bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of a shared decision making intervention for older adults with multiple chronic conditions: the DICO study
Authors: Pel-Littel Ruth E. , Buurman Bianca M. , van de Pol Marjolein H. , Twisk Jos W. R. , Tulner Linda R. , Minkman Mirella M. , Scholte op Reimer Wilma J. M. , van Weert Julia C. M. 
Published: March 2023

Abstract
Background
To evaluate the effects of a shared decision making (SDM) intervention for older adults with multiple chronic conditions (MCCs).

Methods
A pragmatic trial evaluated the effects of the SDMMCC intervention, existing of SDM training for nine geriatricians in two hospitals and a preparatory tool for patients. A prospective pre-intervention post-intervention multi-center clinical study was conducted in which an usual care group of older patients with MCC and their informal caregivers was included before the implementation of the intervention and a new cohort of patients and informal caregivers after the implementation of the intervention. SDM was observed using the OPTIONMCC during video-recorded consultations. Patient- and caregivers reported outcomes regarding their role in SDM, involvement, perceived SDM and decisional conflict were measured. The differences between groups regarding the level of observed SDM (OPTIONMCC) were analyzed with a mixed model analysis. Dichotomous patient-reported outcomes were analyzed with a logistic mixed model.

Results
From two outpatient geriatric clinics 216 patients with MCCs participated. The mean age was 77.3 years, and 56.3% of patients were female. No significant difference was found in the overall level of SDM as measured with the OPTIONMCC or in patient-reported outcomes. However, at item level the items discussing ‘goals’, ‘options’, and ‘decision making’ significantly improved after the intervention. The items discussing ‘partnership’ and ‘evaluating the decision-making process’ showed a significant decrease. Fifty-two percent of the patients completed the preparatory tool, but the results were only discussed in 12% of the consultations.

Conclusion
This study provides scope for improvement of SDM in geriatrics. Engaging older adults with MCCs and informal caregivers in the decision making process should be an essential part of SDM training for geriatricians, beyond the SDM steps of explaining options, benefits and harms. More attention should be paid to the integration of preparatory work in the consultation.
Service availability and readiness to provide comprehensive emergency obstetric and newborn care services in post-conflict at North Wollo Zone hospitals, Northeast Ethiopia: mixed survey
Authors: Tiruneh Misganaw Guadie , Fenta Eneyew Talie , Delie Amare Mebrat , Masresha Seteamlak Adane , Mustofa Semira Muhidin , Kidie Atitegeb Abera , Kodo Tsion Kokeb , Anagaw Tadele Fentabil 
Published: March 2023

Abstract
Introduction
Countries with humanitarian crises and fragile conditions contribute to 61% of the global burden of maternal mortality. Emergency Obstetric and Newborn Care (EmONC) services reduce direct obstetric complications, which cause approximately 70–80% of maternal deaths and 10% to 15% of neonatal deaths. Therefore, this study was aimed to assess the service availability and readiness to provide comprehensive emergency obstetric and newborn care services in post-conflict at North Wollo Zone hospitals, Northeast Ethiopia.

Methods
A facility-based mixed cross-sectional study design was conducted from May 10 to May 25, 2022, among North Wollo zone hospitals. Quantitative data were collected by using structured interviewer-administered questionnaires with observation and record review, entered by using Epi Data Version 4.6, and exported to SPSS 25 for analysis. Qualitative data were collected by key informant interviews and analyzed through thematic analysis. A descriptive data analysis was done to analyze the study variables.

Results
Only three of the six hospitals (Woldia, Shediho Meket, and Saint Lalibella) performed all signal functions of comprehensive emergency obstetric and newborn care in the preceding three months. Cesarean section was the least performed signal function in post-conflict. The overall readiness to provide comprehensive emergency obstetric and newborn care services was 77.7%. Only one of the six hospitals had sufficient blood without interruption, and three of the six facilities had done screening for hepatitis B, HIV, and syphilis. Lack of supplies, equipment, and drugs were the challenges for the performance of EmONC signal functions.

