bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cumulative physiological stress is associated with age-related changes to peripheral T lymphocyte subsets in healthy humans
Authors: Snodgrass Ryan G. , Jiang Xiaowen , Stephensen Charles B. , Laugero Kevin D. 
Published: June 2023

Abstract
Background
Progressive age-associated change in frequencies and functional capacities of immune cells is known as immunosenescence. Despite data linking chronic environmental, physiological, and psychosocial stressors with accelerated aging, how stress contributes to immunosenesence is not well characterized.

Objective
To help delineate the contribution of cumulative physiological stress on immunosensence we assessed relationships between a composite measurement of cumulative physiological stress, reflecting the functioning of the hypothalamic-pituitary-adrenal axis, sympathetic nervous system, cardiovascular system, and metabolic processes, and lymphocyte changes typically affiliated with aging in a cohort of healthy volunteers ranging from 18 to 66 y.

Results
Physiological stress load positively correlated with subject age in the study cohort and was significantly higher in adults 50–66 y compared to adults 18–33 y and 34–49 y. Using physiological stress load, we identified a significant age-dependent association between stress load and frequencies of circulating regulatory T lymphocytes (Tregs). Frequencies were higher in younger participants, but only in participants exhibiting low physiological stress load. As stress load increased, frequencies of Tregs decreased in young participants but were unchanged with increasing stress load in middle and older age individuals. Follow-up analysis of stress load components indicated lower circulating DHEA-S and higher urinary norepinephrine as the primary contributors to the effects of total stress load on Tregs. In addition, we identified age-independent inverse associations between stress load and frequencies of naïve Tregs and naïve CD4 T cells and positive associations between stress load and frequencies of memory Tregs and memory CD4 T cells. These associations were primarily driven by stress load components waist circumference, systolic and diastolic blood pressure, CRP, and HbA1c. In summary, our study results suggest that, in younger people, physiological stress load may diminish regulatory T cell frequencies to levels seen in older persons. Furthermore, independent of age, stress load may contribute to contraction of the naïve Treg pool and accumulation of memory Treg cells.

Clinical trial
Registered on ClincialTrials.gov (Identifier: NCT02367287).
Symptoms of posttraumatic stress partially mediate the relationship between gender-based violence and alcohol misuse among South African women
Authors: Nguyen Kim A. , Myers Bronwyn , Abrahams Naeemah , Jewkes Rachel , Mhlongo Shibe , Seedat Soraya , Lombard Carl , Garcia-Moreno Claudia , Chirwa Esnat , Kengne Andre P. , Peer Nasheeta 
Published: June 2023

Abstract
Background
The association of traumatic experiences with problematic alcohol use has been described, but data on possible mediation effects of mental distress are sparse. We examined whether mental ill-health mediated the association between trauma exposure across the lifespan and alcohol use.

Method
We analysed cross-sectional data from a sample of rape-exposed and non-rape-exposed women, living in KwaZulu-Natal, with self-reported data on alcohol misuse (AUDIT-C cut-off ≥ 3) and exposure to childhood maltreatment (CM), intimate partner violence (IPV), non-partner sexual violence (NPSV), other traumatic events, and mental ill-health. Logistic regression and multiple mediation models were used to test the mediation effects of symptoms of depression and PTSS on the association between abuse/trauma and alcohol misuse.

Results
Of 1615 women, 31% (n = 498) reported alcohol misuse. Exposure to any CM (adjusted odds ratio (aOR): 1.59, 95% confidence interval (CI): 1.27–1.99), as well as to sexual, physical and emotional CM, were independently associated with alcohol misuse. Lifetime exposure to any IPV (aOR:2.01, 95%CI:1.59–2.54), as well as to physical, emotional and economic IPV, NPSV (aOR: 1.75, 95%CI: 1.32–2.33), and other trauma (aOR:2.08, 95%CI:1.62–2.66), was associated with alcohol misuse. Exposure to an increasing number of abuse types, and other traumatic events, was independently associated with alcohol misuse. PTSS partially mediated the associations of CM, IPV, NPSV and other trauma exposures with alcohol misuse (ps ≤ 0.04 for indirect effects), but depression symptoms did not.

