bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring a Novel Approach to Cybersecurity: The Role of Ecological Simulations on Cybersecurity Risk Behaviors
Authors: Abril Tiago , Gamito Pedro , Motta Carolina , Oliveira Jorge , Dias Fábio , Pinto Filipe , Oliveira Miguel 
Published: July 2024

Abstract

In response to the growing cybersecurity problem, this study presents an innovative approach using virtual reality to train individuals in reducing the risk of cyberattacks. The research involved 70 adult participants with or enrolled in higher education studies, who participated in a virtual reality task that simulates a typical workday in a corporate setting. The participants were divided into three groups: a control group of 24 engaged in tasks without cybersecurity threats, and two experimental groups of 23 each, with cybersecurity threats present, but one with feedback on performance and the other without feedback. The results revealed (1) that virtual reality shows promise as an effective tool to create immersive and ecological simulator experiences for cybersecurity training against cyberattacks, (2) the incorporation of feedback in real-world scenario simulators is crucial for participants to fully comprehend the complexities of cyber threats, and (3) risky behaviour within our virtual reality ecological setting, as well as age, can predict attitudes towards cybersecurity and cybercrime within organization. In conclusion, by taking advantage of this cutting-edge virtual reality approach, individuals, businesses, and governments can foster more secure cybersecurity practices, contributing to a safer digital landscape for everyone.
Racial Differences in Psychosocial Resources and Mental and Physical Health Outcomes during Pregnancy: A structural equation modeling approach
Authors: Farewell Charlotte V. , Schmiege Sarah J. , Leiferman Jenn 
Published: July 2024

Abstract

Objectives
Poor prenatal health is of particular concern among minoritized individuals who may experience adverse social determinants of health contributing to the intergenerational transmission of health disparities. The purpose of this study was to investigate associations between psychosocial resources, and mental and physical health among a prenatal sample, and to explore if these relationships vary by race.
Methods
English-speaking pregnant individuals living in the United States were recruited using Centiment (n=340). Participants completed a 121-item cross-sectional survey. We conducted a single- and multi-group structural equation model to test hypothesized relationships, and then investigated differences by pregnant White individuals versus Black, Indigenous, and People of Color (BIPOC).
Results
Our final single-group model exhibited good model fit (χ2 (43) = 99.07, p<.01, CFI = 0.97, SRMR = 0.04, and RMSEA = 0. 06 (0.05 - 0.08)). After controlling for demographic characteristics and social determinants of health, higher levels of mindfulness were statistically significantly related to lower anxiety and depression scores (both p<.01). Higher levels of social supports were statistically significantly related to lower anxiety scores. Scale measurement invariance was confirmed for the multi-group model and the structural model was statistically significantly different between pregnant White individuals and BIPOC in this sample (Δ χ2 (27) = 116.71, p <.01).
Conclusions
Identification of core components of psychosocial resource interventions, consideration of upstream structural determinants, mindfulness and valued-living (MVL)-based strategies, cultural adaptation, and an emphasis on resilience rather than psychopathology may result in improved prenatal health among pregnant individuals traditionally underrepresented in research.
The Effect of Baseline Thyroid Function on Weight Loss Outcomes in Euthyroid Individuals Undergoing Full Meal Replacement Therapy
Authors: Dent Robert , Cheng Ran , Bussières Alexandra , Elisha Belinda , Shiau Judy 
Published: July 2024

Abstract

Background Thyroid function plays a key role in regulating energy metabolism and thermogenesis, with thyroid dysfunction closely linked to alterations in body weight and composition. However, there is a lack of data on the effect of baseline thyroid function on weight loss outcomes in euthyroid individuals.Methods This study constitutes a secondary analysis utilizing prospectively collected data from a cohort study comprising individuals living with obesity (BMI > 30kg/m2 or ≥ 27 kg/m2 with comorbidities) and normal thyroid function participating in a weight management program, which incorporates full meal replacement therapy (FMR). The primary objective was to examine the association between baseline thyroid function and weight loss (WL) outcomes 6-week post-FMR initiation.Results A total of 1078 participants were included in the study: 67% female, aged 45.4±10.9 years, 64% had type 2 diabetes with an initial BMI of 45.0±7.6 kg/m2, and a baseline TSH and fT3 levels of 2.0±0.8 mIU/L and 4.5±2.6 pmol/L respectively. 6-week post-FMR initiation, there was significant correlation between the amount of WL and TSH levels (β:-0.473 IC95[-0.796; -0.150]). The percentage of WL between extreme TSH quantiles (Q1-Q5) were 8.1±1.8% vs 7.3±1.6% (p < 0.001). No correlation was found between WL and TSH levels at 12 weeks and fT3 levels at 6 and 12 weeks.Conclusion Within a cohort of euthyroid individuals living with obesity undergoing FMR, lower baseline TSH levels, not fT3 levels, were predictive of greater weight loss at 6-week. These findings suggest that this parameter might be an important weight loss outcomes predictive factor for euthyroid individuals with obesity.
Comparative study of trace metal concentration in the diagnosis of category III prostatitis
Authors: Lin Zhidi , Li Muyan , Zhang Mingjin , Gong Yimin , Gan Xiang , Liang Weiyuan , Tan Yanjun , Zhang Chong , Gao Qian , Yang Xiaoli 
Published: July 2024

