bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alcohol consumption may be associated with postoperative delirium in the elderly: the PNDABLE study
Authors: Wu Xiaoyue , Zhang Ning , Zhou Bin , Liu Siyu , Wang Fei , Wang Jiahan , Tang Xinhui , Lin Xu , Wang Bin , Bi Yanlin 
Published: June 2023

Abstract
Objectives
This study aimed to reveal the relationship between alcohol consumption and Postoperative delirium (POD) in the elderly.

Methods
We selected 252 patients from the Perioperative Neurocognitive Disorder And Biomarker Lifestyle (PNDABLE ) study. Patients in the PNDABLE database have been measured for Alzheimer-related biomarkers in CSF (Aβ40, Aβ42, P-tau, and tau protein). Mini-Mental State Examination (MMSE) was used to assess the preoperative mental status of patients. POD was diagnosed using the Confusion Assessment Method (CAM) and assessed for severity using the Memorial Delirium Assessment Scale (MDAS). Logistic regression analysis was utilized to explore the association of alcohol consumption with POD. Linear regression analysis was used to study the relationship between alcohol consumption and CSF biomarkers. Mediation analyses with 10,000 bootstrapped iterations were used to explore the mediation effects. Finally, we constructed the receiver operating characteristic (ROC) curve and the nomogram model to evaluate the efficacy of alcohol consumption and CSF biomarkers in predicting POD.

Result
The incidence of POD was 17.5%. Logistic regression showed that alcohol consumption (OR = 1.016, 95%CI 1.009–1.024, P < 0.001) is a risk factor for POD. What’s more, Aβ42 is a protective factor for POD (OR = 0.993, 95%CI 0.989–0.997, P < 0.05), and P-Tau was a risk factor for POD (OR = 1.093, 95%CI 1.022–1.168, P < 0.05). Linear regression analysis revealed that alcohol consumption was negatively associated with CSF Aβ42 (β = -0.638, P < 0.001) in POD patients. Mediation analyses showed that alcohol consumption is likely to partially mediate POD through Aβ42 (proportion:14.21%). ROC curve showed that alcohol consumption (AUC = 0.904; P < 0.001) exhibited a relatively better discriminatory ability in POD prediction compared to Aβ42 (AUC = 0.798; P < 0.001). The calibration curve indicated a good nomogram prediction (P = 0.797).

Conclusion
Alcohol consumption is a risk factor for POD (particularly for those with > 24 g a day on average) in the elderly, and contributes to POD through the mediation of Aβ42.
HMGCR gene polymorphism is associated with residual cholesterol risk in premature triple-vessel disease patients treated with moderate-intensity statins
Authors: Li Jiawen , Tang Xiaofang , Xu Jingjing , Liu Ru , Jiang Lin , Xu Lianjun , Tian Jian , Feng Xinxing , Wu Yajie , Zhang Yin , Wang Dong , Sun Kai , Xu Bo , Zhao Wei , Hui Rutai , Gao Runlin , Song Lei , Yuan Jinqing , Zhao Xueyan 
Published: June 2023

Abstract
Background
To investigate the association of HMGCR and NPC1L1 gene polymorphisms with residual cholesterol risk (RCR) in patients with premature triple-vessel disease (PTVD).

Methods
Three SNPs within HMGCR including rs12916, rs2303151, and rs4629571, and four SNPs within NPC1L1 including rs11763759, rs4720470, rs2072183, and rs2073547 were genotyped. RCR was defined as achieved low-density lipoprotein cholesterol (LDL-C) concentrations after statins higher than 1.8 mmol/L (70 mg/dL).

Results
Finally, a total of 609 PTVD patients treated with moderate-intensity statins were included who were divided into two groups: non-RCR group (n = 88) and RCR group (n = 521) according to LDL-C concentrations. Multivariate logistic regression showed the homozygotes for the minor allele of rs12916 within HMGCR gene (CC) were associated with a 2.08 times higher risk of RCR in recessive model [odds ratio (OR): 2.08, 95% confidence interval (CI): 1.16–3.75]. In codominant model, the individuals homozygous for the minor allele of rs12916 (CC) were associated with a 2.26 times higher risk of RCR (OR: 2.26, 95% CI: 1.16–4.43) while the heterozygous individuals (CT) were not, compared with the individuals homozygous for the major allele of rs12916 (TT). There was no significant association between the SNPs within NPC1L1 gene and RCR in various models.

