bluuebunny/crossref_metadata_2025_split huggingface dataset:
An evaluation of Scottish green health prescriptions using the APEASE criteria
Authors: Howlett Neil , Freethy Imogen , Harding Sian , Wagner Adam P. , Miners Lisa , Anne-Greco Honey , Lamming Laura , Lloyd Nigel , Brown Katherine E. 
Published: February 2025

Abstract

Background
Time spent in green space such as parks and forests can have positive effects on physical and mental health. Green Health Partnerships were set up in Scotland to promote use of green space for health improvement. One of the main mechanisms to achieve this was the setup of Green Health Prescriptions (GHPr). This study evaluates three GHPrs in different localities across a range of feasibility elements, and the funding and resourcing associated with implementation.

Methods
Interviews were conducted across service user, referrer, link worker, and activity provider groups across Dundee, Highland, and North Ayrshire. Interviews were deductively analysed using the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Spillover effects, Equity) criteria. Data within each APEASE domain was then inductively coded producing more reflexive sub-themes. Data on funding and resources associated with delivering each programme was also collected to provide further context to the APEASE criteria.

Results
All stakeholder groups generally found the concept of using green spaces and the GHPr acceptable, and, although service users perceived that staff were often good communicators, there were times where awareness of and knowledge about the GHPr were lacking. There were reported improvements across a wide range of physical and mental health, and social outcomes for service users. The GHPr was also considered affordable in terms of the green health activity sessions. A key issue for staff across practicability, acceptability, and with monitoring equity, was the lack of underpinning IT infrastructure for referrals, communication with link workers, and data capture to reflect on service user progress. As implemented in Dundee, progression through the GHPr, after initial referral, took on average 195 min, at a cost of £64 per service user.

Conclusions
This evaluation highlighted the potential benefits for service users that can be realised through a GHPr. However, a lack of supportive systems to capture referral information, communicate between professionals, and document service user progress limits a more robust and extensive evaluation of the current GHPr model.

Evaluation registration
Research Registry identifier: researchregistry9069, registration date: 25/04/23.
Development of a patient assessment to meet the needs of patients suffering from advanced non-oncological diseases – the KOPAL trial
Authors: Marx Gabriella , Mallon Tina , Stanze Henrikje , Zimansky Manuel , Schneider Nils , Nauck Friedemann , Scherer Martin , Pohontsch Nadine 
Published: February 2025

Abstract

Background
Patients suffering from progressive non-oncologic chronic diseases are primarily treated in primary care. Early integration of palliative care (PC) can improve patients’ quality of life and reduce burdensome physical symptoms. To guide interprofessional counselling between GPs and specialist palliative home care teams, we developed an aide memoire for patients diagnosed with advanced non-oncological chronic diseases, the KOPAL conversation guide, as part of the KOPAL trial. The aim of this study was to ensure the conversation guide covers all relevant care aspects in order to reveal individual gaps and needs in healthcare.

Methods
We conducted three focus groups including four patients, seven health care providers, and five stakeholders. During each group, a draft of the conversation guide was discussed, revised, and consented from the respective perspectives.

Results
The final KOPAL conversation guide contains eight key topics: living with the illness, physical, emotional, personal, and social situation, information and communication, control and autonomy, emergency management. Each topic refers to a number of related subtopics listed in each respective thematic section. The conversation should start with the introductory question referring to the patient’s current well-being. At the end, patients are asked to state their primary concern based on the conversation.

Conclusions
The KOPAL conversation guide is a broad evaluation and communication tool. It covers potential PC needs of non-oncological patients and provides a basis for interprofessional case planning, and counselling. Applying the guide may help to bridge gaps in communication between general and specialist PC professionals as well as between professionals and patients.
The burden of ischemic stroke in Eastern Europe from 1990 to 2021
Authors: Xu Jingyao , Hou Shuai , Chen Zimeng , Liu Yong , Deng Xia , Wang Chunping , Liu Shijie , Wang Yanqiang 
Published: February 2025

Abstract

Background and purpose
Ischemic stroke is a significant public health concern, particularly in Eastern Europe, where the burden remains high. This study aims to evaluate the trends and burden of ischemic stroke in Eastern Europe from 1990 to 2021, providing insights into epidemiological changes and informing public health strategies.