Abstract

Background
Chronic prostatitis (CP) is one of the general diseases in daily diagnosis and treatment of urologists, especially category III prostatitis. Due to the lack of concrete causations, etiology and pathogenesis of chronic prostatitis, the diagnosis is still a distressful question for urologists.
Method
To investigate diagnostic potential of trace metals in this prostatitis, we performed analysis of concentration of zinc (Zn), copper (Cu), calcium (Ca) and magnesium (Mg) in expressed prostatic secretion (EPS) and serum of patients with category III prostatitis and healthy controls, using flame atomic absorption spectrometer (FAAS).
Results
Results showed contents of Zn, Ca and Mg in both serum and EPS samples of all subjects with category III prostatitis changed significantly compared to controls (all P<0.05), while Cu level changed in all EPS samples (P<0.000). In category IIIa prostatitis group, level of EPS Zn, Ca, Mg and serum Ca reduced significantly (all P<0.000), while level of Zn in serum raised markedly (P<0.000). In category IIIb prostatitis group, level of Zn, Ca, Mg in EPS decreased significantly (all P<0.05), level of serum Ca, Mg were lessened visibly (all P<0.000), EPS Cu level had an overt promotion (P<0.05). Moreover , ROC analysis showed Mg and Zn/Mg level in EPS had better diagnostic value in category IIIa prostatitis (AUC=0.796, 0.791, respectively, all P<0.0001); while in category IIIb prostatitis, Cu and Cu/Ca level had greater diagnostic value (AUC=0.880, 0.901, respectively, all P<0.0001).
Conclusion
Summarily, concentration of Zn, Ca, Mg plays an important role in this prostatitis, of which level of Mg, Cu, Zn/Mg, Cu/Ca in EPS may have potential diagnostic value for category III prostatitis.
Healthy Lives 5 Axis Scale for Individuals with Complex Health and Social Needs: Assessment of Validity and Reliability
Authors: White Henry , Gonzalez Peter , Shashar Sagi , Silver Zoe , Scott Hannah , Novack Victor 
Published: July 2024

Abstract

Background: The field of complex care management for patients with urgent health and social challenges has rapidly grown, leading to calls for improved tools for measuring quality and outcomes. Most available measures were not developed specifically for a clinical context with a population with complex needs. The Healthy Lives 5 Axis Scale (HL-5) was created to fulfill this role. This concise, multidimensional scale measures key domains, including health-related functioning, physical and social needs, capacity for self-care, access, and utilization. The purpose of this study was to determine the interrater and test-retest reliability and the construct and concurrent validity of the HL-5.
Methods: The study population includedadults who attended an appointment with a primary care physician at an urban community health center. The reliability assessment of the HL-5 questionnaire included test-retest ratings by the same scorer and between two different scorers. Criterion convergent validity was evaluated by comparing the HL-5 domains with relevant domains of external questionnaires using Pearson correlation coefficients (r). The comparison measures have a strong evidence base, are widely used, and are nonproprietary.
Results: There were 64 participants, with a mean age of 39.1. Test-Retest Reliability, measured by the intraclass coefficient (ICC), was greater than 0.8 for Functioning, Needs, Utilization, and Access, indicating very strong internal consistency and 0.754 for Self-Care, representing good internal consistency. Criterion Validity for the axes, assessed by each axis’ correlations with a criterion measure, was statistically significant at of p<0.05.
Conclusions: This study of the psychometric properties of the Healthy Lives 5 Axis Scale (HL-5) demonstrated its value for assessing patients with complex health and social needs. It showed high levels of reliability in a clinical setting with a diverse patient populations and strong correlations with well-established measures of functioning, needs, self-care, access, and utilization. HL-5 requires only a few minutes to complete and yields actionable results, demonstrating its potential for integration into the workflow of a primary care practice or care management program.
Optimizing Neonatal Care: The Advantages of Level 2 NICUs for Moderate and Late Preterm Infants
Authors: Alshaikh Belal , Murthy Prashanth , Soraisham Amuchou , Momin Sarfaraz , Mehrem Ayman Abou , Thomas Sumesh , Singhal Nalini 
Published: July 2024