Conclusions
We first reported that the variant homozygous CC of rs12916 within HMGCR gene may incur a significantly higher risk of RCR in PTVD patients treated with statins, providing new insights into early individualized guidance of precise lipid-lowering treatment.
Homocysteine induces ferroptosis in endothelial cells through the systemXc−/GPX4 signaling pathway
Authors: Shi Jiahao , Chen Di , Wang Zilin , Li Shaolin , Zhang Shuying 
Published: June 2023

Abstract
Objectives
To investigate whether ferroptosis is involved in HCY-induced endothelial injury and the possible mechanism of HCY-induced ferroptosis.

Methods
EA. hy926 cells were cultured in vitro. Cells were intervened using HCY and Fer-1. The cells were divided into Control groups, HCY (4 mM), HCY (8 mM), HCY + Fer-1 (4 mM HCY + 0.5/2.5/5 µM Fer-1). CCK-8 assay was used to detect cell viability; Flow Cytometry was used to detect cellular Lip-ROS, TBA and Microplate assay was used to detect MDA&GSH, Western blot was used to detect the expression of ferroptosis-related proteins GPX4 and SLC7A11.

Results
HCY can inhibited the proliferation of EA. hy926 cells in a time- and concentration-dependent manner; Fer-1 inhibits HCY-induced ferroptosis in EA.hy926 cells in a concentration-dependent manner; Compared with the control group, the cell viability and GSH content in the HCY group was significantly decreased (p < 0.05), and the Lip-ROS and MDA were significantly increased (p < 0.05); After co-culture of HCY and Fer-1, compared with the HCY (4 mM) group, the cell viability and GSH content in the co-culture group were significantly increased (p < 0.05), and the Lip-ROS and MDA were significantly decreased (p < 0.05) in a concentration-dependent manner; Western blotting results showed that the protein expression levels of ferroptosis-related proteins GPX4 and SLC7A11 in each experimental were significantly decreased after HCY treatment (p < 0.05), and Fer-1 could significantly reverse this effect.

Conclusions
(1) HCY can induce ferroptosis in vascular endothelial cells. (2) HCY may induce vascular endothelial cell ferroptosis through the system Xc–GSH-GPX4 signaling pathway.
Clinical characteristics, management, and 5-year survival compared between no standard modifiable risk factor (SMuRFless) and ≥ 1 SMuRF ACS cases: an analysis of 15,051 cases from Pakistan
Authors: Sheikh Sana , Peerwani Ghazal , Hanif Bashir , Virani Salim 
Published: June 2023

Abstract
Background
There has been an increase in Acute Coronary Syndrome (ACS) patients without standard modifiable risk factors i.e. hypertension, diabetes, dyslipidemia, and tobacco use (SMuRFless) compared to the patients with ≥ 1 SMuRF but this has not been studied in South Asia despite them being a high-risk population. We conducted a comparative analysis of first episodes of ACS cases admitted to a tertiary cardiac center in Pakistan between SMuRFless and ≥ 1 SMuRF patients for clinical presentation, management, in-hospital, and 5-year mortality.

Methods
We undertook a retrospective study and data of 15,051 patients admitted at Tabba Heart Institute (THI) with the first episode of ACS was extracted from Chest Pain-MI™, and the CathPCI Registry® registry affiliated with the National Cardiovascular Data Registry (NCDR®), USA. Logistic regression and Cox proportional algorithm yielded odds ratio (OR) and hazard ratios (HR) with 95% confidence interval (CI) for associated factors of in-patient and 5-year mortality.

Results
There were 15% SMuRFless cases and in-hospital mortality was 4.1% in SMuRFless vs. 3.9% in the ≥ 1 SMuRF group (p-0.59), the difference remained insignificant after adjusting for age, gender, Killip class, multivessel disease, type of ACS, percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) (Adjusted OR:1.1 [0.8, 1.3]. Unadjusted 5-year mortality was 40% lower in the SMuRFless group but the difference was insignificant after adjusting for age, gender, disease at presentation, its severity, and management (Adjusted HR 0.7 95% CI[0.5, 1.0]). STEMI, NSTEMI, Killip class, and multivessel disease increased the risk of overall 5-year mortality.

