bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of acute urinary retention on the results of transurethral resection of the prostate
Authors: Baran Caner 
Published: July 2023

Introduction: Acute urinary retention (AUR) is one of the most severe symptoms of Benign Prostatic Hyperplasia (BPH). There are some studies in the literature describing the risk factors for the development of AUR in BPH patients. However, the studies that summarize the effect of AUR on Transurethral resection of Prostate (TUR-P) surgery results are limited. The aim of this study is to assess the effect of AUR on TUR-P results. Methods: Between 2018 and 2020, patients who underwent TUR-P for AUR or lower urinary tract symptoms (LUTS) were included in the study. The inclusion criteria were, men over 50 years old with a BPH diagnosis and who underwent monopolar TUR-P by a single surgeon. The exclusion criteria were; patients who had prostate cancer, multiple sclerosis, or neurogenic bladder were diagnosed or had previous lower urinary tract surgeries such as TUR-P, TUR-Bladder, Urethrotomy, had a chronic indwelling catheter, and patients who did not accept immediate TUR-P and preferred trial without catheter (TWOC) protocol. The age, PSA, prostate volume, pre- and post-operative flow rates, duration of hospitalization, and complications were recorded. Two groups were constituted for comparison such as AUR and Elective Group and p values <0.05 were considered significant. Results: There were 14 and 46 patients for AUR and Elective Groups respectively. The age, pre-operative prostate volume, free and total PSA values, postoperative complication rate, and re-hospitalization rate were significantly higher in the AUR-Group. However, there were no differences between groups in terms of pre-operative medication, duration of hospitalization, and post-operative uroflow maximum flow rate. Discussion: Patients who underwent TUR-P after AUR have a higher risk for complications and re-hospitalization. Care should be taken in these patients and patients should be warned about the risks.
Racial and Ethnic Differences in Awareness and Prevalence of Unidentified Cardiovascular Risk Factors Among Health System Employees
Authors: Makaryus Amgad N. , Rosen Stacey E. , Kang Leslie , Shaw Leslee J. , Nash Beth , Gajer Reva , Coppolino Whitney , Mieres Jennifer H. 
Published: July 2023

Purpose To evaluate awareness about cardiovascular (CVD) risk among a racially and ethnically diverse cohort of health system employees. Design Cross-sectional study. Setting Voluntary survey of health system employees during an annual CVD awareness and screening event. Subjects 759 health system employees. Measures We performed initial CVD screening measurements (blood pressure, body mass index) and collected patient-reported answers to questions about their own CVD risk factors (hypertension, high cholesterol, diabetes, overweight, smoking, physical inactivity and family history of CVD) and whether or not they believed that CVD is preventable. Subjects were offered in-depth follow-up CVD screening (lipid panel, hs-CRP, hemoglobin A1c), if interested. Analysis Continuous measures were compared across sex and racial/ethnic subsets using a t test and analysis of variance technique. Univariable and multivariable logistic regression models were used to estimate the employee’s willingness to undergo further comprehensive screening. Results African American, Hispanic, and Asian employees were younger than white employees ( P < .0001). More than one-quarter of African Americans reported a history of hypertension, a higher rate than for other subgroups ( P = .001). The rate of self-reported diabetes was highest in African American and Asian employees ( P = .001). African Americans had a 54% reduced odds of electing to pursue follow-up CVD screening (odds ratio: .46, 95% confidence interval = .24−.91, P = .025). Conclusion Presence of CVD risk factors and knowledge of their importance differ among racial and ethnic groups of health system employees in our cohort as does interest in pursuing follow-up screening once risk factors are identified. Development of evidence-based customization strategies by racial and ethnic group may improve understanding of and interest in CVD risk factors and advance prevention. The data from this study will inform future research and strategies for employee health promotion.
Fearing Pain at the End of Life: A Review of Advance Directives
Authors: Luck George , Eggenberger Terry Lynn , Bautista Adriana , Peters Darian , Mellman Ross T. , Keller Kathryn B. , Jacomino Mario 
Published: July 2023

