bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perspectives on which health settings geriatricians should staff: a qualitative study of patients, care providers and health administrators
Authors: Wong Eric Kai-Chung , Tricco Andrea C. , Isaranuwatchai Wanrudee , Naimark David M. J. , Straus Sharon E. , Sale Joanna E. M. 
Published: January 2025

Abstract

Background
With a shortage of geriatricians and an aging population, strategies are needed to optimise the distribution of geriatricians across different healthcare settings (acute care, rehabilitation and community clinics). The perspectives of knowledge users on staffing geriatricians in different healthcare settings are unknown. We aimed to understand the acceptability and feasibility (including barriers and facilitators) of implementing a geriatrician-led comprehensive geriatric assessment (CGA) in acute care, rehabilitation, and community clinic settings.

Methods
A qualitative description approach was used to explore the experience of those implementing (administrative staff), providing (healthcare providers), and receiving (patients/family caregivers) a geriatrician-led CGA in acute care, rehabilitation and community settings. Semi-structured interviews were conducted in Toronto, Canada. The theoretical domains framework and consolidated framework for implementation research informed the interview guide development. Analysis was conducted using a thematic approach.

Results
Of the 27 participants (8 patients/caregivers, 9 physicians, 10 administrators), the mean age was 53 years and 14 participants (52%) identified as a woman (13 [48%] identified as a man). CGAs were generally perceived as acceptable but there was a divergence in opinion about which healthcare setting was most important for geriatricians to staff. Acute care was reported to be most important by some because no other care provider has the intersection of acute medicine skills with geriatric training. Others reported that community clinics were most important to manage geriatric syndromes before hospitalization was necessary. The rehabilitation setting appeared to be viewed as important but as a secondary setting. Facilitators to implementing a geriatrician-led CGA included (i) a multidisciplinary team, (ii) better integration with primary care, (iii) a good electronic patient record system, and (iv) innovative ways to identify patients most in need of a CGA. Barriers to implementing a geriatrician-led CGA included (i) lack of resources or administrative support, (ii) limited team building, and (iii) consultative model where recommendations were made but not implemented.

Conclusions
Overall, participants found CGAs acceptable yet had different preferences of which setting to prioritise staffing if there was a shortage of geriatricians. The main barriers to implementing the geriatrician-led CGA related to lack of resources.

Clinical trial number
Not applicable.
Responsiveness of hand-held dynamometry for measuring changes in trunk muscle strength in people with chronic low back pain
Authors: Althobaiti Shouq , Deane Janet A. , Falla Deborah 
Published: January 2025

Abstract

Objective
To assess the responsiveness of a hand-held dynamometer (HHD) in evaluating changes in trunk isometric strength in people with chronic low back pain (LBP).

Background
Reduced trunk muscle strength has been associated with pain incidence and severity in people with chronic LBP. Trunk muscle strength is an important functional outcome that is measured in clinical practice and research. However, the responsiveness of clinical tools such as HHD for measuring changes in trunk muscle strength remains underexplored.

Methods
Maximum isometric trunk strength was measured using both a HHD and an isokinetic dynamometer (ID) in 21 participants with chronic LBP both before and after 6 weeks of progressive trunk resistance exercises. Effect sizes (ES) and standardised response mean (SRM) were used to evaluate the internal responsiveness of the HHD measures. External responsiveness was determined by correlating the change scores measured with the HHD with those obtained using the ID.

Results
Following the progressive resistance exercise programme, there was a significant improvement in trunk muscle strength measured with the HHD with moderate to large ES (0.40–0.85) and SRM (0.60- 0.74), indicating moderate to high internal responsiveness. Pearson's correlations revealed a weak correlation between changes in trunk strength measured with the HHD and those measured with the ID (r = 0.22- 0.26), indicating inadequate external responsiveness.

