bluuebunny/crossref_metadata_2025_split huggingface dataset:
The national COPD screening programme in China: rationale and design
Authors: Lei Jieping , Huang Ke , Pan Jun , Li Wei , Niu Hongtao , Ren Xiaoxia , Dong Fen , Li Yong , Li Baicun , Jia Cunbo , Yang Ting , Wang Chen 
Published: February 2023

BackgroundCOPD is the most prevalent chronic respiratory disease in China. It is estimated that there is a large, as-yet undetected, high-risk population who will develop in COPD in future.Methods and designIn this context, a nationwide COPD screening programme was launched on 9 October 2021. This multistage sequential screening programme incorporates a previously validated questionnaire (i.e.COPD Screening Questionnaire) and pre- and post-bronchodilator spirometry to target the COPD high-risk population. The programme plans to recruit 800 000 participants (eligible age 35–75 years) from 160 districts or counties of 31 provinces, autonomous regions or municipalities across China. The filtered COPD high-risk population and early-detected COPD patients will receive integrated management and be followed-up for ≥1 year.DiscussionThis is the first large-scale prospective study to determine the net benefit of mass screening for COPD in China. Whether the smoking cessation rate, morbidity, mortality and health status of individuals at high risk of COPD could be improved along with this systematic screening programme will be observed and validated. Moreover, the diagnostic accuracy, cost-effectiveness and superiority of the screening programme will also be assessed and discussed. The programme marks a remarkable achievement in the management of chronic respiratory disease in China.
MXene: fundamentals to applications in electrochemical energy storage
Authors: Ampong Daniel Nframah , Agyekum Emmanuel , Agyemang Frank Ofori , Mensah-Darkwa Kwadwo , Andrews Anthony , Kumar Anuj , Gupta Ram K. 
Published: February 2023

AbstractA new, sizable family of 2D transition metal carbonitrides, carbides, and nitrides known as MXenes has attracted a lot of attention in recent years. This is because MXenes exhibit a variety of intriguing physical, chemical, mechanical, and electrochemical characteristics that are closely linked to the wide variety of their surface terminations and elemental compositions. Particularly, MXenes are readily converted into composites with materials including oxides, polymers, and CNTs, which makes it possible to modify their characteristics for a variety of uses. MXenes and MXene-based composites have demonstrated tremendous promise in environmental applications due to their excellent reducibility, conductivity, and biocompatibility, in addition to their well-known rise to prominence as electrode materials in the energy storage sector. The remarkable characteristics of 2D MXene, including high conductivity, high specific surface area, and enhanced hydrophilicity, account for the increasing prominence of its use in storage devices. In this review, we highlight the most recent developments in the use of MXenes and MXene-based composites for electrochemical energy storage while summarizing their synthesis and characteristics. Key attention is paid to applications in supercapacitors, batteries, and their flexible components. Future research challenges and perspectives are also described.
Clinical significance of the hemodynamic gain index in patients undergoing exercise stress testing and coronary computed tomography angiography
Authors: Mansour Mohamad Jihad , Chammas Elie , Winkler Michael , AlJaroudi Wael 
Published: February 2023

Abstract
Background
Many hemodynamic parameters provide limited information regarding obstructive coronary artery disease (CAD) during exercise stress testing particularly when exercise is suboptimal. Hemodynamic gain index (HGI) is a recent sensitive indicator of ischemia and has been associated with increased mortality. This study evaluated the clinical impact of HGI in patients who underwent concomitant exercise stress testing and coronary computed tomography angiography (CCTA).

Methods
A total of 284 consecutive patients from the executive health program between 2010 and 2018 were identified. Resting and peak heart rate (HR) as well as systolic blood pressure (SBP) measurements were recorded. Framingham risk score (FRS), Duke treadmill score (DTS) and HGI $$(\frac{{{\text{HRpeak}} \times {\text{SBPpeak}} - {\text{HRrest}} \times {\text{SBPrest}}}}{{{\text{HRrest}} \times {\text{SBPrest}}}})$$

(

HRpeak
×
SBPpeak
-
HRrest
×
SBPrest

HRrest
×
SBPrest

)

were calculated. The latter was divided into quartiles. CCTA was used as a reference test to detect any CAD. Multivariate analysis and artificial neural network were used to determine the independent predictors of obstructive CAD.

