bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fatty liver index relationship with biomarkers and lifestyle: result from RaNCD cohort study
Authors: Kamari Negin , Fateh Hawal Lateef , Darbandi Mitra , Najafi Farid , Moradi Mozhgan , Pasdar Yahya 
Published: May 2023

Abstract
Background
Lifestyle intervention can effectively treat patients with non-alcoholic fatty liver disease (NAFLD). The present study aimed to investigate the association between lifestyle factors with fatty liver index (FLI) in Iranian adults.

Methods
This study enrolled 7114 subjects from the Ravansar Non-Communicable Diseases (RaNCD) cohort study in western Iran. To compute the FLI score, anthropometric measures, and a few non-invasive liver status indicators were used. Binary logistic regression models examined the association between FLI score and lifestyle.

Results
Participants with FLI < 60 had a lower daily energy intake compared to those with FLI ≥ 60 (2740.29 vs. 2840.33 kcal/day, P = < 0.001). The risk of NAFLD in males with high socioeconomic status (SES) was 72% higher than in those with low SES (OR: 1.72; 95% CIs 1.42–2.08). An adjusted logistic regression model showed a significantly negative association between high physical activity and fatty liver index in both men and women. (OR: 0.44, p-value < 0.001 and OR: 0.54, p-value < 0.001, respectively). The odds of NAFLD in female participants with depression were 71% higher than in non-depressed participants (OR: 1.71, 95% CI: 1.06–2.64). Dyslipidemia and high visceral fat area (VFA) were also associated with a significant increase in the risk of NAFLD (P < 0.05).

Conclusion
In our study, we found that good SES, high VFA, and dyslipidemia were associated with an increased risk of NAFLD. Conversely, high physical activity reduces the risk of NAFLD. Therefore, lifestyle modification may help improve liver function.
Acute idiopathic pancreatitis is associated with more aggressive disease course in Crohn’s disease but not in ulcerative colitis
Authors: Osman Karim T. , Hoque Asahi , Pasam Ravi Teja , Farhoud Adel , Abdelfattah Ahmed , Ramadorai Vishant , Chaudrey Khadija , Pellish Randall 
Published: May 2023

Abstract
Purpose
Patients with inflammatory bowel disease (IBD), whether Crohn’s disease (CD) or ulcerative colitis (UC), have an increased risk of acute pancreatitis. The prognostic value of diagnosing acute idiopathic pancreatitis in patients with IBD is not well understood.

Methods
A retrospective review of 56 patients with IBD and acute pancreatitis was conducted in a tertiary center from 2011 to 2020. Aggressive disease course was defined as (i)biologic change, (ii)biologic dose escalation, or (iii)IBD-related surgeries occurring within 1 year of acute pancreatitis diagnosis. Logistic regression modelling identified associations between covariates and an aggressive disease course.

Results
Baseline characteristics between idiopathic pancreatitis and other causes of acute pancreatitis, in both CD and UC cohorts, were similar. Idiopathic pancreatitis was significantly associated with an aggressive disease course in CD (P = 0.04). No confounding factors were associated with an aggressive disease course in CD. Idiopathic pancreatitis, however, was not associated with an aggressive disease course in UC (P = 0.35).

Conclusion
The diagnosis of acute idiopathic pancreatitis may provide a prognostic indicator of a more severe disease course in CD. No such association appears to exist with UC. To the best of our knowledge, this is the first study that identifies an association and possible prognostic value between idiopathic pancreatitis and a more severe disease course in CD. More studies with a larger sample size are needed to validate these findings, further define idiopathic pancreatitis as an extraintestinal manifestation of IBD and elucidate a clinical strategy to optimize care in patients with aggressive CD and idiopathic pancreatitis.
Pooling sputum testing to diagnose tuberculosis using xpert MTB/RIF and xpert ultra: a cost-effectiveness analysis
Authors: Iem Vibol , Bimba John S. , Santos Victor S. , Dominguez Jose , Creswell Jacob , Somphavong Silaphet , Wingfield Tom , Khan Jahangir A. M. , Cuevas Luis E. 
Published: May 2023

Abstract
Background
The World Health Organization (WHO) recommends the diagnosis of tuberculosis (TB) using molecular tests, such as Xpert MTB/RIF (MTB/RIF) or Xpert Ultra (Ultra). These tests are expensive and resource-consuming, and cost-effective approaches are needed for greater coverage.

