bluuebunny/crossref_metadata_2025 huggingface dataset:
Explainable Predictive Models of Short Stature and Exploration of Related Environmental Growth Factors: A Case-Control Study
Authors: Liu Jiani , Zhang Xin , Li Wei , Bigambo Francis Manyori , Wang Xu , Teng Beibei
Published: August 2024

Background
Short stature is a prevalent pediatric endocrine disorder where early detection and prediction are pivotal in improving treatment outcomes. However, existing diagnostic criteria often lack the necessary sensitivity and specificity due to the disorder's complex etiology. Hence, this study aims to employ machine learning (ML) techniques to develop an interpretable predictive model for short stature and to explore how growth environments influence its development.
Methods
We conducted a case-control study including 100 cases of short stature who were age-matched with 200 normal controls from the Endocrinology Department of Nanjing Children's Hospital from April to September 2021. Parental surveys were conducted to gather information on the children involved. We assessed 33 readily accessible medical characteristics and utilized conditional logistic regression to explore how growth environments influence the onset of short stature. Additionally, we evaluated the performance of nine ML algorithms to determine the optimal model. Subsequently, the Shapley Additive Explanation (SHAP) method was employed to prioritize feature importance and refine the final model.
Results
In multivariate logistic regression analysis, children's weight (OR = 0.85, 95% CI: 0.76, 0.96), maternal height (OR = 0.77, 95% CI: 0.68, 0.86), paternal height (OR = 0.80, 95% CI: 0.71, 0.91), maternal early puberty (OR = 0.02, 95% CI: 0.00, 0.39), and children's outdoor activity time exceeding 3 hours per day (OR = 0.01, 95% CI: 0.00, 0.68) were identified as protective factors for short stature. This study found that parental height, children's weight, and caregiver education significantly influenced the prediction of short stature risk, and the Random Forest (RF) model demonstrated the best discriminatory ability among 9 ML models.
Conclusions
This study indicates a close correlation between environmental growth factors and the occurrence of childhood short stature, particularly anthropometric characteristics. The Random Forest model performed exceptionally well, demonstrating its potential for clinical applications. These findings provide theoretical support for personalized interventions and preventive measures for short stature.
Heat Adaptation Benefits for Vulnerable groups In Africa (HABVIA): A study protocol for a controlled clinical heat adaptation trial
Authors: Deglon Michaela , Africa Chad , Soepnel Larske Marit , Kapwata Thandi , Aikins Ama de-Graft , Bedu-Addo Kweku , Howard Guy , Lambert Estelle Victoria , Rae Dale Elizabeth , Sibanda Martha , Gordon Christopher , New Mark , Dugas Lara
Published: August 2024

Background Temperatures across Africa are expected to rise at up to twice the rate of mean global temperatures, posing significant health threats to vulnerable communities. Prolonged exposure to high day- and night-time temperatures has been implicated in a myriad of adverse health outcomes. The built environment and inadequate housing can exacerbate these consequences, prompting the need to evaluate heat adaptation interventions as a sustainable adaptation strategy for low-income and informal settlement dwellers. The HABVIA: heat adaptation benefits for vulnerable groups in Africa study aims to assess the impact of passive cooling interventions in homes on several key physiologic and mental health outcomes, as well as building internal thermal conditions. Methods HABIVA is a 3-year prospective controlled study to identify, implement and assess heat adaptation solutions in four low-income communities in one urban and one rural site in Ghana and South Africa, respectively. In each site, N = 240 participants (N = 60 per site) will be assigned to intervention or control groups. The intervention is focused on lowering the nighttime temperature of the home environment. Health and biometric data will be collected through a combination of physiological measurements, questionnaires, and biochemical measures taken at 3 time points during the hot season. Clinical outcomes include objective sleep behaviour, core body temperature, physical activity, blood pressure, blood glucose, anthropometrics and body composition. Indoor and outdoor environmental data will be collected continuously using fixed indoor sensors and automatic weather stations. Housing and community characteristics, and socio-economic information will be collected. Quantitative comparisons will be made between intervention and control conditions using generalised linear mixed models. Qualitative data from consultive workshops will be used to assess the acceptability and feasibility of the adaptations. Discussion Robust evaluation of the environmental and health outcomes of heat adaptations are limited for Africa, despite high climate vulnerability. HABVIA will address some of these gaps by assessing low-cost passive cooling interventions to promote heat resilience and improve health outcomes, providing real-world evidence for the feasibility of readily implementable and scalable adaptations in local contexts. Trial registration: Pan African Clinical Trials Registry (PACTR) PACTR202401521630856, version 1. Retrospectively registered on January 12, 2024.
An Innovative Gamification Tool to Enhance Intercultural Competence and Self-Efficacy among Healthcare Professionals Caring for Vulnerable Migrants and Refugees
Authors: Moreno-Comellas Ruben , Murias-Closas Adria , Evangelidou Stella , Wylie Lloy , Serre-Delcor Nuria
Published: August 2024

