bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of dietary cholesterol on metabolic syndrome risk in middle-aged Korean adults: using the Korean Genome and Epidemiology Study (KoGES)
Authors: Kwon Hyunkyung , Kang Minji , Lim Hyunjung 
Published: September 2024

Abstract
Background
The association between dietary cholesterol and metabolic diseases remains controversial. However, the majority of studies focus on egg intake, and there is a limitation in the availability of prospective cohort studies. Our study examined the association between dietary cholesterol and the incidence risk of metabolic syndrome (MetS) in middle aged adults using large prospective cohort study in Republic of Korea.

Methods
The Health Examinees cohort from the Korean Genome and Epidemiology Study was used from baseline to follow-up. Dietary cholesterol intake was assessed by the validated semi-quantitative food frequency questionnaire. Participants were classified as quintile groups according to adjusted dietary cholesterol for total energy intake. MetS was defined as more than 3 of the 5 components of MetS. Hazard ratio (HR) and 95% confidence intervals (CI) for MetS were evaluated by multivariable cox regression analyses.

Results
Of the total 40,578 participants, metabolic syndrome developed in 4,172 (10.28%) individuals during an average follow-up period of approximately 4.76 years. Dietary cholesterol did not exhibit a significant association with the risk of MetS after adjusting for potential confounding factors, but a trend was observed indicating an increased risk with higher intake (p for trend = 0.044). Among the components of MetS, the incidence risk of high waist circumference (HR: 1.164, 95% CI: 1.049–1.290), high blood pressure (HR: 1.188, 95% CI: 1.075–1.313), high serum triglyceride (HR: 1.132, 95% CI: 1.044–1.227) and high fasting blood glucose (HR: 1.217, 95% CI: 1.132–1.308) in the group that consumed the highest dietary cholesterol intake was increased compared with the group that consumed the lowest dietary cholesterol intake. Dose-response relationship suggested a positive linear association between dietary cholesterol intake and the risk of high waist circumference (p-linearity = 0.004), blood pressure (p-linearity = 0.012), and triglycerides (p-linearity = 0.005).

Conclusion
This study suggests a positive association between dietary cholesterol intake and the risk of MetS and its components (abdominal obesity, hypertension, hypertriglyceridemia, and hyperglycemia) in middle-aged Korean adults.
A long way to syndromic short stature
Authors: Gaudioso Federica , Meossi Camilla , Pezzani Lidia , Grilli Federico , Silipigni Rosamaria , Russo Silvia , Masciadri Maura , Vimercati Alessandro , Marchisio Paola Giovanna , Bedeschi Maria Francesca , Milani Donatella 
Published: September 2024

Abstract
Background
Silver-Russell Syndrome (SRS, MIM #180860) is a clinically and genetically heterogeneous disorder characterized by intrauterine and postnatal growth retardation; SRS is also accompanied by dysmorphic features such as triangular facial appearance, broad forehead, body asymmetry and significant feeding difficulties. The incidence is unknown but estimated at 1:30,000-100,000 live births. The diagnosis of SRS is guided by specific criteria described in the Netchine–Harbison clinical scoring system (NH-CSS).

Case presentation
Hereby we describe four patients with syndromic short stature in whom, despite fitting the criteria for SRS genetic analysis (and one on them even meeting the clinical criteria for SRS), molecular analysis actually diagnosed a different syndrome. Some additional features such as hypotonia, microcephaly, developmental delay and/or intellectual disability, and family history of growth failure, were actually discordant with SRS in our cohort.