Conclusions
These findings highlight the need for trauma-informed interventions to address alcohol misuse that are tailored to the needs of women who have experienced violence.
Local implementation of public health policies revealed by the COVID-19 crisis: the French case
Authors: Mériade Laurent , Rochette Corinne , Cassière François 
Published: June 2023

Abstract
Background
Improving health system performance depends on the quality of health policy implementation at the local level. However, in general, the attention of researchers is mainly directed towards issues of health policy design and evaluation rather than implementation at the local level. The management of the COVID-19 crisis, especially in Europe, has particularly highlighted the complexity of implementing health policies, decided at the national or supranational level, at the local level.

Methods
We conducted 23 semi-structured interviews with the main stakeholders in the management of the COVID-19 crisis in the second largest French region in order to identify the different actors and modes of coordination of the local implementation of health policies that this crisis management illustrates in a very visible way. Our methodology is complemented by a content analysis of the main guidelines and decisions related to this implementation.

Results
The analysis of these data allows us to identify three levels of implementation of health policies at the local level (administrative, organizational and operational). Interviews also reveal the existence of different types of coordination specific to each of these levels of local implementation of health policies. These results then make it possible to identify important managerial avenues for promoting global coordination of these three levels of implementation.

Conclusions
Although research on health services emphasizes the existence of several levels of local implementation of health policies, it offers little in the way of definition or characterization of these levels. The identification in this study of the three levels of local implementation of health policies and their specific forms of coordination contribute to a more precise characterization of this implementation in order to promote, in practice, its global coordination.
Engineered circular guide RNAs boost CRISPR/Cas12a- and CRISPR/Cas13d-based DNA and RNA editing
Authors: Zhang Xin , Wang Xinlong , Lv Jie , Huang Hongxin , Wang Jiahong , Zhuo Ma , Tan Zhihong , Huang Guanjie , Liu Jiawei , Liu Yuchen , Li Mengrao , Lin Qixiao , Li Lian , Ma Shufeng , Huang Tao , Lin Ying , Zhao Xiaoyang , Rong Zhili 
Published: June 2023

Abstract
Background
The CRISPR/Cas12a and CRISPR/Cas13d systems are widely used for fundamental research and hold great potential for future clinical applications. However, the short half-life of guide RNAs (gRNAs), particularly free gRNAs without Cas nuclease binding, limits their editing efficiency and durability.

Results
Here, we engineer circular free gRNAs (cgRNAs) to increase their stability, and thus availability for Cas12a and Cas13d processing and loading, to boost editing. cgRNAs increases the efficiency of Cas12a-based transcription activators and genomic DNA cleavage by approximately 2.1- to 40.2-fold for single gene editing and 1.7- to 2.1-fold for multiplexed gene editing than their linear counterparts, without compromising specificity, across multiple sites and cell lines. Similarly, the RNA interference efficiency of Cas13d is increased by around 1.8-fold. In in vivo mouse liver, cgRNAs are more potent in activating gene expression and cleaving genomic DNA.

Conclusions
CgRNAs enable more efficient programmable DNA and RNA editing for Cas12a and Cas13d with broad applicability for fundamental research and gene therapy.
Impact of a recognition package as an incentive to strengthen the motivation, performance, and retention of village health teams in Uganda: a study protocol for a cluster randomized controlled trial
Authors: Agarwal Smisha , Tweheyo Raymond , Pandya Shivani , Obuya Emmanuel , Kiyomoto Arisa , Mitra Paloma , Schleiff Meike , Nagpal Tanvi , Macis Mario , Rutebemberwa Elizeus 
Published: June 2023

Abstract
Introduction
Uganda’s community health worker (CHW), or village health team (VHT), program faces significant challenges with poor retention and insufficient financial and program investment. Adequate compensation comprising financial and non-financial components is critical to retaining any workforce, including CHWs. This study evaluates the impact of a recognition-based non-financial incentives package on the motivation, performance, and retention of VHTs, as well as on the utilization of health services by the community. The incentive package and intervention were developed in collaboration with the district-level leadership and award VHTs who have met predetermined performance thresholds with a certificate and a government-branded jacket in a public ceremony.

