bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mortality Risk Factors and Clinical Profiles of Pediatric Adenovirus Pneumonia: A Study from a Comprehensive Hospital in Northeast China
Authors: Shen Yuetong , Xu Wei , Song Wenliang 
Published: December 2024

Abstract

Adenovirus pneumonia (ADVP) is a significant cause of morbidity and mortality in children admitted to the Pediatric Intensive Care Unit (PICU). This study analyzes the clinical characteristics and key risk factors for mortality in children with ADVP admitted to a PICU in Northeast China. A total of 91 cases were reviewed, with a focus on clinical features, laboratory results, and radiological findings. In Northeast China, the incidence of ADVP peaked in autumn (34.1%) and winter (38.5%), with a PICU mortality rate of 22.9% in winter. The median onset age was 2.6 years, and the overall PICU mortality rate was 13.19%. Mortality was notably higher among children aged ≤ 2 years and those with a history of preterm birth. Clinical markers such as carbon dioxide retention, a low P/F ratio, hypoalbuminemia, elevated LDH levels, and pleural effusion were associated with increased mortality. Logistic regression identified age ≤ 2 years (OR: 24.542, 95% CI: 1.443 ~ 417.42), preterm birth (OR: 36.107, 95% CI: 1.444 ~ 903.032), and a P/F ratio < 300 mmHg (OR: 19.725, 95% CI: 1.539 ~ 252.808) as independent risk factors for mortality. These findings highlight the need for early risk identification and targeted interventions in high-risk pediatric groups to improve outcomes.
Childhood Strabismus from A Different Perspective: Examining Its Association with Cognitive Development
Authors: Yang Yan , Hou Jinen , Huang Hailu , Tan Siyu , Chen Hong , Ling Shihui , Yang Wenhan , Chang Shuai , Yu Xin-Ping , Yan Jianhua 
Published: December 2024

Abstract

Background: Previous studies have shown that abnormal visual input and processing possibly impact the cognition development in children. We aimed to investigate the relationship between abnormal visual function associated with strabismus and cognition development in children.
Methods: Conducted at Zhongshan Ophthalmic Center, this cross-sectional case-control study involved 201 children aged 4-10 years, including 114 with strabismus and 87 matched controls, between January 2021 and December 2022. Cognitive functions were evaluated using the Wechsler Intelligence Scale for Children—Fourth Edition (WISC-IV) and the Wechsler Preschool and Primary Scale of Intelligence—Fourth Edition (WPPSI-IVR), focusing on the global cognitive score (GCS), verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), and processing speed index (PSI).
Results: Children with strabismus showed significantly lower scores in GCS (t=-8.31, p<0.001), VCI (t=-7.81, p<0.001), PRI (t=-6.18, p<0.001), WMI (t=-5.55, p<0.001), and PSI (t=-3.51, p=0.006) compared to controls. The type of strabismus (esotropia or exotropia, intermittent of constant tropia) did not show a significant association with cognitive performance (p>0.05). Spearman’s correlation and multivariate linear regression analyses identified that better fusion ability (p=0.01) and a shorter duration of strabismus (p=0.002) were associated with higher cognitive function.
Conclusion: The findings reveal a significant decline in cognitive performance among children with strabismus compared to their non-strabismic peers, regardless of the type of strabismus. The duration of strabismus and impaired near fusion function are associated with cognitive development levels, highlighting the importance of early detection and potential interventions to support better cognitive outcomes.
Revealing the possible neglected environmental risk factors contributing to mycetoma in the White Nile state: Sudan
Authors: Alnoor Badraldeen , Nahar Papreen , Zied Osama Abu , Fairhead James 
Published: December 2024

