bluuebunny/crossref_metadata_2025_split huggingface dataset:
Malnutrition is associated with adverse 30-day outcomes after endovascular repair of abdominal aortic aneurysm
Authors: Li Renxi , Sidawy Anton , Nguyen Bao-Ngoc 
Published: September 2024

Background Malnutrition is particularly pertinent in patients undergoing vascular surgery, who frequently present with a high burden of comorbidities and advanced age that can impede nutrient absorption. While previous studies have established that vascular surgery patients with malnutrition had poorer outcomes, the impact of nutritional status in patients undergoing endovascular aneurysm repair (EVAR) has not yet been investigated. Therefore, this study aimed to assess the effect of malnutrition on 30-day outcomes following non-ruptured EVAR. Methods Patients who had infrarenal EVAR were identified in the ACS-NSQIP targeted database from 2012–2022. Exclusion criteria included age less than 18 years, ruptured aneurysm, and emergency. Malnutrition was defined as patients with preoperative weight loss of greater than 10% decrease in body weight in the 6 months immediately preceding the surgery. A 1:5 propensity-score matching was used to match demographics, baseline characteristics, aneurysm diameter, distant aneurysm extent, anesthesia, and concomitant procedures between patients with and without malnutrition. Thirty-day postoperative outcomes were examined. Results There were 154 (0.94%) patients with malnutrition who went under non-ruptured EVAR. Meanwhile, 16,309 patients without malnutrition went under intact EVAR, where 737 of them were matched to all malnutrition patients. Malnourished patients had more comorbidity burdens. After propensity-score matching, patients with malnutrition had elevated but non-significant 30-day mortality (5.92% vs 2.99%, p = .09). However, malnutrition patients had higher risks of renal complications (2.63% vs 0.68%, p = .04), bleeding requiring transfusion (22.37% vs 14.38%, p = .02), and unplanned reoperation (11.18% vs 4.88%, p = .01), as well as longer length of stay (6.11 ± 7.91 vs 4.44 ± 6.22 days, p < .02). Conclusion Patients with malnutrition experienced higher rates of morbidity after non-ruptured EVAR. Targeting malnutrition could be a strategy for preventing complications after EVAR and proper preoperative malnutritional management could be warranted.
Seeking mental health support for feelings of perinatal depression and/or anxiety during the COVID-19 pandemic: A qualitative descriptive study of decision-making
Authors: Shen Katrina , Kuyvenhoven Cassandra , Carruthers Andrea , Pahwa Manisha , Hadid Dima , Greyson Devon , Bayrampour Hamideh , Liauw Jessica , Mniszak Caroline , Vanstone Meredith 
Published: September 2024

Background: Rates of perinatal depression and anxiety increased during the COVID-19 pandemic. It remains unclear how the COVID-19 pandemic influenced risk perception and help-seeking behaviours among pregnant and postpartum individuals. Objectives: To explore pregnant and postpartum individuals’ decision-making process about when and how to seek support for feelings of depression and/or anxiety during the COVID-19 pandemic. Design: A qualitative descriptive design was used. Methods: The current study is a secondary analysis of qualitative data collected for a larger mixed-methods project that recruited participants who gave birth from 1 May 2020, to 1 December 2021, in Ontario and British Columbia, Canada, using maximum variation and purposive sampling. Seventy-three semi-structured interviews were conducted over Zoom or telephone. This analysis focuses on 56 individuals who discussed their self-identified feelings of prenatal or postpartum depression and/or anxiety. Conventional (inductive) content analysis was employed with iterative stages of open coding, focused coding and cross-checking themes. Results: Most participants recognized their need to seek help for their feelings of depression and/or anxiety through discussions with a mental health professional or someone within their social circle. Nearly all participants accessed informal social support for these feelings, which sometimes entailed social contact in contravention of local COVID-19 public health policies. Many also attempted to access formal mental healthcare, encountering barriers both related and unrelated to the pandemic. Participants described the pandemic as having the dual effect of causing or exacerbating their feelings of depression and/or anxiety while also constraining their ability to access timely professional care. Conclusion: Participants struggled to address their feelings of perinatal depression and anxiety during the COVID-19 pandemic, with many describing a lack of readily available resources and limited access to professional mental healthcare. This study highlights the need for improved provision of instrumental mental health support for pregnant and postpartum populations.
Rethinking culture: a narrative review on the evolving role of museum and art gallery-based heritage activities and programmes on wellbeing
Authors: Fares J , Hadjicosti I , Constantinou C 
Published: September 2024

