bluuebunny/crossref_metadata_2025_split huggingface dataset:
Turbidity currents regulate the transport and settling of microplastics in a deep-sea submarine canyon
Authors: Zhang Xiaodong , Liu Zhifei , Li Daoji , Zhao Yulong , Zhang Yanwei 
Published: June 2024

Abstract
Microplastics are widely distributed in deep oceans, with some of the highest concentrations reported in submarine canyons, which are thought to be closely related to turbidity currents. However, the turbidity current role in microplastic transport and deposition is poorly understood. Here, we present temporal variation in microplastic abundance and settling flux from sediment trap observations on the levee of Gaoping Canyon, offshore Taiwan, where turbidity currents occur frequently. The results showed that relatively high microplastic abundance and flux were consistent with the increases of near-bottom suspended sediment concentration caused by turbidity currents. The microplastics, dominated by polypropylene (59%) and polyethylene (21%), were probably derived from Taiwan coastal resuspension and river input and then transported into the submarine canyon by typhoon- or earthquake-triggered turbidity currents. During the turbidity currents, the average microplastic abundance and flux was 4137 particles per kilogram and 40.11 particles per square meter per day, respectively, showing an increase of 49% and 270%, respectively, compared to non–turbidity current periods. The total microplastic flux during the turbidity currents accounted for ~76% of annual flux. Our study highlights turbidity currents to be the major hydrodynamic process in regulating microplastic transport and settling in a submarine canyon.
Identifying subtypes of type 2 diabetes mellitus with machine learning: development, internal validation, prognostic validation and medication burden in linked electronic health records in 420 448 individuals
Authors: Mizani Mehrdad A , Dashtban Ashkan , Pasea Laura , Zeng Qingjia , Khunti Kamlesh , Valabhji Jonathan , Mamza Jil Billy , Gao He , Morris Tamsin , Banerjee Amitava 
Published: June 2024

IntroductionNone of the studies of type 2 diabetes (T2D) subtyping to date have used linked population-level data for incident and prevalent T2D, incorporating a diverse set of variables, explainable methods for cluster characterization, or adhered to an established framework. We aimed to develop and validate machine learning (ML)-informed subtypes for type 2 diabetes mellitus (T2D) using nationally representative data.Research design and methodsIn population-based electronic health records (2006–2020; Clinical Practice Research Datalink) in individuals ≥18 years with incident T2D (n=420 448), we included factors (n=3787), including demography, history, examination, biomarkers and medications. Using a published framework, we identified subtypes through nine unsupervised ML methods (K-means, K-means++, K-mode, K-prototype, mini-batch, agglomerative hierarchical clustering, Birch, Gaussian mixture models, and consensus clustering). We characterized clusters using intracluster distributions and explainable artificial intelligence (AI) techniques. We evaluated subtypes for (1) internal validity (within dataset; across methods); (2) prognostic validity (prediction for 5-year all-cause mortality, hospitalization and new chronic diseases); and (3) medication burden.ResultsDevelopment: We identified four T2D subtypes: metabolic, early onset, late onset and cardiometabolic.Internal validity: Subtypes were predicted with high accuracy (F1 score >0.98).Prognostic validity: 5-year all-cause mortality, hospitalization, new chronic disease incidence and medication burden differed across T2D subtypes. Compared with the metabolic subtype, 5-year risks of mortality and hospitalization in incident T2D were highest in late-onset subtype (HR 1.95, 1.85–2.05 and 1.66, 1.58–1.75) and lowest in early-onset subtype (1.18, 1.11–1.27 and 0.85, 0.80–0.90). Incidence of chronic diseases was highest in late-onset subtype and lowest in early-onset subtype.Medications: Compared with the metabolic subtype, after adjusting for age, sex, and pre-T2D medications, late-onset subtype (1.31, 1.28–1.35) and early-onset subtype (0.83, 0.81–0.85) were most and least likely, respectively, to be prescribed medications within 5 years following T2D onset.ConclusionsIn the largest study using ML to date in incident T2D, we identified four distinct subtypes, with potential future implications for etiology, therapeutics, and risk prediction.
Teen pregnancy involvement among African, Caribbean and Black adolescent boys and girls: A scoping review
Authors: Ojukwu Emmanuela , Bawafaa Eunice , McKay Emily , Grewal Harsimran , Afsah Sara , Singh Shivangi , Saewyc Elizabeth 
Published: June 2024

