bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time to antenatal care booking and its predictors among pregnant women in East Africa: a Weibull gamma shared frailty model using a recent demographic and health survey
Authors: Endawkie Abel , Kebede Shimels Derso , Abera Kaleab Mesfin , Abeje Eyob Tilahun , Enyew Ermias Bekele , Daba Chala , Asmare Lakew , Bayou Fekade Demeke , Arefaynie Mastewal , Mohammed Anissa , Tareke Abiyu Abadi , Keleb Awoke , Kebede Natnael , Tsega Yawkal 
Published: November 2024

BackgroundAntenatal care (ANC) is an important component of maternal and child healthcare. The World Health Organization (WHO) recommends that pregnant women book their ANC contact at or before 12 weeks of gestational age. However, in East Africa, evidence on whether the WHO recommendations have been followed is limited. Therefore, this study aimed to determine the time to ANC booking and its predictors among pregnant women in East Africa.MethodThis study was conducted among 86,662 pregnant women in East Africa. The time to ANC booking was estimated using the Kaplan–Meier (K–M) survival estimate. A Weibull gamma shared frailty model was used to determine the predictors of time to the first ANC visit. An adjusted hazard ratio (AHR) with a 95% confidence interval (CI) was reported.ResultThe median time to ANC booking among pregnant women in East Africa was 4 ± 2 months. Maternal education at the primary (AHR = 1.01, 95% CI: 1.02–1.25), secondary (AHR = 1.03, 95% CI: 1.02–1.05), and higher level (AHR = 1.40, 95% CI: 1.30–1.50); husband's education level at the primary (AHR = 1.08, 95% CI: 1.06–1.09), secondary (AHR = 1.12, 95% CI: 1.10–1.13), and higher (AHR = 1.08, 95% CI: 1.07–1.10) levels as compared to with no education; a middle-class wealth status (AHR = 1.66, 95% CI: 1.60–1.70), being rich (AHR: 1.60, 95% CI: 1.56–1.73), high community-level maternal literacy (AHR = 1.05, 95% CI: 1.04–1.06), high community-level poverty (AHR = 0.99, 95% CI: 0.98–0.99), previous Cesarean section (CS) (AHR = 1.35, 95% CI: 1.33–1.39), and unwanted pregnancy (AHR = 0.74, 95% CI: 0.72–0.77) were predictors of the time to ANC booking.ConclusionThe median time to ANC booking among pregnant women in East Africa is longer than the new WHO recommendation. Maternal and husband education, high community-level maternal literacy, a better household, community-level wealth index, and previous CS increase the likelihood of an early ANC booking. However, unwanted pregnancy lowers the likelihood of an early ANC booking. Therefore, strengthening systematic efforts to improve women’s and their husbands' educational status, encouraging women's education in the community, providing economic support for women with low wealth status and poor communities, encouraging wanted pregnancy, and providing accessible counseling services for women with unwanted pregnancies will help to encourage early ANC booking among pregnant women in East Africa.
Atezolizumab plus bevacizumab and chemotherapy as first-line therapy for cervical cancer: a cost-effectiveness analysis in the US
Authors: Lin Yingtao , Li Cijuan , Wang Chang , Chen Jian , Huang Yuanqing 
Published: November 2024