Aims: The prevalence of chronic mental and physical diseases is increasing globally. In addition, the changing demographics towards an ageing population pose a challenge to healthcare systems, as ageing is associated with a decrease in physical and mental capacity and an increased risk of developing disease. The review aims to explore primary studies that investigated the effect of museum and art gallery-based heritage activities and programmes on the wellbeing of (1) individuals recovering from drug addiction or patients with dementia and (2) younger and older adults. Methods: We conducted a search using specific keywords, and inclusion and exclusion criteria, in databases for the period 2013–2023. Following a detailed examination of numerous articles, 15 original studies were included in this review. Results: 15 original studies investigated the effects of museum and art gallery-based heritage activities or programmes on (1) patients with chronic diagnoses associated with mental health and/or physical impairment, such as drug addiction and dementia and (2) the wellbeing of younger and older populations. The interactive environment of museums had positive health outcomes for patients with chronic mental (addiction recovery, dementia) and physical diseases (cancer) as well as hospitalized patients. In addition, it improved the physical and mental wellbeing of younger and older individuals. Conclusion: Museum art-based interventions may be integrated as part of the non-pharmacological management of patients experiencing mental disorders as well as for improving the wellbeing of younger and older populations.
Evaluating Perceptions of Head and Neck Surgeons on the Role of Single-Entry Models in Managing Surgical Waitlists in Ontario: A Qualitative Study
Authors: Shapiro Justin , Axelrod Charlotte , Levy Ben B. , Bandargal Saruchi , Steinberg Emily C. , Wener Emily , Almeida John de , Davies Joel , Rotenberg Brian , Eskander Antoine , Chung Janet , Urbach David , Chan Yvonne 
Published: September 2024

Background Long surgical wait times have long plagued health systems in Canada and abroad. This backlog and associated strain on health human resources has been exacerbated by the COVID-19 pandemic, affecting surgeries of varying degrees of urgency across all surgical specialties, including head and neck surgery. Single-entry models (SEMs) are being increasingly studied as one possible strategy to help manage surgical wait times, and a growing number of health systems have implemented SEMs within departments such as otolaryngology—head and neck surgery. We sought to evaluate the views of head and neck surgeons at all 8 designated head and neck cancer centers across Ontario on the role of SEMs in managing surgical backlogs. Results We interviewed 10 Ontario head and neck surgeons on the role of SEMs in managing wait times within the field. The following themes were elicited from interview transcripts: (1) anticipated positive impact, (2) barriers to implementation, (3) patient experience, and (4) roadmap to implementation. Participants agreed that SEMs may have utility for certain types of surgeries if implemented to address local needs. They also believe this model would have the greatest impact if employed together with other approaches, such as increasing operating room time or nursing availability. Conclusion Our results highlighted the necessity for a nuanced approach to single-entry model implementation in head and neck surgery. While participants recognized the utility of SEMs for high-volume and low-variation surgeries, participants remained divided on the optimal approach to triaging patients necessitating more complex oncologic treatments. Deliberate collaboration among stakeholder organizations and senior surgeons will be critical if SEMs are to succeed in an intricate and political healthcare environment.
A machine learning–based online web calculator to aid in the diagnosis of sarcopenia in the US community
Authors: Guo Jiale , He Qionghan , She Chunjie , Liu Hefeng , Li Yehai 
Published: September 2024

