bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aspergillus terreus camptothecin-sodium alginate/titanium dioxide nanoparticles as a novel nanocomposite with enhanced compatibility and anticancer efficiency in vivo
Authors: Kelany Nermeen A. , El-Sayed Ashraf S. A. , Ibrahim Manar A. 
Published: April 2023

Abstract
Background
Camptothecin derivatives are one of the most prescribed anticancer drugs for cancer patients, however, the availability, efficiency, and water solubility are the major challenges that halt the applicability of this drug.

Methods
Biosynthetic potency of camptothecin by Aspergillus terreus, open a new avenue for commercial camptothecin production, due to their short-life span, feasibility of controlled growth conditions, and affordability for higher growth, that fulfill the availability of the scaffold of this drug.

Results
Camptothecin (CPT) was purified from the filtrates of A. terreus, and their purity was checked by HPLC, and its chemical structure was verified by LC/MS, regarding to the authentic one. To improve the anticancer efficiency of A. terreus CPT, the drug was conjugated with sodium alginate (SA)/Titanium dioxide nanoparticles (TiO2NPs) composites, and their physicochemical properties were assessed. From the FT-IR profile, a numerous hydrogen bond interactions between TiO2 and SA chains in the SA/TiO2 nanocomposites, in addition to the spectral changes in the characteristic bands of both SA/TiO2 and CPT that confirmed their interactions. Transmission electron microscopy analysis reveals the spherical morphology of the developed SA/TiO2NPs nanocomposite, with the average particle size ~ 13.3 ± 0.35 nm. From the results of zeta potential, successful loading and binding of CPT with SA/TiO2 nanocomposites were observed.

Conclusion
The in vivo study authenticates the significant improvement of the antitumor activity of CPT upon loading in SA/TiO2 nanocomposites, with affordable stability of the green synthesized TiO2NPs with Aloe vera leaves extract.
Can antioxidant treatment replace delay in bracket bonding? An in vitro study
Authors: Zaki Shaimaa S. , Ghorab Sayed M. , Tawfik Marwa A. , Shamaa Marwa S. 
Published: April 2023

Abstract
Background
Deterioration in shear bond strength has been reported after immediate bracket bonding following hydrogen peroxide bleaching. This study compared the effectiveness of three antioxidant agents, namely, alpha-tocopherol, green tea extract, and sodium ascorbate, in reversing the bleaching effect and as possible alternatives to delayed bonding.

Methods
A total of 105 extracted human premolars were arbitrarily assigned to 7 groups (n = 15 each), including group 1 as the unbleached control group and six experimental groups, which were bleached with 40% hydrogen peroxide in three sessions of 15 min each. In experimental group 2, bonding was performed immediately after bleaching, whereas in groups 3 and 4, bonding was delayed for 1 and 2 weeks, respectively; meanwhile, the specimens were immersed in artificial saliva at 37 °C. Groups 5, 6, and 7 were treated immediately after bleaching with 10% of alpha-tocopherol, green tea extract, and sodium ascorbate solutions, respectively, for 15 min. Specimens were processed using 500 thermal cycles between 5 and 55 °C, with a dwell time of 30 s after 24 h of bracket bonding, and then tested for shear bond strength. The adhesive remnant index was examined to evaluate fracture mode. One-way analysis of variance, Kruskal–Wallis H, and post hoc Tukey’s honestly significant difference tests were used to compare the data. Significant results were subjected to pairwise comparisons with Bonferroni’s correction-adjusted of p values ≤ 0.050.

Results
Shear bond strength was significantly lower (p < 0.001) in the immediate bonding and 1-week delay groups than in the control group. However, no significant difference was detected among the 2-week delay, antioxidant-treated, and control groups (p > 0.05).

Conclusions
Application of 10% alpha-tocopherol, green tea extract, or sodium ascorbate for 15 min could restore shear bond strength after 40% hydrogen peroxide bleaching as an alternative to delay in bracket bonding.
Adenoid Cystic Carcinoma (ACC) of the Bartholin's gland misdiagnosed for three times: a case report
Authors: Alhashemi Moustafa , Oubari Sana , Mohamad Aya Haji , Alhashemi Mohamad , Kabel Obaida , Alhelue Afaf , Fattal Farah 
Published: April 2023

Abstract
Background
Adenoid cystic carcinoma (ACC) in Bartholin’s gland is an uncommon malignant tumor. These tumors have a vague clinical feature, so they are diagnosed late and discovered at a high-level stage. Our case presented Three Recurrences and Three times Misdiagnosis of Adenoid Cystic Carcinoma (ACC).

