bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rural Health Care - Challenges and Opportunities: Lessons Learned from the Villages in Rural Rajasthan
Authors: MM Rajeev 
Published: December 2024

Abstract

Rural communities, on average, have far less access to healthcare services than urban areas. Access to health care can prevent disease by means of early identification and treatment, as well as provide a higher quality of life and increase life expectancy for persons in the community. People and communities who lack economic clout and autonomy will inevitably have restricted or non-existent access to medical care. Here, the author highlights the various issues pertaining to health and mental health concerns of people living in the rural areas of Rajasthan, who often experience discrimination as well as social stigma towards services such as health, social, economic, and education. Poor socioeconomic conditions, a lack of education, and poor health status are common among rural people living inside villages. The author emphasizes how discrimination and bias prohibit people from having equal access to healthcare services by preventing vulnerable populations from participating in the delivery of healthcare, limiting their legal access, or preventing them from entering healthcare systems altogether. The study was conducted in the village of Bandarsindri in Kishangarh Taluk, Ajmer district, Rajasthan. The study's aims consist of (a) to know the general health status of people living in the village (b) learn the mental health-related requirements of the individuals in the study location (c) to determine the pressing health problems of the children and women in the village (d) to understand the access to healthcare of the people in the rural areas and (e) to determine the scope of implementing a programme/intervention with the support of Central University of Rajasthan and the use of other local resources. The methodology adopted for this study is qualitative, and the data were collected through individual interviews and focus group discussions. The researcher used a purposive sampling method for selecting the samples; the sample size for the qualitative interviews was 20, and the FGD was 3. The qualitative interviews were conducted among women, aged persons and the youth population in the village. Content analysis was performed for the qualitative study, and detailed notes were prepared for analysing the FGDs. The findings emphasize the urgent need to address the various health needs of the community and empower them to seek health care and support from government resources by building advocacy and networking activities by development professionals.
The Correlation Between Five Inflammatory Indices and Overactive Bladder: A Cross-Sectional Study from NHANES 2005-2010
Authors: Yan Yanyuan , Cheng Qiong , Hong Anjie , Zhou Ping 
Published: December 2024

Abstract

Current research indicates a strong association between inflammation and the development of overactive bladder (OAB). This study aims to explore the correlation between five inflammatory indices—Neutrophil/Lymphocyte Ratio (NLR), Platelet/Lymphocyte Ratio (PLR), Lymphocyte/Monocyte Ratio (LMR), Albumin × Lymphocyte/(CRP × 10) (CALLY), and Systemic Immune-Inflammation Index (SII)—and OAB. We analyzed data from 12,689 participants from 2005 to 2010, defining OAB by nocturia and urgent urinary incontinence. Logistic regression models, Receiver Operating Characteristic (ROC) curves, restricted cubic splines (RCS), and subgroup analyses were utilized to assess the relationship between the five inflammatory indices and OAB. Results indicate that all selected inflammatory indices reflect the inflammation levels in OAB patients, with NLR showing outstanding predictive performance and a significant positive correlation with OAB risk. Higher NLR values are associated with increased likelihood of OAB (OR=1.356, 95% CI=1.241-1.483, P<0.001), and incidence rises with increasing quartiles. This study reveals the correlation between the five inflammatory indices and OAB, suggesting that NLR could serve as a safe, effective, and independent predictive indicator compared to other inflammatory markers. This finding underscores the potential role of NLR as a clinical tool for identifying individuals at risk for OAB.
Incidence, Prevalence, and Mortality of diseases among Children and Adolescents in national and subnational levels of Iran, 1990-2021: A systematic analysis for the Global Burden of Disease 2021
Authors: Gholami Samira , Bastan Mohammad-Mahdi , Gholami Bahareh , Khosravi Sepehr , Malekpour Mohammad-Reza , Rezaei Nazila , Shahin Sarvenaz , Golestani Ali 
Published: December 2024

