bluuebunny/crossref_metadata_2025_split huggingface dataset:
Salidroside regulates tumor microenvironment of non-small cell lung cancer via Hsp70/Stub1/Foxp3 pathway in Tregs
Authors: Wen Zexin , Liu Tong , Zhang Yanli , Yue Qiujuan , Meng Hang , He Yijie , Yang Yi , Li Minghao , Zheng Jianwen , Lin Wei 
Published: August 2023

Abstract
Background
The treatment of non-small cell lung cancer (NSCLC) is challenging due to immune tolerance and evasion. Salidroside (SAL) is an extract in traditional Chinese medicine and has a potential antitumor effect. However, the mechanism of SAL in regulating the immunological microenvironment of NSCLC is yet to be clarified.

Methods
The mouse model with Lewis lung cancer cell line (3LL) in C57BL/6 mice was established. And then, the percentage of tumor-infiltrating T cell subsets including Treg was detected in tumor-bearing mice with or without SAL treatment. In vitro, the effect of SAL on the expression of IL-10, Foxp3 and Stub1 and the function of Treg were detected by flow cytometry. Network pharmacology prediction and molecular docking software were used to predict the target of SAL and intermolecular interaction. Furthermore, the effect of SAL on the expression of Hsp70 and the co-localization of Stub1-Foxp3 in Treg was confirmed by flow cytometry and confocal laser microscopy. Finally, Hsp70 inhibitor was used to verify the above molecular expression.

Results
We discovered that SAL treatment inhibits the growth of tumor cells by decreasing the percentage of tumor-infiltrated CD4+Foxp3+T cells. SAL treatment downregulates the expression of Foxp3 in Tregs, but increases the expression of Stub1, an E3 ubiquitination ligase upstream of Foxp3, and the expression of Hsp70. Inhibiting the expression of Hsp70 reverses the inhibition of SAL on Foxp3 and disrupts the colocalization of Stub1 and Foxp3 in the nucleus of Tregs.

Conclusions
SAL inhibits tumor growth by regulating the Hsp70/stub1/Foxp3 pathway in Treg to suppress the function of Treg. It is a new mechanism of SAL for antitumor therapy.
Impact of virtual group-based acceptance and commitment therapy on social adjustment and work-family conflict among intern nurses: a randomized control trial
Authors: El-Ashry Ayman Mohamed , Elhay Eman Sameh Abd , Taha Samah Mohamed , Salem El Saied Abd El Hamid El Sayed , El-Sayed Mona Metwally 
Published: August 2023

Abstract
Background
An action-oriented approach such as acceptance and commitment therapy may help reduce the fusion of conflicting ideas, empower new intern nurses to act according to their values, and maximize their psychological flexibility.

Objective
To evaluate the impact of a virtual group-based acceptance and commitment therapy intervention on intern nurses’ social adjustment and work-family conflict.

Design
A parallel, single-blind randomized control trial on intern nurses (n = 70) was randomly allocated to either a six-session online acceptance or commitment therapy intervention (n = 35) or a waiting list control group (n = 35), with each session lasting 90 min.

Measures
The work-related acceptance and action questionnaire, the social adjustment scale-self report, and the work-family conflict scale before, after, and one month after the intervention.

Results
The psychological flexibility mean score of the study group was significantly higher than that of the control group (43.11 vs. 34.15, p < .001) immediately after the intervention, and this effect was sustained one month after the intervention (41.88 vs. 33.21, p < .001) with a more significant effect size (F = 128.457, p < .001, η2 = 0.791). The social adjustment mean score of the study group had significantly improved in all four subscales, with statistically significant differences (p < .001). One month after the intervention, the study group had significantly higher scores than the control group in total score, with statistically significant differences (p < .001) and large effect sizes (η2 = 0.932). Work-family conflict mean score of the study group was decreased immediately after the intervention, with statistically significant differences (p < .001). One month after the intervention, the study group had significantly lower scores than the control group in all three subscales of the WFCS, with statistically significant differences (p < .001) and large effect sizes (η2 = 0.943).