Case presentation
We report a case of adenoid cystic carcinoma arising in Bartholin's gland of a 64-year-old female patient that appeared after three previous vulvar tumors were excised. The patient underwent bilateral radiotherapy which was performed on the perineum.

Conclusion
ACC of the vulvar sweat glands is prone to misdiagnosis and delay in both diagnosis and treatment. As seen in our case, it was misdiagnosed three times as Chondroid Syringoma. Further studies need to be conducted to better understand the tumor prognosis, and its optimal treatment options.
Bio-guided isolation of potential anti-inflammatory constituents of some endophytes isolated from the leaves of ground cherry (Physalis pruinosa L.) via ex-vivo and in-silico studies
Authors: Mahana Asmaa , Hammoda Hala M. , Saad Mona M. G. , Radwan Mohamed M. , ElSohly Mahmoud A. , Ghareeb Doaa A. , Harraz Fathallah M. , Shawky Eman 
Published: April 2023

Abstract
Background
Due to the extensive potential of previously studied endophytes in addition to plants belonging to genus Physalis as a source of anti-inflammatory constituents, the present study aimed at isolation for the first time some endophytic fungi from the medicinal plant Physalis pruinosa.

Methods
The endophytic fungi were isolated from the fresh leaves of P. pruinosa then purified and identified by both morphological and molecular methods. Comparative evaluation of the cytotoxic and ex vivo anti-inflammatory activity in addition to gene expression of the three pro-inflammatory indicators (TNF-α, IL-1β and INF-γ) was performed in WBCs treated with lipopolysaccharide (LPS) for the identified endophytes, isolated compounds and the standard anti-inflammatory drug (piroxicam). For prediction of the binding mode of the top-scoring constituents-targets complexes, the Schrödinger Maestro 11.8 package (LLC, New York, NY) was employed in the docking study.

Results
A total of 50 endophytic fungal isolates were separated from P. pruinosa leaves. Selection of six representative isolates was performed for further bioactivity screening based on their morphological characters, which were then identified as Stemphylium simmonsii MN401378, Stemphylium sp. MT084051, Alternaria infectoria MT573465, Alternaria alternata MZ066724, Alternaria alternata MN615420 and Fusarium equiseti MK968015. It could be observed that A. alternata MN615420 extract was the most potent anti-inflammatory candidate with a significant downregulation of TNF-α. Moreover, six secondary metabolites, alternariol monomethyl ether (1), 3’-hydroxyalternariol monomethyl ether (2), alternariol (3), α-acetylorcinol (4), tenuazonic acid (5) and allo-tenuazonic acid (6) were isolated from the most potent candidate (A. alternata MN615420). Among the tested isolated compounds, 3’-hydroxyalternariol monomethyl ether showed the highest anti-inflammatory potential with the most considerable reductions in the level of INF-γ and IL-1β. Meanwhile, alternariol monomethyl ether was the most potent TNF-α inhibitor. The energy values for the protein (IL-1β, TNF-α and INF-γ)–ligand interaction for the best conformation of the isolated compounds were estimated using molecular docking analysis.

Conclusions
The results obtained suggested alternariol derivatives may serve as naturally occurring potent anti-inflammatory candidates. This study opens new avenues for the design and development of innovative anti-inflammatory drugs that specifically target INF-γ, IL-1β and INF-γ.
Fitness-for-purpose of the CanMEDS competencies for workplace-based assessment in General Practitioner’s Training: a Delphi study
Authors: Andreou Vasiliki , Peters Sanne , Eggermont Jan , Embo Mieke , Michels Nele R. , Schoenmakers Birgitte 
Published: April 2023