Background
This article explores the burgeoning challenge of providing adequate healthcare to vulnerable migrants and refugees (VMRs) within the European Union, an issue exacerbated by the recent surge in migration and asylum applications. A critical gap identified is the lack of intercultural competence (ICC) training in healthcare education, which impedes healthcare professionals' ability to offer culturally sensitive care. The study introduces an innovative educational tool, the "Refugee Escape Room" (RER), to address this gap.
Methods
The RER is a novel gamification-based initiative, conceptualized to enhance ICC, self-efficacy (SE), and knowledge among healthcare students and professionals. It employs an immersive learning approach, where participants engage in a simulated migratory scenario set in a future world crisis, necessitating collaborative problem-solving and decision-making under pressure. The study uses a mixed-methods approach, including a pre-post intervention design with a newly validated questionnaire and thematic content analysis of qualitative feedback.
Results
Results from the 101 recruited participants indicate significant improvements in ICC (d=1.13; t=-12.64, p<0.001), SE (d=0.38; t=-3.56; p=0.001), and knowledge (d=1.19; t=-8.40; p<0.001) post-intervention. Participants reported enhanced understanding of VMRs' health challenges and increased empathy, translating their learning into improved attitudes and skills. The study also highlights the potential of educational escape rooms in engaging diverse learners and fostering experiential learning.
Conclusions
The RER, with its focus on VMRs and ICC training, is an innovative, acceptable and feasableeducational tool that attemps to fill a crucial gap in healthcare education. It represents a promising step towards more effective intercultural training in healthcare, thereby addressing health disparities and improving care quality for vulnerable populations. The study suggests the need for more structured research and methodological rigor to further assess the impact of novel educational tools in healthcare training.
Efficacy and Safety of Pasireotide Treatment in Acromegaly: A Systematic Review and Single Arm Meta-Analysis
Authors: Aliyeva Turkan , Muniz Juliana , Soares Gustavo Meira , Firdausa Sarah , Mirza Lubna
Published: August 2024

Background
Acromegaly is an uncommon chronic endocrine disorder which is associated with considerable comorbidities. Many patients fail to achieve biochemical control with current medical therapies, including surgery and first-generation somatostatin analogs. We aimed to perform a systematic review and single-arm meta-analysis to evaluate the efficacy of the multi-receptor ligand somatostatin analog Pasireotide in patients with active or uncontrolled acromegaly.
Methods
We systematically searched PubMed, Embase, and Cochrane databases for studies that assessed the efficacy of Pasireotide in patients with acromegaly and reported the outcomes of (1) biochemical control and its composite indicators; (2) normalized IGF1 level and (3) low GH levels. For the statistical analysis, we used R software.
Results
We included nine studies with a total of 590 patients: four clinical trials and five observational cohorts. The overall population consisted of inadequately controlled or active acromegaly patients. After a follow-up of 12 months, the overall population achieved a biochemical control rate of 26.50% (95% CI: 14.87-42.66). The prevalence of normalized IGF1 and low GH levels was 36.27% (95% CI 29.15-43.39) and 34.76% (95% CI 24.58-44.95), respectively. Additionally, biochemical response rates were sustained throughout the extension phase of these studies. In a pooled analysis including four studies with extension phase results, the prevalence of biochemical control rate in the overall population was 29.03% (95% CI: 11.49–46.58) with 76 events out of 281 patients. The most commonly reported adverse events were gastrointestinal disturbances in 31.26% (95% CI: 7.44–72.01) and hyperglycemia in 29.55% (95% CI: 21.80–37.29) of patients. The incidence of diabetes mellitus significantly increased after pasireotide treatment, with a rate of 23.36% (95% CI: 19.58-27.13).
Conclusion
Pasireotide demonstrates biochemical control in patients with active or uncontrolled acromegaly. Although a high rate of hyperglycemic adverse events and diabetes mellitus related to the treatment were observed, most of them were manageable.
Malaria Risk Assessment Based on the Use of Insecticide Treated Nets in Nsukka Local Government Area, Enugu State, Nigeria
Authors: Nsemani William , Ubachukwu Patience , Boadu Isaac
Published: August 2024

Background: Malaria remains a global pressing issue despite several interventions to reduce the disease prevalence. One of the key interventions that has gained public interest is the use of insecticide treated nets (ITNs) to control the malaria-mosquito vector. This study sought to determine malaria prevalence, ITN ownership and usage and assess the effectiveness of damaged ITNs in malaria prevention in peri-urban communities in Enugu State, South-Eastern Nigeria.
Method: This was a cross-sectional study conducted in three communities (Nsukka, Obimo and Edem) of Nsukka Local Government Area. A total of 317 participants from 125 randomly selected households were screened for malaria using rapid diagnostic test (RDT) and confirmed with microscopy. Socio-demographic data and information related to ITN were collected using structured questionnaires and field observation. Bivariate and multivariable logistic regression analyses were performed to determine socio-demographic and ITN characteristics associated with Malaria.
Results: Malaria prevalence among participants was 23.7% (RDT) and 14.5% (microscopy). Prevalence of malaria differed significantly among the age group (p<0.01), with 5-15 years having the highest prevalence both by RDT (6.9%) and microscopy (5.4%). Severity of malaria cases revealed 54.3%, 30.4% and 15.3% for moderate, low and severe parasitemia respectively. Of the 125 household surveyed, less than half (44.0%) possessed at least one ITN with only a few (18.2%) in good condition. Members of households without ITN were 1.32 more likely to have malaria using RDT (0.23-3.81, p=0.09). Not using ITN (aOR=1.5, CI=0.45- 3.62) and the use of damaged ITN (aOR=3.81, CI=1.24- 9.71) were significantly associated with having malaria by the use of RDT.
Conclusion: Malaria prevalence was high among the study participants particularly the older children. Most of the ITNs used by households were damaged. Participant who did not have ITN were more at risk of being affected with malaria. There is the need for regular provision of ITNs among the risk populations and increased community sensitization on the need to use ITN to prevent human-mosquito contact.
LSD1 and GCN5 inhibition facilitates Am80 (tamibarotene)-mediated differentiation therapy in RARA-high non-APL AML
Authors: Schenk Tino , Zadegan Faezeh Ghazvini , Fiedler Franziska , Stanko Clara , Ölsner Laura , Schuett Jacqueline , Özcan Setenay , Schnöder Tina , Sbirkov Yordan , Szymanski Lukasz , Stengel Sven , Dittrich Peter , Müller Jörg , Heidel Florian , Hochhaus Andreas , Scholl Sebastian , Brioli Annamaria
Published: August 2024

