bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival outcomes following complete mediastinal lymphadenectomy or selective mediastinal lymphadenectomy in patients with stage I–IIIA non-small cell lung cancer: protocol for a systematic review and meta-analysis
Authors: Xu Jianfeng , Lai Jinxing , Huang Xiongfeng , Ren Yuxi , Chen Qiao , Li Weijuan 
Published: March 2024

IntroductionLung cancer remains the largest cause of cancer-related deaths worldwide. Surgical removal of non-small cell lung cancer (NSCLC) has the potential to achieve a cure, although there is ongoing debate regarding the significance of removing mediastinal nodes and the optimal extent of lymph node excision. The purpose of this research is to assess the survival outcomes in patients diagnosed with stage I–IIIA NSCLC who received either complete mediastinal lymphadenectomy (CML) or selective mediastinal lymphadenectomy (SML).Methods and analysisThe protocol follows the guidelines recommended in Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols, and this meta-analysis will be conducted in accordance with the standard methodology recommended by the Cochrane Collaboration and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidance. We will conduct a comprehensive search for randomised controlled trials and non-randomised studies examining the effectiveness of CML compared with SML in patients with stage I–IIIA NSCLC. Two authors will perform a comprehensive search of the MEDLINE/PubMed, Embase, the Cochrane Library, CNKI, WanFang, Sinomed, VIP and Web of Science databases. There will be no restrictions on language or publication date, and the search will be conducted on 10 April 2024, with ongoing searches for new research. Reference lists will also be checked and pertinent journals will be hand searched. The primary outcomes include overall survival (OS) and disease-free survival (DFS), while the secondary outcomes consist of 1-year, 3-year and 5-year OS rates and 1-year, 3-year and 5-year DFS rates. Two independent reviewers will screen, extract data, assess quality and evaluate the potential for bias in the selected research, with a third acting as arbitrator. Subgroup analyses and sensitivity analyses are planned. The quality of the evidence will be evaluated using Grading of Recommendations Assessment, Development and Evaluation. Review Manager V.5.4 will be used for the analysis and synthesis process.Ethics and disseminationEthical review and approval are not necessary for this study because it is based on a secondary analysis of the literature. The results will be submitted for reporting in a peer-reviewed publication.Study registrationOpen Science Framework (https://doi.org/10.17605/OSF.IO/PN7UQ).
Impact of non-participation bias due to psychiatric illness on mortality and cardiovascular event estimates: a Danish longitudinal population study
Authors: Rygner Zerlina , Ellervik Christina , Rasmussen Mads , Torp-Pedersen Christian , Poulsen Henrik E , Jørgensen Anders 
Published: March 2024

ObjectivesThe impact of non-participation due to psychiatric illness on study outcomes in general population studies is insufficiently investigated. Here, we investigate the mental health bias in a population study and the potential impact on estimates of cardiovascular morbidity and overall survival.DesignData were retrieved from nationwide registries.SettingThe Danish General Suburban Population Study (GESUS), a cross-sectional community study conducted in Naestved Municipality, Denmark, from 2010 to 2013.Participants49 707 subjects invited to participate in GESUS.Main outcome measuresFactors related to non-participation were examined using multivariable logistic regression and time-to-event data using Cox proportional hazards models.ResultsOf 21 203 (43%) participants, 823 (3.9%) had a psychiatric diagnosis. Of 28 504 non-participants, 2453 (8.6%) had a psychiatric diagnosis (OR for non-participation 1.84 (95% CI 1.69 to 2.00)). The most under-represented psychiatric disorders in participants were organic mental disorders (5.76 (3.90 to 8.48)), substance abuse (3.12 (2.14 to 4.54)) and schizophrenia (3.12 (2.33 to 4.18)). Overall, more non-participants used psychotropic drugs than participants (1.26 (1.21 to 1.31)), and psychiatric non-participants had higher psychiatric hospital service utilisation than psychiatric participants. Compared with non-psychiatric participants in a 5-year follow-up, psychiatric non-participants had higher rates of cardiovascular events (HR 2.30 (2.07 to 2.56)) and all-cause mortality (3.37 (3.01 to 3.78)) than non-psychiatric non-participants (1.65 (1.48 to 1.83) and 2.26 (2.02 to 2.54), respectively) and psychiatric participants (1.39 (1.21 to 1.59) and 1.23 (1.05 to 1.44), respectively), pinteraction<0.0001 for both outcomes.ConclusionsThis study demonstrates a considerable non-participation bias due to psychiatric illness in a general population health study, potentially leading to distorted estimates of somatic morbidity and mortality. Strategies for better-representing individuals with psychiatric illnesses in population health studies are needed.
Health and economic cost estimates of short-term total and wildfire PM2.5exposure on work loss: using the consecutive California Health Interview Survey (CHIS) data 2015–2018
Authors: Meng Ying-Ying , Yu Yu , Garcia-Gonzales Diane , Al-Hamdan Mohammad Z , Marlier Miriam E , Wilkins Joseph L , Ponce Ninez , Jerrett Michael 
Published: March 2024