Conclusions
Although the use of a HHD was shown to have internal responsiveness for detecting changes in trunk muscle strength, the inadequate external responsiveness warrants further investigation. Future research should also explore the responsiveness of HHD in people with chronic LBP with higher pain and disability levels using comparable measurement setups.
Improving general practitioners’ approaches to functional somatic syndromes: a pilot training program with a focus on compassion and communication
Authors: Ariane Gonthier , Audrey Linder , Johanna Sommer , Jean-Nicolas Despland , Gilles Ambresin 
Published: January 2025

Abstract

Background
Functional somatic syndromes are common in primary care and represent a challenge for general practitioners (GPs), with a risk of deterioration in the doctor-patient relationship, and of compassion fatigue on the part of the physician. Little is known about how to teach better management of these symptoms.

Methods
The aim of our scientific team was to develop a training session about functional somatic syndromes for GPs, with the objective to improve the therapeutic attitude of the participants. The first session of the training was constructed as a pilot session, followed by a qualitative study to complete content validation. The educational framework of the training session is multimodal and includes theory on the pathophysiology of functional somatic syndromes, communication skills, and introspective learning including an introduction to compassion meditation. 20 physicians attended the pilot training session. 10 of them participated in the qualitative study. The qualitative study consisted of five individual semi-structured interviews and one focus group of five persons, investigating the impact of the training session on the clinical practices, as perceived by the participants. The interviews were analysed through an inductive method inspired by Malterud’s systematic text condensation strategy.

Results
We identified three main themes in the responses of the participants: (1) the crucial issue of putting a name to chronic psychosomatic suffering; (2) the importance of self-compassion for physicians; (3) changes in therapeutic attitude fostering a reconciliation between “self” and “care”. Participants expressed a need for more regular meetings of this type. The opportunity to share their negative feelings about therapeutic relationship within a peer group, with compassionate supervision of the trainers, seemed to play an important role in the improvement of their self-compassion

Conclusion
A multimodal teaching session seems to help the physicians to feel more comfortable and competent when treating patients with functional somatic syndromes. Including compassion meditation in the teaching seems a promising tool to prevent compassion fatigue.
Assessing psychosocial risk factors in children with Sickle Cell Disease
Authors: Frey Nicole , LaMotte Julia E. , Bouck Jillian R. , Fancher Lauren , Parker Genese T. , Carter Allie , Jacob Seethal A. 
Published: January 2025

Abstract

Background
Individuals with Sickle Cell Disease (SCD) are a minoritized and marginalized community that have disparate health outcomes as a result of systemic racism and disease-related stigma. The purpose of this study was to determine the psychosocial risk factors for families caring for children with SCD at a pediatric SCD center through use of the Psychosocial Assessment Tool (PAT), a validated caregiver-report screener.

Methods
The PAT was administered annually during routine clinical visits and scored by the SCD Social Worker to provide tailored resources to families. The PAT stratifies scores into 3 categories of psychosocial concern: Universal, Targeted, Clinical. PATs administered between September 2021-December 2022 were analyzed.

Results
Two hundred twenty-five PATs were included for analysis. Most caregivers identified as Black, single Women over 21 years old with a high school degree or more. The average patient age was 8.2 years (0–22 years). Sixty-seven percent of PATs fell into the Universal category. Dyads that scored in the Targeted or Clinical categories were more likely to report financial hardship, caregiver mental health concerns, and family stressors (p < 0.001). Nearly 50% of all families reported some form of financial difficulty, including almost 40% in the Universal category.

