bluuebunny/crossref_metadata_2025_split huggingface dataset:
Talking with pediatric patients with overweight or obesity and their parents: self-rated self-efficacy and perceived barriers of Dutch healthcare professionals from seven disciplines
Authors: van der Voorn B. , Camfferman R. , Seidell J. C. , Halberstadt J. 
Published: October 2022

AbstractBackgroundMany healthcare professionals (HCPs) feel uncomfortable and incompetent talking about weight with children with overweight and obesity and their parents. To optimally target interventions that can improve obesity care for children, we assessed the self-efficacy (SE) and perceived barriers (PBs) of Dutch HCPs with regard to talking about weight and lifestyle when treating children with overweight or obesity. We also analyzed interdisciplinary differences.MethodsA newly developed, practice- and literature-based questionnaire was completed by 578 HCPs from seven disciplines. ANOVA and chi-square tests were used to analyze interdisciplinary differences on SE, PBs, and the effort to discuss weight and lifestyle despite barriers. Regression analyses were used to check whether age, sex or work experience influenced interdisciplinary differences.ResultsOn average, the reported score on SE was 7.2 (SD 1.2; scale 1–10) and the mean number of PBs was 4.0 (SD 2.3). The majority of HCPs (94.6%) reported perceiving one or more barriers (range 0–12 out of 17). HCPs who in most cases perceived too many barriers to discuss weight and lifestyle of the child (9.6%,n = 55) reported a lower SE (mean 6.3) than professionals who were likely to discuss these topics (mean SE 7.3,p < 0.01), despite having a similar number of PBs (mean 4.5 vs 4.0,p > 0.05). In total, 14.2% (n = 82) of HCPs either felt incapable (SE ≤ 5) or reported that in most cases they did not address weight and lifestyle due to PBs.ConclusionsAlthough on average Dutch HCPs rated their self-efficacy as fairly good, for a subgroup major improvements are necessary to lower perceived barriers and improve self-efficacy, in order to improve the quality of care for Dutch children with obesity.
Establishment and validation of a novel prognostic model for non-virus-related hepatocellular carcinoma
Authors: Jiang Yu , Chen Shulin , Wu Yaxian , Qu Yuanye , Jia Lina , Xu Qingxia , Dai Shuqin , Xue Ning 
Published: October 2022

Abstract
Objective
The incidence of non-virus-related hepatocellular carcinoma (NV-HCC) in hepatocellular carcinoma (HCC) is steadily increasing. The aim of this study was to establish a prognostic model to evaluate the overall survival (OS) of NV-HCC patients.

Methods
Overall, 261 patients with NV-HCC were enrolled in this study. A prognostic model was developed by using LASSO-Cox regression analysis. The prognostic power was appraised by the concordance index (C-index), and the time-dependent receiver operating characteristic curve (TD-ROC). Kaplan–Meier (K–M) survival analysis was used to evaluate the predictive ability in the respective subgroups stratified by the prognostic model risk score. A nomogram for survival prediction was established by integrating the prognostic model, TNM stage, and treatment.

Results
According to the LASSO-Cox regression results, the number of nodules, lymphocyte-to-monocyte ratio (LMR), prognostic nutritional index (PNI), alkaline phosphatase (ALP), aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (SLR) and C-reactive protein (CRP) were included for prognostic model construction. The C-index of the prognostic model was 0.759 (95% CI 0.723–0.797) in the development cohort and 0.796 (95% CI 0.737–0.855) in the validation cohort, and its predictive ability was better than TNM stage and treatment. The TD-ROC showed similar results. K–M survival analysis showed that NV-HCC patients with low risk scores had a better prognosis (P < 0.05). A nomogram based on the prognostic model, TNM stage, and treatment was constructed with sufficient discriminatory power with C-indexes of 0.78 and 0.85 in the development and validation cohort, respectively.

