bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of palliative care and rapid emergency screening (P-CaRES) tool, broad and narrow criteria, and surprise questions to predict survival of older emergency department patients
Authors: Koyavatin Siripan , Liu Shan Woo , Sri-on Jiraporn 
Published: June 2023

Abstract
Background
Palliative care is a form of medical care designed to enhance the quality of life of patients with life-threatening conditions. This study was conducted to compare the accuracy of predicted survival the 1 and 3-month survival rate of Broad and narrow criteria, Surprise questions (SQ), and Palliative Care and Rapid Emergency Screening (P-CaRES) after admission to the emergency department (ED).

Methods
This prospective cohort study was conducted at an urban teaching hospital in Thailand. Patients aged ≥ 65 years admitted to the ED were classified according to their emergency severity index (ESI) (Level: 1–3). We collected data on SQ, P-CaRES, and broad and narrow criteria. A survival data of participants were collected at 1 and 3 months after admission to the ED. The survival rate was calculated using the Kaplan–Meier and log-rank tests.

Results
A total of 269 patients completed the study. P-CaRES positive and P-CaRES negative patients had 1-month survival rates of 81% and 94.8%, respectively (P = 0.37), and at 3-month survival rates of 70.7% and 90.1%, respectively (P < 0.001). SQ (not surprised) had a 1-month survival rate of 79.3%, while SQ (surprised) had a 97% survival rate (P = 0.01), and SQ (not surprised) had a 75.4% survival rate at 3-months, while SQ (surprised) had a 96.3% survival rate (P = 0.01). Broad and narrow criteria that were positive and negative had 1-month survival rates of 88.1% and 92.5%, respectively (P = 0.71), while those that were positive and negative had 3-month survival rates of 78.6% and 87.2%, respectively (P = 0.19). The hazard ratio (HR) of SQ (not surprised) at 1 month was 3.22( 95%CI:1.16–8.89). The HR at 3 months of P-CaRES (positive) was 3.31 with a 95% confidence interval (CI): 1.74 − 6.27, while the HR for SQ (not surprise) was 7.33, 95% CI: 3.03–19.79; however, broad and narrow criteria had an HR of 1.78, 95% CI:0.84–3.77.

Conclusions
Among older adults who visited the ED, the SQ were good prognosis tools for predicting 1 and 3-month survival, and P-CaRES were good prognostic tools for predicting 3-month survival.
The mediating effect of job satisfaction and emotional exhaustion on the relationship between psychological empowerment and turnover intention among Chinese nurses during the COVID-19 pandemic: a cross-sectional study
Authors: Ding Jinliang , Wu Yufang 
Published: June 2023

Abstract
Background
Turnover intention occurs frequently in nurses and psychological empowerment has been shown to be major factors that influence turnover intention. However, little is known about the driving force behind turnover intention among nurses in China during the COVID-19 pandemic.

Objectives
To investigate the mediating role of job satisfaction and emotional exhaustion on the association between psychological empowerment and turnover intention among Chinese nurses during the COVID-19 pandemic.

Methods
A cross-sectional design was conducted in China. A total of 507 nurses completed scales of psychological empowerment, job satisfaction, emotional exhaustion and turnover intention anonymously. Descriptive analysis, Pearson’s correlation analysis in SPSS 23.0 and structural equation modeling (SEM) by Mplus 7.4

Results
Psychological empowerment had a significantly effect on turnover intention through three significantly indirect pathways: (1) through job satisfaction (B = -0.14, SE = .03, 95% CI = [-.19, -.09]). (2) through emotional exhaustion (B = -0.07, SE = .02, 95% CI = [-.11, -.03]). (3) through the chain mediating effect of “job satisfaction → emotional exhaustion” (B = -0.12, SE = .02, 95% CI = [-.16, -.09]).

Conclusions
Intervention measures to reduce the incidence of turnover intention of nurses should include the evaluations of work demands and emotional exhaustion of nurses and organization’s management strategies to promote their psychological empowerment and job satisfaction.
Perceptions of nurses regarding quality of adult cardiopulmonary resuscitation in Ghana: a qualitative study
Authors: Amoako-Mensah Esther , Achempim-Ansong Gloria , Gbordzoe Newton Isaac , Adofo Cornelia Esson , Sarfo Jacob Owusu 
Published: June 2023

Abstract
Objectives
Cardiopulmonary resuscitation (CPR) is a necessary life-saving emergency intervention for patients with cardiac arrest and other medical conditions. The study’s primary objective was to qualitatively explore nurses’ perceptions of the quality of adult cardiopulmonary resuscitation in Ghana.