Methods
We evaluated the cost-effectiveness of pooling sputum samples for TB testing by using a fixed amount of 1,000 MTB/RIF or Ultra cartridges. We used the number of people with TB detected as the indicator for cost-effectiveness. Cost-minimization analysis was conducted from the healthcare system perspective and included the costs to the healthcare system using pooled and individual testing.

Results
There was no significant difference in the overall performance of the pooled testing using MTB/RIF or Ultra (sensitivity, 93.9% vs. 97.6%, specificity 98% vs. 97%, p-value > 0.1 for both). The mean unit cost across all studies to test one person was 34.10 international dollars for the individual testing and 21.95 international dollars for the pooled testing, resulting in a savings of 12.15 international dollars per test performed (35.6% decrease). The mean unit cost per bacteriologically confirmed TB case was 249.64 international dollars for the individual testing and 162.44 international dollars for the pooled testing (34.9% decrease). Cost-minimization analysis indicates savings are directly associated with the proportion of samples that are positive. If the TB prevalence is ≥ 30%, pooled testing is not cost-effective.

Conclusion
Pooled sputum testing can be a cost-effective strategy for diagnosis of TB, resulting in significant resource savings. This approach could increase testing capacity and affordability in resource-limited settings and support increased testing towards achievement of WHO End TB strategy.
Effects of serum sodium and chloride levels in the outcome of critically ill pediatric patients in the post-operative period of liver transplantation
Authors: Luglio Michele , de Carvalho Werther B. , Tannuri Uenis , Tannuri Ana Cristina A. , Matsura Rodrigo Hideki , Morais França Gardenia , Delgado Artur F. 
Published: May 2023

AbstractBackgroundSodium and chloride disturbances have attracted increasing attention in recent years. Many pathophysiological effects are associated with hyperchloremia, including reduction in mean arterial pressure and acute renal disease. Pediatric patients undergoing liver transplantation are at risk of developing various electrolyte and biochemical abnormalities, with an impact on their postoperative outcomes.ObjectiveTo analyze the impacts of serum sodium and chloride levels on prognosis of Pediatric Liver Transplant receptors.MethodsThis was a retrospective analytical observational study performed in a single transplant reference center in Sao Paulo, Brazil. Included patients were pediatric patients who underwent liver transplantation between January 2015 and July 2019. Statistical regression analysis and General Estimating Equations analysis were performed to evaluate the impacts of sodium and chloride disturbances on the development of acute renal failure and mortality.ResultsA total of 143 patients were included in this study. The main diagnosis was Biliary Atresia (62.9%). Twenty-seven patients died (18.9%), and graft dysfunction was the main cause of death (29.6%). The only variable individually associated with 28-days mortality was PIM-3 score (HR 1.59, CI 95% 1.165–2.177, p = 0.004). Forty-one patients (28.6%) developed moderate or severe AKI. PIM-3 score (OR 3.052, 95% CI 1.56–5.97, p = 0.001), hypernatremia (OR 3.49, 95% CI 1.32–9.23, p = 0.012), and hyponatremia (OR 4.24, 95% CI 1.52–11.85, p = 0.006) were independently associated with the development of moderate/severe AKI.ConclusionsIn pediatric patients after liver transplantation, PIM-3 score, and abnormal serum sodium levels were correlated with AKI development.
Effect of an educational intervention on the knowledge, attitudes, and practices of healthcare workers at King Hussein Cancer Center towards predatory publishers
Authors: Al-Ani Abdallah , Al-Huneidy Leen , Sultan Hala , Iqneibi Shahad , Nazzal Jamil , Mansour Asem , Al-Hussaini Maysa 
Published: May 2023

Abstract
Aims
We explored the effect of an educational intervention on the knowledge, attitudes, and practices of healthcare workers (HCWs) towards predatory publishing.