ObjectiveMedication is the predominant therapy for advanced cancers. However, the use of novel anticancer medications is a major contributor to disease-related financial hardships. Recently, numerous countries have mandated the pharmacoeconomic assessments of novel oncological agents to mitigate patient financial risks and optimize resource allocation. The present study evaluated the cost-effectiveness of adding atezolizumab to standard therapy (atezolizumab plus bevacizumab [BC]) for metastatic, persistent, and recurrent cervical cancer from the perspective of US healthcare payers, with the aim of supporting policymaking and promoting the rational use of healthcare resources.MethodsUsing clinical efficacy and safety data from the BEATcc clinical trial, in addition to cost and utility values from publicly available databases and published literature, a partitioned survival model over a 20-year lifetime horizon was developed to assess the cost-effectiveness of atezolizumab plus bevacizumab and chemotherapy (ABC) versus BC. The primary output of the model was the incremental cost-effectiveness ratio (ICER) and sensitivity analyses were performed to assess its robustness.ResultsAt both 20 and 4.5 y of time horizon, ABC therapy showed poor cost-effectiveness, with ICER of $193926.48/QALY and $168482.26/QALY, respectively, which were higher than the $150,000/QALY willingness-to-pay threshold. One-way sensitivity analysis showed that the price of atezolizumab had the most significant impact on the model results. When the price of atezolizumab was reduced by 10%, ABC changed from being not cost-effective to cost-effective (ICER = $121531.24/QALY). Probabilistic sensitivity analysis showed a 32.6% probability that ABC would be cost-effective, which increased to 58.6% when the price of atezolizumab was reduced by 10%.ConclusionsFor patients with metastatic, persistent, and recurrent cervical cancer in the US, ABC was not as cost-effective as BC. Appropriate price reduction (10%) is recommended for atezolizumab to improve cost-effectiveness of ABC therapy.
Single spike mutation differentiating XBB.1 and XBB.1.5 enhances SARS-CoV-2 cell-to-cell transmission and facilitates serum-mediated enhancement
Authors: Criscuolo Elena , Giuliani Benedetta , Castelli Matteo , Cavallaro Mattia , Sisti Sofia , Burioni Roberto , Ferrari Davide , Mancini Nicasio , Locatelli Massimo , Clementi Nicola 
Published: November 2024

IntroductionThe ongoing emergence of SARS-CoV-2 variants poses significant challenges to existing therapeutics. The spike (S) glycoprotein is central to both viral entry and cell-to-cell transmission via syncytia formation, a process that confers resistance to neutralizing antibodies. The mechanisms underlying this resistance, particularly in relation to spike-mediated fusion, remain poorly understood.MethodsWe analyzed two clinical SARS-CoV-2 isolates differing by a single amino acid substitution in the S protein. Using biochemical and cell-based assays, we evaluated entry kinetics, syncytia formation, and the neutralizing efficacy of convalescent sera. These parameters were further correlated with S-mediated cell-cell fusion activity.ResultsThe single amino acid substitution significantly altered entry kinetics and enhanced syncytia formation. This modification did not diminished the neutralizing capacity of convalescent sera, but it increased the efficiency of S-induced cell-cell fusion. These findings highlight the mutation’s impact on viral transmissibility and immune evasion.DiscussionOur study demonstrates that even minor changes in the S protein can profoundly influence SARS-CoV-2 transmissibility and resistance to antibody-mediated neutralization. Understanding the molecular basis of S-mediated cell-cell fusion is crucial for anticipating the impact of emerging variants and developing next-generation therapeutic strategies. These insights provide a framework for predicting variant fitness and optimizing treatment approaches against future SARS-CoV-2 variants.
Prognostic performance of early immune and endothelial activation markers in mild-to-moderate COVID-19 outpatients: a nested case-control study
Authors: Alemany Andrea , Balanza Núria , Millat-Martinez Pere , Ouchi Dan , Corbacho-Monné Marc , Morales-Indiano Cristian , Fernández Rivas Gema , Blanco Ignacio , Mitjà Oriol , Aguilar Ruth , Dobaño Carlota , Bassat Quique , Moncunill Gemma , Baro Bàrbara ,   COnV-ert BMK STUDY GROUP
Published: November 2024

