bluuebunny/crossref_metadata_2025_split huggingface dataset:
Structure, Propagation of the 10–25-Day and 30–60-Day Intraseasonal Oscillations and Their Role in Triggering the South China Sea Summer Monsoon Onset
Authors: Ma Tian , Yu Weidong , Speich Sabrina , Luo Hao , Liao Jiayuan 
Published: August 2024

Abstract
The onset of the South China Sea (SCS) summer monsoon (SCSSM) is a complex process that involves multiscale variabilities, including the 10–25-day high-frequency intraseasonal oscillation (HISO) and the 30–60-day low-frequency intraseasonal oscillation (LISO) along with the seasonal variation. Using the reanalysis and satellite data during the period of 1979–2020, this study comprehensively investigates how the HISO and LISO trigger the SCSSM onset, which improves the understanding of the abrupt SCSSM onset from the point of intraseasonal view. It is clearly documented that in most years, the abrupt SCSSM onsets are triggered by the first branch of HISO and/or LISO propagating into the northern SCS along their distinctive pathways. The HISOs (LISO) originating from the northwestern Pacific Ocean (tropical eastern Indian Ocean) propagates westward (northeastward) toward central-to-northern SCS. The diagnosis based on the moist static energy (MSE) budget reveals the different governing mechanisms of HISO and LISO propagations. HISO’s westward propagation is favored by the zonal advection of the anomalous MSE by the mean easterly wind. In contrast, the surface turbulent heating by sea surface temperature (SST) is the dominant term for LISO’s northward propagation, followed by the meridional advection of the anomalous MSE by the mean southerly wind.

Significance Statement
This study provides the comprehensive intraseasonal view of the SCSSM onset, where the respective roles of 10–20-day HISO and 30–60-day LISO in triggering the SCSSM onset are identified and their propagating mechanisms are revealed. The prevailing easterlies in the northwestern Pacific and SST-induced turbulent heat flux in SCS are confirmed as the respective dominant processes governing their distinct propagations. These results improve the understanding of the SCSSM onset and hence have significant implication to the monitoring, simulation, and prediction of SCSSM.
Shared decision-making in healthcare: development and assessment of the translated Finnish version of the SDM-Q-9
Authors: Rosenlund Milla , Turja Tuuli , Saranto Kaija , Kuusisto Hanna , Jylhä Virpi 
Published: August 2024

Aims: The aim of this study was to assess the cultural validity and reliability of a Finnish version of the nine-item Shared Decision-Making Questionnaire (SDM-Q-9) in a sample of patients with different sociodemographic characteristics. Method: The original SDM-Q-9 was translated into Finnish with the agreement of the developers of the original scale. The standardised translation procedure was followed by a pilot test of the questionnaire. The data were collected from an online questionnaire. Reliability was estimated by Cronbach’s alpha. Structural validity of the questionnaire was assessed by confirmatory factor analysis. Results: The pilot study assessing the cultural validity of the scale was a success, as it did not find any expressions needing to be revised. The Finnish version of the SDM-Q-9 – the SDM-Q-9-FIN – was tested in the study where a total of 736 patients responded to the questionnaire. The questionnaire yielded high reliability with a Cronbach’s alpha of 0.92. Confirmatory factor analysis confirmed the unidimensional factor structure with Item 1 excluded. Conclusions: The SDM-Q-9-FIN was shown to be a reliable instrument for evaluating shared decision-making among Finnish patients. Further testing and research are recommended among a greater diversity of patient groups.
Vaginal Health: Insights, Views & Attitudes (VIVA) survey - Canadian cohort
Authors: Frank Sheldon M , Ziegler Cleve , Kokot-Kierepa Marta , Maamari Ricardo , Nappi Rossella E 
Published: August 2024