Methods
An exploratory descriptive qualitative study was conducted among 13 purposively sampled nurses in Ghana. We collected thirteen face-to-face and telephone interviews using a semi-structured interview guide. Data were transcribed verbatim and analysed using the thematic analysis approach recommended by Braun and Clarke.

Results
Data analysis revealed that nurses were filled with positive emotions when patients regained consciousness following resuscitation. When the otherwise happens, they tend to become tortured psychologically and filled with negative emotions. Besides, environmental factors such as the time of initiating CPR following a cardiac arrest, the availability and appropriateness of equipment and medications, workplace ergonomics, and institutional regulations affected the quality of resuscitation practices of nurses. Participants perceived that attitudes of condemnation, prejudice, apathy and skills deficiency also impacted the quality of resuscitation practices. Significant aspects of self-reported behavioural competence that affected resuscitation were knowledge and skills of CPR, confidence in initiating CPR, and the need for effort maximisation.

Conclusion
This study revealed several non-medical factors that influenced the resuscitation practices of nurses from their perspective. Nurses need to maximise their effort toward seeking further education in speciality areas such as emergency nursing and critical care nursing to guide their CPR practices and other newly emerging evidence-based protocols.
Patient and clinician perspectives of a remote monitoring program for COVID-19 and lessons for future programs
Authors: Chaiyachati Krisda H. , Shea Judy A. , Ward Michaela , Nelson Maria N. , Ghosh Medha , Reilly Julianne , Kelly Sheila , Chisholm Deena L. , Barbati Zoe , Hemmons Jessica E. , Abdel-Rahman Dina , Ebert Jeffrey P. , Xiong Ruiying A. , Snider Christopher K. , Lee Kathleen C. , Friedman Ari B. , Meisel Zachary F. , Kilaru Austin S. , Asch David A. , Delgado M. Kit , Morgan Anna U. 
Published: June 2023

AbstractCOVID Watch is a remote patient monitoring program implemented during the pandemic to support home dwelling patients with COVID-19. The program conferred a large survival advantage. We conducted semi-structured interviews of 85 patients and clinicians using COVID Watch to understand how to design such programs even better. Patients and clinicians found COVID Watch to be comforting and beneficial, but both groups desired more clarity about the purpose and timing of enrollment and alternatives to text-messages to adapt to patients’ preferences as these may have limited engagement and enrollment among marginalized patient populations. Because inclusiveness and equity are important elements of programmatic success, future programs will need flexible and multi-channel human-to-human communication pathways for complex clinical interactions or for patients who do not desire tech-first approaches.
Circular RNA FEACR inhibits ferroptosis and alleviates myocardial ischemia/reperfusion injury by interacting with NAMPT
Authors: Ju Jie , Li Xin-Min , Zhao Xue-Mei , Li Fu-Hai , Wang Shao-Cong , Wang Kai , Li Rui-Feng , Zhou Lu-Yu , Liang Lin , Wang Yin , Zhang Yu-Hui , Wang Kun 
Published: June 2023

Abstract
Background
Emerging research has reported that circular RNAs (circRNAs) play important roles in cardiac cell death after myocardial ischemia and reperfusion (I/R). Ferroptosis, a new form of cell death discovered in recent years, has been proven to participate in the regulation of myocardial I/R. This study used circRNA sequencing to explore the key circRNA in the regulation of cardiac ferroptosis after I/R and study the mechanisms of potential circRNA function.

Methods
We performed circRNA sequencing to explore circRNAs differentially expressed after myocardial I/R. We used quantitative polymerase chain reactions to determine the circRNA expression in different tissues and detect the circRNA subcellular localization in the cardiomyocyte. Gain- and loss-of-function experiments were aimed to examine the function of circRNAs in cardiomyocyte ferroptosis and cardiac tissue damage after myocardial I/R. RNA pull-down was applied to explore proteins interacting with circRNA.

Results
Here, we identified a ferroptosis-associated circRNA (FEACR) that has an underlying regulatory role in cardiomyocyte ferroptosis. FEACR overexpression suppressed I/R-induced myocardial infarction and ameliorated cardiac function. FEACR inhibition induces ferroptosis in cardiomyocytes and FEACR overexpression inhibits hypoxia and reoxygenation-induced ferroptosis. Mechanistically, FEACR directly bound to nicotinamide phosphoribosyltransferase (NAMPT) and enhanced the protein stability of NAMPT, which increased NAMPT-dependent Sirtuin1 (Sirt1) expression, which promoted the transcriptional activity of forkhead box protein O1 (FOXO1) by reducing FOXO1 acetylation levels. FOXO1 further upregulated the transcription of ferritin heavy chain 1 (Fth1), a ferroptosis suppressor, which resulted in the inhibition of cardiomyocyte ferroptosis.

