bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a multiagency protocol to support people with No Recourse to Public Funds in Wolverhampton (UK)
Authors: Reddy SM , Mahmood H 
Published: June 2022

Background: No Recourse to Public Funds (NRPF) status is applied to individuals and families that are subject to immigration control, resulting in them having restricted access to state-funded benefits within England. NRPF is a public health risk as it increases the risk of destitution among vulnerable migrants. Aims: The aim of this study was to engage with public and voluntary sector staff within Wolverhampton working with people with a NRPF status to develop and create an easily accessible guide (‘protocol’) to help facilitate identification of appropriate cross-sector interventions and support. Methods: Data were collected via an online survey as well as face-to-face semi-structured interviews with local NRPF stakeholders. Results: Four themes emerged from the thematic analysis of participant responses: understanding NRPF statuses, varying support requirements, poor communication and awareness of vulnerabilities. Currently, in England, there does not appear to be a standardised localised protocol which can be used to reduce the complexities and confusion encountered by public and voluntary sectors who support people with NRPF status. Conclusion: The findings from this study have allowed the Wolverhampton NRPF to create an online information resource that includes training events to raise the awareness of NRPF, as well as the development of a localised multiagency protocol that has better equipped it to support and safeguard people with NRPF.
Agglomerations around natural resources in the hospitality industry: Balancing growth with the Sustainable Development Goals
Authors: Aragón-Correa J Alberto , de la Torre-Ruiz José M , Vidal-Salazar M Dolores 
Published: June 2022

Many tourism agglomerations are situated near natural resources, which implies a need to balance business growth with environmental preservation. Our analysis of the location decisions of 295 luxury beach hotels in Spain between 1960 and 2015 reveals two main findings. First, we confirm the positive relationship between the existence of demand-related urbanization services around natural resources and the attractiveness of agglomerations to new entrants. Second, we find that an agglomeration’s attractiveness negatively affects the density of firms in the agglomeration if that attractiveness hinders firms’ access to the same natural resources. Our results contribute to the strategy literature on agglomerations and provide a better understanding of how the tourism industry can work toward achieving the sustainable development goals (SDGs). JEL CLASSIFICATION: L83, M13, M14, Q50, Q26, R30
Effect of Decompression Craniectomy on Survival and Functional Outcome in Patients with COVID-19 and Malignant Infarct: A Retrospective Cohort Study and Review of Literature
Authors: Sudheer Pachipala , Gomathy Saranya B. , Agarwal Ayush , Vishnu Venugopalan Y. , Pandit Awadh K. , Deepti Vibha , Bhatia Rohit , Srivastava Padma M. V. 
Published: June 2022

Background and objective Amongst the varied neurological manifestations of COVID-19 infection, stroke is one of the common complications. A large portion of patients had large vessel occlusion (LVO) which increases the risk of malignant cerebral infarction requiring decompressive craniectomy. The impact of COVID-19, however, on decompressive craniectomy is not well described. Through this study, we aim to study the impact of decompressive craniectomy in COVID-19 patients presented to our tertiary care hospital. Material and methods Data of all acute ischemic stroke patients who tested COVID positive during the study period was collected. From among them, patients requiring decompressive craniectomy were included. The demographic, clinico-radiological parameters related to stroke, treatment received, outcome and complications were noted. In addition, data from all case reports and case series published on patients with COVID-19, who had developed ischemic stroke and underwent decompression craniectomy was collected and systematically reviewed. Results Twenty-seven stroke patients tested positive for COVID-19 infection, out of whom five patients underwent decompression hemicraniectomy in view of neurologic deterioration. The review of literature yielded 453 abstracts. After reading the full text of 69 articles, 12 studies on 15 patients finally met our inclusion criteria and were included in the systematic review. The mortality rate was 40% among stroke patients requiring decompressive craniectomy in COVID-19 patients. The mortality rate and functional outcomes of this cohort are comparable to the pre-pandemic period. Conclusion Decompressive craniectomy is a life-saving procedure in COVID-19 patients with malignant infarctions similar to patients in the pre-COVID-19 era.
Impact of 5HydroxyMethylCytosine (5hmC) on reverse/direct association of cell-cycle, apoptosis, and extracellular matrix pathways in gastrointestinal cancers
Authors: Moravveji Sayyed Sajjad , Khoshbakht Samane , Mokhtari Majid , Salimi Mahdieh , Lanjanian Hossein , Nematzadeh Sajjad , Torkamanian-Afshar Mahsa , Masoudi-Nejad Ali 
Published: June 2022