Conclusions
Universal implementation of a psychosocial risk screener identified financial challenges for many families, as well as caregiver burden and mental health concerns, allowing for timely resource support. However, overall risk for many of these families was categorized as Universal or low risk, indicating that distribution of resources and support cannot be based on PAT category alone.
Aspergillus fumigatus is responsible for inflammation in a murine model of chronic obstructive pulmonary disease exacerbation
Authors: Bouyssi Alexandra , Trecourt Alexis , Déméautis Tanguy , Persat Florence , Glehen Olivier , Wallon Martine , Devouassoux Gilles , Bentaher Abderrazzak , Menotti Jean 
Published: January 2025

Abstract

Background
In patients with chronic obstructive pulmonary disease (COPD), a sensitization to A. fumigatus has been related to a decline in lung function, but the role of fungal agents in the disease pathogenesis remains unclear. The main purpose of the present study was to investigate whether cell inflammation could worsen after exposure to A. fumigatus spores in vitro and then, in mice, following chronic exposure to cigarette smoke mimicking COPD.

Methods
The inflammatory response to cigarette smoke alone or with A. fumigatus was investigated in cell culture models of murine macrophages and alveolar epithelial cells. In an animal model, mice were exposed daily to two cigarettes smoke over 14 weeks, and two intranasal instillations of 105 spores at weeks 7 and 14. Then, their lungs were recovered to perform inflammatory and histopathological analyses.

Results
In co-cultures of macrophages and epithelial cells treated with both cigarette smoke extracts (CSE) and A. fumigatus compared to CSE alone there were significant inductions in TNF-α (6.2-fold) and CXCL-2 (21.5-fold) gene expression, confirmed by significant increases in the corresponding protein secretion. In the murine model, histological analyses of the lung after chronic smoke exposure showed an increase in airspace enlargement. Moreover, a Bio-Plex approach on bronchoalveolar lavage of cigarette smoke and A. fumigatus-treated mice showed significant increases in multiple inflammatory proteins secreted in the lung.

Conclusions
There was a stronger inflammatory response after cigarette smoke exposure with A. fumigatus compared to cigarette smoke alone. These findings were correlated with histopathological changes in the mouse lung in vivo.
Longitudinal association between DNA methylation and type 2 diabetes: findings from the KORA F4/FF4 study
Authors: Lai Liye , Juntilla Dave Laurence , Del Monica , Del C Gomez-Alonso Monica , Grallert Harald , Thorand Barbara , Farzeen Aiman , Rathmann Wolfgang , Winkelmann Juliane , Prokisch Holger , Gieger Christian , Herder Christian , Peters Annette , Waldenberger Melanie 
Published: January 2025

Abstract

Background
Type 2 diabetes (T2D) has been linked to changes in DNA methylation levels, which can, in turn, alter transcriptional activity. However, most studies for epigenome-wide associations between T2D and DNA methylation comes from cross-sectional design. Few large-scale investigations have explored these associations longitudinally over multiple time-points.

Methods
In this longitudinal study, we examined data from the Cooperative Health Research in the Region of Augsburg (KORA) F4 and FF4 studies, conducted approximately seven years apart. Leucocyte DNA methylation was assessed using the Illumina EPIC and 450K arrays. Linear mixed-effects models were employed to identify significant associations between methylation sites and diabetes status, as well as with fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), homoeostasis model assessment of beta cell function (HOMA-B), and homoeostasis model assessment of insulin resistance (HOMA-IR). Interaction effects between diabetes status and follow-up time were also examined. Additionally, we explored CpG sites associated with persistent prediabetes or T2D, as well as the progression from normal glucose tolerance (NGT) to prediabetes or T2D. Finally, we assessed the associations between the identified CpG sites and their corresponding gene expression levels.

Results
A total of 3,501 observations from 2,556 participants, with methylation measured at least once across two visits, were included in the analyses. We identified 64 sites associated with T2D including 15 novel sites as well as known associations like those with the thioredoxin-interacting protein (TXNIP) and ATP-binding cassette sub-family G member 1 (ABCG1) genes. Of these, eight CpG sites exhibited different rates of annual methylation change between the NGT and T2D groups, and seven CpG sites were linked to the progression from NGT to prediabetes or T2D, including those annotated to mannosidase alpha class 2a member 2 (MAN2A2) and carnitine palmitoyl transferase 1 A (CPT1A). Longitudinal analysis revealed significant associations between methylation and FPG at 128 sites, HbA1c at 41 sites, and HOMA-IR at 57 sites. Additionally, we identified 104 CpG-transcript pairs in whole blood, comprising 40 unique CpG sites and 96 unique gene transcripts.