Acute myeloid leukemia (AML) remains a challenging disease with a poor prognosis, necessitating more personalized therapeutic strategies. Retinoic acid receptor (RAR) activation is crucial for myeloid differentiation, but non-APL AML cells resist differentiation induced by the pan-RAR agonist all-trans retinoic acid (ATRA). Am80, a specific RARA agonist, has been reported to partially overcome this resistance in AML with high RARA expression. However, its effects on myeloid differentiation, especially in comparison to ATRA, remain understudied. We compared the effects of Am80 and ATRA in non-APL AML samples, focusing on subsets with high RARA and/or RARG expression, using molecular and phenotypic differentiation assessments. Contrary to previous findings, high RARA levels alone did not foster myeloid differentiation upon Am80 treatment in primary AML. At cellular and molecular levels, Am80 and ATRA induced identical molecular and differentiation responses. Nevertheless, combined treatment of both retinoids with LSD1 and GCN5 inhibitors efficiently unlocked differentiation in various types of non-APL AML, particularly in those with higher RARA levels. Our findings highlight the potential of Am80 in the field of personalized AML treatment, particularly when utilized in conjunction with epigenetic modifiers in RARA-high AML, warranting further clinical investigation.
Seismic Vulnerability Assessment for a Reinforced Concrete Buildings in the Historic Center: Case Study of Villavicencio, Colombia.
Authors: Granados Luis Felipe , Choque Bregy , Solarte Alexander , Chicangana German , Lozano Emiro
Published: August 2024

Reinforced concrete construction has been important for the development of cities as we know them today, in addition many of the concrete structures present in urban centres have several decades of construction, this passage of time has influenced the deterioration of reinforced concrete structures and generates uncertainty in those people who inhabit them. This situation made it necessary to assess seismic vulnerability of a building in urban centre of Villavicencio,, to know their degree of vulnerability to an earthquake and take measures to reduce it. It was possible to show that the buildings analysed presented different structural deficiencies and pathological problems, which in several cases make it necessary to incorporate them to comply with the norm of the current seismic code. With this work, it was found that some buildings require reinforcement of their structural elements, and it was possible to show that they presented both the ISE and the IFL greater than 1.0, which implies that they require reinforcement of their structural elements.
Willingness to pay for social health insurance and associated factors among government employees in Jigjiga, Eastern Ethiopia: Mixed Method Study
Authors: Abdulahi Darod , Gamachu Mulugeta , Deressa Alemayehu , Reshid Fenan , Negash Belay , Mussa Ibsa
Published: August 2024

Background: Social Health Insurance is a system of financing and managing health care of employees. A million people suffer a health-related financial catastrophe each year, and the majority have difficulty paying health expenditures, which leads government employees to low health service utilization. However, there is no evidence of the status of health insurance in the study area. Therefore, the study aimed to assess willingness to pay for social health insurance and associated factors among government employees, in Jigjiga town, eastern Ethiopia.
Method: A mixed method cross-sectional study was used among 578 randomly selected government employees from March 30 to May 30, 2023, in Jigjiga city. Data was collected using a pre-tested semi-structured questionnaire through self-administration, entered into Epi-data version 3.1, and exported to SPSS version 22.0. Binary logistic regression was conducted to identify factors associated with willingness to pay. An odds ratio with a 95% confidence interval was used to interpret the finding and statistical significance was set at p < 0.05. Nine in-depth interviews were used to collect qualitative data, which were then analyzed thematically.
Results: Willingness to pay for social health insurance was 69.90%. Factors such as age >39 years old [AOR=6.30, 95 % CI;2.23,17.86], masters and above educational [AOR=0.41, 95% CI; 0.17,0.98], family size >=5 [AOR=0.11, 95% CI; 0.03,0.39], chronic illness in a family [AOR=0.37, 95 % CI; 0.25,0.55], and belief social health insurance as no benefit [AOR= 0.26, 95 % CI; 0.08,0.85] were significantly associated with social health insurance. From in-depth interviews, social health insurance has high acceptance and is considered an appropriate program for the study area.
Conclusion: Nearly seven out of ten government employees are willing to pay for the proposed SHI. Age, educational status, family size, presence of chronic disease, and belief in SHI benefits are associated with willingness. A strong emphasis on implementation and providing necessary information for employees should be given to enhance their knowledge. It would be better to advocate the SHI for policymakers in order to start early implementation of the SHI in the Somali region.
Predicting disease progression from the rate of bodyweight change in Nasopharyngeal Carcinoma Patient during Radiotherapy
Authors: Cai Jing , Sun Jiachen , Lam Sai-kit , Zhang Jiang , Teng Xinzhi , Lee Francis Kar-ho , Yip Celia Wai-yi , Chow James Chung-hang , Lee Victor Ho-fun , Sun Ying
Published: August 2024

