bluuebunny/crossref_metadata_2025_split huggingface dataset:
¿Preguntan los profesionales de salud sobre consumo de alcohol? Resultados de Encuesta Nacional Chile 2017
Authors: Duran Santa Cruz Josefina , Niemann Concha Paula , Metcalfe Torres Valentina , Passi Solar Alvaro , Margozzini Maira Paula 
Published: September 2024

Antecedentes y objetivos: La carga de enfermedad y los costos asociados al consumo de alcohol son un problema de salud pública. Formas eficaces de combatir este problema son la detección individual y la consejería breve. El objetivo de este estudio es estimar y describir la cobertura nacional de consulta sobre consumo de alcohol (CCA) dirigida por profesionales de salud en Chile. Métodos: Se incluyó una muestra nacional aleatoria de 5240 participantes de la Encuesta Nacional de Salud de Chile 2017. Las estimaciones fueron ponderadas según diferencias en la probabilidad de selección y las tasas de falta de respuesta. Se realizaron regresiones logísticas univariadas por edad, sexo, zona y región, ajustadas por confundentes. Resultados: La prevalencia nacional de CCA fue de 30 % (IC 95 %: 27,8-32,5), 31,6 % (IC 95 %: 28,1-35,3) y 28,8 % (IC 95%: 25,7-31,9) para hombres y mujeres respectivamente. La prevalencia más baja fue en participantes de 15 a 24 años (25,1%, IC 95%: 19,8-31,1) y la más alta (33%, IC 95%: 29,5-37,3) en la población de 45 a 64 años. En los modelos de regresión, la edad (OR: 1,06, IC 95% 1,00-1,11, por diez años de aumento en la edad) y el uso de drogas hepatotóxicas (OR: 1,45, IC 95%: 1,10-1,90), fueron las únicas variables que se asociaron significativamente con mayor CCA. Conclusión: Este estudio encontró bajos porcentajes de CCA en Chile. Hace falta estudiar a mayor profundidad esta problemática para la mejoría o generación de nuevas políticas.
Tobacco Biomarkers by Latino Heritage and Race, US, 2007 to 2014 National Health and Nutrition Examination Survey
Authors: Duong Chelsea , Rodriquez Erik J. , Hinerman Amanda S. , Hooshmand Somy , Claudel Sophie E. , Benowitz Neal L. , Pérez-Stable Eliseo J. 
Published: September 2024

Abstract

Background:
Tobacco biomarkers reflect smoking intensity and are used to assess cessation status. No study has evaluated variation by Latino heritage.

Methods:
Data from the 2007 to 2014 National Health and Nutrition Examination Survey were used to evaluate geometric mean concentrations of serum cotinine and urinary total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), stratified by smoking status and race and ethnicity, and ROC curves estimated values to distinguish smokers from nonsmokers by race and ethnicity and Latino heritage.

Results:
The sample (n = 18,597) was 50.1% female, 16.6% Latino (58.6% Mexican, 10.4% Central American, 9.1% South American, 7.3% Puerto Rican, 3.5% Dominican, 2.7% Cuban, and 8.4% other Latinos, overall), 12.7% Black, and 70.7% White. Black nonsmokers and smokers had the highest cotinine concentrations (0.1 and 177.1 ng/mL), and among nonsmokers, Black individuals had the highest NNAL concentrations (1.4 pg/mL). Latino smokers had the lowest cotinine (32.7 ng/mL) and NNAL (63.9 pg/mL) concentrations. Among Latino smokers, Puerto Rican individuals had higher concentrations of cotinine (100.0 ng/mL) and NNAL (136.4 pg/mL). Cotinine levels defining smoking (Black: 9.1 ng/mL; Latino: 0.9 ng/mL; White: 3.8 ng/mL) and NNAL (Black: 24.1 pg/mL; Latino: 5.7 pg/mL; White: 15.5 pg/mL) varied. Puerto Rican adults (cotinine: 8.5 ng/mL; NNAL: 17.2 pg/mL) had higher levels than Central American (cotinine: 1.0 ng/mL, NNAL: 5.5 pg/mL) and Mexican (cotinine: 0.9 ng/mL, NNAL: 6.0 pg/mL) adults.

Conclusions:
Cotinine and NNAL concentrations that define smoking differed by race and ethnicity and by heritage among Latinos, showing meaningful differences.