Conclusions
Our finding reveals that the circRNA FEACR-mediated NAMPT-Sirt1-FOXO1-FTH1 signaling axis participates in the regulation of cardiomyocyte ferroptosis and protects the heart function against I/R injury. Thus, FEACR and its downstream factors could be novel targets for alleviating ferroptosis-related myocardial injury in ischemic heart diseases.
Treatment of obstructive sleep apnea in high risk pregnancy: a multicenter randomized controlled trial
Authors: Tantrakul Visasiri , Ingsathit Atiporn , Liamsombut Somprasong , Rattanasiri Sasivimol , Kittivoravitkul Prapun , Imsom-Somboon Nutthaphon , Lertpongpiroon Siwaporn , Jantarasaengaram Surasak , Somchit Werapath , Suwansathit Worakot , Pengjam Janejira , Siriyotha Sukanya , Panburana Panyu , Guilleminault Christian , Preutthipan Aroonwan , Attia John , Thakkinstian Ammarin 
Published: June 2023

Abstract
Background
Obstructive sleep apnea (OSA) during pregnancy is a risk factor for preeclampsia possibly through a link to placental physiology. This study evaluates the efficacy of continuous positive airway pressure (CPAP) on the modulation of blood pressure and the reduction in preeclampsia in women with high-risk pregnancy and OSA.

Methods
A multicenter open-label, randomized controlled trial comparing CPAP treatment versus usual antenatal care was conducted in three academic hospitals in Bangkok, Thailand. Participants included singleton pregnant women aged older than 18 years with any high-risk condition (i.e., chronic hypertension, obesity, history of preeclampsia or gestational diabetes in the previous pregnancy, or diabetes), and OSA (respiratory disturbance index 5–29.99 events/hour by polysomnography), who presented either in the first trimester (gestational age, GA 0–16 weeks) or subsequently developed OSA during the 2nd trimester (GA 24–28 weeks). The primary endpoint was blood pressure during antenatal care. Secondary endpoints included the incidence of preeclampsia. An intention-to-treat analysis was performed with additional per-protocol and counterfactual analyses for handling of nonadherence.

Results
Of 340 participants, 96.5% were recruited during the first trimester. Thirty participants were later excluded leaving 153 and 157 participants in the CPAP and usual-care groups for the modified-intention-to-treat analysis. CPAP adherence rate was 32.7% with average use of 2.5 h/night. Overall, CPAP treatment significantly lowered diastolic blood pressure (DBP) by − 2.2 mmHg [95% CI (− 3.9, − 0.4), p = 0.014], representing approximately − 0.5 mmHg per hour of CPAP use [95%CI (− 0.89, − 0.10), p = 0.013]. CPAP treatment also altered the blood pressure trajectory by continuously lowering DBP throughout pregnancy with mean differences (95% CI) of − 3.09 (− 5.34, − 0.93), − 3.49 (− 5.67, − 1.31) and − 3.03 (− 5.20, − 0.85) mmHg at GA 18–20, 24–28, and 32–34 weeks, respectively compared to 0–16 weeks. Preeclampsia rate was 13.1% (20/153 participants) in the CPAP and 22.3% (35/157 participants) in the usual-care group with a risk difference (95% CI) of − 9% (− 18%, − 1%, p-value = 0.032) and a number-needed-to-treat (95% CI) of 11 (1, 21).

Conclusions
CPAP treatment in women with even mild-to-moderate OSA and high-risk pregnancy demonstrated reductions in both DBP and the incidence of preeclampsia. CPAP treatment also demonstrated a sustained reduction in DBP throughout gestation.
Trial registration ClinicalTrial.GovNCT03356106, retrospectively registered November 29, 2017.
Implementation of PM-JAY in India: a qualitative study exploring the role of competency, organizational and leadership drivers shaping early roll-out of publicly funded health insurance in three Indian states
Authors: Srivastava Swati , Bertone Maria Paola , Basu Sharmishtha , De Allegri Manuela , Brenner Stephan 
Published: June 2023

Abstract
Background
The Pradhan Mantri Jan Arogya Yojana (PM-JAY), a publicly funded health insurance scheme, was launched in India in September 2018 to provide financial access to health services for poor Indians. PM-JAY design enables state-level program adaptations to facilitate implementation in a decentralized health implementation space. This study examines the competency, organizational, and leadership approaches affecting PM-JAY implementation in three contextually different Indian states.