IntroductionEvidence on the association of biomarkers of host response to infection with COVID-19 clinical outcomes has focused mainly on hospitalized patients. We investigated the prognostic performance of 39 immune and endothelial activation markers measured early in the course of disease to predict the development of severe COVID-19 and hospitalization.MethodsWe conducted a nested case-control study from a randomized clinical trial evaluating the efficacy of COVID-19 convalescent plasma in outpatients aged 50 years or older presenting with mild-to-moderate COVID-19. We selected participants who were hospitalized within 28 days (cases) and who were not (controls) to compare their biomarker levels in plasma samples collected at enrolment.ResultsA total of 42 cases and 42 controls were included in this study. The levels of CRP, IL6, IP10, ferritin, IFNα, IL8, IL1RA, MCP1, and RANTES, determined within 7 days of symptoms onset, showed good individual prognostic performance for COVID-19 associated hospitalization by day 28. The biomarkers CRP, IL6, IP10, IL8, IL1RA, and suPAR showed good individual prognostic performance for severe COVID-19. CRP, IL6 and IP10 had the most robust association with both hospitalization and severe COVID-19, with CRP having the highest discriminatory capacity with hospitalization, and IL6 for severe COVID-19.DiscussionOur study shows good prognostic performance of CRP and IL6 for 28-day hospitalization in patients with mild-to-moderate COVID-19, in the absence of clinical criteria for admission upon enrolment. These findings confirm the value of these biomarkers at early stages of COVID-19 disease in the outpatient setting to support management decisions.
Greening the marine map: a comprehensive study of China’s marine ecological and economic synergy
Authors: Li Zechen , Lin Hanqian , Zhang Xuemei 
Published: November 2024

IntroductionThis research examines the coupling coordinated development dynamics between marine ecological governance and marine economic development in China’s coastal provinces. The marine ecological governance and economic development data of China’s 11 coastal provinces were comprehensively analyzed from 2011 to 2021.MethodsWe established a multi-dimensional evaluation index system for marine ecological governance and economic development, employing the global entropy weight method for quantification. Furthermore, the research examines and analyzes the trends in coordinated development and divergence between these two systems by constructing a coupled coordination degree(CCD) model, utilizing the Theil index decomposition method, and employing the geodetector detector.ResultsThe Northern marine economic circle outperforms the Eastern and Southern ones regarding marine ecological governance, while the Eastern marine economic circle is the most advanced in marine economic development. The results of the CCD model indicate that Guangdong, Shandong, Hebei, and Jiangsu have the best coupling coordinated development, while Hainan, Tianjin, and Guangxi are at the bottom. The results of the Theil index decomposition method indicate that intra-regional disparities are the primary cause of coupling coordinated regional development variations. At the same time, the results of the geographic detector further substantiate that energy structure, degree of industrial agglomeration, and foreign overseas direct investment are the principal influencing factors.DiscussionThe study presents policy recommendations derived from the findings intended to foster the integrated advancement of marine ecology and economy in coastal provinces, reduce regional development disparities, and establish a scientific foundation for achieving a sustainable marine economy.
Simulation and analysis of residual stress in 17-7 PH stainless steel welded joints using laser shock peening technology
Authors: Yu Weichen , Li Yaping , Guo Guicang , Li Kangwen 
Published: November 2024

To investigate the effect of power density on the residual stress distribution on the surface of 17-7 PH stainless steel welded joints during laser shock process, we utilized ABAQUS finite element software for analyzing its distribution under different laser shock power densities. The material was tested for residual stress using an X-ray stress diffractometer to verify the accuracy of the simulation results and lay the foundation for finding the optimal process parameters. The simulation results show that when the laser power density is 2.79 GW/cm2, the maximum residual compressive stress value on the surface of the sample after laser shock peening is −37.2 MPa; When the laser power density is 2.79 GW/cm2, the maximum residual compressive stress value on the surface of the sample is −94.1 MPa; When the power density reaches 5.17 GW/cm2, the maximum residual stress value on the surface of the laser shock peening sample is −144.8 MPa, and residual stress cavity is formed. The experimental results show that when the laser power density is 2.79 GW/cm2, the maximum residual compressive stress on the surface of the sample is −37.3 MPa; When the power density is 3.98 GW/cm2, the uniformity of compressive stress distribution on the surface of the sample is optimal, with a maximum residual compressive stress value of −99.0 MPa; When the power density is 5.17 GW/cm2, the maximum residual compressive stress value is −146.1 MPa, and residual stress cavity is formed on the material surface. The simulation results are close to the experimental results, and the model error ranges from 0.2% to 4.9%. The simulation results are accurate and reliable.
Case report: Cerebral syphilitic gumma: a case retrospective report of eight cases
Authors: Liu Jun , Zhang Wenjun , Jiang Qiuhua , Huang Qianliang , Ye Xinyun 
Published: November 2024

