bluuebunny/crossref_metadata_2025_split huggingface dataset:
Like milk on the stove: Healthcare professionals navigating uncertainty when caring for families with 22q11DS
Authors: Ayoub Sophie , De Clercq Eva , Cytrynbaum Cheryl , Steiner Luzius A. , Elger Bernice S. 
Published: January 2025

Introduction
22q11 deletion syndrome (22q11DS) results from a microdeletion on chromosome 22 and is the most common microdeletion disorder in humans, affecting 1 in 2148 live births. Clinical manifestations vary widely among individuals and across different life stages. Effective management requires the involvement of a specialized multidisciplinary team. This study aims to explore the experiences of healthcare professionals in caring for the families of children with 22q11DS, focusing on their challenges, rewards, and coping strategies.

Methods
Data for this interview study were collected as part of a broader mixed methods research project aimed at enhancing the psychosocial well-being of children aged 3–15 years with 22q11DS and their families. The qualitative aspect of this study focused on capturing the experiences of healthcare professionals involved in their care, recruited purposively through collaborators and snowball sampling methods. Reflexive thematic analysis of semi-structured interviews was performed after verbatim transcription.

Results
Twenty healthcare providers from different specialties were interviewed. The majority had a working experience of more than 10 years and were part of a 22q11DS clinic. After data analysis, four themes (and many sub-themes) were identified that were all related to the topic of uncertainty: acknowledging uncertainty, sharing uncertainty, acting on uncertainty and coping with uncertainty. Many experts showed a sense of humbleness when caring for the families and most of the participants emphasized the role of peer support and multidisciplinary teams.

Conclusion
Our study reveals how healthcare professionals manage the uncertainty associated with 22q11DS, highlighting the importance of peer support and multidisciplinary team collaboration. Providers recognize the limits of their medical expertise and value the perspectives of families living with the condition. Their coping strategies play a critical role in handling uncertainty and suggest a need for further emphasis in the literature on the experiences of healthcare professionals dealing with rare diseases.
Diaper dermatitis and associated factors among children aged 0–24 months in low- and middle-income countries: A systematic review protocol
Authors: Negera Atoma , Sento Midekso , Dereje Debela , Firdisa Gamachis , Negera Samuel , Nenko Geleta , Sime Tadesse , Keba Merga 
Published: January 2025

Background
Diaper dermatitis (DD, sometimes known as diaper rash or napkin dermatitis is one of the most prevalent skin infections that occur in the area covered by the diaper. Although diaper dermatitis can be seen in any patient wearing diapers, it is reported to be more common in infants aged 9–12 months. Approximately, 70% of infants and young children suffer from diaper dermatitis at some point during their diaper wearing years and up to 25% of children seek healthcare due to this case.

Methods and analysis: Methods and analysis
A comprehensive literature search will be gathered from electronic databases such as PubMed, Embase, Hinari, Cochrane Library, African Journals Online (AJOL), and Google Scholar. The protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses for Protocol (PRISMA-P) guideline. All studies conducted in low- and middle-income countries (LMICs) will be included regardless of their study design as long as these studies report the magnitude of the problem under study. Joanna Briggs Institute’s (JBI) appraisal checklist will be used to assess the quality of individual studies. Heterogeneity will be checked using Cochrane Q test statistics and I2 test statistics, and a random-effects model will be employed to estimate the pooled prevalence of DD and its associated factors.

Ethics and dissemination of research
Ethics committee approval or written informed consent will not be required to conduct this review, and meta-analysis for the review will be entirely based on published data. The result of this study will be submitted to a peer-reviewed journal, and it will also be presented at relevant research conferences.

Results
The present study will estimate the pooled prevalence of diaper dermatitis and their associated factors in low- and middle-income countries.

