bluuebunny/crossref_metadata_2025_split huggingface dataset:
Midwives’ perspectives about using individualized care plans in the provision of immediate postpartum care in Uganda; an exploratory qualitative study
Authors: Namutebi Mariam , Nalwadda Gorrette K. , Kasasa Simon , Muwanguzi Patience A. , Kaye Dan K. 
Published: September 2023

Abstract
Introduction
Individualized care planning has been slowly integrated into practice in Uganda with minimal documentation of how the concept is applied in providing care. This study explored the perceptions of midwives about the use of individualized care plans (ICPs) in the provision of immediate postpartum care.

Methods
An exploratory descriptive qualitative approach was used in this study. We interviewed fifty midwives from 37 health facilities in Uganda's greater Mpigi region. The midwives, who were certificate and diploma holders, were purposively enrolled in the selected facilities. Deductive content analysis was done based on the COM-B model.

Results
Four themes emerged from the data namely; compatibility, motivation, opportunities, and the midwives’ suggested strategies and targets for improved individualized care planning. The midwives were aware of individualized care planning and they utilized it in their provision of immediate postpartum care especially when assessing clients for risks, preparing clients for referral, caring for Human Immunodeficiency virus (HIV) exposed babies and their mothers, and educating/ supporting first-time mothers (automatic motivation). Having a good nurse-patient relationship, privacy, and ample time to care for the clients were noted as motivators for individualized care plan use, while poor documentation of care, high patient load, and perceived patients’ lack of understanding of the complexities of illness in the immediate postpartum period were the barriers (social opportunity) identified by midwives to the use of individualized care planning.

Conclusion
There are still capability, motivation, and opportunity hindrances to the use of individualized care planning. Staff recruitment, training, and harmonization of the documentation forms may improve the use of care plans in the postpartum period.
Exploring the practicality and acceptability of a brief exercise communication and clinician referral pathway in cancer care: a feasibility study
Authors: Caperchione Cristina M. , English Madeleine , Sharp Paul , Agar Meera R. , Phillips Jane L. , Liauw Winston , Harris Carole A. , McCullough Susan , Lilian Ruth 
Published: September 2023

Abstract
Background
The majority of cancer patients and cancer care clinicians-CCCs (e.g., oncologists) believe that exercise is an important adjunct therapy that should be embedded in standard practice. Yet, CCCs do not routinely discuss exercise with their patients, nor do they regularly refer them to exercise professionals (e.g., exercise physiologists-EPs). This study evaluated the feasibility and acceptability of an evidence-based approach to improving exercise communication between CCCs and their patients, including an exercise referral pathway.

Methods
Implementation and testing of the Exercise Communication and Referral Pathway (ECRP) occurred in Sydney, Australia. The ECRP included a brief oncology-initiated communication exchange with patients, CCC exercise referral to an EP, followed by EP-initiated telephone consultation with patients concerning tailored exercise advice. Participant perceptions concerning the feasibility and applicability of the ECPR were evaluated. Semi-structured interviews were conducted with CCCs (n = 3), cancer patients (n = 21), and an EP (n = 1). Inductive thematic analysis was undertaken.

Results
Analysis generated three themes: (1) Navigating the role of CCCs in the ECRP, suggesting that oncology-initiated communication is a cue to action, however there was a lack of role clarity regarding exercise referral; (2) Implementing Patient-Orientated Care within a Standardised Pathway, highlighting the need for tailored information and advice for patients that reflects individual disease, socio-cultural, and environmental factors, and; (3) Taking Steps Towards Action, revealing the need for structural (e.g., EP initiated contact with patients) and policy changes (i.e., changes to Medicare, direct oncologist referral) to engage patients and better integrate exercise as part of standard care.

Conclusions
Findings provide important insights into improving oncology-patient exercise communication and developing an exercise referral pathway to increase engagement and patient reach. However, individual (e.g., experience, knowledge) and contextual factors (e.g., time, resources) need consideration when implementing an ECRP.