Results
Mean age was 53 ± 12 years with 83% male. Mean HGI was 1.74 ± 0.67, with cut-off value of severely blunted HGI ≤ 1.25 (Quartile 4). Patients with severely blunted HGI were older, had higher FRS, and worse DTS. Patients with obstructive CAD had lower HGI when compared to those with normal CCTA/non-obstructive CAD (1.36 ± 0.53 vs. 1.77 ± 0.67, P = 0.005), and showed a higher prevalence of severely blunted HGI (44% vs. 22%, P = 0.019). After adjusting for traditional risk factors, HGI remained an independent predictor of obstructive CAD while severely blunted HGI was associated with threefold increased odds of having obstructive CAD (P = 0.05). Using artificial intelligence analysis, severely blunted HGI independently predicted obstructive CAD with an area under the curve of 0.83 and 0.96, and normalized importance of HGI of 100% and 63%, respectively for different models.

Conclusions
Among patients who underwent concomitant exercise stress testing and CCTA, severely blunted HGI independently predicted obstructive CAD after multivariate adjustment for traditional risk factors.
Frailty nurse and GP-led models of care in care homes: the role of contextual factors impacting Enhanced health in care homes framework implementation
Authors: Sattar Zeibeda , Young-Murphy Lesley , Craig Lynn , Steven Alison , Wilson-Menzfeld Gemma 
Published: February 2023

Abstract
Background
The Enhanced Health for Care homes (EHCH) framework is an innovative response to provide more proactive, preventative approaches to care for residents living in care homes. It involves co-producing a shared vision with primary care. As part of EHCH a UK clinical commissioning group supported GP’s in two localities to implement their preferred delivery approach involving a new Frailty Nurse-led (FN-led) model in care homes alongside an existing General Practitioner-led (GP-led) model. This paper focuses on implementation of the new FN-led model.

Methods
A qualitative study design was adopted. Forty-eight qualitative semi-structured interviews were undertaken across six care home sites in a Northern locality: three implementing the FN-led and three engaged in an existing GP-led model. Participants included residents, family members, care home managers, care staff, and health professionals working within the EHCH framework.

Results
Two overarching themes were generated from data analysis: Unanticipated implementation issues and Unintended consequences. Unsuccessful attempts to recruit Frailty Nurses (FN) with enhanced clinical skills working at the desired level (UK NHS Band 7) led to an unanticipated evolution in the implementation process of the FN-led model towards ‘training posts’. This prompted misaligned role expectations subsequently provoking unexpected temporary outcomes regarding role-based trust. The existing, well understood nature of the GP-led model may have further exacerbated these unintended consequences.

Conclusion
Within the broader remit of embedding EHCH frameworks, the implementation of new FN roles needed to evolve due to unforeseen recruitment issues. Wider contextual factors are not in the control of those developing new initiatives and cannot always be foreseen, highlighting how wider factors can force evolution of planned implementation processes with unintended consequences. However, the unintended consequences in this study highlight the need for careful consideration of information dissemination (content and timing) to key stakeholders, and the influence of existing ways of working.
The genetic predisposition increases the chances of schoolchildren maintaining higher adiposity levels after three years
Authors: Reuter Éboni Marília , Reuter Cézane Priscila , de Castro Silveira João Francisco , Sehn Ana Paula , Todendi Pâmela Ferreira , de Moura Valim Andréia Rosane , Brazo-Sayavera Javier , de Mello Elza Daniel 
Published: February 2023

Abstract
Background
The behavior of anthropometrics and the relationship with genetic factors through a long-term perspective should be better explored. This study aims to verify the odds of maintaining the nutritional status classification after three years, according to the rs9939609 polymorphism (FTO gene).

Methods
It was a retrospective longitudinal study with 355 schoolchildren (7–17 years). Body mass index, body-fat percentage (BF%), and waist circumference (WC) were measured at baseline and follow-up. The FTO gene was evaluated from blood collection and genotyping performed by real-time polymerase chain reaction. Odds ratios and 95% confidence intervals were calculated.

Results
For those homozygous with the A allele, the odds of being at less favorable classification at follow-up were 2.29 (1.24; 4.22) and 4.05 (2.08; 7.86) times higher than expected for BF% and WC, respectively, whereas the odds of being in the more favorable classification at follow-up were 0.34 (0.12; 0.93) and 0.11 (0.01; 0.78) for BF% and WC, respectively. The odds of being at less favorable classification were higher for AA carriers with less favorable classification at baseline for BF% and WC compared to AT and TT carriers.