Trial registration
PROSPERO registration number: CRD42024578550.
The role of the microbiota and metabolites in the treatment of pulmonary fibrosis with UC-MSCs: Integrating fecal metabolomics and 16S rDNA analysis
Authors: Luo Yukai , Zhou Shuang , Zhang Xiaojing , Lin Yijian , Liu Jun , Cheng Wenzhao , Zeng Yiming 
Published: January 2025

Introduction
Pulmonary fibrosis (PF) is a chronic and irreversible interstitial lung disease characterized by a lack of effective therapies. Mesenchymal stem cells (MSCs) have garnered significant interest in the realm of lung regeneration due to their abundant availability, ease of isolation, and capacity for expansion. The objective of our study was to investigate the potential therapeutic role of umbilical cord-derived MSCs (UC-MSCs) in the management of PF, with a focus on the alterations in the gut microbiota and its metabolites during the use of UC-MSCs for the treatment of pulmonary fibrosis, as well as the possible mechanisms involved.

Methods
Bleomycin injection was utilized to establish a mouse model of lung fibrosis, followed by the application of 16S rDNA sequencing and LC–MS/MS metabolomics to explore the underlying mechanism of UC-MSC treatment for lung fibrosis. Seventy-five mice were allocated into five groups, namely Control, Model, and low/medium/high dose of UC-MSCs groups, and survival metrics, lung morphology, and the levels of the inflammatory cytokines TNF-α, IL-1β, IL-6, and TGF-β1 were subsequently evaluated. Fecal samples from six mice in each of the Control group, Model group, and UC-MSCs-M groups were collected randomly for 16S rDNA sequencing to analyze the gut microbiota and nontargeted metabolomics.

Results
In comparison to IPF model mice, the three treatment groups exhibited increased survival rates, restored alveolar morphology, and reduced levels of the inflammatory cytokines TNF-α, IL-1β, IL-6, and TGF-β1, confirming the anti-inflammatory properties of UC-MSCs in IPF treatment. The findings from the 16S rDNA assay indicate that UC-MSCs treatment effectively lower α-diversity induced such as Chao 1 and ACE, as well as β-diversity, leading to a decrease in microbiota abundance. The findings from the metabolomics analysis revealed that the metabolites exhibiting notable variances were primarily composed of Lipids and lipid-like molecules, Organoheterocyclic compounds, Organic acids and derivatives, and Benzenoids, indicating the potential of UC-MSCs to exert antifibrotic effects via these metabolic pathways.

Conclusion
Umbilical cord-derived mesenchymal stem cells (UC-MSCs) ameliorate bleomycin-induced pulmonary fibrosis symptoms in mice by exerting anti-inflammatory effects and mitigating pulmonary fibrosis through the modulation of gut microbiota disorders and their metabolism. These findings offer novel insights into the potential mechanisms and clinical utility of stem cell therapy for pulmonary fibrosis.
Interrogating green social prescribing in South Wales; A multi-stakeholder qualitative exploration
Authors: Brown Menna , Aylett Katharine Sarah 
Published: January 2025

Background
As an umbrella term, social prescribing offers varied routes into society which promise to support, enhance, and empower individual citizens to take control of their own health and wellbeing. Globally healthcare systems are struggling to cope with the increasing demands of an ageing population and the NHS (UK) is no exception. Social prescribing is heralded as a means to relieve the burden on primary care and provide support for the 20% of patients whose needs are non-medical. As such an increasing array of schemes are available, spanning five sub-sets: creative or nature-based referrals, welfare services, exercise referrals, education programmes or befriending support. Green social prescription offers significant potential to promote wellbeing and improve health outcomes. However limited research has explored this emergent sub-set.

Aim
Explore and interrogate the concept of social prescribing to understand how it is conceptualised, perceived, and experienced by different stakeholders involved in its coordination, delivery, and provision; At a time when it is being formalised in Wales, UK.

Methods
Using qualitative enquiry, from a social constructivist paradigm, stakeholder perspectives pertaining to current social prescribing models, pathways and actions in Wales were explored. Three multi-discipline research workshops and ten semi-structured, one-to-one interviews were conducted either in person or via zoom. Qualitative data were analysed thematically.

