bluuebunny/crossref_metadata_2025_split huggingface dataset:
Underlying causes of cryptogenic stroke and TIA in The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study – the importance of comprehensive clinical evaluation
Authors: Ratajczak-Tretel B. , Lambert A. Tancin , Al-Ani R. , Arntzen K. , Bakkejord G. K. , Bekkeseth H. M.O. , Bjerkeli V. , Eldøen G. , Gulsvik A. K. , Halvorsen B. , Høie G. A. , Ihle-Hansen H. , Ingebrigtsen S. , Kremer C. , Krogseth S. B. , Kruuse C. , Kurz M. , Nakstad I. , Novotny V. , Naess H. , Qazi R. , Rezaj M. K. , Rørholt D. M. , Steffensen L. H. , Sømark J. , Tobro H. , Truelsen T. C. , Wassvik L. , Ægidius K. L. , Atar D. , Aamodt A. H. 
Published: March 2023

Abstract
Background
Cryptogenic stroke is a heterogeneous condition, with a wide spectrum of possible underlying causes for which the optimal secondary prevention may differ substantially. Attempting a correct etiological diagnosis to reduce the stroke recurrence should be the fundamental goal of modern stroke management.

Methods
Prospective observational international multicenter study of cryptogenic stroke and cryptogenic transient ischemic attack (TIA) patients clinically monitored for 12 months to assign the underlying etiology. For atrial fibrillation (AF) detection continuous cardiac rhythm monitoring with insertable cardiac monitor (Reveal LINQ, Medtronic) was performed. The 12-month follow-up data for 250 of 259 initially included NOR-FIB patients were available for analysis.

Results
After 12 months follow-up probable stroke causes were revealed in 43% patients, while 57% still remained cryptogenic. AF and atrial flutter was most prevalent (29%). In 14% patients other possible causes were revealed (small vessel disease, large-artery atherosclerosis, hypercoagulable states, other cardioembolism). Patients remaining cryptogenic were younger (p < 0.001), had lower CHA2DS2-VASc score (p < 0.001) on admission, and lower NIHSS score (p = 0.031) and mRS (p = 0.016) at discharge. Smoking was more prevalent in patients that were still cryptogenic (p = 0.014), while dyslipidaemia was less prevalent (p = 0.044). Stroke recurrence rate was higher in the cryptogenic group compared to the group where the etiology was revealed, 7.7% vs. 2.8%, (p = 0.091).

Conclusion
Cryptogenic stroke often indicates the inability to identify the cause in the acute phase and should be considered as a working diagnosis until efforts of diagnostic work up succeed in identifying a specific underlying etiology. Timeframe of 6-12-month follow-up may be considered as optimal.

Trial registration
ClinicalTrials.gov Identifier NCT02937077, EudraCT 2018-002298-23.
Influencing factors of humanistic care ability and its dimensions among mental health workers during the COVID-19 pandemic: an online cross-sectional study
Authors: Liu Xiaolin , Zhu Hongjin 
Published: March 2023

Abstract
Background
In psychiatric services, humanistic care ability significantly affects the quality of the therapeutic relationship and thus affects the therapeutic outcomes for patients. Mental health workers may be confronted with more obstacles in humanistic care during the COVID-19 pandemic wherethe authors aimed to explore the capacity level of humanistic care among mental health workers and its potential influencing factors.

Method(s)
An online cross-sectional survey was conducted among 262 mental health workers working in Chongqing, China, from December 2020 to January 2021. Data were collected by the Caring Ability Inventory (CAI), the Psychological Capital Questionnaire (PCQ-24), the Eysenck Personality Questionnaire-Revised, and the Short Scale for Chinese (EPQ-RSC). Multiple linear regression analysis was used to explore the influencing factors of humanistic care ability.