Methods
A retrospective pre-post quasi experimental design was implemented on HCWs within King Hussein Cancer Center (KHCC). Following a 60-min educational lecture, a self-administered questionnaire was completed by participants. Pre- and post-intervention scores for familiarity, knowledge, practices, and attitudes were compared using the paired sample t-test. Multivariate linear regression was used to identify predictors of mean differences (MD) of knowledge scores.

Results
A total of 121 respondents completed the questionnaire. The majority of participants demonstrated underwhelming awareness of predatory publishing and average levels of knowledge of their characteristics. Furthermore, respondents did not take the necessary precautions to avoid predatory publishers. The intervention (i.e. the educational lecture) improved familiarity (MD: 13.4; 95%CI: 12.4 – 14.4; p-value < .001), knowledge of predatory journal’s characteristics (MD: 12.9; 95%CI: 11.1 – 14.8; p-value < .001), awareness and perceived compliance to preventive measures (MD: 7.7; 95%CI: 6.7 – 8.6; p-value < .001), and positively influenced attitudes towards open access and safe publishing (MD: 0.8; 95%CI: 0.2 – 1.5; p-value = 0.012). Females had significantly lower familiarity scores (p-value = 0.002). Moreover, those who had published in open access journals, received at least one predatory e-mail, or had more than 5 published original articles had significantly higher familiarity and knowledge scores (all p-value < 0.001).

Conclusions
An educational lecture proved effective in improving awareness of KHCC’s HCW’s to predatory publishers. Nonetheless, the mediocrity of pre-intervention scores raises concerns on effectiveness of the predatory covert practices.
Application of a peer learning and assessment model in an undergraduate pharmacy course
Authors: Yang Liyuan , Wang Yi 
Published: May 2023

Abstract
Background
Timely and accurate feedback is a crucial component for effective undergraduate learning. However, with the expansion of university enrolment in China, student numbers have increased rapidly and, in traditional university classrooms, it is often difficult for the teacher – as the only evaluator – to accommodate students’ diverse needs and learning styles, and provide timely learning feedback. In our teaching practice research, we combined mutual peer evaluation with cooperative learning, and proposed a peer learning and assessment model (PLAM) that encouraged students to cooperate and compete, leading to greater efficiency in giving feedback. The ultimate goal was to improve students’ learning ability. This study aimed to investigate the effect and influencing factors of PLAM in an undergraduate course entitled ‘Medicinal Chemistry of Natural Products’.

Methods
We surveyed the entire pharmacy student body (95 students). Each student was required to provide feedback to the other members within the same study group and students in other groups. We evaluated the effectiveness of PLAM in five aspects: basic information, learning attitude, participation, interpersonal relationship, and organizational approach. The questionnaire was administered online using the Star survey platform. Data were exported to Excel and meta-analysis was performed using SPSS.

Results
PLAM effectively increased feedback efficiency, enhancing students’ learning interest and ability. An ordered logistic regression analysis model was used to analyze the factors influencing the PLAM learning effect. Three factors – learning attitude, participation, and interpersonal relationship – explained up to 71.3% of the model.

Conclusions
The PLAM adopted in this research is an effective learning and evaluation model that can promote collaborative learning and increase learning enthusiasm. It is more suitable for knowledge expansion learning and comprehensive practical learning where teachers cannot be present for the entire process. Students should be encouraged to establish appropriate learning attitudes and a positive group atmosphere. PLAM can positively impact college curriculum learning and could be extended to other teaching domains.
Exploring the training of pharmacists oriented to the demands for clinical pharmacy services: from the perspective of physicians
Authors: Jin Hang , Huang Yuankai , Xi Xiaoyu , Chen Lei 
Published: May 2023

Abstract
Background
To evaluate physicians’ perceptions, experiences and expectations of clinical pharmacists in China from the perspective of physicians’ demands, to improve the training of pharmacists.

Methods
A cross-sectional survey involving physicians (except for primary physicians) was conducted from July to August 2019 in China. Using a field questionnaire, this study gathered data on descriptive information about the respondents and their perceptions, experiences and expectations of clinical pharmacists. Data were analysed descriptively using frequencies, percentages and mean. Several subgroup analyses using Chi-square tests were conducted to identify physicians’ demands for clinical pharmacists in China.