InstructionTo help determine the health protectiveness of government regulations and policies for air pollutant control for Americans, our study aimed to investigate the health and economic impacts of work loss due to sickness associated with daily all-source and wildfire-specific PM2.5(particulate matter with an aerodynamic diameter smaller than 2.5 μm) exposures in California.MethodsWe linked the 2015–2018 California Health Interview Survey respondents’ geocoded home addresses to daily PM2.5estimated by satellites and atmospheric modelling simulations and wildfire-related PM2.5from Community Multiscale Air Quality models. We calculated and applied the coefficient for the association between daily PM2.5exposure and work loss from regression analyses to the Environmental Benefits Mapping and Analysis Program—Community Edition (BenMAP-CE) platform to assess the health and economic impacts of PM2.5exposure on work loss due to sickness.ResultsWe observed that each 1 µg/m3increase in daily total PM2.5exposure will lead to about 1 million days of work loss per year ranging from 1.1 to 1.6 million person-days, and the related economic loss was $310–390 million. Wildfire smoke alone could contribute to 0.7–2.6 million work-loss days with a related economic loss of $129–521 million per year in 2015–2018. Using the function coefficient in the current BenMAP, the excess work-loss days due to sickness was about 250 000 days and the estimated economic loss was about $45–50 million for each 1 µg/m3increase in daily total PM2.5exposure, and wildfire smoke alone would lead to 0.17–0.67 million work-loss days with related economic loss of $31–128 million per year during the same period.ConclusionsBoth conventional and wildfire-specific sources of PM2.5produced substantial work loss and cost in California. Updating the current BenMAP-CE calculations for work-loss days will be essential in quantifying the current health impacts of PM2.5to help inform the policies and regulations to protect public health.
Feasibility of NepaDengue mobile application for dengue prevention and control: user and stakeholder perspectives in Nepal
Authors: Mahotra Anita , Pokhrel Yuvraj , Thapa Tulsi Ram , Arguni Eggi , Andono Riris Ahmad 
Published: March 2024

BackgroundDengue has emerged as a significant public health issue in Nepal since 2006, necessitating innovative approaches to disseminating timely information and promoting preventive behaviour. Our study focuses on developing and pretesting a mobile health app called NepaDengue, assessing its acceptance and factors influencing its implementation.MethodsA concurrent triangulation mixed-method design was used, and an intervention was conducted among 228 university students using the mobile application. Acceptability was assessed using the technology acceptance model (TAM) based on user experiences over 1 week. Focus group discussions among students and female community health volunteers and key informant interviews among key dengue stakeholders were conducted to explore facilitators and barriers. Descriptive statistics were calculated, and a thematic analysis was conducted.ResultsThe high acceptability mean rating scores reported based on the TAM construct indicate that the application is perceived as useful and easy to use and exhibits good functioning and gestural design. The use of the NepaDengue application for dengue prevention and control activities has been perceived as acceptable by users and stakeholders. However, specific barriers were identified, including concerns about sustained usability, illiteracy and limited access to the internet and smartphones. We suggested promoting the application, fostering government ownership and encouraging collaboration to enhance its reach and effective implementation.ConclusionsThe NepaDengue application has been perceived as a promising tool for dengue prevention and control in Nepal. Further piloting and implementation of the app in the community setting is recommended.
Sleep patterns and long-term mortality among older Israeli adults: a population-based study
Authors: Ashri Saar , Cohen Gali , Hasin Tal , Keinan-Boker Lital , Gerber Yariv 
Published: March 2024

