bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between estimated glucose disposal rate and the risk of MAFLD in American adults: a cross-sectional study
Authors: Zhou Yuhang , Wang Bang , Wu Miaoxin , Hong Han , Li Gaochao , Xu Minhui 
Published: December 2024

Abstract

The estimated glucose disposal rate (eGDR), as a novel metric of insulin resistance (IR), has been demonstrated to correlate with hepatic steatosis in patients with diabetes. Although IR is considered as a factor affecting lipid metabolism, the correlation between eGDR and metabolic associated fatty liver disease (MAFLD) is still unclear. Data from the 2017–2020 National Health and Nutrition Examination Survey (NHANES) were employed in this cross-sectional study designed to examine the association between eGDR and MAFLD through the application of weighted multivariate logistic regression model. The nonlinear relationship was described utilizing restricted cubic spline (RCS) regression. Subgroup analysis was performed to assess the consistency of the results and causal mediation analysis was employed to explore potential mediators. The study included 5,805 participants, 3,253 of whom diagnosed MAFLD, with a prevalence rate of 56.1%. After adjusting for all confounding factors, the risk of MAFLD decreased by 51% with each unit increase in the eGDR (odds ratio [OR]: 0.49, 95% confidence interval [CI]: 0.40, 0.61, p < 0.0001). Analysis of eGDR in quartiles further supported this trend (P = 0.001). The smooth curve fitting also showed a negative correlation between eGDR and MAFLD. Causal mediation analysis indicated that the relationship between eGDR and MAFLD was partially mediated by Atherogenic index of plasma (AIP), with a mediation ratio of 18.6%. Our result demonstrated that eGDR has a significant nonlinear negative association with the prevalence of MAFLD, in which AIP plays a mediating role, providing new insights into the prevention and management of MAFLD.
Comparison of clinical outcomes following small incision lenticule extraction performed with the Visumax 800 versus Visumax 500 femtosecond laser
Authors: Kim Bu Ki , Chung Young Taek 
Published: December 2024

Abstract

This study compared clinical outcomes between small incision lenticule extraction (SMILE) procedures performed with the Visumax 800 and Visumax 500 femtosecond lasers. We compared the clinical outcomes of 100 eyes of 50 patients who underwent SMILE using the Visumax 800 (SMILE Pro group) and 100 eyes of 50 patients who underwent SMILE using the Visumax 500 femtosecond laser (SMILE group). Outcomes were assessed at a 3-month follow-up, including standard visual outcomes, optic zone decentration, and corneal higher-order aberrations (HOAs). The mean lenticule creation time was significantly shorter in the SMILE Pro group (10.33 ± 0.82 seconds) than the SMILE group (28.27 ± 2.34 seconds, P < 0.001). At 3 months postoperatively, the groups had no significant differences in uncorrected or corrected distance visual acuity, residual refractive errors, or corneal HOAs. However, the optic zone decentration was significantly smaller in the SMILE Pro group than in the SMILE group (P < 0.001), and the vertical coma induction was significantly lower in the SMILE Pro group compared with the SMILE group (P = 0.034), suggesting that the Visumax 800 provides enhanced centration accuracy, reduced vertical coma induction, and faster lenticule creation, demonstrating comparable efficacy, safety, and predictability to the Visumax 500.
Venous thromboembolic risk in hematological hospitalized patients: a retrospective study
Authors: Cordella Stefano , Coluccio Valeria , Costantini Riccardo Cuoghi , D'Amico Roberto , Luppi Mario , Marietta Marco 
Published: December 2024

