bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of telenursing training based on family-centered empowerment pattern on compliance with diet regimen in patients with diabetes mellitus type 2: a randomized clinical trial
Authors: Shahabi Negar , Kolivand Mitra , Salari Nader , Abbasi Parvin 
Published: February 2022

Abstract
Background
Telenursing facilitates access to efficient care and acceptance and compliance with treatment at home. Given wide complications of lack of compliance with treatment in causing complications and progression of diabetes and role of the family in attending the patient, this study aimed to investigate the effect of telenursing training based on family-centered empowerment pattern on compliance with diet regimen in patients with diabetes mellitus type 2.

Methods
This was a randomized controlled clinical trial. The study population was patients with diabetes mellitus type 2 referred to Alzhara hospital at Gilan Gharb in 2019, of which 60 individuals out of them were classified randomly into two groups of intervention and control. Eight 30-min sessions of family-centered training were held through telenursing for the intervention group. Data were gathered before and after the intervention by standard questionnaire of Mudanlo in both groups and was analyzed using SPSS software version 22.

Results
There was no significant difference among the two intervention and control groups before the study regarding demographic variables (p > 0.05). The scores of subscales of making effort for treatment, intention to take the treatment, adaptability, integrating illness into life, stick to the treatment, indecisiveness for applying treatment, and total score of compliance were significantly increased after training intervention (p = 0.001).

Conclusions
Results of the study indicates positive effects of performing family-centered empowerment pattern using telephone call follow-up on increasing compliance with diet regimen in patients. Therefore, it is recommended to perform family-centered patterns in health policy-makings and also hospitals and other diabetic patients.
It’s how we practice that matters: professional identity formation and legitimate peripheral participation in medical students: a qualitative study
Authors: Orsmond Paul , McMillan Helen , Zvauya Remigio 
Published: February 2022

Abstract
Background
The process of Legitimate Peripheral Participation (LPP) within a community of practice framework (CoP) was used to explore graduate entry medical students’ professional identity formation (PIF) during their first year of study. A conceptual model has been developed that can be used by medical educators to better understand PIF and to aid the explicit incorporation of PIF activity within the undergraduate curriculum.

Methods
Ten students from one UK medical school participated in the longitudinal study and were interviewed at three points during the first year. Semi-structured group interviews were used to explore students’ experience of the clinical environment and the nature of their interactions with both clinicians and patients in a community-based medicine practice. The interviews were audio recorded and transcribed. Thematic analysis was used to identify overarching themes which are represented as facets in the model of PIF.

Results
Results demonstrate that students are legitimately peripherally participating within both medical student CoPs and wider medical CoPs. Themes identified within the narratives have allowed the development of a new model to understand PIF within the context of LPP in a CoP. This has five facets: Awareness, Collaboration, Negotiation, Evaluation and Realisation. Sophisticated reflection-in-action is shown to be an important aspect of PIF and enables a more conscious understanding of the change that is occurring in our students.

Conclusion
PIF is a complex, non-linear process that is supported by reflection-in-action and early student introduction to clinical practice. It can be recognised in students’ narratives in their changing use of language, their understanding of the medical COP, and their evolving relational participation with those around them. This study adds to those that have previously explored PIF. The model of PIF developed in this study illustrates how experiences in the clinical environment support PIF. Medical educators may find this model helpful when considering how PIF can be explicitly encouraged in the medical curriculum and how reflection may be used for the purpose of identity change.
Effects of personalized diets by prediction of glycemic responses on glycemic control and metabolic health in newly diagnosed T2DM: a randomized dietary intervention pilot trial
Authors: Rein Michal , Ben-Yacov Orly , Godneva Anastasia , Shilo Smadar , Zmora Niv , Kolobkov Dmitry , Cohen-Dolev Noa , Wolf Bat-Chen , Kosower Noa , Lotan-Pompan Maya , Weinberger Adina , Halpern Zamir , Zelber-Sagi Shira , Elinav Eran , Segal Eran 
Published: February 2022

Abstract
Background
Dietary modifications are crucial for managing newly diagnosed type 2 diabetes mellitus (T2DM) and preventing its health complications, but many patients fail to achieve clinical goals with diet alone. We sought to evaluate the clinical effects of a personalized postprandial-targeting (PPT) diet on glycemic control and metabolic health in individuals with newly diagnosed T2DM as compared to the commonly recommended Mediterranean-style (MED) diet.

