bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic value of cachexia defined by the Asian Working Group for Cachexia criteria in patients with gastric cancer
Authors: Xie Hai-Lun , Wei Li-Shuang , Wang Shu-Yao , Xu Chang-Hong , Ruan Guo-Tian , Zhang He-Yang , Shi Han-Ping , Chen Jun-Qiang 
Published: December 2024

Abstract

Background
The Asian Working Group for Cachexia (AWGC) criteria are newly proposed diagnostic standards specifically designed for Asian populations. This research focused on validating the predictive value of the AWGC criteria for assessing the prognosis and medical burden of patients with gastric cancer.

Methods
Cox proportional hazards analysis was conducted to evaluate the association between cachexia and overall survival. Logistic regression analysis was used to assess whether there was an independent association between cachexia and the 90-day mortality, the length of stay and the quality of life. Harrell’s concordance index was utilized to demonstrate the discriminative ability of different diagnostic criteria for cachexia.

Results
AWGC-defined cachexia was an independent risk factor for a reduced overall survival in patients (HR = 1.397, 95%
CI = 1.209–1.615, P < 0.001). The predictive accuracy of the AWGC criteria was markedly superior to that of the Fearon criteria (χ
2 = 39.025 vs 13.877). Compared with Fearon standards, the AWGC criteria offered a 2.9% enhancement in clinical benefit (0.029, 95% CI = 0.048–0.008, P = 0.005). Logistic regression analysis showed that only AWGC-defined cachexia was an independent risk factor for 90-day mortality (OR = 2.142, 95% CI = 1.397–3.282, P < 0.001) and prolonged hospitalization (OR = 1.958, 95% CI = 1.587–2.416, P < 0.001) in patients with gastric cancer, whereas cachexia defined by the Fearon criteria was not. Patients with AWGC-defined cachexia exhibited significant reductions in physical function, role function, emotional function, cognitive function, social functioning, and overall quality-of-life scores. Conversely, cachectic patients showed higher levels of fatigue, nausea and vomiting, pain, dyspnea, sleep disturbance, appetite loss, constipation, and financial difficulties. A multivariate logistic regression showed that patients with AWGC-defined cachexia had a 126.1% increased risk of impaired quality of life (OR = 2.261, 95% CI = 1.859–2.749, P < 0.001).

Conclusions
The AWGC criteria are an effective tool for predicting adverse survival outcomes, 90-day mortality, a prolonged hospital stay, and poorer quality of life in patients with gastric cancer.
Associations between salivary microbiota and KSHV infection in people with HIV: a cross-sectional study in ili prefecture, Xinjiang, China
Authors: Wang Tianye , Xu Yiyun , Zhou Sujuan , Zhang Xin , Fang Qiwen , Yuan Huangbo , Wu Xuefu , Li Yi , Chen Tao , Zhang Tiejun 
Published: December 2024

Objective:
Kaposi's sarcoma-associated herpesvirus (KSHV) infection, essential for Kaposi sarcoma development especially in people with HIV (PWH), has been proposed to be transmitted through saliva. The potential role of salivary microbiota played in the infection of KSHV is largely obscure. This study aimed to explore the association between salivary microbiota and KSHV infection among PWH.

Design:
Cross-Sectional Study.

Methods:
During May to Dec 2022, we conducted a cross-sectional study among PWH in Ili prefecture Xinjiang, China. Participants completed face-to-face questionnaires, plasma and saliva samples were collected to assay KSHV infection status and 16S rRNA sequencing. We distinguished demographic characteristics between groups with/without KSHV, and compared the α and β diversity of the salivary microbiota. LEfSe identified key bacterial genera for Random Forest and XGBoost models to recognize the important discriminatory features.

Results:
Among 876 PWH in Xinjiang, 38.7% were KSHV seropositive. Regression models indicated that moderate drinking, absence of dental treatment history, higher CD4 counts, and higher CD4/CD8 ratios were negatively associated with KSHV seropositivity. LEfSe analysis demonstrated that 14 bacterial genera were significantly enriched at the genus level in the group with/without KSHV. Machine learning analyses gave an AUC of 0.66 for Random Forest and 0.85 for XGBoost in predicting KSHV infection status. The bacterial genera, including Alloprevotella, Fusobacterium, Prevotella_7, Porphyromonas, Rothia, and Leptotrichia, were identified as important discriminatory features.