Abstract
Background
Aberrant levels of 5-hydroxymethylcytosine (5-hmC) can lead to cancer progression. Identification of 5-hmC-related biological pathways in cancer studies can produce better understanding of gastrointestinal (GI) cancers.
We conducted a network-based analysis on 5-hmC levels extracted from circulating free DNAs (cfDNA) in GI cancers including colon, gastric, and pancreatic cancers, and from healthy donors. The co-5-hmC network was reconstructed using the weighted-gene co-expression network method. The cancer-related modules/subnetworks were detected. Preservation of three detected 5-hmC-related modules was assessed in an external dataset. The 5-hmC-related modules were functionally enriched, and biological pathways were identified. The relationship between modules was assessed using the Pearson correlation coefficient (p-value < 0.05). An elastic network classifier was used to assess the potential of the 5-hmC modules in distinguishing cancer patients from healthy individuals. To assess the efficiency of the model, the Area Under the Curve (AUC) was computed using five-fold cross-validation in an external dataset.

Results
The main biological pathways were the cell cycle, apoptosis, and extracellular matrix (ECM) organization. Direct association between the cell cycle and apoptosis, inverse association between apoptosis and ECM organization, and inverse association between the cell cycle and ECM organization were detected for the 5-hmC modules in GI cancers. An AUC of 92% (0.73–1.00) was observed for the predictive model including 11 genes.

Conclusion
The intricate association between biological pathways of identified modules may reveal the hidden significance of 5-hmC in GI cancers. The identified predictive model and new biomarkers may be beneficial in cancer detection and precision medicine using liquid biopsy in the early stages.
Transcriptome analysis of SerpinB2-deficient breast tumors provides insight into deciphering SerpinB2-mediated roles in breast cancer progression
Authors: Piao Yin Ji , Kim Hoe Suk , Han Wonshik , Moon Woo Kyung 
Published: June 2022

AbstractBackgroundSerpinB2 is highly expressed in immune and tumor cells and is involved in multiple biological functions, including cell survival and remodeling for disease progression. This study prepared SerpinB2-deficient mice and analyzed the differentially expressed genes (DEGs) to determine if loss of this protein delays mammary tumor progression.ResultsA total of 305 DEGs (75 upregulated and 230 downregulated; > 1.5-fold difference,P < 0.05) were identified in SB2−/−;PyMT tumors compared with PyMT tumors. The DEGs were mainly involved in immune and inflammatory responses related to T cell differentiation, IFN-γ production, and lymphocyte chemotaxis based on 61 enriched GO terms, hierarchical clustering, KEGG pathways, and a functionally grouped annotation network. The significantly changed DEGs (Anxa3, Ccl17, Cxcl13, Cxcr3, IFN-γ, Nr4a1, and Sema3a) annotated with at least two GO categories in SB2−/−;PyMT tumors was validated by qRT-PCR.ConclusionsSerpinB2 deficiency alters the expression of multiple genes in mammary tumors, which might cause a delay in PyMT-induced mammary tumor progression.
Predictors of patient safety activities among registered nurses and nurse aides in long-term care facilities: cross-sectional study
Authors: Lee Youran , Cho Eunhee 
Published: June 2022

Abstract
Background
In Korea, nurse aides (NAs) are legally permitted as substitutes for registered nurses (RNs) in long-term care (LTC) facilities, even though they have very different levels of education and qualification standards. Many studies in hospitals have shown better hospital nurse staffing, more educated nurses, and improved nurse work environments have been associated with lower hospital mortality and length of stay. There is research showing that a higher percentage of RNs with a bachelor’s degree corresponded to lower incidence rates of pressure ulcers in Korean LTC facilities. This study aimed to explore the factors that influence patient safety activities of the RNs and NAs working in LTC facilities and to identify the relationship between patient safety culture (PSC) and patient safety activities.

Methods
This study is a descriptive cross-sectional survey. The study participants were conveniently collected from 88 RNs and 71 NAs who worked at 33 LTC facilities for more than three months. The patient safety activities tool was developed by the researchers for residents of LTC facilities based on the tools developed by Park et al. (2012) for hospital nurses and the patient safety goals of the Joint Commission. The questionnaires were collected by email or mobile application and kept confidential. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression analysis.