ObjectivesThis study aims to investigate the incidence, associated factors and interventions to address teen pregnancy involvement (TPI) among African, Caribbean and Black (ACB) adolescents in North America.DesignWe conducted a scoping review of the literature, guided by the social-ecological model.Data sourcesStudies were retrieved from databases such as Ovid Medline, Ovid Embase, CINAHL, CAB Direct and Google Scholar and imported into COVIDENCE for screening.Eligibility criteriaThe Joanna Briggs Institute scoping reviews protocol guided the establishment of eligibility criteria. Included studies focused on rates, associated factors and interventions related to TPI among ACB boys and girls aged 10–19 in North America. The publication time frame was restricted to 2010–2023, encompassing both peer-reviewed and non-peer-reviewed studies with diverse settings.Data extraction and synthesisData were extracted from 32 articles using a form developed by the principal author, focusing on variables aligned with the research question.ResultsThe scoping review revealed a dearth of knowledge in Canadian and other North American literature on TPI in ACB adolescents. Despite an overall decline in teen pregnancy rates, disparities persist, with interventions such as postpartum prescription of long-acting birth control and teen mentorship programmes proving effective.ConclusionThe findings highlight the need for increased awareness, research and recognition of male involvement in adolescent pregnancies. Addressing gaps in housing, employment, healthcare, sexual health education and health systems policies for marginalised populations is crucial to mitigating TPI among ACB adolescents.ImpactThe review underscores the urgent need for more knowledge from other North American countries, particularly those with growing ACB migrant populations.
Morbidity and trends in length of hospitalisation of very and extremely preterm infants born between 2008 and 2021 in the Netherlands: a cohort study
Authors: de Bijl-Marcus Karen , Benders Manon J N L , Dudink Jeroen , Ahaus Kees , Kahlmann Marijn , Groenendaal Floris 
Published: June 2024

ObjectivesThis study investigated changes in the length of stay (LoS) at a level III/IV neonatal intensive care unit (NICU) and level II neonatology departments until discharge home for very preterm infants and identified factors influencing these trends.DesignRetrospective cohort study based on data recorded in the Netherlands Perinatal Registry between 2008 and 2021.SettingA single level III/IV NICU and multiple level II neonatology departments in the Netherlands.ParticipantsNICU-admitted infants (n=2646) with a gestational age (GA) <32 weeks.Main outcome measuresLoS at the NICU and overall LoS until discharge home.ResultsThe results showed an increase of 5.1 days (95% CI 2.2 to 8, p<0.001) in overall LoS in period 3 after accounting for confounding variables. This increase was primarily driven by extended LoS at level II hospitals, while LoS at the NICU remained stable. The study also indicated a strong association between severe complications of preterm birth and LoS. Treatment of infants with a lower GA and more (severe) complications (such as severe retinopathy of prematurity) during the more recent periods may have increased LoS.ConclusionThe findings of this study highlight the increasing overall LoS for very preterm infants. LoS of very preterm infants is presumably influenced by the occurrence of complications of preterm birth, which are more frequent in infants at a lower gestational age.
An exploratory open-label multicentre phase I/II trial evaluating the safety and efficacy of postnatal or prenatal and postnatal administration of allogeneic expanded fetal mesenchymal stem cells for the treatment of severe osteogenesis imperfecta in infants and fetuses: the BOOSTB4 trial protocol
Authors: Sagar Rachel L , Åström Eva , Chitty Lyn S , Crowe Belinda , David Anna L , DeVile Catherine , Forsmark Annabelle , Franzen Vera , Hermeren Göran , Hill Melissa , Johansson Mats , Lindemans Caroline , Lindgren Peter , Nijhuis Wouter , Oepkes Dick , Rehberg Mirko , Sahlin Nils-Eric , Sakkers Ralph , Semler O , Sundin Mikael , Walther-Jallow Lilian , Verweij E J T Joanne , Westgren Magnus , Götherström Cecilia 
Published: June 2024