Conclusion
Our findings proved that the virtual group-based ACT intervention effectively improved psychological flexibility and social adjustment, reducing work-family conflict among intern nurses. These findings suggest that the virtual group-based ACT intervention can be a practical approach to improving intern nurses’ mental health and well-being, which could affect their job performance and overall quality of life.

Trial registration
The study was registered retrospectively as a randomized clinical trial on 10/2/2023, reference number; NCT05721339.
Cancer awareness in Australian adolescents
Authors: McDonald F. E. J. , Skrabal Ross X. , Hubbard G. , Konings S. , Jeitani A. 
Published: August 2023

Abstract
Background
Over one-third of cancer cases are attributable to modifiable risk factors. Because health-related behaviors are often established at adolescence, it is important that adolescents understand the risks and lifestyle decisions that may reduce their chances of developing cancer. This study aims to identify the levels of cancer awareness of adolescents in Australia.

Methods
Paper questionnaires were used to collect information about baseline levels of cancer awareness. These questionnaires included socio-demographic questions and the Cancer Awareness Measure (CAM) with slight modifications to ensure their suitability for the Australian adolescent population. Students aged 11 to 19 years were recruited from 13 Australian high schools between 2016 and 2019.

Results
A total of 766 adolescents (58% female, mean age = 14.5 years) completed the questionnaires. Adolescents’ cancer awareness was low. Adolescents who knew someone with cancer recognized significantly more cancer risk factors and cancer warning signs than those who did not know someone with cancer (t (756) = 2.35, p = .019; t (747) = 5.57, p = .001). Those from high Index of Community Socio-Educational Advantage (ICSEA) schools significantly recognized more cancer risk factors than those from low ICSEA schools (t (764) = 2.42, p = .016). Females recognized significantly more warning signs than males (t (583) = 3.11, p = .002) and students from senior high school grades recognized more warning signs than those from junior grades (t (754) = 2.24, p = .02). Most adolescents (78%) were aware of skin cancer as one of the most common cancers in Australia, however half or less were aware of other common cancers. Although most adolescents would seek medical help in the presence of possible cancer symptoms as soon as possible, approximately 20% of them would not see a doctor promptly. Emotional barriers were the most common reasons to delay seeing a doctor (56%), for example “being worried about hearing bad news” (27%).

Conclusions
Australian adolescents show poor awareness of cancer risk factors and cancer warning signs. A number of demographic and experience factors were found to be related to lower cancer awareness. Education is essential to raise cancer awareness, promote healthy lifestyles from adolescence and avoid a preventable cancer diagnosis.
Evidence for an association of serum microanalytes and myofascial pain syndrome
Authors: Pradeep Aishwarya , Birerdinc Aybike , Branigan Travis , Phan Vy , Morris Hailey , Shah Jay , DeStefano Secili , Sikdar Siddhartha , Srbely John , Kumbhare Dinesh , Stecco Antonio , Paik James , Gerber Lynn H. 
Published: August 2023

Abstract
Background
Myofascial Pain Syndrome (MPS) is a common pain disorder. Diagnostic criteria include physical findings which are often unreliable or not universally accepted. A precise biosignature may improve diagnosis and treatment effectiveness. The purpose of this study was to assess whether microanalytic assays significantly correlate with characteristic clinical findings in people with MPS.

Methods
This descriptive, prospective study included 38 participants (25 women) with greater than 3 months of myofascial pain in the upper trapezius. Assessments were performed at a university laboratory. The main outcome measures were the Beighton Index, shoulder range of motion, strength asymmetries and microanalytes: DHEA, Kynurenine, VEGF, interleukins (IL-1b, IL-2, IL-4, IL-5, IL-7, IL-8, IL-13), growth factors (IGF-1, IGF2, G-CSF, GM-CSF), MCP-1, MIP-1b, BDNF, Dopamine, Noradrenaline, NPY, and Acetylcholine. Mann–Whitney test and Spearman’s multivariate correlation were applied for all variables. The Spearman’s analysis results were used to generate a standard correlation matrix and heat map matrix.

