bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a prediction nomogram for IgG levels among asymptomatic or mild patients with COVID-19
Authors: Yi Jianying , Liu Zhili , Cao Xi , Pi Lili , Zhou Chunlei , Mu Hong 
Published: December 2024

ObjectiveCOVID-19 has evolved into a seasonal coronavirus disease, characterized by prolonged infection duration and repeated infections, significantly increasing the risk of patients developing long COVID. Our research focused on the immune responses in asymptomatic and mild cases, particularly the critical factors influencing serum immunoglobulin G (IgG) levels and their predictive value.MethodsWe conducted a retrospective analysis on data from 1939 asymptomatic or mildly symptomatic COVID-19 patients hospitalized between September 2022 and June 2023. Spearman methods were used to test the correlation between serum IgG and age, immunoglobulin M (IgM), procalcitonin (PCT), interleukin-6 (IL-6), nucleic acid conversion time, and BMI. Univariate and multivariate logistic regression analyses identified independent key factors influencing serum IgG levels, which were integrated and visualized in a nomogram. Finally, receiver operating characteristic (ROC) curves were plotted to predict the model’s diagnostic performance by calculating the AUC.ResultsMild patients showed higher levels of IgG, IgM, and longer nucleic acid conversion times than asymptomatic patients, and a lower proportion of them had received ≥ 3 COVID-19 vaccine doses. Serum IgG was positively correlated with serum IgM and negatively correlated with age, PCT, IL-6, and BMI. Notably, it showed a moderate negative correlation with nucleic acid conversion time (r = -0.578, P &lt; 0.001). Logistic regression results showed that younger age, lower IL-6 levels, ≥ 3 doses of vaccine, and no comorbidities were independent predictors of serum IgG levels ≥ 21.08 g/L. We used age, IL-6 levels, vaccine doses, and comorbidities to create a nomogram for predicting serum IgG levels, with the area under the ROC curve reaching 0.772.ConclusionAge, IL-6 levels, vaccination status, and comorbidities were independent predictors of serum IgG levels in asymptomatic or mild COVID-19 patients, facilitating risk stratification and clinical decision-making. Notably, receiving ≥3 doses of the COVID-19 vaccine was the most beneficial factor for elevated serum IgG levels.
Associations between self-reported sleep duration and incident cardiovascular diseases in a nationwide prospective cohort study of Chinese middle-aged and older adults
Authors: Zhao Qing , Zhu Yuan , Zhang Yu , Luo Huanyuan , Ma Yantao , Chen Xiaoshan , Gu Jiaming , Wang Lizhi 
Published: December 2024

PurposeThis study explores the correlation between sleep duration and cardiovascular disease (CVD) among middle-aged and older adults in China. Furthermore, we aim to investigate the association between sleep duration and incident CVD in this population, while assessing potential variations across different age and gender subgroups.MethodsUtilizing data from the nationwide prospective survey of the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011, 2013, 2015, and 2018, involving 17,596 participants aged 45 years and above, we employed Cox proportional hazards regression models. These models were used to examine the impact of baseline sleep duration on CVD, considering age (middle-aged/elderly) and gender (male/female) groups.ResultsOver the 8-year follow-up, 2,359 CVD events were recorded. Compared to individuals sleeping 6–8 h per day, a short sleep duration (≤6 h/day) was significantly associated with an increased risk of CVD (HR: 1.17, 95% CI: 1.03–1.33). Subgroup analysis revealed a more pronounced relationship in participants aged ≥60 years, where both short sleep duration (≤6 h/day) (HR: 1.17, 95% CI: 1.02–1.35) and long sleep duration (&gt;8 h/day) (HR: 1.20, 95% CI: 1.02–1.41) were significantly associated with an elevated risk of CVD. Specifically, among female participants, short sleep durations (≤6 h/day) was significantly associated with CVD (HR: 1.24, 95% CI: 1.05–1.47).ConclusionShort sleep durations can serve as predictive factors for CVD in China's population aged 45 and above, particularly among elderly female participants. Our study underscores the importance of considering sleep health as a critical aspect when formulating strategies for enhancing CVD prevention.
Trends in sepsis-associated cardiovascular disease mortality in the United States, 1999 to 2022
Authors: Salman Malik , Cicin Jack , Abdul Jabbar Ali Bin , El-shaer Ahmed , Tauseef Abubakar , Asghar Noureen , Mirza Mohsin , Aboeata Ahmed 
Published: December 2024