Purpose
Bodyweight loss is a common occurrence in Nasopharyngeal Carcinoma (NPC) patients during Radiotherapy (RT). Previous studies found that the prognostic value of percentage weight loss (pWL) during RT is not credible. We aimed to develop a novel progression predictor surrogated to pWL by modelling all bodyweight records measured during the treatment interval.
Method and materials
This retrospective study included two independent hospitals of 624 patients. The Predicted Progression Probability (PPP) was obtained from deep learning-guided differential equation solution, model by the patient’s age, sex, body height, and the weekly measured bodyweight records. The performance of PPP in predicting disease progression was assessed, its association with prognosis and adjuvant chemotherapy response was evaluated.
Results
The PPP was learnt from the training cohort (N = 257) with 7 weeks of bodyweight records. The prediction performance was validated with 367 patients of the testing cohort sub-divided according to the number of bodyweight records found. The area under of curve for patients with 7 weeks (N = 155), 6 weeks(N = 176), and 5 weeks bodyweight records (N = 32) were 0.76, 0.73, and 0.95 respectively. PPP was significantly associated with progression-free and remained an independent prognostic factor adjusting for clinicopathologic variables in multivariate analysis in all study cohort (adjusted hazard ratio [HR] range: 2.50–7.04, all p < 0.001). Patients with high-PPP derived progression benefit from adjuvant chemotherapy (HR:0.41–0.54, all p < 0.03), whereas those with low-PPP did not for both cohorts.
Conclusion
The trajectory of bodyweight change during RT is more robust than the pWL to give a progression prediction after RT. The PPP is a reliable predictor for estimating the risk of residual diseases after RT course, which also helps to predict adjuvant chemotherapy response in locally advanced NPC patients.
Multi-Fidelity Information Fusion for Turbulent TransportModeling in Magnetic Fusion Plasma
Authors: Maeyama Shinya , Honda Mitsuru , Narita Emi , Toda Shinichiro
Published: August 2024

Maintaining the high-temperature and high-pressure conditions that are essential to sustained nuclear fusion reactions is a challenge due to the turbulent transport that naturally occurs in the plasma. It is crucial to construct a reliable model for turbulent transport to make progress in fusion research and development. This study proposes multi-fidelity modeling for the improved accuracy of regression models for turbulent transport in magnetic fusion plasma. Multi-fidelity modeling combines low-fidelity data, which have low accuracy but many data points, with high-fidelity data, which are highly accurate but have few data points or small parameter ranges, to enhance the overall predictive accuracy of a model. We used a multi-fidelity information fusion technique, Nonlinear AutoRegressive Gaussian Process regression (NARGP), to solve the regression problems associated with turbulent transport in plasma. We applied NARGP to (i) merge the low-resolution and high-resolution simulation results, (ii) apply regression of turbulence diffusivity to the experimental dataset using linear analyses, and (iii) adapt the quasilinear transport model to nonlinear simulation results of a particular discharge. We demonstrated that NARGP improved the prediction accuracy of the plasma turbulent transport model. NARGP successfully corrected errors in low-fidelity model predictions by using high-fidelity datasets, and this produced high-accuracy predictions for the related discharges. NARGP offers a robust and versatile method for integrating multi-fidelity data, and its broad applicability may contribute to optimizing fusion reactor design and operation.
Family Mutuality Enhances the Family Resilience of CRC Patients through Positive Family Functioning
Authors: Shao Mengwei , Xue Yanyan , Zhang Menghan , Zhou Huiyue , Ma Bin , Wang Kun , Yang Yi , Yu Lulu , Chen Changying , Wang Tao
Published: August 2024