Conclusion
In-hospital and 5-year mortality was not different between the SMuRFless and ≥ 1 SMuRF group, there is a need to understand mediators of immediate and long-term mortality risk in SMuRFless patients.
“They want you to know who they really are inside of the old visage”—biographical storytelling as a methodological tool to explore emotional challenges in old age
Authors: Fang Chao , Comery Alastair , Carr Sam 
Published: June 2023

AbstractBackgroundGrowing older is often associated with resilience, contentedness and inner growth. Older people however are also at risk of confronting unique emotional challenges as a result of varied ageing-related experiences. By employing a biographical lens, we aim to introduce storytelling as a methodological tool to more holistically explore older people’s emotional challenges and to improve their wellbeing.MethodsBuilding upon theoretical understandings about the narrative construction of identity across the life span, we draw upon a qualitative study about older people’s loneliness as an example to showcase the methodological value and feasibility of biographical storytelling. We aim to better understand the nuanced and sometimes painful emotional experiences that can be encountered alongside ageing.ResultsFindings from the qualitative study we showcase, highlight that unique emotional pains and the (in)ability to deal with such in old age could be deeply rooted in older people’s earlier lives. These findings contextualise people’s emotional challenges and needs within their identity, as a narrative thread that links their past, present and expected future. As such, our example study shows that emotional challenges in old age are not only ageing-related, but can be more fundamentally connected to disruptions to the ongoing flow of narrative identity construction.ConclusionThe highly retrospective and reflexive nature of these findings illustrates the methodological merit of biographical storytelling. We argue that the impact of biographical storytelling can go further than both conventional semi-structured narrative interviews and existing interventional tools. Instead, it is a particularly useful research methodology to explore human experiences and needs in the unique context of ageing. This methodological development thus provides an insightful analytical lens to explore how older people’s earlier life experiences may be carried forward and confronted to shape their emotional stability in the present and future stages of their ageing lives. Beyond the methodological significance, we further demonstrate the benefits of empowering older people to reconstruct their ageing lives in the context of their biography.
The value of enhanced multiparameteric MRI diagnostic model for preoperatively predicting surgical methods of inferior vena cava in patients with renal tumors and inferior vena cava tumor thrombus
Authors: Pei Xinlong , Lu Min , Liu Zhuo , Liu Baohua , Deng Yuhan , Yuan Huishu , Ma Lulin 
Published: June 2023

Abstract
Background
Inferior vena cava tumor thrombus (IVCTT) invading the IVC wall majorly affects the surgical method choice and prognosis in renal tumors. Enhanced multiparameteric MRI plays an important role in preoperative evaluation. In this work, an MRI-based diagnostic model for IVCTT was established so as to guide the preoperative decisions.

Methods
Preoperative MR images of 165 cases of renal tumors with IVCTT were retrospectively analyzed, and imaging indicators were analyzed, including IVCTT morphology and Mayo grade, IVCTT diameter measurements, bland thrombosis, primary MRI-based diagnosis of renal tumor, and involvement of contralateral renal vein. The indicators were analyzed based on intraoperative performance and resection scope of the IVC wall. Multivariate logistic regression analysis was used to establish the diagnostic model.

Results
The morphological classification of the IVCTT, primary MRI-based diagnosis of renal tumors, maximum transverse diameter of IVCTT, and length of the bland thrombus were the main indexes predicting IVC wall invasion. The MRI-based diagnostic model established according to these indexes had good diagnostic efficiency. The prediction probability of 0.61 was set as the cutoff value. The area under the curve of the test set was 0.88, sensitivity was 0.79, specificity was 0.85, and prediction accuracy was 0.79 under the optimal cutoff value.

Conclusion
The preoperative MRI-based diagnostic model could reliably predict IVC wall invasion, which is helpful for better prediction of IVC-associated surgical operations.
Role of body mass index in the relationship between adverse childhood experiences, resilience, and mental health: a multivariate analysis
Authors: Zhang Yi , Li Yonghan , Jiang Tian , Zhang Qiu 
Published: June 2023

Abstract
Objectives
Depression among adolescents is a global concern. Adverse childhood experiences (ACEs) have been correlated with negative physical and mental health such as obesity and depression; however, increasing evidence has suggested that their correlation might be moderated by BMI and resilience. In this study, we aim to explore (1) whether resilience moderate the risk of mental health by ACEs; (2) whether BMI is a moderator of this relationship.