IntroductionThe joint association of night-time sleep duration and daytime napping (siesta) with mortality remains elusive. We explored sleep patterns and long-term mortality in older adults and tested whether the relationship is modified by cognitive function.MethodsWe analysed data from 1519 participants in the National Health and Nutrition Survey of older adults aged 65+ years (‘Mabat Zahav’), conducted by the Israel Center for Disease Control during 2005–2006. A detailed questionnaire was administered at study entry to gather information on sleeping habits, including night-time sleep duration and siesta. A Mini-Mental State Examination was administered to assess cognitive status (score <27 considered impaired). Mortality data were obtained from the Ministry of Health (last follow-up: June 2019; 782 deaths). Cox models were constructed to estimate the HRs for mortality associated with sleep patterns, defined according to night sleep duration (>8 vs ≤8 hours) and siesta (Y/N). Spline regression models were constructed to examine the linearity of the association across cognitive statuses.ResultsSleep categories among participants (mean age 75; 53% women) included 291 (19.2%) with long night sleep and siesta, 139 (9.1%) with long night sleep and no siesta, 806 (53.1%) with short night sleep and siesta, and 283 (18.6%) with short night sleep and no siesta. HRs for mortality were 2.07 (95% CI: 1.63 to 2.62), 1.63 (95% CI: 1.22 to 2.18) and 1.43 (95% CI: 1.16 to 1.76) in the former three versus latter sleep patterns, respectively. Multivariable adjustment for sociodemographic, behavioural and clinical covariates attenuated the HRs to 1.27–1.41 (all p<0.05). The relationship between night sleep duration and mortality was linear (plinearity=0.047) among cognitively preserved individuals and U-shaped (pnon-linearity<0.001) among cognitively impaired ones.ConclusionsProlonged night sleep and siesta were associated with increased mortality, a relationship that varied by cognitive performance.
Adolescents’ reasons for accessing their health records online, perceived usefulness and experienced provider encouragement: a national survey in Sweden
Authors: Hagström Josefin , Blease Charlotte , Scandurra Isabella , Moll Jonas , Cajander Åsa , Rexhepi Hanife , Hägglund Maria 
Published: March 2024

BackgroundHaving online access to electronic health records (EHRs) may help patients become engaged in their care at an early age. However, little is known about adolescents using patient portals. A national survey conducted within the Nordic eHealth project NORDeHEALTH provided an important opportunity to advance our understanding of adolescent users of patient portals. The present study explored reasons for reading the EHRs, the perceived usefulness of information and functions in a patient portal and the association between frequency of use and encouragement to read the EHR.MethodsData were collected in a survey using convenience sampling, available through the Swedish online health portal during 3 weeks in January and February 2022. This study included a subset of items and only respondents aged 15–19. Demographic factors and frequencies on Likert-style questions were reported with descriptive statistics, while Fisher’s exact test was used to explore differences in use frequency based on having been encouraged to read by a healthcare professional (HCP).ResultsOf 13 008 users who completed the survey, 218 (1.7%) were unique users aged 15–19 (females: 77.1%). One-fifth (47/218, 21.6%) had been encouraged by HCPs to read their records, and having been encouraged by HCPs was related to higher use frequency (p=0.018). All types of information were rated high on usefulness, while some functions were rated low, such as blocking specific clinical notes from HCPs and managing services for family members. The main reason for reading their health records online was out of curiosity.ConclusionsAdolescents who read their records online perceive it to be useful. Encouragement by HCPs can lead to increased use of patient portals among adolescents. Findings should be considered in the future design of patient portals for adolescents.
Novel 3D-based deep learning for classification of acute exacerbation of idiopathic pulmonary fibrosis using high-resolution CT
Authors: Huang Xinmei , Si Wufei , Ye Xu , Zhao Yichao , Gu Huimin , Zhang Mingrui , Wu Shufei , Shi Yanchen , Gui Xianhua , Xiao Yonglong , Cao Mengshu 
Published: March 2024