Aims: To elucidate the influencing factors of family resilience of postoperative colorectal cancer (CRC) patients, and how family resilience is affected by family function and mutuality.
Methods: In this cross-sectional study, we investigated 216 postoperative CRC patients from two public hospitals. We started by studying the sociodemographic and disease-related factors impacting family resilience of CRC patient families through t-tests, one-way ANOVA, and Post Hoc Multiple Comparisons. To understand how family resilience could be affected from the family level, given the critical role of the copying capacity of family in the outcomes of postoperative CRC patients, we further investigated three key aspects of a family, i.e., family resilience, family function, and family mutuality using the Family Resilience Questionnaire (FaREQ), the Family Adaptation, Partnership, Growth, Affection, Resolve (APGAR) Scale, and the Mutuality Scale (MS). Then, based on all these results, we examined the interaction between family resilience, family function, and mutuality through Pearson correlations and the SPSS PROCESS macro.
Results: Six factors were identified to be associated with family resilience among families of postoperative CRC patients, including postoperative duration(F=3.684, p=0.013), education level (F=7.609, p< 0.001), marital status (F=2.822, p=0.040), working status (F=3.807, p=0.024), family income (F=9.487, p<0.001), and stoma status (t=-2.991, p=0.003). We found that family resilience was positively correlated with both family mutuality (r=0.170~0.473, p<0.05) and family function (r=0.135~0.451, p<0.05). Furthermore, we found that a healthy family mutuality could enhance family resilience, and the effectiveness of this enhancement was affected by the status of family function.
Conclusions: In addition to sociodemographic and disease-related factors, this work studied the influence factors of family resilience of CRC patient families from a unique perspective, by systematically investigating the interaction between family resilience, family function, and family mutuality. Our results suggested that (1) family mutuality and family function were protective factors for family resilience; (2) Family function played a crucial role in mediating the positive effects of mutuality on family resilience. Based on our results, we suggest that healthcare professionals should assess family resilience actively from not only the sociodemographic and disease levels, but also from a more comprehensive family level, to develop effective intervention strategies to enhance the coping and adaptive capacities of families of CRC patients during the postoperative cancer management.
Three-dimensional personalized porous polyethylen cranioplasty in patients at increased risk of surgical site infection
Authors: Mracek Jan , Seidl Miroslav , Dostal Jiri , Kasik Petr , Tupy Radek , Priban Vladimir
Published: August 2024

Background
Surgical site infection (SSI) is the most consistently reported complication of cranioplasty. No material showed a categorical superiority in the incidence of infection. Porous polyethylene (PE) is considered a low risk material regarding SSI. However, the literature data are very limited. Thus, our objective was to verify the assumed low incidence of SSI after PE cranioplasty in patients at high risk of SSI. The primary objective was the infection rate, while secondary objectives were implant exposure, revision and cosmetic results.
Method
Patients who underwent three-dimensional (3D) personalized PE cranioplasty in the period 2014-2023 were evaluated prospectively. Only patients with an increased risk of SSI, and a satisfactory clinical conditions were included in the study.
Results
Thirty procedures were performed in 30 patients. Cranioplasty was performed 23 times after hemispheric decompressive craniectomy, 5 times after limited size craniotomy and 2 times after bifrontal decompressive craniectomy. Risk factors for the development of infection were 18x previous SSI, 16x previous repeated revision surgeries, 4x intraoperatively opened frontal sinus and 2x radiotherapy. Neither infection nor implant exposure was detected in any patient. All patients were satisfied with the aesthetic result. In two cases, a revision was performed due to postoperative epidural hematoma.
Conclusions
Three-dimensional personalized PE cranioplasty is associated with an extremely low incidence of SSI even in high-risk patients. However, our conclusions can only be confirmed in larger studies.
Residual stress analysis in a polyethylene pipe wall
Authors: ALIMI Latifa , Bouchakhchoukha Soumaya , Chaoui Kamel
Published: August 2024

Residual stresses are tensions that remain in the material even when it is no longer subjected to external pressures. The most prevalent causes of residual stresses include fabrication operations, thermal processing, welding, heat treatment, mechanical shaping, and extrusion. In this study, an experimental method is used to determine the residual stresses in a 125 mm diameter polyethylene tube meant for natural gas transportation. The material removal process in sequential machining is used to extract five successive layers from the tube's wall. In fact, by successively removing layers, the variation in curvature makes it possible to evaluate the stresses that were present in the removed part. It is then theoretically possible to go back to the distribution of stresses in the thickness and to determine the profile of residual stresses. It was found that compressive stresses are relieved in the exterior of the wall. And other positive tensile stresses are released inside the wall. This configuration is related to the manufacturing process, namely extrusion.
Futile Recanalization After Endovascular Treatment in Acute Ischemic Stroke With Large Ischemic Core
Authors: Kim Hyunsoo , Kim Joon-Tae , Choi Kang-Ho , Yoon Woong , Baek Byung Hyun , Kim Seul Kee , Kim You Sub , Kim Tae-Sun , Park Man-Seok
Published: August 2024

Background
Endovascular therapy (EVT) is the treatment of choice for acute ischemic stroke (AIS) with large vessel occlusion. However, many patients do not benefit from EVT recanalization, called futile recanalization (FR). We aimed to identify stroke risk factors and patient characteristics associated with FR in AIS with large core infarct (LCI).
Methods
A total of 137 patients with AIS with LCI treated by EVT at a single stroke center were retrospectively included from January 2016 to June 2023. LCI was defined by Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomography Score < 6. Patient age, sex, modified Rankin Scale (mRS), National Institutes of Health Stroke Scale (NIHSS), time to treatment, risk factors, and radiologic findings were collected, and potential associations with FR were analyzed. FR was defined as successful reperfusion with modified Thrombolysis in Cerebral Infarction (mTICI) ≥ 2b but without functional independence at 90 days (mRS ≥ 3).
Results
Of 137 patients, 120 showed successful recanalization (mTICI ≥ 2b). All patients were divided into FR (n = 80) and no FR (n = 40) groups. Older age (odds ratio [OR] 1.052, 95% confidence interval [CI] 1.002–1.105; p = 0.041), higher initial NIHSS (OR 1.181, 95% CI 1.037–1.344; p = 0.012), and prior intravenous plasminogen activator (OR 0.310, 95% CI 0.118–0.813, p = 0.017) were independent influencing factors of FR.
Conclusions
Older age, higher initial NIHSS, and not receiving intravenous plasminogen activator were independently associated with FR in AIS with LCI and could predict poor responders to EVT recanalization.
Clinicopathological Features of KRAS-Mutated Colon Cancer: An Analytical Cross-Sectional Study
Authors: Hernandez-González Helí , Cortés-Torres Edgar Joaquín , Morfín-Meza Kathia Dayana , García Andrea , Sánchez-Luna Ana Guadalupe , González-Muñoz Samantha Emily , Vázquez-Sánchez Sergio Jiram , González-Ojeda Alejandro , Fuentes-Orozco Clotilde , Cervantes-Guevara Gabino , Cervantes-Pérez Enrique , Ramírez-Ochoa Sol , Álvarez-Villaseñor Andrea Socorro , Cortés-Flores Ana Olivia , Castillo-Cardiel Guadalupe
Published: August 2024