BackgroundCerebral syphilitic gumma (CSG), a rare manifestation of neurosyphilis, presents characteristics akin to intracranial tumors, often leading to clinical misdiagnosis.ObjectiveThis study aimed to summarize the clinical experience in diagnosing and treating CSG.Materials and methodsThe present study conducted a retrospective analysis of clinical data, encompassing the baseline characteristics, clinical presentation, diagnosis, treatment, and prognosis of eight patients with CSG who were treated and diagnosed by our institution.ResultsThe median age at the initial diagnosis was 57.5 years, comprising six males and two females. The predominant clinical manifestations included headaches in eight cases, motor and sensory disorders in four cases, epileptic seizures in one case, and dysarthria in one patient. The serum Treponema pallidum haemagglutination assay (TPHA) and toluidine red unheated serum test (TRUST) yielded positive in all eight patients. The contrast-enhanced magnetic resonance imaging (MRI) revealed irregular ring-shaped enhancement of lesions in three patients, while nodular enhancement of lesions was observed in five patients. In terms of treatment, seven patients underwent surgery. The postoperative pathological tissue showed granulomatous inflammation. Six patients exhibited an elevated protein concentration in their cerebrospinal fluid (CSF), while two patients demonstrated a reduced CSF glucose level. Additionally, positive results were obtained for both CSF TPHA and TRUST in all eight patients. The clinical diagnosis of CSG was confirmed in eight patients who exhibited notable clinical improvement following penicillin treatment. Subsequent reevaluation of the imaging findings demonstrated complete resolution of the enhanced lesions.ConclusionIn clinical practice, CSG should be considered for patients with intracranial lesions and positive serum syphilis antibodies. Timely and accurate diagnosis enables patients with CSG to achieve a more favorable prognosis through active anti-syphilis treatment.
Determinants for worsening in systemic autoimmune rheumatic disease-associated interstitial lung disease: a systematic review and meta-analysis of cohort studies
Authors: Yao Jiaheng , Wang Jun , Guo Luhan , Su Peipei , Li Jiansheng , Li Bin 
Published: November 2024

BackgroundTo identify risk factors for progression, acute exacerbation (AE), and the development of rapidly progressive interstitial lung disease (RP-ILD) in Systemic autoimmune rheumatic disease-associated interstitial lung disease (SARD-ILD).MethodsWe systematically searched PubMed, EMBASE, Scopus, the Cochrane Library, and Web of Science databases to identify eligible cohort studies up until January 01, 2024. Two reviewers independently screened the literature and extracted data. We employed the Newcastle-Ottawa Scale (NOS) to assess study quality and performed meta-analyses using STATA software.ResultsThis review included 50 studies. For progression, 28 studies were included, four significant risk factors were identified: male (OR = 1.97, 95% CI 1.26–3.08, p &lt; 0.001), UIP patterns on HRCT (OR = 1.94, 95% CI 1.48–2.54, p &lt; 0.001), extensive lung involvement (OR = 2.15, 95% CI 1.66–2.80, p &lt; 0.001), and age (OR = 1.07, 95% CI 1.05–1.10, p &lt; 0.001); and 11 potential risk factors. Seven studies were included in AE, and three potential risk factors were highlighted: FVC, UIP patterns on HRCT, and smoking history. In RP-ILD, 15 studies were included. Three risk factors were determined: High CRP (OR = 2.45, 95% CI 1.87–3.21, p &lt; 0.001), Ro-52 positivity (OR = 5.35, 95% CI 3.46–8.29, p &lt; 0.001), and MDA5 antibodies (OR = 2.09, 95% CI 1.47–2.95, p &lt; 0.001); along with 10 potential risk factors.ConclusionOur meta-analysis identified male sex, UIP pattern on HRCT, extensive lung involvement, and advanced age as significant risk factors for the progression of SARD-ILD. High CRP, Ro-52 positivity, and MDA5 antibodies were significant risk factors for developing of RP-ILD in patients with IIM. We also discovered several potential risk factors that may be associated with the progression of SARD-ILD and acute exacerbation, as well as the occurrence of RP-ILD in IIM patients.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/.
Early and rapid diagnosis of Chlamydia psittaci pneumonia by tNGS in six patients: a case series
Authors: Yan Xinsheng , Fu Huali , Deng Wenjun , Zhang Zhenlu , Wang Dong 
Published: November 2024