Abstract

Although patients with hematological malignancies carry a non-negligible risk of venous thromboembolic events (VTE), no risk assessment models (RAMs) have been developed and validated to predict this risk during their hospital stay. Moreover, the performance of RAMs developed to predict the thromboembolic and hemorrhagic risk in hospitalized medical patients has never been assessed in this specific population.
In this observational study we sought to assess the incidence of VTE and hemorrhagic events (HE), to evaluate pharmacological prophylaxis use, and to test existing RAMs for TE and HE (Padua Predictions Score, PPS, and Improve Bleeding Score, IBS, respectively) in a population of 514 hematological patients at their first hospital admission.
165 patients were foundto be at high thromboembolic and 114 at high hemorrhagic risk according to PPS and IBS; a total of 148 patients received pharmacological prophylaxis with low-molecular weight heparin (LMWH).
An incidence of VTE (3.11%) and HE (1.75%) was found, with most thrombotic(15/16) and hemorrhagic (8/9) events occurring in patients not receiving prophylaxis.
At the univariate analysis, the diagnosis of acute leukemia was significantly associated with an increased risk of VTE, whereas prophylaxis was found to be protective. However, at the multivariate analysis the statistical significance was lost for both of these variables (HR=4.61, P=0.170 and HR=0.36, P=0.218, respectively). PPS poorly performed in this population, but no other factors associated with VTE were found.
Larger, multicenter studies to develop better RAMs tailored to HM patientsare needed to improve VTE management in this population.
A mixed methods study on the barriers and facilitators of implementing HIV re-testing guidelines on pregnant women at a referral hospital in Kenya
Authors: Njuki Justina , Wamalwa Dalton , Kumar Rashmi , Macharia Anne-Marie 
Published: December 2024

Abstract

Background
The Ministry of Health-Kenya developed guidelines on HIV testing for pregnant women at different points in time as a mitigative measure against mother-to child-transmission (MTCT) of HIV. However, the barriers and facilitators in the implementation of HIV re-testing guidelines among pregnant women in Kenya are not well understood. The aim of the present study was to evaluate the barriers and facilitators of HIV testing guidelines among pregnant women at the Pumwani Maternity Hospital.
Methods
This was a mixed methods study. Qualitative data on the barriers and facilitators of HIV re-testing among pregnant women was collected by interviewing key informants (healthcare workers). Quantitative data was collected from pregnant women who had been recruited into the study. Women with an initial HIV negative result at the antenatal clinic (ANC) were recruited at the labor/postnatal ward and at six weeks postnatal review. Quantitative data was analyzed using descriptive statistics while qualitative data was audio recorded, transcribed, and themes were identified.
Results
There were 242 women who participated in the interview 97 of whom were followed up at 6 weeks via a telephone interview. There were 170 women interviewed at labor ward. The retesting rate was 116 (69.5%). Majority of the women 114 (67.5%) lacked awareness on the need for HIV retesting. Of the 97 women followed up at 6 weeks postpartum, 72 (75%) were retested for HIV. Of the 15 HCWs who were interviewed, 14 (93.3%) had received HTS training. There was varied knowledge on repeat testing guidelines for HIV and the team relied on mentor mothers and prevention of mother to child transmission (PMTCT) nurses to implement the guideline.
Conclusion
These findings suggest that there were more missed opportunities for HIV re-testing at the labor ward relative to re-testing. There is a need to improve HIV screening at the labor ward to minimize lost opportunities for HIV screening.
Association between triglyceride-glucose-body mass index (TyG-BMI) and in-stent restenosis after coronary interventions: a retrospective cross-sectional study
Authors: Tong Zhuoyan , Hu Mengyao , Cai Zhiyuan , Li Shiyu , Yang Dongwei 
Published: December 2024

Abstract

Background
Insulin resistance has been confirmed to be an independent predictor of cardiovascular diseases. Earlier research have confirmed that triglyceride glucose body mass index (TyG-BMI) can be used as an alternative factor of insulin resistance, and there is a significant correlation between TyG-BMI and cardiovascular diseases. However, the correlation between TyG-BMI and in-stent restenosis (ISR) is still unclear. The purpose of this study was to investigate the correlation between TyG-BMI index and in-stent restenosis after coronary intervention.
Methods
This study was a retrospective cohort study, which included patients with confirmed coronary artery disease undergoing percutaneous coronary intervention (PCI) in Zhengzhou Central Hospital Affiliated to Zhengzhou University and was followed up. TyG-BMI at baseline was divided into three equal parts to analyze the baseline characteristics under different TyG-BMI groupings. Univariate and multivariate Cox proportional risk regression models were used to assess the correlation between TyG-BMI and in-stent restenosis, and restricted cubic spline (RCS) was used to identify whether there was a linear correlation or nonlinear correlation between TyG-BMI and in-stent restenosis.
Results
Of the 818 participants, 588 (71.9%) were men; Median [Q1,Q3] age was 62.0 [53.0,69.0] years. A total of 110 cases of ISR occurred during follow-up. After grouping according to TyG-BMI levels, the number of cases of ISR was significantly smaller in the low TyG-BMI group than in the other two groups.The results of Cox proportional risk modeling suggested that the risk ratio of ISR was significantly higher in the medium and high TyG-BMI groups compared with the low TyG-BMI group. The results of restricted cubic plots suggested a linear correlation between TyG-BMI and the risk of developing ISR (linear P < 0.001,nonlinear P = 0.0670). The risk of ISR was significantly higher when TyG-BMI > 211.47 mmo/L.
Conclusions
This study suggests that there is a significant correlation between TyG-BMI and the occurrence of ISR, and that the level of TyG-BMI indexes needs to be paid attention to in the clinic during the prevention of ISR, especially in female, elderly, overweight or obese patients.
Neonatal Pain Management Practice and Associated Factors among Nurses Working in Public Hospitals of Southern Ethiopia: A Multicenter Cross- sectional study
Authors: Urmale Addisu , Getie Asmare , Degeifa Nega , Bante Agegnehu 
Published: December 2024