Background Sarcopenia places a heavy healthcare burden on individuals and society. Recognizing sarcopenia and intervening at an early stage is critical. However, there is no simple and easy-to-use prediction tool for diagnosing sarcopenia. The aim of this study was to construct a well-performing online web calculator based on a machine learning approach to predict the risk of low lean body mass (LBM) to assist in the diagnosis of sarcopenia. Methods Data from the National Health and Nutritional Examination Surveys 1999–2004 were selected for model construction, and the included data were randomly divided into training and validation sets in the ratio of 75:25. Six machine learning methods— Classification and Regression Trees, Logistic Regression, Neural Network, Random Forest, Support Vector Machine, and Extreme Gradient Boosting (XGBoost)—were used to develop the model. They are screened for features and evaluated for performance. The best-performing models were further developed as an online web calculator for clinical applications. Results There were 3046 participants enrolled in the study and 815 (26.8%) participants with LBM. Through feature screening, height, waist circumference, race, and age were used as machine learning features to construct the model. After performance evaluation and sensitivity analysis, the XGBoost-based model was determined to be the best model with better discriminative performance, clinical utility, and robustness. Conclusion The XGBoost-based model in this study has excellent performance, and the online web calculator based on it can easily and quickly predict the risk of LBM to aid in the diagnosis of sarcopenia in adults over the age of 60.
Provision of ankle foot orthoses for children with cerebral palsy in Norway
Authors: Goihl Tobias , Rusaw David F. , Roeleveld Karin , Brændvik Siri Merete 
Published: September 2024

Introduction Practice of ankle-foot orthoses (AFO) provision for ambulatory children with cerebral palsy is underreported and the literature is not consistent on choice of AFO-design. This study describes clinical practice of AFO provision for children with cerebral palsy and evaluates how clinical practice aligns with existing recommendations. Methods An online, cross-sectional survey was conducted, inviting all Norwegian orthotists working with children with cerebral palsy. Orthotic practice was investigated using a self-reported survey design. Results From all eligible orthotists, 54% responded, revealing that AFO provision involves patients, physicians, and physiotherapists at different stages. Patient preference directly influenced the ultimate AFO-design. Shank vertical angle was evaluated by 79%. For children with crouch gait and those with short gastrocnemius, a majority preferred a combination of rigid and articulated/flexible AFO-designs. Instrumented gait analysis was conducted by 51% at AFO delivery stage. Conclusions The findings show that AFO provision in Norway is collaborative, involving clinical team members and consideration of patient preferences. A discrepancy between clinical practice and existing recommendations for children with crouch gait and those with short gastrocnemius is observed.
Impact of Economic Policy Uncertainty Shocks on China’s Stock Market Development: Evidence from Nonlinear Autoregressive Distributed Lag and Spectral Causality Approaches
Authors: Ullah Assad , Zhao Xinshun , Ye Chenghui , Kamal Muhammad Abdul 
Published: September 2024

Stock markets augment industries by raising and circulating capital in the economic system. This article examines the relationship between economic policy uncertainty (EPU) shocks and stock market development (SMD) in China. To this end, we utilize a novel EPU index the Nonlinear Autoregressive Distributed Lag (NARDL), and the Breitung-Candelon spectral causality approaches. The empirical outcomes suggest that positive (negative) shocks of EPU significantly decrease (increase) China’s SMD. The spectral causality approach confirms the lead-lag relationships among EPU shocks, stock market liquidity, banking sector development, savings, and trade openness. To propel the size of China’s stock market, the concerned authorities should strive to appease high EPU and ensure stability in macroeconomic and financial dynamics. JEL Classification: G11, G12, G15.
Energy Use and Economic Growth: An Empirical Study of Short-Run and Long-Run Dynamics for Colombia Between 1990 and 2021
Authors: Dinas-Morales Alejandro , Burbano-Vallejo Edy Lorena 
Published: September 2024

This research aims to study the relationship between energy use and economic growth between 1990 and 2021 in Colombia. Energy is a key element for economic growth and to improve people’s living standards, especially in developing economies like Colombia. To estimate both the short-run and long-run relationship between economic growth and energy use and economic growth, we used data from 1990 to 2021 and we estimated an error correction model along with a regression using the FMOLS/DOLS estimators. We found that economic growth and energy use are related in the short run in Colombia, according to the Toda–Yamamoto causality test, GDP granger causes energy use and there’s not enough evidence to claim that energy use and GDP are related in the long run. JEL Classification: Q43.
Relative effectiveness of COVID-19 vaccine booster doses in people aged 65 and older—a retrospective cohort study in Türkiye
Authors: Sezerol Mehmet Akif , Sarisaltik Alican 
Published: September 2024