Impact:
Cessation interventions with biomarker validation need to consider Latino heritage.
Prostate Cancer Progression Modeling Provides Insight into Dynamic Molecular Changes Associated with Progressive Disease States
Authors: Chen Runpu , Tang Li , Melendy Thomas , Yang Le , Goodison Steve , Sun Yijun 
Published: September 2024

Abstract

Prostate cancer is a significant health concern and the most commonly diagnosed cancer in men worldwide. Understanding the complex process of prostate tumor evolution and progression is crucial for improved diagnosis, treatments, and patient outcomes. Previous studies have focused on unraveling the dynamics of prostate cancer evolution using phylogenetic or lineage analysis approaches. However, those approaches have limitations in capturing the complete disease process or incorporating genomic and transcriptomic variations comprehensively. In this study, we applied a novel computational approach to derive a prostate cancer progression model using multidimensional data from 497 prostate tumor samples and 52 tumor-adjacent normal samples obtained from The Cancer Genome Atlas study. The model was validated using data from an independent cohort of 545 primary tumor samples. By integrating transcriptomic and genomic data, our model provides a comprehensive view of prostate tumor progression, identifies crucial signaling pathways and genetic events, and uncovers distinct transcription signatures associated with disease progression. Our findings have significant implications for cancer research and hold promise for guiding personalized treatment strategies in prostate cancer.

Significance:
We developed and validated a progression model of prostate cancer using &gt;1,000 tumor and normal tissue samples. The model provided a comprehensive view of prostate tumor evolution and progression.
Cardiomyopathy‐Associated Chronic Heart Failure in Infants Aged <1 Year: A Prospective Observational Cohort Over 5 Years in Northern China
Authors: Ding Wenhong , Wang Benzhen , Hong Jeff , Lu Lingeng , Xiao Yanyan , Shan Guangsong , Myers Connor , Yu Qing , Spurney Christopher , Li Zipu , Han Ling 
Published: September 2024

Background
There have been few large‐scale studies on the outcomes of cardiomyopathy‐associated heart failure (HF) in infants aged <1 year. This study aimed to assess longitudinal echocardiographic outcomes of infants with HF secondary to cardiomyopathy who survived for >1 year.

Methods and Results

A prospective observational study following 327 infant patients up to 5 years in 2 large pediatric heart centers in Northern China between January 2010 and December 2018. A total of 236 (72.2%) patients had reduced left ventricular ejection fraction (LVEF) (HF with reduced ejection fraction group; LVEF <40%), 91 (27.8%) patients had midrange LVEF (HF with midrange ejection fraction group; LVEF ≥40% but <55%). LVEF improved significantly within the first year and remained stable in years 2 through 5 for both groups. The HF with midrange ejection fraction group had a higher rate of LVEF normalization (hazard ratio, 1.65;
P
<0.001). Baseline LVEF ≥40%, baseline left ventricular end‐diastolic diameter
Z
score <7.8, the absence of left bundle‐branch block, and the absence of β‐blocker use were 4 independent favorable predictors for future LVEF normalization. A total of 62.4% of enrolled patients were diagnosed with left ventricular noncompaction. No significant difference in LVEF normalization was found among the different types of cardiomyopathy studied.

Conclusions
A significant number of infants with cardiomyopathy who survived >1 year were found to improve with medical therapies during the first year of diagnosis. Poorer outcomes were associated with decreased LVEF and increased heart size at diagnosis baseline, the presence of left bundle‐branch block and use of β blockers. The Northern Chinese pediatric population may have a high proportion of left ventricular noncompaction.
Associations of Everyday Discrimination With Insomnia and Short Sleep Duration Among Older Women
Authors: Johnson Dayna A. , Ward Laura , Ortiz Laura Bosque , Butler Jonathan , Slopen Natalie , Redline Susan , Buring Julie E. , Williams David R. , Albert Michelle A. 
Published: September 2024

Background
Discrimination may contribute to sleep health disparities among women, yet limited research has investigated the association between discrimination and insomnia with short sleep.

Methods and Results
Among a racially and ethnically diverse sample of women (N=25 920; mean age, 72.2±6.1 years), we investigated the relationship of discrimination with insomnia symptoms and sleep duration. Poisson models with robust variance were fit to examine discrimination with insomnia, sleep duration (short <7 hours or long >9 hours versus recommended 7–9 hours), and insomnia short sleep phenotype adjusted for covariates. Insomnia symptoms, short and long sleep, and high discrimination were reported by 53%, 11%, 15%, and 40% of women, respectively. Women reporting high versus low discrimination were more likely to report insomnia, short sleep, and insomnia short sleep phenotype (insomnia: adjusted prevalence ratio, 1.15 [95% CI, 1.13–1.18]; short sleep: adjusted prevalence ratio, 1.24 [95% CI, 1.16–1.34]; insomnia short sleep phenotype: adjusted prevalence ratio, 1.45 [95% CI, 1.31–1.61]). In exploratory analyses, the association between discrimination and insomnia symptoms was present among Asian and White women, whereas the association between discrimination and sleep duration was among Hispanic (long sleep) and White (short sleep) women. Further, the association between discrimination and insomnia symptoms was more pronounced among those with less than a bachelor's degree, whereas women with a bachelor's degree or higher were less vulnerable to the association between discrimination and long sleep.