Conclusions
The clinical resemblance of other short stature syndromes with SRS poses a risk of diagnostic failure, in particular when clinical SRS only criteria are met, allowing SRS diagnosis in the absence of a positive result of a genetic test. The presence of additional features atypical for SRS diagnosis becomes a red flag for a more extensive and thorough analysis. The signs relevant to the differential diagnosis should be valued as much as possible since a correct diagnosis of these patients is the only way to provide the appropriate care pathway, a thorough genetic counselling, prognosis definition, follow up setting, appropriate monitoring and care of possible medical problems.
Exploring the effectiveness of eHealth interventions in treating Post Intensive Care Syndrome (PICS) outcomes: a systematic review
Authors: Lai Daniel Jie , Liu Zhao , Johnston Elaine , Dikomitis Lisa , D’Oliveira Teresa , Shergill Sukhi 
Published: September 2024

Abstract
Background
It remains unclear how to optimise critical care rehabilitation to reduce the constellation of long-term physical, psychological and cognitive impairments known as Post Intensive Care Syndrome (PICS). Possible reasons for poor recovery include access to care and delayed treatment. eHealth could potentially aid in increasing access and providing consistent care remotely. Our review aimed to evaluate the effectiveness of eHealth interventions on PICS outcomes.

Methods
Studies reporting eHealth interventions targeting Post Intensive Care Syndrome outcomes, published in Medline, CINAHL, PsycINFO, Embase, and Scopus from 30th January 2010 to 12th February 2024, were included in the review. Study eligibility was assessed by two reviewers with any disagreements discussed between them or resolved by a third reviewer. Study quality and risk of bias were assessed using the Mixed Method Appraisal Tool. Further to the identification of effective strategies, our review also aimed to clarify the timeline of recovery considered and the outcomes or domains targeted by the interventions.

Results
Thirteen studies were included in our review. Study duration, eHealth intervention delivery format, and outcome measures varied considerably. No studies reported a theory of behavioural change and only one study was co-produced with patients or carers. Most studies were conducted in the early post-discharge phase (i.e., < 3 months) and had feasibility as a primary outcome. The cognitive domain was the least targeted and no intervention targeted all three domains. Interventions targeting the psychological domain suggest generally positive effects. However, results were underpowered and preliminary. Though all studies were concluded to be feasible, most studies did not assess acceptability. In studies that did assess acceptability, the main facilitators of acceptability were usability and perceived usefulness, and the main barrier was sensitivity to mental health and cognitive issues.

Conclusion
Our systematic review highlighted the promising contributions of eHealth with preliminary support for the feasibility of interventions in the early stages of post-critical care rehabilitation. Future research should focus on demonstrating effectiveness, acceptability, the cognitive domain, and multi-component interventions.
The spatial relationship between leishmaniases and sand flies in Europe and neighboring countries
Authors: Berriatua Eduardo , Pérez-Cutillas Pedro , Vidal Aurora González , Briët Olivier J. T. 
Published: September 2024

Abstract
Background
Leishmania infantum is endemic in Europe (and elsewhere) while L. donovani s.s., L. tropica and L. major are not but are present in neighboring countries in North Africa, the Middle East, (the Asian part of) Turkey and the Southern Caucasus. Lists of sand fly vector species in the scientific literature vary with the criteria for vector incrimination, and criteria vary because, for some, evidence is difficult to generate. With minimal criteria, about 20 sand fly species are proven or suspected vectors of L. infantum in Europe and neighboring countries, while for L. tropica and L. major, there are seven and four proven or suspected vector species, respectively, in this area. For L. donovani s.s., present in Cyprus, the Middle East and (the Asian part of) Turkey, no local vectors have been incriminated so far. The aim was to assess the degree of spatial agreement between Leishmania spp. and various vectors species and their relative contribution to the explained variation.

Methods
We used multivariate regression modeling to analyze the spatial relationship between autochthonous Leishmania spp. and clinical forms in humans and animals and 14 Phlebotomus spp. in Europe and neighboring countries.

Results
There was only fair agreement between parasite and vector distributions. The most parsimonious models describing the distribution of Leishmania spp. and clinical forms included three to six sand fly species and explained between 12% (L. infantum) and 37% (L. donovani) of the observed variation. Selected models included confirmed and suspected vector species as well as unexpected species.

Conclusions
The relatively low agreement between Leishmania and vector distributions highlights the need to improve leishmaniasis reporting and vector surveillance in areas where no information is available, both for a better understanding of the epidemiology of infection in endemic areas and to monitor possible spread of infection into non-endemic areas. While some of the unexpected sand fly-Leishmania spp. statistical associations might be spurious, for others, the existence of sporadic or recent reports of infections warrants further vector competence studies that consider strain variation.

