bluuebunny/crossref_metadata_2025_split huggingface dataset:
Machine-learning based risk prediction of in-hospital outcomes following STEMI: the STEMI-ML score
Authors: Sritharan Hari P. , Nguyen Harrison , Ciofani Jonathan , Bhindi Ravinay , Allahwala Usaid K. 
Published: October 2024

BackgroundTraditional prognostic models for ST-segment elevation myocardial infarction (STEMI) have limitations in statistical methods and usability.ObjectiveWe aimed to develop a machine-learning (ML) based risk score to predict in-hospital mortality, intensive care unit (ICU) admission, and left ventricular ejection fraction less than 40% (LVEF &lt; 40%) in STEMI patients.MethodsWe reviewed 1,863 consecutive STEMI patients undergoing primary percutaneous coronary intervention (pPCI) or rescue PCI. Eight supervised ML methods [LASSO, ridge, elastic net (EN), decision tree, support vector machine, random forest, AdaBoost and gradient boosting] were trained and validated. A feature selection method was used to establish more informative and nonredundant variables, which were then considered in groups of 5/10/15/20/25/30(all). Final models were chosen to optimise area under the curve (AUC) score while ensuring interpretability.ResultsOverall, 128 (6.9%) patients died in hospital, with 292 (15.7%) patients requiring ICU admission and 373 (20.0%) patients with LVEF &lt; 40%. The best-performing model with 5 included variables, EN, achieved an AUC of 0.79 for in-hospital mortality, 0.78 for ICU admission, and 0.74 for LVEF &lt; 40%. The included variables were age, pre-hospital cardiac arrest, robust collateral recruitment (Rentrop grade 2 or 3), family history of coronary disease, initial systolic blood pressure, initial heart rate, hypercholesterolemia, culprit vessel, smoking status and TIMI flow pre-PCI. We developed a user-friendly web application for real-world use, yielding risk scores as a percentage.ConclusionsThe STEMI-ML score effectively predicts in-hospital outcomes in STEMI patients and may assist with risk stratification and individualising patient management.
Exodontia curriculum evaluation: fit for purpose teaching and learning strategies
Authors: Behardien Nashreen , Titus Simone , Roman Nicolette V. 
Published: October 2024

IntroductionCurriculum review is crucial for ensuring health professions education programs remain responsive and relevant. Teaching and learning (T&amp;L) strategies facilitate knowledge acquisition, with traditional methods being supplemented by innovative techniques in a blended curriculum. This study evaluated an Exodontia Block Course (EBC) focused on tooth extraction skills, utilizing a blended-learning approach across three learning environments: classroom, preclinical skills laboratory, and clinical training platform.MethodsA qualitative study employed appreciative inquiry for data collection and analysis. Focus group discussions were conducted with 30 participants: 13 undergraduate students, 10 clinical teachers, and 7 dental practitioners. Data underwent coding and thematic analysis.ResultsTwo main themes relevant to this paper emerged: “Block course structure” and “Recommendations for improvement.” Participants affirmed the blended-learning approach, highlighting strengths like demonstrations, videos, activity workbooks, and assessments that supported learning. Recommendations included integrating more visual technologies, simulated patients, peer-learning, debriefing, case reviews, community-based learning, and dedicated skills laboratories.DiscussionWhile the traditional course adequately achieved its objectives, opportunities for enhancement were identified. Incorporating advanced educational technologies, simulation-based activities, and structured feedback mechanisms could optimize skills development. Real-world clinical experiences and peer-assisted learning may reinforce knowledge and foster competencies like clinical reasoning. Continued curriculum refinement through stakeholder feedback is essential for delivering effective, student-centered dental education, and by inference, improved patient care.
The dynamic immune response of the liver and spleen in leopard coral grouper (Plectropomus leopardus) to Vibrio harveyi infection based on transcriptome analysis
Authors: Liu Yang , Lu Sheng , Guo Mengqi , Wang Ziyuan , Hu Bowen , Zhou Bo , Chen Songlin 
Published: October 2024