Methods
We used data from the Global Burden of Disease 2021 database to comprehensively assess regional and national ischemic stroke indicators in Eastern Europe. These indicators included the number of cases, incidence, number of deaths, mortality, disability-adjusted life years (DALYs), DALY rates, and estimated annual percentage change (EAPC). Joinpoint analysis was employed to examine sex-specific time trends in the burden of ischemic stroke across Eastern European countries. These estimates incorporated the Socio-Demographic Index (SDI).

Results
In 2021, Eastern Europe reported 490,197 cases of ischemic stroke, with an age-standardized incidence rate (ASIR) of 142.57 (95% UI: 122.12 to 164.67), exceeding the global level. The region recorded 329,291 deaths, with an age-standardized mortality rate (ASMR) of 90.99 (95% UI: 82.79 to 98.48), significantly higher than the global rate. Disability-adjusted life years (DALYs) totaled 5,713,718, with an age-standardized DALYs rate (ASDR) of 1601.20 (95% UI: 1483.51 to 1723.12). Our joinpoint regression analysis indicates that the disease burden remains notably high in Eastern Europe, despite an overall declining trend from 1990 to 2021 in ASIR and ASMR across most countries, with estimated annual percentage changes (EAPC) of -1.13 (95% CI: -1.24 to -1.02) and − 2.78 (95% CI: -3.24 to -2.32), respectively. Lithuania reported the highest incidence rate, while the Russian Federation had the highest mortality and DALY rate. Conversely, Estonia showed significant improvements in stroke indicators. Key risk factors included low temperature and smoking, contributing notably to environmental and behavioral risks.

Conclusion
Ischemic stroke continues to be a significant global health issue. Our temporal trends study results indicate that the disease burden remains notably high in Eastern Europe, particularly in Lithuania and the Russian Federation.
Dihydrolipoamide dehydrogenase deficiency in two unrelated Tunisian children
Authors: Aloulou Hajer , Charfi Fatma , Charfi Rim , Chehida Amel Ben , Boudabbous Hela , Chabchoub Imen , Lebigot Elise , Kammoun Thouraya , Maaloul Ines 
Published: February 2025

Abstract

Background
Dihydrolipoamide dehydrogenase deficiency (DLDD) (OMIM# 246,900) is an extremely rare inherited metabolic disorder causing neurological and/or liver impairment. The clinical manifestations are mostly characterized by severe neurological impairment in early childhood, hepatic presentations and rarely by myopathic manifestations.

Case presentations
Here, we describe two patients presenting with recurrent episodes of vomiting and liver dysfunction. DLDD was confirmed via sanger sequencing by identification of the pathogenic variant c.685G > T (p.Gly229Cys) in DLD gene at a homozygous state.

Conclusion
To our knowledge, this is the first Tunisian report of DLDD. Phenotypic spectrum of this disease is very large. Biochemical markers that predict the impairment of the pathways affected by the deficiency of E3 subunit (gluconeogenesis, tricyclic cycle and catabolism of branched chain aminoacids) are variably present. Confirmation is based on genetic study of DLD gene.
Evaluation of color stability in single-shade composite resins using spectrophotometer and cross-polarized mobile photography
Authors: Tepe Hatice , Celiksoz Ozge , Yaman Batu Can 
Published: February 2025

Abstract

Background
This study aimed to evaluate the long-term color stability of single-shade composite resins when exposed to simulated intraoral conditions, including staining, brushing, and thermal cycling. Additionally, the study compared the performance of spectrophotometry and cross-polarized (CP) photography in detecting color changes, focusing on their applicability for both clinical and research purposes.

Materials and methods
The study employed five single-shade composite resins (Omnichroma; OMN, Zenchroma; ZNC, Vittra APS Unique; VTR, Charisma One; CHR, and Essentia Universal; ESU) and one multi-shade composite resin (Filtek Z550: FLT) for testing. The specimens were subjected to thermal cycling, staining, and brushing to simulate intraoral conditions. Color measurements were conducted using a spectrophotometer and CP photography at the initial baseline (t0) and following each subsequent procedure 10-day (t1) and 1-year simulated staining, brushing and thermal cycling (t2). Color differences (ΔE1, ΔE2) were calculated using the CIEDE2000 formula. Statistical analyses included Shapiro-Wilk for normality, ANOVA and paired t-tests for parametric data, and Kruskal-Wallis and Wilcoxon tests for non-parametric data. Method consistency was evaluated with the Intra-Class Correlation Coefficient (ICC) (p < 0.05).