Conclusions
Schoolchildren with a genetic predisposition to obesity and unfavorable anthropometric profile at baseline had more chances of maintaining their nutritional status after three years of follow-up.
Predicting COVID-19 vaccination intentions: the roles of threat appraisal, coping appraisal, subjective norms, and negative affect
Authors: Zou Xia , Chen Qiang , Zhang Yangyi , Evans Richard 
Published: February 2023

Abstract
Background
As a new disease, communities possess little natural immunity to COVID-19 and vaccines are considered critical to preventing and reducing the incidence of severe illness. This study, inspired by Protection Motivation Theory (PMT), examines the relationship between citizens’ threat appraisal, coping appraisal, subjective norms, negative affect, and their COVID-19 vaccination intentions.

Methods
A sample of 340 citizens from two main cities in Mainland China, Xi’an and Wuxi, was used for data analysis. Structural Equation Modeling (SEM) was employed with latent and observed variables to test hypotheses. Data were analyzed using AMOS 24.0.

Results
Several findings extend current understanding. Firstly, our proposed model explains 73% of the variance in vaccination intentions. Secondly, perceived severity only indirectly shapes COVID-19 vaccination intentions through negative affect. Thirdly, negative affect and response costs are negatively related to COVID-19 vaccination intentions. Finally, Perceived probability, subjective norms, response efficacy and self-efficacy are positively related to COVID-19 vaccination intentions; among them, self-efficacy contributes the most, followed by response efficacy and subjective norms, and lastly perceived probability.

Conclusion
Theoretically, this study increases current understanding about subjective norms and affective responses. We provoke a certain amount of thought about the role of affect response in relation to threat appraisal and vaccination intentions. Specifically, governments must be vigilant that citizens’ negative affect, such as fear, may cause vaccine hesitation.
Influencing factors of self-regulated learning of medical-related students in a traditional Chinese medical university: a cross-sectional study
Authors: Li Ling , Zhu Ming-ling , Shi Yu-qing , Yang Li-li 
Published: February 2023

Abstract
Background
In recent years, self-regulated learning (SRL) has become a hot topic in medical education. However, the factors that affect the SRL ability of medical-related specialties, such as clinical medicine, traditional Chinese medicine (TCM), and nursing specialty in TCM colleges and universities are unclear. Whether the teaching of learning strategies can help improve students’ SRL also needs to be further examined.

Method
A cross-sectional survey was distributed, and 878 medical-related students who were from a TCM university were recruited for this study. Descriptive statistics illustrated the status quo of SRL and learning strategies, and an independent t-test and analysis of variance were used to analyze the factors associated with SRL. The relationship between SRL and learning strategies was analyzed with multi-linear regression analysis.

Results
The scores of SRL on learning motivation, learning setting, self-regulation, and total scores were 34.76 ± 4.62, 41.14 ± 4.30, 39.26 ± 4.74, and 115.16 ± 12.42, respectively. The metacognitive, emotion, cognitive, resource management and total scores of learning strategies were 58.54 ± 12.02, 43.24 ± 8.42, 35.49 ± 7.34, 22.89 ± 4.20, 160.16 ± 29.45, and the mean was all above the midpoint. Learning strategies were positively correlated with SRL (r = 0.421, P < 0.01). Some factors can predict 32% of the variation of SRL, including whether they liked their specialty, educational system, specialty, score ranking, scholarship, whether they were taught by a tutor in middle school, gender, monthly family income, the father's educational background, metacognitive strategy, resource management strategy, and cognitive strategy.

Conclusions
The SRL of medical-related students was better. Learning strategies, as well as personal or social factors, can affect SRL. Educators should pay more attention to the cultivation of learning strategies, exercising learning skills, and monitoring, adjustment, and guidance of learning time. It should adopt various methods to improve the SRL of medical-related students according to the different factors.
Substance use and help-seeking barriers: a qualitative study of East African migrants’ experiences of access to Norwegian healthcare services
Authors: Pettersen Ruben Jervell , Debesay Jonas 
Published: February 2023

Abstract
Background
Migration to Norway has increased rapidly in recent decades. Migrants have a lower prevalence of substance use, but may have an elevated risk of developing mental health issues and substance use problems due to various migration and post-migration factors. Few studies have sought to understand substance use problems among migrants in Norway. This study aimed to explore how people of East African background experience help-seeking for substance use problems in the Norwegian healthcare system.