Conclusion
For NV-HCC, this prognostic model could predict an OS benefit for patients, which may assist clinicians in designing individualized therapeutic strategies.
Costunolide is a dual inhibitor of MEK1 and AKT1/2 that overcomes osimertinib resistance in lung cancer
Authors: Tian Xueli , Wang Rui , Gu Tingxuan , Ma Fayang , Laster Kyle Vaughn , Li Xiang , Liu Kangdong , Lee Mee-Hyun , Dong Zigang 
Published: October 2022

AbstractEGFR-TKI targeted therapy is one of the most effective treatments for lung cancer patients harboring EGFR activating mutations. However, inhibition response is easily attenuated by drug resistance, which is mainly due to bypass activation or downstream activation. Herein, we established osimertinib-resistant cells by stepwise dose-escalation in vitro and an osimertinib-resistant patient-derived xenograft model through persistent treatment in vivo. Phosphorylated proteomics identified that MEK1 and AKT1/2 were abnormally activated in resistant cells compared with parental cells. Likewise, EGFR inhibition by osimertinib induced activation of MEK1 and AKT1/2, which weakened osimertinib sensitivity in NSCLC cells. Consequently, this study aimed to identify a novel inhibitor which could suppress resistant cell growth by dual targeting of MEK1 and AKT1/2. Based on computational screening, we identified that costunolide could interact with MEK1 and AKT1/2. Further exploration using in vitro kinase assays validated that costunolide inhibited the kinase activity of MEK1 and AKT1/2, which restrained downstream ERK-RSK2 and GSK3β signal transduction and significantly induced cell apoptosis. Remarkably, the combination of osimertinib and costunolide showed synergistic or additive inhibitory effects on tumor growth in osimertinib-resistant cell lines and PDX model. Hence, this study highlights a potential therapeutic strategy for osimertinib-resistant patients through targeting of MEK1 and AKT1/2 by costunolide.
Cough suppression and HRQoL in adult people with cystic fibrosis: an unexplored correlation
Authors: Niehammer Ute , Steindor Mathis , Straßburg Svenja , Sutharsan Sivagurunathan , Taube Christian , Welsner Matthias , Hirtz Raphael , Stehling Florian 
Published: October 2022

AbstractBackgroundCough suppression assessed by embarrassment about coughing has been shown in adolescents with cystic fibrosis (CF) and negatively affects health-related quality of life (HRQoL) and clinical indicators of disease severity in adolescent females. However, whether cough suppression exists in adults has been studied as little as its effects on clinical and psychological outcomes beyond adolescence.MethodsSeventy-one subjects completed the self-reported 'Cystic Fibrosis Questionnaire-Revised (CFQ-R + 14)' and a self-report questionnaire about cough suppression, health-related perspectives, and therapy adherence. The status of CF disease was quantified in terms of the percentage of predicted forced expiratory volume in one second (ppFEV1), body mass index (BMI), Pseudomonas aeruginosa, pancreatic status, and CF-related diabetes (CFRD). Additional demographic data for sex, age, graduation, employment, and marital status were assessed.ResultsCS exists in adult CF and is associated with impaired HRQoL but not the overall CF disease status regarding BMI, ppFEV1, or health-related perspectives. Despite a higher prevalence of cough suppression in women, no effect of sex regarding either outcome measure was observed.ConclusionThe results of this study suggest that mental health indicators have an impact on cough suppression.
Combined impact of elevated arterial stiffness and left ventricular filling pressure on outcomes after off-pump coronary artery bypass grafting
Authors: Choi Jae-Sung , Oh Se Jin , Oh Sohee 
Published: October 2022

Abstract
Background
Brachial-ankle pulse wave velocity (baPWV) and early diastolic transmitral flow velocity to mitral annular tissue velocity (E/e′)—which are markers of arterial stiffness and left ventricular (LV) filling pressure, respectively—have been associated with morbidity and mortality. We investigated their combined impact on postoperative complications and long-term survival of patients undergoing off-pump coronary artery bypass grafting (OPCAB).

Methods
A cohort of 164 patients were divided into four groups: baPWV ≤ 19 m/s and E/e′ ≤ 15 (reference), baPWV > 19 m/s and E/e′ ≤ 15 (high-PWV-only), baPWV ≤ 19 m/s and E/e′ > 15 (high-E/e′-only), and baPWV > 19 m/s and E/e′ > 15 (high-PWV-and-E/e′). After inverse probability treatment weighting adjustment, each group was compared with the reference group to analyze the odds ratios of postoperative complications and the Kaplan–Meier survival curves, and to identify the group representing an independent prognostic predictor.