Abstract

OBJECTIVE
To compare the length of hospital stay for moderate and late preterm infants (MLPIs) born at tertiary care (level III) perinatal centers versus secondary care perinatal centers (level II).
METHODS
This was a retrospective cohort study of MLPIs admitted to neonatal intensive care units (NICUs) in Calgary, Canada, between January 2016 and December 2017. We excluded infants with major congenital anomalies and planned palliative care. Multivariable logistic and quantile regression analyses were used to adjust for potential confounding factors.
RESULTS
Of 1958 infants who met inclusion criteria, 676 (34.5%) infants were born at a tertiary care perinatal center with a level III NICU, and 1284 (65.5%) were born in secondary care perinatal centers with a level II NICU. Infants born at level II centers had shorter durations of hospital stay (adjusted MD -1.0 day, 95% CI -1.7 to -0.4 and adjusted HR 1.15, 95% CI 1.04 to 1.28) and tube feeding (adjusted MD -2.2 day; 95% CI -2.9 to -1.4), and a higher rate of breastmilk feeding at discharge (aOR 1.34; 95%CI 1.01 to 1.77).
CONCLUSION
Delivery of MLPIs in facilities with secondary care perinatal centers is associated with shorter hospital stays and higher breastmilk feeding rates at discharge.
Development and validation of Cardiovascular disease risk prediction model for patients with Chronic kidney disease stage 3-5 within 5 years
Authors: Liu Huixia , Li Yujuan , Xiong Jing 
Published: July 2024

Abstract

Background and aims: Cardiovascular disease (CVD) is the leading reason for death in patients who are with chronic kidney disease (CKD). However, with progress of CKD, the ability of traditional CVD risk factors to predict clinical outcomes weakens, and non-traditional risk factors play a key role in the pathogenesis of CVD. Previous prediction models based only on traditional CVD risk show limitations and inaccuracies. Our study aims to develop and validate a prediction model for CVD risk including traditional and non-traditional risk factors in stage 3-5 CKD patients within 5 years in China.
Methods: 301 patients with CKD stage 3-5 were recruited from January 2010 to January 2022 and followed up till July 2022. Lasso regression and multivariate logistic regression were used to identify baseline predictors for model development, regression modeling was performed using logistic regression and internally validated using tenfold cross-validation. Discrimination and calibration of resulting prediction models were assessed using c-statistic and P-value of the Hosmer-Lemeshow test. Decision curve analysis was performed to assess clinical effectiveness.
Results: During follow-up, 169 developed first CVD events within 5 years. The median time of occurrence was 10 months. Of 29 clinical parameters, 11 variables were finally identified as significant predictors and included in the prediction model. 4 prediction models were created in a derivation cohort: original, inflammation, imaging and full model. Full model had the lowest AIC of 311.531 and P-value of 0.3319 of the Hosmer-Lemeshow test.
Conclusions: A nomogram was constructed to predict the risk of CVD for CKD patients.
Factors affecting postoperative nasal morphology after Le FortⅠosteotomy on multiple regression analysis
Authors: TOMOMATSU NOBUYOSHI , Nakamura Taishi , Matsumoto Shin , Takahara Namiaki , Nakakuki Koichi , YODA Tetsuya 
Published: July 2024

Abstract

External nasal morphology changes after LeFort I osteotomy, and various techniques including alar cinch suture, and subspinal osteotomy have been devised to accommodate these changes. However, despite various modifications, external nasal morphology may vary unexpectedly on an individual basis. Considering that the patient's external nasal morphology may be a contributing factor, this paper reports a retrospective study of the surgical technique and direction of maxillary movement in addition to the measurement of factors that comprise the external nasal morphology. Multiple regression analysis identified the patient's preoperative nasal width as a factor that increased the alar base width of the nose, in addition to the incision (oral vestibular incision) and the amount of anterior and superior movements at point A of the maxilla. The factors that caused the nasal apex to turn upward were the amount of anterior and superior movements at point A and the absence of subspinal osteotomy. The direction of surgical maxillary movement was influenced not only by anterior movement, but also by superior movement and surgical technique. Furthermore, the patient's preoperative nasal morphology was taken into consideration in determining the preoperative mode of movement.
The significance of cirrhosis in cases with intra-hepatic cholangiocarcinoma: A SEER-based retrospective cohort study
Authors: Wang Wen-Hui , Lin Hong-Jun , Lu Qing 
Published: July 2024

