bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Acting Reversible Contraception (LARC) and Early Childbearing Revisited: Births and Birth Intendedness After LARC Removal in a State Medicaid Population (2012–2020)
Authors: Rendall Michael S. , Eeckhaut Mieke C. W. , Gifford Katie , Hurtado-Acuna Constanza 
Published: October 2024

Objectives. To analyze births and birth intendedness after long-acting reversible contraception (LARC) removal among Medicaid-insured women. Methods. We linked all Delaware women with a Medicaid-covered LARC removal in 2012 to 2020 (n = 8047) to birth records and to Pregnancy Risk Assessment Monitoring System (PRAMS) pregnancy intendedness survey responses (n = 241). Results. Births within 3 years of a Medicaid-covered LARC removal were much more likely to be to women in their 20s compared with all Medicaid births (63.5% vs 53.4%; P < .001). The intended proportion for births within 3 years of Medicaid-covered LARC removal (65.2%) was higher than for all Medicaid-covered births (58.8%; P = .08) and was consistently above 60% across all age groups younger than 30 years. Conclusions. A state Medicaid-insured population’s use of highly effective reversible contraception was associated with births being concentrated among women in their 20s and with consistently high fractions of intended births across younger ages at birth. Public Health Implications. Programs and policies may consider LARC access for its potential to increase low-income women’s reproductive autonomy by enhancing their ability to achieve births at the age of their choosing. ( Am J Public Health. 2025;115(1):95–102. https://doi.org/10.2105/AJPH.2024.307844 )
SIENNA: A Generalizable Parameter-Efficient Machine Learning Diagnostic for Clinical Magnetic Resonance Imaging
Authors: Paluh Janet , Sunil Sreya , Rajeev Rahul , Chatterjee Ayan , Pilitsis Julie , Mukherjee Amitava 
Published: October 2024

Abstract

Contemporary machine learning models for computer vision, although abundant, are largely inappropriate for clinical diagnostics. Clinical sophistication must address data consistency, avoid large parametric needs to reduce model complexity, and achieve stable generalizability across new patient data. Here, we achieve these goals in SIENNA a “Lightweight Energy-efficient Adaptive Next generation” artificial intelligence (LEAN AI) platform along with development of new algorithms for DICOM data consistency and approaches for improved integration of clinical data with deep learning architectures. Applied in the context of brain tumor diagnostics, SIENNA is a nimble AI that requires 175K-285K trainable parameters, 122X less in comparison to other state-of-the-art AI ML tumor models, while outperforming these models. SIENNA is generalizable across diverse patient datasets in inductive tests on benchmark and clinical datasets, achieving high average accuracies of 93–96% in three-way multiclass classification of MRI tumor data, across mixed 1.5 and 3.0 Tesla data and machines. We apply no DICOM MRI data preprocessing beyond data consistency while achieving a parameter-efficient generalizable ML pipeline. SIENNA demonstrates that small clinical datasets can be sufficient to design robust clinical ready architectures to facilitate expanded ML applications in multimodal data integration in a wider range of clinical diagnostic tasks.
Circular RNA circDDX17 suppression to gastric cancer progression via the sponging miR-1208/miR-1279/FKBP5 axis encodes a novel circDDX17-63aa protein
Authors: Shao Shihe , Liu Tingjun , Ma Tieliang , Xue Jiaxin , Zhu Linqi , Cui Feilun , Zhang Haoliang 
Published: October 2024

Abstract

Mounting evidence indicates that circular RNAs (circRNAs) are dysregulated in human gastric cancer (GC). The downregulation of circDDX17 is linked to GC progression. However, the role and specific mechanism of circDDX17-mediated GC progression remains elusive. Herein, we report that the downregulation of circDDX17 was correlating with tumor growth and lymph node metastasis in patients with GC. CircDDX17 inhibited GC cell proliferation, migration, and epithelial-mesenchymal transition (EMT) while promoting apoptosis both in vitro and in vivo. Acting as a sponge for miR-1208 and miR-1279, circDDX17 regulated FKBP5 expression in GC cells. FKBP5, in turn, interacted with ERK1/2, influencing GC development through the ERK1/2 pathway. What is more, circDDX17 encoded circDDX17-63aa, which inhibited GC cell proliferation, migration, and EMT. In sum, CircDDX17 exhibits low-expressed in GC via the miR-1208/miR-1279/FKBP5 axis and circDDX17-63aa.
The Temporal Dynamics of Pathological Profile and Functional Impairment in Neuromyelitis Optica Spectrum Disorders associated Optic Neuritis
Authors: Yang Xiayin , Yao Shi-Qi , Chan Henry Ho-lung , Tan Shaoying 
Published: October 2024