Results
39 different stakeholders contributed. These included social prescribers, community connectors, service coordinators, third sector and voluntary organisation representatives, a general practitioner, occupational therapist, social enterprisers, academics and local area coordinators. Five themes were identified which revolved around stakeholders discussions of critical challenges pertaining to the delivery, provision, and evaluation of green social prescribing schemes in south Wales, UK. Tension between varying stakeholders was also evident, often preceded, or complicated by funding discrepancies, competition, and uncertainty. Stakeholders demanded clarity regarding evaluation outcomes and benchmarking across the sector.

Conclusions
To ensure the continued provision of social prescribing schemes which are highly valued by service users, voluntary and third sector organisations require funding security and stability. The delivery of green, nature-based, schemes require maintenance of trusting, long-term relationships with local service co-ordinators and referrers, secure equitable funding models and agreement over conceptual basis of social prescribing itself, particularly in relation to ‘where’ social prescribing is located within health and social care models. Without resolution and positive progress across these areas the continuation of local green schemes within local communities, which build resilience and support positive change for service users’ health and wellbeing, is questionable.
Evaluating the effects of time-restricted eating on overweight and obese women with polycystic ovary syndrome: A randomized controlled trial study protocol
Authors: Liu Hui , Shangguan Fuliang , Liu Fen , Guo Yu , Yu Huixi , Li Hanbing , Su Yinhua , Li Zhongyu 
Published: January 2025

Background
Time-restricted eating (TRE) manages weight effectively, but choosing how long and what time window remain debatable. Although an 8:00 a.m. to 16:00 p.m. time frame is reported to show positive results in most weight loss trial, its safety and efficacy in overweight and obese women with polycystic ovary syndrome (PCOS) is uncertain. This randomized controlled trial is conducted to evaluate the safety and efficacy of TRE in specific populations.

Objective
This study aims to assess the 6-month effects of TRE on weight change, metabolic improvement, reproductive recovery, and health-related quality of life in overweight and obese women with polycystic ovary syndrome (PCOS), compared to those who did not receive TRE.

Methods
This randomized controlled trial will enroll 96 overweight and obese women with polycystic ovary syndrome (PCOS), who will be randomly assigned to either a TRE group (with an eating window from 8:00 a.m. to 16:00 p.m.) or a control group (without eating time restrictions), with 49 participants in each group. Evaluators and data analysts will remain blinded to group allocation throughout the study. The primary outcomes, including changes in weight and body mass index (BMI), will be assessed weekly. Secondary outcomes, encompassing alterations in sex hormones, metabolic parameters, body composition, sleep quality, quality of life, anxiety, and depression, will be evaluated monthly. Compliance and safety will be continuously monitored throughout the study. Additionally, a 6-month follow-up will be conducted at the end of the trial to assess the long-term effects of TRE. Statistical analysis will include the Anderson-Darling test for normality, T-test/Wilcoxon test based on distribution, mixed-effects models for assessing time/group effects, Cox model for time-to-event analysis, repeated ANOVA for change analysis, and sensitivity analysis. All tests will be conducted using appropriate software, with a significance level set at P<0.05. Missing data will be imputed.

Discussion
The purpose of this study protocol is to further evaluate the effects of TRE in overweight and obese women with PCOS through a randomized controlled trial (RCT). Findings from this study are expected to provide new dietary intervention strategies for overweight and obese PCOS participants.

Ethics and dissemination
This study has received ethics approval from the Medical Ethics Committee of the University of South China (Number: NHHL027). Participants are included after signing informed consent. Results will be submitted for publication in peer-reviewed journals.