Background Patients, caregivers, and healthcare professionals often describe a “good death” as a pain-free process. However, many patients experience pain during their last weeks of life. Advance directives (ADs) are legally binding documents that allow individuals to express their wishes for end-of-life care which should include management of their pain. Methods An interprofessional team conducted a comprehensive analysis of ADs from all 50 states and the District of Columbia to assess the inclusion of language that reflects patients’ wishes for pain relief at the end of life. Results Thirty-seven (73%) of the 51 entities examined reflected the prototypical directive, containing explicit instructions for withholding or withdrawing interventions that may prolong suffering rather than options for treating pain. Of these, 12 (24%) did not include the word “pain”. Only 14 states (27%) provided clear guidance for managing pain. Unexpectantly, researchers found that 13 (25%) addressed the common fears of patients, caregivers, and healthcare teams when using opioids to relieve suffering, such as addiction, sedation, appetite, or respiratory suppression, and hastening death. Conclusion The majority of ADs reviewed lacked clear and comprehensive measures for addressing pain relief. This deficiency may contribute to the undertreatment of pain and amplify the anxiety felt by patients, families, and healthcare providers when making end-of-life decisions. The results highlight the need for improvements in ADs to help ensure that patients' wishes regarding pain management are adequately addressed, documented and respected.
Frequency of new asymptomatic MRI lesions during attacks and follow-up of patients with NMOSD in a real-world setting
Authors: Carnero Contentti Edgar , Lopez Pablo A , Tkachuk Verónica , Vrech Carlos , Zarate María A , Correale Jorge , Deri Norma , Luetic Geraldine , Marrodan Mariano , Pagani Cassara Fátima , Tavolini Darío , Ysrraelit María Célica , Balbuena María E , Hryb Javier , Chiganer Edson , Leguizamon Felisa , Knorre Eduardo , Zanga Gisela , Pestchanker Claudia , Barboza Andrés , Nadur Débora , Cristiano Edgardo , Patrucco Liliana , Alonso Ricardo , Alonso Serena Marina , Paul Friedemann , Rojas Juan Ignacio 
Published: July 2023

Background: We aimed to assess the frequency of new asymptomatic lesions on brain and spinal imaging (magnetic resonance imaging (MRI)) and their association with subsequent relapses in a large cohort of neuromyelitis optica spectrum disorder (NMOSD) patients in Argentina. Methods: We retrospectively reviewed 675 MRI (225 performed during an attack and 450 during the relapse-free period (performed at least 3 months from the last attack)) of NMOSD patients who had at least 2 years of clinical and MRI follow-up since disease onset. Kaplan–Meier (KM) curves were used for depicting time from remission MRI to subsequent relapse. Results: We included 135 NMOSD patients (64.4% were aquaporin-4-immunoglobulin G (AQP4-IgG)-positive). We found that 26 (19.26%) and 66 (48.88%) of patients experienced at least one new asymptomatic MRI lesion during both the relapse-free period and attacks, respectively. The most frequent asymptomatic MRI lesions were optic nerves followed by short-segment myelitis during the relapse-free period and attacks. KM curves did not show differences in the time taken to develop a new relapse. Conclusion: Our findings showed that new asymptomatic lesions are relatively frequent. However, the presence of new asymptomatic MRI lesions during the relapse-free period and at relapses was not associated with a shorter time to developing subsequent relapses.
Digital health care and data work: Who are the data professionals?
Authors: Bossen Claus , Bertelsen Pernille Scholdan 
Published: July 2023

