bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the impact of the COVID-19 pandemic on parental satisfaction in two European neonatal intensive care units
Authors: Zorro Carolina , MacRae Eva , Teresa-Palacio Marta , Williams Emma E , Aldecoa-Bilbao Victoria , Bhat Ravindra , Hickey Ann , Dassios Theodore , Greenough Anne 
Published: September 2022

BackgroundNeonatal units across the world have altered their policies to prevent the spread of infection during the COVID-19 pandemic. Our aim was to report parental experience in two European neonatal units during the pandemic.MethodsParents of infants admitted to each neonatal unit were asked to complete a questionnaire regarding their experience during the COVID-19 pandemic. At King’s College Hospital, UK (KCH), data were collected prospectively between June 2020 and August 2020 (first wave). At the Hospital Clínic Barcelona (HCM), data were collected retrospectively from parents whose infants were admitted between September 2020 and February 2021 (second and third wave).ResultsA total of 74 questionnaires were completed (38 from KCH and 36 from HCM). The parents reported that they were fully involved or involved in the care of their infants in 34 (89.4%) responses in KCH and 33 (91.6%) responses in HCM. Quality time spent with infants during the pandemic was more negatively affected at KCH compared with HCM (n=24 (63.2%) vs n=12 (33.3%)). Parents felt either satisfied or very satisfied with the updates from the clinical care team in 30 (79.0%) responses at KCH and 30 (83.4%) responses in HCM. The parents felt that the restrictions negatively affected breast feeding in six (15.8%) responses at KCH and two (5.6%) responses in HCM. Travelling to the hospital was reported overall to be sometimes difficult (39.2%); this did not differ between the two units (14 (36.8%) respondents at KCH and 15 (41.6%) from HCM). Furthermore, the self-reported amount of time spent giving kangaroo care also did not differ between the two countries.ConclusionRestrictive policies implemented due to the COVID-19 pandemic had a negative impact on the perception of quality of time spent by parents with their newborns admitted to neonatal units.
T cell-intrinsic STING signaling promotes regulatory T cell induction and immunosuppression by upregulating FOXP3 transcription in cervical cancer
Authors: Ni Huanhe , Zhang Huanling , Li Lin , Huang He , Guo Hui , Zhang Lin , Li Chunwei , Xu Jing-Xiao , Nie Cai-Ping , Li Kui , Zhang Xiaoshi , Xia Xiaojun , Li Jiang 
Published: September 2022

BackgroundStimulator of interferon genes (STING) is an innate immune sensor of cytoplasmic double-stranded DNA originating from microorganisms and host cells. The activation of cytosolic DNA-STING pathway in tumor microenvironments is usually linked to more robust adaptive immune responses to tumors, however the intracellular function of STING in regulatory T cells is largely unknown. In the present study, we aimed to explore the contribution of intracellular STING activation to regulatory T cell induction (iTreg) in cervical cancer (CC) microenvironments.MethodsBlood samples and tumor specimens were obtained from patients with CC. The intratumoral STING, CCL22, CD8 and forkhead box P3 (FOXP3) expression levels were measured by immunohistochemistry. T cell-specific STING conditional knockout mice (CD4-Cre/STINGflox/flox, TKO) were generated, and syngeneic TC-1 tumor model were investigated. The differentiation and molecular regulatory pathway of human and murine iTreg under different treatments were investigated by ex vivo assays, immunoblotting and quantitative PCR. Tumor-associated exosomes (T-EXO) were isolated from CC cell lines and exosomal contents were identified by ELISA and Western blot analysis. The impact of T-EXO on T cell differentiation was tested in in vitro cell culture.ResultsIncreased STING, CCL22 level, FOXP3+cells but decreased CD8+cells in tumor tissues predicted poor survival. Tumor-bearing CD4-Cre-STINGflox/flox(TKO) mice displayed slower tumor growth tendencies as well as fewer FOXP3+cells but higher CD8+cell proportion in tumor tissues than wild-type (WT) mice. Activating of STING signaling cooperated with T cell receptor, interleukin-2 receptor and transforming growth factor-beta (TGF-β) signals to promote CD4+CD25highFOXP3+iTreg differentiation from both human and murine CD4+-naïve T cells from WT and IFNAR−/−mice but not TKO or IRF3−/−mice in vitro. Ectopic STING, TBK1 or IRF3 expression promoted iTreg differentiation from human CD4+-naïve T cells. T cell-intrinsic STING activation induced FOXP3 transcription through TBK1-IRF3-mediated SMAD3 and STAT5 phosphorylation independent of interferon-β. In CC, tumor-derived exosomes activated STING signaling in tumor-infiltrated T cells by exosomal TGF-β, cyclic GMP-AMP synthase and 2’-3’-cGAMP, leading to iTreg expansion.ConclusionsThese findings highlight a novel mechanism for iTreg expansion mediated by tumor-derived exosome-activated T cell-intrinsic STING signal, and provide a rationale for developing immunotherapeutic strategies targeting STING signal in CC.
Correlation Analysis of Pathological Features and Axillary Lymph Node Metastasis in Patients with Invasive Breast Cancer
Authors: Chen Hongye , Meng Xiangchao , Hao Xiaopeng , Li Qiao , Tian Lin , Qiu Yue , Chen Yuhui 
Published: September 2022

