bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of prediction models of COVID-19 vaccine uptake among Lebanese and Syrians in a district of Beirut, Lebanon: a population-based study
Authors: Ragi Marie-Elizabeth , Ghattas Hala , Shamas Hazar , DeJong Jocelyn , Melhem Nada M , McCall Stephen J 
Published: October 2024

IntroductionVaccines are essential to prevent infection and reduce the morbidity of infectious diseases. Previous evidence has shown that migrants and refugees are particularly vulnerable to exclusion and discrimination, and low COVID-19 vaccine intention and uptake were observed among refugees globally. This study aimed to develop and internally validate prediction models of COVID-19 vaccine uptake by nationality.MethodsThis is a nested prognostic population-based cross-sectional analysis. Data were collected between June and October 2022 in Sin-El-Fil, a district of Beirut, Lebanon. The study population included a random sample of Lebanese adults and all Syrian adults residing in areas of low socioeconomic status. Data were collected through a telephone survey. The main outcome was the uptake of at least one dose of the COVID-19 vaccine. Predictors of COVID-19 vaccine uptake were assessed using the Least Absolute Shrinkage and Selection Operator regression for Lebanese and Syrian nationalities in separate models.ResultsOf 2028 participants, 79% were Lebanese, 18% Syrians and 3% of other nationalities. COVID-19 vaccination uptake was higher among Lebanese (85% (95% CI 82% to 86%) compared to Syrians (47% (95% CI 43% to 51%)) (p<0.001); adjusted OR 6.2 (95% CI 4.9 to 7.7). Predictors of uptake of one or more COVID-19 vaccine doses for Lebanese were older age, presence of an older adult in the household, higher education, greater asset-based wealth index, private healthcare coverage, feeling susceptible to COVID-19, belief in the safety and efficacy of vaccines and previous receipt of the influenza vaccine. For Syrians, predictors were older age, male sex, completing school or higher education, receipt of cash assistance, presence of chronic illness, belief in the safety and efficacy of vaccines, previous receipt of the influenza vaccine and possession of a legal residency permit in Lebanon.ConclusionsThese findings indicate barriers to vaccine uptake among Syrian refugees and migrants, including legal residency status. These findings call for urgent action to enable equitable access to vaccines by raising awareness about the importance of vaccination and the targeting of migrant and refugee populations through vaccination campaigns.
Exploration of preferences among people with COPD to inform resource allocation: a discrete choice experiment study
Authors: Ettinger Jack , Patel Anita , Ohrnberger Julius , Moore Chris , Bhudiya Manjula , Smith Wayne 
Published: October 2024

IntroductionTreatment options for chronic obstructive pulmonary disease (COPD) are numerous but adherence remains a key challenge. We performed a discrete choice experiment (DCE) of patients’ preferences in accessing care for the management of COPD. The aim of this study was to understand patients’ preferences for modes of accessing care for the management of COPD. This piece of work was then used to inform resource allocation decisions in five integrated care systems (ICSs) in England.MethodsPeople with diagnosed COPD in five ICSs were invited to complete an online survey from August to September 2022. An experimental design built on the principles of minimal overlap, level balance and orthogonality was used to create 20 sets of 11 scenarios for participants to assess. Participants were presented with three hypothetical options and asked to select their most preferred or state that none was preferred. Data were analysed using a hierarchal Bayes algorithm.ResultsOf 82 639 patients with COPD in the study area, 520 completed the survey. The mean health-related quality of life score derived using EuroQol 5-Dimensions 5-Level was 0.57 (0.29). The attributes assigned greatest importance were treatment outcomes, treatment delivery and the type of staff who deliver treatment. Mean utility level scores were substantially higher for little relief (22.75 (SD 78.80)) or some relief from symptoms (20.67 (46.77)) than for complete relief (‒43.42 (83.03)). Of the treatment delivery options, in-person individual appointments were preferred (mean utility score 48.34 (SD 48.14)), and care being provided by healthcare professionals was viewed as very important (77.50 (64.39)).ConclusionsThe DCE approach can help resource allocation decisions by indicating attributes most important to patients and trade-offs they are willing to make in treatment access and delivery.
Delayed admission of patients with hip fracture from the emergency department is associated with an increased mortality risk and increased length of hospital stay
Authors: Clement Nicholas D , Farrow Luke , Chen Bin , Duffy Andrew , Murthy Krishna , Duckworth Andrew D 
Published: October 2024

