bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum copper levels and risk of major adverse cardiovascular events: a systematic review and meta-analysis
Authors: Muñoz-Bravo Carlos , Soler-Iborte Eva , Lozano-Lorca Macarena , Kouiti Malak , González-Palacios Torres Carla , Barrios-Rodríguez Rocío , Jiménez-Moleón José Juan 
Published: June 2023

BackgroundDespite the fact that several studies have investigated the association between serum copper levels (S-Cu) and the risk of cardiovascular diseases, this relationship remains unclear. The aims of this study were to investigate the association between S-Cu and risk of major adverse cardiovascular events (MACE), including total stroke, ischemic stroke, hemorrhagic stroke, myocardial infarction and cardiovascular mortality, and identify potential sources of results heterogeneity.MethodsWe carried out a systematic review and meta-analysis. The selection criteria were: (1) Observational studies (cohort studies, case-control studies and hybrid studies); (2) Studies containing quantitative data about the relationship between S-Cu and risk of MACE; (3) Estimating association measures; and (4) Studies written in English, French or Spanish. Overall pooled Odds ratio (pOR) and 95% confidence intervals (95% CI) of MACE for the highest vs. lowest S-Cu category were calculated using random-effects models.ResultsSixteen studies with a total of 41,322 participants were included in the meta-analysis: 10 prospective cohort studies, 5 nested case-control studies and 1 case-control study. Comparing highest vs. lowest category, high S-Cu levels were associated with total stroke (pOR: 1.49, 95% CI 1.22–1.82; I2 = 0%, p = 0.54), myocardial infarction (pOR: 1.31, 95% CI 1.17–1.46; I2 = 0.0%, p = 0.92) and cardiovascular mortality (pOR: 1.60, 95% CI 1.39–1.86; I2 = 0.0%, p = 0.54). Subgroup analysis showed that studies with a hybrid design had higher risks for cardiovascular mortality (pOR: 3.42, 95% CI 1.98–5.92) and ischemic stroke (pOR: 1.54, 95% CI 1.30–1.83).ConclusionHigh S-Cu levels were associated with an increased risk of total stroke, myocardial infarction and cardiovascular mortality. Hybrid studies seems to modify the strength of the association between S-Cu and the risk of cardiovascular mortality and ischemic stroke.Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022370782], identifier [CRD42022370782].
Moderators and mediators of change of an internet-based mindfulness intervention for college students: secondary analysis from a randomized controlled trial
Authors: Küchler Ann-Marie , Kählke Fanny , Bantleon Leandra , Terhorst Yannik , Ebert David Daniel , Baumeister Harald 
Published: June 2023

BackgroundExisting evidence suggests internet- and mobile-based interventions (IMIs) improve depressive symptoms in college students effectively. However, there is far less knowledge about the potential mechanisms of change of mindfulness-based IMIs, which could contribute to optimizing target groups and interventions. Hence, within this secondary analysis of data from a randomized controlled trial (RCT), potential moderators and mediators of the effectiveness of the IMI StudiCare Mindfulness were investigated.MethodsModeration and mediation analyses were based on secondary data from a RCT that examined the effectiveness of the 7-module IMI StudiCare Mindfulness in a sample of college students (intervention group: n = 217; waitlist control group: n = 127). Assessments were collected before (t0; baseline), 4 weeks after (t1; during intervention), and 8 weeks after (t2; post-intervention) randomization. Longitudinal mediation analyses using structural equation modeling were employed, with depressive symptom severity as the dependent variable. For moderation analyses, bilinear interaction models were calculated with depressive symptom severity and mindfulness at t2 as dependent variables. All data-analyses were performed on an intention-to-treat basis.ResultsMediation analyses showed a significant, full mediation of the intervention effect on depressive symptom severity through mindfulness (indirect effect, a*b = 0.153, p &lt; 0.01). Only the number of semesters (interaction: β = 0.24, p = 0.035) was found to moderate the intervention's effectiveness on depressive symptom severity at t2, and only baseline mindfulness (interaction: β = −0.20, p = 0.047) and baseline self-efficacy (interaction: β = −0.27, p = 0.012) were found to be significant moderators of the intervention effect on mindfulness at t2.ConclusionOur results suggest a mediating role of mindfulness. Moderation analyses demonstrated that the intervention improved depressive symptom severity and mindfulness independent of most examined baseline characteristics. Future confirmatory trials will need to support these findings.Clinical Trial RegistrationThe trial was registered a priori at the WHO International Clinical Trials Registry Platform via the German Clinical Studies Trial Register (TRN: DRKS00014774; registration date: 18 May 2018).
Current status and influential factors associated with adherence to self-monitoring of blood glucose with type 2 diabetes mellitus patients in grassroots communities: a cross-sectional survey based on information-motivation-behavior skills model in China
Authors: Lin Manxin , Chen Tingting , Fan Guanhua 
Published: June 2023