Abstract

Introduction: Child and youth mortality serves as a critical indication of a nation's growth, with significant ramifications for the future of its people. Current statistics on Iranian children and adolescents' disease patterns are inadequate and outdated. This study seeks to examine the incidence, prevalence, and death rates of diseases in children and adolescents at both national and subnational levels in Iran, utilizing the Global Burden of Disease (GBD) 2021 data.
Methods: We employed data from the GBD 2021 study regarding all-cause mortality in children and adolescents, sourced from the Institute for Health Metrics and Evaluation. This research analyzes the patterns in the primary and secondary tiers of the GBD cause hierarchy of mortality and morbidity. We analyze the incidence, prevalence, and mortality rates for children and adolescents under 20 years old in Iran and its 31 provinces from 1990 to 2021.
Results: From 1990 to 2021, there has been a significant reduction in incidence (28.1%), prevalence (19.7%), and death (90.6%) from all causes among children and adolescents in Iran. Several rates that decreased included those for communicable, maternal, neonatal, and nutritional diseases (CMNNDs), non-communicable diseases (NCDs), and injuries. The sole rate that increased was the prevalence rate for NCDs, rising from 82437.7 (95% UI: 80130.1 to 84458.9) to 83458.5 (81399.3 to 85197.9), representing a 1.2% increase. In 2021, respiratory infections and tuberculosis, intestinal infections, and other non-communicable disorders exhibited the greatest incidence rates across all provinces. Moreover, in most areas, transportation injuries, maternal and neonatal disorders, and other non-communicable diseases exhibited the highest mortality rates.
Conclusion: This study highlights the remarkable advancements achieved in lowering mortality, incidence, and prevalence rates among children and adolescents in Iran over the last thirty years; Despite progress, challenges remain, particularly concerning NCDs. Policymakers should draw on insights from studies like these to create specific strategies that respond to the evolving health needs of children and adolescents in Iran, while also working to reduce health inequalities across different provinces.
WITHDRAWN: Postoperative Joint Scores of Comparison between total and unicondylar knee arthroplasty：A matched comparison
Authors: Liu Chen-ci , Zhang Zhen-dong , Shi Chen-hui 
Published: December 2024

Abstract

The full text of this preprint has been withdrawn by the authors as it was submitted and made public without the full consent of all the authors. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.
Association of elevated albumin-corrected anion gap with all-cause mortality risk in atrial fibrillation: a retrospective study
Authors: Xu Jia , Wang Zhen , Wang Yun , Chen Xinran , Ma Lan , Wang Xiaochen 
Published: December 2024

Abstract

Background
Compared to the conventional anion gap, albumin-corrected anion gap (ACAG) offers a more precise measure of acid-base imbalance in patients than, providing superior prognostic insight. However, the prognostic relevance of ACAG in individuals of atrial fibrillation (AF) remains insufficiently explored. This research seeks to evaluate the correlation between ACAG levels and mortality risk in individuals with AF.
Methods
We identified individuals diagnosed with AF from the Medical Information Mart for Intensive Care (MIMIC)-IV database. Participants were categorized into quartiles in accordance with their ACAG levels. The outcomes included 30 days and 365 days all-cause mortality. Cumulative survival across the quartiles was assessed using Kaplan–Meier survival curves. We applied Cox regression and restricted cubic spline regression analyses to evaluate the correlation between ACAG levels and prognosis. Subgroup analyses and interaction assessments were applied to confirm the robustness of the findings.
Results
A total of 2920 AF patients (54.93% male) were incorporated into the analysis. The 30 and 365-day mortality were 22.91% and 39.21%, respectively. Kaplan–Meier survival curves demonstrated that elevated ACAG levels were significantly linked to increased mortality (log-rank P < 0.001). In multivariate Cox proportional hazards analyses, increased ACAG independently predicted mortality at 30 days (adjusted hazard ratio [aHR], 1.04; 95% CI, 1.02–1.05; P < 0.01) and 365 days (aHR, 1.03; 95% CI, 1.02–1.05; P < 0.01) after adjusting for potential confounders. A positive relationship between rising ACAG levels and mortality risk, as showed by restricted cubic spline analysis. Subgroup analyses revealed no significant interactions (all interaction P-values > 0.05).
Conclusions
In individuals with AF, higher ACAG levels are related to a greater mortality risk at 30 and 365 days. These results show the potential value of ACAG as a prognostic indicator for patient stratification. Incorporating ACAG into clinical decision-making could support improved therapeutic strategies and enhance patient outcomes.
Pediatric Traumatic Dental Injuries in Rural Pennsylvania: a 9-year retrospective review
Authors: Salvato Jason , Wang Shengxuan , Stinton Natalie , Malik Gayatri 
Published: December 2024