Methods
A two-armed cluster randomized controlled trial (RCT), conducted at the parish level in Uganda’s Masindi District, will evaluate the effects of the 12-month intervention. The cluster-RCT will use a mixed-methods approach, which includes a baseline/endline VHT survey to assess the impact of the intervention on key outcomes, with an expected sample of 240 VHTs per study arm; our primary outcome is the total number of household visits per VHT and our multiple secondary outcomes include other performance indicators, motivation, and retention; VHT performance and retention data will be validated using monthly phone surveys tracking key performance indicators and through abstraction of VHT-submitted health facility reports; and focus group discussions will be conducted with VHTs and community members to understand how the intervention was received. Data collection activities will be administered in local languages. To assess the impact of the intervention, the study will conduct a regression analysis using Generalized Estimating Equations adjusting for cluster effect. Further, a difference-in-differences analysis will be conducted.

Discussion
This study utilized a cluster-RCT design to assess the impact of a recognition-based incentives intervention on the motivation, performance, and retention of VHTs in Uganda’s Masindi District. Utilizing a mixed-methods approach, the study will provide insights on the effectiveness and limitations of the intervention, VHT perspectives on perceived value, and critical insights on how non-financial incentives might support the strengthening of the community health workforce.

Trial registration
ClinicalTrials.gov NCT05176106. Retrospectively registered on 4 January 2022.
Sex differences in the nonlinear association of triglyceride glucose index with all-cause and cardiovascular mortality in the general population
Authors: Yu Yu , Wang Jing , Ding Ligang , Huang Hao , Cheng Sijing , Deng Yu , Gu Min , Cai Chi , Ning Xiaohui , Chen Xuhua , Niu Hongxia , Hua Wei 
Published: June 2023

Abstract
Background
The evidence on the association between the triglyceride glucose (TyG) index and the risk of death in the general population remains controversial. This study aims to investigate the relationship between the TyG index and all-cause and cardiovascular mortality in the general population, with a focus on sex differences.

Methods
This prospective cohort study analyzed data from the National Health and Nutrition Examination Survey (1999–2002), comprising 7,851 US adults. The study employed multivariate Cox proportional hazards regression and two-segment Cox hazard regression models to evaluate the sex-specific differences in the relationship between the TyG index and all-cause and cardiovascular mortality.

Results
After 11,623 person-years of follow-up, there were 539 deaths, with 10.56% due to all-cause mortality and 2.87% due to cardiovascular mortality. After adjusting for multiple variables, our study found a U-shaped association of the TyG index with all-cause and cardiovascular mortality, with inflection points at 9.36 and 9.52. A significant sex difference was observed in the association between the TyG index and mortality. Below the inflection point, the relationship between the TyG index and mortality was consistent in males and females. However, above the inflection point, only males exhibited a positive association between the TyG index and all-cause mortality (adjusted hazard risk [HR], 1.62, 95% confidence interval [CI], 1.24–2.12) and cardiovascular mortality (adjusted HR, 2.28, 95% CI, 1.32–3.92).

Conclusions
Our study showed a U-shaped association between the TyG index and all-cause and cardiovascular mortality in the general population. Furthermore, sex differences were observed in the association between the TyG index and mortality once it exceeded a certain threshold.
Developing a model for predicting safety performance of nurses based on psychosocial safety climate and role of job demands and resources, job satisfaction, and emotional exhaustion as mediators
Authors: Abdi Fatemeh , Jahangiri Mehdi , Kamalinia Mojtaba , Cousins Rosanna , Mokarami Hamidreza 
Published: June 2023

Abstract
Background
The present study aimed to develop a model for predicting the safety performance of nurses based on psychosocial safety climate (PSC) and the role of job demands and resources, job satisfaction, and emotional exhaustion as mediators.

Methods
A cross-sectional study using structural equation modeling (SEM) was carried out among nurses in Iran. Data were collected using the Psychosocial Safety Climate questionnaire, Neal and Griffin’s Safety Performance Scale, the Management Standards Indicator Tool, the Effort-Reward Imbalance questionnaire, the Michigan Organizational Assessment Job Satisfaction subscale and the Maslach Burnout Inventory.

Results
Surveys were distributed to 340 nurses provided informed consent. After removing incplete surveys, data from 280 partipants were analysed. The completion rate was 82.35%. The SEM results indicated that PSC can directly and indirectly predict nurses’ safety performance. The final model showed an acceptable goodness of fit (p = 0.023). It indicated that PSC, job demands, and job satisfaction were directly related to safety performance, and also that PSC, emotional exhaustion, job resources, and job demands were all indirectly related to safety performance. Also, PSC had a significant relationship with all mediator variables, and job demands had direct effect on emotional exhaustion.