BackgroundThe aims of this study were to assess whether delayed admission from the ED influenced mortality risk, length of acute hospital stay, risk of developing delirium and return to domicile for patients presenting with a hip fracture.MethodsA single centre service evaluation was undertaken including patients aged over 50 years who were admitted to a Scottish hospital through the ED with a hip fracture during a 42-month period (from January 2019 to June 2022). Delay was defined as spending >4 hours in the ED from arrival. Patient demographics and perioperative variables and mortality were collected. Cox regression analysis (adjusting for age, sex, season, socioeconomic status, American Society of Anesthesiologists grade, place of residence, fracture type, delirium and time from ward to theatre) was used to determine the independent association between delayed disposition from the ED and mortality (90 days and final follow-up) as recorded on a regional database.ResultsThe cohort consisted of 3266 patients with a mean age of 81 years, of which 2359 (72.2%) were female. 1261 (38.6%) patients stayed >4 hours in ED. The median follow-up was 529 days, during which time there were 1314 (40.2%) deaths. Survival at 90 days was significantly lower (hazard ratio [HR] 0.76, 95% CI 0.63 to 0.91) for patients who stayed >4 hours (92.9%) compared with those who stayed ≤4 hours (95.7%). Delayed disposition was independently associated with an increased mortality risk at 90 days (adjusted HR 1.36, 95% CI 1.12 to 1.63, p=0.001) and at final follow-up (adjusted HR 1.15, 95% CI 1.03 to 1.29, p=0.017). Delay was also associated with a longer length of hospital stay (difference in medians of 1 day, p<0.001). There were no differences in the risk of delirium on the ward (p=0.256) or return to place of residence (p≥0.315).ConclusionDelayed disposition from our ED was associated with an increased mortality risk and longer length of hospital stay in patients presenting with a hip fracture.
Effectiveness of rapid access chest pain clinics: a systematic review of patient outcomes and resource utilisation
Authors: Black James Andrew , Eaves Scott , Chapman Niamh , Campbell Julie , Bui Tan Van , Cho Kenneth , Chow Clara K , Sharman James E 
Published: October 2024

BackgroundRapid Access Chest Pain Clinics (RACPC) are widely used for the outpatient assessment of chest pain, but there appears to be limited high-quality evidence justifying this model of care. This study aimed to review the literature to determine the effectiveness of RACPCs.MethodsA systematic review of studies evaluating the effectiveness of RACPCs was conducted to assess the quality of the evidence supporting this model. Outcomes related to effectiveness included major adverse cardiovascular events, emergency department reattendance, cost-effectiveness and patient satisfaction. Study quality was assessed using the RoB 2 tool, Newcastle-Ottawa quality assessment tool or the Consolidated Criteria for Reporting Qualitative Studies checklist, as appropriate.ResultsThirty-two studies were eligible for inclusion, including one randomised trial. Five analytical cohort studies were included, with three comparing outcomes against non-RACPC controls. Three qualitative studies were included. Most reports were descriptive. Findings were consistent with RACPCs being associated with favourable clinical outcomes, reduced emergency department reattendance, cost-effectiveness and high patient satisfaction. However, there was significant heterogeneity in care models, and overall literature quality was low, with a high risk of publication bias.ConclusionWhile the literature suggests RACPCs are safe and efficient, the quality of the available evidence is limited. Further high-quality data from adequately controlled clinical trials or large scare registries are needed to inform healthcare resource allocation decisions.PROSPERO registration numberCRD42023417110.
Association between kidney function, frailty and receipt of invasive management after acute coronary syndrome
Authors: Scott Jemima Kate , Johnson Thomas , Caskey Fergus John , Bailey Pippa , Selman Lucy Ellen , Mulla Abdulrahim , Glampson Ben , Davies Jim , Papdimitriou Dimitri , Woods Kerrie , O'Gallagher Kevin , Williams Bryan , Asselbergs Folkert W , Mayer Erik K , Lee Richard , Herbert Christopher , Grant Stuart W , Curzen Nick , Squire Iain , Kharbanda Rajesh , Shah Ajay , Perera Divaka , Patel Riyaz S , Channon Keith , Mayet Jamil , Kaura Amit , Ben-Shlomo Yoav 
Published: October 2024