Abstract

Background Optic neuritis (ON) linked to Neuromyelitis Optica Spectrum Disorders (NMOSD), particularly in Asians, causes irreversible vision loss. The lack of comprehensive analysis that tracks the progression of changes over time hinders the identification of optimal timeframes for observation and intervention of the disease. Our aim is to map disease progression histologically and functionally in an optimized Neuromyelitis Optica Spectrum Disorders associated Optic Neuritis (NMOSD-ON) animal model.Materials and Methods The animals in the NMOSD-ON group involved the injections of aquaporin-4-immunoglobulin G (AQP4-IgG) and human complement into the posterior optic nerve, separated by 24 hours, repeated twice. The control group received injections of normal immunoglobulin G (normal IgG) and human complement. Histological analyses examined the immunoreactivity of aquaporin-4 (AQP4) protein, glial fibrillary acidic protein (GFAP) protein (maker of astrocytes), microglial activation, myelin oligodendrocyte glycoprotein (MOG) (maker of myelin sheath), and degeneration of retinal ganglion cells (RGCs), along with gene expression profiling of inflammatory cytokines at various time points (Baseline, Day 2, Week 1, Week 2, Week 4). In-vivo visual functional and retinal structural assessments were performed weekly up to Week 4 to track disease progression.Results Administration of AQP4-IgG and human complement triggered a series of events in mice with NMOSD-ON, leading to early changes in astrocyte pathology (loss of AQP4 and GFAP staining), upregulation of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β), CXCL10, brain-derived neurotrophic factor (BDNF) and microglia activation in Week 1. This was followed by demyelination, culminating in damage to RGCs and nerve fibers in Week 2. Functionally, the delays of visual evoked potential N1 latency were detectable from Week 2, with reduced N1P1 amplitudes by Week 2. For the electroretinogram, the postive scotopic threshold response (pSTR) amplitude decreased at Week 2, while scotopic a- and b-wave amplitudes remained unchange, which corresponded to the retinal nerve fibre layer thinning in the in-vivo retinal structural scan commencing at Week 2.Conclusion This study outlines the progression timeline of NMOSD-ON disease and connects histological and molecular findings to retinal structural changes, in-vivo functional impariment following NMOSD-ON onset in an optimized animal model.
Onion membrane based composite scaffolds incorporated with N-Boc L-cysteine methyl ester enhances mineralization for bone tissue engineering applications
Authors: MV Sivasankar , Parcha Sreenivasa Rao 
Published: October 2024

Abstract

Composite scaffolds S1(C-MFC-PCL), S2 (C-MFC-PCL-H), and S3 (C-MFC-PCL-Zr) containing micro-fibrillated cellulose (MFC), chitosan (C), polycaprolactone (PCL), zirconium oxide (Zr), and hydroxyapatite (H) were synthesized by freeze-drying process. N-Boc-L-cysteine methyl ester (NBLCME) was synthesized and incorporated into the composite scaffolds S1, S2, and S3 at different concentrations (20–100µg/ml). FTIR analysis confirmed the interactions between S1, S2, S3, and NBLCME. SEM analysis showed that the S1, S2, and S3 had 70–85% porosity with a pore diameter range of 100–450µm. The scaffolds S1, S2, and S3 scaffolds achieved sustained drug delivery following Fickian diffusion behavior (n ≤ 0.45). The cytotoxic effects of NBLCME treated scaffolds (S1, S2, and S3) on MG63 cell line were studied by examining cell viability, alkaline phosphatase activity (ALP), Alizarin red S activity (ARS), and cell adhesion. The cytotoxicity of the treated scaffolds on MG63 cell line was dose-dependent, with no cytotoxic effects at concentrations below 60µg/ml. However, higher concentrations of NBLCME (> 60µg/ml) significantly reduced ALP and ARS activity of MG63 cells due to lactate dehydrogenase leakage. Composite scaffolds S1, S2, and S3 showed significant results in mechanical properties, swelling behavior, sustainable drug release, slow degradation rate, cell adhesion, growth, and proliferation. S3 composite scaffold exhibit excellent properties than other composite scaffolds S2 and S3. Therefore, S3 can be used as promising biomaterial for bone tissue engineering.
Semiautomatic 3D Ultrasound Kidney Volume Segmentation in Pediatric Hydronephrosis: Interrater Agreement and Correlation to Conventional Hydronephrosis Grading
Authors: Esser Michael , Tsiflikas Ilias , Jago James R. , Rouet Laurence , Stebner Alexander , Schäfer Jürgen F. 
Published: October 2024