Conclusions:
This study suggests the potential role of salivary microbiota in KSHV transmission among PWH. Identified microbial genera offer promising biomarkers for monitoring and managing KSHV in PWH.
Differential systemic immune-inflammation index levels in people with and without HIV infection
Authors: Wang Crystal , Letendre Scott L. , Hong Suzi , Andalibi Mohammad , Iudicello Jennifer , Ellis Ronald J. 
Published: December 2024

Background:
HIV infection is linked to persistent inflammation despite effective antiretroviral therapy (ART). The Systemic Immune-Inflammation Index (SII) is a marker of inflammation in various conditions.

Methods:
We compared SII values between PWH and PWoH. Clinical blood laboratory data were used to calculate the SII for each participant using the formula [(Platelet count × Neutrophil count) / Lymphocyte count]. Differences in SII values between the groups were analyzed using the Wilcoxon test, and the impact potential confounders was assessed with multivariable regression models.

Results:
The study included 343 PWH and 199 PWoH. Age and race did not significantly differ, but sex distribution did (83.1% male in PWH vs. 55.8% in PWoH, P < 0.0001). Among PWH, median [IQR] nadir and current CD4 counts were 199 cells/μL [50, 350] and 650 [461,858], respectively. Nearly all PWH were on ART, with 97.2% achieving viral suppression. PWH had lower SII values than PWoH (327 [224, 444] vs. 484 [335,657], P = 1.35e-14). PWH also had lower neutrophils and platelets (ps < 0.001) and higher lymphocyte counts (P = 0.001). These differences remained significant after adjusting for age, sex, and other potential confounders.

Discussion:
Contrary to expectations, PWH had lower SII levels, likely due to altered hematologic parameters influenced by HIV and ART. These findings suggest that SII interpretation in PWH requires consideration of unique hematologic profiles and underscore the need for further research to understand the mechanisms and clinical implications of SII in HIV management.
Towards personalized nicotinamide mononucleotide (NMN) supplementation: nicotinamide adenine dinucleotide (NAD) concentration
Authors: Kuerec Ajla Hodzic , Wang Weilan , Yi Lin , Tao Rongsheng , Lin Zhigang , Vaidya Aditi , Pendse Sohal , Thasma Sornaraja , Andhalkar Niranjan , Avhad Ganesh , Kumbhar Vidyadhar , Maier Andrea B. 
Published: December 2024

AbstractNicotinamide mononucleotide (NMN) is a precursor of nicotinamide adenine dinucleotide (NAD), which declines with age. Supplementation of NMN has been shown to improve blood NAD concentration. However, the optimal NMN dose remains unclear. This is a post-hoc analysis of a double-blinded clinical trial involving 80 generally healthy adults aged 40 to 65 years. The participants received a placebo or daily 300 mg, 600 mg, or 900 mg NMN for 60 days. Blood NAD concentration, blood biological age, homeostatic model assessment for insulin resistance, 6-minute walk test, and 36-item short-form survey (SF-36) were measured at baseline and after supplement. A significant dose-dependent increase in NAD concentration change (NADΔ) was observed following NMN supplementation, with a large coefficient of variation (29.2-113.3%) within group. The increase in NADΔwas associated with an improvement in the walking distance of 6-minute walk test and the SF-36 score. The median effect dose of NADΔfor the 6-minute walk test and SF-36 score was 15.7 nmol/L (95% CI: 10.9-20.5 nmol/L) and 13.5 nmol/L (95% CI; 10.5-16.5 nmol/L), respectively. Because of the high interindividual variability of the NADΔafter NMN supplementation, monitoring NAD concentration can provide valuable insights for tailoring personalized dosage regimens and optimizing NMN utilization.HighlightsLarge interindividual variability in blood NAD response to NMN supplement was observed.The median effective dose of blood NAD concentration improvement to achieve clinically significant improvement in functional outcome and quality of life was around 15 nmol/L.A close monitoring of NAD concentration change and personalized regimen of NMN supplements is needed.
Higher FSH Level Is Associated With Increased Risk Of Incident Hip Fracture In Older Adults, Independent Of Sex Hormone Levels
Authors: Koh Eileen H. , Ewing Susan K. , Sigurdsson Sigurdur , Gudnason Vilmundur , Hue Trisha F. , Vittinghoff Eric , Ohlsson Claes , Tivesten Åsa , Grahnemo Louise , Yuen Tony , Zaidi Mone , Rosen Clifford J. , Schwartz Ann V. , Schafer Anne L. 
Published: December 2024