Trial registration
This trial was prospectively registered with the Australian New Zealand Clinical (#ACTRN12620000358943) on March 13, 2020.
Use of evidence-based approaches in procurement and implementation of health and welfare technologies – a survey among Swedish municipalities
Authors: Richardson Matt X. , Andersson Sarah Wamala 
Published: September 2023

Abstract
Background
Health and welfare technologies (HWT) are increasingly procured and implemented by public providers in Swedish municipalities, but it remains unclear if and how evidence for these technologies’ effectiveness is used in both processes. The aim of this study was to investigate the use of evidence in Swedish municipal public sector procurement and implementation of HWT.

Methods
A telephone survey of 197 municipalities was conducted with questions regarding the use of evidence in both processes, as well as eventual support needs regarding its use. Standard definitions of HWT and evidence were provided prior to the survey. Response frequencies and percentage proportions were calculated per question. Lambda (Λ) values with corresponding significance values were calculated for associations between responses to selected questions and the size and type of municipality, with values of 0.01 to 0.19 designated as weak associations, 0.20 to 0.39 as moderate, and 0.40 and above as strong.

Results
Sixty-four municipalities completed the entire survey. Consistent use of evidence for effectiveness of HWT occurred in less than half of respondents’ municipal public procurement processes. Two-thirds of municipalities did not have an established model or process for implementation of HWT that used evidence in any manner. More than three quarters of municipalities lacked a systematic plan for follow-up and evaluation of effectiveness of implemented HWT, and of those that did less than half followed their plan consistently. Most municipalities expressed the need for support in using evidence in HWT-related processes but did not consider evidence and systematic evaluation to be prioritized.

Conclusions
Weaknesses and gaps in using evidence in procurement and implementation processes may create a legacy of sub-optimal implementation of HWT in Swedish municipal health- and social care services, and lost opportunities for real-world evidence generation. There was a clear indication of the need for unified national guidance for using and generating evidence in key HWT-related municipal processes and implementation. Such guidance needs to be developed and effectively communicated.
Activation of CTNNB1 by deubiquitinase UCHL3-mediated stabilization facilitates bladder cancer progression
Authors: Liu Tao , Fan Meng-Qi , Xie Xiao-Xiao , Shu Qi-Peng , Du Xue-Hua , Qi Lin-Zhi , Zhang Xiao-Dong , Zhang Ming-Hui , Shan Guang , Du Run-Lei , Li Shang-Ze 
Published: September 2023

Abstract
Background
The catenin beta 1 gene (CTNNB1) plays a crucial role in the malignant progression of various cancers. Recent studies have suggested that CTNNB1 hyperactivation is closely related to the occurrence and development of bladder cancer (BCa). As a member of the deubiquitinating enzyme (DUB) family, ubiquitin C-terminal hydrolase L3 (UCHL3) is abnormally expressed in various cancers. In this study, we discovered that UCHL3 is a novel oncogene in bladder cancer, suggesting it is a promising target against bladder cancer.

Methods
We utilized CRISPR‒Cas9 technology to construct cell lines with UCHL3 stably overexpressed or knocked out. The successful overexpression or knockout of UCHL3 was determined using Western blotting. Then, we performed CCK-8, colony formation, soft agar and Transwell migration assays to determine the impact of the UCHL3 gene on cell phenotype. RNA-seq was performed with UCHL3-depleted T24 cells (established via CRISPR–Cas9-mediated genomic editing). We analyzed differences in WNT pathway gene expression in wild-type and UCHL3-deficient T24 cell lines using a heatmap and by gene set enrichment analysis (GSEA). Then, we validated the effect of UCHL3 on the Wnt pathway using a dual fluorescence reporter. We then analyzed the underlying mechanisms involved using Western blots, co-IP, and immunofluorescence results. We also conducted nude mouse tumor formation experiments. Moreover, conditional UCHL3-knockout mice and bladder cancer model mice were established for research.