Abstract

Background
For decades, poor Sudanese communities in rural areas have silently battled mycetoma, a stigmatizing, disabling neglected tropical disease. Its linkage to specific, ecology-dependent livelihoods such as farming, woodcutting and collecting and animal herding has obscured its cause and environmental dimensions at both the local and global levels. Challenging the prevailing singular focus on the injuries that have dominated biomedical reasoning for years.
Methods
This ethnographic study sheds light on diverse potential perceived causal factors and possible risk exposure pathways. Through participant observation, in-depth interviews and focused group discussions.
Results
we revealed that not only through pricks but also injuries from agricultural tools, bamboo sticks, glass, seasonal cracks, and even stepping on gravel may introduce mycetoma-causative agents. Moreover, structural forces such as failed irrigation systems, especially during the rainy season, flooding, and concealing hazardous materials were found to increase the exposure risk to further injuries.
Conclusion
These findings necessitate a global re-evaluation of mycetoma perceived causality, shifting the paradigm beyond a single lens of trauma and exploring potential new risk factors. They pave the way for a more holistic understanding that integrates medical interventions with environmental and social determinants. By uncovering the hidden complexity of mycetoma, we open doors to prevention strategies that triumph over neglect.
Predictive value of the tumor burden score and gamma-glutamyl transpeptidase to albumin ratio among patients with intrahepatic cholangiocarcinoma
Authors: Zeng Yongyi , Lin Qizhu , Fu Jun , Huang Tingfeng , Liu Hongzhi , Fan Ruilin , Wang Kui 
Published: December 2024

Abstract

Background: The prognostic significance of the tumor burden score (TBS) in relation to the gamma-glutamyl transpeptidase-to-albumin ratio (GAR) has not been investigated among patients undergoing resection for intrahepatic cholangiocarcinoma (ICC). We evaluated the predictive value of the combined TBS and GAR (TBGA) grading system.
Methods: Patients who underwent curative-intent resection for ICC between 2015 and 2019 were identified from a large multi-institutional database. The influence of the TBS, GAR, and TBGA grading system on overall survival (OS) and recurrence was analyzed, as was the impact of TBGA on short-term outcomes. A receiver operating characteristic (ROC) curve was used to assess the model’s predictive accuracy. Additionally, multivariate Cox regression analysis was conducted to identify factors associated with recurrence and OS.
Results: Among the 428 patients, 282 were male (65.89%), and 146 were female (34.11%). A total of 130 patients (30.37%) were categorized as having a low TBGA (low TBS and low GAR), 216 (50.47%) as having an intermediate TBGA (low TBS and high GAR or high TBS and low GAR), and 89 (19.16%) as having a high TBGA (high TBS and high GAR). The 5-year OS rates and 3-year RFS rates for the three groups were 49.1%, 31.0%, and 13.2% and 41.9%, 19.1%, and 13.7%, respectively, with all Pvalues < 0.001. Multivariate Cox regression analysis demonstrated that TBGA grade was an independent risk factor for postoperative recurrence and OS in ICC patients. The model exhibited good predictive performance, with an area under the curve (AUC) of 0.67 for OS and 0.65 for RFS. Additionally, patients in the higher TBGA group were more likely to exhibit invasive biological characteristics and experience poorer short-term outcomes.
Conclusions: TBGA demonstrated strong predictive ability in ICC patients. Higher TBGA grades are incrementally associated with poorer long-term and short-term outcomes, offering valuable references for clinicians in making treatment decisions.
Cer(d18:1/16:0) as Predictive Biomarkers for Acute Coronary Syndrome: Insights from a Chinese Cohort
Authors: Zhang Liang , Zhang Yang , Ding YaoDong , Jin Tong , Song Yi , Li Lin , Wang XiaoFang , Zeng Yong 
Published: December 2024