Results
The mean scores of PSC and patient safety activities were 4.03 ± 0.51 points and 4.29 ± 0.49 points out of 5, respectively. There was significant correlation between PSC and patient safety activities (r = .23, p = .004). Factors influencing patient safety activities among RNs and NAs in LTC facilities were RNs (β = .377, p < .001), organizational system of PSC (β = .314, p < .010), and work shift type (fixed night shift, on-call, 24-h shift) (β = -.264, p = .004), which explained about 36.0% of total variance (F = 5.69, p < .001).

Conclusion
The findings indicate that it is necessary to mandate RNs instead of NAs to enhance residents’ safety in LTC facilities. Additionally, the importance of an organizational safety system and effective working shift types to prevent residents’ safety accidents in LTC facilities is indicated.
Circulating lymphocyte subsets are prognostic factors in patients with nasopharyngeal carcinoma
Authors: Zhu Jing , Fang Ruhua , Pan Zhiwen , Qian Xu 
Published: June 2022

Abstract
Background
Nasopharyngeal carcinoma (NPC) is a geographically and racially variable disease that has a high incidence in Southeast China. According to previous studies on tumor immunity, we compared multiple clinical parameters and blood indexes with outcomes regarding to Epstein-Barr virus (EBV) status in NPC patients.

Methods
According to the EBV load at diagnosis, 220 NPC patients who received concurrent chemoradiotherapy (CRT) were divided into two groups: EBV DNA ≥ 1500 copies/mL and EBV DNA < 1500 copies/mL, respectively. We compared clinical parameters with peripheral blood mononuclear cells, lymphocyte subsets and biochemical indexes. We also analyzed distant metastases and the overall survival rate regarding to these characteristics.

Results
In most cases, the two groups showed the same trends. Most blood indexes were decreased during CRT and the decrease of the absolute count was more significant than the percentage. Patients with younger age showed the higher CD3+ and CD3 + CD8+ percentages. Patients whose EBV DNA ≥ 1500 copies/mL showed a higher N classification than those with EBV DNA < 1500 copies/mL at first diagnosis. Within patients with EBV DNA ≥ 1500 copies/mL, a higher CD3 + CD8+ percentage or lower CD3-CD56+ percentage had better OS rates, and the CD3 + CD8+ percentage was an independent prognostic factor by multivariate survival analyses.

Conclusions
CRT caused an overall decrease of blood cells in NPC patients. Among all the blood indexes, the CD3 + CD8+ percentage showed a correlation with age and was an independent prognostic factor in patients with EBV DNA ≥ 1500 copies/mL at first diagnosis, which is worthy for further large cohort study.
Clinical significance and potential regulatory mechanism of overexpression of pituitary tumor-transforming gene transcription factor in bladder cancer
Authors: Li Jian-Di , Farah Abdirahman Ahmed , Huang Zhi-Guang , Zhai Gao-Qiang , Wang Rui-Gong , Liu Jia-Lin , Wang Qin-Jie , Zhang Guan-Lan , Lei Zi-Long , Dang Yi-Wu , Li Sheng-Hua 
Published: June 2022

Abstract
Background
Pituitary tumor transforming gene-1 (PTTG1) transcription factor is identified as carcinogenic and associated with tumor invasiveness, but its role in bladder cancer (BLCA) remains obscure. This research is intended to analyze the aberrant expression and clinical significance of PTTG1 in BLCA, explore the relationship between PTTG1 and tumor microenvironment characteristics and predict its potential transcriptional activity in BLCA tissue.

Methods
We compared the expression discrepancy of PTTG1 mRNA in BLCA and normal bladder tissue, using the BLCA transcriptomic datasets from GEO, ArrayExpress, TCGA, and GTEx. In-house immunohistochemical staining was implemented to determine the PTTG1 protein intensity. The prognostic value of PTTG1 was evaluated using the Kaplan-Meier Plotter. CRISPR screen data was utilized to estimate the effect PTTG1 interference has on BLCA cell lines. We predicted the abundance of the immune cells in the BLCA tumor microenvironment using the microenvironment cell populations-counter and ESTIMATE algorithms. Single-cell RNA sequencing data was applied to identify the major cell types in BLCA, and the dynamics of BLCA progression were revealed using pseudotime analysis. PTTG1 target genes were predicted by CistromeDB.