Results
Mean age of participants was 32 years (20–61). Eight (21%) had widespread pain (Widespread Pain Index ≥ 7). Thirteen (34%) had MPS for 1–3 years, 14 (37%) 3–10 years, and 11 (29%) for > 10 years. The following showed strong correlations: IL1b,2,4,5,7,8; GM-CSF and IL 2,4,5,7; between DHEA and BDNF and between BDNF and Kynurenine, NPY and acetylcholine. The heat map analysis demonstrated strong correlations between the Beighton Index and IL 5,7, GM-CSF, DHEA. Asymmetries of shoulder and cervical spine motion and strength associated with select microanalytes.

Conclusion
Cytokine levels significantly correlate with selected clinical assessments. This indirectly suggests possible biological relevance for understanding MPS. Correlations among some cytokine clusters; and DHEA, BDNF kynurenine, NPY, and acetylcholine may act together in MPS. These findings should be further investigated for confirmation that link these microanalytes with select clinical findings in people with MPS.
Impact of para aortic lymph node removal on survival following resection for pancreatic adenocarcinoma
Authors: Sillesen Martin , Hansen Carsten Palnæs , Burgdorf Stefan Kobbelgaard , Dencker Emilie Even , Krohn Paul Suno , Gisela Kollbeck Sophie Louise , Stender Mogens Tornby , Storkholm Jan Henrik 
Published: August 2023

Abstract
Introduction
For PDAC patients undergoing resection, it remains unclear whether metastases to the paraaortic lymph nodes (PALN+) have any prognostic significance and whether metastases should lead to the operation not being carried out. Our hypothesis is that PALN + status would be associated with short overall survival (OS) compared with PALN-, but longer OS compared with patients undergoing surgical exploration only (EXP).

Methods
Patients with registered PALN removal from the nationwide Danish Pancreatic Cancer Database (DPCD) from May 1st 2011 to December 31st 2020 were assessed. A cohort of PDAC patients who only had explorative laparotomy due to non-resectable tumors were also included (EXP group). Survival analysis between groups were performed with cox-regression in a multivariate approach including relevant confounders.

Results
A total of 1758 patients were assessed, including 424 (24.1%) patients who only underwent explorative surgery leaving 1334 (75.8%) patients for further assessment. Of these 158 patients (11.8%) had selective PALN removal, of whom 19 patients (12.0%) had PALN+. Survival analyses indicated that explorative surgery was associated with significantly shorter OS compared with resection and PALN + status (Hazard Ratio 2.36, p < 0.001). No difference between PALN + and PALN- status could be demonstrated in resected patients after controlling for confounders.

Conclusion
PALN + status in patients undergoing resection offer improved survival compared with EXP. PALN + should not be seen as a contraindication for curative intended resection.
Prediction and optimization of indirect shoot regeneration of Passiflora caerulea using machine learning and optimization algorithms
Authors: Jafari Marziyeh , Daneshvar Mohammad Hosein 
Published: August 2023

Abstract
Background
Optimization of indirect shoot regeneration protocols is one of the key prerequisites for the development of Agrobacterium-mediated genetic transformation and/or genome editing in Passiflora caerulea. Comprehensive knowledge of indirect shoot regeneration and optimized protocol can be obtained by the application of a combination of machine learning (ML) and optimization algorithms.

Materials and methods
In the present investigation, the indirect shoot regeneration responses (i.e., de novo shoot regeneration rate, the number of de novo shoots, and length of de novo shoots) of P. caerulea were predicted based on different types and concentrations of PGRs (i.e., TDZ, BAP, PUT, KIN, and IBA) as well as callus types (i.e., callus derived from different explants including leaf, node, and internode) using generalized regression neural network (GRNN) and random forest (RF). Moreover, the developed models were integrated into the genetic algorithm (GA) to optimize the concentration of PGRs and callus types for maximizing indirect shoot regeneration responses. Moreover, sensitivity analysis was conducted to assess the importance of each input variable on the studied parameters.

Results
The results showed that both algorithms (RF and GRNN) had high predictive accuracy (R2 > 0.86) in both training and testing sets for modeling all studied parameters. Based on the results of optimization process, the highest de novo shoot regeneration rate (100%) would be obtained from callus derived from nodal segments cultured in the medium supplemented with 0.77 mg/L BAP plus 2.41 mg/L PUT plus 0.06 mg/L IBA. The results of the sensitivity analysis showed the explant-dependent impact of exogenous application of PGRs on indirect de novo shoot regeneration.