Results
We found that the overexpression of UCHL3 boosted bladder cancer cell proliferation, invasion and migration, while the depletion of UCHL3 in bladder cancer cells delayed tumor tumorigenesis in vitro and in vivo. UCHL3 was highly associated with the Wnt signaling pathway and triggered the activation of the Wnt signaling pathway, which showed that its functions depend on its deubiquitination activity. Notably, Uchl3-deficient mice were less susceptible to bladder tumorigenesis. Additionally, UCHL3 was highly expressed in bladder cancer cells and associated with indicators of advanced clinicopathology.

Conclusion
In summary, we found that UCHL3 is amplified in bladder cancer and functions as a tumor promoter that enhances proliferation and migration of tumor cells in vitro and bladder tumorigenesis and progression in vivo. Furthermore, we revealed that UCHL3 stabilizes CTNNB1 expression, resulting in the activation of the oncogenic Wnt signaling pathway. Therefore, our findings strongly suggest that UCHL3 is a promising therapeutic target for bladder cancer.
The effect of hyperthyroidism on cognitive function, neuroinflammation, and necroptosis in APP/PS1 mice
Authors: Lou Kai , Liu Shudong , Zhang Fengxia , Sun Wenxiu , Su Xinhuan , Bi Wenkai , Yin Qingqing , Qiu Yaxin , Zhang Zhenyuan , Jing Mengzhe , Ma Shizhan 
Published: September 2023

Abstract
Background
Increasing evidence has linked the thyroid dysfunction to the pathogenesis of dementia. Evidence from clinical studies has demonstrated that hypothyroidism is related to an increased risk of dementia. But the association of hyperthyroidism with dementia is largely unknown.

Methods
We used the adenovirus containing thyrotropin receptor (TSHR) amino acid residues 1-289 (Ad-TSHR289)-induced Graves’ disease (GD) phenotype in Alzheimer’s disease (AD) model mice (APP/PS1 mice) to evaluate the effect of hyperthyroidism on the cognitive function and β-amyloid (Aβ) accumulation.

Results
GD mice exhibited a stable long-term hyperthyroidism and cognitive deficits. Single Cell RNA-sequencing analysis indicated that microglia function played a critical role in the pathophysiological processes in GD mice. Neuroinflammation and polarization of microglia (M1/M2 phenotype) and activated receptor-interacting serine/threonine protein kinase 3 (RIPK3)/mixed lineage kinase domain–like pseudo-kinase (MLKL)-mediated necroptosis contributed to the pathological process, including Aβ deposition and neuronal loss. RIPK3 inhibitor could inhibit GD-mediated Aβ accumulation and neuronal loss.

Conclusions
Our findings reveal that GD hyperthyroidism aggravates cognitive deficits in AD mice and induces Aβ deposition and neuronal loss by inducing neuroinflammation and RIPK3/MLKL-mediated necroptosis.
Investigating the interactions of endornaviruses with each other and with other viruses in common bean, Phaseolus vulgaris
Authors: Brine Thomas J. , Viswanathan Satish B. , Murphy Alex M. , Pate Adrienne E. , Wamonje Francis O. , Carr John P. 
Published: September 2023

Abstract
Background
Plant viruses of the genus Alphaendornavirus are transmitted solely via seed and pollen and generally cause no apparent disease. It has been conjectured that certain plant endornaviruses may confer advantages on their hosts through improved performance (e.g., seed yield) or resilience to abiotic or biotic insult. We recently characterised nine common bean (Phaseolus vulgaris L.) varieties that harboured either Phaseolus vulgaris endornavirus (PvEV1) alone, or PvEV1 in combination with PvEV2 or PvEV1 in combination with PvEV2 and PvEV3. Here, we investigated the interactions of these endornaviruses with each other, and with three infectious pathogenic viruses: cucumber mosaic virus (CMV), bean common mosaic virus (BCMV), and bean common mosaic necrosis virus (BCMNV).

Results
In lines harbouring PvEV1, PvEV1 and PvEV2, or PvEV1, PvEV2 plus PvEV3, the levels of PvEV1 and PvEV3 RNA were very similar between lines, although there were variations in PvEV2 RNA accumulation. In plants inoculated with infectious viruses, CMV, BCMV and BCMNV levels varied between lines, but this was most likely due to host genotype differences rather than to the presence or absence of endornaviruses. We tested the effects of endornaviruses on seed production and seedborne transmission of infectious pathogenic viruses but found no consistent relationship between the presence of endornaviruses and seed yield or protection from seedborne transmission of infectious pathogenic viruses.