Abstract

Background: Two-dimensional assessment of the kidney volume underestimates real kidney volume with a high interobserver variability. Limited data exist on innovative 3D ultrasound (3DUS) technique for the evaluation of pediatric hydronephrosis.
Objective: To evaluate the interrater agreement of kidney volume segmentation by 3DUS with a matrix array transducer in children with hydronephrosis and comparison of 3D metrics to conventional hydronephrosis grading.
Materials and methods: 48 kidney volumes were prospectively acquired in 45 patients with hydronephrosis by freehand 3DUS (6-1MHz volumetric sector array, electronic rotation; median age, 4years; 1month to 16years). Semi-automated kidney segmentation was performed by two independent readers providing volumes for total kidney (renal capsule), dilated collective system, renal parenchyma (renal capsule - collective system) and hydronephrosis index (renal parenchyma / renal capsule). Interrater agreement was evaluated with Bland–Altman plots, intraclass correlation coefficient (ICC) and Dice similarity coefficients. The maximum 2D diameter of renal pelvis was measured and hydronephroses were morphologically classified grade 1-4.
Results: Interrater agreement for renal capsule, collective system, hydronephrosis index and renal parenchyma was good to excellent with ICC of 0.94, 0.87, 0.83 and 0.92 respectively (p<0.001 each). Median Dice was 0.90 (capsule), 0.77 (collective system) and 0.88 (parenchyma). There was a positive correlation between hydronephrosis grading and ultrasonic hydronephrosis index and between renal pelvis diameter and collective system volume (p<0.001 both).
Conclusion: Semiautomatic 3DUS volumetric analysis has a high degree of interrater agreement providing parenchyma volume in hydronephrotic kidneys. Volumes of the collective system and hydronephrosis index correlate with the extent of hydronephrosis.
Trial registry: trial registration number, DRKS00022772; date of registration, 07/31/2020
Construction of a risk prediction model for sepsis-associated delirium in the intensive unit patients: A retrospective cohort study
Authors: Jiang Zeping , Wang Yusheng , Xie Tian , Liu Furong , Wan Rui , Xu Jiansui , Zhou Zaotian , Zhou Lan , Liu Yang 
Published: October 2024

Abstract

Background: To identify the risk factors associated with sepsis-associated delirium and to develop a nomogram for predicting the risk of delirium in patients with sepsis on the basis of the Medical Information Mart for Intensive Care IV database.
Methods: A total of 12029 patients from the Medical Information Mart for Intensive Care-IV database (MIMIC-IV 2.0) were divided into a training set and a testing set at a ratio of 7:3. The primary outcome was the occurrence of sepsis-associated delirium (SAD) in ICU patients with sepsis. Hierarchical logistic regression analyses were conducted in the training set, sequentially analyzing basic information and clinical features (Model 1) followed by additional nursing management factors (Model 2), to identify factors associated with the risk of SAD. These identified factors were utilized to construct a nomogram for predicting the risk of SAD. The predictive performance of the nomogram was evaluated via receiver operating characteristic curves and calibration curves.
Results: A total of 12,029 patients were enrolled, of whom 1,666 patients (13.3%) died in the hospital and 4,807 patients (39.96%) had SAD. In-hospital mortality in the SAD group was greater than that in the non-SAD group (23.4% vs. 7.5%, p < 0.001). By hierarchical logistic regression, two models were compared, and a nomogram integrating basic information, clinical features and easily overlooked nursing management factors was constructed. The risk factors for sepsis-associated delirium include age ≥ 65 years, tobacco use, SOFA score, intensive care unit (ICU) type at admission, hypernatremia, hypocalcemia and diet type on the first day. CRRT during sepsis and receiving skin care decrease the risk of sepsis-associated delirium. The AUCs of the developed model were 0.832 (95% CI 0.823–0.841) in the training set and 0.832 (95% CI 0.818–0.846) in the testing set. The calibration curve showed good concordance between the predicted and observed delirium rates among sepsis patients.
Conclusions: We developed a nomogram incorporating ten features of clinical work,especially adding factors related to nursing management. The constructed nomogram has good performance and clinical applicability and can help identify SAD patients in a timely manner for early intervention and improve neurological outcomes.
Does the Brazilian Version of the Strengthening Families Program (Famílias Fortes) Reduce Adolescent Substance Use and Improve Parental Behavior? Evidence from a 2-Year Follow-Up Study
Authors: Sanchez Zila M , Caetano Sheila C , Galvao Patricia P O , GUBERT FABIANE A , Rebouças Lidiane N , Soares-Santos Luis Eduardo , Valente Juliana Y 
Published: October 2024