Study Design
Adolescents were obtained from 4 grade college students by a multi-stage convenience sampling method in the period of May to Jun, 2022.

Methods
We use the Connor-Davidson Resilience scale, Depression, Anxiety and Stress Scale-21 Item (DASS-21) questionnaires to measure the ACEs, BMI, resilience and mental health. The primary exposure was ACEs and the primary outcome was mental health; while resilience and BMI were moderators. Multivariable linear regression model was used to establish the relationship of ACEs, resilience and BMI against mental health status. Moderate analysis was employed by PROCESS method to explore the relationship between these variables.

Results
A total of 3600 individuals were initially enrolled, after excluding 22 with invalid questionnaires, 3578 adolescents were finally included. The mean age was (20.53 ± 1.65) years old. After adjusted for covariates, multivariable linear regression suggest that the high level ACEs (, β =0.58, , 95%CI:0.54,0.62, P < 0.01), resilience (, β=-0.27, 95%CI: , 95%CI: -0.28,-0.26, P < 0.01) were associated with higher depression symptoms, and BMI (, β =0.073, 95%CI: 0.002–0.15, P < 0.05) was associated with higher depression symptoms. There is also the interaction between resilience, ACEs and mental health (depression, anxiety and stress symptoms). In the relationship between ACEs and mental health, resilience and BMI played a moderator role.

Conclusions
The moderate analysis also provided further evidence of a link between resilience, ACEs, BMI and mental health. The findings shed new light on potential mechanisms between ACEs and mental health, including the effects of the co-interaction of resilience and BMI, adding to previous literature. ACEs may be a profound variable to measure adolescents’ psychosocial environment to influence mental health, and resilience moderate this effect and is also moderated by BMI.
Barriers and facilitating factors to healthcare accessibility among Nepalese migrants during COVID-19 crisis in Japan: an exploratory sequential mixed methods study
Authors: Paudel Sushila , K C Bhandari Aliza , Gilmour Stuart , Lee Hyeon Ju , Kanbara Sakiko 
Published: June 2023

Abstract
Background
The COVID-19 pandemic has highlighted the need for global unity and timely access to healthcare for all including multilingual and intercultural societies. This study aimed to identify barriers to healthcare access due to the COVID-19 crisis among Nepalese migrants in Japan and explore ways to counter these barriers, both in routine and crisis situations.

Methods
This study used an exploratory sequential mixed-methods study design. The researchers conducted 11 focus group discussions including 89 participants and an online survey involving 937 respondents. The integration of focus group discussions and logistic regression analysis from the survey was reported via a ‘joint display’.

Results
Twenty-six themes on barriers to and six on facilitators of healthcare accessibility were identified by the focus group discussions among which 17 barriers like lack of knowledge of health insurance, language barriers, lack of hotline services, unawareness of available services, fear of discrimination etc. had significant association in our logistic regression analysis after adjusting for all confounders. Similarly, the only facilitator that had a significant impact, according to the multivariable logistic regression analysis, was receiving health information from Nepali healthcare professionals (OR = 1.36, 95% CI = (1.01 – 1.82), p-value < 0.05).

Conclusion
The study suggests the need for a crisis information hub which could be coordinated by the Nepal embassy or concerned authorities, flexible policies for active deployment of Nepalese health workers and volunteers, accessible hotlines in the Nepali language, and incorporation of Nepali telehealth services in Japan.
A risk score model based on endoplasmic reticulum stress related genes for predicting prognostic value of osteosarcoma
Authors: Zhao Yong , Gao Jijian , Fan Yong , Xu Hongyu , Wang Yun , Yao Pengjie 
Published: June 2023