Methods
We enrolled 23 adults with newly diagnosed T2DM (aged 53.5 ± 8.9 years, 48% males) for a randomized crossover trial of two 2-week-long dietary interventions. Participants were blinded to their assignment to one of the two sequence groups: either PPT-MED or MED-PPT diets. The PPT diet relies on a machine learning algorithm that integrates clinical and microbiome features to predict personal postprandial glucose responses (PPGR). We further evaluated the long-term effects of PPT diet on glycemic control and metabolic health by an additional 6-month PPT intervention (n = 16). Participants were connected to continuous glucose monitoring (CGM) throughout the study and self-recorded dietary intake using a smartphone application.

Results
In the crossover intervention, the PPT diet lead to significant lower levels of CGM-based measures as compared to the MED diet, including average PPGR (mean difference between diets, − 19.8 ± 16.3 mg/dl × h, p < 0.001), mean glucose (mean difference between diets, − 7.8 ± 5.5 mg/dl, p < 0.001), and daily time of glucose levels > 140 mg/dl (mean difference between diets, − 2.42 ± 1.7 h/day, p < 0.001). Blood fructosamine also decreased significantly more during PPT compared to MED intervention (mean change difference between diets, − 16.4 ± 37 μmol/dl, p < 0.0001). At the end of 6 months, the PPT intervention leads to significant improvements in multiple metabolic health parameters, among them HbA1c (mean ± SD, − 0.39 ± 0.48%, p < 0.001), fasting glucose (− 16.4 ± 24.2 mg/dl, p = 0.02) and triglycerides (− 49 ± 46 mg/dl, p < 0.001). Importantly, 61% of the participants exhibited diabetes remission, as measured by HbA1c < 6.5%. Finally, some clinical improvements were significantly associated with gut microbiome changes per person.

Conclusion
In this crossover trial in subjects with newly diagnosed T2DM, a PPT diet improved CGM-based glycemic measures significantly more than a Mediterranean-style MED diet. Additional 6-month PPT intervention further improved glycemic control and metabolic health parameters, supporting the clinical efficacy of this approach.

Trial registration
ClinicalTrials.gov number, NCT01892956
Omega-3 fatty acids attenuate cardiovascular effects of short-term exposure to ambient air pollution
Authors: Chen Hao , Zhang Siqi , Shen Wan , Salazar Claudia , Schneider Alexandra , Wyatt Lauren H. , Rappold Ana G. , Diaz-Sanchez David , Devlin Robert B. , Samet James M. , Tong Haiyan 
Published: February 2022

Abstract
Background
Exposure to air pollution is associated with elevated cardiovascular risk. Evidence shows that omega-3 polyunsaturated fatty acids (omega-3 PUFA) may attenuate the adverse cardiovascular effects of exposure to fine particulate matter (PM2.5). However, it is unclear whether habitual dietary intake of omega-3 PUFA protects against the cardiovascular effects of short-term exposure to low-level ambient air pollution in healthy participants. In the present study, sixty-two adults with low or high dietary omega-3 PUFA intake were enrolled. Blood lipids, markers of vascular inflammation, coagulation and fibrinolysis, and heart rate variability (HRV) and repolarization were repeatedly assessed in 5 sessions separated by at least 7 days. This study was carried out in the Research Triangle area of North Carolina, USA between October 2016 and September 2019. Daily PM2.5 and maximum 8-h ozone (O3) concentrations were obtained from nearby air quality monitoring stations. Linear mixed-effects models were used to assess the associations between air pollutant concentrations and cardiovascular responses stratified by the omega-3 intake levels.

Results
The average concentrations of ambient PM2.5 and O3 were well below the U.S. National Ambient Air Quality Standards during the study period. Significant associations between exposure to PM2.5 and changes in total cholesterol, von Willebrand factor (vWF), tissue plasminogen activator, D-dimer, and very-low frequency HRV were observed in the low omega-3 group, but not in the high group. Similarly, O3-associated adverse changes in cardiovascular biomarkers (total cholesterol, high-density lipoprotein, serum amyloid A, soluable intracellular adhesion molecule 1, and vWF) were mainly observed in the low omega-3 group. Lag-time-dependent biphasic changes were observed for some biomarkers.