Abstract

Background: Neonatal pain management is an integral part of nurse’s practices working in neonatal intensive care units. Improper neonatal pain management can have negative consequence for the health and development of newborns. In Ethiopia, neonatal pain management practices among nurses working in neonatal intensive care unit were not well known. Hence, this study assessed neonatal pain management practice and associated factors among nurses working in the neonatal intensive care units of public hospitals in Southern Ethiopia.
Methods: An institution-based cross-sectional study design was conducted among 369 randomly selected nurses working in the neonatal intensive care units of public hospitals in southern Ethiopia. Data were collected using a pre-tested, structured, and self-administered questionnaire accompanied with an observation checklist. The collected data were reviewed, coded and entered using Epi-data version 3.1 and exported to SPSS version 26 for analysis. Bivariate and multivariable logistic regression analyses were used to identify the associations between outcome and predictor variables. The degree of association was estimated with odds ratio with 95% confidence level and P-values < 0.05 were considered to detect statistical significance.
Results: The study revealed that 18.3% (95%CI: 14.4, 22.7) of the nurses had good neonatal pain management practice. On observation 16.2% (95%CI: 6.2, 32.0) of nurses were practicing proper neonatal pain management. Respondents with age ≤ 30 years [AOR = 3.02, 95%CI (1.30, 7.01)], married nurses [AOR = 4.90, 95%CI(2.09, 9.49)],availability of anti-pain drug in the unit [AOR = 7.24, (2.66, 11.69)], shortage of nursing staff at each shift [AOR = 0.097, (0.034, 0.279), and poor knowledge about neonatal pain [AOR = 0.23, (0.08, 0.62)] were factors significantly associated with good neonatal pain management practice.
Conclusions: The overall practice of neonatal pain management is relatively low. Improving practice of neonatal pain management requires; hiring of adequate nursing staff, improving acess to anti-pain drugs in the unit, and enhancing nurse’s knowledge regarding neonatal pain management.
Succinate Dehydrogenase Inhibitors as Triggers of Azole Resistance in Aspergillus fumigatus: The Role of sdh1 and Efflux Pathways
Authors: Zhang Heng , Zhu Zhangling , Gong Xiao , Cheng Wenxu , Liao Weizu , Ma Tianyan , Hu Qingwen , Li Linyun , Dun-zhu Zha-xi , Drol-ga Lha-zom , Sun Yi 
Published: December 2024