Background: This article reports on a study that investigated data professionals in health care. The topic is interesting and relevant because of the ongoing trend towards digitisation of the healthcare domain and efforts for it to become data driven, which entail a wide variety of work with data. Objective: Despite an interest in data science and more broadly in data work, we know surprisingly little about the people who work with data in healthcare. Therefore, we investigated data work at a large national healthcare data organisation in Denmark. Method: An explorative mixed method approach combining a non-probability technique for design of an open survey with a target population of 300+ and 11 semi-structured interviews, was applied. Results: We report findings relevant to educational background, work identity, work tasks, and how staff acquired competences and knowledge, as well as what these attributes comprised. We found recurring themes of healthcare knowledge, data analytical skills, and information technology, reflected in education, competences and knowledge. However, there was considerable variation within and beyond those themes, and indeed most competences were learned “on the job” rather than as part of formal education. Conclusion: Becoming a professional working with data in health care can be the result of different career paths. The most recurring work identity was that of “data analyst”; however, a wide variety of responses indicated that a stable data worker identity has not yet developed. Implications: The findings present implications for educational policy makers and healthcare managers.
Defining career success: A cross-sectional analysis of health information managers’ perceptions
Authors: Nexhip Abbey , Riley Merilyn , Robinson Kerin 
Published: July 2023

Background: Career success can be defined as the accomplishment of desirable outcomes in an individual’s work experiences. It can be divided into objective and subjective career success. Objective success refers to tangible and measurable outcomes such as promotions and position titles. Subjective career success relates to an individual’s interpretations of their success or accomplishments. The career success of health information management professionals has not been explored in the literature. Aim: To determine the indicators of career success as reported by health information managers (HIMs) and identify whether there are any differences based on length of time in the profession. Methods: Using a cross-sectional study design, an online survey was administered to a sample of La Trobe University and Lincoln Institute of Health Sciences Medical Record Administration and Health Information Management graduates from 1985, 1995, 2005 and 2015, which included the following question: “How would you define success in your career?” Results: Almost 88% ( n = 63) of overall participants in the study responded to this item. Subjective factors ( n = 77) of career success, compared to objective factors ( n = 22), were more common. The categories of recognition (feeling valued/appreciated), job satisfaction and feelings of accomplishment/sense of achievement were commonly reported. Discussion: Subjective factors of an individual’s career success were deemed to be more significant than objective factors among HIMs. Conclusion: Factors such as recognition and appreciation at work, job satisfaction, fostering high-quality work outputs and creating a sense of achievement should be the major foci for managers, organisations and individuals.
Fibula Stress Fractures: A Systematic Review
Authors: Encinas Rodrigo , Sharpe John , Bakaes Yianni , Mazoue Chris , Jackson Benjamin , Gonzalez Tyler 
Published: July 2023

Background Fibula stress fractures are moderately common injuries among athletes and military recruits. Most of the available data for treatment come from case reports with a limited number of large studies. This systematic review aims to evaluate and present the current literature on fibula stress fractures to help set evidence-based goals and establish realistic expectations for return to activity and sport in injured patients. Methods Systematic literature search using 3 databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol and the Cochrane Handbook guidelines were followed. The terms “fibula stress fracture” or “fibular stress fracture” were searched. Date range for inclusion was 2010-2022. Pediatric, non-English, lack of full text available, and studies lacking differentiating fibula stress fracture versus other types of fractures in their data were excluded. Results A total of 3 studies with 10 987 subjects were included. Among 521 stress fractures in all 3 studies, there were 45 (8.6% of all fractures) cases involving the fibula. All fibular stress fractures healed successfully with nonoperative measures and non-weight-bearing precautions, on average, by 7 weeks and patients resumed activity, on average, by 9 weeks. Among the 3 studies, there were no reported cases of nonunion or delayed union. Conclusion This review found that fibula stress fractures have a relatively moderate incidence among stress fracture injuries with a frequency up to 8.6%. Despite this high number, there is sufficient healing in fibula stress fractures when managed nonoperatively with activity modification in a weight-bearing foot to allow for resumption of baseline activities, on average, by 9 weeks. This review can be used to help set evidence-based goals and establish realistic expectations for return to activity and sport in patients who suffer from fibula stress fractures. Levels of Evidence: Level II
Systematic Review of Protein Biomarkers in Adult Patients With Chronic Rhinosinusitis
Authors: Gokani Shyam A. , Espehana Andreas , Pratas Ana C. , Luke Louis , Sharma Ekta , Mattock Jennifer , Gavrilovic Jelena , Clark Allan , Wileman Tom , Philpott Carl M. 
Published: July 2023