Background
Colon cancer is a leading neoplasm worldwide, with 35–45% of colorectal cancer patients exhibiting mutations in the Kirsten rat sarcoma oncogene (KRAS). This mutation affects disease development and serves as a biomarker for early detection, prognosis, and treatment.
Objective
Identify the clinicopathological characteristics of colon cancer patients with KRAS mutations.
Material and Methods
Analytical cross-sectional study, including patients with colorectal cancer (CRC). The study variables included sex, age, tumor location, KRAS and BRAF mutations, and the presence of metastases.
Results
The study involved 51 male patients, with a mean age of 61.4 ± 11.0 years. The most common tumor location was the sigmoid colon (35.3%), and 45.1% of patients were classified as TNM stage III with lymph node dissemination. Genetic analysis revealed that 35% of patients had KRAS mutations, while 32% had BRAF mutations. Notably, 61.1% of KRAS-positive patients also had BRAF mutations compared to 15.1% of KRAS-negative patients (p = 0.02).
Conclusions
The study indicates that colon cancer patients with KRAS(+) mutations tend to be older and have a higher incidence of comorbidities.
Neonatal mortality rate and burden of disease in Thai neonates: A nationwide data analysis
Authors: Kiatchoosakun Pakaphan , Jirapradittha Junya , Paopongsawan Pongsatorn , Thepsuthammarat Kaewjai , Manopunya Satit , Sutra Sumitr
Published: August 2024

Background: Neonatal mortality rate (NMR) is an international indicator reflecting a country’s health problems and services. This study is the most extensive nationwide effort to evaluate in-hospital mortality and disease burden among neonates in Thailand.
Methods: A descriptive-analytic study used data from neonates born in hospitals under the Universal Health Coverage Scheme between 2015 and 2020. Data were extracted from discharge summaries using the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Thai Modification (ICD-10-TM).
Results: Overall, 3,141,215 live births were recorded during the 6-year study period, and 10,623 infants died within 28 days of life. In-hospital NMR was 3.38 per 1,000 live births. The annual NMR decreased significantly from 3.60 per 1,000 in 2015 to 3.05 per 1,000 in 2020 (p-value <0.001). Sixty-seven percent (n=7,149) of deaths occurred within 7 days of life (early neonatal death), and 46.7% (n=4,957) died within 3 days. The leading causes of neonatal death were disorders related to prematurity (36.3%), followed by congenital malformations and chromosomal abnormalities (23.5%), respiratory problems and persistent pulmonary hypertension of the newborn (17.8%), neonatal sepsis (12.3%), and perinatal asphyxia (7.6%). The regional NMR varied significantly, from 2.35 per 1,000 in the northern region to 5.22 per 1,000 in Bangkok. Factors significantly associated with NMR include low birth weight, small for gestational age, persistent pulmonary hypertension of the newborn, pulmonary hemorrhage, air leak, major congenital anomalies, severe asphyxia, hypo-hyperglycemia, disturbance of sodium balance, and sepsis.
Common comorbidities among Thai neonates were neonatal jaundice (23.9%), respiratory problems (12.1%), disorders related to prematurity and low birth weight (11.1%), congenital malformations and chromosomal abnormalities (7.2%), sepsis (5.8%), and perinatal asphyxia (2.1%).
Conclusion: The declining birth rate and NMR in Thailand highlight significant changes in the country’s demographics and improvements in healthcare services. Prematurity remains the leading cause of neonatal death, emphasizing the critical need for targeted interventions in maternal and neonatal care. Regional disparities in NMR indicate uneven distribution and access to healthcare resources, suggesting that strategic allocation and improvement of perinatal and post-natal care services are necessary to address these variations and enhance overall neonatal health outcomes in Thailand.
Complete genome assemblies and antibiograms of 22 Staphylococcus capitis isolates
Authors: Wan Yu , Pike Rachel , Harley Alessandra , Mumin Zaynab , Potterill Isabelle , Meunier Danièle , Ganner Mark , Getino Maria , Coelho Juliana , Jauneikaite Elita , Moganeradj Kartyk , Brown Colin S. , Holmes Alison H. , Demirjian Alicia , Hopkins Katie L. , Pichon Bruno
Published: August 2024