AbstractBackgroundIn view of the exponential use of the CanMEDS framework along with the lack of rigorous evidence about its applicability in workplace-based medical trainings, further exploring is necessary before accepting the framework as accurate and reliable competency outcomes for postgraduate medical trainings. Therefore, this study investigated whether the CanMEDS key competencies could be used, first, as outcome measures for assessing trainees’ competence in the workplace, and second, as consistent outcome measures across different training settings and phases in a postgraduate General Practitioner’s (GP) Training.MethodsIn a three-round web-based Delphi study, a panel of experts (n = 25–43) was asked to rate on a 5-point Likert scale whether the CanMEDS key competencies were feasible for workplace-based assessment, and whether they could be consistently assessed across different training settings and phases. Comments on each CanMEDS key competency were encouraged. Descriptive statistics of the ratings were calculated, while content analysis was used to analyse panellists’ comments.ResultsOut of twenty-seven CanMEDS key competencies, consensus was not reached on six competencies for feasibility of assessment in the workplace, and on eleven for consistency of assessment across training settings and phases. Regarding feasibility, three out of four key competencies under the role “Leader”, one out of two competencies under the role “Health Advocate”, one out of four competencies under the role “Scholar”, and one out of four competencies under the role “Professional” were deemed as not feasible for assessment in a workplace setting. Regarding consistency, consensus was not achieved for one out of five competencies under “Medical Expert”, two out of five competencies under “Communicator”,one out of three competencies under “Collaborator”, one out of two under “Health Advocate”, one out of four competencies under “Scholar”, one out of four competencies under “Professional”. No competency under the role “Leader” was deemed to be consistently assessed across training settings and phases.ConclusionsThe findings indicate a mismatch between the initial intent of the CanMEDS framework and its applicability in the context of workplace-based assessment. Although the CanMEDS framework could offer starting points, further contextualization of the framework is required before implementing in workplace-based postgraduate medical trainings.
A structural equation modelling analysis: interprofessional team collaboration, organizational career management, and post competency of community nurses
Authors: Ma Li , Wang Xinwei , Zou Shiyue , Lin Min , Qiu Shi , Li Weimin 
Published: April 2023

Abstract
Background
With the advent of an ageing society and an increase in the prevalence of chronic diseases, the role of primary health care has become increasingly important and reliant on multidisciplinary collaboration. As members of this interprofessional cooperative team, community nurses play a dominant role. Thus, the post competencies of community nurses study deserve our attention. In addition, organizational career management can affect nurses in some ways. This study aims to examine the current situation and relationship among interprofessional team collaboration, organizational career management and post-competency of community nurses.

Methods
A survey was conducted among 530 nurses in 28 community medical institutions from November 2021 to April 2022 in Chengdu, Sichuan Province, China. Descriptive analysis was used for analysis, and a structural equation model was used to hypothesize and verify the model. A total of 88.2% of respondents met the inclusion criteria and did not meet the exclusion criteria. The main reason nurses gave for not participating was that they were too busy.

Results
Among the competencies on the questionnaire, ensuring quality and helping roles scored the lowest. The teaching-coaching and diagnostic functions played a mediating role. Nurses with greater seniority and those who were transferred to administrative departments had lower scores, and the difference was statistically significant (p < 0.05). In the structural equation model, CFI = 0.992 and RMSEA = 0.049, which shows that the model fit well, suggesting that organizational career management had no statistically significant effect on post competency (β = -0.006, p = 0.932) but that interprofessional team collaboration had a statistically significant effect on post competency (β = 1.146, p < 0.001) and organizational career management had a statistically significant effect on interprofessional team collaboration (β = 0.684, p < 0.001).

Conclusions
Attention should be given to the improvement of community nurses' post competency in ensuring quality and performing helping, teaching-coaching, and diagnostic roles. Moreover, researchers should focus on the decline in community nurses' abilities, particularly for those with greater seniority or in administrative roles. The structural equation model shows that interprofessional team collaboration is a complete intermediary between organizational career management and post competency.
Downregulation of circ-YES1 suppresses NSCLC migration and proliferation through the miR-142-3p–HMGB1 axis
Authors: Jin Mingming , Wang Yan , Zhou Dawei , Liu Wanchao , Han Ruodong , Chi Yongbin 
Published: April 2023

Abstract
Background
Circular RNAs (circRNAs) are a new family of abundant regulatory RNAs with roles in various types of cancer. While the hsa_circ_0046701 (circ-YES1) function in non-small cell lung cancer (NSCLC) is unclear.