Objective. To investigate the risk factors of axillary lymph node metastasis in patients with invasive breast cancer. Methods. This study retrospectively included 122 cases of invasive breast cancer patients admitted to the First Medical Center of PLA General Hospital from January 2019 to September 2020. According to postoperative pathological results, axillary lymph node metastasis was divided into axillary lymph node metastasis (ALNM) group (

n

=40) and non-axillary lymph node metastasis (NALNM) group (

n

=82). General demographic information was collected and compared between the two groups. Collected pathological results included lymphovascular invasion (LVI) and the expression of estrogen receptor (ER), progestogen receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 detected by immunohistochemistry. Imaging parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) including apparent diffusion coefficient (ADC), early enhanced rate, and time-intensity curve (TIC) were also included into univariate analysis. The variables with differences between the two groups were compared by univariate analysis, and the related factors of axillary lymph node metastasis were analyzed by logistic regression model. Results. There was no significant difference in general demographic information between the two groups. No significant differences were found in the positive rates of HER-2, ER, PR, Ki-67, pathological types, and clavicular lymph node metastasis and skin chest wall invasion between the two groups (

P
>
0.05

). The proportion of LVI in ALNM group was significantly higher than that in NALNM group (37.50% vs. 6.10%,

P
<
0.001

). The proportion of breast cancer on the left side in the ALNM group was higher than that in the NALNM group, and the difference was statistically significant (70.00% vs. 47.56%,

P
=
0.019

). There were no significant differences in the imaging parameters obtained by DCE-MRI between the two groups. Binary logistics regression analysis showed that LVI (OR =12.258, 95% CI =3.681-40.812,

P
<
0.001

) and left breast cancer (OR =3.598, 95% CI =1.404-9.219,

P
=
0.008

) were risk factors for axillary lymph node metastasis in patients with invasive breast cancer. Conclusion. The formation of vascular tumor thrombi in breast cancer tissue and left breast cancer are risk factors for axillary lymph node metastasis in invasive breast cancer and might be helpful for preoperative detailed assessment of the patient’s condition.
Birds as Companion Animals in Traditional Polynesian Narratives
Authors: Richter-Gravier Raphael 
Published: September 2022

Abstract
In all traditional Polynesian societies, people developed a deep knowledge of all feathered creatures, and devised a great many stories about them. This paper offers a summary and a comparative study of seventeen traditional narratives from throughout Polynesia that feature birds as the companions of the human, divine, or semidivine protagonists of the stories. These oral traditions, which were put in writing in the 19th and 20th centuries by Westerners, show that, in traditional Polynesian societies, people perceived birds as much more than a food source: They were deeply attached to the feathered creatures that they kept as companion animals.
“I was Close to Helping him but Couldn't Quite get There”: Psychiatrists’ Experiences of a Patient’s Death by Suicide
Authors: Furqan Zainab , Cooper Rachel Beth , Lustig Andrew , Sinyor Mark , Nakhost Arash , Kurdyak Paul , Rudoler David , Naeem Farooq , Stergiopoulos Vicky , Zaheer Juveria 
Published: September 2022

Objectives A patient's death by suicide is a common experience for psychiatrists, ranging from 33% to 80%, however, research about the impact of patient suicide on psychiatrists is limited to a few survey studies. This study had three main objectives: (1) understanding the emotional and behavioural impact of a patient's suicide on psychiatrists, (2) exploring if and how the experience of a patient's suicide results in changes in psychiatrist practice patterns, and (3) understanding the tangible steps that psychiatrists and institutions take to manage the emotional and behavioural impact of patient suicide on psychiatrists. Methods Eighteen psychiatrists were recruited using snowball sampling and interviewed to collect demographic data, followed by an in-depth exploration of their experiences of patient suicide. Interviews were then transcribed verbatim and analysed using constructivist grounded theory. Results Study participants described strong emotional reactions in response to patient suicide. Emotional reactions were mediated by a physician, patient, relationship and institutional factors. While psychiatrists did not change the acuity or setting of their practice in response to patient suicide, they made several changes in their practice, including increased caution regarding discharges and passes from inpatient units, more thorough documentation and continuing education about suicide. Conclusions Patient suicide has a profound impact on psychiatrists and based on the findings of this study, we propose steps that psychiatrists and institutions can take to manage the emotional, psychological and behavioural burden of this event.
Improvement in mechanical and physical properties of starch-based films provided by cellulose nanocrystals extracted from rice straw
Authors: Sheydai Azemat , Nikzad Maryam , Peyravi Majid 
Published: September 2022