Leopard coral grouper (Plectropomus leopardus) is one of the most important cultured fish in the Pacific and Indian oceans. Vibrio harveyi is a serious pathogen causing serious skin ulceration and high mortality in P. leopardus. To gain more insight into the tissue-specific and dynamic immune regulation process of P. leopardus in response to V. harveyi infection, RNA sequencing (RNA-seq) was used to examine the transcriptome profiles in the spleen and liver at 0, 6, 12, 24, 48, and 72 h post-infection. The upregulated differentially expressed genes (DEGs) were predominantly involved in the immune response in the spleen and liver at the early infection stage (6–12 h), and downregulated DEGs were mainly involved in metabolic processes in the liver at the early and middle infection stage (6–48 h). Moreover, an overview of the immune response of P. leopardus against V. harveyi was exhibited including innate and adaptive immune-related pathways. Afterwards, the results of WGCNA analysis in the spleen indicated that TAP2, IRF1, SOCS1, and CFLAR were the hub genes closely involved in immune regulation in the gene co-expression network. This study provides a global picture of V. harveyi-induced gene expression profiles of P. leopardus at the transcriptome level and uncovers a set of key immune pathways and genes closely linked to V. harveyi infection, which will lay a foundation for further study the immune regulation of bacterial diseases in P. leopardus.
Efficacy of vitamin D supplementation on depressive symptoms in older patients: a meta-analysis of randomized controlled trials
Authors: Fu Jiamin , Zhang Yuchi , Chen Xiaoyu , Yu Xing , Yan Maoxin , Jing Biying , Yu Hongjuan , Li Wenzhen , Guo Qi 
Published: October 2024

BackgroundThe relationship between vitamin D and depression has garnered significant attention in recent years. However, the efficacy of vitamin D in ameliorating depression among specific subgroups of older patients remains controversial. This study aimed to assess the impact of vitamin D supplementation on depressive symptoms and the prevalence of depression in older adults. Additionally, the study sought to examine potential moderating factors, including differences among population subgroups and various supplementation strategies.MethodsA systematic literature search was conducted in the databases PubMed, EMBASE, Web of Science, and the Cochrane Library up to March 2024. The RevMan 5.3 software was utilized to calculate the standardized mean difference (SMD) and to evaluate the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The objective was to determine the efficacy of vitamin D supplementation in alleviating depressive symptoms or treating depression in older adults.ResultsThis meta-analysis encompassed eleven studies, comprising a total of 21,561 participants. The findings did not indicate a statistically significant therapeutic benefit of vitamin D supplementation for depression in older patients [SMD: −0.10; 95% CI: (−1.19, 0.00); p = 0.05]. Subgroup analyses revealed that the efficacy of vitamin D intervention in geriatric depression correlated with several factors, including baseline serum 25(OH)D levels, the dosage of the intervention, gender, and the initial presence of depressive symptoms or a diagnosis of depression.ConclusionThe current evidence is insufficient to conclusively establish the significant efficacy of vitamin D supplementation in alleviating depressive symptoms among older patients. Consequently, additional randomized controlled trials are warranted to further validate the relationship between vitamin D supplementation and depression in the older adults.
CT gastrography and enterography retrospective analysis: thickened diaphragm crura is a false indication for a gastric fundic tumor
Authors: Zhang Xin , Wen Ying , Wang Qi , Chen Manman , Yang Ming , Han Xiaoyu , Tang Wenjuan , Shi Heshui 
Published: October 2024

ObjectivesTo mitigate the incidence of misdiagnosis and distinguish between gastric fundic tumors (GFTs) and thickened diaphragmatic crura (TDC).Materials and methodsComputed tomographic enterography (CTE) data from 3844 cases and computed tomographic gastrography (CTG) data from 4351 cases were retrospectively analyzed. A total of 105 cases were selected and categorized into three groups: 47 cases with TDC examined via CTE, 31 with adenocarcinoma, and 27 with gastrointestinal stromal tumors (GIST) examined via CTG. Inter-group differences in age, sex distribution, mass dimensions, mass-stomach interface (MSI), chief complaints, gastric underlying diseases, and enhancement patterns were analyzed.ResultsThe misdiagnosis rate of TDC as a tumor by radiologists is approximately 1.2% (47/3844). Age (p&lt;0.05), sex ratio (p&lt;0.05), mean mass size (p&lt;0.05), chief complaint (p&lt;0.05) and mass-stomach interface (MSI, p&lt;0.05) were significantly different among patients with GIST, adenocarcinoma and TDC. The contrast enhancement pattern of TDC markedly differed from that observed in adenocarcinoma (p&lt;0.05) and GIST (p&lt;0.05) patients.ConclusionsMisdiagnosis of GFTs is occasionally and may be challenging to differentiate from TDC using CTE. To drastically lower the chance of misdiagnosis, this research aimed to assist radiologists in identifying and considering the possibility of TDC.
The efficiency of liposomal paclitaxel versus docetaxel in neoadjuvant chemotherapy with the TPF regimen for locally advanced nasopharyngeal carcinoma: a retrospective study
Authors: Yang Zhi , Zuo Quan , Liu Rong , Wu Hui , Chen Jia , Xiong Li , Jia Jieqi , Xiang Zhibi 
Published: October 2024

