bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factor Related to Compliance to Participate in Family Planning Program in Bangkala Health Centre Working Area
Authors: Multazam Andi , Arni Rizqiani Rusydi  , Ella Andayanie  , A. Rizki Amelia AP  
Published: February 2025

Family planning is an action to achieve prosperity through marriage counseling, treatment of infertility, prevention of unwanted pregnancies in married couples, regulating the number of children, and the spacing of childbirths. Family planning aims to improve health and welfare and create happy and prosperous small families by controlling birth rates and population growth. This study aims to determine factors related to family planning acceptors' adherence to family planning programs in the working area of ​​the Bangkala Health Center. The type of research used is a quantitative design using a cross-sectional study design approach. The sampling used a non-probability sampling method with an accidental sampling technique; the number of samples was 290—analyzed with the chi-square correlation test. The results showed a significant relationship between knowledge and compliance with family planning acceptors (P-Value 0.000 <0.05). There is no significant relationship between health workers' support and family planning acceptors' compliance (P-Value = 0.867 > 0.05). Despite this, the role of health workers in supporting family planning acceptors is crucial and their efforts are highly valued. Based on the results of this study, it is hoped that the Bangkala Health Center will continue to improve counseling about family planning, primarily related to the use of contraceptive devices for family planning acceptors in the Bangkala Health Center work area so that family planning acceptors are expected to increase their understanding of family planning and raise awareness to comply with the family planning program.
Cost of illness of Heart Valve Diseases (HVDs): A real-world analysis in Italy
Authors: Sciattella Paolo , Scortichini Matteo 
Published: February 2025

Introduction: Heart valve diseases constitute a significant public health challenge with substantial clinical and economic implications. The ageing population, coupled with advancements in surgical techniques, has led to increased hospitalizations for cardiac valve interventions over the past decade. Despite progress, the economic burden of heart valve diseases remains underexplored, particularly in the context of the Italian healthcare system. This study aims to comprehensively assess the economic burden of heart valve diseases in Italy through a real-world analysis.
Methods: Using data from the national Italian Hospital Discharge Records (SDO), we identified the number of adult patients undergoing interventions on the aortic, mitral, and tricuspid valves, along with the associated costs borne by the National Health System. Additionally, we estimated indirect costs by analyzing social security benefit applications related to valve diseases from 2016 to 2019.
Results: A notable rise in hospitalizations for cardiac valve interventions, particularly for the aortic (+53.3%) and mitral valves (+29.5%) was revealed through the study period. In-hospital mortality rates declined, reflecting advancements in perioperative care. The economic burden of heart valve diseases in Italy was substantial, with hospitalization costs reaching €808 million in 2018. Social security benefit applications also increased, adding an annual cost of €29 million.
Conclusions: Heart valve diseases represent a growing clinical and socio-economic challenge in Italy. This study underscores the imperative for a multidisciplinary approach to effectively manage these conditions. Emphasizing prevention, early diagnosis, and timely interventions is crucial to mitigate the economic impact and enhance the quality of life for patients.
Non-ischemic phenotypes of low-risk chest pain patients based on exercise stress echocardiography: a pilot study
Authors: Ryabova Tamara , Abramenko Elena , Yolgin Ivan , Zavadovsky Konstantin , Ryabov Vyacheslav 
Published: February 2025