Methods
Using an explorative approach, in-depth individual interviews were conducted with six adult participants from Somalia, Eritrea and Sudan who had been in contact with the Norwegian healthcare system. The goal of the interviews was to facilitate in-depth and nuanced descriptions of the participants’ lived experience of help-seeking for substance use problems. The data were analysed using interpretive phenomenological analysis.

Results
The analysis resulted in five themes in which participants described their help-seeking experiences for substance use problems as lack of knowledge and access to information, scepticism towards a ‘white system’, fear of exclusion from family and ethnic community, racism as a barrier to help-seeking, and positive experiences and ideas for future treatment practices.

Conclusion
This study provides an improved understanding of how migrants with substance use problems experience help-seeking in healthcare. The variety of barriers illustrates inequality in substance use care for East African migrants in Norway.
Changes in HER3 expression profiles between primary and recurrent gynecological cancers
Authors: Kojima Yuki , Sudo Kazuki , Yoshida Hiroshi , Yazaki Shu , Tokura Momoko , Mizoguchi Chiharu , Okuma Hitomi S. , Kita Shosuke , Yamamoto Kasumi , Nishikawa Tadaaki , Noguchi Emi , Shimoi Tatsunori , Tanase Yasuhito , Uno Masaya , Ishikawa Mitsuya , Kato Tomoyasu , Koyama Kumiko , Kobayashi Maki , Kakegawa Tomoya , Fujiwara Yasuhiro , Yonemori Kan 
Published: February 2023

Abstract
Background
Human epidermal growth factor receptor-3 (HER3) is a member of the epidermal growth factor receptor family of receptor tyrosine kinases, and its overexpression is associated with inferior prognosis in several cancers. However, it is unclear whether HER3 expression status changes in tumor tissue at recurrence. Therefore, this study aimed to evaluate the changes in HER3 expression between primary and recurrent status in gynecological cancers.

Methods
This retrospective study used matched-pair tissues of gynecological cancer patients at initial diagnosis and at recurrence. Immunohistochemical (IHC) scores of 3 + or 2 + were termed “HER3-high”, while IHC scores of 1 + or 0 were designated as “HER3-low/zero”.

Results
A total of 86 patients (40 with ovarian cancers, 32 with endometrial cancers, and 14 with cervical cancers) were included in this study. In ovarian cancer, 67.5% and 80.0% of the patients received a HER3-high at initial and recurrent diagnosis, respectively. The H-score was significantly increased at recurrence (p = 0.004). The proportion of HER3-high endometrial cancer patients increased from 46.9% at initial diagnosis to 68.8% at recurrence, and the H-score tended to increase at recurrence (p = 0.08). The fraction of HER3-high-rated cervical cancer patients remained unchanged at 85.7% both at initial and recurrent diagnosis. The discordance rate of HER3 expression detection in initial and recurrent diagnosis samples was 27.5%, 53.1%, and 14.3% for ovarian, endometrial, and cervical cancers, respectively. Ovarian and endometrial cancers with a HER3-high recurrent score tended to show shorter median survival time than those with a HER3-low/zero recurrent rating.

Conclusion
Our findings suggest that, in main types of gynecological cancers, the proportion of patients having a HER3-high score increased from initial to recurrent diagnosis.
Tofacitinib reduces acute lung injury and improves survival in a rat model of sepsis by inhibiting the JAK-STAT/NF-κB pathway
Authors: Zhang Xinxin , Wang Xingsheng , Sun Li , Gao Guangsheng , Li Yun 
Published: February 2023

AbstractAcute lung injury is a major cause of death in sepsis. Tofacitinib (TOFA), a JAK inhibitor, has anti-inflammatory activity in autoimmune diseases, but its role in acute lung injury in sepsis remains unclear. The purpose of this study is to establish a septic rat model by cecal ligation and perforation, and to evaluate the effect of tofacitinib on the survival rate of septic rat model and its role in acute lung injury in septic rats and the possible mechanism of action. In this study, TOFA (1 mg/kg, 3 mg/kg, 10 mg/kg) was used to observe the survival rate of septic rats. It was found that TOFA (10 mg/kg) significantly improved the survival rate of septic rats. We selected TOFA (10 mg/kg) and focused on the protective effect of TOFA on acute lung injury. The results confirmed that TOFA significantly inhibited the expression of TNF-α, IL-1β, IL-6 and IFN-γ inflammatory factors, reduced the W/D weight ratio of septic lung tissue, and significantly improved lung histopathological damage. These results may be related to the inhibitory effect of TOFA on JAK-STAT/NF-κ B signaling pathway. In conclusion, for the first time, we found that TOFA has a protective effect against sepsis-induced acute lung injury, and it may be a promising drug for the treatment of acute lung injury in sepsis.
Apoptotic tumor cell-derived microparticles loading Napabucasin inhibit CSCs and synergistic immune therapy
Authors: Jing Boping , Guo Feng , An Rui , Gao Yu , Li Yuman , Xie Yuji , Wang Jing , Chen Yihan , Li He , Gao Tang , Jin Qiaofeng , Zhang Li , Xie Mingxing 
Published: February 2023