BackgroundReduced estimated glomerular filtration rate (eGFR) is associated with lower use of invasive management and increased mortality after acute coronary syndrome (ACS). The reasons for this are unclear.MethodsA retrospective clinical cohort study was performed using data from the English National Institute for Health Research Health Informatics Collaborative (2010–2017). Multivariable logistic regression was used to investigate whether eGFR<90 mL/min/1.73 m2was associated with conservative ACS management and test whether (a) differences in care could be related to frailty and (b) associations between eGFR and mortality could be related to variation in revascularisation rates.ResultsAmong 10 205 people with ACS, an eGFR of <60 mL/min/1.73m2was found in 25%. Strong inverse linear associations were found between worsening eGFR category and receipt of invasive management, on a relative and absolute scale. People with an eGFR <30 mL compared with ≥90 mL/min/1.73 m2were half as likely to receive coronary angiography (OR 0.50, 95% CI 0.40 to 0.64) after non-ST-elevation (NSTE)-ACS and one-third as likely after STEMI (OR 0.30, 95% CI 0.19 to 0.46), resulting in 15 and 17 per 100 fewer procedures, respectively. Following multivariable adjustment, the ORs for receipt of angiography following NSTE-ACS were 1.05 (95% CI 0.88 to 1.27), 0.98 (95% CI 0.77 to 1.26), 0.76 (95% CI 0.57 to 1.01) and 0.58 (95% CI 0.44 to 0.77) in eGFR categories 60–89, 45–59, 30–44 and <30, respectively. After STEMI, the respective ORs were 1.20 (95% CI 0.84 to 1.71), 0.77 (95% CI 0.47 to 1.24), 0.33 (95% CI 0.20 to 0.56) and 0.28 (95% CI 0.16 to 0.48) (p<0.001 for linear trends). ORs were unchanged following adjustment for frailty. A positive association between the worse eGFR category and 30-day mortality was found (test for trend p<0.001), which was unaffected by adjustment for frailty.ConclusionsIn people with ACS, lower eGFR was associated with reduced receipt of invasive coronary management and increased mortality. Adjustment for frailty failed to change these observations. Further research is required to explain these disparities and determine whether treatment variation reflects optimal care for people with low eGFR.Trial registration numberNCT03507309.
Increasing rate of non-Candida albicansyeasts and fluconazole resistance in yeast isolates from women with recurrent vulvovaginal candidiasis in Leeds, United Kingdom
Authors: Ratner Jennifer C , Wilson Janet , Roberts Kevin , Armitage Catherine , Barton Richard Christopher 
Published: October 2024

ObjectivesAzoles have been the mainstay of recurrent vulvovaginal candidiasis (RVVC) for many years. Because of a recent anecdotal increase in non-Candida albicansyeasts (NCAY) and azole-resistantC. albicanscases, their prevalence was calculated from cultures for yeasts in women with complicated/RVVC over 3 years.MethodsRetrospective data search of vaginal cultures from adult women in Leeds, UK between April 2018 and March 2021 was conducted. Samples with clinical details of complicated/RVVC had full yeast identification and antifungal susceptibility performed. Differences in prevalence between 12-month periods were determined using χ2tests.ResultsOver the 3 years, cultures were performed on 5461 vaginal samples from women with clinical information indicating they had complicated/RVVC, RVVC, with 1828 (33.5%) growing yeasts.Over 85% of yeasts each year wereC. albicans, however the proportion declined yearly with an increase in NCAY species.Nakaseomyces glabratawas the most frequent NCAY species isolated, increasing from 2.8% in 2018–19 to 6.8% in 2020–21. Total NCAY species increased from 6.0% in 2018–19 to 12.6% in 2020–21. Fluconazole-sensitive dose-dependant (SDD) and resistant isolates increased from 3.5% in 2018–19 to 7.7% in 2019–20 and 9.6% in 2020–21. Most resistance was inC. albicansand the majority of cases were seen in primary care. Most fluconazole non-sensitive isolates were either SDD or resistant to itraconazole (77% and 23%, respectively) and were intermediate or resistant to voriconazole (36.4% and 60%, respectively).ConclusionThere was a significant increase in the prevalence of NCAY and fluconazole-resistantC. albicansin complicated/RVVC cultures over these 3 years. Successful treatment of such cases can be very challenging. The exact reasons for this increase remain unclear but it follows a policy change that encouraged a clinical diagnosis and empirical treatment of vulvovaginal candidiasis, rather than fungal culture, in primary care.
SYRMEP beamline: state of the art, upgrades and future prospects
Authors: Longo Elena , Contillo Adriano , D’Amico Lorenzo , Prašek Marko , Saccomano Giulia , Sodini Nicola , Dullin Christian , Dreossi Diego , Tromba Giuliana 
Published: October 2024