Abstract

Purpose
Rural communities face unique challenges regarding traumatic dental injuries (TDIs) which may influence the causes of TDIs. The aim of this study was to analyze a pediatric population of patients who had suffered from TDIs in rural environments.
Methods
Electronic health records of 268 pediatric dental patients, ages 6 months to 17 years, who had presented at the emergency department at Geisinger Medical Center between July 2010 and July 2019 with TDIs were reviewed. The electronic health records of each patient were evaluated, including an analysis of epidemiological variables.
Results
The patient population consisted of 171 males and 97 females, with a mean age of 11.9 years. A total of 350 orofacial trauma injuries were recorded. The most frequently injured primary tooth was #E (20.4%), while the most commonly injured permanent tooth was #9 (38.6%). The most prevalent types of TDIs were uncomplicated crown fractures (25.7%) and avulsions (18.6%). TDIs were more common in male patients (63.8%) than female patients (36.2%). TDIs were most likely to be present during the summer months of May, June, July, and August (41.8%). The most common injury location was outdoors (32.2%), with falls (21.9%) and sporting activities (20.0%) being the leading causes of TDIs.
Conclusions
Based on the findings of the analysis, it can be concluded that males were more frequently affected by TDIs than females. Half of the patients suffered from TDIs before they turned 12 years of age. Overall, the uncomplicated crown fractures were found to be the most frequent injury, followed by avulsions.
Bioclimatic Conditions of Turkey: Spatial analysis of thermal comfort zones according to monthly mean physiological equivalent temperatures
Authors: Çalışkan Onur 
Published: December 2024

Abstract

Turkey is composed of two peninsulas situated between the European and Asian continents. Due to variations in elevation and continentality, the country experiences 13 different climate types, ranging from semi-arid to polar tundra. The bioclimatic conditions of Turkey were determined by analyzing data from 262 stations for the period 1975–2022, considering latitude, elevation, and maritime characteristics. A multiple linear regression model was employed to evaluate the spatial distribution of monthly mean Physiological Equivalent Temperature (PET). According to the calculations, PET values in the coastal belt and lowlands (floodplains and coastal plains) in the south and west of Turkey are 5°C-25°C higher than in other areas. PETs in the mountain ranges, which generally extend in a north-south direction, are approximately 10°C lower than in the surrounding lowlands. The highest PET values are observed in the lowlands of the southeast from May to September, and along the Mediterranean coast from October to April. The lowest PET values occur at the summits of the mountains border to Black Sea during the warm season, which are more northerly and maritime, and at the summit of Greater Ararat Mountain (volcanic mountain in Eastern Anatolia) during the cold season, which is more continental and elevated. PET values decrease with increasing latitude, maritime influence, and elevation. Annually, mean PET values decline by 1.4°C for every 1° increase in latitude northward, by 0.72°C for every 100 m increase in elevation and increase by 1.09°C for every 100 km distance from the sea.
Cost Effective Analysis of Inhalers Used for Asthma Management: An Interventional Approach
Authors: Alexander Nizi , Nair Prathiksha S , Iyer Swaminath G , Dharman Dhanya , Chandran Chintha , Dharan Shaiju. S. 
Published: December 2024

