bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding how users of home-based aged care services with cognitive impairment rate their social care related quality of life
Authors: Phillipson Lyn , Caiels James , Smith Louisa , Towers Ann-Marie 
Published: January 2025

Abstract
Background
Over the past decades, self-directed models of care have been implemented throughout the world to support older people, including those with dementia, to live at home. However, there is limited information about how self-directed home care is experienced by older people with cognitive impairment and dementia, and how their thinking informs their care choices and quality of life.

Methods
We used the ASCOT-Easy Read, a staggered reveal method, talk aloud techniques, probing questions, and physical assistance to support users of self-directed home care in Australia with cognitive impairment and dementia to discuss their Social Care Related Quality of Life (SCRQoL). Interviews were recorded, transcribed and analysed thematically in NVivo. Demographic, functional, cognitive and SCRQoL scores were analysed in Excel and SPSS. Analysis of both the quantitative and qualitative data for each participant allowed us to examine consistency or discordance between ratings and participants’ comments about their experiences within each domain.

Results
Twenty six older people with cognitive impairment and/or dementia completed an interview. Ratings of SCRQoL were more favourable in lower order domains (e.g. food and drink, personal cleanliness, accommodation comfort and cleanliness and safety) than in the higher order domains (e.g. occupation and social participation). Overall SCRQOL also varied significantly from 0.40 to 0.97. Despite variable ratings, all participants described unmet needs associated with limitations in personal function and mobility, transport and the amount and flexibility of home care services they received. Qualitative comments suggest many experienced more significant limitations than some of their ratings may imply. This was attributed to adaptation and acceptance of limitations as a normal part of aging. The choice to remain living in one’s own home was perceived as the most important outcome.

Conclusions
Some older people living at home with cognitive impairment and/or dementia adapt and accept their limitations as a normal part of the aging process. This affects expectations about their lives at home and their support. Rather than relying on self-direction, supports to live well at home could be enhanced by a greater emphasis on comprehensive needs assessment and more supports to promote reablement and enhance personal and community level participation.
Negotiating a physically active life in tune with ageing: a grounded theory study of older persons’ experiences of participating in high-intensity interval training
Authors: Fridberg Helena , Wiklund Maria , Snellman Fredrik , Rosendahl Erik , Hedlund Mattias , Boraxbekk Carl-Johan , Lindelöf Nina 
Published: January 2025

Abstract
Background
Physical activity and exercise are promoted worldwide as effective interventions for healthy ageing. Various exercise initiatives have been developed and evaluated for their efficacy and effectiveness among older populations. However, a deeper understanding of participants’ experiences with these initiatives is crucial to foster long-term activity and exercise among older persons.

Methods
A constructivist grounded theory study was conducted to explore the experiences of older persons participating in a supervised group supramaximal high-intensity training (HIT) programme. Four focus groups were held, involving 28 persons aged 65 to 78. The focus groups were analysed inductively, followed by an iterative process of abstraction, abduction, and theory generation using a constant comparative method. A conceptual framework comprising three theoretical concepts—stereotype embodiment, ageist practices, and self-efficacy—was employed during the abductive phase as an analytical lens.

Results
The core category of our grounded theory, Negotiating a physically active life in tune with ageing, encapsulates the complex processes and actions influencing older persons as they engage in physical activities in their daily lives and in relation to HIT. This core category was created from the conceptual framework and the four categories: Grit in the moment and overall life, Empowered by the training group, Navigating one’s physically active self, and Committing to exercise for duty and pleasure. Participants reported feeling invigorated by the exercise, enjoying the challenge, and valuing the group setup for its social connectedness and structure. The generated theory illustrates how participants’ engagement with physical activity and exercise is shaped by various perspectives accumulated over their lifespan. The findings provide a plausible explanation of how participation in HIT groups can challenge negative age stereotypes and ageist practices while enhancing self-efficacy for high-intensity exercise.