Conclusions
Post-conflict availability and readiness for comprehensive emergency obstetric and newborn care services in the North Wollo Zone was suboptimal. Shortage of medical supplies, equipment and emergency transportation was the challenges to provide these services. Thus, the hospital decision makers should strengthen leadership commitment, which focuses on recovering and rebuilding the destructed hospitals with resource mobilization and support.
Development and Evaluation of Rehabilitation Service Areas for the United States
Authors: Reistetter Timothy A. , Dean Julianna M. , Haas Allen M. , Prochaska John D. , Jupiter Daniel C. , Eschbach Karl , Kuo Yong-Fang 
Published: March 2023

Abstract
Background
Geographic areas have been developed for many healthcare sectors including acute and primary care. These areas aid in understanding health care supply, use, and outcomes. However, little attention has been given to developing similar geographic tools for understanding rehabilitation in post-acute care. The purpose of this study was to develop and characterize post-acute care Rehabilitation Service Areas (RSAs) in the United States (US) that reflect rehabilitation use by Medicare beneficiaries.

Methods
A patient origin study was conducted to cluster beneficiary ZIP (Zone Improvement Plan) code tabulation areas (ZCTAs) with providers who service those areas using Ward’s clustering method. We used US national Medicare claims data for 2013 to 2015 for beneficiaries discharged from an acute care hospital to an inpatient rehabilitation facility (IRF), skilled nursing facility (SNF), long-term care hospital (LTCH), or home health agency (HHA). Medicare is a US health insurance program primarily for older adults. The study population included patient records across all diagnostic groups. We used IRF, SNF, LTCH and HHA services to create the RSAs. We used 2013 and 2014 data (n = 2,730,366) to develop the RSAs and 2015 data (n = 1,118,936) to evaluate stability. We described the RSAs by provider type availability, population, and traveling patterns among beneficiaries.

Results
The method resulted in 1,711 discrete RSAs. 38.7% of these RSAs had IRFs, 16.1% had LTCHs, and 99.7% had SNFs. The number of RSAs varied across states; some had fewer than 10 while others had greater than 70. Overall, 21.9% of beneficiaries traveled from the RSA where they resided to another RSA for care.

Conclusions
Rehabilitation Service Areas are a new tool for the measurement and understanding of post-acute care utilization, resources, quality, and outcomes. These areas provide policy makers, researchers, and administrators with small-area boundaries to assess access, supply, demand, and understanding of financing to improve practice and policy for post-acute care in the US.
A snapshot of the prevalence of dihydropteroate synthase-431V mutation and other sulfadoxine-pyrimethamine resistance markers in Plasmodium falciparum isolates in Nigeria
Authors: Adegbola Adebanjo J. , Ijarotimi Omotade A. , Ubom Akaninyene E. , Adesoji Bukola A. , Babalola Olajide E. , Hocke Emma F. , Hansson Helle , Mousa Andria , Bolaji Oluseye O. , Alifrangis Michael , Roper Cally 
Published: March 2023

Abstract
Background
Malaria is a major public health issue with substantial risks among vulnerable populations. Currently, the World Health Organization (WHO) recommends SP-IPTp in the second and third trimesters. However, the efficacy of SP-IPTp is threatened by the emergence of sulfadoxine-pyrimethamine resistant malaria parasites due to single nucleotide polymorphisms in the Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthetase genes. This study aimed to assess the current prevalence of Pfdhfr/Pfdhps mutations in P. falciparum isolates collected from individuals residing in Ile-Ife, Nigeria, and also present maps of the prevalence of Pfdhps 431V and 581G within Nigeria and surrounding countries.

Methods
Between October 2020 and April 2021, samples were collected as dried blood spots among 188 participants who showed malaria positivity with a histidine-rich-protein-based rapid diagnostic test (RDT). Nested PCR assays were used to confirm falciparum in the samples with RDT positivity, and to amplify fragments of the Pfdhfr/Pfdhps genes followed by targeted amplicon sequencing. Published data since 2007 on the prevalence of the Pfdhps genotypes in Nigeria and the neighbouring countries were used to produce maps to show the distribution of the mutant genotypes.