PurposeCardiovascular disease (CVD) is the leading cause of death in the United States, and sepsis significantly contributes to hospitalization and mortality. This study aims to assess the trends of sepsis-associated CVD mortality rates and variations in mortality based on demographics and regions in the US.MethodsThe Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database was used to identify CVD and sepsis-related deaths from 1999 to 2022. Data on gender, race and ethnicity, age groups, region, and state classification were statistically analyzed to obtain crude and age-adjusted mortality rates (AAMR). The Joinpoint Regression Program was used to determine trends in mortality within the study period.ResultsDuring the study period, there were a total of 1,842,641 deaths with both CVD and sepsis listed as a cause of death. Sepsis-associated CVD mortality decreased between 1999 and 2013, from AAMR of 65.7 in 1999 to 58.8 in 2013 (APC −1.06*%, 95% CI: −2.12% to −0.26%), then rose to 74.3 in 2022 (APC 3.23*%, 95% CI: 2.18%–5.40%). Throughout the study period, mortality rates were highest in men, NH Black adults, and elderly adults (65+ years old). The Northeast region, which had the highest mortality rate in the initial part of the study period, was the only region to see a decline in mortality, while the Northwest, Midwest, and Southern regions experienced significant increases in mortality rates.ConclusionSepsis-associated CVD mortality has increased in the US over the past decade, and both this general trend and the demographic disparities have worsened since the onset of the COVID-19 pandemic.
Association of cardiovascular-kidney-metabolic index with all-cause mortality during hospitalization in critically ill patients: a retrospective cohort study from MIMIC IV2.2
Authors: Qu Xiaolong , Liu Yuping , Nie Peng , Huang Lei 
Published: December 2024

BackgroundThe cardiovascular-kidney-metabolic index (CKMI), a novel functional indicator proposed in this study, aims to accurately reflect the functional status of the heart, kidneys, and metabolism. However, its ability to predict mortality risk in critically ill patients during their stay in the intensive care unit (ICU) remains uncertain. Therefore, this study aims to validate the correlation between the CKMI during hospitalization and all-cause mortality.MethodsThe study utilized the Medical Information Mart for Intensive Care IV 2.2 (MIMIC-IV) dataset for a retrospective analysis of cohorts. The cohorts were divided into quartiles based on CKMI index levels. The primary endpoint was all-cause mortality during ICU and hospital stay, while secondary endpoints included the duration of ICU stay and overall hospitalization period. We established Cox proportional hazards models and employed multivariable Cox regression analysis and restricted cubic spline (RCS) regression analysis to explore the relationship between CKMI index and all-cause mortality during hospitalization in critically ill patients. Additionally, subgroup analyses were conducted based on different subgroups.ResultsThe study enrolled 1,576 patients (male 60.79%). In-patient and ICU mortality was 11.55% and 6.73%. Multivariate COX regression analysis demonstrated a significant negative correlation between CKMI index and the risk of hospital death [HR, 0.26 (95% CI 0.07–0.93), P = 0.038] and ICU mortality [HR, 0.13 (95% CI 0.03–0.67), P = 0.014].RCS regression model revealed that in-hospital mortality (P-value =0.015, P-Nonlinear =0.459) and ICU mortality (P-value =0.029, P-Nonlinear =0.432) increased linearly with increasing CKMI index. Subgroup analysis confirmed consistent effect size and direction across different subgroups, ensuring stable results.ConclusionOur research findings suggest that a higher CKMI index is associated with a significant reduction in both in-hospital and ICU mortality among critically ill patients. Therefore, CKMI index emerges as a highly valuable prognostic indicator for predicting the risk of in-hospital death in this population. However, to strengthen the validity of these results, further validation through larger-scale prospective studies is imperative.
From thankfulness to taking it for granted – a qualitative study of dental education during COVID
Authors: Goetz Katja , Reimer Ida , Wenz Hans-Jürgen , Hertrampf Katrin 
Published: December 2024