ObjectiveSelf-monitoring of blood glucose (SMBG) plays a vital role in the maintenance of blood glucose with type 2 diabetes mellitus(T2DM) and pre-diabetes patients. The study was intended to describe the current status of SMBG with T2DM and pre-diabetes patients in grassroots communities, explore the relationship between SMBG frequency and blood glucose level and apply information-motivation-behavior(IMB) model to analyze the potential influencing factors of SMBG compliance based on electronic questionnaires.MethodsA cross-sectional study was conducted with 1388 T2DM and pre-diabetes patients who completed electronic questionnaires composed of demographics and IMB model content. Chi-square test, Mann-Whitney U test and multivariable logistic regression model analysis were utilized to explore deeply causes of SMBG compliance.ResultsThe results of this study showed that among 1388 T2DM patients, only 26.2% (363/1388) patients reached SMBG standard, indicating low compliance with SMBG. Given that SMBG is one of the individual predictors of type 2 risk in prediabetes patients, this result suggests that the SMBG compliance rate needs to be improved. Patients with fixed occupation (OR=1.989, P=0.035), BMI in normal range (OR=1.336, P=0.049), smoking habit(OR=1.492, P=0.019), understanding SMBG frequency (OR=1.825, P&lt;0.001), understanding control goal of blood glucose (OR=1.414, P&lt;0.001), knowing all the functions of the blood glucose meter (OR=1.923, P&lt;0.001), buying a blood glucose meter/test paper conveniently(OR=2.329, P=0.047), taking supplementary measurement when forgetting blood glucose test(OR=2.044, P=0.005), rotating all the fingers when measuring blood glucose (OR=1.616, P&lt;0.001) and less pain at the needling site(OR=2.114, P&lt;0.001)were independently promoting factors of adherence to SMBG. However, the lack of accessibility and convenience of blood glucose meter or heavy financial burden were blocking factors of adherence to SMBG. Moreover, there were still bottlenecks such as lack of health care knowledge and needle pricking pain.ConclusionThis study verified the practicability of applying IMB model to SMBG with T2DM and pre-diabetes patients. Adherence to SMBG still remained to improved, and putting more emphasis in improvement of individual information, motivation and behavioral skills with patients might be beneficial to maintain better adherence to SMBG in long-term routine of diabetes self-management.
Cord blood-derived CD19-specific chimeric antigen receptor T cells: an off-the-shelf promising therapeutic option for treatment of diffuse large B-cell lymphoma
Authors: Yu Tiantian , Luo Cancan , Zhang Huihui , Tan Yi , Yu Li 
Published: June 2023

PurposeAutologous chimeric antigen receptor (CAR) T cell therapy is one of the most significant breakthroughs in hematological malignancies. However, a three-week manufacturing cycle and ineffective T cell dysfunction in some patients hinder the widespread application of auto-CAR T cell therapy. Studies suggest that cord blood (CB), with its unique biological properties, could be an optimal source for CAR T cells, providing a product with ‘off-the-shelf’ availability. Therefore, exploring the potential of CB as an immunotherapeutic agent is essential for understanding and promoting the further use of CAR T cell therapy.Experimental designWe used CB to generate CB-derived CD19-targeting CAR T (CB CD19-CAR T) cells. We assessed the anti-tumor capacity of CB CD19-CAR T cells to kill diffuse large B cell lymphoma (DLBCL) in vitro and in vivo.ResultsCB CD19-CAR T cells showed the target-specific killing of CD19+ T cell lymphoma cell line BV173 and CD19+ DLBCL cell line SUDHL-4, activated various effector functions, and inhibited tumor progression in a mouse (BALB/c nude) model. However, some exhaustion-associated genes were involved in off-tumor cytotoxicity towards activated lymphocytes. Gene expression profiles confirmed increased chemokines/chemokine receptors and exhaustion genes in CB CD19-CAR T cells upon tumor stimulation compared to CB T cells. They indicated inherent changes in the associated signaling pathways in the constructed CB CAR T cells and targeted tumor processes.ConclusionCB CD19-CAR T cells represent a promising therapeutic strategy for treating DLBCL. The unique biological properties and high availability of CB CD19-CAR T cells make this approach feasible.
Locally advanced rectal cancer with dMMR/MSI-H may be excused from surgery after neoadjuvant anti-PD-1 monotherapy: a multiple-center, cohort study
Authors: Yang Renfang , Wu Tao , Yu Jiehai , Cai Xinyi , Li Guoyu , Li Xiangshu , Huang Weixin , Zhang Ya , Wang Yuqin , Yang Xudong , Ren Yongping , Hu Ruixi , Feng Qing , Ding Peirong , Zhang Xuan , Li Yunfeng 
Published: June 2023