Results
Only 74 and 61 samples were successfully amplified for the Pfdhfr and Pfdhps genes, respectively. At codons resulting in N51I, C59R, and S108N, Pfdhfr carried mutant alleles of 97.3% (72/74), 97.3% (72/74) and 98.6% (73/74), respectively. The Pfdhps gene carried mutations at codons resulting in amino acid changes at 431–436-437–540-581–613; I431V [45.9%, (28/61)], A581G [31.1% (19/61)] and A613S [49.2% (30/61)]. Constructed haplotypes were mainly the triple Pfdhfr mutant 51I-59R-108N (95.9%), and the most common haplotypes observed for the Pfdhps gene were the ISGKAA (32.8%), ISGKGS (8.2%), VAGKAA (14.8%), VAGKAS (9.8%) and VAGKGS (14.8%). In the context of the previously published data, a high prevalence of 431V/581G mutations was found in the study population. It seems quite evident that the Pfdhps 431V, 581G and 613S often co-occur as Pfdhps-VAGKGS haplotype.

Conclusion
This study showed that the prevalence of VAGKGS haplotype seems to be increasing in prevalence. If this is similar in effect to the emergence of 581G in East Africa, the efficacy of SP-IPTp in the presence of these novel Pfdhps mutants should be re-assessed.
Identifying individual, household and environmental risk factors for malaria infection on Bioko Island to inform interventions
Authors: García Guillermo A. , Janko Mark , Hergott Dianna E. B. , Donfack Olivier T. , Smith Jordan M. , Mba Eyono Jeremías Nzamío , DeBoer Kylie R. , Nguema Avue Restituto Mba , Phiri Wonder P. , Aldrich Edward M. , Schwabe Christopher , Stabler Thomas C. , Rivas Matilde Riloha , Cameron Ewan , Guerra Carlos A. , Cook Jackie , Kleinschmidt Immo , Bradley John 
Published: March 2023

Abstract
Background
Since 2004, malaria transmission on Bioko Island has declined significantly as a result of the scaling-up of control interventions. The aim of eliminating malaria from the Island remains elusive, however, underscoring the need to adapt control to the local context. Understanding the factors driving the risk of malaria infection is critical to inform optimal suits of interventions in this adaptive approach.

Methods
This study used individual and household-level data from the 2015 and 2018 annual malaria indicator surveys on Bioko Island, as well as remotely-sensed environmental data in multilevel logistic regression models to quantify the odds of malaria infection. The analyses were stratified by urban and rural settings and by survey year.

Results
Malaria prevalence was higher in 10–14-year-old children and similar between female and male individuals. After adjusting for demographic factors and other covariates, many of the variables investigated showed no significant association with malaria infection. The factor most strongly associated was history of travel to mainland Equatorial Guinea (mEG), which increased the odds significantly both in urban and rural settings (people who travelled had 4 times the odds of infection). Sleeping under a long-lasting insecticidal net decreased significantly the odds of malaria across urban and rural settings and survey years (net users had around 30% less odds of infection), highlighting their contribution to malaria control on the Island. Improved housing conditions indicated some protection, though this was not consistent across settings and survey year.

Conclusions
Malaria risk on Bioko Island is heterogeneous and determined by a combination of factors interacting with local mosquito ecology. These interactions grant further investigation in order to better adapt control according to need. The single most important risk factor identified was travel to mEG, in line with previous investigations, and represents a great challenge for the success of malaria control on the Island.
LncRNA-BC069792 suppresses tumor progression by targeting KCNQ4 in breast cancer
Authors: Zhang Yunxiang , Dong Xiaotong , Guo Xiangyu , Li Chunsen , Fan Yanping , Liu Pengju , Yuan Dawei , Ma Xialin , Wang Jingru , Zheng Jie , Li Hongli , Gao Peng 
Published: March 2023

Abstract
Background
Breast cancer is the most common malignant tumor that threatens women's health. Attention has been paid on the study of long- non-coding RNA (lncRNA) in breast cancer. However, the specific mechanism remains not clear.

Methods
In this study, we explored the role of lncRNA BC069792 in breast cancer. In vitro and in vivo functional experiments were carried out in cell culture and mouse models. High-throughput next-generation sequencing technology and real-time fluorescence quantitative PCR technology were used to evaluate differentially expressed genes and mRNA expression, Western blot and immunohistochemical staining were used to detect protein expression. RNA immunoprecipitation assay and dual-luciferase activity assay were used to evaluate the competing endogenous RNAs (ceRNA), and rescue and mutation experiments were used for verification.

