bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of no cost sharing for paediatric care on healthcare usage by household income levels: regression discontinuity design
Authors: Fukuma Shingo , Kato Hirotaka , Takaku Reo , Tsugawa Yusuke 
Published: August 2023

ObjectivesTo investigate the impact of no cost sharing on paediatric care on usage and health outcomes, and whether the effect varies by household income levels.DesignRegression discontinuity design.SettingNationwide medical claims database in Japan.ParticipantsChildren aged younger than 20 years from April 2018 to March 2022.ExposureCo-insurance rate that increases sharply from 0% to 30% at a certain age threshold (the threshold age varies between 6 and 20 years depending on region).Primary outcome measuresThe outpatient care usage (outpatient visit days and healthcare spending for outpatient care) and inpatient care (experience of any hospitalisation and healthcare spending for inpatient care).ResultsOf 244 549 children, 49 556 participants were in the bandwidth and thus included in our analyses. Results from the regression discontinuity analysis indicate that no cost sharing was associated with a significant increase in the number of outpatient visit days (+5.26 days; 95% CI, +4.89 to +5.82; p<0.01; estimated arc price elasticity, −0.45) and in outpatient healthcare spending (+US$369; 95% CI, +US$344 to +US$406; p<0.01; arc price elasticity, −0.55). We found no evidence that no cost sharing was associated with changes in inpatient care usage. Notably, the effect of no cost-sharing policy on outpatient healthcare usage was larger among children from high-income households (visit days +5.96 days; 95% CI, +4.88 to +7.64, spending +US$511; 95% CI, +US$440 to +US$627) compared with children from low-income households (visit days +2.64 days; 95% CI, +1.54 to +4.23, spending +US$154; 95% CI, +US$80 to +US$249).ConclusionsNo cost sharing for paediatric care was associated with a greater usage of outpatient care services, but did not affect inpatient care usage. The study found that this effect was more pronounced among children from high-income households, indicating that the no cost sharing disproportionately benefits high-income households and may contribute to larger disparities.
Effects of coaching on medical student well-being and distress: a systematic review protocol
Authors: Breslin Lauren , Dyrbye Liselotte , Chelf Cynthia , West Colin 
Published: August 2023

IntroductionMedical students experience higher rates of distress and burnout compared with their age-similar peers overall. Coaching has been proposed as one means of combating distress and burnout within the medical profession. The purpose of this systematic review is to synthesise the current evidence on the effects of coaching interventions on medical student well-being, including engagement, resilience, quality of life, professional fulfilment and meaning in work and distress, including burnout, anxiety and depressive symptoms.Methods and analysisWe will conduct a systematic review of interventional and observational comparative studies that assess the effects of coaching interventions on well-being, including engagement, resilience, quality of life, professional fulfilment and meaning in work and distress, including burnout, anxiety and depressive symptoms among undergraduate medical students internationally. We will search PubMed (MEDLINE), Embase (OVID), PsycINFO (OVID), Scopus, ERIC, Cochrane Database of Systematic Reviews (OVID) and Cochrane Central Register of Controlled Trials (OVID) from their respective inception dates using the following search terms: (medical students OR medical student OR undergraduate medical education) AND (coach OR coaching OR coaches). Studies in any language will be eligible. Studies that report one or more outcomes of distress or well-being among medical students who receive a coaching intervention will be included. Data on participant and intervention characteristics, outcomes and instruments used will be collected as well as quality/risk of bias assessments. Two reviewers will screen studies against the inclusion criteria and perform data extraction. We will conduct a narrative synthesis, with meta-analysis if evidence permits quantitative pooling of results. Heterogeneity of results across studies according to study design, learner level and study risk of bias will be evaluated, as well as publication bias.Ethics and disseminationEthical approval is not required for this review. Results will be disseminated by publication in a scientific journal.PROSPERO registration numberCRD42022322503.
Cytokine pattern in patients with ST-elevation myocardial infarction treated with the interleukin-6 receptor antagonist tocilizumab
Authors: Woxholt Sindre , Ueland T , Aukrust Pål , Anstensrud Anne Kristine , Broch Kaspar , Tøllefsen Ingvild Maria , Ryan Liv , Bendz Bjørn , Hopp Einar , Kløw Nils-Einar , Seljeflot Ingebjørg , Halvorsen Bente , Dahl Tuva B , Huse Camilla , Andersen Geir Øystein , Gullestad Lars , Wiseth Rune , Amundsen Brage H , Damas Jan Kristian , Kleveland Ola 
Published: August 2023