Conclusions
Discrimination was associated with insomnia and short sleep, a more severe phenotype for adverse cardiovascular health. Discrimination may be a target for reducing sleep problems among older women.
BEEAF
2
Score: A New Risk Stratification Score for Patients With Stage B Heart Failure From the KUNIUMI Registry Chronic Cohort
Authors: Odajima Susumu , Fujimoto Wataru , Takegami Misa , Nishimura Kunihiro , Iwasaki Masamichi , Okuda Masanori , Konishi Akihide , Shinohara Masakazu , Nagao Manabu , Toh Ryuji , Hirata Ken‐ichi , Tanaka Hidekazu 
Published: September 2024

Background
Stage B heart failure (HF) refers to structural heart disease without signs or symptoms of HF, so that early intervention may delay or prevent the onset of overt HF. However, stage B HF is a very broad concept, and risk stratification of such patients can be challenging.

Methods and Results

We conducted a prospective study of data for 1646 consecutive patients with HF from the KUNIUMI (Kobe University Heart Failure Registry in Awaji Medical Center) registry chronic cohort. The definition of HF stages was based on current guidelines for classification of 29 patients as stage A HF, 761 as stage B HF, 827 as stage C HF, and 29 patients as stage D HF. The primary end point was the time‐to‐first‐event defined as cardiovascular death or HF hospitalization within 2.0 years of follow‐up. A maximum of 6 adjustment factor points was assigned based on Cox proportional hazards analysis findings for the hazard ratio (HR) of independent risk factors for the primary end point: 1 point for anemia, estimated glomerular filtration rate <45 mL/min per 1.73 m
2
, brain natriuretic peptide ≥150 pg/mL, and average ratio of early transmitral flow velocity to early diastolic mitral annular velocity >14, and 2 points for clinical frailty scale >3. Patients with stage B HF were stratified into 3 groups, low risk (0–1 points), moderate risk (2–3 points), and high risk (4–6 points). Based on this scoring system (BEEAF
2
[brain natriuretic peptide, estimated glomerular filtration rate, ratio of early transmitral flow velocity to early diastolic mitral annular velocity, anemia, and frailty]), the outcome was found to become worse in accordance with risk level. High‐risk patients with stage B HF and patients with stage C HF showed similar outcomes.

Conclusions
Our scoring system offers an easy‐to‐use evaluation of risk stratification for patients with stage B HF.
Predicting Individual Treatment Effects to Determine Duration of Dual Antiplatelet Therapy After Stent Implantation
Authors: Lee Seung‐Jun , Cho Jaehyeong , Shin Jihye , Hong Sung‐Jin , Ahn Chul‐Min , Kim Jung‐Sun , Ko Young‐Guk , Choi Donghoon , Hong Myeong‐Ki , You Seng Chan , Kim Byeong‐Keuk 
Published: September 2024

Background
After coronary stent implantation, prolonged dual antiplatelet therapy (DAPT) increases bleeding risk, requiring personalization of DAPT duration. The aim of this study was to develop and validate a machine learning model to predict optimal DAPT duration after contemporary drug‐eluting stent implantation in patients with coronary artery disease.