Conclusions
Our grounded theory underscores that physical activity and exercise should be regarded as multifaceted processes, which must be considered when promoting physical activity initiatives for older persons. By considering the older person and societal norms and values, we can gather knowledge to design physical exercise interventions that are not only effective but also enjoyable and capable of transforming how individuals perceive themselves as exercising persons.
Functional fitness and psychological well-being in older adults
Authors: Tóth Eliza E. , Vujić Aleksandar , Ihász Ferenc , Ruíz-Barquín Roberto , Szabo Attila 
Published: January 2025

Abstract
Background
Physical fitness and functioning are related to better mental health in older age. However, which fitness components (body composition, strength, flexibility, coordination, and endurance) are more closely related to psychological well-being (PWB) is unclear.

Methods
This research examined how body mass index (BMI) and six indices of functional fitness (i.e., lower and upper body strength, lower and upper body flexibility, coordination [based on agility and balance], and aerobic endurance) relate to five psychological measures that could mirror PWB (i.e., resilience, mental well-being, optimism, life satisfaction, and happiness). Thirty-nine older adults (60–94 years; two-thirds female) were examined with the Fullerton Functional Fitness Test (FFFT) after completing five psychometric instruments.

Results
Data were analyzed with correlations, ordinary least squares regressions, and regularized (elastic net) regressions, calculating the Lindeman, Merenda, and Gold (LMG) indices of the relative importance of the six FFFT components separately for the five psychological measures. Results revealed that BMI, upper body strength, and upper body flexibility were the least significant predictors of PWB. In contrast, endurance, complex movement coordination, and lower body flexibility emerged as the most significant predictors. Still, lower body strength correlated moderately positively with all PWB indices, and similarly, upper body flexibility with resilience, mental well-being, and happiness.

Conclusions
These findings should stimulate research on the mechanism connecting functional fitness with PWB in older adults. Further, apart from their novelty, the findings could be valuable in providing directions for physical fitness intervention programs targeting mental and physical health for older people.
Effect of pre-hospital living setting on nutritional intake route upon discharge in older adults with aspiration pneumonia: a prospective cohort study
Authors: Yamaguchi Kohei , Miyagami Taiju , Imada Ryoko , Yanagida Ryosuke , Kushiro Seiko , Morikawa Toru , Nakagawa Kazuharu , Yoshimi Kanako , Naito Toshio , Tohara Haruka 
Published: January 2025

Abstract
Background
Aspiration pneumonia, which often recurs due to dysphagia, worsens as patients move between homes, facilities, and hospitals. The impact of pre-hospital living setting on oral intake at discharge remains unclear. The purpose of this study was to identify the effects of the pre-hospital living setting on the nutritional intake route upon discharge in older patients with aspiration pneumonia.

Methods
This prospective cohort study included patients aged ≥ 65 years who were admitted to an acute care hospital and diagnosed with aspiration pneumonia. Patients were followed up until discharge or death during hospitalisation. Patient demographic information, pre-hospital living setting (home or nursing facility), functional oral intake scale (FOIS) score, pneumonia severity index, clinical frailty scale score, history of aspiration pneumonia, and pneumonia recurrence during hospitalisation were recorded. Binary logistic regression was used to assess the impact of the pre-hospital living setting on oral intake at discharge as the primary outcome.

Results
Among the 89 included patients (52 males (58.4%); mean age, 84.8 ± 7.9 years), 39.3% (n = 35) had pneumonia recurrence during hospitalisation. The average follow-up period was 44.0 ± 36.6 days. The pre-hospital living setting was independently associated with the nutritional intake route upon discharge (odds ratio = 7.72, 95% confidence interval (95%CI) = 1.70–35.1, p = 0.008).

