology interface is particularly interesting and important. This is a case series of 3 endocrine diseases presenting with acute myocardial infarction without obstructive coronary arterial diseases (MINOCA). The diagnosis was Cushing’s disease due to pituitary microadenoma, adrenal pheochromocytoma, and primary hyperaldosteronism due to unilateral adrenal hyperplasia. All patients were managed conservatively and improved considerably following the management of underlying endocrine and cardiovascular diseases. A spectrum of classical endocrine diseases can present with MINOCA, and the underlying diagnosis is often overlooked. Patients without traditional risk factors for MINOCA should undergo hormonal workup to reveal the underlying diagnosis.
Pedagogy of Power
Authors: Rydel Courtney E. 
Published: January 2025

Abstract
Students in a first-year seminar gained a deeper understanding of Arthurian literature and its modern adaptations by studying the 2018 animated series She-Ra and the Princesses of Power in conversation with Chrétien de Troyes's twelfth-century story Perceval. She-Ra and Perceval share many motifs, symbols, and character elements due to their common heritage in medieval romance. Students analyzed how the inclusive, diverse She-Ra recuperates the themes of the Grail story from Perceval and extended its tradition of coming-of-age stories, which provides strategies for other teachers to use in bringing together historically and generically disparate texts. Studying She-Ra in the context of medieval literature enabled my students to deepen their understanding of both works and to think critically about how modern media transforms and transmits the stories and ideologies of the past.