PurposeThis retrospective study aimed to explore the efficiency and untoward reaction of liposomal paclitaxel versus docetaxel for locally advanced nasopharyngeal carcinoma (NPC).MethodsThis retrospective study included 115 patients diagnosed with NPC at our hospital between January 2018 and December 2021. Patients were stratified into two groups based on their treatment with either liposomal paclitaxel (n = 71) or docetaxel (n = 44) as part of the neoadjuvant chemotherapy regimen. Objective response rate (ORR), progression-free survival (PFS), locoregional relapse-free survival (LRFS), distant metastasis-free survival (DMFS), and overall survival (OS) were compared between the two groups.ResultsORR was significantly improved in the liposomal paclitaxel group than in the docetaxel group (62.0% versus 40.9%, p = 0.028). The 3-year PFS (PFS: 84.4% versus 77.5%, p = 0.303), LRFS (95.8% versus 94.4%, p = 0.810), DMFS (87.2% versus 83.0%, p = 0.443), and OS (90.7% versus 88.8%, p = 0.306) revealed no significance. The neutrophil-to-lymphocyte ratio [hazard ratio (HR): 3.510; p = 0.039] and distant metastasis (HR: 4.384; p = 0.035) were regarded as the risk factors using multivariate regression analysis. Moreover, the incidence of leukopenia at grades 1–2 in the liposomal paclitaxel group was significantly lower than that in the docetaxel group (28.1% versus 79.5%, p &lt; 0.05).ConclusionsLiposomal paclitaxel had better efficacy in terms of short-term effects and lower incidence of leukopenia at grades 1–2 compared with the docetaxel group.
Measurements of enteral feeding intolerance in critically ill children: a scoping review
Authors: Li Yan , Fu Cong-Hui , Ju Min-Jie , Liu Ji , Yang Xiao-Ya , Xu Ting-Ting 
Published: October 2024

ObjectiveTo examine the measurements on enteral feeding intolerance (EFI) in critically ill children.MethodsThe Joanna Briggs Institute methods for conducting a scoping review were followed. Articles published since 2004 which assessed EFI in critically ill children were identified. A full search strategy was executed in seven English databases (MEDLINE, EMBASE, PubMed, Web of Science, Cochrane Central Register of Controlled Trials, JBI EBP, CINAHL) and four Chinese databases (CNKI, VIP, Wanfang, Sinomed). Two reviewers screened records according to our inclusion and exclusion criteria, and conducted a full-text review of selected articles. The reference lists of all studied selected were screened for additional sources. Relevant data was extracted using a researcher-developed tool.ResultsOf the 627 articles identified, 32 were included in this scoping review. Most articles focused on the measurement of high gastric residual volume (n = 22), followed by diarrhea (n = 20), and vomiting (n = 9). Most of the studies were of observational-analytic design (13/32) and experimental design (8/32).ConclusionThis scoping review addressed the complexity and diversity of EFI measurements. Given the importance of adequacy of enteral nutrient intake, we highlighted the necessary to develop individual measurements of EFI, taking the age of children and disease condition into consideration. Further studies can also investigate accurate and objective physiological measurements of EFI to advance EN and improve outcomes in critically ill children.
Network meta-analysis of treatment interventions for Helicobacter pylori infection in adult populations in East and Southeast Asia
Authors: Zhang Li , Li Bo-Ren , Guo Si-Tong , Li Yan 
Published: October 2024