ObjectiveExamine patients with locally advanced rectal cancer (LARC) with deficient mismatch repair (dMMR) or microsatellite instability-high (MSI-H) who received neoadjuvant immunotherapy (nIT), and compare the outcomes of those who chose a watch-and-wait (WW) approach after achieving clinical complete response (cCR) or near-cCR with those who underwent surgery and were confirmed as pathological complete response (pCR).MethodsLARC patients with dMMR/MSI-H who received nIT were retrospectively examined. The endpoints were 2-year overall survival (OS), 2-year disease-free survival (DFS), local recurrence (LR), and distant metastasis (DM). The efficacy of programmed cell death protein-1 (PD-1) inhibitor, immune-related adverse events (irAEs), surgery-related adverse events (srAEs), and enterostomy were also recorded.ResultsTwenty patients who received a PD-1 inhibitor as initial nIT were examined. Eighteen patients (90%) achieved complete response (CR) after a median of 7 nIT cycles, including 11 with pCR after surgery (pCR group), and 7 chose a WW strategy after evaluation as cCR or near-cCR (WW group). Both groups had median follow-up times of 25.0 months. Neither group had a case of LR or DM, and the 2-year DFS and OS in each group was 100%. The two groups had similar incidences of irAEs (P=0.627). In the pCR group, however, 2 patients (18.2%) had permanent colostomy, 3 (27.3%) had temporary ileostomy, and 2 (18.2%) had srAEs.ConclusionNeoadjuvant PD-1 blockade had high efficacy and led to a high rate of CR in LARC patients with dMMR/MSI-H. A WW strategy appears to be a safe and reliable option for these patients who achieve cCR or near-cCR after nIT.
Discrepancies in breast cancer’s oncological outcomes between public and private institutions in the southeast region of Brazil: a retrospective cohort study
Authors: Andrade Diocésio Alves Pinto , Veneziani Ana Carolina , Paiva Carlos Eduardo , Reis Ricardo dos , Filho Carlos Alberto Fruet , Sanches André Octávio Nicolau , Barroso Alison Wagner Azevedo , Paz Alessandra Caroline Moretto Carbinatto , Kons Georgia Cristina de Mello , Preto Daniel D’Almeida , Budib Maria Carolina Bogoni , Safro Maria Augusta , Pinto Gustavo Sanches Faria , Bilibio João Paolo , Souza Cristiano de Pádua 
Published: June 2023

BackgroundBrazil is a middle-income country with inequalities in its healthcare system. The disparities between public and private services affect the diagnosis and treatment of patients with breast cancer. The aim of this study is to assess whether disease-free survival (DFS) and overall survival (OS) are different in public and private specialized centers.Patient and methodsA retrospective cohort study with 1,545 breast cancer patients diagnosed from 2003 to 2011 at Barretos Cancer Hospital—BCH (public group, N = 1,408) and InORP Oncoclinicas (private group, N = 137) was conducted. A 1:1 propensity score matching (PSM) analysis was used to adjust the differences between the groups’ characteristics (n = 137 in each group).ResultsThe median age at diagnosis was 54.4 years. Estimated DFS rates at 1, 5, and 10 years were 96.0%, 71.8%, and 59.6%, respectively, at BCH and 97.8%, 86.9%, and 78%, respectively, at InORP (HR: 2.09; 95% confidence interval [CI], 1.41–3.10; p &lt; 0.0001). Estimated OS rates at 1, 5, and 10 years were 98.1%, 78.5%, and 65.4%, respectively, at BCH and 99.3%, 94.5%, and 91.9%, respectively, at InORP (HR: 3.84; 95% CI, 2.16–6.82; p &lt; 0.0001). After adjustment by PSM, DFS and OS results in 1, 3, and 5 years remained worse in the public service compared to the private service.ConclusionPatients treated in a public center have worse DFS and OS after a follow-up period of more than 5 years. These results were corroborated after carrying out the PSM.
Clinical characteristics of pediatric patients with confirmed SARS-CoV-2 infection who followed rigorous measures during two years of the COVID-19 pandemic in a hospital in Mexico
Authors: Ramírez-Cázares Ana Carolina , Hernández-Ruíz Yodira Guadalupe , Martínez-Longoria César Adrián , Tamez-Gómez César Eduardo , Medina-Macías Obed , Treviño-Montalvo Roberto Guadalupe 
Published: June 2023