Results
All composite groups demonstrated statistically significant color changes following the simulated conditions (p < 0.001). The CHR group exhibited the highest values for both ΔE1 and ΔE2, indicating the greatest degree of discoloration. The FLT and ZNC groups exhibited the lowest ΔE values across methods at various time points. A positive correlation was identified between spectrophotometer and CP photography measurements for all parameters (p < 0.001), although the correlation for ΔE1 and ΔE2 was less robust.

Conclusions
Single-shade composites display a high susceptibility to significant discoloration when subjected to simulated intraoral conditions, with CHR exhibiting the most pronounced alterations. Both spectrophotometry and CP photography were effective in assessing color stability, with CP photography offering a practical alternative for clinical settings. These findings offer insight into the aesthetic durability of single-shade composites and underscore the importance of long-term evaluations.
Exploring the knowledge, attitude, and practice of community pharmacists regarding pediatric asthma management in Guangdong Province, China: a cross-sectional survey study
Authors: Lin Guohua , Lai Meijun , Chau Chi Ian , Hu Hao , Ung Carolina Oi Lam 
Published: February 2025

Abstract

Background
Pediatric asthma is a common respiratory disease that significantly affects children's physical and mental health. This study aims to investigate community pharmacists' self-reported knowledge of asthma and explore their attitude and practice in providing pharmaceutical services to address the needs of pediatric asthma patients.

Methods
An online questionnaire informed by recent literature was distributed to community pharmacists in Guangdong Province, China via Qualtrics using convenience sampling and snowballing. Descriptive analysis and generalized multiple linear regression analysis were used for data analysis.

Results
Out of 579 community pharmacists who attempted this questionnaire, 473 completed it, giving a completion rate of 81.7%. Among the participants, 217 (45.9%) were female, and 319 (67.5%) aged between 31 and 50. The mean score of self-reported knowledge was 60.29 ± 6.16 out of 95 (range: 19–76); the mean score of attitude was 87.62 ± 8.37 out of 130 (range: 77–130); the mean score of practice was 18.72 ± 2.32 out of 30 (range: 6–24). Age, years of employment, highest education level, the average number of patients serving per day, and the average number of asthma patients serving per week were factors significantly associated with participants' self-reported knowledge, attitude, or practice toward pediatric asthma management (p < 0.05).

Conclusions
Many community pharmacists felt they lacked sufficient knowledge about pediatric asthma and infrequently provided pharmaceutical services to children with asthma, despite having a positive attitude towards this professional role. To enhance the pharmaceutical care for pediatric asthma patients, it is essential to develop practice guidelines and care models, and provide education and training to community pharmacists accordingly.
Machine learning-based prediction of post-induction hypotension: identifying risk factors and enhancing anesthesia management
Authors: Chen Ming , Zhang Dingyu 
Published: February 2025

Abstract

Background
Post-induction hypotension (PIH) increases surgical complications including myocardial injury, acute kidney injury, delirium, stroke, prolonged hospitalization, and endangerment of the patient's life. Machine learning is an effective tool to analyze large amounts of data and identify perioperative complication factors. This study aims to identify risk factors for PIH and develop predictive models to support anesthesia management.

Methods
A dataset of 5406 patients was analyzed using machine learning methods. Logistic regression, random forest, XGBoost, and neural network models were compared. Model performance was evaluated using the area under the receiver operating characteristic curve (AUROC), calibration curves, and decision curve analysis (DCA).

Results
The logistic regression model achieved an AUROC of 0.74 (95% CI: 0.71–0.77), outperforming the random forest (AUROC: 0.71), XGBoost (AUROC: 0.72), and neural network (AUROC: 0.72) models. In terms of calibration, logistic regression demonstrated superior performance, as reflected by Brier Scores and calibration curves, followed by XGBoost, random forest, and neural network. Decision curve analysis indicated that the logistic regression model provided the greatest clinical utility among all models. Baseline blood pressure, age, sex, type of surgery, platelet count, and certain anesthesia-inducing drugs were identified as important features.