Results
Mental health workers’ humanistic care ability is at a low level, with a score of 186.47 ± 21.34. Psychological capital is positively associated with humanistic care ability (β[95%CI] = 0.41 [0.46–0.77], p < 0.001), and its two dimensions (cognition: β[95%CI] = 0.51 [0.30–0.47], p < 0.001; patience: β[95%CI] = 0.48 [0.17–0.28], p < 0.001). Psychoticism is negatively associated with humanistic care ability (β[95%CI] = -0.28 [-5.18 - -2.51], p < 0.001) and its three dimensions (cognition: β[95%CI] = -0.12 [-1.57 - -0.17], p < 0.05; courage: β[95%CI] = -0.17 [-1.7 - -0.32], p < 0.01; patience: β[95%CI] = -0.19 [-1.33 - -0.36], p < 0.01). Extroversion is positively associated with humanistic care ability (β[95%CI] = 0.19 [0.69–2.08], p < 0.001), and its two dimensions (cognition: β[95%CI] = 0.19 [0.32–1.05], p < 0.001; courage: β[95%CI] = 0.27 [0.5–1.23], p < 0.001). Neuroticism is negatively associated with humanistic care ability (β[95%CI] = -0.13[-1.37 - -0.19], p < 0.01) and its one dimension (courage: β[95%CI] = -0.25 [-0.98 - -0.35], p < 0.001).

Conclusion(s)
The research has found that the humanistic care ability of mental health workers is at a low level, and the psychological capital and personality traits are significant factors influencing the humanistic care ability and its sub-dimensions. Interventions to improve the psychological capital of mental health workers or to promote the change of personality traits they want are recommended, thereby to promote humanistic practice.
Mindfulness-based stress reduction (MBSR) effects on the worries of women with poly cystic ovary syndrome (PCOS)
Authors: Salajegheh Zahra , Ahmadi Atefeh , Shahrahmani Hadis , Jahani Yunes , Alidousti Katayoun , Nasiri Amiri Fatemeh , Salari Zohreh 
Published: March 2023

Abstract
Introduction
Polycystic ovary syndrome is one of the women’s most common endocrine disorders that can cause anxiety, psychological distress, and reduced quality of life. Therefore, the present study aimed to determine the effect of mindfulness-based stress reduction counseling on the worries of women with polycystic ovary syndrome.

Materials and methods
This quasi-experimental was implemented on 60 women with polycystic ovary syndrome, referring to health centers in Kerman, Iran, from April to September 2021. In the intervention group, MBSR was conducted in eight 90-minute sessions twice a week. A researcher-made questionnaire with 34 questions (with six domains including worries related to mental complications, interpersonal problems, non-pregnancy physical complications, pregnancy complications, sexual complications, and religious issues) on the worries of women with polycystic ovary syndrome was completed by the participants in two intervention and control groups as pre-and post-test and one month later. 22 SPSS statistical software was used for analysis.

Results
The mean score of worries in the intervention group (48.18 ± 5.18) compared to the control group (75.73 ± 8.08) was significantly reduced in total and all six domains immediately after the intervention (P < 0.0001). One month later also, the total mean score of worries and subtitles decreased significantly (P < 0.0001) in the intervention group (38.27 ± 3.58) in comparison with the control group (76.13 ± 7.52).

Conclusion
Results showed that the method of reducing stress based on mindfulness had caused a significant reduction in worries in the intervention group. Therefore, this method can be used to improve the mental health of this group of patients in health centers.
Understanding registered nurses’ career choices in home care services: a qualitative study
Authors: Haaland Guro Hognestad , Øygarden Olaug , Storm Marianne , Mikkelsen Aslaug 
Published: March 2023

Abstract
Background
The anticipated growth in number of older people with long-term health problems is associated with a greater need for registered nurses. Home care services needs enough nurses that can deliver high quality services in patients’ homes. This article improves our understanding of nurses’ career choices in home care services.

Methods
A qualitative study using individual semi-structured interviews with 20 registered nurses working in home care services. The interviews were audio-recorded, transcribed and thematically analyzed.

Results
The analysis resulted in three themes emphasizing the importance of multiple stakeholders and contextual factors, fit with nurses’ private life, and meaning of work. The results offer important insights that can be used to improve organizational policy and HR practices to sustain a workforce of registered nurses in home care services.

Conclusion
The results illustrate the importance of having a whole life perspective to understand nurses’ career choices, and how nurses’ career preferences changes over time.
Bosutinib high density lipoprotein nanoformulation has potent tumour radiosensitisation effects
Authors: Dehghankelishadi Pouya , Badiee Parisa , Maritz Michelle F. , Dmochowska Nicole , Thierry Benjamin 
Published: March 2023