Abstract

Background: Ceramides play a crucial role in atherosclerosis progression and have been linked to cardiovascular events. The objective of this study was to investigate the association between serum ceramide levels and Acute coronary syndrome, as well as evaluate their potential for predicting ACS in Chinese population.
Methods: Data of 1327 patients with suspected or known coronary artery disease from Beijing anzhen Hospital and Handan First hospital were collected. Plasma ceramide were measured using the LC-MS/MS system. The area under the ROC curve was used to screen the most valuable predictor. Machine learning algorithms were used to identify critical ACS-related variables. Subgroup analysis and interaction test were performed to control for confounding factors. Multivariate Logistic models and restricted cubic spline analysis were conducted to examine the associations between Ceramide and ACS.
Results: Cer (d18:1/14:0), Cer (d18:1/16:0), Cer (d18:1/18:0), Cer (d18:1/20:0), Cer (d18:1/22:0), and Cer (d18:1/24:0) were significantly elevated in the ACS group. Diagnostic performance assessments showed that Cer(d18:1/16:0) had superior accuracy in detecting ACS compared to other ceramides tested. The Boruta algorithm identified 15 significant variables related to ACS. Cer(d18:1/16:0) associated with ACS were discovered using the LASSO logistic regression technique. Subgroup analyses and logistic regression models further supported the relationship between Cer(d18:1/16:0) and ACS. Additionally, a significant nonlinear relationship was observed between Cer(d18:1/16:0) and ACS, with a threshold of 150umol/L.
Conclusion: The study found that ceramides, particularly Cer(d18:1/16:0), were significantly associated with ACS and could be a potential biomarker for predicting and diagnosing ACS in Chinese populations experiencing chest pain.
Recurrent tensional pneumothorax led to diagnosis of alpha-1 antitrypsin deficiency
Authors: Ludeña Angelica , Cardenas Silvia Sánchez , Cabrera Leosbel Hurtado , Rodríguez Alvaro Aranda , Díaz Maria Vazquez 
Published: December 2024

Abstract

Alpha-1 antitrypsin deficiency (AATD) is a genetic condition caused by mutations in the SERPINA1 gene, leading to reduced levels of alpha-1 antitrypsin (AAT) in circulation. This deficiency predisposes most individuals to early development of chronic obstructive pulmonary disease (COPD) and other pulmonary complications, including secondary spontaneous pneumothorax (SSP). Therefore, we report the case of a 76-year-old male patient with a history of extensive tobacco use and pulmonary emphysema who presented to the emergency department with sudden shortness of breath and pain. Laboratory tests indicated compensated chronic respiratory acidosis. Imaging revealed a right-sided pneumothorax and multiple pulmonary bullae. Genetic testing confirmed the MIZ genotype for AATD, with serum AAT levels at 94 mg/dL. The patient underwent bullectomy, and pathology confirmed emphysematous changes. The association between AATD and COPD, as well as the increased incidence of SSP in patients with COPD, underscores the importance of early recognition and diagnosis. This case highlights the need for heightened awareness of AATD among clinicians, particularly in patients with a history of respiratory symptoms and familial COPD. International guidelines recommend AAT testing for individuals with symptomatic emphysema, asthma with airflow obstruction, and those with unexplained chronic liver disease. In conclusion increased awareness of AATD can lead to early diagnosis and intervention, potentially improving the quality of life for affected individuals. Preventative measures, including lifestyle modifications and AAT augmentation therapy, may be beneficial in slowing disease progression.
Changes in dementia risk along with onset age of depression: A longitudinal cohort study of elderly depressed patients
Authors: Jang Yoo Jin , Kim Min-Ji , Moon Young Kyung , Lim Shinn-Won , Kim Doh Kwan 
Published: December 2024

Abstract

Background
Depression in late-life is linked to an increased risk of Alzheimer's dementia (AD), with the risk potentially varying based on the onset age of depression. Previous research typically dichotomized depression onset age between 55 and 65 years; however, the specific age at which depression onset increases AD risk in older adults remains unclear. In this study, we aimed to investigate the relationship between depression onset age and AD risk and compare characteristics between different onset age groups.
Methods
A longitudinal cohort of 251 elderly patients diagnosed with major depressive disorder was followed for up to 22 years. Participants were categorized into four groups based on depression onset age: ≤ 54 years, 55–64, 65–74, and ≥ 75 years. Annual cognitive assessments were conducted using the Korean Mini-Mental State Examination, with further neuropsychological testing when cognitive decline was suspected. Cox proportional hazards models were used to assess AD conversion risk across groups, adjusting for covariates.
Results
During follow-up, 75 patients (29.88%) converted to AD. Depression onset after age 75 was significantly associated with a higher risk of AD conversion (hazard ratio [HR], 8.95; 95% confidence interval [CI], 3.41–23.48; p < 0.0001) and a shorter time to conversion compared to onset before age 55 (40.93 vs. 83.40 months). After adjusting for covariates, depression onset after age 75 remained significantly associated with AD conversion (adjusted HR, 6.07; 95% CI, 1.26–29.34; p = 0.0189). This group also had milder depressive symptoms and a higher prevalence of hypertension and cerebrovascular disease than those with depression onset before age 55.
Conclusions
Depression onset after age 75 is strongly associated with an increased risk of AD and a shorter time to dementia onset. Individuals with depression onset after age 75 appear more closely linked to vascular comorbidities, while those with depression onset before age 55 are characterized by severe and recurrent depressive episodes. The mechanisms leading to AD in individuals with depression may differ from those without prior depression.
Trial registration:
The study is registered (NCT01237275, 1994-10-14, Development of A Technique to Predict Antidepressant Responsiveness in Depressive Patients) in ClinicalTrials.gov.
China, regional and Global burden of thyroid cancer among women of reproductive age, 1990–2019
Authors: Yang yiqiu , Shen Yang , Li Zhong 
Published: December 2024