Objective
Staphylococcus capitis is part of the human microbiome and an opportunistic pathogen known to cause catheter-associated bacteraemia, prosthetic joint infections, skin and wound infections, among others. Detection of S. capitis in normally sterile body sites saw an increase over the last decade in England, where a multidrug-resistant clone, NRCS-A, was widely identified in blood samples from infants in neonatal intensive care units. To address a lack of complete genomes and antibiograms of S. capitis in public databases, we performed long- and short-read whole-genome sequencing, hybrid genome assembly, and antimicrobial susceptibility testing of 22 diverse isolates.
Data description
We present complete genome assemblies of two S. capitis type strains (subspecies capitis: DSM 20326; subspecies urealyticus: DSM 6717) and 20 clinical isolates (NRCS-A: 10) from England. Each genome is accompanied by minimum inhibitory concentrations of 13 antimicrobials including vancomycin, teicoplanin, daptomycin, linezolid, and clindamycin. These 22 genomes were 2.4–2.7 Mbp in length and had a GC content of 33%. Plasmids were identified in 20 isolates. Resistance to teicoplanin, daptomycin, gentamicin, fusidic acid, rifampicin, ciprofloxacin, clindamycin, and erythromycin was seen in 1–10 isolates. Our data are a resource for future studies on genomics, evolution, and antimicrobial resistance of S. capitis.
The Songbird Connectome (OSCINE-NET.ORG): Structure-Function Organization Beyond the Canonical Vocal Control Network
Authors: Savoy Andrew , Anderson Katherine L. , Gogola Joseph V.
Published: August 2024

Background
Understanding the neural basis of behavior requires insight into how different brain systems coordinate. Existing connectomes for various species have highlighted brain systems essential to various aspects of behavior, yet their application to complex learned behaviors remains limited. Vocal learning in songbirds has extensively focused on the vocal control network, though recent work implicates a variety of circuits in contributing to important aspects of vocal behavior. Thus, a more comprehensive understanding of brain-wide connectivity is essential to further assess the totality of circuitry underlying this complex learned behavior.
Results
We present the Oscine Structural Connectome for Investigating NEural NETwork ORGanization (OSCINE-NET.ORG), the first interactive mesoscale connectome for any vocal learner. This comprehensive digital map includes all known connectivity data, covering major brain superstructures and functional networks. Our analysis reveals that the songbird brain exhibits small-world properties, with highly connected communities functionally designated as motor, visual, associative, vocal, social, and auditory. Moreover, there is a small set of significant connections across these communities, including from social and auditory sub-communities to vocal sub-communities, which highlight ethologically relevant facets of vocal learning and production. Notably, the vocal community contains the majority of the canonical vocal control network, as well as a variety of other nodes that are highly interconnected with it, meriting further evaluation for their inclusion in this network. A subset of nodes forms a "rich broker club," highly connected across the brain and forming a small circuit amongst themselves, indicating they may play a key role in information transfer broadly. Collectively, their bidirectional connectivity with multiple communities indicates they may act as liaisons across multiple functional circuits for a variety of complex behaviors.
Conclusions
OSCINE-NET.ORG offers unprecedented access to detailed songbird connectivity data, promoting insight into the neural circuits underlying complex behaviors. This data emphasizes the importance of brain-wide integration in vocal learning, facilitating a potential reevaluation of the canonical vocal control network. Furthermore, we identify a small, previously unidentified circuit—one which may play an impactful role in brain-wide coordination of multiple complex behaviors.
A Comparative Analysis of Large language Models on Clinical Questions for Autoimmune Diseases
Authors: Zhang Weiming , Yu Jie , Ma Juntao , Feng Jiawei , Geng Linyu , Chen Yuxin , Zhang Huayong , Ning Mingzhe
Published: August 2024

Background
Artificial intelligence (AI) has made great strides. Our study evaluated the performance in delivering clinical questions related to autoimmune diseases (AIDs).
Methods
46 AIDs-related questions were compiled and entered into ChatGPT 3.5, ChatGPT 4.0, and Gemini. The replies were collected and sent to laboratory specialists for scoring according to relevance, correctness, completeness, helpfulness, and safety. Scores for three chatbots in five quality dimensions and the scores of the replies to the questions under each quality dimension were analyzed.
Results
ChatGPT 4.0 showed superior performance than ChatGPT 3.5 and Gemini in all five quality dimensions. ChatGPT 4.0 outperformed ChatGPT 3.5 or Gemini on the relevance, completeness or helpfulness in answering about the prognosis, diagnosis, or the report interpretation of AIDs. ChatGPT 4.0’s replies were the longest, followed by ChatGPT 3.5, Gemini’s was the shortest.
Conclusions
Our findings highlight ChatGPT 4.0 is superior to delivering comprehensive and accurate responses to AIDs-related clinical questions.
The most precious resource: time allocation of immigrants in the U.S.
Authors: Coniglio Nicola D. , Hoxhaj Rezart , Jayet Hubert
Published: August 2024