Results
The median age and follow-up duration were 69 years and 57.2 months, respectively. Both postoperative acute kidney injury (POAKI) and atrial fibrillation (POAF) were higher in the high-PWV-and-E/e′ group (adjusted odds ratio (OR) = 89.5; 95% confidence interval (CI), 8.5–942.3; p < 0.001 and OR = 12.5; CI, 2.5–63.8; p = 0.002, respectively). Compared to the reference group, only the high-PWV-and-E/e′ group showed significantly lower survival rate (91.0%; CI, 82.8–100% vs. 44.8%; CI, 21.2–94.6%) and a higher hazard for all-cause mortality after adjustment for covariates (hazard ratio = 6.1; p = 0.002).

Conclusion
Concurrent elevation in PWV and E/e′ may independently affect not only the rates of POAKI and POAF but also long-term survival after OPCAB.
Thymic adenocarcinoma presenting as an incidental mediastinal mass
Authors: O’Shea Anne E. , Nissen Alexander P. , Bowen Donnell K. , Barnett Taylor L. , Gustafson Joshua D. 
Published: October 2022

Abstract
Background
Primary thymic adenocarcinoma represents an exceptionally rare malignancy, for which the cornerstone of therapy is margin-negative resection, with radiation and systemic therapy reserved for invasive and advanced disease. Thymic adenocarcinoma has not been previously reported in the setting of a concomitant malignancy, as reported herein.

Case presentation
We present a case of a 55-year-old previously healthy male diagnosed with acute myeloid leukemia, also found to have a mediastinal mass. Evaluation of the mediastinal mass with tumor markers, biopsies, and next-generation sequencing proved non-diagnostic, while he was simultaneously treated with induction chemotherapy to prevent leukemia-related blast crisis. After completing and recovering from induction chemotherapy, he underwent successful thymectomy during a chemotherapy holiday, with a margin-negative resection of thymic adenocarcinoma. He has subsequently recovered and undergone successful allogeneic hematopoietic stem cell transplant.

Conclusions
We present a case of synchronous adult acute myeloid leukemia and primary thymic adenocarcinoma requiring a tailored approach for management of simultaneous malignancies.
Post-esophagectomy chylothorax refractory to mass ligation of thoracic duct above diaphragm: a case report
Authors: Wang Shengxi , Jiang Wenpeng 
Published: October 2022

Abstract
Background
Post-esophagectomy chylothorax is a relatively rare but potentially lethal complication. The treatment strategy of post-esophagectomy chylothorax remains a subject of debate which mainly focuses on the indication and timing of surgical intervention. For cases in which the leakage site is not localized, a mass ligation of the thoracic duct above diaphragm is advocated as the surgical procedure is believed to ensure sealing all the accessory ducts that could be the source of the chylothorax. But in this paper, we report a case of post-esophagectomy chylothorax which was refractory to mass ligation of thoracic duct above diaphragm.

Case presentation
A 59-year old man suffered from high output chylothorax (> 1000 ml/24 h for more than 30 days) after esophagectomy through left thoracotomy. Considering the failure of lymphangiography, we performed mass ligation of thoracic duct above diaphragm. However, we failed to close the chylous leakage. Finally, we found that a rare variated tributary of thoracic duct was the resource of the chylous output. Both the variation of lymphatic system and the coincidence of injured site lead to the invalidness of reoperation. After definitely ligating the variated tributary, chylothorax was cured.

Conclusion
This case supplies a direct evidence that mass ligation of thoracic duct is of no avail in some refractory chylothorax, which indicates the importance of chylous leakage localization.
Structural Behavior Analysis of UHPC Hybrid Tower for 3-MW Super Tall Wind Turbine Under Rated Wind Load
Authors: Wu Xiangguo , Zhang Xuesen , Bhattarai Hom Bahadur , Hwang Hyeon-Jong , Yang Jing , Kang Soonpil 
Published: October 2022