Results
A total of 1376 physicians from secondary and tertiary hospitals in China (response rate = 92%) participated. The majority of the respondents were comfortable with clinical pharmacists providing education to patients (59.09%) and detecting and preventing prescription errors (60.17%), but they appeared uncomfortable when asked about clinical pharmacists suggesting the use of prescription medications to patients (15.71%). Most respondents agreed that clinical pharmacists are a reliable source of general drug information (81.84%) instead of clinical drug information (79.58%). The majority of the respondents expected clinical pharmacists to be knowledgeable drug therapy experts (95.56%) and to educate their patients about the safe and appropriate use of medications (95.56%).

Conclusion
Physicians’ perceptions and experiences were positively associated with the frequency of their interaction with clinical pharmacists. They had high expectations of clinical pharmacists as knowledgeable drug therapy experts. Corresponding policies and measures are needed to improve the education and training system of clinical pharmacists in China.
ISG15 targets glycosylated PD-L1 and promotes its degradation to enhance antitumor immune effects in lung adenocarcinoma
Authors: Qu Tongyuan , Zhang Wenshuai , Yan Chenhui , Ren Danyang , Wang Yalei , Guo Yuhong , Guo Qianru , Wang Jinpeng , Liu Liren , Han Lei , Li Lingmei , Huang Qiujuan , Cao Lu , Ye Zhaoxiang , Zhang Bin , Zhao Qiang , Cao Wenfeng 
Published: May 2023

Abstract
Background
Immunocheckpoint inhibitors (ICIs) have been widely used in the clinical treatment of lung cancer. Although clinical studies and trials have shown that patients can benefit significantly after PD-1/PD-L1 blocking therapy, less than 20% of patients can benefit from ICIs therapy due to tumor heterogeneity and the complexity of immune microenvironment. Several recent studies have explored the immunosuppression of PD-L1 expression and activity by post-translational regulation. Our published articles demonstrate that ISG15 inhibits lung adenocarcinoma progression. Whether ISG15 can enhance the efficacy of ICIs by modulating PD-L1 remains unknown.

Methods
The relationship between ISG15 and lymphocyte infiltration was identified by IHC. The effects of ISG15 on tumor cells and T lymphocytes were assessed using RT-qPCR and Western Blot and in vivo experiments. The underlying mechanism of PD-L1 post-translational modification by ISG15 was revealed by Western blot, RT-qPCR, flow cytometry, and Co-IP. Finally, we performed validation in C57 mice as well as in lung adenocarcinoma tissues.

Results
ISG15 promotes the infiltration of CD4+ T lymphocytes. In vivo and in vitro experiments demonstrated that ISG15 induces CD4+ T cell proliferation and invalidity and immune responses against tumors. Mechanistically, we demonstrated that the ubiquitination-like modifying effect of ISG15 on PD-L1 increased the modification of K48-linked ubiquitin chains thus increasing the degradation rate of glycosylated PD-L1 targeting proteasomal pathway. The expression of ISG15 and PD-L1 was negatively correlated in NSCLC tissues. In addition, reduced accumulation of PD-L1 by ISG15 in mice also increased splenic lymphocyte infiltration as well as promoted cytotoxic T cell infiltration in the tumor microenvironment, thereby enhancing anti-tumor immunity.

Conclusions
The ubiquitination modification of PD-L1 by ISG15 increases K48-linked ubiquitin chain modification, thereby increasing the degradation rate of glycosylated PD-L1-targeted proteasome pathway. More importantly, ISG15 enhanced the sensitivity to immunosuppressive therapy. Our study shows that ISG15, as a post-translational modifier of PD-L1, reduces the stability of PD-L1 and may be a potential therapeutic target for cancer immunotherapy.
Circular RNA Tmcc1 improves astrocytic glutamate metabolism and spatial memory via NF-κB and CREB signaling in a bile duct ligation mouse model: transcriptional and cellular analyses
Authors: Jo Danbi , Lim Yeong-Hwan , Jung Yoon Seok , Kim Young-Kook , Song Juhyun 
Published: May 2023

Abstract
Background
Hepatic encephalopathy-induced hyperammonemia alters astrocytic glutamate metabolism in the brain, which is involved in cognitive decline. To identify specific therapeutic strategies for the treatment of hepatic encephalopathy, various molecular signaling studies, such as non-coding RNA functional study, have been conducted. However, despite several reports of circular RNAs (circRNAs) in the brain, few studies of circRNAs in hepatic encephalopathy-induced neuropathophysiological diseases have been conducted.