Films based on starch (ST) have been widely used for food packaging; however, it is necessary to improve their mechanical properties. In this context, eco-friendly starch films incorporated with cellulose nanocrystal (CNC) were prepared using the casting method. CNCs were isolated using acid hydrolysis from rice straw (RS) as raw material and characterized by FESEM, TEM, FIIR, XRD, TGA and zeta potential analyzer. The isolated CNC presented a rod-like structure, high crystallinity (75%) with a diameter of around 12 nm. Subsequently, the starch-based films reinforced with various concentrations of CNC (2, 5, 10, and 15 wt%) were characterized for their morphological features, mechanical, barrier, and thermal properties and compared with control film. It was shown that the addition of CNCs to the film improved the mechanical properties and decreased the water vapor permeability, as important characteristics in food packaging materials.
Greater Acute Articular Inflammatory Response in Tibial Plafond Fractures as Compared to Ankle Fractures
Authors: Marchand Lucas S. , Rothberg David L. , Higgins Thomas F. , Haller Justin M. 
Published: September 2022

Background: Several factors are thought to contribute to posttraumatic osteoarthritis (PTOA) development, including the posttraumatic inflammatory response. The purpose of this study was to compare 2 injuries at the same joint with a different severity and prognosis. This study compared the intra-articular inflammatory response after rotational ankle fracture (lower energy and less PTOA) with tibial plafond fracture (higher energy and more PTOA). Methods: This prospective comparative study was conducted at a level 1 trauma center between 2014-2019. Patients between 18 and 60 years of age with acute ankle or tibial plafond fractures were enrolled. Patients with preexisting ankle OA, autoimmune disease, additional injury, or open fractures were excluded. Synovial fluid aspirations were obtained within 24 hours of injury. The concentrations of interleukin (IL)-1β, IL-1 receptor antagonist (IL-1RA), IL-6, IL-8, and IL-10 and matrix metalloproteinase (MMP)-1, MMP-3, and MMP-13 were quantified. Results: Aspiration were obtained from 29 plafond fractures and 36 ankle fractures. Mean age was 43 years, and patients were predominately female (64%). Age, gender, and comorbidities did not vary between cohorts. Of the plafond fractures, 13 were 43-B and 16 were 43-C injuries. Ankle fractures were predominately 44-B injuries, and 15 ankle fracture had articular impaction. IL-10, IL-1β, IL-6, IL-8, MMP-1, MMP-3, and MMP-13 were all significantly higher in acute plafond fractures as compared to acute ankle fractures. Conclusion: This study compared articular inflammatory marker profiles after fractures of different severities. Several cytokines were elevated in plafond fractures as compared to ankle fractures, suggesting a greater inflammatory response with plafond fractures. Given the difference in prognosis for and higher rate of PTOA after plafond fractures, these data strengthen the case that postinjury inflammatory response plays a role in PTOA development. Given that the postinjury inflammatory response is one of the few modifiable variables of these injuries, future research in this area remains important. Level of Evidence: Level II, prospective.
Comparable long-term retention rates and effects on bone mineral density of denosumab treatment in patients with osteoporosis with or without autoimmune inflammatory rheumatic diseases: real-life data
Authors: Fassio Angelo , Gatti Davide , Bertelle Davide , Fracassi Elena , Zanetti Giulia , Viapiana Ombretta , Rossini Maurizio , Adami Giovanni 
Published: September 2022