Graphical Abstract
Elucidating the genotoxicity of Fusobacterium nucleatum-secreted mutagens in colorectal cancer carcinogenesis
Authors: Xu Wenye , Zhang Yuchen , Chen Dongjiao , Huang Dan , Zhao Yang , Hu Wei , Lin Ling , Liu Yingzhi , Wang Shilan , Zeng Judeng , Xie Chuan , Chan Hung , Li Qing , Chen Huarong , Liu Xiaodong , Wong Sunny H. , Yu Jun , Chan Francis K. L. , Chan Matthew T. V. , Ng Siew C. , Wu William K. K. , Zhang Lin 
Published: September 2024

Abstract
Background
Fusobacterium nucleatum (F. nucleatum) is one of the key tumorigenic bacteria in colorectal cancer (CRC), yet how F. nucleatum is involved in colorectal cancer carcinogenesis remains unknown.

Results
In the present study, we carried out PathSeq analysis on RNA sequencing data from the 430 primary colon adenocarcinomas in TCGA database to assess the relationship between patients’ survival and F. nucleatum abundance. Among patients with cecum and ascending colon tumors, we found that F. nucleatum transcriptome abundance is positively correlated with mutation load. We further demonstrated that patients with both high tumoral abundance of F. nucleatum and high mutation load exhibited poorer survival and DNA damage. We furthermore determined that F. nucleatum-conditioned medium (Fn. CM) induces DNA damage in both in vitro and in vivo studies. In addition, two F. nucleatum-secreted mutagens, namely DL-homocystine and allantoic acid, were identified to lead to DNA damage.

Conclusions
Our finding delineates the genotoxicity of F.nucleatum-secreted mutagens, which provides a basis for further work to investigate the role of F. nucleatum in the pathogenicity of CRC.
Stopping use of E-cigarettes and smoking combustible cigarettes: findings from a large longitudinal digital smoking cessation intervention study in the United States
Authors: Lee Donghee N. , Faro Jamie M. , Stevens Elise M. , Pbert Lori , Yang Chengwu , Sadasivam Rajani S. 
Published: September 2024

Abstract
Objective
Digital interventions have been widely implemented to promote tobacco cessation. However, implementations of these interventions have not yet considered how participants’ e-cigarette use may influence their quitting outcomes. We explored the association of e-cigarette use and quitting smoking within the context of a study testing a digital tobacco cessation intervention among individuals in the United States who were 18 years and older, smoked combustible cigarettes, and enrolled in the intervention between August 2017 and March 2019.

Results
We identified four e-cigarette user groups (n = 990) based on the participants’ baseline and six-month e-cigarette use (non-users, n = 621; recently started users, n = 60; sustained users, n = 187; recently stopped users, n = 122). A multiple logistic regression was used to estimate the adjusted odds ratios (AOR) of six-month quit outcome and the e-cigarette user groups. Compared to e-cigarette non-users, the odds of quitting smoking were significantly higher among recently stopped users (AOR = 1.68, 95% CI [1.06, 2.67], p = 0.03). Participants who were most successful at quitting combustible cigarettes also stopped using e-cigarettes at follow-up, although many sustained using both products. Findings suggest that digital tobacco cessation interventions may carefully consider how to promote e-cigarette use cessation among participants who successfully quit smoking.