AbstractSYRMEP is the hard X-ray imaging beamline of Elettra synchrotron offering X-ray full-field techniques, micro-computed tomography (microCT) and phase-contrast modality in the energy range 10–40 keV. The beamline operates in a multidisciplinary research context spanning from biomedical applications to botany, from zoology to food technology and cultural heritage, from materials engineering to geology and earth science. Thanks to the flexibility of SYRMEP setup, in situ experiments can be performed as well, novel imaging methods can be developed and implemented in a synergical manner with interested users and collaborators. SYRMEP peculiar wide beam together with the long sample-to-detector distance enables multiscale phase-contrast studies with optimized contrast and spatial resolution on rather large specimens, such as human lung phantoms. This is particularly relevant in view of future clinical lung imaging foreseen in the framework of Elettra 2.0 program. Here, the current beamline features and recent upgrades are illustrated, an overview of the imaging methods routinely offered to SYRMEP users’ community is presented, and the outlook for the new beamline SYRMEP-Life Science (SYRMEP-LS) is reported.
Advancing early detection of biological events by digital holographic microscopy and simulation of microorganisms
Authors: Molani Alessandro , Mihalik Béla , Pennati Francesca , Rahi Praveen , Mező Anna , Pálhalmi János , Aliverti Andrea , Bela Györgyi 
Published: October 2024

Abstract
There is a global need to advance bio-aerosol sensing for CBRN (Chemical, Biological, Radiological, and Nuclear) applications by compact and cost-effective devices. Employing digital holographic microscopy (DHM) and deep learning, we developed a system called HoloZcan to automate the analysis of airborne microbial pathogens and particles. DHM provides valuable information, but obtaining data from biological specimens for robust investigations is challenging. This paper introduces a custom simulation approach using the open-source software Meep and the finite-difference time-domain (FDTD) method to overcome limitations of existing Mie-based simulators, especially when dealing with complex microbial shapes. The simulation tool enables the modelling of specific microorganisms, offering a safer and more flexible alternative for CBRN research by bypassing ethical and logistical constraints associated with live pathogens. The study details the simulation workflow, built upon the construction of a database of optical properties of biological materials, for realistic simulations of light-microbe interactions. Evaluations on homogeneous and non-homogeneous objects demonstrate the tool’s limited intrinsic errors and superior sensitivity to refractive index changes compared to traditional Mie-based simulations. This work significantly advances our capability to accurately simulate and analyse CBRN-related scenarios, enhancing comprehensive research in bio-aerosol sensing.

Graphical abstract
In Vitro Aging and Fracture Tests on Differently Veneered Partially Stabilized Zirconia Anterior Crowns
Authors: Zenthöfer Andreas , Ilani Ali , Rues Stefan 
Published: October 2024

Objectives: To evaluate the fracture resistance of veneered incisor crowns made from highly translucent zirconia frameworks.Materials and Methods: Ninety‐six all‐ceramic single crowns were based on either a coping with minimum wall thickness or a cutback framework fabricated from highly translucent zirconia (5Y‐PSZ). Each one‐third of the specimens was finalized with different veneering ceramics using standardizations and glaze firing. Crowns were luted to cobalt–chromium dies with MDP‐containing composite cement. Half of the entire sample underwent artificial aging (chewing simulation and thermocycling) before fracture load tests were conducted using a 6 mm steel sphere applied in a 90° angle to the oral aspect of the crowns with 1.3 mm distance to the incisal edge. Besides descriptive presentation of recorded forces at first damage (F1d) and fracture (Fu), Kruskal Wallis and Mann–Whitney U tests were used to analyze data at α = 0.05.Results: Directly after manufacturing, incisor crowns of all test groups showed sufficient mean fracture resistances. After artificial aging, crack formation was observed in a high percentage for fully veneered crowns of all test groups, but only for one veneering ceramics with cutback crowns. Mean test forces of unaged crowns were F1d,mean ≥ 422 N | Fu,mean ≥ 749 N (fully veneered) and F1d,mean ≥ 644 N | Fu,mean ≥ 706 N (cutback) dropped significantly to F1d,mean ≥ 131 N | Fu,mean ≥ 223 N (fully veneered) and F1d,mean ≥ 324 N | Fu,mean ≥ 524 N (cutback) .Conclusions: Within the limitations of this laboratory study, 5Y‐PSZ based anterior crowns can be a viable treatment option. Framework design, choice of the veneering ceramics and artificial aging show relevant effects on the fracture resistances. Concerted veneering ceramics should be used and partially veneering of the zirconia frameworks should be favored over full veneers.
Tumor-Specific Antigen Delivery for T-cell Therapy via a pH-Sensitive Peptide Conjugate
Authors: Yurkevicz Annali M. , Liu Yanfeng , Katz Samuel G. , Glazer Peter M. 
Published: October 2024