ObjectiveA significant proportion (∼85%) of low-risk non-ST-elevation acute coronary syndrome (NSTE-ACS) patients do not receive objective confirmation of ischemia by stress echocardiography (SE), yet remain a healthcare burden due to lower long-term survival and overuse of medical services. We aimed to identify non-ischemic phenotypes in low-risk NSTE-ACS patients by analyzing a wide range of parameters available during exercise SE.MethodsInpatients [n = 103, median age 56 (46–65) years, 65 (63%) men] with suspected NSTE-ACS without high-risk criteria underwent exercise SE using a semi-supine cycle ergometer. Abnormal stress biomarkers [regional wall motion abnormalities (RWMAs), ST-segment depression, induced angina, peak systolic blood pressure, force-based contractile reserve (CR), heart rate reserve (HRR), and low exercise capacity] were used for phenotyping. Non-ischemic phenotypes were identified as patients not belonging to the clusters with the highest rates of RWMA, ST-segment depression, and induced angina. Invasive or non-invasive coronary angiography was used to assess coronary anatomy.ResultsThe majority (90%) of patients presented with one or more abnormal stress biomarkers. Cluster analysis revealed six phenotypes, four of which were classified as non-ischemic and identified in 65 (63%) patients. Non-ischemic phenotypes differed in the prevalence of hypertensive response, reduced CR, and reduced HRR. Among patients with non-ischemic phenotypes, the incidence of coronary artery disease was low (23%).ConclusionsFour non-ischemic phenotypes of low-risk NSTE-ACS patients were identified: “near-normal type,” “inotropic insufficiency type,” “hypertensive type,” and “chronotropic insufficiency type.” Further studies are needed to investigate the long-term significance of the obtained phenotypes.
Dietary and lifestyle oxidative balance scores and their impact on cardiovascular diseases: exploring the mediating influence of hepatic function and blood lipid levels
Authors: He Yi , Lan Ying 
Published: February 2025

BackgroundLimited evidence exists regarding the association between oxidative stress induced by dietary and lifestyle factors and cardiovascular diseases (CVDs).MethodsWe conducted a weighted analysis using data from 13,530 adults in the National Health and Nutrition Examination Survey (NHANES), covering the period from 2003 to 2018. The total oxidative balance score (OBS) was derived from 20 oxidative stress-related exposures, including dietary and lifestyle factors. Survey-weighted multivariable logistic regression and stratified analyses were performed to examine the association between OBS and CVDs. To further investigate the nonlinear relationship, we employed restricted cubic spline analysis and threshold effect analysis. Additionally, we assessed whether hepatic function and blood lipid levels mediate the OBS-CVDs relationship.ResultsThis study included 13,530 participants, representing a weighted population of 81,006,649.2 individuals. After adjusting for potential confounders, a linear relationship was observed between total OBS, dietary OBS, and CVDs, while lifestyle OBS exhibited a nonlinear association, with a significant threshold effect at a score of 4. When the lifestyle OBS exceeded this threshold, a marked negative correlation with CVDs was observed. Furthermore, albumin (Alb) mediated 23.59% of the relationship between the total OBS and CVDs.ConclusionsLower levels of total OBS were inversely associated with CVDs. This association was partially mediated by blood lipid levels and hepatic function. Interventions focusing on antioxidant-rich dietary and lifestyle modifications may play a pivotal role in reducing the possibility of CVDs.
Unveiling formative assessment in Ethiopian higher education institutions: practices and socioeconomic influences
Authors: Wondim Mebrat Gedfie , Dessie Behailu Atinafu 
Published: February 2025

IntroductionFormative assessment tries to improve learning rather than simply providing judgments on learners’ achievement.ObjectiveThe purpose of the study is to examine the practice of formative assessment (FA) and the influence of socio-demographic factors (experience, education, and university category) on the practice.MethodsThe study used a quantitative research approach with a descriptive survey research design, with data collected from 319 teachers through a questionnaire designed to measure three major components of FA (feedback, alignment of FA with objectives and contents, peer, and self-assessment). To select the participants, this study used both stratified and random sampling techniques. The data analysis techniques used were both descriptive and inferential statistics.ResultsThe analysis revealed that most higher education teachers did not use formative assessment strategies to help students progress. This was shown by miss aligning FA strategies with learning objectives and contents of the course; improper feedback for learners, and lack of learners’ involvement in the assessment procedure. We did one-way ANOVA, a statistical test that reveals whether the differences we identified between groups were due to chance or were genuinely significant. The analysis noted that the level of practicing FA was found to differ significantly by university category and experience in teaching. However, ‘educational level’ yielded non-significant results on the extent of practicing FA, implying that a higher degree does not imply that a more likely to use FA strategies.Conclusions and recommendationsOverall, teachers in higher education institutions were not practicing FA strategies. Thus, universities are required to organize discussions and training that would enable teachers to recognize and discharge their multifaceted roles in performing FA.
Clinical application of Myxovirus resistance protein A as a diagnostic biomarker to differentiate viral and bacterial respiratory infections in pediatric patients
Authors: Zhu Min , Chen Lijin , Cao Jiali , Cai Jianguo , Huang Shuying , Wang Huibin , He Huanjuan , Chen Zimin , Huang Rongfu , Ye Huiming 
Published: February 2025