IntroductionSevere osteogenesis imperfecta (OI) is a debilitating disease with no cure or sufficiently effective treatment. Mesenchymal stem cells (MSCs) have good safety profile, show promising effects and can form bone. The Boost Brittle Bones Before Birth (BOOSTB4) trial evaluates administration of allogeneic expanded human first trimester fetal liver MSCs (BOOST cells) for OI type 3 or severe type 4.Methods and analysisBOOSTB4 is an exploratory, open-label, multiple dose, phase I/II clinical trial evaluating safety and efficacy of postnatal (n=15) or prenatal and postnatal (n=3, originally n=15) administration of BOOST cells for the treatment of severe OI compared with a combination of historical (1–5/subject) and untreated prospective controls (≤30). Infants<18 months of age (originally<12 months) and singleton pregnant women whose fetus has severe OI with confirmed glycine substitution inCOL1A1orCOL1A2can be included in the trial.Each subject receives four intravenous doses of 3×106/kg BOOST cells at 4 month intervals, with 48 (doses 1–2) or 24 (doses 3–4) hours in-patient follow-up, primary follow-up at 6 and 12 months after the last dose and long-term follow-up yearly until 10 years after the first dose. Prenatal subjects receive the first dose via ultrasound-guided injection into the umbilical vein within the fetal liver (16+0 to 35+6 weeks), and three doses postnatally.The primary outcome measures are safety and tolerability of repeated BOOST cell administration. The secondary outcome measures are number of fractures from baseline to primary and long-term follow-up, growth, change in bone mineral density, clinical OI status and biochemical bone turnover.Ethics and disseminationThe trial is approved by Competent Authorities in Sweden, the UK and the Netherlands (postnatal only). Results from the trial will be disseminated via CTIS, ClinicalTrials.gov and in scientific open-access scientific journals.Trial registration numbersEudraCT 2015-003699-60, EUCT: 2023-504593-38-00,NCT03706482.
Assessing the association between a sedentary lifestyle and prevalence of primary osteoporosis: a community-based cross-sectional study among Chinese population
Authors: Wang Xiao-Song , Chen Yong , Zhao Yun-Wu , Chen Ming-Wei , Wang Heng 
Published: June 2024

ObjectivesTo reveal the association between a sedentary lifestyle and the prevalence of primary osteoporosis (POP).DesignA community-based cross-sectional study was conducted.SettingThis study was conducted in communities in Hefei city, Anhui province, China.ParticipantsA total of 1346 residents aged 40 and above underwent POP screening via calcaneus ultrasound bone mineral density (BMD) testing and completed a questionnaire survey.Outcome measuresThe average daily sitting time was included in the study variable and used to assess sedentary behaviour. The 15 control variables included general information, dietary information and life behaviour information. Logistic regression was used to analyse the association between the POP prevalence and study or control variables in different models.Results1346 participants were finally included in the study. According to the 15 control variables, the crude model and 4 models were established. The analysis revealed that the average daily sitting time showed a significant correlation with the prevalence of POP in the crude model (OR=2.02, 95% CI=1.74 to 2.36, p<0.001), Model 1 (OR=2.65, 95% CI=2.21 to 3.17, p<0.001), Model 2 (OR=2.63, 95% CI=2.19 to 3.15, p<0.001), Model 3 (OR=2.62, 95% CI=2.18 to 3.15, p<0.001) and Model 4 (OR=2.58, 95% CI=2.14 to 3.11, p<0.001). Besides, gender, age and body mass index showed a significant correlation with the POP prevalence in all models.ConclusionsThis study suggests a potential association between a sedentary lifestyle and the prevalence of POP within the Chinese population. Modifying sedentary behaviours could contribute to a reduction in POP risk. However, longitudinal cohort studies are necessary to confirm this hypothesis in the future.
Group arts therapies for patients with schizophrenia: a protocol of systematic review and meta-analysis
Authors: Zhang Aijia , Luo Xuexing , Lin Runqing , He Caihong , Wang Jue , Huang Guanghui 
Published: June 2024