Objective To evaluate knowledge of vaginal atrophy among postmenopausal women (aged 55-65 years), using the Vaginal Health: Insights, Views & Attitudes (VIVA) survey. Methods An independent research organization conducted a quantitative Internet-based survey, to obtain information from 3520 women who were living in the UK. the USA, Canada, Sweden, Denmark, Finland or Norway. Findings from Canada are presented ( n = 500). Results Almost half of Canadian respondents had experienced vaginal discomfort since they had stopped menstruating, most commonly (88%) vaginal dryness; over half (56%) reported having experienced symptoms for three years or longer. Seven percent would have attributed vaginal symptoms to vaginal atrophy. Eighty-two percent of women felt that vaginal discomfort would have a negative impact on various aspects of their lives, most notably sexual intimacy (72%), ‘having a loving relationship with a partner’ (39%) and ‘overall quality of life’ (30%). While the majority of women (66%) who had experienced vaginal atrophy eventually sought the assistance of a health-care professional, a considerable proportion (34%) did not. Most women (58%) had tried lubricating gels and creams to treat their symptoms, but many were less aware of specific means of treating the underlying cause. However, compared with systemic hormone replacement therapy, more women indicated that they would consider local estrogen therapy (e.g. vaginal tablets or creams). Conclusions These data indicate that many postmenopausal women in Canada have a low understanding of vaginal atrophy. Medical practitioners should proactively initiate dialogue about this chronic condition with their patients, and discuss appropriate treatment options.
Early clinical effect of cladribine in patients with highly active multiple sclerosis in Mexico
Authors: Sauri-Suarez Sergio , Quiñones Sandra , De la Maza-Flores Manuel , Marin-Contreras Arturo , Playas-Pérez Gil , Bertado-Cortes Brenda , Frias-Marquez Francisco , Zuñiga-García Gilberto , Rodriguez-Leal Francisco , Blaisdell-Vidal Carlos , Gomez-Figueroa Enrique 
Published: August 2024

Background Cladribine shows efficacy in multiple sclerosis (MS), but Latin American (LATAM) real-world data is limited, despite potential sociodemographic variations. Objective Investigate baseline characteristics and clinical response in highly active MS patients in Mexico, identifying predictors of early treatment response. Method A multicenter cohort study analyzed retrospective data from individuals with “highly active” MS in the Cladribine Patient Support Program across 11 Mexican clinics. Criteria included one-year prior treatment with another disease-modifying treatment and recent relapse with specific MRI findings. Primary outcomes focused on achieving NEDA-3 status after 12 months. Results In the follow-up, 67.5% maintained NEDA-3 status. Baseline EDSS scores decreased significantly from 1.50 to 1.00 ( p = 0.011), with no confirmed disability worsening. No significant differences were observed between NEDA-3 achievers and non-achievers in demographic and clinical variables. No severe adverse events were reported. Conclusion Cladribine showed early and effective control of active MS in Mexican patients, demonstrating a secure profile with minimal adverse events. This study provides valuable real-world evidence in the LATAM context.
Association of blood inflammatory phenotypes and asthma burden in children with moderate-to-severe asthma
Authors: Alizadeh Bahmani Amir Hossein , Vijverberg Susanne J.H. , Hashimoto Simone , Wolff Christine , Almqvist Catarina , Bloemsma Lizan D. , Brandstetter Susanne , Corcuera-Elosegui Paula , Gorenjak Mario , Harner Susanne , Hedman Anna M. , Kabesch Michael , López-Fernández Leyre , Kraneveld Aletta D. , Neerincx Anne H. , Pino-Yanes Maria , Potočnik Uroš , Sardón-Prado Olaia , Dierdorp Barbara S. , Dekker Tamara , Metwally Nariman K.A. , Duitman Jan Willem , Lutter René , Brinkman Paul , Abdel-Aziz Mahmoud I. , Maitland-van der Zee Anke H. 
Published: August 2024

BackgroundUnderlying immunological mechanisms in children with moderate-to-severe asthma are complex and unclear. We aimed to investigate the association between blood inflammatory parameters and asthma burden in children with moderate-to-severe asthma.MethodsBlood inflammatory parameters (eosinophil and neutrophil counts and inflammatory mediators using multiplex immunoassay technology) were measured in children (6–17 years) with moderate-to-severe asthma from the SysPharmPediA cohort across four European countries. Based upon low/high blood eosinophil (LBE/HBE) counts of </≥0.3×109·L−1, respectively and low/high blood neutrophil (LBN/HBN) counts of </≥4×109·L−1, respectively, mixed (HBE-HBN), eosinophilic (HBE-LBN), neutrophilic (LBE-HBN) and paucigranulocytic (LBE-LBN) phenotypes were defined. Inflammatory mediator profiles and burden of disease (asthma control status, exacerbations and school days missed in the past year) were compared between phenotypes using adjusted logistic regression models.ResultsAmong 126 included children (41% girls and mean (sd) age of 11.94 (2.76)), 22%, 44%, 11% and 23% were classified as mixed, eosinophilic, neutrophilic and paucigranulocytic phenotypes, respectively. Neutrophilic children had the lowest lung function (forced expiratory volume in 1 s % predicted pre-salbutamol) compared with other groups. Children with mixed asthma were most often uncontrolled and had the highest asthma-related school absence in the past year. Interleukin (IL)-6 and matrix metalloproteinase-9 levels were significantly higher in patients with mixed or neutrophilic asthma, whereas tissue inhibitor of metalloproteinase-2 was lower in patients with neutrophilic asthma compared with eosinophilic or paucigranulocytic asthma. IL-5 was increased in eosinophilic group compared with the neutrophilic and paucigranulocytic groups, irrespective of the chosen cut-off for eosinophilia.ConclusionDifferences in asthma burden-related clinical expression and distinct blood inflammatory mediator profiles were found between phenotypes, highlighting implications for optimising personalised treatment and management strategies in children with moderate-to-severe asthma.
Anti-interleukin-5/anti-interleukin-5 receptor α treatment improves self-reported work productivity in patients with severe eosinophilic asthma: a prospective cohort trial
Authors: Brinkmann Lina , Fuge Jan , Welte Tobias , Suhling Hendrik , Drick Nora 
Published: August 2024