Trial registration
ClinicalTrials.gov identifier NCT03224520 (July 21, 2017).
Dissecting human adipose tissue heterogeneity using single‐cell omics technologies
Authors: Di Rocco Giuliana , Trivisonno Angelo , Trivisonno Giovanni , Toietta Gabriele 
Published: September 2024

AbstractSingle-cell omics technologies that profile genes (genomic and epigenomic) and determine the abundance of mRNA (transcriptomic), protein (proteomic and secretomic), lipids (lipidomic), and extracellular matrix (matrisomic) support the dissection of adipose tissue heterogeneity at unprecedented resolution in a temporally and spatially defined manner. In particular, cell omics technologies may provide innovative biomarkers for the identification of rare specific progenitor cell subpopulations, assess transcriptional and proteomic changes affecting cell proliferation and immunomodulatory potential, and accurately define the lineage hierarchy and differentiation status of progenitor cells. Unraveling adipose tissue complexity may also provide for the precise assessment of a dysfunctional state, which has been associated with cancer, as cancer-associated adipocytes play an important role in shaping the tumor microenvironment supporting tumor progression and metastasis, obesity, metabolic syndrome, and type 2 diabetes mellitus. The information collected by single-cell omics has relevant implications for regenerative medicine because adipose tissue is an accessible source of multipotent cells; alternative cell-free approaches, including the use of adipose tissue stromal cell-conditioned medium, extracellular vesicles, or decellularized extracellular matrix, are clinically valid options. Subcutaneous white adipose tissue, which is generally harvested via liposuction, is highly heterogeneous because of intrinsic biological variability and extrinsic inconsistencies in the harvesting and processing procedures. The current limited understanding of adipose tissue heterogeneity impinges on the definition of quality standards appropriate for clinical translation, which requires consistency and uniformity of the administered product. We review the methods used for dissecting adipose tissue heterogeneity and provide an overview of advances in omics technology that may contribute to the exploration of heterogeneity and dynamics of adipose tissue at the single-cell level.
Keeping medical information safe and confidential: a qualitative study on perceptions of Israeli physicians
Authors: Semyonov-Tal Keren 
Published: September 2024

Abstract
Background
Patients expect their information to remain confidential, and physicians have a legal and ethical obligation to keep it this way. Confidentiality is not just a legal requirement but a crucial element in establishing trust between patients and healthcare providers. Patients must feel confident that their personal and medical information is kept confidential and shared only with those who need to know. Previous studies have primarily concentrated on patients’ perceptions of medical confidentiality, data privacy, and data protection issues. However, research on the practical practices and perceptions of medical confidentiality among hospital physicians is scant, underscoring the need for a deeper understanding of this critical issue.

Methods
Through qualitative methods and as part of a large-scale study on aspects of patient dignity and responsiveness in Israel, physicians shared their views and practices on managing medical information.

Results
The study revealed the practical challenges physicians face in upholding various aspects of data protection within hospital settings. These challenges, strategies, and deviations from data protection principles that physicians discussed are of significant practical relevance. The importance of patient consent and the practical measures for safeguarding patient information were also highlighted. While physicians acknowledged the importance of protecting patient information, they also grappled with the realities of doing so in a complex healthcare environment. In future healthcare policies, it is critical to ensure robust measures are in place to safeguard and uphold medical confidentiality. These can include specific measures to increase compliance, such as regularly monitoring compliance with confidentiality policies, producing safe and anonymous channels to voice concerns, and enforcing consequences for any breaches to ensure accountability.

Conclusions
While protecting medical information has emerged as an important goal, it is equally crucial to strike a balance between the need to share information to advance and provide quality medical care. Physicians and policymakers must navigate this delicate balance. Additionally, organizations should strengthen compliance to enhance their monitoring and enforcement of confidentiality policies. Ineffective implementation of medical confidentiality leads to theoretical guidelines that do not translate effectively into practice.
Subjective performance assessment protocol for visual explanations-based face verification explainability
Authors: Bousnina Naima , Ascenso João , Correia Paulo Lobato , Pereira Fernando 
Published: September 2024