IntroductionSchizophrenia, a chronic mental problem, significantly impacts cognition, emotion and social functioning. Conventional pharmacotherapy faces challenges including numerous side effects, low adherence to medication and substantial costs. In this context, group arts therapies (GATs) emerge as a promising complementary approach for symptom alleviation in schizophrenia patients. Nonetheless, the effectiveness and safety of GATs are yet to be firmly established. This study aims to systematically assess the therapeutic impact of all group-based artistic interventions as complementary treatments for schizophrenia, focusing on their potential benefits.Methods and analysisThis study will search four English-language databases (PubMed, Web of Science, Cochrane Library and Embase), two Chinese databases (Wanfang Data and China National Knowledge Infrastructure) and three Korean databases (RISS, Korean Citation Index and DBpia) from their inception until October 2023. It will include all randomised controlled trials that compare GATs for schizophrenia with standard rehabilitation methods. The primary outcome is the improvement in patients’ positive and negative symptoms. Methodologies such as bias risk assessment, data synthesis, sensitivity analysis and subgroup analysis will be implemented using Review Manager V.5.4. Study results with high heterogeneity will be merged using a random-effects model (I2>50% or p<0.1). In cases where meta-analysis is not viable due to significant clinical and methodological heterogeneity, a qualitative summary of the findings will be provided.Ethics and disseminationThe data used in this systematic review are anonymised, devoid of any private information, eliminating the requirement for ethical approval. Dissemination of the research findings will be conducted via peer-reviewed publications.PROSPERO registration numberCRD42023471583.
Association between magnesium depletion score and chronic obstructive pulmonary disease risk: a secondary data analysis from NHANES
Authors: Wang Kai Jin , Chen Hong , Wang Jin , Wang Yang 
Published: June 2024

Background and objectiveThe association between magnesium depletion score (MDS) and the risk of chronic obstructive pulmonary disease (COPD) has not been examined to date. Meanwhile, the potential impact of dietary magnesium intake on this association remains unclear. This study aimed to investigate the influence of dietary magnesium intake on the association between MDS and COPD incidence.MethodsIn this cross-sectional study using the National Health and Nutrition Examination Survey database, we analysed the relationship between MDS and COPD, while also exploring the role of dietary magnesium.ResultsA total of 39 852 participants, including 1762 patients with COPD and 38 090 patients with non-COPD, were included in the analysis. After adjusting for confounding factors, our results demonstrated a significant association between higher MDS and increased COPD incidence (OR=1.48, 95% CI: 1.10 to 1.99). Furthermore, it was observed that dietary magnesium intake did not significantly impact this association.ConclusionThis study highlights a significant positive correlation between MDS and the incidence of COPD. Nonetheless, no significant alteration in this association was observed with dietary magnesium intake.
Influence of the COVID-19 pandemic on births and induced abortions in Southern Sweden: a register-based study
Authors: Thacher Jesse D , Vilhelmsson Andreas , Blomberg Annelise J , Rylander Lars , Jöud Anna , Schmidt Lone , Hougaard Charlotte Ørsted , Elmerstig Eva , Vassard Ditte , Mattsson Kristina 
Published: June 2024

BackgroundPandemics are linked with declining birth rates, but little is known about how the COVID-19 pandemic has influenced childbearing decisions. We aimed to investigate the associations between the COVID-19 pandemic and reproductive decisions, specifically to identify potential changes in the frequency of deliveries and induced abortions in Skåne, Sweden.MethodsUsing the Skåne Healthcare Register, we identified women aged 15–45 years who had at least one pregnancy-related care visit registered between 1 January 2013 and 11 November 11 2021. Deliveries and induced abortions were identified, and changes in weekly delivery and abortion counts were assessed using an interrupted time series design. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated from a Poisson regression model.ResultsDuring the study period we identified 129 131 deliveries and 38 591 abortions. Compared with the counterfactual (exposed interval assuming COVID-19 had not occurred), pandemic exposure was associated with fewer deliveries (RR 0.93; 95% CI 0.89 to 0.98). For abortions, pandemic exposure appeared to be associated with fewer abortions (RR 0.95; 95% CI 0.90 to 1.00); however, age-related differences were found. Among women aged 25 years and over, pandemic exposure was more strongly associated with fewer abortions. Contrastingly, among women aged under 25 years, abortions appeared to increase.ConclusionsThe COVID-19 pandemic seemed to have contributed to a decline in births in Southern Sweden. During the same period, abortions declined in women in the older age range, but contrastingly increased among younger women.
Psychometric validation of a patient-reported experience measure for older adults attending the emergency department: the PREM-ED 65 study
Authors: Graham Blair , Smith Jason E , Wei Yinghui , Nelmes Pamela , Latour Jos M 
Published: June 2024