Results
The elevated expression level of PTTG1 was confirmed in 1037 BLCA samples compared with 127 non-BLCA samples, with a standardized mean difference value of 1.04. Higher PTTG1 expression status exhibited a poorer BLCA prognosis. Moreover, the PTTG1 Chronos genetic effect scores were negative, indicating that PTTG1 silence may inhibit the proliferation and survival of BLCA cells. With PTTG1 mRNA expression level increasing, higher natural killer, cytotoxic lymphocyte, and monocyte lineage cell infiltration levels were observed. A total of four candidate targets containing CHEK2, OCIAD2, UBE2L3, and ZNF367 were determined ultimately.

Conclusions
PTTG1 mRNA over-expression may become a potential biomarker for BLCA prognosis. Additionally, PTTG1 may correlate with the BLCA tumor microenvironment and exert transcriptional activity by targeting CHEK2, OCIAD2, UBE2L3, and ZNF367 in BLCA tissue.
Prognostic analysis of E2F transcription factors E2F1 and E2F3 in four independent pediatric neuroblastoma cohorts
Authors: Wang Haiwei , Wang Xinrui , Xu Liangpu , Zhang Ji 
Published: June 2022

Abstract
Background
Previously, we had analyzed the prognosis of E2F transcription factors across adult tumor types. However, the expressions and prognosis of E2F transcription factors in pediatric neuroblastoma have not yet been fully studied.

Methods
The prognosis of E2F transcription factors was determined in four independent pediatric neuroblastoma cohorts from Therapeutically Applicable Research to Generate Effective Treatments (TARGET), Gene Expression Omnibus (GEO) and European ArrayExpres datasets using Kaplan–Meier and cox regression analysis.

Results
E2F regulated gene set was associated with the event free survival and the overall survival of neuroblastoma. E2F1 and E2F3 were prognostic factors in all four independent pediatric neuroblastoma cohorts. Over-expressions of E2F1 or E2F3 were correlated with the shorted event free survival and overall survival of neuroblastoma. Expression levels of E2F1 and E2F3 were higher in neuroblastoma patients with MYCN amplification or age at diagnosis ≥ 18 months. Moreover, the prognostic significance of E2F1 or E2F3 in neuroblastoma was independent of MYCN amplification and age of diagnosis. Combinations of E2F1, E2F3 with MYCN amplification or age of diagnosis achieved better prognosis of neuroblastoma. Identification of 234 genes were associated with E2F1 and E2F3 expressions in neuroblastoma and those genes were significantly enriched in cell cycle signaling pathway. Also, higher scores of cell cycle signaling pathway were correlated with the adverse prognosis of neuroblastoma.

Conclusions
E2F transcription factors E2F1 and E2F3 were prognostic makers of neuroblastoma.
Effectiveness of a healthcare-based mobile intervention on sedentary patterns, physical activity, mental well-being and clinical and productivity outcomes in office employees with type 2 diabetes: study protocol for a randomized controlled trial
Authors: Alòs Francesc , Colomer Mª. Àngels , Martin-Cantera Carlos , Solís-Muñoz Montserrat , Bort-Roig Judit , Saigi I. , Chirveches-Pérez E. , Solà-Gonfaus Mercè , Molina-Aragonés Josep Maria , Puig-Ribera Anna 
Published: June 2022

Abstract
Background
Prolonged sedentary time is associated with an increased incidence of chronic disease including type 2 diabetes mellitus (DM2). Given that occupational sedentary time contributes significantly to the total amount of daily sedentariness, incorporating programmes to reduce occupational sedentary time in patients with chronic disease would allow for physical, mental and productivity benefits. The aim of this study is to evaluate the short-, medium- and long-term effectiveness of a mHealth programme for sitting less and moving more at work on habitual and occupational sedentary behaviour and physical activity in office staff with DM2. Secondary aims. To evaluate the effectiveness on glycaemic control and lipid profile at 6- and 12-month follow-up; anthropometric profile, blood pressure, mental well-being and work-related post-intervention outcomes at 3, 6 and 12 months.