Conclusions
The current study presented a new model for predicting safety performance in nurses in which PSC, both directly and indirectly, plays an important role. In addition to paying attention to the physical aspects of the workplace, healthcare organizations should also take into account PSC to improve safety. Next steps in reducing safety issues in nursing is to develop intervention studies using this new evidence-based model as a framework.
Post_production. architectural design and the landscape of de-industrialisation
Authors: Spanedda Francesco 
Published: June 2023

AbstractIndustrial facilities have been dispersed across the American and European landscapes since the early Nineteenth century. Also, their activity encouraged the growth of a vast global network of logistical, mining, and agricultural infrastructures. Yet, since the late 1960s, a significant number of productive sectors have been gradually dismantled as a result of technical advancement, obsolescence, and changes in industrial regulations. The repurposing of “brownfields”, as abandoned industrial sites have been dubbed, became a topic of discussion in the architectural community. In the 1980s, this circumstance presented an amazing opportunity to modernise the layout of Western cities. Yet, contemporary critical views on the nature and effects of industrialism, societal transformations, and awareness of the environmental crisis at the turn of the Twentieth century call for refocusing the architectural discussion regarding brownfields. In this essay, case studies are examined and set against the backdrop of an expanding conversation in architecture regarding sustainability.
How well-intentioned white male physicists maintain ignorance of inequity and justify inaction
Authors: Dancy Melissa , Hodari Apriel K. 
Published: June 2023

Abstract
Background
We present an analysis of interviews with 27 self-identified progressive white-male physics faculty and graduate students discussing race and gender in physics. White cis men dominate most STEM fields and are particularly overrepresented in positions of status and influence (i.e., full professors, chairs, deans, etc.), positioning them as a potentially powerful demographic for enacting systemic reform. Despite their proclaimed outrage at and interest in addressing inequity, they frequently engage in patterns of belief, speech and (in)action that ultimately support the status quo of white male privilege in opposition to their intentions.

Results
The white male physicists we interviewed used numerous discourses which support racist and sexist norms and position them as powerless to disrupt their own privilege. We present and discuss three overarching themes, seen in our data, demonstrating how highly educated, well-intentioned people of privilege maintain their power and privilege despite their own intentions: (1) denying inequity is physically near them; (2) locating causes of inequity in large societal systems over which they have little influence; and (3) justifying inaction.

Conclusions
Despite being progressively minded and highly educated, these men are frequently complicit in racism and sexism. We end with recommendations for helping cis men engage the power they hold to better work with marginalized people to disrupt inequity.
Air gap eccentric analysis and fault detection of traction motor
Authors: Yin Jintian , He Zhilong , Liu Li , Peng Zhihua 
Published: June 2023

AbstractTo solve the problem of air gap eccentric fault of traction motor, the fault characteristic frequency is close to the fundamental frequency, and the decomposed frequency affects each other, which is easy to cause spectrum aliasing. A reconstruction of variational mode decomposition method is proposed (reconstructed variational mode decomposition, RVMD); first of all, to construct and solve the variational stator current signal problem, to find the best decomposition number, and to obtain multiple modal functions, and to realize the effective separation and frequency profile of each component of the signal. Then, the decomposed modal function components with different frequencies and different amplitude can keep the decomposed positions unchanged and be reconstructed to form a new frequency spectrum. Experimental results show that the proposed RVMD method can detect weak faults timely and effectively, and has good application value.
Shared sorrow, shared costs: cost-effectiveness analysis of the Empowerment group therapy approach to treat affective disorders in refugee populations
Authors: Strupf Michael , Hoell Andreas , Bajbouj Malek , Böge Kerem , Wiechers Maren , Karnouk Carine , Kamp-Becker Inge , Banaschewski Tobias , Meyer-Lindenberg Andreas , Rapp Michael , Hasan Alkomiet , Falkai Peter , Habel Ute , Heinz Andreas , Plener Paul , Kaiser Franziska , Weigold Stefanie , Mehran Nassim , Übleis Aline , Padberg Frank 
Published: June 2023

Background
Refugees and asylum seekers (RAS) in Germany need tailored and resource-oriented mental healthcare interventions.