BackgroundCOVID-19 infections have been described as asymptomatic or mild, with a low incidence of severe cases in children and adolescents who followed the basic hygiene measures. The objective of this study was to describe the clinical and epidemiological characteristics of our pediatric population during four waves of the COVID-19 pandemic from a private hospital.MethodsA retrospective observational study in patients under 15 years old with confirmed SARS-CoV-2 infection by real-time reverse transcription-polymerase chain reaction (RT-PCR) test from April 1, 2020 to April 30, 2022. Demographic, clinical, and therapy variables were examined, and the Chi-square test was used for comparisons.ResultsFrom 5,870 RT-PCR taken through the first two years of the pandemic, 1,371 tested positive, obtaining a positivity rate of 23.37%. Patients' median (IQR) age was 9.0 (7.0) years, and most were male (n = 705, 51.4%). The primary comorbidities were rhinitis (n = 239, 17.4%) and asthma (n = 172, 12.5%). Most cases were scholars (n = 568, 41.4%) during the fourth COVID-19 wave (n = 831, 60.6%). Almost all cases (88.2%) reported prior exposure to SARS-CoV-2-infected households. Six percent (n = 82) of the patients reported being vaccinated against SARS-CoV-2. Most participants (89.3%) received outpatient care, and 0.6% required hospitalization. Nine (0.6%) patients were diagnosed with Multisystemic Inflammatory Syndrome in Children (MIS-C). The second COVID-19 wave reported a higher frequency of anosmia and dysgeusia; the third wave reported fever and malaise, and the fourth wave reported cough, odynophagia, and vomiting (p &lt; 0.05). The second wave reported no treatment (n = 23, 15.3%), while the third and fourth waves reported outpatient care and hospitalization (n = 367, 95.1%; and n = 4, 1.0%, respectively) (p = &lt;0.001). Reinfection cases were frequent during the second wave (n = 8, 5.3%) (p=&lt;0.001). Rhinorrhea, vomiting, and diarrhea were reported mainly by infants; fever by preschoolers; abdominal pain by scholars; and headache, odynophagia, anosmia, dysgeusia, myalgia, arthralgia, and malaise by adolescents (p &lt; 0.05). Neither treatment nor reinfection showed age-related differences (p = 0.496 and p = 0.224, respectively).ConclusionThe study demonstrated a lower positive rate for SARS-CoV-2 in our hospital'The majority of cases in our study were outpatients who reported a mild infection with a favorable evolution based on symptomatic treatment.
Targeted delivery of silibinin via magnetic niosomal nanoparticles: potential application in treatment of colon cancer cells
Authors: Shafiei Golchin , Jafari-Gharabaghlou Davoud , Farhoudi-Sefidan-Jadid Mahdi , Alizadeh Effat , Fathi Marziyeh , Zarghami Nosratollah 
Published: June 2023