AbstractBased on the conceptual design of an advanced wind turbine tower system, use of ultra-high-performance cementitious composites material with compressive strength of 200 MPa (UHPC-200) is proposed to ensure high durability and ductility of the UHPC hybrid wind turbine tower. Key design parameters are proposed for the structural design of a 3-MW wind turbine. The material properties, mixing compositions, simplified constitutive relationship, and model parameters are outlined. Using nonlinear finite element analysis, the effects of wall thickness, wall thickness ratio, and prestressing tendon on the structural performance including the longitudinal stress field, lateral displacement, stress concentration at the transition zone between the middle and bottom segments are evaluated. Based on the stress-field analysis, the design limitation of the segmental wall thickness and its ratio is recommended. The numerical results show that the tower with the wall thickness ratio of 2:3 (i.e., thickness 200–300 mm) with prestressing tendons is an optimal design for the UHPC hybrid tower. The results of this study can be used as a reference for the engineering design of a new type of UHPC hybrid wind turbine tower.
Effects of lactic acid bacteria-fermented formula milk supplementation on ileal microbiota, transcriptomic profile, and mucosal immunity in weaned piglets
Authors: Lin Ailian , Yan Xiaoxi , Wang Hongyu , Su Yong , Zhu Weiyun 
Published: October 2022

Abstract
Background
Lactic acid bacteria (LAB) participating in milk fermentation naturally release and enrich the fermented dairy product with a broad range of bioactive metabolites, which has numerous roles in the intestinal health-promoting of the consumer. However, information is lacking regarding the application prospect of LAB fermented milk in the animal industry. This study investigated the effects of lactic acid bacteria-fermented formula milk (LFM) on the growth performance, intestinal immunity, microbiota composition, and transcriptomic responses in weaned piglets. A total of 24 male weaned piglets were randomly divided into the control (CON) and LFM groups. Each group consisted of 6 replicates (cages) with 2 piglets per cage. Each piglet in the LFM group were supplemented with 80 mL LFM three times a day, while the CON group was treated with the same amount of drinking water.

Results
LFM significantly increased the average daily gain of piglets over the entire 14 d (P < 0.01) and the average daily feed intake from 7 to 14 d (P < 0.05). Compared to the CON group, ileal goblet cell count, villus-crypt ratio, sIgA, and lactate concentrations in the LFM group were significantly increased (P < 0.05). Transcriptomic analysis of ileal mucosa identified 487 differentially expressed genes (DEGs) between two groups. Especially, DEGs involved in the intestinal immune network for IgA production pathways, such as polymeric immunoglobulin receptor (PIGR), were significantly up-regulated (P < 0.01) by LFM supplementation. Moreover, trefoil factor 2 (TFF2) in the LFM group, one of the DEGs involved in the secretory function of goblet cells, was also significantly up-regulated (P < 0.01). Sequencing of the 16S rRNA gene of microbiota demonstrated that LFM led to selective enrichment of lactate-producing and short-chain fatty acid (SCFA)-producing bacteria in the ileum, such as an increase in the relative abundance of Enterococcus (P = 0.09) and Acetitomaculum (P < 0.05).

Conclusions
LFM can improve intestinal health and immune tolerance, thus enhancing the growth performance of weaned piglets. The changes in microbiota and metabolites induced by LFM might mediate the regulation of the secretory function of goblet cells.
The mediating role of psychological capital in relations between spiritual well-being and mental health among nursing students
Authors: Parviniannasab Ali Mohammad , Bijani Mostafa , Dehghani Ali 
Published: October 2022

Abstract
Background
Nursing students face mental and emotional issues due to the nature of their profession. The role of protective factors such as psychological capital and spiritual well-being is vital in improving mental health. This study investigated the mediating role of psychological capital as a mediator in the relationships between spiritual well-being and mental health in Iran.

Methods
The present study was descriptive, cross-sectional research conducted on 426 undergraduate nursing students within a four-year educational program in Iran from July to December 2021. The participants were selected via convenience sampling. This research used psychological capital scale, spiritual well-being, and general health questionnaire. The collected data were then analyzed using descriptive tests, Pearson correlation, and a structural equation model.

Results
Spiritual well-being positively affects mental health and psychological capital. Psychological capital also is positively related to mental health. Psychological capital partially mediated the effect of spiritual well-being on mental health.