Conclusions
A combination of ML (GRNN and RF) and GA can display a forward-thinking aid to optimize and predict in vitro culture systems and consequentially cope with several challenges faced currently in Passiflora tissue culture.
Approaches and styles of mothers in sex education process of children and the related factors
Authors: Nesfechi Elnaz Faraji , Pouralizadeh Moluk , Khalesi Zahra Bostani , Maroufizadeh Saman 
Published: August 2023

Abstract
Introduction
Sex education supports the development of suitable sexual behaviors in children. However, due to the limitations of sexual issues in Iran, parents may have different sex education styles. This study aimed to assess the styles of mothers in the sex education process of children and the related factors.

Methods
In a cross-sectional study, from March to May 2021, 306 mothers with a 4–12-year-old child who were referred to the comprehensive health service centers in Rasht city were entered into the study by a convenience sampling method. The tool was a questionnaire of parents' sex education styles. Data analysis was performed with independent t-tests, one-way ANOVA, Pearson's correlation coefficient, and the multiple linear regression model using SPSS software version 16.

Results
The majority of the mothers had a mean age of 36.2 ± 6.4 years. The score of the authoritarian sex education style was significantly higher than the other styles (P < 0.001). According to the multivariate analysis, 40.6% of the changes in the strict style (R2 = 0.406), 32.7% of the changes in the permissive style (R2 = 0.327), and 36.1% of the changes in the authoritative style (R2 = 0.361) were explained by the personal characteristics of the participants.

Conclusion
The authoritative style was a dominant sex education style. Identifying the factors associated with types of child sex education styles has an important role in promoting the health of children and the community. It is recommended that nursing policymakers identify related factors of sex education styles in mothers of different cultures, and therefore, implement training programs for empowering mothers.
Women with PCOS who undergo IVF: a comprehensive review of therapeutic strategies for successful outcomes
Authors: Kotlyar Alexander M. , Seifer David B. 
Published: August 2023

AbstractPolycystic ovarian syndrome (PCOS) is a widespread syndrome that poses unique challenges and constraints to the field of assisted reproductive technology. This condition is the most common cause of anovulation among infertile couples. Debate exists over the best therapeutic course of action when patients with PCOS proceed to IVF. In this review, we evaluate the best-performing and safest methods of IVF preparation, ovarian stimulation, trigger method for maturation of stimulated egg growth, and planning for embryo transfer. Pre-IVF considerations include being aware of individual AMH and vitamin D levels as well as BMI prior to selecting an ovarian stimulation protocol. Numerous supplements such as myo-inositol complement the benefits of lifestyle change and may enhance IVF performance including oocyte yield and pregnancy rate. Concerning stimulation protocols, antagonist cycles with the judicious use of GnRH agonist trigger, pre-treatment with metformin and vitamin D repletion may help mitigate the accompanied risk of ovarian hyperstimulation syndrome (OHSS). Following ovarian stimulation, PCOS patients typically undergo programmed frozen embryo transfer (FET) cycles which are more conducive for women with irregular cycles, but likely carry a higher risk of hypertensive disorders of pregnancy. However, newer stimulated FET protocols using Letrozole may offer improved outcomes. Overall, patients with PCOS require careful individual tailoring of their IVF cycle to achieve optimal results.
Strategies for maintaining and strengthening the health care workers during epidemics: a scoping review
Authors: Valiee Sadra , Zarei Jelyani Zahra , Kia Mohammad , Jajarmizadeh Ali , Delavari Sajad , Shalyari Naseh , Ahmadi Marzaleh Milad 
Published: August 2023

Abstract
Introduction
During epidemics such as COVID-19, healthcare workers (HCWs) face several challenges, leading to a shortage and weakening of human resources. To address this issue, employing effective strategies is essential in maintaining and strengthening human resources during outbreaks. This study aimed to gather and classify strategies that could retain and strengthen human health resources during epidemics.