ABSTRACTContextHigher levels of follicle stimulating hormone (FSH) are associated with bone loss among women during the perimenopausal transition and among older men, independent of estradiol and testosterone levels, but it is unknown whether higher FSH is an independent risk factor for fracture.ObjectiveDetermine whether baseline FSH level predicts subsequent hip fracture in older adults.Setting, Design, ParticipantsUsing a case-cohort design, we randomly sampled 295 participants stratified by sex from the Age, Gene/Environment Susceptibility (AGES)-Reykjavik cohort, including 25 participants with incident hip fracture within 10 years after baseline. We sampled an additional 230 sex-stratified participants with incident hip fracture. Serum FSH and sex hormone levels were measured at baseline. Robust weighted Cox proportional hazards models were used to determine the relationship between FSH and hip fracture risk.Main OutcomeIncident hip fractureResultsAs no interaction was identified between FSH and sex for the relationship with fracture, men and women were pooled for analysis. Higher levels of FSH were associated with a significantly increased risk of incident hip fracture in models adjusted for age and sex [hazard ratio (HR) 1.24 (95% CI 1.04-1.48, p=0.02)] and after further adjustment for estradiol, testosterone, and sex hormone binding globulin levels [HR 1.20 (95% CI 1.01-1.44, p=0.04) per sex-specific SD increase in FSH level].ConclusionsHigher FSH is associated with increased risk of subsequent hip fracture. Our findings support a growing body of evidence for direct pleiotropic effects of FSH on bone, and for a role for FSH in aging and disability independent of sex hormone levels.
How good are large language models for automated data extraction from randomized trials?
Authors: Sun Zhuanlan , Zhang Ruilin , Doi Suhail A. , Furuya-Kanamori Luis , Yu Tianqi , Lin Lifeng , Xu Chang 
Published: December 2024

AbstractIn evidence synthesis, data extraction is a crucial procedure, but it is time intensive and prone to human error. The rise of large language models (LLMs) in the field of artificial intelligence (AI) offers a solution to these problems through automation. In this case study, we evaluated the performance of two prominent LLM-based AI tools for use in automated data extraction. Randomized trials from two systematic reviews were used as part of the case study. Prompts related to each data extraction task (e.g., extract event counts of control group) were formulated separately for binary and continuous outcomes. The percentage of correct responses (Pcorr) was tested in 39 randomized controlled trials reporting 10 binary outcomes and 49 randomized controlled trials reporting one continuous outcome. ThePcorrand agreement across three runs for data extracted by two AI tools were compared with well-verified metadata. For the extraction of binary events in the treatment group across 10 outcomes, thePcorrranged from 40% to 87% and from 46% to 97% for ChatPDF and for Claude, respectively. For continuous outcomes, thePcorrranged from 33% to 39% across six tasks (Claude only). The agreement of the response between the three runs of each task was generally good, with Cohen’s kappa statistic ranging from 0.78 to 0.96 and from 0.65 to 0.82 for ChatPDF and Claude, respectively. Our results highlight the potential of ChatPDF and Claude for automated data extraction. Whilst promising, the percentage of correct responses is still unsatisfactory and therefore substantial improvements are needed for current AI tools to be adopted in research practice.Highlights1.What is already knownIn evidence synthesis, data extraction is a crucial procedure, but it is time intensive and prone to human error, with reported data extraction error rates at meta-analyses level reaching up to 67%.The rise of large language models (LLMs) in the field of artificial intelligence (AI) offers a solution to these problems through automation.2.What is newIn this case study, we investigated the performance of two AI tools for data extraction and confirmed that AI tools can reach the same or better performance than humans in terms of data extraction from randomized trials for binary outcomes.However, AI tools performed poorly at extracting data from continuous outcomes.3.Potential impact for Research Synthesis Methods readers outside the authors’ fieldOur study suggests LLMs have great potential in assisting data extraction in evidence syntheses through (semi-)automation. Further efforts are needed to improve accuracy, especially for continuous outcomes data.
Accidental Exposure to Body Fluids Among Healthcare Workers in a Referral Hospital in the Security-Challenged Region of South West Cameroon
Authors: Takougang Innocent , Lekeumo Cheuyem Fabrice Zobel , Asongu Changeh Blessing , Nyonga Ngati Denetria , Mengong Moneboulou Hortense 
Published: December 2024