Abstract

Blackground: The Brazilian adaptation of the Strengthening Families Program (SFP), known as Famílias Fortes (FF-BR 10-14), has demonstrated positive short-term effects on parental behavior. This study aimed to evaluate the 12- and 24-month follow-ups of the FF-BR 10-14, focusing on parental outcomes and substance use prevention.
Methods: A total of 805 adolescents (aged 10–14) and their caregivers participated in a parallel-cluster randomized controlled trial across 12 municipalities in Brazil. FF-BR 10-14, comprising seven sessions, was delivered by the Social Assistance Reference Center (SARC) staff. This study presented data collected at three time points: baseline, 12 and 24 months of follow-up. Multilevel mixed-effects models assessed the program effects on parental and adolescent outcomes (drug use and family behavior), with adjustments for sociodemographic factors.
Results: The results revealed no statistically significant differences between the groups in terms of adolescent drug use after either follow-up. However, participating in the program showed a reduction in negligent parental style (aOR 0.46, 95%CI 0.22;0.97), parental binge drinking (aOR 0.24, 95%CI 0.08; 0.74), as well as an increase in parental ability to set clear rules regarding their children's drug use (Coef 0.43, 95%CI 0.03; 0.83) and an improvement in adolescents' skills to resolve family conflicts (Coef 0.79, 95%CI 0.11; 1.46) and to manage stress (Coef 0.65, 95%CI 0.16; 1.15).
Conclusion: The Famílias Fortes program shows positive effects on mediators, such as parenting practices and adolescent coping skills, but not on the primary outcomes of adolescent substance use. These findings highlight the program's role in improving the family environment and supporting prevention efforts through intermediary behaviors.
Risk of Falls Associated with Benzodiazepine Hypnotics Use in Elderly Inpatients:A Case-Crossover Study
Authors: Chen Qiongfang , Zhang Xiaojie , Zhong Cuina , Ou Taoni , Huang Yuli , He Jingcheng 
Published: October 2024

Abstract

Background
Preventing falls in patients is one of the most important concerns in hospitals. This study aimed to analyse the risk of falls associated with benzodiazepine hypnotic drugs use in elderly inpatients.
Methods
We used a case-crossover design to investigate hospitalized fall patients who were older than 60 years and had taken benzodiazepine hypnotic medication from January 1st,2021 to December 31st,2023.We defined the day before the fall event as the case day (day 1) and days 2–8 before the fall event as the control days.The multivariate analysis result was reported as an odds ratio (OR) with 95% confidence interval (CI).
Results
In 70 eligible patients, the total case day was 70 days and the control days was244.Hypnotic drugs revealed a positive association with fall events (odds ratio [OR]: 1.836, 95%confidence interval [CI] = 1.029–3.275, p = 0.040). Among them, benzodiazepine receptor agonists (odds ratio [OR]:1.824, 95%confidence interval [CI] = 1.007–1.303, p = 0.047), and alprazolam (odds ratio [OR]: 1.937, 95%confidence interval [CI] = 1.021–3.673, p = 0.043), showed a positive association with fall events.
Conclusion
This study confirmed that the occurrence of falls in hospitalized elderly patients aged older than 60 years was clearly associated with the use of benzodiazepine hypnotics. Fall prevention plans should be developed and implemented for olderly inpatients taking hypnotic drugs.
Treatment outcome of ultrasound-guided hydrostatic reduction of intussusception and its associated factors among pediatric patients in a resource-limited setting
Authors: Ayana Chala Takele , Feleke Tesfahunegn H , Bazezew Anduamlak , Mehari Zelalem , Abraham Yodit , Getinet Tewodros , Belina Merga , Hailu Samuel S 
Published: October 2024