PurposeAcute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is the primary cause of death in patients with IPF, characterised by diffuse, bilateral ground-glass opacification on high-resolution CT (HRCT). This study proposes a three-dimensional (3D)-based deep learning algorithm for classifying AE-IPF using HRCT images.Materials and methodsA novel 3D-based deep learning algorithm, SlowFast, was developed by applying a database of 306 HRCT scans obtained from two centres. The scans were divided into four separate subsets (training set, n=105; internal validation set, n=26; temporal test set 1, n=79; and geographical test set 2, n=96). The final training data set consisted of 1050 samples with 33 600 images for algorithm training. Algorithm performance was evaluated using accuracy, sensitivity, specificity, positive predictive value, negative predictive value, receiver operating characteristic (ROC) curve and weighted κ coefficient.ResultsThe accuracy of the algorithm in classifying AE-IPF on the test sets 1 and 2 was 93.9% and 86.5%, respectively. Interobserver agreements between the algorithm and the majority opinion of the radiologists were good (κw=0.90 for test set 1 and κw=0.73 for test set 2, respectively). The ROC accuracy of the algorithm for classifying AE-IPF on the test sets 1 and 2 was 0.96 and 0.92, respectively. The algorithm performance was superior to visual analysis in accurately diagnosing radiological findings. Furthermore, the algorithm’s categorisation was a significant predictor of IPF progression.ConclusionsThe deep learning algorithm provides high auxiliary diagnostic efficiency in patients with AE-IPF and may serve as a useful clinical aid for diagnosis.
Novel peptide-based oncolytic vaccine for enhancement of adaptive antitumor immune response via co-engagement of innate Fcγ and Fcα receptors
Authors: Feola Sara , Hamdan Firas , Russo Salvatore , Chiaro Jacopo , Fusciello Manlio , Feodoroff Michaela , Antignani Gabriella , D'Alessio Federica , Mölsä Riikka , Stigzelius Virpi , Bottega Paolo , Pesonen Sari , Leusen Jeanette , Grönholm Mikaela , Cerullo Vincenzo 
Published: March 2024

BackgroundCancer immunotherapy relies on using the immune system to recognize and eradicate cancer cells. Adaptive immunity, which consists of mainly antigen-specific cytotoxic T cells, plays a pivotal role in controlling cancer progression. However, innate immunity is a necessary component of the cancer immune response to support an immunomodulatory state, enabling T-cell immunosurveillance.MethodsHere, we elucidated and exploited innate immune cells to sustain the generation of antigen-specific T cells on the use of our cancer vaccine platform. We explored a previously developed oncolytic adenovirus (AdCab) encoding for a PD-L1 (Programmed-Death Ligand 1) checkpoint inhibitor, which consists of a PD-1 (Programmed Cell Death Protein 1) ectodomain fused to an IgG/A cross-hybrid Fc. We coated AdCab with major histocompatibility complex (MHC-I)-restricted tumor peptides, generating a vaccine platform (named PeptiCab); the latter takes advantage of viral immunogenicity, peptide cancer specificity to prime T-cell responses, and antibody-mediated effector functions.ResultsAs proof of concept, PeptiCab was used in murine models of melanoma and colon cancer, resulting in tumor growth control and generation of systemic T-cell-mediated antitumor responses. In specific, PeptiCab was able to generate antitumor T effector memory cells able to secrete various inflammatory cytokines. Moreover, PeptiCab was able to polarize neutrophils to attain an antigen-presenting phenotype by upregulating MHC-II, CD80 and CD86 resulting in an enhanced T-cell expansion.ConclusionOur data suggest that exploiting innate immunity activates T-cell antitumor responses, enhancing the efficiency of a vaccine platform based on oncolytic adenovirus coated with MHC-I-restricted tumor peptides.
Association of genetic variation on X chromosome with systemic lupus erythematosus in both Thai and Chinese populations
Authors: Tangtanatakul Pattarin , Lei Yao , Jaiwan Krisana , Yang Wanling , Boonbangyang Manon , Kunhapan Punna , Sodsai Pimpayao , Mahasirimongkol Surakameth , Pisitkun Prapaporn , Yang Yi , Eu-Ahsunthornwattana Jakris , Aekplakorn Wichai , Jinawath Natini , Neelapaichit Nareemarn , Hirankarn Nattiya , Wang Yong-Fei 
Published: March 2024