Conclusions
This study provides a valuable tool for personalized preoperative risk assessment and customized anesthesia management, allowing for early intervention and improved patient outcomes. Integration of machine learning models into electronic medical record systems can facilitate real-time risk assessment and prediction.
Attachment sites of Ixodes ricinus, Ixodes hexagonus/Ixodes canisuga and Dermacentor reticulatus ticks and risk factors of infestation intensity and engorgement duration in dogs and cats
Authors: Probst Julia , Springer Andrea , Strube Christina 
Published: February 2025

Abstract

Background
Over the last decades, climatic and environmental changes have led to an expanding seasonal activity pattern and increasing distribution of ticks across Europe. In particular, Dermacentor reticulatus is now commonly found on dogs in central Europe. The present study compared attachment sites between Ixodes spp. and Dermacentor reticulatus ticks collected by veterinarians from dogs and cats, and investigated risk factors associated with tick infestation intensity and engorgement duration.

Results
The dataset comprised 6,335 dogs harbouring 10,287 ticks (8,095 Ixodes ricinus, 1,860 D. reticulatus, 218 Ixodes hexagonus/Ixodes canisuga, 114 of other tick species) respectively 4,248 cats harbouring 8,005 ticks (7,344 I. ricinus, 56 D. reticulatus, 505 I. hexagonus/I. canisuga, 100 of other tick species). Differing sites of tick attachment were not only found between the different host and tick species, but also between the tick developmental stages. Regarding the risk of infestation with multiple ticks, dogs and cats living in rural areas harboured significantly more often multiple than single specimens. Further, a long coat in cats was associated with a higher probability of multiple infestation, while this was not observed in dogs. However, there was a tendency towards a potential influence of the density of the undercoat (p = 0.051). In dogs, a tall to very tall body size as well as folded ears increased the risk of multiple infestation, while in cats, increasing age and increasing body size were negatively associated with multiple infestations. Ticks with an engorgement duration of > 48 h were found significantly more often on senior dogs and cats than on younger individuals, as well as on working/utility dog breeds, while engorgement duration was negatively correlated with infestation intensity in dogs. In cats, female gender and a rural residence were significantly associated with longer attachment duration.

Conclusions
Individual as well as breed specific characteristics can lead to a higher tick infestation intensity or longer engorgement duration. The knowledge of tick attachment sites and specific risk factors can help to raise awareness among owners concerning the importance of tick control with licensed acaricides, as recommended e.g. by the European Scientific Counsel Companion Animal Parasites (ESCCAP), and may aid in early tick removal to decrease the risk of pathogen transmission to dogs and cats whose owners nonetheless refuse acaricidal drugs.
Identifying malaria risks amongst forest going populations in Mondulkiri province and Kampong Speu province, Cambodia: a large cross-sectional survey
Authors: Chen Ingrid , Doum Dyna , McIver David J. , Keo Vanney , Vong Pisey , Pech Sophak , Meth Vanny , Bun Sour , Pen Kimheng , Chea Sopagna , Ly Kanha , Hok Kry , Sovannaroth Siv , Ting Jafit , Lovin Diane D. , Cunningham Joanne M. , Vajda Élodie A. , Tatarsky Allison , Lobo Neil F. 
Published: February 2025

Abstract

Background
Cambodia strives to eliminate all species of human malaria by 2025, requiring that foci among forest-exposed populations in remote settings be addressed. This study explores malaria risks amongst forest-exposed groups in Mondulkiri and Kampong Speu Provinces, Cambodia as part of a multi-stage study on novel mosquito bite prevention tools (Project BITE).

Methods
A serial cross-sectional survey explored the demographics, housing structure openness, mosquito bite prevention habits, and protection from malaria amongst three target groups: forest goers who work in the forest, forest dwellers who live in the forest, and forest rangers who patrol forested regions. Malaria prevalence data was collected at three time points using rapid diagnostic tests (RDTs) for febrile individuals and qPCR for all participants. Infection locations and travel patterns of Plasmodium falciparum-infected individuals were analysed for clustering and the potential movement of infections.