Methods and Results
The One‐Month DAPT, RESET (Real Safety and Efficacy of 3‐Month Dual Antiplatelet Therapy Following Endeavor Zotarolimus‐Eluting Stent Implantation), and IVUS‐XPL (Impact of Intravascular Ultrasound Guidance on Outcomes of Xience Prime Stents in Long Lesion) trials provided a derivation cohort (n=6568). Using the X‐learner approach, an individualized DAPT score was developed to determine the therapeutic benefit of abbreviated (1–6 months) versus standard (12‐month) DAPT using various predictors. The primary outcome was major bleeding; the secondary outcomes included 1‐year major adverse cardiac and cerebrovascular events and 1‐year net adverse clinical events. The risk reduction with abbreviated DAPT (3 months) in the individualized DAPT–determined higher predicted benefit group was validated in the TICO (Ticagrelor Monotherapy After 3 Months in the Patients Treated With New Generation Sirolimus‐Eluting Stent for Acute Coronary Syndrome) trial (n=3056), which enrolled patients with acute coronary syndrome treated with ticagrelor. The validation cohort comprised 1527 abbreviated and 1529 standard DAPT cases. Major bleeding occurred in 25 (1.7%) and 45 (3.0%) patients in the abbreviated and standard DAPT groups, respectively. The individualized DAPT score identified 2582 (84.5%) participants who would benefit from abbreviated DAPT, which was significantly associated with a lower major bleeding risk (absolute risk difference [ARD], 1.26 [95% CI, 0.15–2.36]) and net adverse clinical events (ARD, 1.59 [95% CI, 0.07–3.10]) but not major adverse cardiac and cerebrovascular events (ARD, 0.63 [95% CI, −0.34 to 1.61]), compared with standard DAPT in the higher predicted benefit group. Abbreviated DAPT had no significant difference in clinical outcomes of major bleeding (ARD, 1.49 [95% CI, −1.74 to 4.72]), net adverse clinical events (ARD, 2.57 [95% CI, −1.85 to 6.99]), or major adverse cardiac and cerebrovascular events (ARD, 1.54 [95% CI, −1.26 to 4.34]), compared with standard DAPT in the individualized DAPT–determined lower predicted benefit group.

Conclusions
Machine learning using the X‐learner approach identifies patients with acute coronary syndrome who may benefit from abbreviated DAPT after drug‐eluting stent implantation, laying the groundwork for personalized antiplatelet therapy.
The United Nations Security Council and Global Health Threats
Authors: Kamradt-Scott Adam 
Published: September 2024

Abstract
covid-19 has prompted a range of new suggestions to reform the existing international system. One recommendation garnering political support has been to create a new Global Health Threats Council, comprised of heads of state, to facilitate sustained political commitment and investment in pandemic preparedness and response. A question that currently remains unanswered, however, is how and where this new body aligns to existing governance arrangements. Some observers have suggested the new body should report the United Nations Security Council on the basis it is charged with maintaining international peace and security. This paper evaluates the UN Security Council’s engagement with health crises over recent decades to consider the legal, political, and practical feasibility of the body assuming a larger role in responding to future disease events, and the appropriateness of the proposed Global Health Threats Council falling under the authority of the UN’s principal organ for international security.
“What the Secretariat Makes It”: United Nations Civil Servants between Administrative Function and Contemporary International Lawmaking
Authors: Birkenkötter Hannah 
Published: September 2024

Abstract
As the only international organization that aspires to be unviersal both in terms of its membership as well as in terms of the policy fields in which it intervenes, the United Nations (UN) occupies a unique position in international lawmaking. Focusing on the UN’s political and judicial or quasi-judicial organs does not, however, fully capture the organization’s lawmaking activities. Instead, much of the UN’s impact on international law today can be traced back to its civil servants. In this paper, I argue that international lawmaking today is best understood as processual and fluid, and that in contemporary lawmaking thus understood, the UN Secretariat plays an important role. I then propose two ways in which international civil servants add to international lawmaking: they engage in executive interpretation of broad and elusive norms, and they act as an interface between various actors on different governance levels. This raises novel legitimacy challenges for the international legal order.
Severe bleeding in patients following “tubeless” percutaneous nephrolithotomy: Predictors of angioembolization
Authors: Surag K. R. , Shah Abhijit , Vishwanath Gali Kasi , Krishnakanth A. V. B. , Chawla Arun , Hegde Padmaraj , Choudhary Anupam , Rao Mithun 
Published: September 2024