BackgroundDifferentiating between viral and bacterial respiratory tract infections in pediatric patients remains a significant diagnostic challenge, often leading to the overuse of antibiotics. Myxovirus resistance protein A (MxA) has been identified as a promising biomarker for viral infections. This study aimed to assess the fluctuations in blood MxA levels among children with viral respiratory infections and to explore the differences in MxA levels between viral and bacterial infections, focusing on clinical implications for antibiotic use.MethodsWe conducted a retrospective study using enzyme-linked immunosorbent assay (ELISA) to measure MxA levels in a cohort of 314 children with respiratory tract infections and 89 healthy controls. The study compared MxA levels across children with viral, bacterial, and mixed infections. Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curve analysis to distinguish between viral and bacterial infections or between viral and co-infections, with additional comparisons to other established infection biomarkers.ResultsMxA levels were significantly elevated in children with viral infections (n=205) compared to bacterial infections (n=21) (p&lt;0.0001). The ROC curve analysis demonstrated that MxA had an area under the curve (AUC) of 0.8019 (95% CI: 0.6989 to 0.9049) for distinguishing viral from bacterial infections. Combining MxA with C-reactive protein (CRP) further enhanced diagnostic performance, achieving an AUC of 0.8713 (95% CI: 0.7916 to 0.9510). However, the use of MxA or MxA/CRP alone is insufficient to differentiate viral and viral - bacterial coinfection. The AUC of MxA is 0.5161 (95% CI: 0.4392 to 0.5930), and the AUC of MxA/CRP is 0.5429 (95% CI: 0.4705 to 0.6153).ConclusionsThis study highlights the diagnostic potential of MxA as a biomarker for differentiating viral from bacterial respiratory infections in children. The combined use of MxA and CRP offers a novel approach to improve diagnostic accuracy. Still, a combination with other clinical and laboratory markers remains required to determine whether to administer antibiotics to children with respiratory tract infections.
Association between systemic immune-inflammation index and central obesity in pediatric populations: a cross-sectional and cohort study
Authors: Zhang Qian , Kong Bingxuan , Zhou Zhiyu , Liu Fangqu , Wen Erya , Lin Bingliang , Xuan Peng , Lu Wenlong , Su Zhe , Li Yanyan , Tang Yuhan , Xiong Jingfan , Yao Ping , Li Yan 
Published: February 2025

BackgroundCentral obesity in children represents a significant public health concern due to its strong association with an elevated risk of metabolic and cardiovascular disorders. The systemic immune inflammation index (SII) has been implicated in the pathophysiology of obesity-related chronic inflammation. Despite its potential relevance, the specific relationship between central obesity and SII in the pediatric population remains insufficiently explored. The objective of this study was to examine the relationship between SII and central obesity, with a particular focus on the potential of SII as a predictor of central obesity and a means of preventing obesity at an early stage of life.MethodsWaist-to-height ratio (WHtR), subcutaneous fat, and visceral fat were employed as obesity proxies. Central obesity was defined according to WHtR with a cutoff value of 0.46. The implications of SII on central obesity were examined in a sample of 4,730 individuals in 2021 and validated through a prospective study involving 1,425 subjects in 2023. Cross-sectional associations between SII and central obesity were examined using binomial logistic regression models and generalized linear models. The restricted cubic spline regression was used to explore the non-linear relationship between SII and obesity indicators. In a prospective study, we employed a modified Poisson regression model to investigate the potential causal relationship between SII and central obesity.ResultsCross-sectionally, adolescents in the highest quartile of SII levels exhibited the greatest risk for central obesity(OR=3.07, 95% CI:2.45~3.87) when compared to those in the lowest quartile. Subgroup analyses showed that higher SII was associated with central obesity. Longitudinally, individuals in the highest SII quartile were found to have the highest risk of developing central obesity (RR=1.83, 95% CI:1.18~2.83) over time.
Effect of rapid rehabilitation surgery on postoperative rehabilitation, complications and long-term prognosis in radical laryngectomy: a PSM matching study
Authors: Huang Yibo , Wang Meifang , Pu Jianfeng , Zang Yunpeng , He Teng 
Published: February 2025