Abstract

Background:
The burden of thyroid cancer is trending towards younger populations and is on the rise. However, there is limited analysis on the impact and epidemiology of thyroid cancer in women of reproductive age. We aim to assess and analyze the burden and trends of thyroid cancer in women of reproductive age globally, regionally and in China from 1990 to 2021.
Methods:
Data on thyroid cancer in women of reproductive age were extracted from the Global Burden of Disease (GBD) study for 2021. The age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), disability-adjusted life years (DALYs), age-standardized DALYs(ASDR) and estimated annual percentage change (EAPC) were calculated to analyze the temporal changes in the burden from 1990 to 2021, assessing the trend of thyroid cancer (TC) among women of reproductive age.
Results:
Between 1990 and 2021, the number of incident cases and ASIR of TC increased in China and globally. The overall ASMR and ASDR showed a decreasing trend. China's ASIR, ASMR, and ASDR were below the global average, with a higher increasing trend in incidence compared to the worldwide level, while mortality and disability rates declined more rapidly than the global average. Regionally, the highest ASIR in 2021 were observed in the high-income Asia Pacific and high-income North America regions. The Southern Sub-Saharan Africa region had the lowest ASIR and the highest ASMR, with incident cases, deaths, and DALYs all ranking in the top three for growth trends. Central Europe experienced the fastest decline in incidence and DALYs, while East Asia saw a relatively rapid decline in deaths and DALYs. At the national level, overall incidence and disability rates increased from 1990 to 2021, while mortality rates decreased. The incidence rate in 2021 ranged from 0.02 to 14.96, showing a significant disparity, with Zimbabwe having relatively high ASMR and ASDR, and Poland experiencing a rapid decline in ASIR and ASDR. Overall, ASIR increased with the Socio-demographic Index (SDI), with higher incidence rates in high SDI and low-middle SDI regions, while ASMR and ASDR decreased with SDI. High SDI regions had the highest incidence rates and experienced the largest reduction in ASMR from 1990 to 2021. In the 15–19 age group, the ASIR, ASMR, and ASDR were the lowest, while the 45–49 years age group has the highest rates. With increasing age, there was a demonstrated upward trend.
Conclusion:
Although the age-standardized rates of ASIR, ASDR, and ASDR for thyroid cancer among women of reproductive age globally decreased from 1990 to 2021, alarming increases were observed in low SDI and low-middle SDI regions. Effective prevention and treatment measures must be taken in these areas to reduce the incidence and mortality of thyroid cancer.
Does addiction skip a generation? Patterns of intergenerational transmission of substance abuse
Authors: Kravchenko Olly , Bishop Lauren , Almquist Ylva B 
Published: December 2024