AbstractIntroductionAccidental exposure to body fluids (AEBs) increases the risk of blood-borne infections among susceptible HCWs. While 90% of the AEB reported occur in developed nations, developing countries bear 90% of the burden of healthcare associated infections, especially those of sub-Saharan Africa. Social insecurity may contribute further to the vulnerability of HCWs. Our study sought to determine the prevalence, reporting and management of AEBs among HCWs in the security-challenged Region of South-West Cameroon.MethodsA cross-sectional study was carried out from February 2023 to April 2023, at the Buea Regional Hospital. Following informed consent, a 28-item interviewer-administered questionnaire to HCW was used. Data was entered and analyzed using R Statistics version 4.3.1.ResultsOut of the 230 HCWs that were approached, 200 were responded for a participation rate of >85%. The prevalence of AEB was high (93%). Exposures occurred while administering injections (37%), during blood sample collection (16%), delivery (11%), surgery (10.2%) and washing. The main risk factors for AEB included female gender (aOR=2.86) and those exercising in the medical (aOR=5.95), pediatrics (aOR=10.5), obstetrical (aOR=22.6), dental (aOR=26.3) units. Only 46.8% of AEBs were reported. Post-exposure management was carried out for 67.2% of the reported cases. Most HCW were unaware of the existence of an Infection Control Committee within the study setting, corroborating gaps in the observance of Standard Precautions.ConclusionsMost HCWs experienced AEBs over the last year. There is a need to sensitize and enforce the observance of universal precautions among HCW of the Buea Regional Hospital. Such measures should be extended to other health facilities in related settings.
The Cost Outcome Pathway Framework: Integrating socio-economic impacts to Adverse Outcome Pathways
Authors: Coustillet Thibaut , Coumoul Xavier , Villégier Anne-Sophie , Bisson Michèle , Fritsche Ellen , Brignon Jean-Marc , Zeman Florence , Audouze Karine 
Published: December 2024

AbstractSeveral chemical’s families are linked to a loss of intellectual quotient (IQ) points in children. This may lead to reduced working productivity and/or lower wages in adulthood and contribute to increasing the substantial socio-economic burden worldwide. The Adverse Outcome Pathway (AOP) concept, that leverages existing data to formalize knowledge, is a well-accepted concept in risk assessment although it does not handle the socio-economic impact that environment-induced diseases may generate. Here, we propose to extend the AOP framework by bridging an adverse outcome (AO) to a cost outcome (CO) creating so-called Cost Outcome Pathways (COPs) for including the socio-economic costs of exposure to chemicals. As a case study, a COP related to neurodevelopmental toxicity was designed, with a connection between the AO ‘decreased, IQ’ and the CO ‘increased, socio-economic burden’. For support to policymaking in the public health sector, this framework might also hold great potential for environmental exposure-related diseases such as cancer or obesity which are diseases with known detrimental socio-economic impacts.
An economic evaluation of routine hepatocellular carcinoma surveillance for high-risk patients using a novel approach to modelling competing risks
Authors: Worthington Joachim , He Emily , Caruana Michael , Wade Stephen , de Graaff Barbara , Nguyen Anh Le Tuan , George Jacob , Canfell Karen , Feletto Eleonora 
Published: December 2024

AbstractIntroductionLiver cancer is the only cancer in Australia for which mortality rates have consistently risen, despite tests to identify high-risk individuals. Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer. Curative treatment for HCC is typically only available if detected early. Australian clinical guidelines recommend routine 6-monthly ultrasound surveillance, with or without serum alpha-fetoprotein, for individuals with liver cirrhosis. This study assesses the health and economic implications of this recommendation, utilizing novel modeling techniques.MethodsWe designed thesojourn time density modelmathematical framework to develop a model of the evolving risk of HCC, liver disease, and death based on time since diagnosis, incorporating data on liver decompensation, HCC incidence, and HCC survival, and the impact of surveillance on cancer stage and survival.ResultsWe estimated that adherence to 6-monthly ultrasound, with or without alpha-fetoprotein, can increase early-stage diagnosis rates, reducing HCC mortality by 22%. We estimate a cost-effectiveness ratio of $33,850 per quality-adjusted life-year (QALY) saved for 6-monthly ultrasound HCC surveillance, under the $50,000/QALY cost-effectiveness threshold. HCC surveillance was also estimated to be cost-effective at any interval from 3-24 months.ConclusionsThese findings support the current clinical guideline recommendation for 6-monthly ultrasound surveillance, affirming its health benefits and cost-effectiveness, and show that alternative surveillance intervals would remain beneficial and cost-effective. Our model may be used to refine surveillance recommendations for other at-risk population subgroups and inform evidence-based clinical practice recommendations, and the framework can be adapted for other epidemiological modelling. Supporting the clinical guidelines and their ongoing development as evidence evolves may be key to reversing increasing HCC mortality rates in Australia, which are predicted to increase by more than 20% by 2040.
Evaluation of a district-wide sanitation programme in rural Malawi: does it include people living with disabilities?
Authors: Davies Katherine , Panulo Mindy , MacLeod Clara , Wilbur Jane , Morse Tracy , Chidziwisano Kondwani , Dreibelbis Robert 
Published: December 2024