Abstract

Background
Aspergillus fumigatus is a major cause of invasive aspergillosis in immunocompromised patients. The rise in antifungal resistance is linked to the use of succinate dehydrogenase inhibitors (SDHIs).
Objective
This study investigates the mechanism of acquired azole resistance in A. fumigatus, triggered by SDHIs, which are widely used agricultural fungicides.
Methods
Conidia of A. fumigatus were co-cultured with four SDHIs (Boscalid, Thifluzamide, Fluopyram, Carboxin) to assess sensitivity to three azole drugs: voriconazole, itraconazole, and posaconazole. RT-qPCR identified genes related to resistance, focusing on sdh1, a gene encoding a succinate dehydrogenase subunit. A sdh1 knockout strain was created to evaluate its impact on growth, azole sensitivity, ATP levels, superoxide dismutase (SOD) activity, and ergosterol biosynthesis.
Results
SDHI exposure increased resistance to azoles, with 4.12% of 2,496 strains showing higher minimum inhibitory concentration (MIC). Four strains had an eightfold MIC increase and reduced sdh1 expression. The sdh1 knockout strain showed impaired growth, increased azoles resistance, and lower reactive oxygen species (ROS), ATP production (P < 0.001), and SOD activity (P < 0.05). RNA sequencing indicated that sdh1 deletion upregulated efflux pump genes and enhanced ergosterol synthesis.
Conclusion
SDHIs may induce azole resistance in A. fumigatus by downregulating sdh1. The findings highlight a potential new resistance mechanism, providing insights for managing A. fumigatus infections and azole resistance.
A Research Protocol to Study the Critical Time Window for Rehabilitation After Incomplete Spinal Cord Injury: Early vs Late Locomotor Training
Authors: Henry Molly , Coxe Ryan C. , Barry Alex , O’Donnell Amanda , Kessler Allison , Shan Guogen , Swank Chad , Rymer W. Zev , Sandhu Milap S. 
Published: December 2024

Abstract

Spinal cord injury (SCI) often results in severe motor and sensory deficits, leading to significant disability. Preclinical studies and retrospective studies suggest that a critical window of enhanced neuroplasticity may exist immediately after SCI, during which therapeutic interventions could yield greater functional improvements. The impact of time interval since SCI on efficacy of rehabilitation has not been directly assessed and is the focus of this clinical trial. This study will compare the efficacy of high-intensity gait training, initiated at different time intervals post-injury, on walking performance in individuals with SCI. We hypothesize that early intervention will yield the greatest improvements in walking ability and community ambulation, compared to training initiated at 3 or 6 months after SCI, or standard of care.
This randomized, multi-site clinical trial will enroll 108 participants with acute, traumatic SCI. Participants will be randomized to receive 20 hours of high-intensity gait training that will be initiated either early (<60 days post-SCI), sub-acute (3 months), chronic (6 months), or to a control group receiving standard of care. Primary outcomes include gait speed (10 Meter Walk Test) and walking endurance (6-Minute Walk Test). Secondary outcomes include daily step count via wearable sensors, lower extremity strength, and quality of life measures. Assessments will occur at baseline, pre/post-intervention, and at 3, 6, 9, and 12 months post-SCI.
This study will provide insights into the optimal timing of rehabilitation post-SCI and could have profound effects on our approach to training individuals with SCI in the healthcare setting as well as long term recovery outcomes.
Trial Registration
ClinicalTrials.gov NCT06176833 was completed on 12/11/2023.
Concave side of proximal thoracic zone vulnerable to pedicle screw perforation in adolescent idiopathic scoliosis surgery: Comparative analysis of pre- and intraoperative computed tomography navigation
Authors: Yamada Tomohiro , Yu Yamato , Hasegawa Tomohiko , Yoshida Go , Banno Tomohiro , Arima Hideyuki , Oe Shin , Ide Koichiro , Kurosu Kenta , Matsuyama Yukihiro 
Published: December 2024

Abstract

Purpose
To evaluate the accuracy of pedicle screw (PS) and clarify the characteristics of pre- or intraoperative perforation using computed tomography (CT) navigation in adolescent idiopathic scoliosis (AIS) surgery.
Methods
One hundred and seven patients who underwent surgery were retrospectively selected. Overall, 853 PSs were implanted in 48 patients using preoperative CT, whereas 1,059 PSs were implanted in 59 patients using intraoperative CT with a second intraoperative 3-dimensional (3D) scan. We analyzed the postoperative CT images for pedicle perforation using Rampersaud criteria.
Results
Total PS placement accuracy (grade A, B) was significantly higher in the intraoperative group than the preoperative CT group (97.2% vs 94.8%, respectively; P = 0.008). Accuracy was significantly higher among Lenke type 1 AIS cases in the intraoperative CT group (97.8% vs 95.1%, respectively; P = 0.014). Grade D perforation occurred most frequently at the concave side of proximal thoracic (PT) zone, followed by the transitional PT/main thoracic zone in both groups. The second intraoperative 3D scan allowed the re-insertion of 10 screws to prevent grade D perforation in the intraoperative CT group.
Conclusions
Both navigation systems were sufficiently accurate. However, surgeons must be careful at the concave side of the PT zone. Intraoperative CT navigation yielded higher accuracy by using the intraoperative second 3D scan than preoperative navigation.
Ion Concentrations in CSF and Serum are Differentially and Precisely Regulated
Authors: Lyckenvik Tim , Forsberg My , Johansson Kalle , Axelsson Markus , Zetterberg Henrik , Blennow Kaj , Illes Sebastian , Wasling Pontus , Hanse Eric 
Published: December 2024