Introduction: Percutaneous nephrolithotomy (PCNL) is a widely used procedure for treating renal calculi. Advanced techniques have improved outcomes, but hemorrhage remains a significant complication. While most cases of hemorrhagic complications are typically managed conservatively, few cases necessitate interventions like angioembolization (AE). The purpose of this study is to identify risk factors closely associated with severe bleeding post-PCNL requiring AE and to assess if these factors can independently predict the type of lesion [arteriovenous fistula (AVF) vs pseudoaneurysm (PA)]. Materials and method: A retrospective analysis was conducted on 119 patients who underwent “tubeless” PCNL and experienced severe bleeding between January 2018 and December 2023. The study reviewed demographic characteristics, stone characteristics, perioperative factors, and adverse events. The chi-square test and Fisher’s exact test were used for univariate analysis. Logistic regression analysis was used in binomial analysis with a value of p < 0.05 considered statistically significant. Results: Out of 119 patients, 51 required AE. Elevated preoperative serum creatinine levels (>1.5 mg/dl) [ p = 0.01], upper pole access [ p = 0.008], and a larger access sheath size (standard PCNL vs mini-PCNL) [ p ⩽ 0.001] were found to be significantly associated with AE. Logistic regression analysis revealed standard PCNL was significantly associated with post-PCNL bleeding requiring AE (odds ratio [OR]: 50, 95% confidence interval [CI]: 6.529–382.90, p ⩽ 0.001). Stone size and co-morbidities showed no significant association with AE. The average duration of presentation of symptoms post PCNL was 13.6 days. Most patients underwent coiling for AE, with a clinical success rate of 94%. Conclusion: Elevated serum creatinine levels, upper pole access, and tract size >24 Fr are more prone to post-tubeless PCNL severe bleeding, which requires renal AE. The findings suggest that early angiography and possible AE should be considered for at-risk patients. In the future, these predictors may be integrated into predictive models to improve patient risk stratification.
Exploring intradermal sterile water injection as an alternative to natrium diclofenac for kidney-stone related pain relief: A systematic review and meta-analysis of randomized controlled trials
Authors: Gohtama Satria , Thaniel Malvin , Janice Livia , Rulando Michael , Wiyarta Elvan 
Published: September 2024

Background: Kidney stone-related pain often presents significant challenges in clinical practice, mainly due to the adverse effects by NSAIDs, which are the current first-line treatment for urolithiasis. Patients presenting with gastrointestinal tract disorders and contraindications toward NSAIDs are particularly susceptible. Intradermal sterile water injection (SWI) has evidently become apparent as one of the promising alternatives, offering rapid pain relief with minimal adverse effects. This purpose of this study to assess the safety and efficacy of SWI in comparison to NSAIDs particularly Natrium Diclofenac in the management of kidney-stone related pain. Main Body: A systematic review and meta-analysis was performed on papers published up to January 2024 obtained from scientific databases, guided by the PRISMA flowchart. The Cochrane risk of bias 2.0 tool was used to assess quality of the included studies. Statistical analyses were then performed using Review Manager 5.4.1 on studies that provide the baseline and complete follow-up numerical outcomes (e.g. mean and standard deviation) required. After screening was done, 3 retrievable studies met the inclusion and exclusion criteria with a total of 770 participants with kidney stone related pain. The result revealed no significant difference in pain reduction between SWI and Natrium diclofenac at 30 min (MD −0.12, 95% CI −0.68 to 0.44) and 60 min (MD −0.23, 95% CI −0.65 to 0.18). Furthermore, patients treated with SWI display a reduced need for rescue analgesia compared to Natrium Diclofenac (OR 0.73, 95% CI 0.36 to 1.49). Adverse events result was more superior in SWI, having lower occurrence when compared to Natrium Diclofenac, although not significant (OR 0.14, 95% CI 0.05 to 0.39). Conclusions: Intradermal sterile water injection (SWI) appears to be a promising alternative to NSAIDs for kidney stone related pain management, offering comparable efficacy in pain reduction, reduced need for rescue analgesia while maintaining a favorable safety profile. However, further research with larger sample sizes and standardized treatment protocols are required to further validate its safety and efficacy.
Primary Aortic Malignant Peripheral Nerve Sheath Tumor
Authors: Mori Hisaya , Takagi Hisato 
Published: September 2024

A 74 year-old woman suffering 1 month persisting lumbago was referred with diagnosis of thoracic aortic aneurysm. Blood examinations indicated slightly or moderately elevated noradrenaline, dopamine, and homovanillic acid with normal-range vanillylmandelic acid. Contrast-enhanced CT scans revealed a tumor, protruding both intra- and extra-luminally, in the wall of the distal descending thoracic aorta without any primary focuses in the whole body. Primary aortic sarcoma or periaortic catecholamine-producing paraganglioma infiltrating the aorta was suspected. The tumor with the normal proximal and distal aorta 2-3 cm apart from it was completely resected under femoro-femoral partial cardiopulmonary bypass. Macroscopically, the tumor was originated from the aortic wall and protruded both intra- and extra-luminally. Immunohistochemically, positive S-100 and vimentin; Ki67 levels of 40%; and negative CD34, CK AE1/AE3, and SMA were identified. The aforementioned findings definitively diagnosed primary aortic malignant peripheral nerve sheath tumor, which has been never reported in the literature.