IntroductionThe coronavirus (COVID-19) pandemic brought public life to a standstill. For universities, this meant the suspension or corresponding adjustment of practical and theoretical teaching. In Germany, the Kiel Dental Clinic received special permits to start face-to-face teaching under appropriate hygienic conditions. Therefore, the aim of this study, which was conducted using a longitudinal qualitative panel, was to interview students and teachers over a period of three semesters under pandemic conditions regarding the effects of the pandemic on dental teaching at a structural, individual and social aspect in order to determine which strategies can be acquired for future teaching design.MethodsQualitative methods based on interviews were used for data collection. The same dental students from different semesters (6th, 8th and 10th) and the same teaching staff responsible for the content and implementation of courses within the dental curriculum were interviewed in the summer semesters of 2020 and 2021. The data analysis was performed by qualitative content analysis.ResultsA total of 27 students and 15 teaching staff participated. Our study team received interesting results on the implications of the teaching and learning situation from the start of the emergency transition to remote teaching and then to practical courses in face-to-face situations with specific regulations. Teaching under pandemic conditions resulted in a very stressful situation for the students and teaching staff. The learning process for teaching has led to an improvement in digital literacy for both groups over the last two years.DiscussionThis qualitative longitudinal study describes the different factors that played a role during the course of the various “Corona” semesters. The development process, from thankfulness to taking it for granted, demonstrated that students’ expectation towards the implementation of the courses increased. Simultaneously, the results clearly show that the degree of stress and anxiety among students and teachers increased also. The necessary self-structuring of everyday student life under COVID conditions was not possible for everyone. It was also noted that teachers in particular were aware of this and that they developed a certain vigilance towards students.
Education sector development and teacher identity construction: a reflective experience
Authors: Lawrent Godlove 
Published: December 2024

IntroductionTanzania, like other developing countries, has adopted numerous educational reforms geared towards addressing challenges rooted in either the colonial or post-colonial educational systems. However, the influence of these reforms on teacher professionalism is seldom studied. This study, therefore, gained insights into how the secondary education expansion policy related challenges affected teachers as teaching professionals.MethodsThe qualitative case study design was adopted in order to capture the holistic overview of the phenomena under exploration. Individual interviews, focus group discussion, and document analysis were utilized for gathering data. The main participants were teachers and school principals who were purposively selected from the Iringa region, Tanzania. The region promptly managed to build at least one secondary school in each ward (i.e., at least two villages) as per the government’s expansion enactment directives.ResultsIt was revealed that the inadequate enactment of the expansion policy adversely affected teachers’ self-beliefs about their own teaching aptitudes, their apathy towards teaching, as well as their social status. These issues undermined successful implementation of the policy itself.DiscussionThe study adds to a growing body of literature around how teachers “construct” what secondary expansion means for them as both effective and ethical professionals.
Influence of renal function on blood pressure control and outcome in thrombolyzed patients after acute ischemic stroke: post-hoc analysis of the ENCHANTED trial
Authors: Ren Xinwen , Chen Chen , Wang Xia , Li Qiang , Zhao Yang , You Shoujiang , Ouyang Menglu , Robinson Thompson , Lindley Richard I. , Arima Hisatomi , Chen Xiaoying , Chalmers John , Anderson Craig S. , Song Lili 
Published: December 2024