Abstract
Background
Cancer stem cells (CSCs) are crucial for the growth, metastasis, drug resistance, recurrence, and spread of tumors. Napabucasin (NAP) could effectively inhibit CSC, but its mechanism has not been fully explained. Additionally, NAP also has the drawbacks of poor water solubility and low utilization. Therefore, this study not only elaborated the new mechanism of NAP inhibiting CSCs, but also built NAP-loaded nanoprobes using apoptotic tumor-derived microparticles (TMPs) as carriers to combine diagnose and treat of colon cancer and lessen the adverse effects of NAP.

Results
The study discovered a new mechanism for NAP inhibiting tumors. NAP, in addition to inhibiting STAT3, may also inhibit STAT1, thereby inhibiting the expression of CD44, and the stemness of colon cancer. N3-TMPs@NAP was successfully synthesized, and it possessed a lipid bilayer with a particle size of 220.13 ± 4.52 nm, as well as strong tumor binding ability and anti-tumor effect in vitro. In static PET/CT imaging studies, the tumor was clearly visible and showed higher uptake after N3-TMPs@NAP injection than after oral administration. The average tumor volume and weight of the N3-TMPs@NAP group on day 14 of the treatment studies were computed to be 270.55 ± 107.59 mm3 and 0.30 ± 0.12 g, respectively. These values were significantly lower than those of the other groups. Additionally, N3-TMPs@NAP might prevent colon cancer from spreading to the liver. Furthermore, due to TMPs’ stimulation of innate immunity, N3-TMPs@NAP might stimulate anti-tumor.

Conclusions
As a combined diagnostic and therapeutic nanoprobe, N3-TMPs@NAP could successfully conduct PET/CT imaging, suppress CSCs, and synergistically stimulate anticancer immune responses. Additionally, this nanoprobe might someday be employed in clinical situations because TMPs for it can be produced from human tissue and NAP has FDA approval.
Evaluation of factors predicting postoperative recurrence and metastasis of parathyroid cancer: a single-center study
Authors: Ohkuwa Keiko , Katoh Ryohei , Sugino Kiminori , Nagahama Mitsuji , Kitagawa Wataru , Matsuzu Kenichi , Fukunari Nobuhiro , Ito Koichi 
Published: February 2023

Abstract

Purpose
The purpose of this study was to examine the postoperative clinical course of parathyroid carcinoma to determine factors that predict postoperative recurrence and distant metastasis.

Methods
In this retrospective study, we included 38 patients with parathyroid carcinoma who received surgical intervention at Itoh Hospital between 1979 and 2020. Clinicopathologic characteristics (age, sex, intact PTH, serum Ca level, operation type, parathyroid weight, parathyroid size, histopathologic findings: vascular invasion, capsular invasion, necrosis, histological type, and Ki-67 staining) were used. The median follow-up observation period was 63.7 months.

Results
Postoperatively, 5 patients (13.2%) developed distant metastasis or had localized recurrence, and 3 patients died (7.9%). The results of the univariate analysis revealed three factors affecting distant metastasis and recurrence, which were Ki-67 (p = 0.0041), the presence or absence of necrosis (p = 0.0163), and tumor weight (p = 00,189). Using the cutoff values obtained by ROC analysis, which were 4.1 for Ki-67 (sensitivity of 80% and specificity of 96.9%) and 4890 mg for tumor weight (sensitivity of 100% and specificity of 60.9%), we calculated the cumulative incidence of recurrence and distant metastasis by the three factors retained. We found that the presence of the three factors was associated with a high possibility of distant metastasis or recurrence during the 5-year follow-up period.

Conclusions
Three factors, Ki-67, necrosis, and tumor weight in parathyroid carcinoma, may predict outcomes of postoperative recurrence and distant metastasis.