BackgroundTocilizumab improves myocardial salvage index (MSI) in patients with ST-elevation myocardial infarction (STEMI), but its mechanisms of action are unclear. Here, we explored how cytokines were affected by tocilizumab and their correlations with neutrophils, C-reactive protein (CRP), troponin T, MSI and infarct size.MethodsSTEMI patients were randomised to receive a single dose of 280 mg tocilizumab (n=101) or placebo (n=98) before percutaneous coronary intervention. Blood samples were collected before infusion of tocilizumab or placebo at baseline, during follow-up at 24–36, 72–168 hours, 3 and 6 months. 27 cytokines were analysed using a multiplex cytokine assay. Cardiac MRI was performed during hospitalisation and 6 months.ResultsRepeated measures analysis of variance showed significant (p<0.001) between-group difference in changes for IL-6, IL-8 and IL-1ra due to an increase in the tocilizumab group during hospitalisation. IL-6 and IL-8 correlated to neutrophils in the placebo group (r=0.73, 0.68, respectively), which was attenuated in the tocilizumab group (r=0.28, 0.27, respectively). A similar pattern was seen for MSI and IL-6 and IL-8 in the placebo group (r=−0.29, –0.25, respectively) in patients presenting ≤3 hours from symptom onset, which was attenuated in the tocilizumab group (r=−0.09,–0.14, respectively).ConclusionsTocilizumab increases IL-6, IL-8 and IL-1ra in STEMI. IL-6 and IL-8 show correlations to neutrophils/CRP and markers of cardiac injury in the placebo group that was attenuated in the tocilizumab group. This may suggest a beneficial effect of tocilizumab on the ischaemia-reperfusion injury in STEMI patients.Trial registration numberNCT03004703.
Acute palliative care models: scoping review
Authors: Ohana Shulamit , Shaulov Adir , DeKeyser Ganz Freda 
Published: August 2023

ObjectiveThe goal of this scoping review is to identify the most commonly used models of palliative care delivery in acute care settings, their advantages and disadvantages, and to review existent research evidence in support of each model.MethodsWe conducted an extensive search using EMBASE, Medline, CINAHL and Pubmed, using various combinations of terms relating to models in palliative care and acute care settings. Data were analysed using tabular summaries and content analysis.Results41 articles were analysed. Four models were identified: primary, consultative, integrative and hybrid models of palliative care. All four models have varying characteristics in terms of access to specialist palliative care; fragmentation of healthcare services; therapeutic relationships between patients and providers; optimal usage of scarce palliative care resources; timing of provision of palliative care; communication and collaboration between providers and clarity of provider roles. Moreover, all four models have different patient outcomes and healthcare utilisation. Gaps in research limit the ability to determine what model of care is more applicable in an acute care setting.ConclusionNo ideal model of care was identified. Each model had its advantages and disadvantages. Future work is needed to investigate which setting one model may be better than the other.
Nutrition risk and cognitive performance in community-living older adults without cognitive impairment: a cross-sectional analysis of the Canadian Longitudinal Study on Aging
Authors: Trinca Vanessa , Anderson Nicole D. , Fiocco Alexandra J. , Ferland Guylaine , Laurin Danielle , Keller Heather H. 
Published: August 2023

Malnutrition is correlated with poor cognition; however, an understanding of the association between nutrition risk, which precedes malnutrition, and cognition is lacking. This study aimed to determine if nutrition risk measured with the SCREEN-8 tool is associated with cognitive performance among cognitively healthy adults aged 55+, after adjusting for demographic and lifestyle covariates. Sex- and age-stratified analyses were also explored. Baseline data from the Canadian Longitudinal Study on Aging was used. Cognition was determined using a 6-measure composite score based on four executive functions and two memory tasks, taking into account age, sex, and education. Multivariable linear regression was performed while adjusting for body mass index (BMI), lifestyle, and health covariates in the entire sample ( n = 11 378) and then stratified by sex and age. Approximately half of participants were female (54.5%) aged 65+ (54.1%). Greater nutrition risk was associated with poorer cognitive performance in the entire sample ( F[1, 11 368] = 5.36, p = 0.021) and among participants aged 55–64 ( n = 5227; F[1, 5217] = 5.45, p = 0.020). Sex differences in lifestyle and health factors associated with cognition were apparent, but nutrition risk was not associated with cognition in sex-stratified models. Based on this analysis, there may be an association between nutrition risk and cognitive performance in older adults. When screening for either cognitive impairment or nutrition risk, complementary assessments for these conditions is warranted, as early intervention may provide benefit.
Lightbox: Sensor Attack Detection for Photoelectric Sensors via Spectrum Fingerprinting
Authors: Kim Dohyun , Cho Mangi , Shin Hocheol , Kim Jaehoon , Noh Juhwan , Kim Yongdae 
Published: August 2023