This study offers a comprehensive examination of the time-use patterns of immigrants versus native-born populations in the U.S., drawing from the American Time-Use Survey (ATUS) spanning 2003–2019. We analyse differences in the concentration and diversity of time allocation, looking both at participation likelihood and at the time spent in a highly disaggregated set of activities. Our findings underscore pronounced differences between immigrants and native-born, with distinct patterns emerging across genders and influenced by socio-economic attributes. The data reveals a nuanced assimilation trajectory based on the duration of immigrants' residency. Male immigrants show assimilation in time-use patterns after approximately 20 years, while female immigrants exhibit a more gradual alignment, with significant convergence occurring after two decades. Immigrants also exhibit heightened gender specialization in time-use, which narrows over time but remains pronounced relative to native-born. Second-generation immigrants display time-use patterns similar to long-term first-generation immigrants, aligning closely with the trend of native-born. This study provides valuable insights into the dynamics of time-use, assimilation processes, and gendered divisions, informing socio-economic and integration policies.
Balloon guide catheter for Intra-arterial thrombectomy of M1, and more distal Middle Cerebral Artery occlusion
Authors: Choi Jung Min , Shin Shang Hun , Youn Sung Won , Kim Wook-joo
Published: August 2024

Balloon guide catheters (BGCs) have helped advance endovascular thrombectomy for large vessel occlusion. This study aimed to understand whether a BGC would be useful in thrombectomy of the vessels that are distant from the BGC, such as M1 or more distal artery occlusions. We retrospectively reviewed patients with acute stroke who underwent mechanical thrombectomy at two stroke centers. Data were collected for patients with M1, M2, or proximal M3 occlusions who underwent intra-arterial thrombectomies in 2020 and 2021. Baseline angiographic and clinical characteristics, time intervals, recanalization rates, and clinical outcomes were compared between patients treated with and without BGCs. Sixty-one patients (68.9 ± 12.8 years; males, 62.3%; 35 with BGC) were included. The combined contact aspiration and stent retriever technique was used primarily in both groups. Patients without BGC were older, had a shorter procedural time, and a higher rate of first pass recanalization. Good clinical outcome rate did not significantly differ. In conclusion, BGC did not seem to provide better endovascular or clinical outcomes in intra-arterial thrombectomy for patients with acute ischemic stroke with M1 and more distal artery occlusions when combined contact aspiration and stent retriever is performed.
Barriers to development of health literacy in iran's health system: A Qualitative Study
Authors: Ziapour Arash , Darabi Fateme , Mohammadkhah Fatemeh , Yıldırım Murat , Nejhaddadgar Nazila
Published: August 2024

Background Despite the significance of health literacy, studies show the inadequacy of health literacy in the health system of Iran. Inadequate health literacy is considered a warning for service providers. It needs to be integrated in educational programs run in health and medical centers. Therefore, the present study was conducted to explore the barriers to health literacy in Iran health system.
Methods The present qualitative study was conducted in 2023 using a conventional content analysis. To this aim, 18 subjects were selected among urban health center staff, 21 from rural health centers, 10 health volunteers and 8 trainees for interviews and group discussions. The data were collected through semi-structured interviews and focal group discussions, and were simultaneously analyzed using a conventional qualitative analysis suggested by Lundman and Graneheim.
Results The data analysis led to the extraction of 4 themes: personal barriers (trainee’s inadequate competence, lack of physical or mental health, low motivational factors, wrong beliefs, contextual barriers), interpersonal barriers (healthcare providers’ misunderstanding of correct training, mal- or miscommunication in training sessions, high workload of healthcare staff, the trainer’s limited skill, underestimated role of education in behavior change, supervision and monitoring problems, low work commitment of health staff), organizational barriers (inadequate human resources, poor management, low organizational motivation) and social barriers (uninterest in learning about health issues, issues related to the Internet and cyberspace, lack of intersectoral cooperation, distrust in the health system).
Conclusion Considering the multidimensional nature of barriers for health literacy, it is recommended to make and implement a comprehensive plan to integrate efforts by health authorities and institutions, mass media, experts, decision-makers, policy-makers, and service providers to remove barriers.
A preliminary study on the use of the Boston Cognitive Assessment to assess cognitive function in a Chinese population
Authors: Ding Jiahui , Gao Xiaoxia , Tang Ying , Wu Yehuan , Yuan Xiaofang , Zhang Jianan , Shi Yue , Wang Ya , Guo Jing , Fei Xiao , Zhang Yi
Published: August 2024

Background
This study explored the reliability and validity of the Boston Cognitive Assessment (BOCA) in a healthy China population to obtain an objective basis for its application in China.
Methods
In total, 111 healthy individuals were recruited as research participants from Changzhou Prefecture from December 2023 to July 2024. The Mini-Mental State Examination (MMSE) was conducted offline with paper and pen, whereas the BOCA self-assessment scale was conducted online. The correlation, internal consistency, test–retest reliability, content validity, and calibration validity were analyzed based on the relevant data.
Results
Age was moderately negatively correlated with BOCA scores, while length of education was moderately positively correlated with BOCA scores. The overall Cronbach’s α coefficient of the BOCA scale was 0.774, indicating good internal consistency. The intra-group correlation coefficient (ICC) of the total scores was 0.796, indicating good test–retest reliability. The correlation coefficient between the scores of each BOCA item and the total score was between 0.202 and 0.751 (P < 0.05), indicating good content validity. A moderate positive correlation was found between the total BOCA and MMSE scores (r = 0.682, P < 0.01), indicating good calibration validity.
Conclusions
The BOCA scale has good reliability and validity, indicating its reliability in comprehensively and effectively assessing cognitive function in healthy people in China, and thus it can be used as a remote cognitive self-assessment tool for the Chinese population.