Abstract

Background: Ultrasound-guided hydrostatic reduction (USGHR) of intussusception was recently introduced and adopted as the initial management option for intussusception in children. Knowledge of the treatment outcome and associated factors will enhance the expansion of this technique to hospitals in Sub-Saharan Africa, where surgery largely remains the exclusive treatment strategy.
Methods: An institution-based cross-sectional study was conducted. We consecutively enrolled children with US-confirmed intussusception for whom USGHR of intussusception with normal saline was performed by a senior radiologist and/or final-year residents after ruling out contraindications. Firth’s logistic regression analysis was undertaken to determine odds ratios (ORs) and 95% confidence intervals (CIs) of factors predictive of successful outcomes.
Results: A total of 145 children with a mean age of 24 months were enrolled in the current study. The majority of patients 123 (84.8%) presented within 24 hours of symptom onset and colicky abdominal pain was the most common complaint 79 (54.5%). Ileocolic type and short-length intussusception were visualized more on ultrasound 135 (93.1) and 118 (81.4%), respectively. The overall reduction success rate was 93.1% [95% CI (89.0-97.2)]. Ten patients (13.5%) underwent surgery after a failed hydrostatic reduction with good postoperative outcomes. Reported duration of illness less than 24 hours Adjusted odds ratio (AOR) 6.77 (95% CI [1.25-30.42]) and length of intussusception less than 3.5 cm AOR 6.24 [95% CI (1.18-33.00)] were significantly associated with successful hydrostatic reduction outcomes.
Conclusion: We have found a high success rate of USGHR of intussusception in an implementation phase and a relatively low resource setup. Early presentation and short intussusception segments were favorably associated with successful outcomes.
Seasonal dynamics and geographic influences on the total ozone column in the Maceió region
Authors: de Souza Amaury , Takemura Celina M. , Özonur Deniz , de Medeiros Elias Silva , Pobocikova Ivana , Leivas Janice F. , de Oliveira-Júnior José Francisco , Rosalvo Kelvy Alencar Cardoso , Abreu Marcel Carvalho , Pansera Wagner Alessandro , Gautam Sneha 
Published: October 2024

Abstract

This study analyzes the Total Ozone Column (TCO) over six cities in the state of Alagoas, Brazil, with the objective of evaluating their spatial and temporal homogeneity and identifying seasonal and annual patterns over the period from 2008 to 2016. OCT is an important indicator for monitoring the ozone layer and its implications for public health, due to the role of ozone in filtering ultraviolet radiation. For the analysis, OCT data provided by satellite measurements were used, and the homogeneity of the variances was verified by means of the Bartlett test with a significance level of 95%. In addition, descriptive statistical analyses were performed to characterize the distribution of TCO values over time, and probability density functions (PDFs) were applied to identify the distribution that best fits the data. The results showed a significant homogeneity in the annual and seasonal concentrations of TCO, with an annual average of 263.24 ± 9.91 DU. The results indicated that the seasonal cycle of TCO is dominated by a biannual cycle, with two maximums and two minimums throughout the year, reflecting the influence of the Earth's orbit around the Sun and the photochemistry of ozone in the stratosphere. The highest seasonal average TCO was observed during the spring, while the lowest values occurred in the fall. The Normal distribution was identified as the one that best represents the data over the analyzed period. These patterns reflect the influence of the Brewer-Dobson Circulation, which contributes to the uniform distribution of ozone in the stratosphere, minimizing the impacts of atmospheric phenomena such as the Antarctic Polar Vortex. In conclusion, this study provides a comprehensive overview of TCO variability in six cities in Alagoas, highlighting the importance of continuous monitoring to understand atmospheric dynamics and their implications for health and the environment. The limitations of the work, such as the sensitivity of the statistical tests and the restricted geographic coverage, indicate the need for future studies to deepen the understanding of the factors that affect the distribution of ozone in the region.