AbstractDisruption of the cell cycle is among the most effective approach to increase tumour cells’ radio-sensitivity. However, the presence of dose-limiting side effects hampers the clinical use of tyrosine kinase inhibitors targeting the cell cycle. Towards addressing this challenge, we identified a bosutinib nanoformulation within high density lipoprotein nanoparticles (HDL NPs) as a promising radiosensitiser. Bosutinib is a kinase inhibitor clinically approved for the treatment of chronic myeloid leukemia that possesses radiosensitising properties through cell cycle checkpoint inhibition. We found that a remarkably high bosutinib loading (> 10%) within HDL NPs could be reliably achieved under optimal preparation conditions. The radiosensitisation activity of the bosutinib-HDL nanoformulation was first assessed in vitro in UM-SCC-1 head and neck squamous cell carcinoma (HNSCC) cells, which confirmed efficient disruption of the radiation induced G2/M cell cycle arrest. Interestingly, the bosutinib nanoformulation out-performed free bosutinib, likely because of the specific affinity of HDL NPs with tumour cells. The combination of bosutinib-HDL NPs and radiotherapy significantly controlled tumour growth in an immunocompetent murine HNSCC model. The bosutinib-HDL nanoformulation also enhanced the radiation induced immune response through the polarisation of tumour associated macrophages towards proinflammatory phenotypes.
Impact of ¡Míranos! on parent-reported home-based healthy energy balance-related behaviors in low-income Latino preschool children: a clustered randomized controlled trial
Authors: Ullevig Sarah L. , Parra-Medina Deborah , Liang Yuanyuan , Howard Jeffrey , Sosa Erica , Estrada-Coats Vanessa M. , Errisuriz Vanessa , Li Shiyu , Yin Zenong 
Published: March 2023

Abstract
Background
Widespread establishment of home-based healthy energy balance-related behaviors (EBRBs), like diet, physical activity, sedentary behavior, screen time, and sleep, among low-income preschool-aged children could curb the childhood obesity epidemic. We examined the effect of an 8-month multicomponent intervention on changes in EBRBs among preschool children enrolled in 12 Head Start centers.

Methods
The Head Start (HS) centers were randomly assigned to one of three treatment arms: center-based intervention group (CBI), center-based plus home-based intervention group (CBI + HBI), or control. Before and following the intervention, parents of 3-year-olds enrolled in participating HS centers completed questionnaires about their child’s at-home EBRBs. Adult-facilitated physical activity (PA) was measured by an index based on questions assessing the child’s level of PA participation at home, with or facilitated by an adult. Fruit, vegetable, and added sugar intake were measured via a short food frequency questionnaire, and sleep time and screen time were measured using 7-day logs. A linear mixed effects model examined the intervention’s effect on post-intervention changes in PA, intake of fruit, vegetable, and added sugar, sleep time, and screen time from baseline to post-intervention.

Results
A total of 325 parents participated in the study (CBI n = 101; CBI + HBI n = 101; and control n = 123). Compared to control children, CBI and CBI + HBI parents reported decreases in children’s intake of added sugar from sugar-sweetened beverages. Both CBI and CBI + HBI parents also reported smaller increases in children’s average weekday screen time relative to controls. In addition, CBI + HBI parents reported CBI + HBI parents reported increases in children’s adult-facilitated PA, fruit and vegetable intake, and daily sleep time during weekdays (excluding weekends) and the total week from baseline to post-intervention, while children in the CBI increased sleep time over the total week compared to the children in the control group.

Conclusions
Parent engagement strengthened the improvement in parent-reported EBRBs at home in young children participating in an evidence-based obesity prevention program in a childcare setting. Future studies should investigate equity-related contextual factors that influence the impact of obesity prevention in health-disparity populations.

Trial registration
ClinicalTrials.gov, NCT03590834. Registered July 18, 2018, https://clinicaltrials.gov/ct2/show/NCT03590834
Immune profiling and prognostic model of pancreatic cancer using quantitative pathology and single-cell RNA sequencing
Authors: Chen Kai , Wang Qi , Liu Xinxin , Tian Xiaodong , Dong Aimei , Yang Yinmo 
Published: March 2023

Abstract
Background
Pancreatic ductal adenocarcinoma (PDAC) has a complex tumor immune microenvironment (TIME), the clinical value of which remains elusive. This study aimed to delineate the immune landscape of PDAC and determine the clinical value of immune features in TIME.

Methods
Univariable and multivariable Cox regression analyses were performed to evaluate the clinical value of immune features and establish a new prognostic model. We also conducted single-cell RNA sequencing (scRNA-seq) to further characterize the immune profiles of PDAC and explore cell-to-cell interactions.