BackgroundHelicobacter pylori (H. pylori) infection poses a global health challenge, necessitating diverse treatment strategies. This network meta-analysis aimed to assess various treatment regimens for H. pylori in East and Southeast Asian populations.MethodsA systematic search was conducted in PubMed, Embase, and the Cochrane Library databases from inception to 20 Dec 2023, to identify relevant randomized controlled trials (RCTs) on H. pylori treatment interventions in East Asian and Southeast Asian populations. The primary outcome focused on effectiveness, specifically the rate of H. pylori eradication, while the secondary outcome evaluated overall safety, including the incidence of total and serious adverse effects. Network geometry plots were generated to illustrate direct and indirect treatment comparisons, using triple therapy (TT) as the reference standard. Odds Ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects models to account for study heterogeneity and consistency models for indirect comparisons. The treatment hierarchy was assessed using the ranking probabilities and surface under the cumulative ranking curve (SUCRA) values.Results79 studies met the inclusion criteria, with 99 paired comparisons. The included studies, conducted in Southeast Asia and among East Asian populations, included 29,903 patients. Significant outcomes in treat effectiveness were observed in various comparisons, such as sequential therapy vs. TT, bismuth quadruple therapy (BQT) vs. TT, high-dose dual therapy (HDDT) vs. TT, concomitant therapy vs. TT, P-CAB-based therapy vs. TT, and R-HT/HT vs. TT. R-HT/HT was the top choice based on rankograms and SUCRA values (SUCRA = 96.5). Regarding overall safety, significant results were noted in comparisons involving BQT, HDDT, concomitant therapy, sequential therapy, and P-CAB-based therapy. HDDT achieved the highest overall safety based on rankograms and SUCRA values (SUCRA = 0.0). HDDT demonstrated the lowest incidence of serious adverse events, according to global rankograms and SUCRA values (SUCRA = 19.7).ConclusionThis network meta-analysis highlights the complexity of treating H. pylori in East and Southeast Asia. R-HT/HT emerged as the most effective regimen, while HDDT proved to be the safest, with the lowest incidence of serious adverse events. These findings are crucial for optimizing treatment protocols in these regions.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023435318.
Five weeks of dynamic finger flexor strength training on bouldering performance and climbing-specific strength tests. A randomized controlled trial
Authors: Saeterbakken Atle Hole , Bratland Erik , Andersen Vidar , Stien Nicolay 
Published: October 2024

The aim of the study was to examine the effects of a 5-week dynamic finger flexor strength training program on bouldering performance and climbing-specific strength tests. Advanced to elite level boulderers (n = 31) were randomized to a dynamic finger strength training group (DFS) or a control group (CON). The DFS training program consisted of 3 weekly sessions (3–5 sets, 4–10 repetitions per session). Both groups continued bouldering training as usual throughout the intervention period. Pre- and post-intervention measures included bouldering performance, maximal dynamic finger strength, isometric finger strength (peak and average force), and rate of force development (RFD). The DFS demonstrated greater improvement in dynamic finger strength (11.5%, 3.9 kg) than the CON (5.3%, 1.7 kg; p = 0.075, ES = 0.90), but there were no differences between the groups in 1RM (p = 0.075, ES = 0.67), bouldering performance (p = 0.39, ES = 0.35), isometric finger strength (p = 0.42–0.56, ES = 0.20–0.22) or RFD (p = 0.30, ES = 0.46). The DFS improved dynamic (p &lt; 0.01, ES = 1.83) and isometric peak and average (p &lt; 0.01, ES = 0.98, and p &lt; 0.01, ES = 0.75, respectively) finger strength, while the CON only increased dynamic finger strength (p &lt; 0.05, ES = 0.58). None of groups improved bouldering performance or RFD (p = 0.07–0.58). In conclusion, 5 weeks of DFS training improving dynamic strength to a greater extent than bouldering alone in addition to improving isometric finger strength among advanced boulderers. Isolated bouldering improved dynamic finger flexor strength, but importantly, increased finger strength (dynamic or isometric) did not improve bouldering performance.
Potential impact of the 2024 UK Parliamentary Elections: the long shadow of Brexit
Authors: Kurecic Petar , Kokotovic Filip 
Published: October 2024