BackgroundSevere asthma affects the working life of millions of people worldwide. Interleukin (IL)-5/anti-interleukin-5 receptor α (IL-5Rα) antibodies are highly effective in reducing symptoms in patients with severe eosinophilic asthma. We analysed effects of anti-IL-5/anti-IL-5Rα treatment on self-reported productivity and absenteeism at work in patients with severe eosinophilic asthma.MethodsIn this prospective single-centre study, patients with severe eosinophilic asthma received a questionnaire assessing their actual occupational status and the influence asthma has on their work life, productivity and missed days at work prior to initiation of antibody treatment and after 6 and 12 months of therapy. Among others, the Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI:SHP) was used.ResultsOut of 54 patients with a median age of 60 years, 27 (50%) were employed. In addition to an increase in asthma control and lung function, self-reported productivity increased significantly with a decrease on the WPAI:SHP from 30% (interquartile range (IQR) 20–50%) to 10% (IQR 0–27.5%) under treatment (p=0.001). Furthermore, self-reported missed days at work were reduced from 2 days·month−1(IQR 1.75–6 days·month−1) to 0 days·month−1(IQR 0–2 days·month−1; p=0.067). At baseline 22 employed patients (81%) stated they were affected at work by their asthma. After 12 months of treatment, this number decreased to eight patients (30%; p=0.038).ConclusionsThis prospective analysis could prove the substantial impact severe asthma has on patients’ working life. Anti-IL-5/anti-IL-5Rα treatment in patients with severe eosinophilic asthma leads to a significant increase in self-reported productivity at work, and after 12 months of treatment patients state substantially fewer negative effects on their working situation.
Biomarkers troponin and procalcitonin in addition to CRB-65 enhance risk stratification in patients with community-acquired pneumonia
Authors: Farhat Imrana , Rosolowski Maciej , Ahrens Katharina , Lienau Jasmin , Ahnert Peter , Pletz Mathias , Rohde Gernot , Rupp Jan , Scholz Markus , Witzenrath Martin ,   the CAPNETZ Study Group
Published: August 2024

BackgroundCommunity-acquired pneumonia (CAP) remains a leading cause of infectious disease mortality globally, necessitating intensive care unit (ICU) admission for ∼10% of hospitalised patients. Accurate prediction of disease severity facilitates timely therapeutic interventions.MethodsOur study aimed to enhance the predictive capacity of the clinical CRB-65 score by evaluating eight candidate biomarkers: troponin T high-sensitive (TnT-hs), procalcitonin (PCT), N-terminal pro-brain natriuretic peptide, angiopoietin-2, copeptin, endothelin-1, lipocalin-2 and mid-regional pro-adrenomedullin. We utilised a machine-learning approach on 800 samples from the German CAPNETZ network (competence network for CAP) to refine risk prediction models combining these biomarkers with the CRB-65 score regarding our defined end-point: death or ICU admission during the current CAP episode within 28 days after study inclusion.ResultsElevated levels of biomarkers were associated with the end-point. TnT-hs exhibited the highest predictive performance among individual features (area under the receiver operating characteristic curve, AUC=0.74), followed closely by PCT (AUC=0.73). Combining biomarkers with the CRB-65 score significantly improved prediction accuracy. The combined model of CRB-65, TnT-hs and PCT demonstrated the best balance between high predictive value and parsimony, with an AUC of 0.77 (95% CI: 0.72–0.82), while CRB-65 alone achieved an AUC of 0.67 (95% CI: 0.64–0.73).ConclusionOur findings suggest that augmenting the CRB-65 score with TnT-hs and PCT enhances the prediction of death or ICU admission in hospitalised CAP patients. Validation of this improved risk score in additional CAP cohorts and prospective clinical studies is warranted to assess its broad clinical utility.
Therapeutic doses of efzofitimod demonstrate efficacy in pulmonary sarcoidosis
Authors: Obi Ogugua Ndili , Baughman Robert P. , Crouser Elliott D. , Julian Mark W. , Locke Landon W. , Chandrasekaran Abhijeeth , Ramesh Pavithra , Kinnersley Nelson , Niranjan Vis , Culver Daniel A. , Sporn Peter H.S. 
Published: August 2024