BackgroundThe effect of renal impairment in patients who receive intravenous thrombolysis for acute ischemic stroke (AIS) is unclear. We aimed to determine the associations of renal impairment and clinical outcomes and any modification of the effect of intensive versus guideline-recommended blood pressure (BP) control in the BP arm of the International Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED).MethodsWe conducted a post-hoc analysis of the ENCHANTED BP arm, which involved 2,196 thrombolyzed AIS patients. Logistic regression models were used to define the association between eGFR and clinical outcomes of death, death or major disability [modified Rankin scale (mRS) scores 3–6], and major disability (mRS 3–5) at 90 days.ResultsOf the 2,151 patients with available baseline renal function data (mean age 66.9 years; 38% women), 993 (46.2%), 822 (38.2%), and 336 (15.6%) had normal (eGFR ≥ 90 mL/min/1.73 m2), mildly (60–89), and moderate-to-severely impaired (&lt;60) renal function, respectively. Compared with patients with normal eGFR, mortality was higher in those with moderate-to-severe renal impairment (adjusted odds ratio 1.77, 95% confidence interval 1.05–2.99; p = 0.031 for trend). However, the difference in death or major disability (mRS 3–6) was not significant between groups. There was no heterogeneity in the effect of intensive versus guideline-recommended BP-lowering treatment on death by grades of renal function (p for interaction = 0.545).DiscussionThe presence of moderate-to-severe renal impairment is associated with increased mortality in thrombolyzed patients with AIS. Renal function does not modify the effect of early intensive BP-lowering treatment on death in this patient group.
Development and validation of a clinical prediction model for blastocyst formation during IVF/ICSI-ET
Authors: Liu Xingnan , Zhao Jingyun , Zhang Yi , Nie Zhaoyan , Li Qiaoxia , Guo Lina , Fan Chunhui , Zhang Jianfeng , Zhang Na 
Published: December 2024

PurposeThis study aims to create and validate a clinical model that predict the probability of blastocyst formation in IVF/ICSI-ET cycles.MethodsThis study employed a retrospective methodology, gathering data from 4961 cleavage-stage embryos that cultured in the reproductive center’s of the Fourth Hospital of Hebei Medical University between June 2020 and March 2024. 3472 were in the training set and 1489 were in the validation set when it was randomly split into the training set and validation set in a 7:3 ratio. The study employed both univariate and multivariate logistic regression analysis to determine the factors those influence in the process of blastocyst formation. Based on the multiple regression model, a predictive model of blastocyst formation during IVF was created. The calibration and decision curves were used to assess the effectiveness and therapeutic usefulness of this model.ResultsThe following factors independently predicted the probability of blastocyst formation: the method of insemination, number of oocytes retrieved, pronuclear morphological score, the number of cleavage ball, cleavage embryo symmetry, fragmentation rate and morphological score and basal P levels of female. The receiver operating characteristic curve’s area under the curve (AUC) in the training set is 0.742 (95% CI: 0.724,0.759), while the validation set’s AUC is 0.729 (95% CI: 0.703,0.755), indicating a rather high clinical prediction capacity.ConclusionOur generated nomogram has the ability to forecast the probability of blastocyst formation in IVF, hence can assist clinical staff in making informed decisions.
Risk factor screening and prediction modeling of gastrointestinal adverse reactions caused by GLP-1RAs
Authors: Gao Rui , Li Yue , Li Anan , Zhou Penglin , Zong Huiying , Li Yan 
Published: December 2024

ObjectiveThis study aimed to explore the risk factors for gastrointestinal side effects (GISEs) in patients with type 2 diabetes mellitus (T2DM) during treatment with glucagon-like peptide-1 receptor agonists (GLP-1RAs) based on real-world data and to develop a prediction model for GLP-1RA-related GISEs.MethodsA total of 855 patients who attended the First Affiliated Hospital of Shandong First Medical University from January 2020 to May 2023 were selected as the study participants, who were divided into the training set (598 cases) and the validation set (297 cases) using a simple random sampling method at a ratio of 7:3. The general information and biochemical indicators of the participants were collected to assess the risk factors for GLP-1RA-related GISEs, and multifactorial logistic regression analysis was used to obtain the best predictors. A nomogram prediction model was constructed. The Hosmer–Lemeshow test was used to assess the differentiation and calibration of the nomogram model, and decision curve analysis (DCA) was used to evaluate the clinical utility of the model.ResultsAge, gender, history of gastrointestinal disorders, and number of combined oral medications were found as risk factors for the occurrence of GISEs in patients with T2DM using GLP-1RAs (p &lt; 0.05). The nomogram prediction model based on these four factors had good discriminability (AUC values of the training and validation sets of 0.855 and 0.836, respectively) and accuracy (Hosmer–Lemeshow test: p &gt; 0.05 for the validation set). DCA showed that the prediction model curve had clinical utility in the threshold probability interval of &gt;5%.ConclusionsThe established nomogram model has an excellent predictive effect on GISEs induced by GLP-1RAs in patients with T2DM.
The win-stay, lose-switch renesting strategy of a territorial bird endemic to subtropical salt marshes
Authors: Sandretti-Silva Giovanna , Corrêa Leandro , Amirati Mariana , Laurino Ivan Rodrigo Abrão , Passos Fernando Camargo , Pie Marcio R. , Bornschein Marcos R. 
Published: December 2024