Methods
We used a framework on implementation drivers (competency, organizational, and leadership) to understand factors facilitating or hampering implementation experiences in three PM-JAY models: third-party administrator in Uttar Pradesh, insurance in Chhattisgarh, and hybrid in Tamil Nadu. We adopted a qualitative exploratory approach and conducted 92 interviews with national, state, district, and hospital stakeholders involved in program design and implementation in Delhi, three state capitals, and two anonymized districts in each state, between February and April 2019. We used a deductive approach to content analysis and interpreted coded material to identify linkages between organizational features, drivers, and contextual elements affecting implementation.

Results and conclusion
PM-JAY guideline flexibilities enabled implementation in very different states through state-adapted implementation models. These models utilized contextually relevant adaptations for staff and facility competencies and organizational and facilitative administration, which had considerable scope for improvement in terms of recruitment, competency development, programmatic implementation support, and rationalizing the joint needs of the program and implementers. Adaptations also created structural barriers in staff interactions and challenged implicit power asymmetries and organizational culture, indicating a need for aligning staff hierarchies and incentive structures. At the same time, specific adaptations such as decentralizing staff selection and task shifting (all models); sharing of claims processing between the insurer and state agency (insurance and hybrid model); and using stringent empanelment, accreditation, monitoring, and benchmarking criteria for performance assessment, and reserving secondary care benefit packages for public hospitals (both in the hybrid model) contributed to successful implementation. Contextual elements such as institutional memory of previous schemes and underlying state capacities influenced all aspects of implementation, including leadership styles and autonomy. These variations make comparisons across models difficult, yet highlight constraints and opportunities for cross-learning and optimizing implementation to achieve universal health coverage in decentralized contexts.
Unique features of the arterial blood–brain barrier
Authors: Bell Batia , Anzi Shira , Sasson Esther , Ben-Zvi Ayal 
Published: June 2023

AbstractCNS vasculature differs from vascular networks of peripheral organs by its ability to tightly control selective material exchange across capillary barriers. Capillary permeability is mostly defined by unique cellular components of the endothelium. While capillaries are extensively investigated, the barrier properties of larger vessels are understudied. Here, we investigate barrier properties of CNS arterial walls. Using tracer challenges and various imaging modalities, we discovered that at the mouse cortex, the arterial barrier does not reside at the classical level of the endothelium. The arterial wall’s unique permeability acts bi-directionally; CSF substances travel along the glymphatic path and can penetrate from the peri-vascular space through arteriolar walls towards the lumen. We found that caveolae vesicles in arteriole endothelial are functional transcytosis machinery components, and that a similar mechanism is evident in the human brain. Our discoveries highlight vascular heterogeneity investigations as a potent approach to uncover new barrier mechanisms.
Gegen Qinlian Decoction treatment of asymptomatic hyperuricemia by targeting circadian immune function
Authors: Wang Xiaojun , Liu Xuanqi , Gao Qiushuang , Gu Xuchao , Zhang Guannan , Sheng Zhiyuan , Wu Tao , Su Zheling , Wang Wenhao , Ye Maoqing 
Published: June 2023