Conclusions
This study demonstrates associations between short-term exposure to PM2.5 and O3, at concentrations below regulatory standard, and subclinical cardiovascular responses, and that dietary omega-3 PUFA consumption may provide protection against such cardiovascular effects in healthy adults.
Patient-related risk factors for late rectal bleeding after hypofractionated radiotherapy for localized prostate cancer: a single-center retrospective study
Authors: Kim Tae Gyu , Park Byungdo , Song Yun Gyu , Lee Hyoun Wook , Oh Tae Hee , Ryu Dong-Soo , Jeong Seung Chan , Cho Daehyeon , Oh Jieun , Kim Kwang Min , Lee Jung Won , Lee Hyoun Soo , Kong Sung Min , Kim Jun Young , Kim Haeyoung 
Published: February 2022

Abstract
Background
Several studies have reported patient-related risk factors for late rectal bleeding following conventionally fractionated radiotherapy for prostate cancer. We investigated patient-related risk factors for late rectal bleeding after hypofractionated radiotherapy.

Methods
A total of 231 patients with local or locally advanced prostate cancer treated with hypofractionated radiotherapy (70 or 67.2 Gy in 28 fractions) were evaluated retrospectively. All patients received intensity-modulated radiotherapy with daily image guidance. The relationships between late rectal bleeding and risk factors like diabetes, hypertension, cirrhosis, and anticoagulant use were analyzed.

Results
During a median follow-up of 23 months, the crude rates of grade ≥ 1, grade ≥ 2, and grade ≥ 3 late rectal bleeding were 23.8%, 16.9%, and 9.5%, respectively. Cirrhosis and anticoagulant use predicted an increased risk of grade ≥ 3 rectal bleeding in multivariable analyses (hazard ratio [HR] 14.37, 95% confidence interval [CI] 3.09–66.87, P = 0.001, and HR 2.93, 95% CI 1.14–7.55, P = 0.026, respectively). The non-anticoagulant group had a significantly superior 5-year freedom from grade ≥ 3 bleeding compared to the anticoagulant group in a propensity-weighted log-rank analysis (88.0% vs. 76.7%, P = 0.041). A receiver operating characteristic curve analysis revealed that rectal bleeding was minimized in the anticoagulant group if the equivalent dose at fractionation of 2 Gy (EQD2) V77 Gy of the rectum was < 4.5% or if the EQD2 V8.2 Gy was < 71.0%.

Conclusions
Patients taking anticoagulants or those with cirrhosis had a significantly higher risk of severe late rectal bleeding than other patients after hypofractionated radiotherapy for prostate cancer in the present study. The bleeding risk could be lowered by minimizing hotspots in patients taking anticoagulants.
Dipeptidyl peptidase-4 is associated with myogenesis in patients with adolescent idiopathic scoliosis possibly via mediation of insulin sensitivity
Authors: Dai Zhicheng , Xue Bingchuan , Xu Leilei , Feng Zhenhua , Wu Zhichong , Qiu Yong , Zhu Zezhang 
Published: February 2022

Abstract
Background
Abnormal metabolic features have been previously described in adolescent idiopathic scoliosis (AIS) patients. As an important regulator involved in energy metabolism, DPP-4 activity was reported to be remarkably decreased in osteoblasts of AIS patients. To date, there was still a lack of knowledge concerning the role of DPP-4 in the myogenesis of AIS.

Methods
Circulation DPP-4 level was assessed in the serum of 80 AIS girls and 50 healthy controls by ELISA. Myoblasts were purified from muscle specimens of AIS patients and LDH controls, and then treated with metabolic effectors including glucose and insulin. CCK-8 assay was used to assess the cell viability and myotube fusion index was calculated to evaluate myogenesis ability. Gene expressions of downstream signals of DPP-4 were evaluated by RT-qPCR and Western blot respectively.

Results
AIS girls had remarkably down-expressed DPP-4 in both serum level (0.76 fold) and tissue (0.68 fold) level. Treatment with metabolic effectors led to significantly increased DPP-4 expression in the control cells, while there was no increase of DPP-4 in AIS cells. CCK-8 assay showed that the proliferation rate of control cells was significantly increased after being treated. Remarkably higher fusion index was also observed in the treated control cells. By contrast, the fusion index and cell proliferation rate were comparable between the treated and the untreated AIS cells.