Abstract

Purpose
Familial aggregation of substance abuse (SA) is well-documented in epidemiological literature, yet the specific transmission patterns across multiple generations remain unclear. This study aimed to elucidate the trajectories of SA continuity across three generations, focusing on whether it persists directly through SA or manifests as other forms of psychopathology in the intermediate generation.
Methods
This prospective multigenerational cohort study (n = 29,115) included individuals born in Stockholm in 1953, their parents, and their children, followed through register linkages until 2016. Linear probability modeling assessed whether parental SA and psychopathology mediate and/or moderate the relationship between grandparental and grandchild SA.
Results
In the absence of grandparental SA, the probability of grandchildren having SA followed a gradient based on parental profiles: 7.1% with no parental SA or psychopathology, 12.8% with parental psychopathology, 17.5% with parental SA, and 22.1% with both. However, in the presence of grandparental SA, grandchild SA rates remained consistent across all problematic parental profiles (25.0%, 24.2%, and 25.9%, respectively). Notably, the most substantial increase in SA occurred in the third generation when parents had only psychiatric disorders (25.0% versus 12.8% without grandparental SA).
Conclusion
The study suggests that grandparental SA significantly elevates the risk of SA in grandchildren and is partially mediated and moderated by both parental SA and psychopathology. These findings underscore the importance of considering alternative pathways of SA transmission for understanding and preventing its continuity across generations.
Establishing the Radiological Safety Zone in the Ischium to Prevent Neurovascular Injury During Endoscopic Hamstring Tendon Repair: A Cadaveric Study
Authors: Aydemir Selahaddin , Cici Hakan , Celtik Mustafa , Zeybek Gulsah , Arslan Ahmet Kaan , Yarol Raif Can , Balci Ali , Hapa Onur 
Published: December 2024

Abstract

Background
This study aimed to establish safe zones for arthroscopic hamstring repair by pinpointing the radiological borders of the proximal hamstring tendon. These landmarks will aid surgeons in positioning anchors safely, minimizing the risk of nerve and vascular damage, and lowering the potential for intraoperative complications.
Materials and Methods
In this anatomical and radiological study, five human cadavers fixed with formaldehyde (10 hips) were analyzed. Marking pins were placed at the borders of the proximal hamstring tendon footprint to determine its anatomical boundaries. Pelvis PA and hip PA radiographs were then taken to determine the radiological boundaries of the tendon footprint and its relationship with the ischial tuberosity. The distances from the tendon’s superior, medial, lateral, and inferior borders to the line joining the ischial tuberosities and the ischial apex were calculated. The accuracy of hip and pelvis radiographs was compared to assess their usefulness in surgical planning. Statistical analysis was performed using the Mann-Whitney U test.
Results
Four of the five cadavers were male, with a mean age of 67 years. The distances of the hamstring tendon to the line joining the ischium and to the ischial apex were determined with similar measurements on PA radiographs of the pelvis and hip. The distances of the superior, medial, lateral, and inferior borders to the line joining the ischium were 35.3 mm, 22.5 mm, 30.3 mm, and 17.5 mm, respectively, in the pelvis radiograph. In comparison, these values were 35.3 mm, 22.1 mm, 29.7 mm, and 18.9 mm in the hip radiograph. The distances of the superior, medial, lateral, and inferior borders to the ischial apex were 47.7 mm, 33.9 mm, 43.3 mm, and 31.4 mm, respectively, in the pelvic radiograph. In comparison, these values were 47.9 mm, 32.7 mm, 44 mm, and 33.2 mm in the hip radiograph. The distances between the medial and lateral borders and the distances between the superior and inferior borders were also similar.
Conclusion
Defining the radiological margins of the hamstring tendon provides a critical reference for portal opening and safe and anatomical anchor placement in arthroscopic hamstring repairs. The findings suggest that consistent identification of these boundaries by preoperative imaging and intraoperative fluoroscopy may reduce the risk of neurovascular injury and improve surgical success. The difference in distance between pelvis and hip PA radiographs was not statistically significant, supporting the reliability and reproducibility of both methods.
Trial registration:
Not applicable.
Covid and the income gap between family structures
Authors: Shideler John 
Published: December 2024

Abstract

Family structure can influence household income in a number of important ways. From the motherhood penalty, to the financial advantages of a dual-income-no-kids household, to the pros and cons of having extended family under the same roof. Caring for children increases expenses and can limit household labor supply. During the Covid Pandemic, the shut-down of schools, daycares, and businesses increased the challenges for household labor supply in families with kids, particularly those young enough to need 24-hour supervision. This paper uses the Survey of Household Economics and Decision-making (SHED) data to investigate how the Covid pandemic affected household income heterogeneously related to family structure and childcare limitations. This work proposes an income gap between households with children under eighteen years of age and households without children under eighteen years of age, and finds that this income gap widens as a result of challenges related to the Covid pandemic.
JEL: J00 J12 J22 D10