Conclusions
The pre-hospital living setting could serve as a good indicator of the nutritional intake route upon discharge. It is essential to optimize care in both nursing facilities and hospital settings when caring for older patients with aspiration pneumonia.
Forecasting cardiovascular disease mortality using artificial neural networks in Sindh, Pakistan
Authors: Qureshi Moiz , Ishaq Khushboo , Daniyal Muhammad , Iftikhar Hasnain , Rehman Mohd Ziaur , Salar S. A. Atif 
Published: January 2025

AbstractCardiovascular disease (CVD) is a leading cause of death and disability worldwide, and its incidence and prevalence are increasing in many countries. Modeling of CVD plays a crucial role in understanding the trend of CVD death cases, evaluating the effectiveness of interventions, and predicting future disease trends. This study aims to investigate the modeling and forecasting of CVD mortality, specifically in the Sindh province of Pakistan. The civil hospital in the Nawabshah area of Sindh province, Pakistan, provided the data set used in this study. It is a time series dataset with actual cardiovascular disease (CVD) mortality cases from 1999 to 2021 included. This study analyzes and forecasts the CVD deaths in the Sindh province of Pakistan using classical time series models, including Naïve, Holt-Winters, and Simple Exponential Smoothing (SES), which have been adopted and compared with a machine learning approach called the Artificial Neural Network Auto-Regressive (ANNAR) model. The performance of both the classical time series models and the ANNAR model has been evaluated using key performance indicators such as Root Mean Square Deviation Error, Mean Absolute Error (MAE), and Mean Absolute Percentage Error (MAPE). After comparing the results, it was found that the ANNAR model outperformed all the selected models, demonstrating its effectiveness in predicting CVD mortality and quantifying future disease burden in the Sindh province of Pakistan. The study concludes that the ANNAR model is the best-selected model among the competing models for predicting CVD mortality in the Sindh province. This model provides valuable insights into the impact of interventions aimed at reducing CVD and can assist in formulating health policies and allocating economic resources. By accurately forecasting CVD mortality, policymakers can make informed decisions to address this public health issue effectively.
Fracture resistance and marginal fit of three different overlay designs using advanced zirconia-reinforced lithium disilicate CAD/CAM material
Authors: Refaey Heidi Saad , Abdelkader Sanaa H. , Aly Yasser M. 
Published: January 2025

Abstract
Background
Conservative dentistry introduced modern restoration designs, contributing to the greater use of partial-coverage ceramic restorations. New strong bondable ceramic materials made fabricating partial coverage ceramic restorations easier to restore the badly destructed teeth.

Aim of the study
This study investigated the impact of three distinct overlay preparation designs on the marginal fit (both before and after thermal aging) and the fracture resistance of overlay restorations fabricated using advanced zirconia-reinforced lithium disilicate (ALD) CAD/CAM glass-ceramic blocks.

Materials and methods
Using a standardized preparation protocol, three typodont molars were prepared to receive three different indirect overlay ceramic restoration designs. The typodont teeth were duplicated to get 27 resin dies that were randomly allocated into three groups (n = 9) based on the preparation design; group (O): a traditional overlay preparation with anatomical occlusal reduction, group (OS): anatomical occlusal reduction with circumferential shoulder finish line, and group (OG): anatomical occlusal reduction with a central groove preparation at the mid-occlusal surface. After standardized restorations fabricated following the manufacturer’s guidelines, the restorations were cemented to their corresponding dies and exposed to thermal aging corresponding to 6-month clinical service. Marginal gap was measured before and after thermal aging procedure using an optical microscope. To measure fracture resistance, specimens were loaded till failure using the universal testing machine. The Kruskal Wallis test was utilized to assess data among the groups, followed by Dunn’s post hoc test with Bonferroni correction. Differences in the marginal fit before and after thermal aging were evaluated using Wilcoxon Sign Rank test.

Results
A statistically significant difference in marginal fit was observed between the studied groups, with a p-value of 0.032 where group OS has the lowest micro gap compared to group OG and group O. The fracture resistance group (O) recorded the highest fracture resistance with a statistically significant difference between the studied groups at p value = 0.043.