Abstract

Objective: To evaluate the cost-effectiveness of corticosteroid inhalers, patient counseling, and factors influencing prescribing patterns and medication adherence.
Methods: Prospective interventional sampling approach included patients aged 18-60 with asthma, excluding pregnant/lactating women, unwilling patients, and those with communication problems. Patients received counseling on inhaler use.
Results: Asthma incidence peaked in patients aged 48+ (30.6%).Upper-middle-class patients predominated (59%). Counseling improved adherence (76.4%). Patient satisfaction was high (47.2%). Pulmonary function test (PFT) values improved post-adherence (84.118±12.647). Fluticasone/Formoterol was the most common inhaler (41.7%). Budesonide/Formoterol had the lowest mean drug cost (Rupees 476.095±119.717). Total cost analysis revealed Fluticasone/Formoterol as most cost-effective (Rupees 5464.547 ± 1015.616). Proper adherence reduced drug costs (Rupees 544.042±398.614 vs. 1154.499 ± 369.435).
Conclusion: Fluticasone/Formoterol was the most cost-effective corticosteroid inhaler. Direct patient/caregiver interaction and counseling significantly improved asthma control, medication adherence, and patient satisfaction. Using clear language and visual aids enhanced comprehension.
Microbiome and Cancer: Exploring the Influence of Gut Microbiota on Immunotherapy Efficacy and Toxicity
Authors: MANFOUO WILFRED QUENTIN WOLASSE 
Published: December 2024

Abstract

The gut microbiome is a complex ecosystem of trillions of microorganisms that are essential to help regulate the human immune system, and its role in cancer treatment outcomes has become recognized as particularly relevant for immunotherapy. The landscape of cancers such as melanoma, lung or renal cancer has dramatically changed since immune checkpoint inhibitors (ICIs) including anti-PD-1, anti-PD-L1 and anti CTLA-4 therapies emerged. Nevertheless, response rates are limited and challenges remain regarding immune-related adverse events (irAEs). Recent studies have compellingly shown ICIs efficacy and toxicity to be influenced by the composition of an individual’s gut microbiota. Several bacterial taxa, including Akkermansia muciniphila, Faecalibacterium and Bifidobacterium are associated with better response to therapy whereas dysbiosis can contribute both treatment failure and irAEs. The review examines the mechanisms of gut microbiota in affecting immune responses and discusses how translating these findings might be used to leverage immunotherapy, as well describing potential actions already available (probiotic/ pre/pro-symbiotics/ FMT) for improving efficacy; also, it presents implications on clinical perspectives using microbiome-based strategies driving personalized cancer care. Given the critical role of gut-cancer-immune axis in cancer immunotherapy, a more comprehensive understanding on its mechanisms could open new avenues for improving patient outcomes and reducing toxicity.
The Predictive Value of Laboratory Parameters in Diagnosing Gastrointestinal Malignancy in Older Adults
Authors: Borazan Funda Yildirim , Yilmaz Meryem , Tuzcu Barış , Gulbahar Ozlem , Göker Berna , Varan Hacer Dogan 
Published: December 2024