Results
We found that lncRNA BC069792 was expressed at a low level in breast cancer tissues, and significantly decreased in breast cancer with high pathological grade, lymph node metastasis and high Ki-67 index groups. Moreover, BC069792 inhibited the proliferation, invasion and metastasis of breast cancer cells in vitro and in vivo. Mechanically, BC069792 acts as a molecular sponge to adsorb hsa-miR-658 and hsa-miR-4739, to up-regulate the protein expression of Potassium Voltage-Gated Channel Q4 (KCNQ4), inhibits the activities of JAK2 and p-AKT, and plays a role in inhibiting breast cancer growth.

Conclusions
LncRNA BC069792 plays the role of tumor suppressor gene in breast cancer and is a new diagnostic index and therapeutic target in breast cancer.
An intravitreal-injectable hydrogel depot doped borneol-decorated dual-drug-coloaded microemulsions for long-lasting retina delivery and synergistic therapy of wAMD
Authors: Su Wenting , Liu Congyan , Jiang Xi , Lv Yanli , Chen Qin , Shi Jiachen , Zhang Huangqin , Ma Qiuling , Ge Chang , Kong Fei , Li Xiaoqi , Liu Yuping , Chen Yan , Qu Ding 
Published: March 2023

AbstractSustained retina drug delivery and rational drug combination are considered essential for enhancing the efficacy of therapy for wet age-related macular degeneration (wAMD) due to the conservative structure of the posterior ocular segment and the multi-factorial pathological mechanism. Designing a drug co-delivery system that can simultaneously achieve deep penetration and long-lasting retention in the vitreous is highly desired, yet remains a huge challenge. In this study, we fabricated Bor/RB-M@TRG as an intravitreal-injectable hydrogel depot for deep penetration into the posterior ocular segment and long-lasting distribution in the retinal pigment epithelium (RPE) layer. The Bor/RB-M@TRG consisted of borneol-decorated rhein and baicalein-coloaded microemulsions (Bor/RB-M, the therapy entity) and a temperature-responsive hydrogel matrix (the intravitreal depot). Bor/RB-M exhibited the strongest in vitro anti-angiogenic effects among all the groups studied, which is potentially associated with improved cellular uptake, as well as the synergism of rhein and baicalein, acting via anti-angiogenic and anti-oxidative stress pathways, respectively. Importantly, a single intravitreal (IVT) injection with Bor/RB-M@TRG displayed significant inhibition against the CNV of wAMD model mice, compared to all other groups. Particularly, coumarin-6-labeled Bor/RB-M@TRG (Bor/C6-M@TRG) could not only deeply penetrate into the retina but also stably accumulate in the RPE layer for at least 14 days. Our design integrates the advantages of borneol-decorated microemulsions and hydrogel depots, offering a promising new approach for clinically-translatable retinal drug delivery and synergistic anti-wAMD treatment.
Mutation spectrum of Kallmann syndrome: identification of five novel mutations across ANOS1 and FGFR1
Authors: Chu Guoming , Li Pingping , Zhao Qian , He Rong , Zhao Yanyan 
Published: March 2023

Abstract
Background
Kallmann syndrome (KS) is a common type of idiopathic hypogonadotropic hypogonadism. To date, more than 30 genes including ANOS1 and FGFR1 have been identified in different genetic models of KS without affirmatory genotype–phenotype correlation, and novel mutations have been found.

Methods
A total of 35 unrelated patients with clinical features of disorder of sex development were recruited. Custom-panel sequencing or whole-exome sequencing was performed to detect the pathogenic mutations. Sanger sequencing was performed to verify single-nucleotide variants. Copy number variation-sequencing (CNV-seq) was performed to determine CNVs. The pathogenicity of the identified variant was predicted in silico. mRNA transcript analysis and minigene reporter assay were performed to test the effect of the mutation on splicing.

Results
ANOS1 gene c.709 T > A and c.711 G > T were evaluated as pathogenic by several commonly used software, and c.1063-2 A > T was verified by transcriptional splicing assay. The c.1063-2 A > T mutation activated a cryptic splice acceptor site downstream of the original splice acceptor site and resulted in an aberrant splicing of the 24-basepair at the 5′ end of exon 8, yielding a new transcript with c.1063–1086 deletion. FRFR1 gene c.1835delA was assessed as pathogenic according to the ACMG guideline. The CNV of del(8)(p12p11.22)chr8:g.36140000_38460000del was judged as pathogenic according to the ACMG & ClinGen technical standards.