Conclusions
Adjusting the tooth preparation significantly influenced both the fracture resistance load and the marginal fit observed for advanced zirconia-reinforced lithium disilicate glass-ceramic (ALD) overlays.
Simulator training in focus assessed transthoracic echocardiography (FATE) for undergraduate medical students: results from the FateSim randomized controlled trial
Authors: Weimer Johannes Matthias , Sprengart Franziska Marietta , Vieth Thomas , Göbel Sebastian , Dionysopoulou Anna , Krüger Rebecca , Beer Jan , Weimer Andreas Michael , Buggenhagen Holger , Kloeckner Roman , Pillong Lukas , Helfrich Johanna , Waezsada Elias , Wand Philipp , Weinmann-Menke Julia 
Published: January 2025

Abstract
Introduction
Ultrasound is important in heart diagnostics, yet implementing effective cardiac ultrasound requires training. While current strategies incorporate digital learning and ultrasound simulators, the effectiveness of these simulators for learning remains uncertain. This study evaluates the effectiveness of simulator-based versus human-based training in Focused Assessed with Transthoracic Echocardiography (FATE).

Materials and methods
This single-centre, prospective, randomised controlled study was conducted during an extracurricular FATE workshop (approximately 420 min) for third-year medical students. Participants were randomly assigned to the study group (training solely on simulators) or the control group (training on human subjects). Both groups completed a theory test and a self-assessment questionnaire before the course (T1) and at the end of the training (T2). At T2, all participants also completed two Direct Observation of Procedural Skills (DOPS) tests—one on the simulator (DOPSSim) and one on humans (DOPSHuman).

Results
Data from 128 participants were analysed (n = 63 study group; n = 65 control group). Both groups exhibited increased competency between the T1 and T2 self-assessments and theory tests (p < 0.01). In the DOPSHuman assessment at T2, the control group performed significantly better (p < 0.001) than the study group. While motivation remained consistently high among both groups, the study group rated their “personal overall learning experience” and the “realistic nature of the training” significantly worse than the control group (p < 0.0001). Both groups supported the use of ultrasound simulators as a “supplement to human training” (study: 1.6 ± 1.1 vs. control: 1.7 ± 1.2; p = 0.38), but not as a “replacement for human training” (study: 5.0 ± 2.3 vs. control: 5.4 ± 2.1; p = 0.37).

Conclusion
Both simulator- and human-based training effectively developed theoretical and practical skills in FATE. However, the simulator group demonstrated significantly poorer performance when applying their skills to human subjects, indicating limitations in the transferability of this simulator-based training to real-life patient care. These limitations of simulator-based ultrasound training should be considered in future training concepts.

Clinical trial number
Not Applicable.
Immobilization of purified pectinase from Aspergillus nidulans on chitosan and alginate beads for biotechnological applications
Authors: El-Shora Hamed M. , Abo-Elmaaty Sabah A. , El-Sayyad Gharieb S. , Al-Bishri Widad M. , El-Batal Ahmed I. , Hassan Mervat G. 
Published: January 2025

Abstract
Background
Because the process is cost-effective, microbial pectinase is used in juice clearing. The isolation, immobilization, and characterization of pectinase from Aspergillus nidulans (Eidam) G. Winter (AUMC No. 7147) were therefore the focus of the current investigation.