Photoelectric sensors are utilized in a range of safety-critical applications, such as medical devices and autonomous vehicles. However, the public exposure of the input channel of a photoelectric sensor makes it vulnerable to malicious inputs. Several studies have suggested possible attacks on photoelectric sensors by injecting malicious signals. While a few defense techniques have been proposed against such attacks, they could be either bypassed or used for limited purposes.
In this study, we propose Lightbox, a novel defense system to detect sensor attacks on photoelectric sensors based on signal fingerprinting. Lightbox uses the spectrum of the received light as a feature to distinguish the attacker’s malicious signals from the authentic signal, which is a signal from the sensor’s light source. We evaluated Lightbox against (1) a saturation attacker, (2) a simple spoofing attacker, and (3) a sophisticated attacker who is aware of Lightbox and can combine multiple light sources to mimic the authentic light source. Lightbox achieved the overall accuracy over 99% for the saturation attacker and simple spoofing attacker, and robustness against a sophisticated attacker. We also evaluated Lightbox considering various environments such as transmission medium, background noise, and input waveform. Finally, we demonstrate the practicality of Lightbox with experiments using a single-board computer after further reducing the training time.
Nanoparticle Delivery of Immunostimulatory Alu RNA for Cancer Immunotherapy
Authors: Garland Kyle M. , Kwiatkowski Alexander J. , Tossberg John T. , Crooke Philip S. , Aune Thomas M. , Wilson John T. 
Published: August 2023

It was recently found that patients with relapsing remitting multiple sclerosis exhibit widespread loss of adenosine-to-inosine (A-to-I) RNA editing, which contributes to the accumulation of immunostimulatory double-stranded Alu RNA in circulating leukocytes and an attendant increase in levels of proinflammatory cytokines (e.g., type I IFNs). A specific Alu RNA (i.e., AluJb RNA) was implicated in activating multiple RNA-sensing pathways and found to be a potent innate immune agonist. Here, we have performed a bioinformatic analysis of A-to-I RNA editing in human melanoma samples and determined that pre-therapy levels of A-to-I RNA editing negatively correlate with survival times, suggesting that an accumulation of endogenous double-stranded Alu RNA might contribute to cancer patient survival. Furthermore, we demonstrated that immunostimulatory Alu RNA can be leveraged pharmacologically for cancer immunotherapy. AluJb RNA was in vitro transcribed and then formulated with endosome-destabilizing polymer nanoparticles to improve intracellular delivery of the RNA and enable activation of RNA-sensing pathways. AluJb RNA/polymer complexes (i.e., Alu-NPs) were engineered to form colloidally stable nanoparticles that exhibited immunostimulatory activity in vitro and in vivo. Finally, the therapeutic potential of Alu-NPs for the treatment of cancer was demonstrated by attenuated tumor growth and prolonged survival in the B16.F10 murine melanoma tumor model. Thus, these data collectively implicate intratumoral Alu RNA as a potentiator of antitumor innate immunity and identify AluJb RNA as a novel nucleic acid immunotherapeutic for cancer.

Significance:
Loss of A-to-I editing leads to accumulation of unedited Alu RNAs that activate innate immunity via RNA-sensing pattern recognition receptors. When packaged into endosome-releasing polymer nanoparticles, AluJB RNA becomes highly immunostimulatory and can be used pharmacologically to inhibit tumor growth in mouse melanoma models. These findings identify Alu RNAs as a new class of nucleic acid innate immune agonists for cancer immunotherapy.
A Druggable FOXA1-Glucocorticoid Receptor Transcriptional Axis Drives Tumor Growth in a Subset of Non-Small Cell Lung Cancer
Authors: Dorso M. , Patel Payal T. , Pankov Aleksandr , Boyer Jacob A. , Soni Rajesh K. , Del Priore Isabella S. , Hayatt Omar , Kulick Amanda , Hagen Connor J. , de Stanchina Elisa , Junttila Melissa R. , Daemen Anneleen , Friedman Lori S. , Hendrickson Ronald C. , Chandarlapaty Sarat 
Published: August 2023