Results
There was a significant difference in the immune profiles between PDAC and adjacent noncancerous tissues. Several novel immune features were captured by quantitative pathological analysis on multiplex immunohistochemistry (mIHC), some of which were significantly correlated with the prognosis of patients with PDAC. A risk score-based prognostic model was established based on these immune features. We also constructed a user-friendly nomogram plot to predict the overall survival (OS) of patients by combining the risk score and clinicopathological features. Both mIHC and scRNA-seq analysis revealed PD-L1 expression was low in PDAC. We found that PD1 + cells were distributed in different T cell subpopulations, and were not enriched in a specific subpopulation. In addition, there were other conserved receptor-ligand pairs (CCL5-SDC1/4) besides the PD1-PD-L1 interaction between PD1 + T cells and PD-L1 + tumor cells.

Conclusion
Our findings reveal the immune landscape of PDAC and highlight the significant value of the combined application of mIHC and scRNA-seq for uncovering TIME, which might provide new clues for developing immunotherapy combination strategies.
Transcriptomes of the tumor-adjacent normal tissues are more informative than tumors in predicting recurrence in colorectal cancer patients
Authors: Kim Jinho , Kim Hyunjung , Lee Min-Seok , Lee Heetak , Kim Yeon Jeong , Lee Woo Yong , Yun Seong Hyeon , Kim Hee Cheol , Hong Hye Kyung , Hannenhalli Sridhar , Cho Yong Beom , Park Donghyun , Choi Sun Shim 
Published: March 2023

Abstract
Background
Previous investigations of transcriptomic signatures of cancer patient survival and post-therapy relapse have focused on tumor tissue. In contrast, here we show that in colorectal cancer (CRC) transcriptomes derived from normal tissues adjacent to tumors (NATs) are better predictors of relapse.

Results
Using the transcriptomes of paired tumor and NAT specimens from 80 Korean CRC patients retrospectively determined to be in recurrence or nonrecurrence states, we found that, when comparing recurrent with nonrecurrent samples, NATs exhibit a greater number of differentially expressed genes (DEGs) than tumors. Training two prognostic elastic net-based machine learning models—NAT-based and tumor-based in our Samsung Medical Center (SMC) cohort, we found that NAT-based model performed better in predicting the survival when the model was applied to the tumor-derived transcriptomes of an independent cohort of 450 COAD patients in TCGA. Furthermore, compositions of tumor-infiltrating immune cells in NATs were found to have better prognostic capability than in tumors. We also confirmed through Cox regression analysis that in both SMC-CRC as well as in TCGA-COAD cohorts, a greater proportion of genes exhibited significant hazard ratio when NAT-derived transcriptome was used compared to when tumor-derived transcriptome was used.

Conclusions
Taken together, our results strongly suggest that NAT-derived transcriptomes and immune cell composition of CRC are better predictors of patient survival and tumor recurrence than the primary tumor.
Women’s and health providers’ perceptions of companionship during labor and childbirth: a formative study for the implementation of WHO companionship model in Burkina Faso
Authors: Yaya Bocoum Fadima , Kabore Charles Paulin , Barro Saran , Zerbo Roger , Tiendrebeogo Simon , Hanson Claudia , Dumont Alexandre , Betran Ana Pilar , Bohren Meghan A. 
Published: March 2023

Abstract
Introduction
A key component of achieving respectful maternal and newborn care is labor companionship. Despite important health benefits for the woman and baby, there are critical gaps in implementing labor companionship for all women globally. The paper aims to present the perceptions and experiences of pregnant women, postpartum women, and health care providers regarding companionship during labor and childbirth, and to identify barriers and facilitating factors to the implementation of labor companionship in Burkina Faso.

Methods
This is a formative study to inform the “Appropriate use of cesarean section through QUALIty DECision-making by women and providers” (QUALI-DEC) study, to design, adapt and implement a strategy to optimize the use of the cesarean section, including labor companionship. We use in-depth interviews (women, potential companions, and health workers) and health facility readiness assessments in eight hospitals across Burkina Faso. We use a thematic analysis approach for interviews, and narrative summaries to describe facility readiness assessment.

Results
In all, 77 qualitative interviews and eight readiness assessments are included in this analysis. The findings showed that all participants acknowledged an existing traditional companionship model, which allowed companions to support women only in the hospital waiting room and post-natal room. Despite recognizing clear benefits, participants were not familiar with companionship during labor and childbirth in the hospital as recommended by WHO. Key barriers to implementing companionship throughout labor and birth include limited space in labor and delivery wards, no private rooms for women, hospital rules preventing companionship, and social norms preventing the choice of a companion by the woman.