Methods
In this scoping review, all studies published about strategies for maintaining and strengthening HCWs in epidemics were collected from 4 international databases, including PubMed, Embase, Scopus, and Web of Science. The English language articles published after 2000 up until June 2022 recommended specific strategies regarding the research question. Then, they were analyzed and classified according to thematic analysis based on Braun and Clarke 6 phases protocols.

Results
In total, 9405 records were screened, of which 59 articles were included, and their full texts were reviewed. Fifty factors were identified and classified into five themes: Instruction, Protection, Supporting, Caring, and Communication. Most of the suggestions were conducted in high-income countries and related to the Supporting theme.

Discussion
The majority of strategies discussed in the literature addressed only one or two aspects of human resources. This study provides a holistic perspective on these issues by providing a thematic map of different strategies for strengthening and maintaining HCWs during epidemics. Considering the multidimensionality of human nature, it is suggested that policymakers and managers of health systems provide facilities that simultaneously address a wide range of needs.
The role of MSCs and CAR-MSCs in cellular immunotherapy
Authors: Yan Lun , Li Jing , Zhang Cheng 
Published: August 2023

AbstractChimeric antigen receptors (CARs) are widely used by T cells (CAR-T cells), natural killer cells dendritic cells and macrophages, and they are of great importance in cellular immunotherapy. However, the use of CAR-related products faces several challenges, including the poor persistence of cells carrying CARs, cell dysfunction or exhaustion, relapse of disease, immune effector cell-associated neurotoxicity syndrome, cytokine release syndrome, low efficacy against solid tumors and immunosuppression by the tumor microenvironment. Another important cell therapy regimen involves mesenchymal stem cells (MSCs). Recent studies have shown that MSCs can improve the anticancer functions of CAR-related products. CAR-MSCs can overcome the flaws of cellular immunotherapy. Thus, MSCs can be used as a biological vehicle for CARs. In this review, we first discuss the characteristics and immunomodulatory functions of MSCs. Then, the role of MSCs as a source of exosomes, including the characteristics of MSC-derived exosomes and their immunomodulatory functions, is discussed. The role of MSCs in CAR-related products, CAR-related product-derived exosomes and the effect of MSCs on CAR-related products are reviewed. Finally, the use of MSCs as CAR vehicles is discussed.
Graphical Abstract
Balance assessment in selected stages of Parkinson’s disease using trend change analysis
Authors: Wodarski Piotr , Jurkojć Jacek , Michalska Justyna , Kamieniarz Anna , Juras Grzegorz , Gzik Marek 
Published: August 2023

Abstract
Background
Balance disorders in patients diagnosed with Parkinson’s disease (PD) are associated with a change in balance-keeping strategy and reflex disorders which regulate the maintenance of vertical body posture. Center of foot pressure (COP) displacement signals were analyzed during quiet standing experiments to define such changes. The research aimed to apply stock exchange indices based on the trend change analyses to the assessment of a level of the Parkinson disease progression on the grounds of the analysis of the COP signals.

Methods
30 patients in two stages of PD, 40 elderly participants, and 20 individuals at a young age were studied. Each person was subjected to 3 measurements with open and closed eyes. A technical analysis of the COP displacement signal was performed, and the following quantities were determined: indices related to the number of trend changes (TCI), indices defining a mean time (TCI_dT), and mean displacement (TCI_dS) and mean velocity (TCI_dV) between such changes.

Results
The results indicate a higher TCI value for PD than for aged-matched control group (p < 0.05). In the case of PD patients, there was also an increase in the TCI_dS value by 2–5 mm, which mainly contributed to the increase in TCI_dV. Statistically significant differences for the TCI_dT values occurred between all groups in which differences in the average COP velocity were noted.

Conclusions
The TCI and TCI_dV results obtained for the healthy participants enabled the development of indices supporting PD diagnostics. The causes of the TCI_dV changes in patients were determined, i.e., whether they resulted from an increase in the TCI_dT or TCI_dS between the moments of trend changes indicated by the developed algorithm. The developed methodology provides new information on the impact of PD on the strategy of maintaining balance, which was impossible to obtain using currently used analyses.
Trial registration The conducted research is an observational study and does not include a health care intervention. Participants gave their consent to participate in the research and the procedure was approved by the Institutional Bioethics Committee.