bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relationship between beliefs in substance craving and quality of life among narcotics anonymous: a cross-sectional study in southeastern Iran
Authors: Dehghan Mahlagha , Malakoutikhah Alireza , Kazemy Homayoon , Fattahi Toqroljerdi Mohammad Hossein , Mokhtarabadi Sima , Zakeri Mohammad Ali 
Published: April 2023

Abstract
Background
Addiction is a chronic and relapsing disorder characterized by compulsive drug seeking and lasting changes in the brain. Low quality of life may influence the substance craving, which leads to relapsing. Therefore, the present study aimed to investigate the relationship between beliefs in substance craving and quality of life among narcotics anonymous.

Methods
This cross-sectional study was performed on 202 narcotics anonymous in Kerman, southeastern Iran. Convenience sampling was used to select anonymous patients in the Narcotics Anonymous (NA) association in Kerman city. Narcotics anonymous completed the demographic questionnaire, the Craving Beliefs Questionnaire (CBQ), and the World Health Organization Quality of Life-BREF (WHOQOL-BREF). Multiple linear regression model was used to determine the predictors of craving beliefs. The data were then analyzed using SPSS 22.

Results
The mean age of the participants was 38.48 ± 11.32 years. The majority of the samples were male (86.1%), married (65.4%), educated (93.6%) and urban (86.1%). The mean scores of craving beliefs and overall Quality of Life (QOL) were 77.58 ± 20.70 and 64.42 ± 23.13, respectively. Forty-two-point 1% had high level of craving beliefs. We found a significant negative and weak correlation between beliefs in substance craving, physical health domain (r = -0.16, p = 0.02), and overall quality of life (r = -0.15, p = 0.03). History of crack use, job, and physical health domain of QOL were predictors of beliefs in substance craving among the NAs.

Conclusion
Based on the study results, the participants had a high level of substance craving, and some aspects of the quality of life had an impact on the beliefs of addiction. However, it is necessary to conduct more studies in this field; psychological interventions and programs to increase the quality of life may reduce the substance craving.
Prognostic stratification of oropharyngeal cancer patients in a betel nut chewing and low HPV area
Authors: Lee Huai-Pao , Lee Ching-Chih 
Published: April 2023

Background This study aimed to establish a simple predictive model for oropharyngeal cancer (OPC) in an area with a relatively low prevalence of human papillomavirus (HPV) and frequent betel nut chewing. Methods A total of 116 patients with OPC were recruited from the clinical research database of a referral cancer center between 2013 and 2018. Patient characteristics—including age, gender, tumor stage, differentiation, and treatment modality—were extracted from the database. Patients diagnosed after 2018 were staged using the 7th AJCC staging system to explore the impact of extra-nodal tumor extension (ENE) on survival. Immunohistochemical analysis was performed for p16, epidermal growth factor receptor (EGFR), p53, and programmed cell death ligand 1 (PD-L1). ENE status was evaluated by pathological analysis or radiological features. Primary outcome was disease-specific overall survival (OS). Univariate and multivariate Cox regression were used to establish a predictive model. Results Mean age was 57.3 ± 9.9 years; 103 patients (88.8%) were male. P16 positive OPC was positively associated with higher PD-L1 and a tonsillar sub-site and negatively associated with betel nut chewing and cigarette smoking. In Cox regression, age, p16 status, EGFR, cT4, ENE, and cigarette smoking were significantly associated with OS. In survival tree analysis, cT stage was the most important risk stratification parameter, followed by EGFR expression and p16 status. Patients with cT4 stage or high EGFR were classified as the high-risk group and had poorest OS. Conclusions Due to the low prevalence of HPV and popularity of betel nut chewing in Asia, the relative importance of prognostic predictors for OPC are not identical to Western countries. Identification of significant prognostic biomarkers may improve treatment. Trial registration This study was registered and approved by the Institutional Review Board (IRB) of Kaohsiung Veterans General Hospital (VGHKS19-CT9-07; date of approval: Aug 9, 2019). Graphic Abstract
Potential of cell-free hemoglobin and haptoglobin as prognostic markers in patients with ARDS and treatment with veno-venous ECMO
Authors: Bünger Victoria , Hunsicker Oliver , Krannich Alexander , Balzer Felix , Spies Claudia D. , Kuebler Wolfgang M. , Weber-Carstens Steffen , Menk Mario , Graw Jan A. 
Published: April 2023

Abstract
Background
Hemolysis is associated with increased mortality in patients with sepsis, ARDS, or therapy with extracorporeal membrane oxygenation (ECMO). To quantify a critical threshold of hemolysis in patients with ARDS and treatment with veno-venous ECMO, we aimed to identify cutoff values for cell-free hemoglobin (CFH) and haptoglobin (Hp) plasma concentrations associated with a significant increase in ICU mortality.