Conclusions
Our study identified novel differentially methylated loci linked to T2D as well as to changes in diabetes status through a longitudinal approach. We report CpG sites with different rates of annual methylation change and demonstrate that DNA methylation associated with T2D is linked to following transcriptional differences. These findings provide new insights into the molecular mechanisms of diabetes development.

Graphical abstract
Application of stem cells alone and in combination with low-level laser therapy for sciatic nerve repair in rats
Authors: Shalalvand Mohsen , Mahaseni Aghdam Hamidreza , Asghari Ahmad , Nehzat Siamak , Shahsavari Fatemeh , Ardalani Rojin 
Published: January 2025

Abstract
This study evaluated the efficacy of tubular constructs containing stem cells and Type I collagen, both independently and in conjunction with low-level laser therapy (LLLT), in repairing the sciatic nerve in a rat model. In this animal study, the right sciatic nerve of 30 male Wistar rats, each weighing 250–300 g, was surgically excised to a length of 8 mm. The rats were then randomly allocated to three groups (n = 10 per group). In Group 1, the excised nerve segment was utilized as an autograft and sutured at the defect site. In Group 2, a tubular construct containing stem cells and Type I collagen was used to bridge the proximal and distal ends of the nerve. Group 3 received the same intervention as group 2, supplemented with 5 weeks of LLLT. After 5 and 12 weeks, rats underwent histological, behavioral, and electrophysiological assessments. Data were statistically analyzed using analysis of variance (ANOVA), Bonferroni post-hoc test, and Kruskal–Wallis test. At both 5 and 12 weeks, axonal count and nerve repair scores showed no significant differences among the three groups (P > 0.05). Notably, the Sciatic Functional Index (SFI) was the most favorable (lowest) in the autograft group, whereas the stem cell-only group exhibited the least favorable (highest) SFI at 5 weeks (P < 0.001). Additionally, distal latency was highest in the stem cell group and lowest in the stem cell combined with LLLT group at 5 weeks (P < 0.001). A significant difference was observed between the autograft and stem cell plus LLLT groups (P < 0.05). In conclusion, the application of stem cell-laden tubular constructs in conjunction with LLLT demonstrated efficacy for sciatic nerve repair in rats.
Assessment of greenness, blueness, and whiteness profiles of a validated HPLC-DAD method for quantitation of Donepezil HCl and Curcumin in their laboratory prepared co-formulated nanoliposomes
Authors: Abd Elwahab Mennah M. , Saad Samar , Sheribah Zeinab A. , El-Enany Nahed 
Published: January 2025

Abstract
White and Green Analytical Chemistry are innovative approaches in analytical chemistry that prioritize both sustainability and efficiency. Together, these approaches aim to advance scientific research while minimizing environmental impact and enhancing safety. This integration of environmental consciousness into analytical practices represents a significant step forward in achieving sustainable scientific progress. In the present study, a sensitive eco-friendly HPLC-DAD method was carried out and validated to allow concurrent determination of Donepezil HCl (DPZ) and Curcumin (CUR) in their pure form and laboratory made nano-liposome formulation. Optimum seperation was accomplished by utilising Zobrax Eclipse Plus C18 column (4.6*100 mm,5 μm) with gradient elution of the mobile phase composed of 0.02 M phosphate buffer at pH 3.2 and ethanol at flow rate of 1.5 ml/min. A diode array detector (DAD) was implemented for detection at 273 nm and 435 nm for DPZ and CUR, respectively, with the column oven set at 40 °C. The method was validated according to ICH specifications in terms of accuracy, precision, linearity range, detection and quantification limit. The calibration plots were linear with correlation coefficients (r2) = 0.999 over the range (0.1–100 µg/ml) and (0.1–100 µg/ml) for DPZ and CUR, successively. The validated HPLC-DAD approach was adopted to analyse both medications in laboratory prepared nano-liposomal formulation in which the analytes were successfully quantified with good recovery values and no disrubtion from the added excipients. The investigation of whiteness, blueness, and greenness metrics revealed a major benefit of the suggested approach over previous reported ones.
Optimizing Phaeodactylum tricornutum cultivation: integrated strategies for enhancing biomass, lipid, and fucoxanthin production
Authors: Elshobary Mostafa E. , Abo-Shanab Walaa A. , Ende Stephan S. W. , Alquraishi Mohammed , El-Shenody Rania A. 
Published: January 2025