ObjectiveTo evaluate the effects of Enhanced Recovery After Surgery (ERAS) on postoperative rehabilitation, complications, and long-term prognosis in patients undergoing radical laryngectomy using a single-center propensity score matching (PSM) study.MethodsA retrospective cohort study included patients newly diagnosed with laryngeal cancer between January 1, 2019, and January 1, 2021, scheduled for partial laryngectomy. The control group (CG) comprised patients treated with standard interventions in 2019, while the research group (RG) included patients undergoing ERAS in 2020. After exclusions, 233 individuals remained: 94 in the RG and 204 in the CG. Following PSM in a 2:1 ratio, there were 180 in the CG and 90 in the RG. Relevant indices were analyzed.ResultsNo significant differences were found in baseline characteristics (p &gt; 0.05). The RG showed significantly lower hospital stay, nasogastric tube and tracheal cannula duration, early enteral nutrition, hospitalization expenses, and readmission rates compared to the CG (p &lt; 0.05). The RG had higher albumin and prealbumin levels on postoperative days 3 and 7 (p &lt; 0.05) but not on day 1 (p &gt; 0.05). No significant differences were found in 1-year or 2-year overall survival rates, nor in recurrence-free survival rates between the groups (p &gt; 0.05), though the RG showed marginally better survival.ConclusionERAS treatment for postoperative laryngeal cancer patients reduces hospitalization duration, nasogastric tube and tracheal cannula use, costs, readmission rates, and complications, while accelerating recovery and facilitating early discharge. ERAS enhances patient comfort and clinical outcomes, supporting broader clinical adoption.
Simulated driving behavior over the adult age span
Authors: Menze Felix , Churchill Nathan W. , Schweizer Tom A. , Graham Simon J. 
Published: February 2025

BackgroundMotor vehicle accidents remain a leading cause of accidental death worldwide. Death and injury rates are particularly high for both young inexperienced drivers and elderly drivers. Understanding the behavioral changes that are associated with maturation and aging could inform assessments of driving performance and lead to new measures identifying at-risk drivers. To shed further light on such effects, this study aims to characterize simulated driving behavior across and within age groups using a large driving simulation dataset.MethodsThe analyzed dataset consisted of 112 participants [47/112 (42%) female] between the ages of 17 and 85 (average ± standard deviation: 54 ± 22 years). Participants performed navigation in scenarios modeled after the standard licensing test of Ontario, Canada, which included a series of turns at intersections with different levels of complexity (e.g., involving oncoming traffic or pedestrians) and levels of distraction (requiring auditory responses to common-knowledge questions). Behavioral metrics were defined and investigated not only for the full completion of each task but also based on common subtasks (e.g., braking at an intersection), which were then compared across and within age groups (young, middle-aged, old).ResultsOverall, young adults behaved similarly to middle-aged adults for basic tasks but showed differences during traffic navigation subtasks when distracted, such as starting to decelerate significantly later when approaching intersections. Old drivers, on the other hand, drove at lower average speed, stopped earlier at intersections, and left increased distances to pedestrians, but required significantly more time to complete the driving tasks.ConclusionWith rich detail arising from intra-task quantification, the results were consistent with and additive to previous literature showcasing that compared to middle-aged adults, young adults showed performance suggestive of riskier driving behavior, and old adults showed performance suggestive of caution consequent to declining driving ability. In particular, the intra-task quantification revealed that the driving of young adults was more impacted by the presence of distraction (e.g., delayed decelerating), whereas old adults prioritized safe driving (e.g., correctly braking at intersections) over responding to distractions. The study may be used as motivation for future studies of driving safety and accident prevention, and informed assessment of governmental regulations.
A prospective comparison of Scheimpflug-based anterior segment imaging systems in normal and abnormal corneas: Oculus Pentacam vs. Remidio Visionix VX650
Authors: Kumar Sonam , Negiloni Kalpa , Gupta Parul Chawla , K Ranjitha , N Neha , Parthasarathy Rao Divya , Damani Jyothi , Thakur Ritika , Ballae Ganesh Rao Shonraj , Duggal Mona 
Published: February 2025