Background: Immunization in the elderly population is critical due to the high frequency of health outcomes related to COVID-19. Objectives: This study aimed to compare the effectiveness levels of COVID-19 vaccine schedules in preventing SARS-CoV-2 infection in the older adult group who received at least one booster dose. Design: Retrospective cohort study. Methods: This study evaluated 8969 adults aged 65 and over in the Sultanbeyli district of İstanbul. COVID-19 vaccination and SARS-CoV-2 polymerase chain reaction testing data between January 14, 2021 and December 2, 2022 were obtained from the National Public Health Management System. Results: The median age of participants was 71 years. The vaccines were mostly administered as CoronaVac for the first and second doses (81.4% and 82.2%, respectively) and BNT162b2 for the third and fourth doses (61.8% and 73.1%, respectively). Turkovac was administered only in booster doses (third dose 0.6%, fourth dose 4.8%). The adjusted relative vaccine effectiveness (rVE) was found to be 61.8% (95% confidence interval (CI) 51.5–69.9) in two doses of inactivated vaccine and one dose of mRNA vaccine schedule compared to the homolog booster of CoronaVac primary vaccine schedule. In two booster doses receipts, the adjusted rVE was found to be 45.4% (95% CI 13.8–65.4) in three doses of inactivated and one dose mRNA vaccine schedule and 43.0% (95% CI 20.5–59.2) in two doses of inactivated and two doses of mRNA vaccines schedule compared to the two homolog boosters with CoronaVac primary vaccine schedule. Conclusion: In this study, the effectiveness of the mRNA vaccine as a booster dose was higher than that of the homologous boosters in participants receiving the CoronaVac primary series for those aged 65 and over.
Daratumumab with lenalidomide as maintenance after transplant in newly diagnosed multiple myeloma: the AURIGA study
Authors: Badros Ashraf , Foster Laahn , Anderson Larry D. , Chaulagain Chakra P. , Pettijohn Erin , Cowan Andrew J. , Costello Caitlin , Larson Sarah , Sborov Douglas W. , Shain Kenneth H. , Silbermann Rebecca , Shah Nina , Chung Alfred , Krevvata Maria , Pei Huiling , Patel Sharmila , Khare Vipin , Cortoos Annelore , Carson Robin , Lin Thomas S. , Voorhees Peter 
Published: September 2024

Abstract
No randomized trial has directly compared daratumumab and lenalidomide (D-R) maintenance with standard-of-care lenalidomide (R) alone after transplant. Herein, we report the primary results of the phase 3 AURIGA study evaluating D-R vs R maintenance in patients with newly diagnosed multiple myeloma (NDMM) who had very good or better partial response, were minimal residual disease (MRD)-positive (10–5) and anti-CD38–naïve after transplant. Two hundred patients were randomly assigned (1:1) to D-R (n = 99) or R (n = 101) maintenance for up to 36 cycles. The MRD-negative (10–5) conversion rate by 12 months from start of maintenance (primary end point) was significantly higher for D-R than R (50.5% vs 18.8%; odds ratio [OR], 4.51; 95% confidence interval [CI], 2.37-8.57; P &lt; .0001). MRD-negative (10–6) conversion rate was similarly higher with D-R (23.2% vs 5.0%; OR, 5.97; 95% CI, 2.15-16.58; P = .0002). At median follow-up (32.3 months), D-R achieved a higher overall MRD-negative (10–5) conversion rate (D-R, 60.6% vs R, 27.7%; OR, 4.12; 95% CI, 2.26-7.52; P &lt; .0001) and complete response rate or better (75.8% vs 61.4%; OR, 2.00; 95% CI, 1.08-3.69; P = .0255) vs R. Progression-free survival (PFS) favored D-R vs R (hazard ratio, 0.53; 95% CI, 0.29-0.97); estimated 30-month PFS rates were 82.7% for D-R and 66.4% for R. Incidences of grade 3/4 cytopenias (54.2% vs 46.9%) and infections (18.8% vs 13.3%) were slightly higher with D-R than R. In conclusion, D-R maintenance achieved a higher MRD-negative conversion rate and improved PFS after transplant vs R, with no new safety concerns. This trial was registered at www.clinicaltrials.gov as #NCT03901963.
Virtual reality for assessing emergency medical competencies in junior doctors – a pilot study
Authors: Keicher Franca , Backhaus Joy , König Sarah , Mühling Tobias 
Published: September 2024