AbstractThe integration of Face Verification (FV) systems into multiple critical moments of daily life has become increasingly prevalent, raising concerns regarding the transparency and reliability of these systems. Consequently, there is a growing need for FV explainability tools to provide insights into the behavior of these systems. FV explainability tools that generate visual explanations, e.g., saliency maps, heatmaps, contour-based visualization maps, and face segmentation maps, show promise in enhancing FV transparency by highlighting the contributions of different face regions to the FV decision-making process. However, evaluating the performance of such explainability tools remains challenging due to the lack of standardized assessment metrics and protocols. In this context, this paper proposes a subjective performance assessment protocol for evaluating the explainability performance of visual explanation-based FV explainability tools through pairwise comparisons of their explanation outputs. The proposed protocol encompasses a set of key specifications designed to efficiently collect the subjects’ preferences and estimate explainability performance scores, facilitating the relative assessment of the explainability tools. This protocol aims to address the current gap in evaluating the effectiveness of visual explanation-based FV explainability tools, providing a structured approach for assessing their performance and comparing with alternative tools. The proposed protocol is exercised and validated through an experiment conducted using two distinct heatmap-based FV explainability tools, notably FV-RISE and CorrRISE, taken as examples of visual explanation-based explainability tools, considering the various types of FV decisions, i.e., True Acceptance (TA), False Acceptance (FA), True Rejection (TR), and False Rejection (FR). A group of subjects with variety in age, gender, and ethnicity was tasked to express their preferences regarding the heatmap-based explanations generated by the two selected explainability tools. The subject preferences were collected and statistically processed to derive quantifiable scores, expressing the relative explainability performance of the assessed tools. The experimental results revealed that both assessed explainability tools exhibit comparable explainability performance for FA, TR, and FR decisions with CorrRISE performing slightly better than FV-RISE for TA decisions.
Interpolation for neural-network operators activated with a generalized logistic-type function
Authors: Uyan Hande , Aslan Abdullah Ozan , Karateke Seda , Büyükyazıcı İbrahim 
Published: September 2024

AbstractThis paper defines a family of neural-network interpolation operators. The first derivative of generalized logistic-type functions is considered as a density function. Using the first-order uniform approximation theorem for continuous functions defined on the finite intervals, the interpolation properties of these operators are presented. A Kantorovich-type variant of the operators $F_{n}^{a,\varepsilon} $

F
n

a
,
ε

is also introduced. The approximation of Kantorovich-type operators in $L_{P}$

L
P

spaces with $1 \leq p\leq \infty $
1
≤
p
≤
∞
is studied. Further, different combinations of the parameters of our generalized logistic-type activation function $\theta _{s, a}$

θ

s
,
a

are examined to see which parameter values might give us a more efficient activation function. By choosing suitable parameters for the operator $F_{n}^{a,\varepsilon} $

F
n

a
,
ε

and the Kantorovich variant of the operator $F_{n}^{a,\varepsilon} $

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n

a
,
ε

, the approximation of various function examples is studied.
Research priorities to strengthen environmental cleaning in healthcare facilities: the CLEAN Group Consensus
Authors: Gon Giorgia , Dramowski Angela , Hornsey Emilio , Graham Wendy , Fardousi Nasser , Aiken Alexander , Allegranzi Benedetta , Anderson Darcy , Bartram James , Bhattacharya Sanjay , Brogan John , Caluwaerts An , Padoveze Maria Clara , Damani Nizam , Dancer Stephanie , Deeves Miranda , Denny Lindsay , Feasey Nicholas , Hall Lisa , Hopman Joost , Chettry Laxman Kharal , Kiernan Martin , Kilpatrick Claire , Mehtar Shaheen , Moe Christine , Nurse-Findlay Stephen , Ogunsola Folasade , Okwor Tochi , Pascual Bruno , Patrick Molly , Pearse Oliver , Peters Alexandra , Pittet Didier , Storr Julie , Tomczyk Sara , Weiser Thomas G. , Yakubu Habib 
Published: September 2024

AbstractEnvironmental cleaning is essential to patient and health worker safety, yet it is a substantially neglected area in terms of knowledge, practice, and capacity-building, especially in resource-limited settings. Public health advocacy, research and investment are urgently needed to develop and implement cost-effective interventions to improve environmental cleanliness and, thus, overall healthcare quality and safety. We outline here the CLEAN Group Consensus exercise yielding twelve urgent research questions, grouped into four thematic areas: standards, system strengthening, behaviour change, and innovation.