Methods
Circ-YES1 expression in normal pulmonary epithelial and NSCLC cells was examined. The small interfering RNA for circ-YES1 was prepared, cell proliferation and migration were assessed. Tumorigenesis in nude mice was assayed to validate the role of circ-YES1. Bioinformatics analyses and luciferase reporter assays were utilized to identify downstream targets of circ-YES1.

Results
Compared to normal pulmonary epithelial cells, the circ-YES1 expression increased in NSCLC cells, and cell proliferation and migration were suppressed after circ-YES1 knockdown. Both high mobility group protein B1 (HMGB1) and miR-142-3p were found to be downstream targets of circ-YES1, and miR-142-3p inhibition and HMGB1 overexpression reversed the effects of circ-YES1 knockdown on cell proliferation and migration. Similarly, HMGB1 overexpression reversed the miR-142-3p overexpression effects on these two processes. The imaging experiment results revealed that circ-YES1 knockdown impeded tumor development and metastasis in a nude mouse xenograft model.

Conclusion
Taken together, our results show that circ-YES1 promotes tumor development through the miR-142-3p–HMGB1 axis and support the development of circ-YES1 probability as a new therapeutic NSCLC target.
Relationship between triglyceride-glucose index and aminotransferase among Royal Thai Army personnel 2017–2021: a serial cross-sectional study
Authors: Lertsakulbunlue Sethapong , Mungthin Mathirut , Rangsin Ram , Kantiwong Anupong , Sakboonyarat Boonsub 
Published: April 2023

Abstract
Background
Insulin resistance (IR) is a major pathogenesis of nonalcoholic fatty liver disease (NAFLD). The triglyceride-glucose (TyG) index has recently gained popularity to assess IR and NAFLD due to its simplicity and low cost. The aim of the current study was to evaluate the relationship between the TyG index and aminotransferase.

Methods
A serial cross-sectional study was conducted among 232,235 Royal Thai Army (RTA) personnel aged 35–60 years from 2017–2021. Elevated aminotransferase was defined as ≥ 40 U/L and ≥ 35 U/L among males and females, respectively. A linear regression analysis between the TyG index and log-transformed aminotransferase was performed. High- and low-TyG index groups were divided according to Youden’s index cut point for predicting elevated aminotransferase. Multivariable logistic analysis was also utilized to investigate the association between the TyG index and elevated aminotransferase.

Results
The TyG index revealed a dose‒response relationship with log-transformed aminotransferase in both sexes and all age groups. The TyG index was positively associated with the prevalence of elevated aminotransferases. In comparison with the first TyG quartile (< 8.37), participants in the fourth quartile (> 9.23) had a higher chance for elevated ALT (AOR: 2.81, 95% CI: 2.71–2.90 for males and AOR: 4.01, 95% CI: 3.50–4.60 for females, P < 0.001 for both). In the fourth TyG quartile, the prevalence of elevated ALT was 47.8% and 40.2% in the participants aged 35–44 and male participants, respectively.

Conclusion
A high TyG index is a novel risk factor for elevated aminotransferase among RTA personnel. Those with a high TyG index should be screened for elevated aminotransferase, particularly males aged 35–44 years.
Efficacy of granulocyte colony-stimulating factor for infertility undergoing IVF: a systematic review and meta-analysis
Authors: Fu Lu-lu , Xu Ying , Yan Jing , Zhang Xue-ying , Li Dan-dan , Zheng Lian-wen 
Published: April 2023