Abstract

Background Disturbances in brain ion concentrations have been implicated in the regulation of brain states such as sleep and wakefulness, as well as in a variety of neurological conditions, including dementia, epilepsy, and migraine. Despite this, studies specifically characterizing normal cerebrospinal fluid (CSF) ion composition are generally lacking.Methods We quantify the normal human CSF ion composition in this non-interventional, cross-sectional, retrospective study using paired CSF and serum concentrations of Ca²⁺, Cl⁻, K⁺, Mg²⁺, and Na⁺ measured in healthy young to middle-aged volunteers (n = 28) and patients without neurological disease (n = 14). Relationships with variables such as albumin quotient, age, sampling time, and sex were analyzed. Group differences were assessed using the Kruskal-Wallis and Mann-Whitney U tests, while correlations were examined with Spearman's rank correlation coefficient.Results CSF ion concentrations were significantly different from serum for all ions measured (P < 0.0001). Cl− (+ 25%), Na+ (+ 5%) and Mg2+ (+ 37%) concentrations were higher, while K+ (-30%) and Ca2+ (-50%) concentrations were lower. These differences were consistent with no overlap between serum and CSF concentrations. There was a trend toward higher ion concentrations in samples collected later in the day and in men, but no significant correlation with the albumin quotient.Conclusions The distinct ion composition of CSF, compared to serum, may establish a low baseline neuronal excitability, allowing for controlled modulation by neuromodulators without leading to pathological hyperexcitability. This might offer new insights for targeting neurological diseases associated with disrupted ion homeostasis.
Long-term effect of COVID-19 social distancing measures on pertussis transmission in England; a mathematical modelling study
Authors: Choi Yoon Hong , Leeuwen Edwin , Miller Elizabeth 
Published: December 2024

Abstract

Background.
In 2024 England, in common with many other countries, experienced a pertussis resurgence the cause of which is unclear. We used a pertussis transmission model, previously developed to investigate the cause of the pertussis resurgence in England in 2012, to explore potential factors contributing to the increase in pertussis cases observed in England in 2024.
Methods
An age-stratified dynamic transmission model fitted to pertussis notification data from England between 1953 and 2013 was run until 2054 with and without changes in social mixing as estimated from Google mobility and school attendance data during the COVID-19 pandemic. The model assumes vaccination protects better against disease than pertussis infection, and that an infection results in more durable immunity than vaccination. Counterfactual scenarios were also run to explore the effect of reductions in vaccine coverage during the pandemic and of the addition in 2014 of boosters in the 2nd year of life and in adolescence.
Results
A resurgence was only generated with reduced social mixing and could not be explained by short-term reductions in vaccine coverage. Additional boosters at 18 months and 14 years from 2014 would not have prevented a resurgence though would have reduced its magnitude. Peaks of increased pertussis incidence are predicted over the next decade. The parameter sets that generated a resurgence in 2024 had the shortest duration of acellular vaccine protection, median 5 years with 90% protection against infection.
Conclusion
This modelling study implicates reduced mixing in England during the COVID-19 pandemic as the cause of the pertussis resurgence in 2024 together with the short duration of protection from acellular vaccine. Interruption of the background rate of natural boosting during the pandemic increased the pool of susceptible individuals resulting in increased transmission post-pandemic with clinical cases in those with waned vaccine–induced protection and the unvaccinated, including infants of unvaccinated mothers. In countries using acellular pertussis vaccines, infection continues to play an important role in maintaining population immunity around an endemic equilibrium. Improved pertussis vaccines that provide more complete and more durable protection against infection are needed to improve pertussis control.