Introduction: In recent years, various nanoparticles (NPs) have been discovered and synthesized for the targeted therapy of cancer cells. Targeted delivery increases the local concentration of therapeutics and minimizes side effects. Therefore, NPs-mediated targeted drug delivery systems have become a promising approach for the treatment of various cancers. As a result, in the current study, we aimed to design silibinin-loaded magnetic niosomes nanoparticles (MNNPs) and investigate their cytotoxicity property in colorectal cancer cell treatment.Methods: MNPs ferrofluids were prepared and encapsulated into niosomes (NIOs) by the thin film hydration method. Afterward, the morphology, size, and chemical structure of the synthesized MNNPs were evaluated using the TEM, DLS, and FT-IR techniques, respectively.Results and Discussion: The distribution number of MNNPs was obtained at about 50 nm and 70 nm with a surface charge of −19.0 mV by TEM and DLS analysis, respectively. Silibinin loading efficiency in NIOs was about 90%, and the drug release pattern showed a controlled release with a maximum amount of about 49% and 70%, within 4 h in pH = 7.4 and pH = 5.8, respectively. To investigate the cytotoxicity effect, HT-29 cells were treated with the various concentration of the drugs for 24 and 48 h and evaluated by the MTT as well as flow cytometry assays. Obtained results demonstrated promoted cell cytotoxicity of silibinin-loaded MNNPs (5-fold decrease in cell viability) compared to pure silibinin (3-fold decrease in cell viability) while had no significant cytotoxic effect on HEK-293 (normal cell line) cells, and the cellular uptake level of MNNPs by the HT-29 cell line was enhanced compared to the control group. In conclusion, silibinin-loaded MNNPs complex can be considered as an efficient treatment approach for colorectal cancer cells.
Optimization of macronutrients for improved grain yield of quinoa (Chenopodium quinoa Wild.) crop under semi-arid conditions of Morocco
Authors: Taaime Nawal , El Mejahed Khalil , Choukr-Allah Redouane , Bouabid Rachid , Oukarroum Abdallah , El Gharous Mohamed 
Published: June 2023

In the context of climate change, quinoa represents a potential alternative crop for increasing crops diversity, agricultural productivity, and farmer’s income in semi-arid regions. However, appropriate crop management practices under limited water supply are still poorly documented. Quinoa, like other cultivated crops, needs optimum quantities of nutrients, especially nitrogen (N), phosphorus (P), and potassium (K), for better growth and high grain yield. To determine the adequate levels of nutrient requirements and their effect on quinoa growth and productivity, a field experiment was conducted during two growing seasons (2020–2021 and 2021–2022). The experiment was conducted in Ben Guerir region, north-central Morocco, and consisted of a randomized complete block design (RCBD) with three replications. The treatments studied consist of a combination of four N rates (0, 40, 80, and 120 kg ha−1), three P rates (0, 30, and 60 kg P2O5 ha−1), and three K rates (0, 60, and 120 kg K2O ha−1). The physiological, nutritional, and production parameters of quinoa were collected and analyzed. The results showed that the highest total biomass (3.9 t ha−1) and grain yield (0.8 t ha−1) under semi-arid conditions were obtained with 40 kg N ha−1, 60 kg P2O5 ha−1, and 120 kg K2O ha−1. The application of 40–60–120 kg ha−1 of N–P2O5–K2O increased plant height by 44%, chlorophyll content index by 96%, total biomass by 134%, grain yield by 112%, and seed weight by 118%. Among the three macronutrients, N was the most limiting factor, followed by K and P. Nutrients uptake data showed that quinoa needs 60 kg N, 26 kg P2O5, and 205 kg K2O to produce 1 t of grain yield. Our field results provide future recommendations for improving the agronomic and environmental sustainability of quinoa cultivation in dryland areas in Morocco.
Knowledge assessment on the functions of government authorities. Assemblymen, council, prefect, and mayor
Authors: León-Alberca Tatiana , Torres-Toukoumidis Angel , Casero-Ripollés Andreu 
Published: June 2023

IntroductionElections allow citizens to participate in the political process and to choose those candidates they consider suitable to govern their nation.MethodsIn this context, this research aims to investigate the level of knowledge of Ecuadorians about the authorities, for which a survey was applied to 1,376 inhabitants from different provinces and ages. The survey evaluated knowledge about executive function, mayor and prefect, legislative office positions, assembly members and councils.ResultsThe information showed that people know more about the functions of the mayor, followed by the assemblyman, prefect and finally council, admitting that age is a correlated factor. It was also seen that Ecuadorians show they know more about the functions of the prefect than of the mayor, also reinforcing the premise: the older the person, the more knowledge he/she has about executive functions of popular representations. However, in legislative functions, there is more knowledge about the work of councils than the members, unlike what was evidenced before. Regarding age, a significant variation is observed, demonstrating that the group between 27 and 64 years is the one with more correct options.ConclusionsThe results reveal the urgent need of governments, academia and society in general to work on electoral processes literacy.