PurposeAdvancements in anterior segment imaging have significantly improved the precision of corneal diagnostics, aiding ocular conditions management. The study evaluated the agreement between two Scheimpflug devices—Pentacam and Remidio Visionix 650 (VX650)—in assessing corneal and anterior chamber parameters in patients with and without corneal abnormalities.Materials and methodsThis prospective study at a tertiary eye care hospital measured pachymetry values (central corneal thickness, thinnest point), front corneal surface parameters (keratometry, curvature, astigmatism), back corneal surface parameters (elevation, curvature) and anterior chamber parameters (depth, volume, angle). Bland-Altman analysis assessed agreement between the devices, and the Intraclass Correlation Coefficient (ICC) evaluated VX650’s repeatability.ResultsOf the 202 patients (mean age was 25 ± 4.33 years), 141 eyes were classified as normal and 61 as abnormal (41 keratoconus, 17 post-LASIK, 3 post-ICL). Bland-Altman analysis showed good agreement between Pentacam and VX650 for anterior segment parameters. The VX650 measured marginally thicker corneal thickness (mean difference of central corneal thickness (CCT) of -4.0 ± 6.3 µm). Statistically significant differences in apical corneal thickness were noted for post-refractive surgery patients. K1 and K2 values showed significant variations in keratoconus but were not clinically significant. Anterior chamber depth was similar between devices, though volume differences were observed post-surgery. ICC indicated good to excellent repeatability (above 0.75) for most parameters.ConclusionRemidio Visionix VX650 showed good agreement with Pentacam for key anterior segment measurements, confirming its reliability for corneal diagnostics. Additionally, its multifunctional capabilities offer potential for streamlining workflows, especially in clinics seeking efficient, comprehensive eye assessments.
Integration of multi-omics profiling reveals an epigenetic-based molecular classification of lung adenocarcinoma: implications for drug sensitivity and immunotherapy response prediction
Authors: Wang Ning , Li Yinan , Wang Yaoyao , Wang Wenting 
Published: February 2025

BackgroundLung adenocarcinoma (LUAD) remains a major cause of cancer-related mortality worldwide, with high heterogeneity and poor prognosis. Epigenetic dysregulation plays a crucial role in LUAD progression, yet its potential in molecular classification and therapeutic prediction remains largely unexplored.MethodsWe performed an integrated multi-omics analysis of 432 LUAD patients from TCGA and 398 patients from GEO datasets. Using consensus clustering and random survival forest (RSF) algorithms, we established an epigenetic-based molecular classification system and constructed a prognostic model. The model’s performance was validated in multiple independent cohorts, and its biological implications were investigated through comprehensive functional analyses.ResultsWe identified two distinct molecular subtypes (CS1 and CS2) with significant differences in epigenetic modification patterns, immune microenvironment, and clinical outcomes (P = 0.005). The RSF-based prognostic model demonstrated robust performance in both training (TCGA-LUAD) and validation (GSE72094) cohorts, with time-dependent AUC values ranging from 0.625 to 0.694. Low-risk patients exhibited enhanced immune cell infiltration, particularly CD8+ T cells and M1 macrophages, and showed better responses to immune checkpoint inhibitors. Drug sensitivity analysis revealed subtype-specific therapeutic vulnerabilities, with low-risk patients showing higher sensitivity to conventional chemotherapy and targeted therapy.ConclusionOur study establishes a novel epigenetic-based classification system and predictive model for LUAD, providing valuable insights into patient stratification and personalized treatment selection. The model’s ability to predict immunotherapy response and drug sensitivity offers practical guidance for clinical decision-making, potentially improving patient outcomes through precision medicine approaches.