IntroductionThe “win-stay, lose-switch” (WSLS) strategy used by birds involves decisions to maintain or alter the characteristics of the subsequent nest according to the outcome of the previous one. In salt marshes, nest failure occurs due to flooding, predation, or tipping, creating a trade-off for nest placement: it should be low enough to avoid predators from above and tipping by the wind, and high enough to avoid flooding. In salt marshes of Southern Brazil, predation from above is carried out by rails that also prey on nests from below, promoting nondirectional pressure capable of neutralizing bird responses. We aim to test the WSLS strategy and to assess its adaptive significance for Formicivora acutirostris, the only thamnophilid endemic to salt marshes. Our general premise is that the adoption of the WSLS strategy would vary in response to the fate of the previous nest, considering also the environment type.MethodsWe evaluated the fate, environment type, height, altitude, and thickness of nests of F. acutirostris in southern Brazil, between 2006 and 2023. We assessed the effects of the nest attributes, tested the adoption of the WSLS strategy, and explored its adaptive significance using generalized linear mixed models. We also examined the influence of factors such as nest environment, nesting timing, and pair age on nest fate and parental behavior.ResultsWe studied 98 renesting cases. Flooded nests were at a lower height than predated, tipped, and successful nests, and tipped nests were thicker than flooded and successful nests. Nest heights differed among environment types. The species adopted the WSLS strategy by increasing nest height after flooding, but we do not support its adaptive significance. No additional factors influenced the behavior of the species.DiscussionAlthough the adoption of the WSLS strategy by F. acutirostris was confirmed regarding the increase in nest height after flooding, it did not result in a significant increase in reproductive success, suggesting that other pressures, such as predation and tipping, are limiting the adaptive potential of this strategy. We emphasize the threat of the high reproductive failure for the conservation of F. acutirostris and proposes reducing predation pressure as an important conservation strategy.
UDP-glucuronosyltransferases 2A3 as a biomarker for ulcerative colitis and colon cancer
Authors: Chen Hao 
Published: December 2024

BackgroundUlcerative colitis has a serious impact on the quality of life of patients and is more likely to progress to colon cancer. Therefore, early diagnosis and timely intervention are of considerable importance.MethodsGene expression data of active ulcerative colitis were downloaded from the Gene Expression Omnibus (GEO) database, and genes with significant differential expression were identified. Biochemical markers with diagnostic significance were selected through machine learning methods. The expression differences of the selected markers between colon adenocarcinoma (COAD) and healthy control groups in The Cancer Genome Atlas (TCGA) database were analyzed to evaluate their diagnostic value. In addition, the correlation between the selected markers and clinical indicators, as well as their predictive efficacy for the survival of COAD patients, was explored.ResultsThrough machine learning and LASSO regression analysis, UGT2A3 was finally determined as a diagnostic marker for ulcerative colitis. It demonstrated high diagnostic accuracy in both the training set and the external validation set. Furthermore, UGT2A3 was significantly downregulated in COAD tissues compared to normal control tissues. The ROC curve suggested that UGT2A3 could serve as a diagnostic marker for COAD with excellent performance, achieving an AUC of 0.969. Immune infiltration analysis indicated a significant negative correlation between the expression of UGT2A3 and neutrophils. Correlation analysis suggested a link between UGT2A3 and the pathological classification of colon cancer. Survival analysis showed that UGT2A3 is negatively correlated with OS, PPS, and RFS in colon cancer.ConclusionThe author identified UGT2A3 as a diagnostic marker for ulcerative colitis through bioinformatics methods, and verified its significant downregulation in colon cancer, as well as its predictive role in the survival of COAD patients. These findings suggest that UGT2A3 may serve not only as a diagnostic marker for ulcerative colitis and colon cancer but also as a potential prognostic indicator for colon cancer.