Trail registration
Trail registration number: ChiCTR2400086815.
The efficacy of acupuncture for generalized anxiety disorder (GAD) in college students: Study protocol for a randomized controlled trial
Authors: Wang Yang , Gu Xinbo , Zhi Baohua , Yan Yan , Lu Fengyan , Hu Hantong , Zhang Quanai 
Published: January 2025

Introduction
Generalized anxiety disorder (GAD) is the most common type of anxiety disorders. GAD usually occurs in adolescence or early adulthood, and the prevalence of GAD is higher among college-enrolled young adults than in the general adult population. However, there is a lack of evidence regarding the effectiveness of acupuncture in the treatment of GAD. This study’s objective is to evaluate the efficacy of acupuncture in the treatment of GAD in college students and its stability.

Methods
A total of 142 subjects will be recruited for the randomized controlled trial (RCT) of current undergraduate and graduate students with GAD and will be randomized into treatment and control groups. The treatment group will receive conventional acupuncture, while the control group will receive sham acupuncture using Streitberger needles. Both groups will be administered 8 acupuncture treatment (2 times per week for 4 weeks). The follow-up duration will be 2 months. The Hamilton Anxiety Scale (HAMA) will be used as the primary outcome of the study to measure the severity of anxiety disorder. The secondary outcomes of this study will be included the Pittsburgh Sleep Quality Index (PSQI) and Self-rating anxiety Scale (SAS). The study will also evaluate the success of blinding and the safety.

Discussions
Findings of this RCT will help evaluate the efficacy of acupuncture treatment for GAD in college students, potentially promoting it as an alternative treatment option. The protocol was registered at clinicaltrials.gov (Identifier: ChiCTR2400080688)
Recruitment, follow-up and survival in an 11-country cohort study of patients at the end of life and their relatives
Authors: Schelin Maria E. C. , Hedman Christel , Barnestein-Fonseca Pilar , Egloff Martina , Ellershaw John , Faksvåg Haugen Dagny , Fischer Claudia , Joshi Melanie , Korfage Ida J. , Lunder Urška , Mason Stephen , Simon Judit , Tripodoro Vilma A. , Yildiz Berivan , Zambrano Sofia C. , Eychmueller Steffen , van Zuylen Lia , van der Heide Agnes , Fürst Carl Johan ,   the iLIVE Consortium
Published: January 2025

Background
Large, international cohort studies generate high-level evidence, but are resource intense. In end-of-life care such studies are scarce. Hence, planning for future studies in terms of data on screening, recruitment, retention and survival remains a challenge.

Objectives
The aim was to describe recruitment, follow-up and survival in a multinational study of patients’ and relatives’ expectations, concerns and preferences at the end of life.

Methods
In this 11-country cohort study with six months follow-up patients, >18 years old, were included on the basis of an adapted “surprise question” to assess patients´ end of life status. Patients were required to be aware of their limited life expectancy. We collected patient questionnaires (baseline and 1 month), and searched medical records for the date of death. One relative per patient was invited to participate.

Results
26735 patients were screened for inclusion, 3065 (11%) were found eligible and were invited to participate, 1509 chose to participate, i.e. 6% of those initially screened. A total of 699 patients (49%) participated in the 1-month follow-up, with proportions varying according to survival time, from 20% if the patient died at month 2, to 75% if the patient died at month 6. Survival time was not associated with patient gender or age, but with diagnosis, country of residence and healthcare setting.

Conclusion
Approximately 20 times the desired cohort size had to be screened for eligibility. Prognostication was difficult, we noted a wide distribution of survival after inclusion. Patients’ ability to complete follow-up questionnaires declined well before death.
Mammography screening: Eliciting the voices of informed citizens
Authors: Jensen Manja D. , Hansen Kasper M. , Siersma Volkert , Brodersen John 
Published: January 2025

Background
Many medical organisations recommend continuing with existing mammography screening programmes but some recommend stopping or de-intensifying them. In Denmark women aged 50–69 are offered biennial mammograms free-of-charge.

Objectives
The aim of this study was to determine whether or not an informed public would recommend continuation of the Danish mammography screening programme, and to determine whether this recommendation was in line with what participants considered to be acceptable levels of mortality reduction and overdiagnosis.