Abstract
Background
The teaching and assessment of clinical-practical skills in medical education face challenges in adequately preparing students for professional practice, especially in handling emergency situations. This study aimed to evaluate the emergency medical competencies of junior doctors using Virtual Reality (VR)-based scenarios to determine their preparedness for real-world clinical situations.

Methods
Junior doctors with 0–6 months of professional experience participated in one of three VR-based emergency scenarios. These scenarios were designed to test competencies in emergency medical care. Performance was automatically assessed through a scenario-specific checklist, and participants also completed self-assessments and a clinical reasoning ability test using the Post-Encounter Form.

Results
Twenty-one junior doctors participated in the study. Results showed that while general stabilization tasks were performed well, there were notable deficiencies in disease-specific diagnostic and therapeutic actions. On average, 65.6% of the required actions were performed correctly, with no significant variance between different scenarios. Participants achieved an average score of 80.5% in the Post-Encounter-Form, indicating a robust ability to handle diagnostic decisions. Self-assessments did not correlate significantly with objective measures of competency, highlighting the subjective nature of self-evaluation.

Conclusion
VR-based simulations can provide a detailed picture of EMC, covering both diagnostic and therapeutic aspects. The findings of this pilot study suggest that while participants are generally well-prepared for routine tasks, more focus is needed on complex case management. VR assessments could be a promising tool for evaluating the readiness of new medical professionals for clinical practice.
DiscovEpi: automated whole proteome MHC-I-epitope prediction and visualization
Authors: Mahncke C. , Schmiedeke F. , Simm S. , Kaderali L. , Bröker B. M. , Seifert U. , Cammann C. 
Published: September 2024

Abstract
Background
Antigen presentation is a central step in initiating and shaping the adaptive immune response. To activate CD8+ T cells, pathogen-derived peptides are presented on the cell surface of antigen-presenting cells bound to major histocompatibility complex (MHC) class I molecules. CD8+ T cells that recognize these complexes with their T cell receptor are activated and ideally eliminate infected cells. Prediction of putative peptides binding to MHC class I (MHC-I) is crucial for understanding pathogen recognition in specific immune responses and for supporting drug and vaccine design. There are reliable databases for epitope prediction algorithms available however they primarily focus on the prediction of epitopes in single immunogenic proteins.

Results
We have developed the tool DiscovEpi to establish an interface between whole proteomes and epitope prediction. The tool allows the automated identification of all potential MHC-I-binding peptides within a proteome and calculates the epitope density and average binding score for every protein, a protein-centric approach. DiscovEpi provides a convenient interface between automated multiple sequence extraction by organism and cell compartment from the database UniProt for subsequent epitope prediction via NetMHCpan. Furthermore, it allows ranking of proteins by their predicted immunogenicity on the one hand and comparison of different proteomes on the other. By applying the tool, we predict a higher immunogenic potential of membrane-associated proteins of SARS-CoV-2 compared to those of influenza A based on the presented metrics epitope density and binding score. This could be confirmed visually by comparing the epitope maps of the influenza A strain and SARS-CoV-2.

Conclusion
Automated prediction of whole proteomes and the subsequent visualization of the location of putative epitopes on sequence-level facilitate the search for putative immunogenic proteins or protein regions and support the study of adaptive immune responses and vaccine design.