Objectives: To investigate whether concomitant autoimmune inflammatory rheumatic diseases (AIIRDs) represent a risk factor for denosumab discontinuation and to explore other possible predictors. Design: This is a real-life retrospective study conducted at our centre on consecutive patients who started treatment with denosumab from January 2014 to October 2021. Methods: Data on patients’ characteristics, denosumab prescriptions and reason for discontinuation were collected from their medical electronic records. A log-rank test was run to assess differences in the denosumab retention rate between the not AIIRD and AIIRD patients. A backward stepwise logistic regression was used to identify possible predictors of denosumab discontinuation. When available, BMD data of the lumbar spine and total hip were collected. Results: Three hundred and sixty-three patients were included (265 not AIIRD and 98 AIIRD; median follow-up, 44 months). Sixty-nine patients discontinued denosumab at any time point (4 due to patient’s decision, 3 due to medical decision, 62 were lost in follow-up). The log-rank test did not find a statistically significant difference for denosumab persistence between the two subgroups. In the binary logistic regression analysis, only older age at initiation and lower baseline serum 25-hydroxy vitamin D were confirmed as predictors for discontinuation. BMD significantly increased from baseline to the last prescription visit at both the lumbar spine and the total hip, without statistically significant differences in the not AIIRD and AIIRD patients. Conclusion: The present data seem to suggest that AIIRDs do not represent a risk factor for denosumab discontinuation. Furthermore, the presence of AIIRDs does not seem to impair its effectiveness in terms of BMD.
Carbon Nanostructure-Based DNA Sensor Used for Quickly Detecting Breast Cancer-Associated Genes
Authors: Zhang Yingqi , Song Jisu , Yang Songlin , Ouyang Jianying , Zhang Jin 
Published: September 2022

AbstractThe early diagnosis of breast cancer highly relies on the detection of mutant DNA at low concentrations. Förster resonance energy transfer (FRET) quenching may offer a solution to quickly detect a small amount of single-strand DNA (ssDNA) through the combination of nanomaterials with special luminescence and unique structures of DNA double helix structure. Here, carbon quantum dots (CDs) modified with Capture ssDNA act as the FRET donor which interact with the two-dimensional fluorescence quencher, i.e., graphene oxide nanosheets (GO), to detect breast cancer-associated Target ssDNA at a low concentration. CDs bioconjugated with the designed Capture ssDNA (named CDs-Capture ssDNA) have the maximum fluorescence intensity (Imax) at the emission (λem) = 510 nm. The fluorescence of CDs-Capture ssDNA is quenched, while they interact with GO due to the π–π* interaction between ssDNA and GO. In the presence of Target ssDNA, the Imax is restored because of the stronger interaction between Target ssDNA and CDs-Capture ssDNA through the hydrogen bond. The restored fluorescence intensity of CDs has a linear relationship with the concentration of Target ssDNA from 0.25 to 2.5 μM with a detection limit around 0.24 μM. The selectivity of the sensing system has been further evaluated by testing the 3-base mismatched and non-base matched in which efficient restoration of photoluminescence of the sensing system cannot be observed. This carbon nanostructure-based DNA sensing system offers a user-friendly and quick detection of single-strand DNA at lower concentration.
Individual characteristics associated with the utilization of nursing care in the very old population: a cross-sectional study
Authors: Zimmermann Jaroslava 
Published: September 2022

Abstract
Background
As older adults ≥80 years are often underrepresented in previous studies, little is known about their characteristics associated with the utilization of nursing care services. Therefore, this study examined individual (predisposing, enabling, and need) predictors of nursing care utilization in the very old population of North Rhine-Westphalia (NRW) in Germany.

Methods
Data from a representative cross-sectional study included 1531 community-dwelling individuals and nursing home residents aged ≥80 years. Multinomial regression was applied to investigate the factors that explain the use of outpatient care services, day care, and/or private care (odpNCU), and inpatient nursing care (inpNCU).

Results
Overall, 1083 (69.9%) participants did not use nursing care services (noNCU), 339 (21.9%) used outpatient, day, and/or private care, and 127 (8.2%) used inpatient nursing care. Compared to noNCU, odpNCU was associated with a higher likelihood of being older [odds ratio (OR) = 1.06, 95% confidence interval (CI): 1.01-1.11], having no partner (OR = 0.58, 95%CI: 0.37-0.91), experiencing higher functional (basic activities of daily living, OR = 0.02, 95%CI: 0.01-0.04; instrumental activities of daily living, OR = 0.18, 95%CI: 0.11-0.30) and cognitive disabilities (OR = 0.63, 95%CI: 0.44-0.89). Compared to noNCU, nursing home residents were more likely older (OR = 1.14, 95%CI: 1.07-1.22), had lower socioeconomic status (OR = 0.98, 95%CI: 0.97-1.00), were childless (OR = 3.83, 95%CI: 1.71-8.56) and without partners (OR = 0.43, 95%CI: 0.20-0.96), socially isolated (OR = 3.94, 95%CI: 2.06-7.55), were more likely to be lonely (OR = 2.94, 95%CI: 1.58-7.89), more functionally (basic activities of daily living, OR = 0.01, 95%CI: 0.00-0.03; instrumental activities of daily living, OR = 0.04, 95%CI: 0.02-0.09) and cognitively impaired (OR = 0.48, 95%CI: 0.31-0.74), but they were less likely to experience five or more chronic conditions (OR = 0.42, 95%CI: 0.20-0.88) and less likely to be physically pre-frail (OR = 0.24, 95%CI: 0.10-0.58) and frail (OR = 0.09, 95%CI: 0.03-0.27).