Conclusions
Our study suggested a potential role of DPP-4 in abnormal metabolic condition of AIS patients. Compared with control cells, AIS myoblasts presented obviously impaired sensitivity to the treatment of glucose and insulin. Aberrant DPP-4 expression could lead to impaired insulin sensitivity in myoblasts and further influence the cell viability during myogenesis. The molecular mechanism connecting DPP-4 and insulin-related signaling in AIS is worthy of further investigation.
Combination therapy for pancreatic cancer: anti-PD-(L)1-based strategy
Authors: Liu Lingyue , Huang Xing , Shi Fukang , Song Jinyuan , Guo Chengxiang , Yang Jiaqi , Liang Tingbo , Bai Xueli 
Published: February 2022

AbstractMortality associated with pancreatic cancer is among the highest of all malignancies, with a 5-year overall survival of 5–10%. Immunotherapy, represented by the blocking antibodies against programmed cell death protein 1 or its ligand 1 (anti-PD-(L)1), has achieved remarkable success in a number of malignancies. However, due to the immune-suppressive tumor microenvironment, the therapeutic efficacy of anti-PD-(L)1 in pancreatic cancer is far from expectation. To address such a fundamental issue, chemotherapy, radiotherapy, targeted therapy and even immunotherapy itself, have individually been attempted to combine with anti-PD-(L)1 in preclinical and clinical investigation. This review, with a particular focus on pancreatic cancer therapy, collects current anti-PD-(L)1-based combination strategy, highlights potential adverse effects of accumulative combination, and further points out future direction in optimization of combination, including targeting post-translational modification of PD-(L)1 and improving precision of treatment.
Peculiar characteristics of new-onset Type 1 Diabetes during COVID-19 pandemic
Authors: Mastromauro Concetta , Blasetti Annalisa , Primavera Marina , Ceglie Lucio , Mohn Angelika , Chiarelli Francesco , Giannini Cosimo 
Published: February 2022

Abstract
Background
The COVID-19 pandemic period is having a strong impact on the management of diabetes as well as other chronic diseases as shown by the most severe clinical presentation at onset. The aim of this study was to evaluate the severity of diabetic ketoacidosis (DKA) in youth with newly diagnosed type 1 diabetes in “Santissima Annunziata Hospital” (Chieti, Italy) during COVID-19 pandemic in comparison to the five previous years.

Methods
A retrospective population-based incidence study was performed. Data were obtained from hospital records of 172 patients with new onset type 1 diabetes divided into two groups according to the diagnosis: Group I, between January 2015 and February 2020; Group II, between March 2020 and April 2021. Data regarding anthropometric, socio-economic and laboratory test were analyzed. DKA (pH < 7.30) and different severity of the disease (severe pH < 7.10; moderate pH < 7.20, mild pH < 7.30) were evaluated. A Spearman correlation between pH values and the main variables of interest was performed.

Results
DKA frequency was increased by 19 percentage in Group II compared to Group I (55% vs 36%; P = 0.03) with a significant increased risk of severe DKA cases compared to the previous five years (severe DKA 22.5% vs. 8.4%, P = 0.01). pH values were significantly related with HbA1c, blood glucose and c-peptide values in all groups. In addition, in Group II but not in Group I, pH values correlated with Triglycerides and TG/HDL cholesterol ratio.

Conclusions
During COVID-19 pandemic the risk of more severe clinical presentation of type 1 diabetes at onset is increased. The correlation with lipid profile might suppose an additional effect of lifestyle changes beside the delay in the diagnosis. Modifications of health care system need to be implemented during this peculiar situation in order to avoid such a relevant complication at onset.
Effectiveness of intravaginal electrical stimulation combined with electromyography biofeedback-mediated pelvic floor muscle training for postpartum symptomatic pelvic organ prolapse: protocol for the PROSPECT randomized trial
Authors: Min Li , Chunxue Yang , Qiubo Lv , Xudong Dong , Yan Zhang , Guifang Zhang , Kejia Hu , Tianzi Gai , Qing Feng 
Published: February 2022

Abstract
Background
Pelvic organ prolapse (POP) is seen in up to 30–70% of women presenting for routine gynecology care and 10% of women suffering from bothersome POP symptoms. Vaginal childbirth is one of the most prominent contributing factors for POP. Pelvic muscle training (PFMT) is considered effective to improve mild to moderate POP symptoms. In addition, higher-intensity, supervised PFMT aided by biofeedback and electrical stimulation may confer greater benefit. However, the long-term efficacy of the PFMT combined with electromyography biofeedback is unknown, which indicates the need for further evidence.