Methods
In this study, we performed RNA sequencing to identify whether the candidate circRNA cirTmcc1 is specifically expressed in the brain cortex in a bile duct ligation (BDL) mouse model of hepatic encephalopathy.

Results
Based on transcriptional and cellular analysis, we investigated the circTmcc1-dysregulation-induced changes in the expression of several genes that are associated with intracellular metabolism and astrocyte function. We found that the circTmcc1 binds with the NF-κB p65-CREB transcriptional complex and regulates the expression of the astrocyte transporter EAAT2. Furthermore, circTmcc1 contributed to the secretion of proinflammatory mediators and glutamate metabolism in astrocytes and subsequently modulated an improvement in spatial memory by mediating neuronal synaptic plasticity.

Conclusions
Thus, circTmcc1 may be a promising circRNA candidate for targeted interventions to prevent and treat the neuropathophysiological complications that occur due to hepatic encephalopathy.
Drug use patterns and factors related to the use and discontinuation of medications for opioid use disorder in the age of fentanyl: findings from a mixed-methods study of people who use drugs
Authors: Hughto Jaclyn M. W. , Tapper Abigail , Rapisarda Sabrina S. , Stopka Thomas J. , Palacios Wilson R. , Case Patricia , Silcox Joseph , Moyo Patience , Green Traci C. 
Published: May 2023

Abstract
Background
Medications for opioid use disorder (MOUD; methadone, buprenorphine, naltrexone) are the most effective treatments for OUD, and MOUD is protective against fatal overdoses. However, continued illegal drug use can increase the risk of treatment discontinuation. Given the widespread presence of fentanyl in the drug supply, research is needed to understand who is at greatest risk for concurrent MOUD and drug use and the contexts shaping use and treatment discontinuation.

Methods
From 2017 to 2020, Massachusetts residents with past-30-day illegal drug use completed surveys (N = 284) and interviews (N = 99) about MOUD and drug use. An age-adjusted multinomial logistic regression model tested associations between past-30-day drug use and MOUD use (current/past/never). Among those on methadone or buprenorphine (N = 108), multivariable logistic regression models examined the association between socio-demographics, MOUD type; and past-30-day use of heroin/fentanyl; crack; benzodiazepines; and pain medications. Qualitative interviews explored drivers of concurrent drug and MOUD use.

Results
Most (79.9%) participants had used MOUD (38.7% currently; 41.2% past), and past 30-day drug use was high: 74.4% heroin/fentanyl; 51.4% crack cocaine; 31.3% benzodiazepines, and 18% pain medications. In exploring drug use by MOUD history, multinomial regression analyses found that crack use was positively associated with past and current MOUD use (outcome referent: never used MOUD); whereas benzodiazepine use was not associated with past MOUD use but was positively associated with current use. Conversely, pain medication use was associated with reduced odds of past and current MOUD use. Among those on methadone or buprenorphine, separate multivariable logistic regression models found that benzodiazepine and methadone use were positively associated with heroin/fentanyl use; living in a medium-sized city and sex work were positively associated with crack use; heroin/fentanyl use was positively associated with benzodiazepine use; and witnessing an overdose was inversely associated with pain medication use. Many participants qualitatively reported reducing illegal opioid use while on MOUD, yet inadequate dosage, trauma, psychological cravings, and environmental triggers drove their continued drug use, which increased their risk of treatment discontinuation and overdose.

Conclusions
Findings highlight variations in continued drug use by MOUD use history, reasons for concurrent use, and implications for MOUD treatment delivery and continuity.