AbstractCommunity-led total sanitation (CLTS) is embraced as a key strategy to achieve universal sanitation coverage (Sustainable Development Goal 6.2). Although inclusion is identified as a predictor of CLTS success, people living with disabilities are often excluded from community sanitation programmes and there is limited research exploring CLTS participation amongst people living with disabilities. This study aims to explore the extent to which people living with disabilities participated in a CLTS intervention delivered in rural Malawi.This cross-sectional study was conducted in the Chiradzulu district of Malawi. A household questionnaire was administered to collect information about CLTS participation. Multivariable logistic regression was performed to compare participation in different CLTS activities between households with (n=80) and without a member with a disability (n=167), and between household members with (n=55) and without a disability (n=226). No difference in CLTS participation was observed at the household-level, but there were marked differences in CLTS participation between household members with and without a disability. Household members without a disability reported higher attendance at the triggering session (OR=2.09, 95%CI 1.00–4.37), gave more input in triggering activities (OR=3.72, 95%CI 1.46-9.51), and reported higher participation in the transect walk (OR=4.03, 95%CI 1.52-10.68), community action planning (OR=2.89, 95%CI 1.23-6.79), and follow-up visits (OR=3.37, 95%CI 1.67-6.82) compared to household members with disabilities. There was no difference in the likelihood of being invited to triggering (OR=0.98, 95%CI 0.43–2.22) or participating in community mapping (OR=2.38, 95%CI 0.63-8.99) between household members with and without a disability.This study revealed intra-household inequalities in CLTS participation. To improve participation in CLTS interventions, facilitators should be trained on action steps to make CLTS more inclusive. Further research could include an in-depth analysis of predictors of CLTS participation amongst people living with disabilities, including disability types, severity and age.
The Use of Home-Based Behaviours for Detecting Early Dementia:Protocol for the CUBOId Study
Authors: Selwood James , Twomey Niall , Craddock Ian , Coulthard Liz , Kumpik Daniel , Newson Margaret , Poyiadzi Rafael , Santos-Rodriguez Raul , Yang Weisong , Ben-Shlomo Yoav 
Published: December 2024

AbstractIntroductionThere is a pressing need to automatically understand the state and progression of chronic neurological diseases such as dementia. The emergence of state-of-the-art sensing platforms offers unprecedented opportunities for indirect and automatic evaluation of disease state through the lens of behavioural monitoring. The ContinUous behavioural Biomarkers Of cognitive Impairment (CUBOId) project specifically seeks to characterise behavioural signatures of mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in the early stages of the disease. Bespoke behavioural models will be introduced and deployed on a novel dataset of longitudinal sensor data from persons with MCI and AD to analyse key symptoms of the disease.Methods and analysisCUBOId is a longitudinal observational study. Participants have diagnoses of MCI or AD, and controls are their live-in partners with no such diagnosis. Multimodal activity data were passively acquired from wearables and in-home fixed sensors over timespans of 2–22 months. Behavioural testing is supported by neuropsychological assessment for deriving ground truths on cognitive status. Machine learning will be used to generate fused multimodal sensor data for optimisation of diagnostic and predictive performance from localisation, activity, and speech together.Ethics and disseminationCUBOId was approved by an NHS Research Ethics Committee (Wales REC; ref: 18/WA/0158) and is sponsored by the University of Bristol. It is also supported by the National Institute for Health Research (NIHR) Clinical Research Network West of England. Results will be reported at conferences and in peer-reviewed scientific journals.