The FOXA1 pioneer factor is an essential mediator of steroid receptor function in multiple hormone-dependent cancers, including breast and prostate cancers, enabling nuclear receptors such as estrogen receptor (ER) and androgen receptor (AR) to activate lineage-specific growth programs. FOXA1 is also highly expressed in non–small cell lung cancer (NSCLC), but whether and how it regulates tumor growth in this context is not known. Analyzing data from loss-of-function screens, we identified a subset of NSCLC tumor lines where proliferation is FOXA1 dependent. Using rapid immunoprecipitation and mass spectrometry of endogenous protein, we identified chromatin-localized interactions between FOXA1 and glucocorticoid receptor (GR) in these tumor cells. Knockdown of GR inhibited proliferation of FOXA1-dependent, but not FOXA1-independent NSCLC cells. In these FOXA1-dependent models, FOXA1 and GR cooperate to regulate gene targets involved in EGF signaling and G1–S cell-cycle progression. To investigate the therapeutic potential for targeting this complex, we examined the effects of highly selective inhibitors of the GR ligand-binding pocket and found that GR antagonism with ORIC-101 suppressed FOXA1/GR target expression, activation of EGF signaling, entry into the S-phase, and attendant proliferation in vitro and in vivo. Taken together, our findings point to a subset of NSCLCs harboring a dependence on the FOXA1/GR growth program and provide rationale for its therapeutic targeting.

Significance:
NSCLC is the leading cause of cancer deaths worldwide. There is a need to identify novel druggable dependencies. We identify a subset of NSCLCs dependent on FOXA1-GR and sensitive to GR antagonism.
Hezekiah’s “Showing” and the Babylonian Ambassadors’ “Seeing” of the Royal Treasures
Authors: Martins Francisco 
Published: August 2023

Abstract
The book of Kings offers a detailed description of Hezekiah’s reign. Among the episodes recorded, there is the visit of a Babylonian embassy to whom the king shows the treasures of his palace. This act prompts the prophet Isaiah to announce that all these riches will be carried away to Babylon (2 Kgs 20:12–19). Although the plot is relatively straightforward in its broad contours, scholars have struggled to make sense of the relationship between the king’s gesture and Isaiah’s reaction. This article argues that a semantic-pragmatic phenomenon observed in Akkadian offers a path towards a new understanding of the text’s inner logic and meaning. Hezekiah’s “showing” and the Babylonian envoys’ “seeing” of the royal treasures acquire, in light of the parallel evoked, unexpected “legal overtones”: the king’s actions constitute a kind of legal symbolic act, whose dire consequences are fully explicated by Isaiah’s pronouncement.
Passover and the Festival of Unleavened Bread as a Single Ritual Complex
Authors: Thames John Tracy 
Published: August 2023

Abstract
Discussions of the prehistory of the rituals Passover and the Festival of Unleavened Bread have frequently held that they stem from distinct origins and purposes. In part, this claim corresponds with the biblical presentation of the rituals as distinct and separable. But in an academic tradition reaching back to the early 19th century, scholarly reconstructions have additionally assumed that the rituals suggest sociological details about the putatively distinct populations that observed them—that Passover was a rite associated with nomadic pastoralists and Unleavened Bread served an agrarian populace. This article challenges such notions based on ritual texts from Emar. Emar’s ritual writings—especially those detailing the zukru festival—demonstrate that Passover and the Festival of Unleavened Bread share a structure for equinoctial ritualizing that suggests a history of those rites as integral to one another and refutes notions of their separability based on equation with social lifestyles.
From Missed Tolerance to Civil Equality
Authors: Dumitran Daniel 
Published: August 2023