IntroductionDespite the relative harmony of the Western states on essential security issues, the July 2024 parliamentary elections in the United Kingdom (the UK), ending with the overwhelming victory of the Labour Party, who has returned to power after 14 years, may have a significant impact on the relationship this country has with the European Union (the EU). Since Brexit, the diminished trade has contributed to a decline in the economy of the United Kingdom and it is one of the countries most significantly impacted by the “increasing cost of living” crisis.MethodsUsing an Impulse Response Function (IRF), this paper will assess the impact of a further decline of EU-UK relations as well as the policy implications of some proposals supported by significant fractions of the Conservative Party, namely tax cuts.Results and discussionThe paper concludes that a further decline in trade relations between the EU and the UK will lead to a further decline in the economy of the UK that has few feasible alternatives in terms of trading partners.
Relationship between social anxiety and sleep quality in depressed adolescents: the mediating role of internet addiction
Authors: Ma Yifan , Li Jingya , Zhang Meng , Zuo Tiantian , Kong Linghua , Yang Ying 
Published: October 2024

ObjectiveThis study investigated the association between social anxiety and sleep quality and further explored the potential mediating role of internet addiction in depressed adolescents.MethodsThis study included 440 Chinese depressed adolescents (mean age = 15.0 years, SD = 2.0). Participants completed questionnaires, including Social Avoidance and Social Distress Scale, Internet Addiction Test, and Pittsburgh Sleep Quality Index. A structural equation model was used to analyze the association between social anxiety and sleep quality, with internet addiction as a mediator. Gender differences were examined by multi-group analysis.ResultsAmong participants, 61.8% reported poor sleep quality. The sleep quality was significantly different on the level of gender (p = 0.016), education level (p = 0.043), and family history (p = 0.002). Sleep quality was positively associated with social anxiety (p &lt; 0.001) and internet addiction (p &lt; 0.001). Furthermore, internet addiction partially mediated the relationship between social anxiety and sleep quality, and the mediation effect ratio was 16.1% (p &lt; 0.001). Finally, no significant differences were found in this mechanism.ConclusionWe concluded that both social anxiety and internet addiction were risk factors for depressed adolescents’ poor sleep quality. Social anxiety further affected sleep quality through internet addiction.
The prevalence of functional disability and associated factors among older adults living in Bahir Dar City, Northwest, Ethiopia: a community-based cross-sectional study
Authors: Yihenew Addisu , Ejigu Anteneh Yeshambel , Miheret Tewodros , Gobezie Melese , Eriku Getachew Azeze , Yimer Shibabaw Yadelew , Kassa Tesfa 
Published: October 2024

BackgroundThe limitation of carry out everyday activities independently is a common experience for older adults with functional disabilities, which can hurt their overall well-being. Unfortunately, there is still a dearth of evidence about how common it is among older adults, especially in low-and middle-income countries like Ethiopia. Therefore, the study aimed to assess the prevalence and associated factors of functional disability among older adults living in Bahir Dar city, Northwest, Ethiopia, 2023.MethodA community-based cross-sectional study was conducted among older adults (≥60 years) living in Bahir Dar city, Northwest, Ethiopia. A total of 598 study participants were included using a multistage sampling technique. Data were collected through interviewer-administered questionnaires. Barthel Index (BI) was used to assess the functional capacity of older adults which comprises 10 items. The total score ranges from 0 to 100. Variables significant in bivariable analysis were entered into multivariable logistic regression analysis. A p &lt; 0.05 was considered statistically significant in the final logistic regression model.ResultsAmong the 598 participants studied, the overall prevalence of functional disability was 29.6 (95% CI: 26.0–33.4). Older age (≥70 years) {adjusted odds ratio(AOR: 2.24; 95% CI: 1.03–4.88)}, comorbidity (AOR: 2.96; 95% CI: 1.47–5.94), physically inactive (AOR: 2.42; 95% CI: 1.18–4.96), one and more drug users (AOR: 3.61; 95% CI: 2.12–6.15), cognitive impairment (AOR: 3.66; 95% CI: 2.26–4.93) and depression (AOR: 1.70; 95% CI: 1.08–2.68) were found significant associated factors of functional disabilities among older adults.ConclusionThis study found that nearly one-third of older adults had functional disabilities. Functional disability was significantly associated with factors such as increasing age, presence of comorbidities, being physically inactive, one and more drug users, who developed cognitive impairment, and having depression symptoms. Proactive measures need to be initiated to ensure proper care and support of functionally disabled individuals, especially targeting vulnerable groups identified in this study.