ObjectivesX chromosome has been considered as a risk factor for SLE, which is a prototype of autoimmune diseases with a significant sex difference (female:male ratio is around 9:1). Our study aimed at exploring the association of genetic variants in X chromosome and investigating the influence of trisomy X in the development of SLE.MethodsX chromosome-wide association studies were conducted using data from both Thai (835 patients with SLE and 2995 controls) and Chinese populations (1604 patients with SLE and 3324 controls). Association analyses were performed separately in females and males, followed by a meta-analysis of the sex-specific results. In addition, the dosage of X chromosome in females with SLE were also examined.ResultsOur analyses replicated the association ofTMEM187-IRAK1-MECP2,TLR7,PRPS2andGPR173loci with SLE. We also identified two loci suggestively associated with SLE. In addition, making use of the difference in linkage disequilibrium between Thai and Chinese populations, a synonymous variant inTMEM187was prioritised as a likely causal variant. This variant located in an active enhancer of immune-related cells, with the risk allele associated with decreased expression level ofTMEM187. More importantly, we identified trisomy X (47,XXX) in 5 of 2231 (0.22%) females with SLE. The frequency is significantly higher than that found in the female controls (0.08%; two-sided exact binomial test P=0.002).ConclusionOur study confirmed previous SLE associations in X chromosome, and identified two loci suggestively associated with SLE. More importantly, our study indicated a higher risk of SLE for females with trisomy X.
Expanded application of wearable cardioverter defibrillators beyond current guidelines: proposal for a European register explained through single clinical scenarios
Authors: Buia Veronica , Ciotola Francesco , Bastian Dirk , Stangl Dorina , Walascheck Janusch , Rittger Harald , Vitali-Serdoz Laura 
Published: March 2024

The wearable cardioverter defibrillator (WCD) is becoming a more and more widely used instrument for the prevention of sudden cardiac death of patients either with a secondary prevention implantable cardioverter defibrillator indication or with a transient high risk of sudden cardiac death. Although clinical practice has demonstrated a benefit of protecting patients for a period as long as 3–6 months with such devices, the current European guidelines concerning ventricular arrhythmias and sudden cardiac death are still extremely restrictive in the patient selection in part because of the costs derived from such a prevention device, in part because of the lack of robust randomised trials.To illustrate expanded use cases for the WCD, four real-life clinical cases are presented where patients received the device slightly outside the established guidelines. These cases demonstrate the broader utility of WCDs in situations involving acute myocarditis, thyrotoxicosis, pre-excited atrial fibrillation and awaiting staging/prognosis of a lung tumour. The findings prompt expansion of the existing guidelines for WCD use to efficiently protect more patients whose risk of arrhythmic cardiac death is transient or uncertain. This could be achieved by establishing a European register of the patients who receive a WCD for further analysis.
Mixed plaque on coronary CT angiography predicts atherosclerotic events in asymptomatic intermediate-risk individuals
Authors: Warren Josephine , Ellims Andris , Bloom Jason , Sutherland Nigel , Lew Philip , Kavnoudias Helen , Paleri Sarang , Stub Dion , Taylor Andrew 
Published: March 2024

ObjectiveCoronary CT angiography (CCTA) permits both qualitative and quantitative analysis of atherosclerotic plaque and may be a suitable risk modifier in assessing patients at intermediate risk of atherosclerotic cardiovascular disease. We sought to determine the association of plaque components with long-term major adverse cardiovascular events (MACEs) in asymptomatic intermediate-risk patients, compared with conventional coronary artery calcium (CAC) score.Methods100 intermediate-risk patients underwent double-blinded CCTA. Follow-up was conducted at 10 years and data were cross-referenced with the National Death Index. The primary outcome was MACE, which was a composite of death, acute coronary syndrome (ACS), revascularisation and stroke.ResultsThe median time from CCTA to follow-up was 9.5 years. 83 patients completed follow-up interview and mortality data were available on all 100 patients. MACE occurred in 17 (20.5%) patients, which included 2 (2%) deaths, 8 (10%) ACS, 3 (4%) strokes and 5 (6%) revascularisation procedures. 47 (57%) patients had mixed plaque, which was predictive of MACE (OR 4.68 (95% CI 1.19 to 18.5) p=0.028). The burden of non-calcified and mixed plaque, defined by non-calcified plaque segment stenosis score, was also a predictor of long-term MACE (OR 1.59 (95% CI 1.18 to 2.13) p=0.002). Neither calcified plaque (OR 3.92 (95% CI 0.80 to 19.3)) nor CAC score (OR 1.01 (95% CI 0.999 to 1.02)) was associated with long-term MACE.ConclusionThe presence and burden of mixed plaque on CCTA is associated with an increased risk of long-term MACE among asymptomatic intermediate-risk patients and is a superior predictor to CAC score.