Conclusions
It was concluded that endornaviruses do not interfere with each other’s accumulation. There appears to be no direct synergy or competition between infectious pathogenic viruses and endornaviruses, however, the effects of host genotype may obscure interactions between endornaviruses and infectious viruses. There is no consistent effect of endornaviruses on seed yield or susceptibility to seedborne transmission of other viruses.
Dose delivery reproducibility for PBS proton treatment of breast cancer patients with and without mask immobilization
Authors: Kang Yixiu , Bues Martin , Halyard Michele Y. , McGee Lisa A. , Vern-Gross Tamara Z. , Wong William W. , Keole Sameer R. , Vargas Carlos , James Sarah E. , Ahmed Safia K. , Archuleta James P. , Ridgway Ana K. , Lara Pedro R. , Fatyga Mirek 
Published: September 2023

Abstract
Background
Setup reproducibility of the tissue in the proton beam path is critical in maintaining the planned clinical target volume (CTV) dose coverage and sparing the organs at risk (OAR). In this study, we retrospectively evaluated radiation therapy dose reproducibility for proton pencil beam scanning (PBS) treatment of breast cancer patients with and without mask immobilization.

Methods
Ninety-four patients treated between January 2019 and September 2022 with at least one verification CT scan (V-CT) in treatment position were included for this study. All patients were set up with arms up using the Orfit AIO patient positioning system, with (69 patients) or without (25 patients) mask immobilization in chin, neck, shoulder, upper arm, and chest areas. Two to three enface or near enface single field uniform dose PBS beams were optimized using a commercial treatment planning system. Prescription doses were 25 to 60 GyRBE in 5 to 45 fractions. Treatment plan doses re-calculated on V-CTs were compared to the corresponding planned doses. Cumulative doses were also calculated for patients with at least 3 V-CTs by deform and weighted sum doses from V-CTs to corresponding P-CTs. CTV D95%, ipsilateral-lung V40%, esophagus D0.01cc, and heart mean dose were evaluated and reported as percentages of prescription doses. Differences were large dose deteriorations (LDD) if: (1) CTV (V-CT/cumulative D95%) – (Planned D95%) < − 5%; or (2) Ipsilateral-lung (V-CT/cumulative V40%) – (Planned V40%) > 5%; or (3) Esophagus (V-CT/cumulative D0.01cc) – (Planned D0.01cc) > 10%; or (4) Heart (V-CT/cumulative mean) – (Planned mean) > 1.5%.

Results
On average, V-CT/cumulative and planned CTV/OAR dose parameter differences were less than 2.2%/1.7% and 3.4%/3.7% for masked and maskless patients, respectively. The percentages of patients with at least one CTV or OAR V-CT/cumulative dose LDD were 20.3%/25.0% and 72.0%/54.0% for masked and maskless patients, respectively.

Conclusions
On average, masked/maskless setups achieved delivered and planned CTV/OAR dose parameters agreed within 2.2%/3.7% for PBS treatment of breast cancer patients in this study. Maskless patients had higher rate of CTV/OAR LDDs compared to masked patients. Dosimetric differences large enough to raise clinical concerns in either group were able to be addressed with replannings.
Health-related quality of life in a european sample of adults with early-treated classical PKU
Authors: Maissen-Abgottspon Stephanie , Muri Raphaela , Hochuli Michel , Reismann Péter , Barta András Gellért , Alptekin Ismail Mucahit , Hermida-Ameijeiras Álvaro , Burlina Alessandro P. , Burlina Alberto B. , Cazzorla Chiara , Carretta Jessica , Trepp Roman , Everts Regula 
Published: September 2023