BackgroundPsittacosis is a zoonotic infectious disease caused by Chlamydia psittaci (C. psittaci) infection, which can be transmitted by birds, poultry and wild animals. The symptoms and imaging findings of C. psittaci pneumonia are atypical and primarily rely on etiological diagnosis. The incidence of C. psittaci infection has been significantly underestimated because of the low sensitivity and poor timeliness of traditional diagnostic methods. Therefore, early and accurate diagnosis of psittacosis remains a challenge.Case presentationA case series with six pneumonia patients who were admitted to our hospital in the period from January 2023 to June 2023 is presented. These patients exhibited acute onset and symptoms, including fever, cough, poor appetite, dry mouth, dizziness, chills, and chest tightness. Despite comprehensive laboratory and radiological examinations, the cause of the pneumonia remained unidentified. Therefore, a sample of bronchoalveolar lavage fluid (BALF) was tested via target next-generation sequencing (tNGS), which revealed a positive result for C. psittaci. Prompt adjustment of the treatment regimens upon identification of the pathogen led to favorable outcomes in all patients.ConclusiontNGS is a novel diagnostic technology that enables rapid, accurate and cost-effective detection of C. psittaci pneumonia. Early detection of C. psittaci can improve patient outcomes through timely adjustment of therapies.
Multi-omics analysis reveals indicator features of microbe-host interactions during Candida albicans colonization and subsequent infection
Authors: Zhang Huan , Song Daoyuan , Luo Qiulin , Yu Jiangkun , Wei Yingpu , Chen Di , Wu Guangjuan , Zhang Zhi , Li Zhao , Jiang Hongchao , Gan Jingquan , Deng Deyao , Li Hui , Yuan Wenli 
Published: November 2024

IntroductionCandida albicans gastrointestinal (GI) colonization is crucial for the onset of invasive disease. This research encompassed 31 patients diagnosed with Candida spp. bloodstream infections during their admission to a university hospital in China.MethodsWe explored risk factors associated with C. albicans GI colonization and ensuing translocated infection. Animal models were established via gavage with clinical isolates of C. albicans to induce GI tract colonization and subsequent kidney translocation infection. Our analysis is focused on 16S rRNA gene sequencing, metabolomics of colon contents, and transcriptomics of colon tissues, examining the intestinal barrier, inflammatory responses, and immune cell infiltration.ResultsThis study observed that down-regulation of programmed cell death 1 (PD-1) in colon tissues is likely linked to the progression from C. albicans colonization to translocated infection. Notably, reductions in Dubosiella abundance and Short-chain fatty acids (SCFA) levels, coupled with increases in Mucispirillum and D-erythro-imidazolylglycerol phosphate, were indicator features during the advancement to translocated invasive infection in hosts with rectal colonization by C. albicans and lower serum protein levels.ConclusionGiven the similarity in intestinal bacterial communities and metabolome profiles, antifungal treatment may not be necessary for patients with nonpathogenic C. albicans colonization. The reduced expression of PD-1 in colon tissues may contribute to the transition from colonized C. albicans to subsequent translocated infection. The indicator features of decreased Dubosiella abundance and SCFA levels, coupled with increased Mucispirillum and D-erythro-imidazolylglycerol phosphate, are likely linked to the development of translocated invasive infection in hosts colonized rectally by C. albicans with lower serum protein levels.ImportanceCandida albicans invasive infections pose a significant challenge to contemporary medicine, with mortality rates from such fungal infections remaining high despite antifungal treatment. Gastrointestinal colonization by potential pathogens is a critical precursor to the development of translocated infections. Consequently, there is an increasing demand to identify clinical risk factors, multi-omics profiles, and key indicators to prevent the progression to translocated invasive infections in patients colonized rectally by C. albicans.