Conclusions
Herein, we identified three novel ANOS1 mutations and two novel FGFR1 variations in Chinese KS families. In silico prediction and functional experiment evaluated the pathogenesis of ANOS1 mutations. FRFR1 c.1835delA mutation and del(8)(p12p11.22)chr8:g.36140000_38460000del were assessed as pathogenic variations. Therefore, our study expands the spectrum of mutations associated with KS and provides diagnostic evidence for patients who carry the same mutation in the future.
The relationship between psychological contract and occupational wellbeing of mother–infant care helpers in Zhejiang Province
Authors: Li Qingge , Li Yacen , Jin Ying , Feng Suwen 
Published: March 2023

Abstract
Background
Mother–infant care (MIC) helpers have become an indispensable part in hospital services. In order to stabilize the MIC workforce, it is essential for administrators to have a solid understanding of what may influence occupational wellbeing. This article aims to explore how demographic characteristics and psychological contract affect occupational wellbeing among MIC helpers in Zhejiang Province, China.

Methods
This is a quantitative, cross-sectional study with MIC helpers in obstetrics from 20 hospitals in Zhejiang Province. A questionnaire including demographic data, a psychological contract scale and an occupational wellbeing scale was used in this study. Multiple linear regression was conducted to investigate the relationships between demographic characteristics, psychological contract and occupational wellbeing.

Results
This study surveyed 260 MIC helpers and found out the mean score of the psychological contract was 4.38 and the mean score of the occupational wellbeing was 4.01. Monthly income and psychological contract were significant predictors of occupational wellbeing (F = 142.167, p < 0.001), which explained 62.1% of the total amount of variance in occupational wellbeing. Psychological contract was the most important predictor of occupational wellbeing.

Conclusions
Administrators should pay attention to the effect of psychological contract on occupational wellbeing of the MIC helpers in China. Focusing on the inner needs should be considered as a strategy for stabilizing the team.
Berberine ameliorates depression-like behaviors in mice via inhibiting NLRP3 inflammasome-mediated neuroinflammation and preventing neuroplasticity disruption
Authors: Qin Zongshi , Shi Dong-Dong , Li Wenqi , Cheng Dan , Zhang Ying-Dan , Zhang Sen , Tsoi Bun , Zhao Jia , Wang Zhen , Zhang Zhang-Jin 
Published: March 2023

Abstract
Objectives
Neuroinflammation has been suggested that affects the processing of depression. There is renewed interest in berberine owing to its anti-inflammatory effects. Herein, we investigated whether berberine attenuate depressive-like behaviors via inhibiting NLRP3 inflammasome activation in mice model of depression.

Methods
Adult male C57BL/6N mice were administrated corticosterone (CORT, 20 mg/kg/day) for 35 days. Two doses (100 mg/kg/day and 200 mg/kg/day) of berberine were orally administrated from day 7 until day 35. Behavioral tests were performed to measure the depression-like behaviors alterations. Differentially expressed gene analysis was performed for RNA-sequencing data in the prefrontal cortex. NLRP3 inflammasome was measured by quantitative reverse transcription polymerase chain reaction, western blotting, and immunofluorescence labeling. The neuroplasticity and synaptic function were measured by immunofluorescence labeling, Golgi–Cox staining, transmission electron microscope, and whole-cell patch-clamp recordings.

Results
The results of behavioral tests demonstrated that berberine attenuated the depression-like behaviors induced by CORT. RNA-sequencing identified that NLRP3 was markedly upregulated after long-term CORT exposure. Berberine reversed the concentrations of peripheral and brain cytokines, NLRP3 inflammasome elicited by CORT in the prefrontal cortex and hippocampus were decreased by berberine. In addition, the lower frequency of neuronal excitation as well as the dendritic spine reduction were reversed by berberine treatment. Together, berberine increases hippocampal adult neurogenesis and synaptic plasticity induced by CORT.

Conclusion
The anti-depressants effects of berberine were accompanied by reduced the neuroinflammatory response via inhibiting the activation of NLRP3 inflammasome and rescued the neuronal deterioration via suppression of impairments in synaptic plasticity and neurogenesis.