Methods
Patients with ARDS admitted to a tertiary ARDS referral center between 01/2007 and 12/2018 and treatment with veno-venous ECMO were included. Cutoff values for mean CFH (mCFH) and mean Hp (mHp) plasma concentrations dividing the cohort into groups with significantly different ICU mortalities were calculated and patient characteristics were compared. A multiple logistic regression model with stepwise backward variable selection was included. In addition, cutoff values for vulnerable relative timespans for the respective CFH and Hp concentrations were calculated.

Results
A quantitative cutoff value of 11 mg/dl for mCFH separated the cohort (n = 442) regarding ICU mortality (mCFH ≤ 11 mg/dl: 38%, [95%-CI: 32.22–43.93] (n = 277) vs. mCFH > 11 mg/dl: 70%, [61.99–76.47] (n = 165), p < 0.001). Analogously, a mHp cutoff value ≤ 0.39 g/l was associated with a significant increase in ICU mortality (mHp ≤ 0.39 g/l: 68.7%, [60.91–75.61] (n = 163) vs. mHp > 0.39 g/l: 38.7%, [33.01–44.72] (n = 279), p < 0.001). The independent association of ICU mortality with CFH and Hp cutoff values was confirmed by logistic regression adjusting for confounders (CFH Grouping: OR 3.77, [2.51–5.72], p < 0.001; Hp Grouping: OR 0.29, [0.19–0.43], p < 0.001). A significant increase in ICU mortality was observed when CFH plasma concentration exceeded the limit of 11 mg/dl on 13.3% of therapy days (≤ 13.3% of days with CFH > 11 mg/dl: 33%; [26.81–40.54] (n = 192) vs. > 13.3% of days with CFH > 11 mg/dl: 62%; [56.05–68.36] (n = 250), p < 0.001). Analogously, a mortality increase was detected when Hp plasma concentration remained ≤ 0.39 g/l for > 18.2% of therapy days (≤ 18.2% days with Hp ≤ 0.39 g/l: 27%; [19.80–35.14] (n = 138) vs. > 18.2% days with Hp ≤ 0.39 g/l: 60%; [54.43–65.70] (n = 304), p < 0.001).

Conclusions
Moderate hemolysis with mCFH-levels as low as 11 mg/dl impacts mortality in patients with ARDS and therapy with veno-venous ECMO. Furthermore, a cumulative dose effect should be considered indicated by the relative therapy days with CFH-concentrations > 11 mg/dl. In addition, also Hp plasma concentrations need consideration when the injurious effect of elevated CFH is evaluated.
Enhancement of alkaline protease production in recombinant Bacillus licheniformis by response surface methodology
Authors: Zhang Ying , Hu Jingmin , Zhang Qing , Cai Dongbo , Chen Shouwen , Wang Yonghong 
Published: April 2023

AbstractAlkaline protease is widely used in the food, detergent, and pharmaceutical industries because of its comparatively great hydrolysis ability and alkali tolerance. To improve the ability of the recombinant Bacillus licheniformis to produce alkaline protease, single-factor experiments and response surface methodology (RSM) were utilized to determine and develop optimal culture conditions. The results showed that three factors (corn starch content, soybean meal content, and initial medium pH) had significant effects on alkaline protease production (P < 0.05), as determined through the Plackett‒Burman design. The maximum enzyme activity was observed with an optimal medium composition by central composite design (CCD): corn starch, 92.3 g/L; soybean meal, 35.8 g/L; and initial medium pH, 9.58. Under these optimum conditions, the alkaline protease activity of strain BL10::aprE was 15,435.1 U/mL, 82% higher than that in the initial fermentation medium. To further investigate the application of the optimum fermentation medium, the overexpressed strain BL10::aprE/pHYaprE was cultured using the optimized medium to achieve an enzyme activity of 39,233.6 U/mL. The present study achieved the highest enzyme activity of alkaline protease by B. licheniformis at the shake-flask fermentation level, which has important application value for large-scale production.
Graphical Abstract
Extractive adsorption of 1,3-propanediol on a novel polystyrene macroporous resin enclosing medium and long-chain alcohols as extractant
Authors: Sui Wen-Bo , Huang Lu-Sheng , Wang Xiao-Li , Zhou Xu , Sun Ya-Qin , Xiu Zhi-Long 
Published: April 2023