Results
2935 participants were enrolled between October 2022 and February 2023, consisting of 1093 (37%) forest goers and 1787 (61%) forest dwellers across both provinces, and 55 (5%) forest rangers in Mondulkiri province. Most worked outdoors as farmers, day labourers, and forest collectors, and reported going to the forest five to seven days a week. For housing, 29% and 39% of participants reported living in partially open primary and secondary structures, respectively. The main methods of mosquito bite protection used were insecticide-treated nets, wearing long sleeves, and burning mosquito coils, with limited protection during the daytime and outside at night. All febrile individuals had negative RDT test results. For qPCR, 24 P. falciparum infections (< 1%) were detected among forest goers and dwellers, clustered in Pu Trom and Pu Nhav villages in Mondulkiri Province, and Banteay Roka and Banteay Roka Kirisenchey (M) villages in Kampong Speu Province. Plasmodium vivax cases were detected (216 cases, 5%) across all enrolled villages. Only two infections were found in forest rangers.

Conclusion
Malaria elimination strategies for forest-exposed populations in Cambodia should focus on vector intervention strategies that offer protection during the day and outside at night, and drug-based strategies to clear subpatent infections, targeting forest goers and dwellers in villages where cases are detected.
Planetary health diet index and mortality among US cancer survivors: mediating roles of systemic immune-inflammation index and neutrophil-to-lymphocyte ratio
Authors: Chen Haolin , Yang Qinglong , Zheng Huihui , Tan Jianhui , Xie Jiayi , Xu Miaojie , Ouyang Xue , Li Zhiyang , Chen Yexi 
Published: February 2025

Abstract

Background
Cancer-related deaths and environmental issues pose significant global challenges. The Planetary Health Diet (PHD) is a healthy dietary pattern that simultaneously promotes human health and ecology. This study aims to investigate the association between the Planetary Health Diet Index (PHDI) and mortality among cancer survivors, as well as the mediating role of inflammation between PHDI and all-cause mortality.

Methods
This study analyzed data from 3,442 cancer survivors enrolled in the United States National Health and Nutrition Examination Survey between 1999 and 2018. To investigate the association between PHDI and mortality, we applied weighted multivariate Cox proportional hazards regression, restricted cubic spline analysis, subgroup analysis, and sensitivity analysis. The mediating effects of the Systemic Immune-Inflammation Index (SII) and Neutrophil-to-Lymphocyte Ratio (NLR) were assessed using the bootstrap method with 1000 simulations.

Results
In the fully adjusted model, each 10-point PHDI increase correlated with a 9% decrease in all-cause mortality (HR, 0.91; 95% CI, 0.86–0.95), a 10% decrease in cancer mortality (HR, 0.90; 95% CI, 0.83–0.99), and a 10% decrease in non-cancer mortality (HR, 0.90; 95% CI, 0.85–0.96). The PHDI was significantly inversely correlated with SII and NLR, which were positively related to all-cause mortality. The mediation proportions of SII and NLR between the PHDI and all-cause mortality were 6.52% and 8.52%, respectively.

Conclusions
Adherence to the PHD is associated with reduced all-cause, cancer, and non-cancer mortality among cancer survivors. Additionally, SII and NLR may mediate the relationship between PHDI and all-cause mortality.
p53-regulated SESN1 and SESN2 regulate cell proliferation and cell death through control of STAT3
Authors: Haidurov Alexander , Zheltukhin Andrei O. , Snezhkina Anastasiya V. , Krasnov George S. , Kudryavtseva Anna V. , Budanov Andrei V. 
Published: February 2025

Abstract
Sestrin1 and Sestrin2 (SESN1&2) are evolutionarily conserved, stress-responsive proteins that regulate cell growth and viability. The primary target of Sestrins is the mTORC1 protein kinase, an activator of anabolic processes and an autophagy inhibitor. Our previous studies showed that inactivating SESN1&2 in lung adenocarcinoma A549 cells accelerates cell proliferation and confers resistance to cell death without affecting mTORC1 activity, suggesting that SESN1&2 modulate cellular processes via mTORC1-independent mechanisms. This work describes a new mechanism through which SESN1&2 regulate cell proliferation and death by suppressing the STAT3 transcription factor. Normally activated in response to stress and inflammation, STAT3 is frequently overactivated in human cancers. This overactivation promotes the expression of pro-proliferative and anti-apoptotic genes that drive carcinogenesis. We demonstrate that SESN1&2 inactivation stimulates STAT3 by downregulating the PTPRD phosphatase, a protein responsible for STAT3 dephosphorylation. Our study demonstrates that SESN1&2 deficiency may cause STAT3 activation and facilitate carcinogenesis and drug resistance, making SESN1&2 reactivation a potential cancer treatment strategy.