AbstractBackgroundPhenylketonuria (PKU) is a rare inborn error of metabolism affecting the catabolism of phenylalanine (Phe). To date, findings regarding health-related quality of life (HRQoL) in adults with early-treated classical PKU are discrepant. Moreover, little is known about metabolic, demographic, and cognitive factors associated with HRQoL. Hence, we aimed to investigate HRQoL and its association with demographic, metabolic, and cognitive characteristics in a large European sample of adults with early-treated classical PKU.ResultsThis cross-sectional study included 124 adults with early-treated classical PKU from Hungary, Italy, Spain, Switzerland, and Turkey. All participants prospectively completed the PKU quality of life questionnaire (PKU-QoL), a questionnaire specifically designed to evaluate the impact of PKU and its treatment on HRQoL in individuals with PKU. In addition, information about Phe levels (concurrent and past year), demographic (age and sex), and cognitive variables (intelligence quotient, IQ) were collected. Most domains revealed little or no impact of PKU on HRQoL and more than three-quarters of the patients rated their health status as good, very good, or excellent. Nevertheless, some areas of concern for patients were identified. Patients were worried about the guilt that they experience if they do not adhere to the dietary protein restriction and they were most concerned about high Phe levels during pregnancy. Further, tiredness was the most affected symptom, and the supplements’ taste was considered a main issue for individuals with PKU. The overall impact of PKU on HRQoL was higher in women (U = 1315.5,p = .012) and in adults with a lower IQ (rs = − 0.448,p = .005). The overall impact of dietary protein restriction was higher in adults with higher concurrent Phe levels (rs= 0.272,p = .007) and higher Phe levels during the past year (rs= 0.280,p = .009).ConclusionThe impact of PKU on most domains assessed in the PKU-QoL was considered to be low. These results likely reflect the successful implementation of the newborn screening resulting in the prevention of severe adverse long-term outcomes. However, a particular clinical focus should be given to patients with lower IQ, higher Phe levels, and women, as these variables were associated with a lower HRQoL.
Overhead squat assessment reflects treadmill running kinematics
Authors: Sever Ozan , Kır Rıdvan , Baykal Cihan , Akyildiz Zeki , Nobari Hadi 
Published: September 2023

Abstract
Purpose
Overhead squat assessment (OHSA) is a pre-activity dynamic movement analysis tool used to define deviations from an ideal motion pattern which known as compensation. Compensatory movements may result from abnormality in myofascial activity, length-tension relationships, neuro-motor control strategies, osteokinematics and arthrokinematics. The aim of this study is to identify the association between selected biomechanical variables of the ankle, knee, hip, pelvis, torso during OHSA and 16 km/h treadmill running tasks.

Methods
Thirteen national long distance male runners (17.3 ± 0.5 age (years); 5.89 ± 1.95 experience (years), 57.9 ± 3.7 body mass (kg); 175.4 ± 5.7 height (cm)) participated in this 2controlled laboratory study. Three-dimensional kinematics were collected at 250 Hz using a 9-camera Qualisys motion analysis system (Qualisys AB, Goteborg, Sweden) while participants performed 16 km/h treadmill running and OHSA tasks.

Results
Correlation coefficients demonstrated that OHSA pelvic anterior tilt angle was in a positive association with foot strike (FS), mid-stance (MS), and toe-off (TO) pelvic anterior tilt angles and MS tibial internal rotation on talus, MS ankle pronation, MS hip internal rotation. OHSA pelvic anterior tilt angle was in a negative association with TO hip extension. OHSA maximal hip adduction was positively correlated with MS and stance maximal knee adduction. FS, MS, stance maximal angular dorsiflexion values were positively correlated with OHSA dorsiflexion. Increased OHSA dorsiflexion angle was negatively associated with TO plantar flexion. OHSA pronation was positively associated with MS and stance pronation. MS hip internal rotation, MS hip adduction angles were increased, and MS ankle dorsiflexion was significantly decreased with the increase of trunk forward lean relative to tibia during OHSA.

Conclusions
OHSA was associated with some important and dysfunction-related hip, knee and ankle kinematics. Running coaches, may use OHSA as an assessment tool before the corrective training plan to detect injury-related compensation patterns to reduce the risk of injury and improve running technique.