AbstractExtractive adsorption is an integrated separation method employing a novel resin with both particle and liquid characteristics in terms of adsorption and extraction. In this study, the novel extractive adsorption polystyrene-divinylbenzene (PS-DVB) macroporous resin was synthesized by suspension polymerization, in which n-octanol (OL-PS-DVB) or mixed alcohols of n-octanol, undecyl alcohol, and tetradecyl alcohol (MA-PS-DVB) were added as porogen and enclosed in the resin skeleton after the reaction. The characterization of the two novel resins of OL-PS-DVB and MA-PS-DVB showed that they have large specific surface areas of 48.7 and 17.4 m2/g, respectively. Additionally, the two synthesized resins have much higher static adsorption capacities of 1,3-propanediol (511 and 473 mg/g) and dynamic adsorption capacities (312 and 267 mg/g) than traditional resins, because extractants enclosed in the resin can increase the adsorption capacity. Through Langmuir equation, the theoretical static maximum adsorption capacity of the mixed alcohols resin is 515 mg/g at 298 K and Gibbs free energy change of adsorption was -3781 J/mol, indicating that the adsorption process was spontaneous. In addition, the sorbent concentration effect in the resin was generated at high 1,3-propanediol (1,3-PDO) concentrations. The fitting of the Flocculation model can reveal that there is a possible relation between adsorption and flocculation. Compared to OL-PS-DVB, MA-PS-DVB showed better performance in the recovery yield of 1,3-PDO and other byproducts, the removal rates of the inorganic salt and protein, and the efficiency of recycled resin. For MA-PS-DVB, the recovery of 1,3-PDO, butyrate acid, acetic acid, and residual glycerol was 97.1%, 94.7%, 93.3%, and 90.3%, respectively. Simultaneously, the resin of MA-PS-DVB could remove 93.8% of inorganic salts and 90.9% of proteins in the concentrated fermentation broth. The two synthesized resins of OL-PS-DVB and MA-PS-DVB still had 90% or 92% of capacity for extractive adsorption of 1,3-propanediol after 10 times of recycling, which exhibited potential application in the separation of 1,3-propanediol from fermentation broth.
Qualitative concept elicitation and cognitive debriefing interviews of symptoms, impacts and selected customized PROMIS® Short Forms: a study in patients with axial spondyloarthritis
Authors: Findley Amy , Middlehurst Jessica M. , Howse Chloe A. , Clifford Molly J. , Neill William , Tatlock Sophi , Chen Wen-Hung , Bracher Marguerite G. , Patel Dharm S. 
Published: April 2023

Abstract
Background
Sleep disturbance, pain, and fatigue are key symptoms/impacts of axial spondyloarthritis (axSpA). Three customized Patient-Reported Outcomes Measurement Information System (PROMIS®) Short Forms (Sleep Disturbance, Pain Interference, and Fatigue) have been proposed for use in axSpA to assess these key disease concepts. This study was designed to further understand the patient experience of axSpA and evaluate the content validity of the three customized PROMIS® Short Forms to support their use in axSpA clinical trials.

Methods
Non-interventional, cross-sectional, qualitative (concept elicitation [CE] and cognitive debriefing [CD]) study. Participants took part in 90-min telephone interviews. The CE section used open-ended questions to elicit information about axSpA symptoms and impacts. The CD section involved a ‘think-aloud’ exercise where participants read out each instruction, item, and response option for the customized PROMIS® Short Forms and shared their feedback. Participants also discussed the relevance of the items, response options and recall period. Verbatim interview transcripts were subject to thematic and content analysis.