Background Chronic rhinosinusitis (CRS) is a heterogeneous condition characterized by differing inflammatory endotypes. The identification of suitable biomarkers could enable personalized approaches to treatment selection. Objective This study aimed to identify and summarize clinical studies of biomarkers in adults with CRS in order to inform future research into CRS endotypes. Methods We conducted systematic searches of MEDLINE and Web of Science from inception to January 30, 2022 and included all clinical studies of adult CRS patients and healthy controls measuring biomarkers using enzyme-linked immunosorbent assays or Luminex immunoassays. Outcomes included the name and tissue type of identified biomarkers and expression patterns within CRS phenotypes. Study quality was assessed using the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies. A narrative synthesis was performed. Results We identified 78 relevant studies involving up to 9394 patients, predominantly with CRS with nasal polyposis. Studies identified 80 biomarkers from nasal tissue, 25 from nasal secretions, 14 from nasal lavage fluid, 24 from serum, and one from urine. The majority of biomarkers found to distinguish CRS phenotypes were identified in nasal tissue, especially in nasal polyps. Serum biomarkers were more commonly found to differentiate CRS from controls. The most frequently measured biomarker was IL-5, followed by IL-13 and IL-4. Serum IgE, IL-17, pentraxin-3 and nasal phospho-janus kinase 2, IL-5, IL-6, IL-17A, granulocyte-colony stimulating factor, and interferon gamma were identified as correlated with disease severity. Conclusion We have identified numerous potential biomarkers to differentiate a range of CRS phenotypes. Future studies should focus on the prognostic role of nasal tissue biomarkers or expand on the more limited studies of nasal secretions and nasal lavage fluid. We registered this study in PROSPERO (CRD42022302787).
PKC-δ Promotes IL-1β-Induced Apoptosis of Rat Chondrocytes and Via Activating JNK and P38 MAPK Pathways
Authors: Lu Jinfeng , Yu Miao , Li Jia 
Published: July 2023

Objective Protein kinase C-delta (PKC-δ) is involved in apoptosis. This study aimed to establish whether PKC-δ can further promote IL-1β-induced chondrocyte apoptosis by mediating the phosphorylation of the JNK and p38 mitogen-activated protein kinase (MAPK) signaling pathways In osteoarthritis (OA). Methods We employed chondrocyte staining to determine the extent of cartilage degeneration. PKC-δ and p38 signal expressions were used in the immunohistochemical (IHC) test and apoptosis was assayed at the TUNEL test in human osteoarthritic and controls. We stimulated rat cartilage cells using IL-1β (10 ng/ml)/rottlerin (10 μM) or lentivirus. To determine the apoptosis rate, we employed flow cytometry. The mRNA of both BCL2-related X (BAX) and cysteine aspartate protease 3 (caspase-3) could be measured via qRT-PCR. Western blot measured the protein levels of BAX, caspase-3, PKC-δ, p-JNK/JNK and p-p38/p38. Results The positive rate of PKC-δ and the apoptotic rate of chondrocytes in OA were higher than controls. The manifestation of PKC-δ was positively related to the degree of cartilage degeneration, p38 protein expression, and apoptosis rate. IL-1β exposure upregulated PKC-δ expression in chondrocytes in a dose-dependent manner. Decreasing PKC-δ expression and its phosphorylation in OA can inhibit MAPK signaling pathway activation (phosphorylation) by downregulating JNK and p38 protein phosphorylation and expression. This inhibition decreases caspase-3 and BAX levels, consequently lowering the apoptosis rate in chondrocytes. Conclusion PKC-δ activation by IL-1β in OA promotes chondrocyte apoptosis via activation of the JNK and p38 MAPK signal pathways, thereby promoting the OA progression.
Homeostasis of cellular amino acids in Acanthamoeba castellanii exposed to different media under amoeba-bacteria coculture conditions
Authors: Tsai Chih-Ming , Chen Chun-Hsien , Cheng Wei-Hung , Stelma Foekje F. , Li Sung-Chou , Lin Wei-Chen 
Published: July 2023