AbstractBackgroundThe Gegen Qinlian Decoction (GGQLD) is a renowned traditional Chinese medicinal formula that has been used for centuries to effectively treat asymptomatic Hyperuricemia (HUA). This study aims to investigate the underlying mechanism of GGQLD's therapeutic effects on HUA.MethodsThe study enrolled a total of 25 healthy participants and 32 middle-aged and elderly individuals with asymptomatic HUA. All asymptomatic HUA participants were treated with GGQLD. Venous blood samples were collected from all participants to isolate peripheral blood mononuclear cells (PBMCs), which were then analyzed for biological profiles using flow cytometry. Network pharmacology analysis was utilized to identify the potential pathways involved in the therapeutic effects of GGQLD. Transcriptomic patterns of cultured proximal tubule epithelial cells (PTECs) were evaluated via bulk RNA-seq, and critical differentially expressed genes (DEGs) were identified and verified through ELISA. Molecular docking and molecular dynamics (MD) simulation were employed to investigate the potential compounds in GGQLD that may be involved in treating HUA.ResultsNetwork pharmacology analysis revealed that immune-related pathways might be involved in the therapeutic mechanism of GGQLD. RNA-seq analysis confirmed the involvement of innate lymphoid cell (ILC) development-related genes and clock genes. Polychromatic flow cytometric analysis demonstrated that GGQLD treatment reduced the proportion of ILC3s in total ILCs in asymptomatic HUA patients. ELISA results showed that GGQLD treatment reduced the levels of activating factors, such as ILC3-IL-18 and IL-1β, in the plasma of HUA patients. GGQLD was also found to regulate circadian clock gene expression in PBMCs to treat asymptomatic HUA. Furthermore, the interaction between 40 compounds in GGQLD and HDAC3 (Histone Deacetylase 3), NLRP3 (NOD-like receptor protein 3), RORA (RAR-related orphan receptor A), and REV-ERBα (nuclear receptor subfamily 1) revealed that GGQLD may regulate ILCs and clock genes to treat asymptomatic HUA.ConclusionsThe regulation of circadian clock gene expression and the proportion of ILC cells may be involved in the therapeutic effects of GGQLD on asymptomatic HUA patients.
LCK facilitates DNA damage repair by stabilizing RAD51 and BRCA1 in the nucleus of chemoresistant ovarian cancer
Authors: Dey Goutam , Bharti Rashmi , Braley Chad , Alluri Ravi , Esakov Emily , Crean-Tate Katie , McCrae Keith , Joehlin-Price Amy , Rose Peter G. , Lathia Justin , Gong Zihua , Reizes Ofer 
Published: June 2023

AbstractPoly-ADP Ribose Polymerase (PARP) targeted therapy is clinically approved for the treatment of homologous recombination (HR) repair deficient tumors. The remarkable success of this therapy in the treatment of HR repair deficient cancers has not translated to HR-proficient cancers. Our studies identify the novel role of non-receptor lymphocyte-specific protein tyrosine kinase (LCK) in the regulation of HR repair in endometrioid epithelial ovarian cancer (eEOC) model. We show that DNA damage leads to direct interaction of LCK with the HR repair proteins RAD51 and BRCA1 in a kinase dependent manner RAD51 and BRCA1 stabilization. LCK expression is induced and activated in the nucleus in response to DNA damage insult. Disruption of LCK expression attenuates RAD51, BRCA1, and BRCA2 protein expression by hampering there stability and results in inhibition of HR-mediated DNA repair including suppression of RAD51 foci formation, and augmentation of γH2AX foci formation. In contrast LCK overexpression leads to increased RAD51 and BRCA1 expression with a concomitant increase in HR DNA damage repair. Importantly, attenuation of LCK sensitizes HR-proficient eEOC cells to PARP inhibitor in cells and pre-clinical mouse studies. Collectively, our findings identify a novel therapeutic strategy to expand the utility of PARP targeted therapy in HR proficient ovarian cancer.
Graphical Abstract
Comparison of anti-Müllerian hormone and antral follicle count in the prediction of ovarian response: a systematic review and meta-analysis
Authors: Liu Yang , Pan Zhengmei , Wu Yanzhi , Song Jiamei , Chen Jingsi 
Published: June 2023

Abstract
Background
Increasingly studies reported that the Anti-Müllerian hormone (AMH) seems to be a promising and reliable marker of functional ovarian follicle reserve, even better than the AFC test. Our study aimed to conduct a meta-analysis to assess the predictive value of AMH and AFC for predicting poor or high response in IVF treatment. An electronic search was conducted, and the following databases were used: PubMed, EMBASE, and the Cochrane Library (up to 7 May 2022). The bivariate regression model was used to calculate the pooled sensitivity, specificity, and area under the receiver operator characteristic (ROC) curve. Subgroup analyses and meta-regression also were used in the presented study. Overall performance was assessed by estimating pooled ROC curves between AMH and AFC.

Results
Forty-two studies were eligible for this meta-analysis. Comparison of the summary estimates for the prediction of poor or high response showed significant difference in performance for AMH compared with AFC [poor (sensitivity: 0.80 vs 0.74, P < 0.050; specificity: 0.81 vs 0.85, P < 0.001); high (sensitivity: 0.81 vs 0.87, P < 0.001)]. However, there were no significant differences between the ROC curves of AMH and AFC for predicting high (P = 0.835) or poor response (P = 0.567). The cut-off value was a significant source of heterogeneity in the present study.

Conclusions
The present meta-analysis demonstrated that both AMH and AFC have a good predictive ability to the prediction of poor or high responses in IVF treatment.