Methods
A Deliberative Poll on mammography screening was held online in Denmark and 89 citizens participated. They were representative of the general population on sociodemographic parameters, attitudes towards and knowledge of mammography screening. Participants studied a video about the programme and took part in an online citizens’ assembly where they deliberated with peers and experts in the field. All participants answered a survey at four time points: at recruitment; after video information; after deliberation, and a month after the assembly.

Results
Questionnaire data revealed that many participants were influenced by the deliberative polling process as 36%, changed their recommendation afterwards. At recruitment, 72% of participants strongly supported the continuation of mammography screening. This proportion was lower after the presentation of video information (55%), after deliberation (65%), and a month after the assembly (58%). Interestingly, these changes in recommendation were not correlated to changes in knowledge. The proportion of participants who recommended continuation following what they stated were acceptable rates of mortality reduction and overdiagnosis rose from 21% at recruitment to 40% after information and deliberation. Most participants (60%), therefore, made a recommendation that was not in line with levels of mortality reduction and overdiagnosis that they felt were acceptable.

Conclusion
After video information and deliberation participants were less supportive of the mammography screening programme compared to their immediate recommendation at the beginning of the process.
Perioperative management of patients undergoing spine surgery: a survey of spine surgeons and a non-systematic review of the literature
Authors: Lebedev V. B. , Kinzyagulov B. R. , Epifanov D. S. , Zuev A. A. 
Published: January 2025

Objective. To assess trends in the management of patients after surgical treatment for degenerative diseases of the spine and to analyze literature data on perioperative management of this category of patients.Material and Methods. An anonymous online survey of 55 spine surgeons was conducted on the specifics of management of patients operated on for spinal stenosis and intervertebral disc herniation using microsurgical and endoscopic methods. The results of the survey were analyzed along with relevant literature data to provide a comprehensive understanding of the current practices in this field.Results. The analysis of questionnaires showed that there are significant differences and contradictions among surgeons regarding the use of antibiotics, restrictions on sitting after surgery, length of hospital stay, and use of a lumbar orthosis. A review of the world and domestic literature revealed a sufficient evidence of some studies to support their use as recommendations, while there is still a lack of evidence for most of the issues raised.Conclusion. Existing statements and protocols for the treatment of patients undergoing spine surgery need to be improved; randomized studies are required to establish the optimal approach for perioperative management of this group of patients.
A compact multiband frequency reconfigurable antenna integrated with sextuple band artificial magnetic conductor for heterogeneous wireless applications
Authors: Rajavel Vellaichamy , Ghoshal Dibyendu 
Published: January 2025

Abstract
As wireless communication continues to grow, reconfigurable antenna technologies have emerged as an optimal choice for multiband antennas. This study incorporates a 4 × 4 Artificial Magnetic Conductor (AMC) surface into a compact multiband frequency-reconfigurable antenna for diverse wireless applications. The antenna featured interconnected octagonal and rectangular patch slots in a radiating element with a defective ground structure. The antenna uses two-pin diodes to switch between four distinct working modes that produce dual wideband, triple-band, and quad-band responses. The AMC unit cell exhibits sextuple-band behavior at 2.5 GHz, 5 GHz, 6.5 GHz, 8.7 GHz, 10.5 GHz, and 11.4 GHz, with Double Negative material properties. The integrated antenna with dimension 50 × 50 × 10.2 mm3 achieves an average gain enhancement of 3.29 dB across its four switching states, with a peak Front-to-Back Ratio (FBR) reaching 31.23 dB, a notable radiation efficiency of 87 % with an average back lobe gain reduction of 13.75 dB. The Specific Absorption Rate (SAR) reached a minimum of 0.0594 W/kg with an overall average reduction of 93.25 %. The antenna was tested in an anechoic chamber using a vector network analyzer, and the results matched the simulations. Ultimately, the antenna design offers a compact, low-profile configuration that is ideal for versatile wireless applications with multiple bands and modes.