Abstract
The analysis dedicated to the history of Transylvanian Jews follows their communities’ evolution in a regional context, from the perspective of integration projects, through the policy of tolerance and civil equality recognition, to see whether the tendencies characteristic of Central Europe, and especially Hungary, were relevant for them. The investigation refers to the last quarter of the eighteenth century and the first half of the nineteenth century, defined by significant evolutions of demographics and legal status of the Jews. The research conclusions underline the integration of Transylvanian Jews in the Central European cultural area, with differences between the communities determined by their religious orientation.
Clip migration complicated by choledocholithiasis after laparoscopic biliary surgery: a report of four cases
Authors: Wu Xudong , Yan Huanjun , Zhao Shuangying , Zhang Xiaodong , Zhu Kelei 
Published: August 2023

Background Migration of tissue clips into the common bile duct and formation of common bile duct stones after laparoscopic biliary surgery are extremely rare complications, and their etiologies remain elusive. We herein report four cases of migrated clips complicated by stones after laparoscopic biliary surgery. Case presentation Two patients (72- and 62-year-old women) were admitted because of varying degrees of epigastric pain, and two patients (88- and 69-year-old men) were admitted because of epigastric pain with chills and fever. They had previously undergone laparoscopic cholecystectomy (LC) plus laparoscopic common bile duct exploration (LCBDE) in our hospital. In Cases 1, 2, and 4, surgery revealed gallbladder triangle adhesion, inflamed dilated bile ducts, and fragile tissues. Blood tests showed elevated liver enzymes and bilirubin. Imaging indicated common bile duct stones. All patients underwent successful surgery with Hem-o-lok clips. No postoperative pain recurred. Conclusion Clip migration after laparoscopic biliary surgery may be associated with preoperative biliary duct inflammation, improper use of tissue clips, and postoperative biliary leak-induced inflammation. The clinical presentation is similar to that of calculous cholangitis. Once symptoms of cholangitis appear in patients with a history of LC or LCBDE, the possibility of clip migration and stone formation should be considered.
Correlations between Bone Histopathology and Serum Biochemistry in Uremic Patients on Chronic Hemodialysis
Authors: Canavese C. , Barolo S. , Gurioli L. , Cadario A. , Portigliatti M. , Isaia G. , Thea A. , Marangella M. , Bongiorno P. , Cavagnino A. , Peona C. , Boero R. , Damicone M. , Cardelli R. , Rossi P. , Piccoli G. 
Published: August 2023

To define which noninvasive investigations are of value in predicting bone histology, we analyzed transiliac bone specimens (66 biopsies, 14 autopsies) from 80 uremic patients on chronic dialysis. Results were compared with values of different measurements of parathyroid hormone (PTH), alkaline phosphatase (APH), osteocalcin, calcitonin, baseline and post-deferroxamine (DFO) aluminium (Al), - β2 microglobulin, ferritin and bone mineral density Among histomorphometric parameters, woven osteoid, active osteoblastic surface and resorption surface showed the best correlations with dynamic and biochemical marks of active bone metabolism. Among biochemical parameters, intact PTH and APH were better related to histomorphometric and dynamic bone parameters than other PTH measurements as well as osteocalcin, while calcitonin was related to no parameters. Stainable Al alone, and not total bone Al content was related to bone histology. Baseline Al was related to lamellar osteoid, while post-DFO Al was related to stainable Al. β2 microglobulin was positively related to active osteoid surface and ferritin was inversely related to the mineral apposition rate, while bone mineral density was related only to total bone volume. We conclude that, though definite diagnosis requires the use of histological methods, few simple biochemical parameters may offer insight to the bone metabolic status, useful to the physician in day to day clinical practice.
Suppression of DNA Synthesis of Cultured Mesothelial Cells by Supplemented Albumin
Authors: Horiuchi T. , Hayashi K. , Kumano K. 
Published: August 2023

Mesothelial cells, harvested from rat omentum, were cultured with 10% FCS/MEM till the third passage, and then seeded at a density of 2-3x104/cm2 in a 96 well micro-titer plate. Both albumin and glucose were added to each culture medium at final concentrations of 0–2 g/dl and 0–90 mM, respectively. On days 2 and 3, 5-bromo-2'-deoxy-uridine (BrdU) was added and incubated for 24-h to be incorporated into cellular DNA and detected by the ELISA principle. The lowest DNA synthesis was seen when both 2.0 g/dl of albumin and 90 mM of glucose were supplemented to the medium while the highest was obtained without albumin supplement. In the range of 0–90 mM of glucose and 0–2 g/dl of albumin, generally speaking, DNA synthesis of cultured mesothelial cells could be suppressed by either glucose or albumin, and it was greatly enhanced when both concentrations increased.