AbstractObjectiveThis study aimed to evaluate the effectiveness of granulocyte colony-stimulating factor (G-CSF) for infertility and recurrent spontaneous abortion.MethodsExisting research was searched in PubMed, Embase and Cochrane Library till Dec 2021. Randomized control trials (RCTs) that compared G-CSF administration with the control group in infertility women undergoing IVF were included. The primary outcomes included clinical pregnancy rate; the secondary outcomes included live birth rate, abortion ratebiochemical pregnancy rate, embryo implantation rate, as well as endometrial thickness.Result(s)20 RCTs were included in this study. G-CSF increased the clinical pregnancy rate (RR = 1.85; 95% CI: 1.07, 3.18) and the endometrial thickness (MD = 2.25; 95% CI: 1.58,2.92;) in patients with thin endometrium undergoing IVF. G-CSF increased the biochemical pregnancy rate (RR = 2.12; 95% CI: 1.54, 2.93), the embryo implantation rate (RR = 2.51; 95% CI: 1.82, 3.47) and the clinical pregnancy rate (RR = 1.93; 95% CI: 1.63, 2.29) in patients with a history of repeated implantation failure undergoing IVF. No differences were found in pregnancy outcomes of general IVF patients.ConclusionsGranulocyte colony-stimulating factor is likely to be a potential option for infertility women undergoing IVF with thin endometrium or recurrent implantation failure .Trial registrationRetrospectively registered (The PROSPERO registration number: CRD42022360161).
Early death after palliative radiation treatment: 30-, 35- and 40-day mortality data and statistically robust predictors
Authors: Nieder Carsten , Stanisavljevic Luka , Mannsåker Bård , Haukland Ellinor C. 
Published: April 2023

Abstract
Background
This study analyzed mortality after radiotherapy for bone metastases (287 courses). Endpoints such as treatment in the last month of life and death within 30, 35 and 40 days from start of radiotherapy were evaluated.

Methods
Different baseline parameters including but not limited to blood test results and patterns of metastases were assessed for association with early death. After univariate analyses, multi-nominal logistic regression was employed.

Results
Of 287 treatment courses, 42 (15%) took place in the last month of life. Mortality from start of radiotherapy was 13% (30-day), 15% (35-day) and 18% (40-day), respectively. We identified three significant predictors of 30-day mortality (performance status (≤ 50, 60–70, 80–100), weight loss of at least 10% within 6 months (yes/no), pleural effusion (present/absent)) and employed these to construct a predictive model with 5 strata and mortality rates of 0–75%. All predictors of 30-day mortality were also associated with both, 35- and 40-day mortality.

Conclusion
Early death was not limited to the first 30 days after start of radiotherapy. For different cut-off points, similar predictive factors emerged. A model based on three robust predictors was developed.
Predicting deterioration of patients with early sepsis at the emergency department using continuous heart rate variability analysis: a model-based approach
Authors: van Wijk Raymond J. , Quinten Vincent M. , van Rossum Mathilde C. , Bouma Hjalmar R. , ter Maaten Jan C. 
Published: April 2023

Abstract
Background
Sepsis is a life-threatening disease with an in-hospital mortality rate of approximately 20%. Physicians at the emergency department (ED) have to estimate the risk of deterioration in the coming hours or days and decide whether the patient should be admitted to the general ward, ICU or can be discharged. Current risk stratification tools are based on measurements of vital parameters at a single timepoint. Here, we performed a time, frequency, and trend analysis on continuous electrocardiograms (ECG) at the ED to try and predict deterioration of septic patients.

Methods
Patients were connected to a mobile bedside monitor that continuously recorded ECG waveforms from triage at the ED up to 48 h. Patients were post-hoc stratified into three groups depending on the development of organ dysfunction: no organ dysfunction, stable organ dysfunction or progressive organ dysfunction (i.e., deterioration). Patients with de novo organ dysfunction and those admitted to the ICU or died were also stratified to the group of progressive organ dysfunction. Heart rate variability (HRV) features over time were compared between the three groups.

Results
In total 171 unique ED visits with suspected sepsis were included between January 2017 and December 2018. HRV features were calculated over 5-min time windows and summarized into 3-h intervals for analysis. For each interval, the mean and slope of each feature was calculated. Of all analyzed features, the average of the NN-interval, ultra-low frequency, very low frequency, low frequency and total power were different between the groups at multiple points in time.

Conclusions
We showed that continuous ECG recordings can be automatically analyzed and used to extract HRV features associated with clinical deterioration in sepsis. The predictive accuracy of our current model based on HRV features derived from the ECG only shows the potential of HRV measurements at the ED. Unlike other risk stratification tools employing multiple vital parameters this does not require manual calculation of the score and can be used on continuous data over time.
Trial registration The protocol of this study is published by Quinten et al., 2017.