Results
In total, there were 28 participants (non-radiographic axSpA, n = 12; ankylosing spondylitis, n = 16), from the US (n = 20) and Germany (n = 8). Mean age was 52.8 years, and 57% were male; mean time since diagnosis was 9.5 years. The CE section identified 12 distinct symptoms that characterized axSpA: pain, sleep problems, fatigue/tiredness, stiffness, swelling, vision/eye issues, restricted body movements, headache/migraine, spasms, change in posture/stature, balance/coordination problems, and numbness. Pain, sleep problems, and fatigue/tiredness were experienced by ≥ 90% of participants, occurring simultaneously and exacerbating one another. Participants reported axSpA impacted their lives across six domains of health-related quality of life (HRQoL): physical functioning (100%), emotional wellbeing (89%), work/volunteering (79%), social functioning (75%), activities of daily living (61%) and cognitive functioning (54%). Impacts were most frequently associated with pain, stiffness, and fatigue. CD showed the PROMIS® instruments were conceptually comprehensive and well understood, with all items relevant to ≥ 50% of participants.

Conclusions
Pain, sleep problems and fatigue are pivotal symptoms of axSpA and associated with HRQoL impacts. These results were used to update a conceptual model of axSpA which was originally developed based on a targeted literature review. Interpretability and content validity of the customized PROMIS® Short Forms were confirmed, with each deemed to adequately assess key impacts associated with axSpA, making them suitable for use in axSpA clinical trials.
Development and early qualitative evidence of two novel patient-reported outcome instruments to assess daily functioning in people with early-stage Parkinson’s
Authors: Morel Thomas , Cleanthous Sophie , Andrejack John , Barker Roger A. , Biagioni Milton , Blavat Geraldine , Bloem Bastiaan R. , Boroojerdi Babak , Brooks William , Burns Paul , Cano Stefan , Gallagher Casey , Gosden Lesley , Siu Carroll , Slagle Ashley F. , Ratcliffe Natasha , Schroeder Karlin 
Published: April 2023

Abstract
Background
Previous research on concepts that are important to people living with early-stage Parkinson’s indicated that ‘functional’ slowness, fine motor skills, and subtle gait abnormalities are cardinal concepts that are not comprehensively captured by existing patient-reported outcome (PRO) instruments that are used in clinical practice and research to assess symptoms and daily functioning within this patient population. We sought to develop novel PRO instruments to address this unmet need.

Methods
PRO instrument development was led by a multidisciplinary research group, including people living with Parkinson’s (termed ‘patient experts’), as well as patient engagement and involvement, regulatory science, clinical, and outcome measurement experts. A first set of PRO instruments, termed Early Parkinson’s Function Slowness (42 items) and Early Parkinson’s Mobility (26 items), were drafted to capture ‘functional’ slowness, fine motor skills, and subtle gait abnormalities. These PRO instruments were used in cognitive debriefing interviews with people living with early-stage Parkinson’s (who were not involved with the multidisciplinary research group) to identify issues with relevance, clarity, ease of completion, conceptual overlap, or missing concepts.

Results
Sixty people living with early-stage Parkinson’s were interviewed, which led to refining the items to 45 for the Early Parkinson’s Functional Slowness and 23 for the Early Parkinson’s Mobility PRO instruments. Refinement included rewording items to address clarity issues, merging or splitting items to address overlap issues, and adding new items to address missing concepts. The Early Parkinson’s Function Slowness PRO instrument resulted in a multidimensional instrument covering upper limb, complex/whole body, general activity, and cognitive functional slowness. The Early Parkinson’s Mobility PRO instrument resulted in comprehensive coverage of everyday mobility tasks, with a focus on gait concepts, plus complex/whole body, balance, and lower limb mobility.

Conclusions
The Early Parkinson’s Function Slowness and Early Parkinson’s Mobility PRO instruments aim to address gaps in existing PRO instruments to measure meaningful symptoms and daily functioning in people living with early-stage Parkinson’s. Utilizing a meticulous study design led by a multidisciplinary research group that included patient experts helped to ensure that the PRO instruments were patient-centric, content valid, and meaningful from a clinical and measurement perspective.
Evaluating the sustainability of lightweight drones for delivery: towards a suitable methodology for assessment
Authors: Mitchell Sinéad , Steinbach Juliana , Flanagan Tomás , Ghabezi Pouyan , Harrison Noel , O’Reilly Simon , Killian Stephen , Finnegan William 
Published: April 2023