Abstract

Background

Phaeodactylum tricornutum is a versatile marine microalga renowned for its high-value metabolite production, including omega-3 fatty acids and fucoxanthin, with emerging potential for integrated biorefinery approaches that encompass biofuel and bioproduct generation. Therefore, in this study we aimed to optimize the cultivation conditions for boosting biomass, lipid, and fucoxanthin production in P. tricornutum, focusing on the impacts of different nutrient ratios (nitrogen, phosphorus, silicate), glycerol supplementation, and light regimes.

Results
Optimized medium (− 50%N%, + 50% P, Zero-Si, 2 g glycerol) under low-intensity blue light (100 μmol m⁻2 s⁻1) improved biomass to 1.6 g L⁻1, with lipid productivity reaching 539.25 mg g⁻1, while fucoxanthin increased to 20.44 mg g−1. Total saturated fatty acid (ΣSFA) content in the optimized culture increased approximately 2.4-fold compared to the control F/2 medium. This change in fatty acid composition led to improved biodiesel properties, including a higher cetane number (59.18 vs. 56.04) and lower iodine value (53.96 vs 88.99 g I2/100 g oil). The optimized conditions also altered the biodiesel characteristics, such as kinematic viscosity, cloud point, and higher heating value.

Conclusion
Our optimization approach reveals the significant potential of P. tricornutum as a versatile microbial platform for biomass, lipid, and fucoxanthin production. The tailored cultivation strategy successfully enhanced biomass and lipid accumulation, with notable improvements in biodiesel properties through strategic nutrient and light regime manipulation. These findings demonstrate the critical role of precise cultivation conditions in optimizing microalgal metabolic performance for biotechnological applications.
Headache in radiologically isolated syndrome: a hint toward imminent conversion: a case report
Authors: Etemadifar Masoud , Kaveyee Hasan , Zohrabi Parto , Jozaie Amir Mohammad , Salari Mehri , ebne-ali-heydari Yasin 
Published: January 2025

Abstract

Background
Headaches are more prevalent in patients with multiple sclerosis compared with the general population. However, headaches are still considered a rare symptom of multiple sclerosis, especially when they appear as an initial symptom. The occurrence of a headache as a symptom of radiologically isolated syndrome (RIS) is uncommon, and it can significantly increase the likelihood of developing multiple sclerosis.

Case presentation
We report the case of a 36-year-old Iranian woman experiencing severe unilateral headaches without other multiple sclerosis symptoms. Despite normal physical and laboratory exams, cerebrospinal fluid analysis showed positive oligoclonal bands. Magnetic resonance imaging (MRI) revealed multiple demyelinating plaques consistent with RIS. She was treated with dimethyl fumarate. Subsequent MRI confirmed multiple sclerosis by showing new gadolinium-enhanced lesions. After 3 months of dimethyl fumarate treatment, her headache intensity decreased, and she remained otherwise symptom free. Written informed consent was obtained from the patient.

Conclusion
Effectively managing headaches in patients with RIS is a challenge for clinicians to improve their quality of life and delay the progression of multiple sclerosis.