Abstract
Identifying an optimal antigen for targeted cancer therapy is challenging as the antigen landscape on cancerous tissues mimics that of healthy tissues, with few unique tumor-specific antigens identified in individual patients. pH low insertion peptide (pHLIP) acts as a unique delivery platform that can specifically target the acidic microenvironment of tumors, sparing healthy tissue in the process. We developed a pHLIP-peptide conjugate to deliver the SIINFEKL peptide, an immunogenic fragment of ovalbumin (OVA), to tumor cells in vivo. When processed intracellularly, SIINFEKL is presented for immune recognition through the major histocompatibility complex (MHC) class I pathway. We observed selective delivery of pHLIP-SIINFEKL both in vitro and in vivo using fluorescently labeled constructs. In vitro, treatment of melanoma tumor cells with pHLIP-SIINFEKL resulted in recognition by SIINFEKL-specific T cells (OT1), leading to T-cell activation and effector function. Mechanistically, we show that this recognition by OT1 T cells was abrogated by siRNA/shRNA knockdown of multiple components within the MHC class I pathway in the target tumor cells, indicating that an intact antigen processing pathway in the cancer cells is necessary to mediate the effect of pHLIP-directed SIINFEKL delivery. In vivo, pHLIP-SIINFEKL treatment of tumor-bearing mice resulted in the recruitment of OT1 T cells and suppression of tumor growth in two syngeneic tumor models in immunocompetent mice, with no effect when mutating either the pHLIP or SIINFEKL components of the conjugate. These results suggest that pHLIP-mediated peptide delivery can be used to deliver novel artificial antigens that can be targeted by cell-based therapies.
Riluzole Enhancing Anti-PD-1 Efficacy by Activating cGAS/STING Signaling in Colorectal Cancer
Authors: Liang Beiyuan , Khan Misbah , Storts Hayden , Zhang Evan H. , Zheng Xinru , Xing Xuanxuan , Claybon Hazel , Wilson Jenna , Li Chunjie , Jin Ning , Fishel Richard , Miles Wayne O. , Wang Jing J. 
Published: October 2024

Abstract
Colorectal cancer is the second leading cause of cancer mortality in the United States. Although immune checkpoint blockade therapies including anti-PD-1/PD-L1 have been successful in treating a subset of patients with colorectal cancer, the response rates remain low. We have found that riluzole, a well-tolerated FDA-approved oral medicine for treating amyotrophic lateral sclerosis, increased intratumoral CD8+ T cells and suppressed tumor growth of colon cancer cells in syngeneic immune–competent mice. Riluzole-mediated tumor suppression was dependent on the presence of CD8+ T cells. Riluzole activates the cytosolic DNA sensing cyclic GMP-AMP synthase (cGAS)/stimulator of interferon genes (STING) pathway in colon cancer cells, resulting in increased expression of IFNβ and IFNβ-regulated genes including CXCL10. Inhibition of ataxia telangiectasia mutated (ATM), but not ATM-related, resulted in a synergistic increase in IFNβ expression, suggesting that riluzole induces ATM-mediated damage response that contributes to cGAS/STING activation. Depletion of cGAS or STING significantly attenuated riluzole-induced expression of IFNβ and CXCL10 as well as increase of intratumoral CD8+ T cells and suppression of tumor growth. These results indicate that riluzole-mediated tumor infiltration of CD8+ T cells and attenuation of tumor growth is dependent on tumor cell–intrinsic STING activation. To determine whether riluzole treatment primes the tumor microenvironment for immune checkpoint modulation, riluzole was combined with anti-PD-1 treatment. This combination showed greater efficacy than either single agent and strongly suppressed tumor growth in vivo. Taken together, our studies indicate that riluzole activates cGAS/STING-mediated innate immune responses, which might be exploited to sensitize colorectal tumors to anti-PD-1/PD-L1 therapies.