Methods
This multicenter randomized controlled trial compares the effectiveness and cost-effectiveness of conventional PFMT versus biofeedback-mediated PFMT plus neuromuscular electrical stimulation (NMES) for postpartum symptomatic POP women. The primary outcome is the proportion of patients with the improvement of at least one POP-Q stage at 36 months after randomization. The primary economic outcome measure is incremental cost per quality-adjusted life year at 36 months. Two hundred seventy-four women from four outpatient medical centers are randomized and followed up with pelvic floor examination, questionnaires, and pelvic ultrasonography imaging. All participants are arranged for three appointments over 12 weeks. NMES and electromyography biofeedback via intravaginal probe are added to PFMT for participants in the biofeedback-mediated PFMT group. Group allocation could not be blinded from participants and healthcare staff that deliver intervention but remain masked from medical staff that carry out PFM assessment. An intention-to-treat analysis of the primary outcome will estimate the difference of the proportion of POP-Q stage improvement between the trial groups right after the intervention, and during the follow-up until 36 months, using the chi-square test and multilevel mixed models respectively. A logistic regression analysis was used for adjusting for important baseline variables that are unbalanced.

Discussion
The trial results will provide evidence of the effectiveness of electromyography biofeedback-mediated PFMT in improving women’s POP-Q staging, quality of life, and cost-effectiveness.

Trial registration
CCTR Registry ChiCTR210002171917. Registered on March 6, 2019
Acute effects from the half-squat performed using a repetition versus differential approach in youth soccer players
Authors: Coutinho Diogo , Abade Eduardo , Gonçalves Bruno , Santos Sara , Schöllhorn Wolfgang , Sampaio Jaime 
Published: February 2022

Abstract
Background
Over the last years there have been a wide body of research exploring the best strategies to promote acute enhancements in players’ performance. Despite that, most studies have been focused on adult and elite players, and different results may be identified when considering players from lower levels of performance and belonging to youth categories. In addition, most studies conducted in this domain focused in repetitive movement patterns, and while adding variability has been considered as a useful approach to enhance players’ performance at short and long-term perspectives, less is known regarding it applicability to acute enhance players physical performance. Therefore, this study aimed to compare the acute enhancement effects of performing the half-squat in a flywheel ergometer between a more-repetitive approach (low noise) and a more variable approach (differential learning, high noise) in youth soccer players.

Methods
A total of sixteen players (age = 16.2 ± 0.6 years) was exposed to four conditions in a randomized order: (1) repetitive intervention for 30 s; (2) repetitive intervention for 10-min; (3) differential learning intervention for 30 s; (4) differential learning intervention for 10-min. Each condition consisted in 3 sets of 6 repetitions of eccentric half squats performed in a flywheel ergometer. Countermovement jump, 10 m and 30 m linear sprint, and change-of-direction ability were measured every session at baseline (pre-test) and after each protocol (post-test).

Results
No potentiation effect was observed overall with any of the interventions. In addition, no differences between protocols were found for sprinting. However, the repetitive intervention impaired jumping performance for both 30 s (small effects, p ≤ .05) and 10-min intervals (small effects, p ≤ .05), as well as in the change-of-direction task for 30 s (p ≤ .05).

Conclusions
These results may be due to the players’ low experience in eccentric flywheel training. Despite these findings, individual potentiation responses emerged from both protocols when considering the individual responses, reinforcing the need to establish more personalized approaches.
Fixed point results of weakly contraction mappings in partially ordered b-metric spaces
Authors: Kalyani K. , Seshagiri Rao N. 
Published: February 2022

Abstract
Objectives
We explored the results of fixed point, coincidence point and coupled coincidence point for the mappings in an ordered metric spaces. Our results generalized and extended the well-known results in the literature. Some numerical examples are provided for justifying the results obtained.

Result
Some fixed point results are found for a self mapping in a partially ordered b-metric space which satisfies a generalized week contraction condition. Furthermore, these results are extended for two self mappings for obtaining coincidence point, coupled coincidence point and coupled common fixed point in the same context. A few examples are presented to support the findings.