Conclusions
Individual need factors dominated in explaining odpNCU, suggesting that the very old population in NRW may have equitable access to these services. As social structure, region, and social resources explain inpNCU, this type of care may be inequitably accessible.
Immediate outcome prognostic value of plasma factors in patients with acute ischemic stroke after intravenous thrombolytic treatment
Authors: Lu Huanhuan , Li Siyi , Zhong Xin , Huang Shuxuan , Jiao Xue , He Guoyong , Jiang Bingjian , Liu Yuping , Gao Zhili , Wei Jinhong , Lin Yushen , Chen Zhi , Li Yanhua 
Published: September 2022

AbstractIn the present study, we explored multiple plasma factors to predict the outcomes of patients with AIS after IVT. Fifty AIS patients who received IVT with alteplase were recruited and divided into two groups according to their NIHSS scores. Serum from all subjects was collected to quantitatively analyze the levels of different plasma factors, IL-6, MMP-9, ADAMTS13, TNC, GSN and TRX, using Luminex assays or ELISA measurements. Compared with the levels assessed at the onset of AIS, the levels of MMP-9 (P < 0.001), ADAMTS13 (P < 0.001), and TRX (P < 0.001) significantly decreased after IVT. The level of IL-6 was significantly increased in the NIHSS > 5 group at admission (P < 0.001) compared to the NIHSS ≤ 5 group. AIS patients with a poor prognosis had lower levels of ADAMTS13 at 72 h post-IVT compared with patients with a good prognosis (P = 0.021). IL-6 also was notably higher in the poor outcome group (P = 0.012). After adjusting for confounders, ADAMTS13 at 72 h post-IVT was an independent protective factor for prognosis in AIS patients with an adjusted OR of 0.07 (P = 0.049), whereas IL-6 was an independent predictor of risk for AIS patients with an adjusted OR of 1.152 (P = 0.028). IVT decreased MMP-9, ADAMTS13, and TRX levels in the plasma of AIS patients. Patients with a NIHSS score of less than 5 exhibited lower IL-6 levels, indicating that increased levels of IL-6 correlated with AIS severity after IVT. Therefore, IL-6 and ADAMTS13 might be useful plasma markers to predict the prognosis in AIS patients at 90-days after IVT.
Retinal changes of primary vitreoretinal lymphoma after intravitreal methotrexate
Authors: Jiang Tingting , Gu Junxiang , Liu Shixue , Chang Qing 
Published: September 2022

Abstract
Background
To identify retinal changes using spectral-domain optical coherence tomography (SD-OCT) and ultra-widefield images in eyes with primary vitreoretinal lymphoma (PVRL) during intravitreal methotrexate (MTX) treatment.

Methods
This study retrospectively reviewed 111 eyes of 58 patients with vitreous cytology-proven confirmed PVRL, who received intravitreal injections of MTX.

Results
At the initial visit, the OCT manifestations included vitreous cells (105 eyes, 94.6%), intraretinal infiltration (44 eyes,39.6%), subretinal infiltration (45 eyes, 40.5%,), retinal pigment epithelium (RPE) abnormalities (66 eyes, 59.5%), disruption of the ellipsoid zone (58 eyes, 52.3%), subretinal fluid (4 eyes, 3.6%), RPE detachment (PED) (28 eyes, 25.2%), epiretinal membrane (ERM) (8 eyes, 7.2%), macular edema (10 eyes, 9%). After therapy, tumor regression was achieved in all eyes. Between the initial presentation and regression, the vitreous cells (94.6% vs. 0%, P < 0.001), intraretinal infiltration (39.6% vs. 0%, P < 0.001), RPE abnormalities (59.5% vs.19.8%, P < 0.001), PED (25.2% vs.0%, P < 0.001), and subretinal infiltration (40.5%vs.16.2%, P < 0.001) were significantly reduced. The fundus photography findings all improved after therapy. The mean Logarithm of the Minimum Angle of Resolution (logMAR) for the best corrected visual acuity (BCVA) at presentation was 0.79 ± 0.81 (range, 0–2.9), which improved to 0.70 ± 0.97 (range, 0–2.9, P = 0.01) at the final visit.

Conclusions
SD-OCT combined with ultra-widefield imaging, which can reflect retinal changes, are valuable tools for monitoring the effect of PVRL treatment.