AbstractDrone technology is widely available and is rapidly becoming a crucial instrument in the functions of businesses and government agencies worldwide. The demand for delivery services is accelerating particularly since the Covid-19 pandemic. Both companies and customers want these services to be efficient, timely, safe, and sustainable, but these are major challenges. Last-mile delivery by lightweight short-range drones has the potential to address these challenges. However, there is a lack of consistency and transparency in assessing and reporting the sustainability of last-mile delivery services and drones. This paper critically reviews published papers on Life Cycle Assessments of drones to date. The study reveals a lack of comprehensive studies, and a need to examine composite and battery manufacturing developments and provides key considerations for future study development.
Graphical Abstract
Biochemical and histopathological responses of Biomphalaria alexandrina to RIPEX (plant growth regulator)
Authors: Abdel-Azeem Hoda H. , Mohamed Azza H. , Habib Mohamed R. 
Published: April 2023

Abstract
Background
Plant growth regulators are widely used in agriculture for increasing the growth and ripening of plants, but they endanger the aquatic ecosystem. The current study assessed the effect of sublethal exposure to RIPEX 48% EC concentrations (8 and 16 µL/L) on oxidative stress parameters, sex hormones, immune potential enzymes, differential hemocyte counts, and the histopathology of digestive glands and ovotestis in Biomphalaria alexandrina snails.

Results
RIPEX exposure caused an overall increase in Superoxide dismutase and Glutathione-S-Transferase activities in B. alexandrina. However, extreme RIPEX exposure inhibits SOD activity in snails. Malondialdehyde activity showed an increase in B. alexandrina exposed to both concentrations after all exposure periods. RIPEX also caused a significant increase in testosterone in snails exposed to 16 µL/L, it did, however, reduce hormone levels in snails exposed to 8 µL/L at 7 days. Regarding estradiol, there was a significant increase after 3 days of exposure to 16 µl/L and 7 days of exposure to 8 µL/L. RIPEX exposure also increased the activities of Myeloperoxidase and Adenosine deaminase enzymes in the digestive glands of snails. It increased the total hemocyte count of exposed snails as well as the number of granulocytes. Snail digestive glands and ovotestis showed pathological alterations after 7 days of RIPEX exposure.

Conclusions
These findings suggest that RIPEX is toxic to B. alexandrina and that this snail can be used as a bioindicator for environmental contamination with plant growth regulators.
The effectiveness of a primary care-based collaborative care model to improve quality of life in people with severe mental illness: PARTNERS2 cluster randomised controlled trial
Authors: Byng Richard , Creanor Siobhan , Jones Benjamin , Hosking Joanne , Plappert Humera , Bevan Sheriden , Britten Nicky , Clark Michael , Davies Linda , Frost Julia , Gask Linda , Gibbons Bliss , Gibson John , Hardy Pollyanna , Hobson-Merrett Charley , Huxley Peter , Jeffery Alison , Marwaha Steven , Rawcliffe Tim , Reilly Siobhan , Richards Debra , Sayers Ruth , Williams Lynsey , Pinfold Vanessa , Birchwood Maximillian 
Published: April 2023

BackgroundIndividuals living with severe mental illness can have significant emotional, physical and social challenges. Collaborative care combines clinical and organisational components.AimsWe tested whether a primary care-based collaborative care model (PARTNERS) would improve quality of life for people with diagnoses of schizophrenia, bipolar disorder or other psychoses, compared with usual care.MethodWe conducted a general practice-based, cluster randomised controlled superiority trial. Practices were recruited from four English regions and allocated (1:1) to intervention or control. Individuals receiving limited input in secondary care or who were under primary care only were eligible. The 12-month PARTNERS intervention incorporated person-centred coaching support and liaison work. The primary outcome was quality of life as measured by the Manchester Short Assessment of Quality of Life (MANSA).ResultsWe allocated 39 general practices, with 198 participants, to the PARTNERS intervention (20 practices, 116 participants) or control (19 practices, 82 participants). Primary outcome data were available for 99 (85.3%) intervention and 71 (86.6%) control participants. Mean change in overall MANSA score did not differ between the groups (intervention: 0.25, s.d. 0.73; control: 0.21, s.d. 0.86; estimated fully adjusted between-group difference 0.03, 95% CI −0.25 to 0.31; P = 0.819). Acute mental health episodes (safety outcome) included three crises in the intervention group and four in the control group.ConclusionsThere was no evidence of a difference in quality of life, as measured with the MANSA, between those receiving the PARTNERS intervention and usual care. Shifting care to primary care was not associated with increased adverse outcomes.