Abstract
Background
Acanthamoeba castellanii is a free-living protist that feeds on diverse bacteria. A. castellanii has frequently been utilized in studies on microbial interactions. Grazing bacteria also exhibit diverse effects on the physiological characteristics of amoebae, such as their growth, encystation, and cytotoxicity. Since the composition of amoebae amino acids is closely related to cellular activities, it can indicate the overall responses of A. castellanii to various stimuli.

Method
A. castellanii was exposed to different culture conditions in low-nutrient medium with heat-killed DH5α to clarify their effects. A targeted metabolomic technique was utilized to evaluate the concentration of cellular amino acids. The amino acid composition and pathways were analyzed by two web-based tools: MetaboAnalyst and Pathview. Then, long-term exposure to A. castellanii was investigated through in silico and in vitro methods to elucidate the homeostasis of amino acids and the growth of A. castellanii.

Results
Under short-term exposure, all kinds of amino acids were enriched in all exposed groups. In contrast to the presence of heat-killed bacteria, the medium exhibited obvious effects on the amino acid composition of A. castellanii. After long-term exposure, the amino acid composition was more similar to that of the control group. A. castellanii may achieve amino acid homeostasis through pathways related to alanine, aspartate, citrulline, and serine.

Discussion
Under short-term exposure, compared to the presence of bacteria, the type of medium exerted a more powerful effect on the amino acid composition of the amoeba. Previous studies focused on the interaction of the amoeba and bacteria with effective secretion systems and effectors. This may have caused the effects of low-nutrient environments to be overlooked.

Conclusion
When A. castellanii was stimulated in the coculture system through various methods, such as the presence of bacteria and a low-nutrient environment, it accumulated intracellular amino acids within a short period. However, different stimulations correspond to different amino acid compositions. After long-term exposure, A. castellanii achieved an amino acid equilibrium by downregulating the biosynthesis of several amino acids.
Phospholipid:diacylglycerol acyltransferase1-overexpression stimulates lipid turnover, oil production and fitness in cold-grown plants
Authors: Klińska-Bąchor Sylwia , Kędzierska Sara , Demski Kamil , Banaś Antoni 
Published: July 2023

Abstract
Background
Extensive population growth and climate change accelerate the search for alternative ways of plant-based biomass, biofuel and feed production. Here, we focus on hitherto unknow, new promising cold-stimulated function of phospholipid:diacylglycerol acyltransferase1 (PDAT1) – an enzyme catalyzing the last step of triacylglycerol (TAG) biosynthesis.

Result
Overexpression of AtPDAT1 boosted seed yield by 160% in Arabidopsis plants exposed to long-term cold compared to standard conditions. Such seeds increased both their weight and acyl-lipids content. This work also elucidates PDAT1’s role in leaves, which was previously unclear. Aerial parts of AtPDAT1-overexpressing plants were characterized by accelerated growth at early and vegetative stages of development and by biomass weighing three times more than control. Overexpression of PDAT1 increased the expression of SUGAR-DEPENDENT1 (SDP1) TAG lipase and enhanced lipid remodeling, driving lipid turnover and influencing biomass increment. This effect was especially pronounced in cold conditions, where the elevated synergistic expression of PDAT1 and SDP1 resulted in double biomass increase compared to standard conditions. Elevated phospholipid remodeling also enhanced autophagy flux in AtPDAT1-overexpresing lines subjected to cold, despite the overall diminished autophagy intensity in cold conditions.

Conclusions
Our data suggest that PDAT1 promotes greater vitality in cold-exposed plants, stimulates their longevity and boosts oilseed oil production at low temperature.