Conclusion
Labor companionship was considered highly acceptable in Burkina Faso, but more work is needed to adapt to the hospital environment. Revisions to hospital policies to allow companions during labor and childbirth are needed as well as changes to provide private space for women. Training potential companions about their roles and encouraging women’s rights to choose their companions may help to facilitate effective implementation.
Effect of different doses of Lacticaseibacillus paracasei K56 on body fat and metabolic parameters in adult individuals with obesity: a pilot study
Authors: Kadeer Guzailinuer , Fu Wanrui , He Yaqi , Feng Ying , Liu Wei-Hsein , Hung Wei-Lian , Feng Haotian , Zhao Wen 
Published: March 2023

Abstract
Background
Studies have shown that probiotics have an effect on reducing body fat on a strain-specific and dose–response bases. The purpose of this study was to evaluate the effect of a novel probiotic strain Lacticaseibacillus paracasei K56 on body fat and metabolic biomarkers in adult individuals with obesity.

Methods
74 adult subjects with obesity (body mass index ≥ 30 kg/m2, or percent body fat > 25% for men, percent body fat > 30% for women) were randomized into 5 groups and supplemented with different doses of K56 (groups VL_K56, L_K56, H_K56, and VH_K56: K56 capsules, 2 × 107 CFU/day, 2 × 109 CFU/day, 2 × 1010 CFU/day, 2 × 1011 CFU/day, respectively) or placebo (group Pla: placebo capsule) for 60 days. Subjects were advised to maintain their original dietary intake and physical activity. Anthropometric measurements, body composition assessment, and metabolic parameters were measured at baseline and after 60 days of intervention.

Results
The results showed that the L_K56 group had significant decreases in percent body fat (p = 0.004), visceral fat area (p = 0.0007), total body fat mass (p = 0.018), trunk body fat mass (p = 0.003), waist circumference (p = 0.003), glycosylated hemoglobin(p = 0.002) at the end of the study compared with baseline. There were non-significant reductions in Body weight and BMI in the L_K56, H_K56, VL_K56 groups, whereas increases were observed in the placebo and VH_K56 groups compared with baseline values. In addition, K56 supplementation modulated gut microbiota characteristics and diversity indices in the L-K56 group. However, mean changes in body fat mass, visceral fat area, weight, body mass index, waist circumference and hip circumference were not significantly different between groups.

Conclusions
The results suggest that supplementation with different doses of Lacticaseibacillus paracasei K56 has certain effect on reducing body fat and glycosylated hemoglobin, especially at a dose of 109 CFU/day.
Trial registration: clinicaltrials.gov Identifier: NCT04980599.
“And when will you install the new water pump?”: disconcerted reflections on how to be a ‘good’ Global Health scholar
Authors: Borst Robert A.J. , Wehrens Rik , Bal Roland 
Published: March 2023

Abstract
Background
While critique on Global Health is not new, recent years show a surge of criticism on the field’s colonial legacy and practices specifically. Such accounts argue that despite Global Health’s strive for universality and equity in health, its activities regularly produce the opposite. The epistemic privileging of Northern academics and scientific method, further augmented by how Global Health funding is arranged, paints a picture of a fragmented field in which ‘doing good’ has become a normatively laden and controversial term. It is specifically this controversy that we seek to unpack in this paper: what does it take to be a ‘good’ Global Health scholar?

Results
We used Helen Verran’s notion of ‘disconcertment’ to analyse three auto-ethnographic vignettes of Robert’s Global Health ‘fieldwork’. We illustrate that disconcertment, a bodily and personalised experience of unease and conflicting feelings, may serve as an important diagnostic of conflicting imperatives in Global Health. Robert’s fieldwork was entangled with incongruous imperatives which he constantly had to navigate through and that repeatedly produced disconcertment. The contribution that we seek to make here is that such disconcertment is not something to defuse or ignore, but to take seriously and stay with instead.

Conclusion
Staying with the disconcertment serves as a starting point for conversations about ‘doing good’ in Global Health fieldwork and creates opportunity for making Global Health teaching and projects more reflexive. The paper thereby positions itself in discussions about fair collaborations between the Global North and South and our analysis offers a set of considerations that can be used by Northern scholars to critically reflect on their own role within Global Health.