Abstract

Introduction: Early diagnosis and treatment through screening tests to identify and remove precancerous lesions or detect cancer at a curable stage are crucial for managing gastrointestinal (GI) cancers. However, achieving early detection in older adults, particularly those who are frail, can be challenging. This retrospective study aimed to evaluate the predictive value of pre-endoscopic biochemical parameters for detecting malignant lesions in older adults undergoing upper and lower GI endoscopies.
Material and Methods: We retrospectively analyzed 419 individuals aged 60 and above. Of these, 109 older adult patients who underwent both upper and lower GI endoscopies were included in the study. Patients with a prior history of GI cancer or those who could not complete the procedure due to intolerance were excluded. Patients were categorized based on the presence of benign or malignant lesions.
Results: Malignant lesions were identified in 10.1% (11/109) of patients. Statistically significant differences were observed between the benign and malignant groups in terms of hemoglobin (Hb), neutrophil count, mean corpuscular volume (MCV), neutrophil-lymphocyte ratio (NLR), iron (Fe), 25-hydroxyvitamin D [25(OH)D], C-reactive protein (CRP), total protein, albumin (Alb), blood urea nitrogen (BUN), CRP/albumin ratio (CAR), and aspartate aminotransferase (AST). The ROC curve analysis suggests that MCV, NLR, 25(OH)D, Fe, and CAR are valuable indicators for predicting malignant lesions in older adults, with optimal cut-off values of 79.5 fL, 3.28, 12 µg/L, 22 µg/dL, and 5.93, respectively.
Conclusion: These findings underscore the predictive value of CAR, NLR, MCV, Fe, and 25(OH)D in identifying GI neoplasms in older adults. The study suggests that patients should undergo an endoscopic evaluation to investigate potential GI malignancies when they have MCV ≤79.5 fL, NLR <3.28, 25(OH)D ≤12 µg/L, Fe≤22 µg/dL and CAR >5.93.
Noise Pollution in the Center of the Iberian Peninsula: Diversity and Abundance on Urban Birds Breeding
Authors: Almarza-Batuecas Paula , Pescador Moisés 
Published: December 2024

Abstract

In an increasingly urbanized world, biodiversity, and more specifically birdlife located in urbanized ecosystems, faces several threats. Among these, noise pollution has proven to be one of the most significant, as it affects the effectiveness and efficiency of acoustic communication. We studied the relationship between noise and the diversity and abundance of birds breeding in urban areas in the central region of the Iberian Peninsula (Spain). We analyzed how species diversity and density varied across three levels of noise pollution (high, medium, and low). Species diversity decreased in areas with high noise pollution as compared to the sites with medium and low levels of noise. We analyzed the density of the most frequent species found within each category. We identified eight additional noise-tolerant species, whose density had significantly increased in environments with high levels of noise (e.g. Blackbird, Eurasian Tree Sparrow, and the Coal Tit). The ten most sensitive species, such as the Common Linnet, House Sparrow, and the European Greenfinch, had significantly decreased densities when the level of noise increased. Identifying the sensitivity (the effect) of urban bird species to acoustic pollution is vital for effective conservation management measures and for the sustainable planning and management of cities.
Fluoroestradiol (FES) and Fluorodeoxyglucose (FDG) PET imaging in patients with ER+, HER2-positive or HER2-negative metastatic breast cancer
Authors: Hunter Natasha B , Peterson Lanell M , Specht Jennifer M , Mankoff David A , Muzi Mark , Chen Delphine L , Gwin William R , Vinayak Shaveta , Davidson Nancy E , Linden Hannah M 
Published: December 2024

Abstract

Background
18F-Fluorodeoxyglucose (FDG) and 18F-Fluorestradiol (FES) have been FDA approved for measuring tumor glycolytic activity and estrogen receptor (ER) uptake, respectively, in clinical positron emission tomography (PET) imaging for patients with hormone-receptor (HR) positive metastatic breast cancer (MBC), but little is known about its utility in patients with breast tumors that overexpress human epidermal growth factor 2 (HER2). We hypothesize that comparing patterns of FDG and FES uptake in patients with HER2-positive versus HER2-negative MBC can guide further biologic and clinical studies into the HR/HER2-positive phenotype.
Methods
We conducted a retrospective study examining uptake in matched lesions for FES and FDG-PET scans, assessing these parameters in 213 patients with ER-positive/HER2-positive (n = 33) versus ER-positive/HER2-negative MBC (n = 180).
Results
No difference in FES or FDG avidity was observed between patients with HER2-negative or HER2-positive tumor status. Limited data also suggests that patients with HER2-positive disease had better overall survival (p = 0.024), than those with HER2-negative disease, but not time-to-progression between the same patient cohorts.
Conclusion
This retrospective analysis suggests that there is a possible role for future trials using FES-PET in helping to select patients with ER+/HER2-positive primary tumors who retain ER expression at all sites of disease and may benefit from endocrine therapy.