BackgroundIn a phase 1b/2a clinical trial of efzofitimod in patients with corticosteroid-requiring pulmonary sarcoidosis, treatment resulted in dose-dependent improvement in key end-points. We undertook apost hocanalysis pooling dose arms that achieved therapeutic concentrations of efzofitimod (Therapeutic group)versusthose that did not (Subtherapeutic group).MethodsPeripheral blood mononuclear cells incubated with tuberculin-coated beads were exposed to varying concentrations of efzofitimod in anin vitroassay to determine concentrations that inhibited granuloma formation. In thepost hocanalysis, we compared time-to-first-relapse and changes in pulmonary function after a protocolised corticosteroid taper in the Therapeutic and Subtherapeutic groups.ResultsEfzofitimod at ≥300 nM (19 µg·mL−1) inhibited granuloma formationin vitro. Based on mean efzofitimod serum concentrations achieved in the phase 1b/2a study, the 3 and 5 mg·kg−1dose arms were pooled as the Therapeutic group, while the 1 mg·kg−1arm was pooled with the placebo arm as the Subtherapeutic group. Relapse rates were 54.4% and 7.7% in the Subtherapeutic group and Therapeutic group, respectively. Median time-to-first-relapse in the Subtherapeutic group was 126 days, whereas in the Therapeutic group, only one of 17 patients relapsed by the end of the 24-week study (p=0.017). Slopes analysis showed that forced vital capacity increased in the Therapeutic group, but decreased in the Subtherapeutic group, over the course of the trial (p=0.035).ConclusionTreatment with efzofitimod at therapeutic doses, as compared with a subtherapeutic dose or placebo, was associated with a lower rate of relapse as corticosteroids were tapered.
Financial strain and social support as moderators of the relationship between living alone and depressive symptoms in older people
Authors: Chen Tsui-Fang , Pien Li-Chung , Fan Chun-Sung , Liang Kai-Lin , Chiu Yi-Wen 
Published: August 2024

AbstractThis study investigated the moderating effect of financial strain or social support on depressive symptoms among older people living alone in Taiwan. Data were collected from the “Taiwan Longitudinal Study on Aging (TLSA),” which included 1513 participants aged 65 and over, among them, 153 (10.1%) were living alone, while 1360 (89.9%) were living with others. Measurement tools included the Depression scale (CES-D), financial stress scale, social support scale, ADL scale, IADL scale, and stress scale, with Cronbach’s α coefficients were 0.85, 0.78, 0.67, 0.91, 0.90, and 0.70 respectively. Hierarchical multiple regression was used to examine the moderator effect. The findings revealed that (1) Financial strain was found to moderate the relationship between living alone and depressive symptoms, acting as a promotive moderator among older men living alone. For older women, financial stress does not moderate the relationship between living alone and depressive symptoms. However, financial strain was also identified as a significant factor associated with depressive symptoms among older women living alone. (2) Social support does not moderate effect on the relationship between living alone and depressive symptoms in older men or older women. These results underscore the importance of considering financial stress in mental health policy development by government agencies. It is imperative to address the unique challenges faced by older individuals living alone, particularly in relation to financial strain, in order to promote their mental well-being.
Paxlovid reduces the 28-day mortality of patients with COVID-19: a retrospective cohort study
Authors: Zong Kaican , Xu Li , Luo Chun , Luo Chen , Liu Bin , Chen Jiacheng , Wu Huizi , Liu Zhiqiang , Zhuang Rongjuan , Guo Shuliang 
Published: August 2024

Abstract
Purpose
In this study, we aim to explore the efficacy of paxlovid on reducing mortality of COVID-19 patients in clinical setting, especially whether paxlovid modifies the risk of death in these severe and critical patients.