Abstract

Objective
To systematically evaluate the significance of cirrhosis in cases of intrahepatic cholangiocarcinoma (IHCC) concerning short and long-term outcomes.
Methods
Cases diagnosed with IHCC from 2000 to 2020 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Comparative analyses were conducted between cases with cirrhosis and those without cirrhosis.
Results
A total of 644 cases with sufficient staging information and cirrhosis data were ultimately included. Comparative analyses indicated that cirrhosis was more prevalent among male cases (72.3% vs 50.6%, P < 0.001). Similar tumor differentiation status was observed between the two groups (P = 0.510). Cases without cirrhosis exhibited a higher incidence of T3-T4 disease (19.3% vs 12.2%, P = 0.025). Radiotherapy (3.3% vs 7.9%, P = 0.024), chemotherapy (45.5% vs 56.8%, P = 0.007), and surgery (37.1% vs 47.1%, P = 0.016) were more frequently performed among cases without cirrhosis. Cirrhosis was identified as a risk factor with minimal impact on survival but was not a prognostic factor. Even after matching, cases with cirrhosis still demonstrated a comparable long-term prognosis compared to those without cirrhosis.
Conclusion
Cirrhosis represents a risk factor rather than a prognostic factor for IHCC cases. While cirrhotic cases may have a lower resectability rate, their overall prognosis is similar to that of non-cirrhotic cases.
Safety and pharmacokinetics of subcutaneous administration of broadly neutralizing anti-HIV-1 monoclonal antibodies (bNAbs), given to HIV-1 exposed, uninfected neonates and infants: study protocol for a phase I trial Acronym: PedMAb1
Authors: Goga Ameena , Ramraj Trisha , Naidoo Logashvari , Daniels Brodie , Matlou Masefetsane , Chetty Terusha , Dassaye Reshmi , Ngandu Nobubelo , Galli Laura , Reddy Tarylee , Seocharan Ishen , Ndlangamandla Qondeni , September Qholokazi , Ngcobo Nokwanda , Reddy Mayuri , Cafun-Naidoo Tamon , Woeber Kubashni , Jeenarain Nitesha , Imamdin Rabia , Keshnee Maharajh , Ramjeth Ashmintha , Bhengu Thobile , Clarence Emma , de perre Philippe van , Tylleskar Thorkild , Nagot Nicolas , Moles Jean-Pierre , Moore Penny L. , Mkhize Nonhlanhla N. , Gama Lucio , Dispinseri Stefania , Biswas Priscilla , Scarlatti Gabriella 
Published: July 2024

Abstract

Background:
The ambitious goal to eliminate new pediatric HIV infections by 2030 requires accelerated prevention strategies in high-risk settings such as South Africa. One approach could be pre-exposure prophylaxis (PrEP) with broadly neutralizing anti-HIV-1 monoclonal antibodies (bNAbs). The aim of our study is to define the optimal dose(s), the ideal combination(s) of bNAbs in terms of potency and breadth, and timing of subcutaneous (SC) administration(s) to prevent breast milk transmission of HIV.
Methods:
Two bNAbs, CAP256V2LS and VRC07-523LS, will be assessed in a sequential and randomized phase I, single-site, single-blind, dose-finding trial. We aim to investigate the 28-day safety and pharmacokinetics (PK) profile of incrementally higher doses of these bNAbs in breastfeeding HIV-1 exposed born without HIV neonates alongside standard of care antiretroviral (ARV) medication to prevent (infants) or treat (mothers) HIV infection.
The trial design includes 3 steps and 7 arms (1, 2, 3, 4, 5, 6 and 6b) with 8 infants in each arm. The first step will evaluate the safety and PK profile of the bNAbs when given alone as a single subcutaneous (SC) administration at increasing mg/kg body weight doses within 96 hours of birth: arms 1, 2 and 3 at doses of 5, 10, and 20 mg/kg of CAP256V2LS, respectively; arms 4 and 5 at doses of 20 and 30 mg/kg of VRC07-523LS, respectively. Step two will evaluate the safety and PK profile of a combination of the two bNAbs administered SC at fixed doses within 96 hours of birth. Step three will evaluate the safety and PK profile of the two bNAbs administered SC in combination at fixed doses, after 3 months. Arms 1 and 6 will follow sequential recruitment, whereas randomization will occur sequentially between arms (a) 2 & 4 and (b) 3 & 5. Before each randomization, a safety pause will allow review of safety data of the preceding arms.
Discussion: The results of this trial will guide further studies on bNAbs to prevent breast milk transmission of HIV.
Protocol Version: Version 4.0 dated 15 March 2024.
Trial Registration:
Pan African Clinical Trial Registry (PACTR): PACTR202205715278722, 21 April 2022; South African National Clinical Trial Registry (SANCTR): DOH-27-062022-6058.
Effect of aortic valve replacement on myocardial perfusion and exercise capacity in patients with severe aortic stenosis
Authors: Aslam Saadia , Dattani Abhishek , Alfuhied Aseel , Gulsin Gaurav S. , Arnold Jayanth R. , Steadman Christopher D. , Jerosch-Herold Michael , Xue Hui , Kellman Peter , McCann Gerry P. , Singh Anvesha 
Published: July 2024