Results
Ammonium sulphate (85%), DEAE-cellulose, and Sephadex G-200 were used to purify the enzyme. With a yield of 30.4%, the final specific activity was 400 units mg−1 protein and 125-fold purification. Using SDS-PAGE to validate the purification of the pectinase, a single band showing the homogeneity of the purified pectinase with a molecular weight of 50 kD was found. Chitosan and calcium alginate both effectively immobilized pectinase, with immobilization efficiencies of 85.7 and 69.4%, respectively. At 50, 55, 60, and 65 °C, the thermostability of both free and chitosan-immobilized pectinase was examined. The free and chitosan-immobilized enzymes had half-lives (t1/2) of 23.83 and 28.64 min at 65 °C, and their Kd values were 0.0291 and 0.0242 min−1, respectively. In addition, the Z values were 44.6 and 31.54 °C, while the D values were 79.2 and 95.1 min. Compared to the untreated one, the orange, mango, and pineapple juices treated with immobilized pure pectinase showed greater clarity. Following treatment with pure pectinase, the fruit juice’s 1, 1-diphenyl-2-picrylhydrazyl and 2, 2′-azino-bis 3-ethylbenzothiazoline-6-sulfonate scavenging activities increased. Following treatment with pure pectinase, the amounts of total phenolics and total flavonoids increased.

Conclusion
The procedure is deemed cost-effective in the food industry because the strong affinity of fungal pectinase for pectin. The investigated pectinase supported its usage in the food industry by being able to clear orange, mango, and pineapple juices.
Metabolic engineering of Priestia megaterium for 2’-fucosyllactose production
Authors: Park Bu-Soo , Yoon Jihee , Lee Jun-Min , Cho Sang-Hyeok , Choi Yoojeong , Cho Byung-Kwan , Oh Min-Kyu 
Published: January 2025

Abstract
Background
2′-Fucosyllactose (2′-FL) is a predominant human milk oligosaccharide that significantly enhances infant nutrition and immune health. This study addresses the need for a safe and economical production of 2’-FL by employing Generally Recognized As Safe (GRAS) microbial strain, Priestia megaterium ATCC 14581. This strain was chosen for its robust growth and established safety profile and attributing suitable for industrial-scale production.

Results
The engineering targets included the deletion of the lacZ gene to prevent lactose metabolism interference, introduction of α-1,2-fucosyltransferase derived from the non-pathogenic strain, and optimization of the GDP-L-fucose biosynthesis pathway through the overexpression of manA and manC. These changes, coupled with improvements in lactose uptake and utilization through random mutagenesis, led to a high 2’-FL yield of 28.6 g/L in fed-batch fermentation, highlighting the potential of our metabolic engineering strategies on P. megaterium.

Conclusions
The GRAS strain P. megaterium ATCC 14581 was successfully engineered to overproduce 2’-FL, a valuable human milk oligosaccharide, through a series of genetic modifications and metabolic pathway optimizations. This work underscores the feasibility of using GRAS strains for the production of oligosaccharides, paving the way for safer and more efficient methods in biotechnological applications. Future studies could explore additional genetic modifications and optimization of fermentation conditions of the strain to further enhance 2’-FL yield and scalability.
Current status and innovative developments of CAR-T-cell therapy for the treatment of breast cancer
Authors: Marei Hany E. , Bedair Khaled , Hasan Anwarul , Al-Mansoori Layla , Caratelli Sara , Sconocchia Giuseppe , Gaiba Alice , Cenciarelli Carlo 
Published: January 2025

SummaryBreast cancer will overtake all other cancers in terms of diagnoses in 2024. Breast cancer counts highest among women in terms of cancer incidence and death rates. Innovative treatment approaches are desperately needed because treatment resistance brought on by current clinical drugs impedes therapeutic efficacy. The T cell-based immunotherapy known as chimeric antigen receptor (CAR) T cell treatment, which uses the patient’s immune cells to fight cancer, has demonstrated remarkable efficacy in treating hematologic malignancies; nevertheless, the treatment effects in solid tumors, like breast cancer, have not lived up to expectations. We discuss in detail the role of tumor-associated antigens in breast cancer, current clinical trials, barriers to the intended therapeutic effects of CAR-T cell therapy, and potential ways to increase treatment efficacy. Finally, our review aims to stimulate readers’ curiosity by summarizing the most recent advancements in CAR-T cell therapy for breast cancer.