AbstractBackgroundWe aimed to establish an osteosarcoma prognosis prediction model based on a signature of endoplasmic reticulum stress-related genes.MethodsDifferentially expressed genes (DEGs) between osteosarcoma with and without metastasis from The Cancer Genome Atlas (TCGA) database were mapped to ERS genes retrieved from Gene Set Enrichment Analysis to select endoplasmic reticulum stress-related DEGs. Subsequently, we constructed a risk score model based on survival-related endoplasmic reticulum stress DEGs and a nomogram of independent survival prognostic factors. Based on the median risk score, we stratified the samples into high- and low-risk groups. The ability of the model was assessed by Kaplan–Meier, receiver operating characteristic curve, and functional analyses. Additionally, the expression of the identified prognostic endoplasmic reticulum stress-related DEGs was verified using real-time quantitative PCR (RT-qPCR).ResultsIn total, 41 endoplasmic reticulum stress-related DEGs were identified in patients with osteosarcoma with metastasis. A risk score model consisting of six prognostic endoplasmic reticulum stress-related DEGs (ATP2A3, ERMP1, FBXO6, ITPR1, NFE2L2, andUSP13) was established, and the Kaplan–Meier and receiver operating characteristic curves validated their performance in the training and validation datasets. Age, tumor metastasis, and the risk score model were demonstrated to be independent prognostic clinical factors for osteosarcoma and were used to establish a nomogram survival model. The nomogram model showed similar performance of one, three, and five year-survival rate to the actual survival rates. Nine immune cell types in the high-risk group were found to be significantly different from those in the low-risk group. These survival-related genes were significantly enriched in nine Kyoto Encyclopedia of Genes and Genomes pathways, including cell adhesion molecule cascades, and chemokine signaling pathways. Further, RT-qPCR results demonstrated that the consistency rate of bioinformatics analysis was approximately 83.33%, suggesting the relatively high reliability of the bioinformatics analysis.ConclusionWe established an osteosarcoma prediction model based on six prognostic endoplasmic reticulum stress-related DEGs that could be helpful in directing personalized treatment.
Understanding pediatric palliative care within interdisciplinary palliative programs: a qualitative study
Authors: Rico-Mena Patricia , Güeita-Rodríguez Javier , Martino-Alba Ricardo , Chocarro-Gonzalez Lourdes , Sanz-Esteban Ismael , Palacios-Ceña Domingo 
Published: June 2023

Abstract
Purpose
To describe the process of delivery of pediatric palliative care from the perspective of a pediatric interdisciplinary team and the children’s parents.

Methods
A qualitative descriptive case study was conducted. Purposeful sampling took place within a specialized pediatric palliative care Unit in Madrid (Spain), located at the Niño Jesus Hospital. The study participants included a specialized pediatric palliative care team from Madrid's pediatric palliative care program, other professional teams involved in interdisciplinary care and parents of children under pediatric palliative care. Data were collected via semi-structured interviews, focus groups and researchers’ field notes. A thematic analysis was performed.

Results
This study included 28 participants (20 women, 8 men), of whom 18 were professionals who belonged to the pediatric palliative care interdisciplinary team, 4 professionals were from other units that collaborated with the pediatric palliative care, and 6 were parents (5 women, 1 man). The mean age of the pediatric palliative care members was 38.2 years (SD ± 7.9), that of the collaborating professionals was 40.5 (SD ± 6.8), and that of the parents was 44.2 (SD ± 5.4). Two main themes emerged: a) Pediatric palliative care has a distinct identity, associated with life. It represents the provision of special care in highly complex children, in the context of the home, far from the hospital environment; b) The team is key: its interdisciplinary organization provides a more comprehensive view of the child and their family, fosters communication among professionals, and improves coordination with other services involved in the care of children. The mindset shift experienced by ID-PPC professionals towards a palliative approach makes them more sensitive to the needs of their patients and leads them to develop specific skills in areas such as communication, decision-making, and adaptability that were identified as differentiating aspects of pediatric palliative care.

Conclusions
Describing pediatric palliative care from the professional and parental perspective helps to establish realistic and comprehensive goals for the care of children and their parents. The findings of this study may help with the establishment of a pediatric palliative care team, as a necessary organizational change in a health care system that cares for children with complex and life-threatening conditions. Promoting training in pediatric palliative care, prioritizing more horizontal organizations, providing tools and spaces for coordination and communication between professionals from different services, together with the creation of a position of case coordinator in the care process of children could enhance the understanding of pediatric palliative care services.