Abstract

Aortic valve replacement (AVR) leads to reverse cardiac remodeling in patients with aortic stenosis (AS). The aim of this secondary pooled analysis was to assess the degree and determinants of changes in myocardial perfusion post AVR, and its link with exercise capacity, in patients with severe AS. A total of 68 patients underwent same-day echocardiography and cardiac magnetic resonance imaging with adenosine stress pre and 6–12 months post-AVR. Of these, 50 had matched perfusion data available (age 67 ± 8 years, 86% male, aortic valve peak velocity 4.38 ± 0.63m/s, aortic valve area index 0.45 ± 0.13cm2/m2). A subgroup of 34 patients underwent a symptom-limited cardiopulmonary exercise test (CPET) to assess maximal exercise capacity (peak VO2). Baseline and post-AVR parameters were compared and linear regression was used to determine associations between baseline variables and change in myocardial perfusion and exercise capacity. Following AVR, stress myocardial blood flow (MBF) increased from 1.56 ± 0.52 mL/min/g to 1.80 ± 0.62 mL/min/g (p < 0.001), with a corresponding 15% increase in myocardial perfusion reserve (MPR) (2.04 ± 0.57 to 2.34 ± 0.68; p = 0.004). Increasing severity of AS, presence of late gadolinium enhancement, lower baseline stress MBF and MPR were associated with a greater improvement in MPR post-AVR. On multivariable analysis low baseline MPR was independently associated with increased MPR post-AVR. There was no significant change in peak VO2 post-AVR, but a significant increase in exercise duration. Change in MPR was associated with change in peak VO2 post AVR (r = 0.346, p = 0.045). Those with the most impaired stress MBF and MPR at baseline demonstrate the greatest improvements in these parameters following AVR and the magnitude of change in MPR correlated with improvement in peak VO2, the gold standard measure of aerobic exercise capacity.
Association of First-trimester Remnant Cholesterol and Gestational Diabetes Mellitus: a retrospective cohort study
Authors: Guo Xueke , Wang Ruifang , Xiang Junmiao , Jiang Feina , Zhang Jie , Peng Xuting , Zheng Xiuying , Dai Yuanyuan , Cai Zhuhua 
Published: July 2024

Abstract

Background
LACK of research on the correlation between first trimester levels of remnant cholesterol (RC) and Gestational Diabetes Mellitus (GDM), and no studies have investigated the association between RC and complement.
Method & outcome measures:
This study is a retrospective cohort study conducted at the Third Affiliated Hospital of Wenzhou Medical University from May 2018 to December 2022. Baseline characteristics and laboratory test results were collected from all participants. The widely used formula for calculating RC is detailed as RC (mmol/L) = TC (mmol/L) - HDL-c (mmol/L) - LDL-c (mmol/L). Logistic regression and subgroup analysis were utilized to evaluate the risk impact of RC on GDM. Additionally, a correlation matrix was constructed to assess the relationship between RC and its associated factors.
Results
The study involved 830 participants, with a median RC of 0.4 mmol/L. Among them, 121 pregnant women (14.6%) were ultimately diagnosed with GDM. Multivariate adjusted logistic regression analysis revealed a positive correlation between RC and GDM risk (OR = 1.81, 95% CI 1.09–2.99). Subsequent subgroup analysis indicated no significant interaction between the groups (P > 0.05). The study also observed the strongest correlations between RC and age (r = 0.11), RC and BMI (r = 0.09), RC and C1q (r = 0.14), RC and GLU (r = 0.08).
Conclusion
The serum RC level at 4–8 weeks of pregnancy is positively correlated with the risk of GDM in pregnant women. First-trimester RC serves as an early warning indicator for GDM in pregnant women. This study may contribute to optimizing GDM prevention and early intervention in pregnant women.