Aims
To evaluate the cost-effectiveness of group psychotherapy for RAS with moderate depressive symptoms.

Method
This is a post hoc cost-effectiveness analysis of Empowerment group psychotherapy that was embedded in a stratified stepped and collaborative care model (SCCM) from the multicentre randomised controlled MEHIRA trial. One hundred and forty-nine participants were randomly assigned to SCCM or treatment as usual (TAU) and underwent Empowerment (i.e. level 3 of the SCCM for adults) or TAU. Effects were measured with the nine-item Patient Health Questionnaire (PHQ-9) and quality adjusted life-years (QALY) post-intervention. Health service and intervention costs were measured. Incremental cost-effectiveness ratios (ICER) were estimated and net monetary benefit (NMB) regressions with 95% confidence intervals were performed. Cost-effectiveness was ascertained for different values of willingness to pay (WTP) using cost-effectiveness acceptability curves for probable scenarios. Trial registration number: NCT03109028 on ClinicalTrials.gov.

Results
Health service use costs were significantly lower for Empowerment than TAU after 1 year. Intervention costs were on average €409.6. Empowerment led to a significant change in PHQ-9 scores but not QALY. Bootstrapped mean ICER indicated cost-effectiveness according to PHQ-9 and varied considerably for QALY in the base case. NMB for a unit reduction in PHQ-9 score at WTP of €0 was €354.3 (€978.5 to −€269.9). Results were confirmed for different scenarios and varying WTP thresholds.

Conclusions
The Empowerment intervention was cost-effective in refugees with moderate depressive symptoms regarding the clinical outcome and led to a reduction in direct healthcare consumption. Concerning QALYs, there was a lack of confidence that Empowerment differed from TAU.
Operational Metrics for the ELAINE 2 Study Combining a Traditional Approach With a Just-in-TIME Model
Authors: Blau Sibel , Peguero Julio Antonio , Moore Halle C.F. , Anderson Ian Churchill , Barve Minal A. , Cherian Mathew Amprayil , Elkhanany Ahmed , O'Sullivan Ciara Catherine , Moreno-Aspitia Alvaro , Plourde Paul , Gleich Lyon L. , Riesen Kendra , Ezzati Ross , Degele Meghan , Shulman Megan , Stempf Stephanie Dobson , Sachse Laura , Iyer Amrita A. , Damodaran Senthil , Cooney Matthew M. 
Published: June 2023

PURPOSEThere are numerous barriers to enrollment in oncology biomarker-driven studies.METHODSThe ELAINE 2 study (ClinicalTrials.gov identifier: NCT04432454 ) is an open-label phase 2 study of lasofoxifene combined with abemaciclib in patients with advanced or metastatic estrogen receptor–positive/human epidermal growth factor receptor 2–negative breast cancer with an ESR1 mutation. ELAINE 2 opened clinical sites by using a Traditional approach, which activated a site before patient identification, and the Tempus TIME Trial network, which opened a site only after identifying an eligible patient. This manuscript presents the operational metrics comparing the Traditional and TIME Trial site data.RESULTSThe study enrolled patients over 34 weeks and 16 sites (six Traditional and 10 TIME Trial) participated. Duration for full clinical trial agreement execution for Traditional sites and TIME Trial sites averaged 200.5 (range, 142-257) and 7.6 days (range, 2-14), respectively. Institutional review board approval time for Traditional sites and TIME Trial sites was 27.5 (range, 12-71) and 3.0 days (range, 1-12), respectively. Duration from study activation to first consent was 33.3 (range, 18-58) and 8.8 days (range, 1-35) for Traditional and TIME Trial sites, respectively. The first patient on study was at a TIME Trial site 115 days before a Traditional site and the first seven patients enrolled were at TIME Trial sites. Traditional sites consented 23 and enrolled 16 patients, while TIME Trial sites consented 16 and enrolled 13. The trial enrolled 29 patients in 8.5 months with the anticipated enrollment duration being 12-18 months.CONCLUSIONThe TIME Trial network opened earlier and enrolled the first study patients. These results demonstrate that the Just-in-TIME model, along with a Traditional model, can improve enrollment in biomarker-driven studies.