IntroductionOptimising emergency department (ED) patient experience is vital to ensure care quality. However, there are few validated instruments to measure the experiences of specific patient groups, including older adults. We previously developed a draft 82-item Patient Reported Experience Measure (PREM-ED 65) for adults ≥65 attending the ED. This study aimed to derive a final item list and provide initial validation of the PREM-ED 65 survey.MethodsA cross-sectional study involving patients in 18 EDs in England. Adults aged 65 years or over, deemed eligible for ED discharge, were recruited between May and August 2021 and asked to complete the 82-item PREM at the end of the ED visit and 7–10 days post discharge. Test–retest reliability was assessed 7—10 days following initial attendance. Analysis included descriptive statistics, including per-item proportions of responses, hierarchical item reduction, exploratory factor analysis (EFA), reliability testing and assessment of criterion validity.ResultsFive hundred and ten initial surveys and 52 retest surveys were completed. The median respondent age was 76. A similar gender mix (men 47.5% vs women 50.7%) and reason for attendance (40.3% injury vs 49.0% illness) was observed. Most participants self-reported their ethnicity as white (88.6%).Hierarchical item reduction identified 53/82 (64.6%) items for exclusion, due to inadequate engagement (n=33), ceiling effects (n=5), excessive inter-item correlation (n=12) or significant differential validity (n=3). Twenty-nine items were retained.EFA revealed 25 out of the 29 items demonstrating high factor loadings (>0.4) across four scales with an Eigenvalue >1. These scales were interpreted as measuring ‘relational care’, ‘the ED environment’, ‘staying informed’ and ‘pain assessment’. Cronbach alpha for the scales ranged from 0.786 to 0.944, indicating good internal consistency. Test–retest reliability was adequate (intraclass correlation coefficient 0.67). Criterion validity was fair (r=0.397) when measured against the Friends and Families Test question.ConclusionsPsychometric testing demonstrates that the 25-item PREM-ED 65 is suitable for administration to adults ≥65 years old up to 10 days following ED discharge.
Investigating low birth weight and preterm birth as potential mediators in the relationship between prenatal infections and early child development: a linked administrative health data analysis
Authors: Hardie Iain , Murray Aja , King Josiah , Hall Hildigunnar Anna , Okelo Kenneth , Luedecke Emily , Marryat Louise , Thompson Lucy , Minnis Helen , Lombardo Michael , Wilson Philip , Auyeung Bonnie 
Published: June 2024

BackgroundPrenatal infections are associated with childhood developmental outcomes such as reduced cognitive abilities, emotional problems and other developmental vulnerabilities. However, there is currently a lack of research examining whether this arises due to potential intermediary variables like low birth weight or preterm birth, or due to some other mechanisms of maternal immune activation arising from prenatal infections.MethodsAdministrative data from the National Health Service health board of Greater Glasgow & Clyde, Scotland, were used, linking birth records to hospital records and universal child health review records for 55 534 children born from 2011 to 2015, and their mothers. Causal mediation analysis was conducted to examine the extent to which low birth weight and preterm birth mediate the relationship between hospital-diagnosed prenatal infections and having developmental concern(s) identified by a health visitor during 6–8 weeks or 27–30 months child health reviews.ResultsModel estimates suggest that 5.18% (95% CI 3.77% to 7.65%) of the positive association observed between hospital-diagnosed prenatal infections and developmental concern(s) was mediated by low birth weight, while 7.37% (95% CI 5.36 to 10.88%) was mediated by preterm birth.ConclusionLow birth weight and preterm birth appear to mediate the relationship between prenatal infections and childhood development, but only to a small extent. Maternal immune activation mechanisms unrelated to low birth weight and preterm birth remain the most likely explanation for associations observed between prenatal infections and child developmental outcomes, although other factors (for example, genetic factors) may also be involved.