Conclusion
According to the results, High level of spiritual well-being can improve nursing students' mental health and the relationship is partially mediated Psychological capital. Therefore, psychological capital is an important factor in improving nursing students’ mental health.
Deep learning enhancing banking services: a hybrid transaction classification and cash flow prediction approach
Authors: Kotios Dimitrios , Makridis Georgios , Fatouros Georgios , Kyriazis Dimosthenis 
Published: October 2022

AbstractSmall Medium Enterprises (SMEs) are vital to the global economy and all societies. However, they face a complex and challenging environment, as in most sectors they are lagging behind in their digital transformation. Banks, retaining a variety of data of their SME customers to perform their main activities, could offer a solution by leveraging all available data to provide a Business Financial Management (BFM) toolkit to their customers, providing value added services on top of their core business. In this direction, this paper revolves around the development of a smart, highly personalized hybrid transaction categorization model, interconnected with a cash flow prediction model based on Recurrent Neural Networks (RNNs). As the classification of transactions is of great significance, this research is extended towards explainable AI, where LIME and SHAP frameworks are utilized to interpret and illustrate the ML classification results. Our approach shows promising results on a real-world banking use case and acts as the foundation for the development of further BFM banking microservices, such as transaction fraud detection and budget monitoring.
Plasma rich in growth factors (PRGF) and leukocyte-platelet rich fibrin (L-PRF): comparative release of growth factors and biological effect on osteoblasts
Authors: Baca-Gonzalez Laura , Serrano Zamora Rebeca , Rancan Lisa , González Fernández-Tresguerres Francisco , Fernández-Tresguerres Isabel , López-Pintor Rosa M. , López-Quiles Juan , Leco Isabel , Torres Jesús 
Published: October 2022

Abstract
Purpose
To compare the release of platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), insulin-like growth factor (IGF-I) and interleukin 1β (IL-1β) of plasma rich in growth factors (PRGF) and leucocyte platelet-rich fibrin (L-PRF) and to evaluate their biological implication in osteoblasts.

Methods
Blood from 3 healthy volunteers was processed into PRGF, immediate L-PRF (L-PRF 0ʹ) and L-PRF 30 min after collection (L-PRF-30ʹ) and a control group. Growth factors release were analyzed at 7 times by ELISA. Cell proliferation, collagen-I synthesis and alkaline phosphatase activity were assessed in primary cultures of human osteoblasts.

Results
A slower controlled release of IGF-I, VEGF and PDGF was observed in the PRGF group at day 14. A higher synthesis of type I collagen was also quantified in PRGF. L-PRF released significantly higher amounts of IL-1β, that was almost absent in the PRGF.

Conclusions
The addition of leukocytes dramatically increases the secretion of proinflammatory cytokines, which are likely to negatively influence the synthesis of type I collagen and alkaline phosphatase (ALP) by osteoblasts.
Analysis of the drivers of ASF introduction into the officially approved pig compartments in South Africa and implications for the revision of biosecurity standards
Authors: Stoffel Carla , Buholzer Patrik , Fanelli Angela , De Nardi Marco 
Published: October 2022

AbstractBackgroundWhile African Swine Fever (ASF) virus has historically circulated in wild pigs and inOrnithodorosticks in parts of South Africa, the virus has spread among domestic pigs throughout the country since 2019. South Africa’s compartment system has been used as a mainstay approach to protecting the swine industry in the face of ASF. However, in 2020, two compartments broke down with ASF. The objectives of this study are to investigate the drivers for ASF introduction into the compartments, to categorize compartments by risk of ASF introduction, and to make corresponding recommendations. The relevance of risk factors for ASF introduction for each compartment were investigated among veterinarians and farm managers. The analysis of risk factors weighted according to an expert elicitation were used to categorize compartments into risk levels.ResultsDrivers of disease related to human behaviors and to domestic pig management are perceived by farm managers and veterinarians of the compartments to be critical for ASF introduction into compartments in South Africa. Twenty-four units were categorized as high risk, forty-seven as medium risk, and twenty-four as low risk. “Insufficient boot and clothing biosecurity by animal health personnel” was identified as a relevant risk factor in all high risk units. Other prominent risk factors were “insufficient boot and clothing biosecurity by external people,” “underreporting of suspect ASF cases,” “improper hunting/ culling of wild suids inside the compartment,” “un-tested introductions into the herd,” and “entry and contact with free-roaming pigs.” The roles of wild pigs and competent vectors are considered minimal. There is a need for revision of the compartment standards and training of compartment personnel on the standards. The major gaps identified in the standards were absence of a monitoring programme to assess biosecurity implementation and suboptimal surveillance testing and audit strategies.ConclusionsThe results of our study confirm that ASF is increasingly an anthropogenic problem. Updating the compartment standards and addressing gaps in the knowledge of compartment personnel on ASF are most critical. To enhance compliance with biosecurity measures and thus control the disease, close engagement with all stakeholders linked to the compartments is needed.