Methods
Multicentre randomized controlled trial. A sample size of 220 patients will be randomly allocated into a control (n = 110) or intervention group (n = 110), with post-intervention follow-ups at 6 and 12 months. Health professionals from Spanish Primary Health Care units will randomly invite patients (18–65 years of age) diagnosed with DM2, who have sedentary office desk-based jobs. The control group will receive usual healthcare and information on the health benefits of sitting less and moving more. The intervention group will receive, through a smartphone app and website, strategies and real-time feedback for 13 weeks to change occupational sedentary behaviour. Variables: (1) Subjective and objective habitual and occupational sedentary behaviour and physical activity (Workforce Sitting Questionnaire, Brief Physical Activity Assessment Tool, activPAL3TM); 2) Glucose, HbA1c; 3) Weight, height, waist circumference; 4) Total, HDL and LDL cholesterol, triglycerides; (5) Systolic, diastolic blood pressure; (6) Mental well-being (Warwick-Edinburgh Mental Well-being); (7) Presenteeism (Work Limitations Questionnaire); (8) Impact of work on employees´ health, sickness absence (6th European Working Conditions Survey); (9) Job-related mental strain (Job Content Questionnaire). Differences between groups pre- and post- intervention on the average value of the variables will be analysed.

Discussion
If the mHealth intervention is effective in reducing sedentary time and increasing physical activity in office employees with DM2, health professionals would have a low-cost tool for the control of patients with chronic disease.

Trial Registration
ClinicalTrials.gov NCT04092738. Registered September 17, 2019.
Non-age-related gait kinematics and kinetics in the elderly
Authors: Liang Yuanhao , Xu Tinghan , Qi Shichen , Cao Xiang , Yeung Eric Hiu Kwong , Hu Yong 
Published: June 2022

Abstract
Background
The change of gait kinematics and kinetics along aging were reported to indicate age-related gait patterns. However, few studies focus on non-age-related gait analysis. This study aims to explore the non-age-related gait kinematics and kinetics by comparing gait analysis outcomes among the healthy elderly and young subjects.

Methods
Gait analysis at self-paced was conducted on 12 healthy young subjects and 8 healthy elderly subjects. Kinematic and kinetic features of ankle, knee and hip joints were analyzed and compared in two groups. The degree of variation between the young and elderly in each kinematic or kinetic feature was calculated from pattern distance and percentage of significant difference. The k-means clustering and Elbow Method were applied to select and validate non-age-related features. The average waveforms with standard deviation were plotted for the comparison of the results.

Results
A total of five kinematic and five kinetic features were analyzed on ankle, knee and hip joints in healthy young and elderly groups. The degrees of variation in ankle moment, knee angle, hip flexion angle, and hip adduction moment were 0.1074, 0.1593, 0.1407, and 0.1593, respectively. The turning point was where the k value equals two. The clustering centers were 0.1417 and 0.3691, and the two critical values closest to the cutoff were 0.1593 and 0.3037. The average waveforms of the kinematic or kinetic features mentioned above were highly overlapped with a minor standard deviation between the healthy young and elderly but showed larger variations between the healthy and abnormal.

Conclusions
The cluster with a minor degree of variation in kinematic and kinetic features between the young and elderly were identified as non-age-related, including ankle moment, knee angle, hip flexion angle, and hip adduction moment. Non-age-related gait kinematics and kinetics are essential indicators for gait with normal function, which is essential in the evaluation of mobility and functional ability of the elderly, and data fusion of the assistant device.
A novel sternoclavicular hook plate for treatment of proximal clavicle fracture with dislocation of sternoclavicular join
Authors: Zhang Yadi , Xing Baorui , Hou Xiuxiu , Li Yunmei 
Published: June 2022

Abstract
Purpose
The aim of this study was to explore the efficacy of sternoclavicular hook plate for treatment of proximal clavicle fracture with dislocation of sternoclavicular joint.

Methods
Between October 2016 and December 2020, 16 cases (9 male and 7 female patient, with a mean age of (42 ± 10) years) of proximal clavicle fracture with dislocation of sternoclavicular joint were included in the study. Injured side, injury mechanism, time to surgery, Complications and duration of follow-up were recorded. The outcomes were evaluated with radiographic assessment, American Shoulder and Elbow Surgeons’ Form (ASES). All the patients were evaluated on postoperative 3rd, 6th, and 12th months.

Results
According to the ASES scoring system, the average score was 49 ± 4 (preoperative score), 87 ± 5 (3 months follow-up), 88 ± 3 (6 months follow-up) and 91 ± 3 (12 months follow-up). Statistics differences was showed between preoperative and 3,6,12 months follow-up score of ASES score (p < 0.001). The postoperative physical function was better than the preoperative function. Internal fixation failure and fracture non-union complications in two patients.

Conclusion
Our study indicates that open reduction and sternoclavicular hook plate fixation for the treatment of traumatic sternoclavicular fracture is a safe, relatively straightforward surgical procedure that can lead to satisfactory outcomes.