Methods
Our retrospective cohort study was conducted on the medical records of patients, consecutively admitted for COVID-19 to five hospitals in Chongqing, China from Dec 8, 2022 to Jan 20, 2023. Based on whether patients received paxlovid during their hospitalization, patients were grouped as paxlovid group and non-paxlovid group. We used 1:1 ratio propensity score matching (PSM) in our study to adjust for confounding factors and differences between groups. Statistical analysis were performed by SPSS 23.0. The differences in 28-day mortality between these two groups and its influencing factors were the main results we focused on.

Results
There were 1018 patients included in our study cohort. With 1:1 ratio PSM, each of the paxlovid group and non-paxlovid group included 237 patients. The results showed that patients using paxlovid have a lower 28-day mortality in overall population either before PSM (OR 0.594, 95% CI 0.385–0.917, p = 0.019) or after PSM (OR 0.458, 95% CI 0.272–0.774, p = 0.003) with multivariable adjusted logistic regression models. Meanwhile, in severe subgroup, it showed similar findings.With paxlovid treatment, it showed a significantly lower 28-day mortality in severe subgroup both before PSM (28% vs.41%, p = 0.008) and after PSM (19% vs.32%, p = 0.007).

Conclusion
Paxlovid can significantly reduce the risk of 28-day mortality in overall population and severe subgroup patients.This study distinguished the severe subgroup patients with COVID-19 who benefit more from paxlovid treatment.
A case report of empyema caused by Enterococcus gallinarum
Authors: Liu Min , Liu Jixiang , Wu Juanjuan , Liu Shuang , Sun Lu , Li Fajiu , Li Chenghong 
Published: August 2024

Abstract
Background
Enterococcus gallinarum is an infrequently intestinal symbiotic pathogen associated with nosocomial infection in immunocompromised individuals. To date, rare cases of pulmonary infection attributable to Enterococcus gallinarum were reported. Herein, we presented the first case of empyema resulting from Enterococcus gallinarum infection.

Case presentation
An 81-year-old male presented with fever and dyspnea upon admission. Chest CT scan and thoracic ultrasonography confirmed the presence of right pleural effusion. Thoracoscopy revealed extensive adhesion, purulent fluid, and necrotic materials within the thoracic cavity. Enterococcus gallinarum was identified through pleural effusion culture. The patient underwent an intrathoracic injection of urokinase along with thoracic drainage. Following surgery, He took oral linezolid for over one month. Undergoing comprehensive treatment, the patient exhibited favorable recovery.

Conclusions
We reported the first case of empyema due to Enterococcus gallinarum infection. It should be suspected in patients with impaired immune function and invasive therapies, without responding to conventional anti-infectious treatment.
Nomograms established for predicting microvascular invasion and early recurrence in patients with small hepatocellular carcinoma
Authors: Wang Xi , Chai Xinqun , Zhang Ji , Tang Ruiya , Chen Qinjunjie 
Published: August 2024

Abstract
Background
In this study, we aimed to establish nomograms to predict the microvascular invasion (MVI) and early recurrence in patients with small hepatocellular carcinoma (SHCC), thereby guiding individualized treatment strategies for prognosis improvement.

Methods
This study retrospectively analyzed 326 SHCC patients who underwent radical resection at Wuhan Union Hospital between April 2017 and January 2022. They were randomly divided into a training set and a validation set at a 7:3 ratio. The preoperative nomogram for MVI was constructed based on univariate and multivariate logistic regression analysis, and the prognostic nomogram for early recurrence was constructed based on univariate and multivariate Cox regression analysis. We used the receiver operating characteristic (ROC) curves, area under the curves (AUCs), and calibration curves to estimate the predictive accuracy and discriminability of nomograms. Decision curve analysis (DCA) and Kaplan-Meier survival curves were employed to further confirm the clinical effectiveness of nomograms.

Results
The AUCs of the preoperative nomogram for MVI on the training set and validation set were 0.749 (95%CI: 0.684–0.813) and 0.856 (95%CI: 0.805–0.906), respectively. For the prognostic nomogram, the AUCs of 1-year and 2-year RFS respectively reached 0.839 (95%CI: 0.775–0.903) and 0.856 (95%CI: 0.806–0.905) in the training set, and 0.808 (95%CI: 0.719–0.896) and 0.874 (95%CI: 0.804–0.943) in the validation set. Subsequent calibration curves, DCA analysis and Kaplan-Meier survival curves demonstrated the high accuracy and efficacy of the nomograms for clinical application.

Conclusions
The nomograms we constructed could effectively predict MVI and early recurrence in SHCC patients, providing a basis for clinical decision-making.