bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distribution of blood lead and cadmium levels in healthy children aged 0 to 18 years and analysis of related influencing factors in Henan, China: data findings from 2017 to 2022
Authors: Yan Hui , Zhai Bo , Feng Ruiling , Wang Penggao , Yang Fang , Zhou Yang 
Published: March 2024

Abstract
Background
There is still a lack of data on blood lead levels (BLLs) and blood lead levels (BLLs) in healthy children of all ages from 0 to 18 years in China. This study was performed to analyze the BLLs and BCLs in healthy children aged 0-18 years from 2017 to 2022 in urban and rural areas of Henan Province, Central China, as well as their relationships with socio-demographic variables and certain relevant exposure factors. To provide a basis for evaluating public health policy development and exposure risk management.

Methods
This was an observational study containing data from 17 prefecture-level cities in Henan, China. Blood Pb and Cd levels were determined using a triple quadrupole inductively coupled plasma mass spectrometer equipped with an autosampler. We first calculated the concentrations of Pb and Cd elements in participants of different genders, ages and years, and then created visual graphs depicting the distribution of each element in terms of gender, age and year (2017-2022). The rates between different groups were compared using the Chi-square test or Fisher exact test (if applicable). The means were compared by one-way ANOVA, medians were compared with the Kruskal-Wallis rank-sum test. Generalized linear models (GLM) were performed to estimate the effects of various factors on blood Pb and Cd concentrations in children.

Results
We recruited a total of 25,920 children (16,142 boys and 9,778 girls) aged 0.01 to 18.00 years (2.58 (1.00,6.25)). The median of BLLs was 23.48µg/L, around 9.39% of studied children had elevated BLLs. The median of BCLs was 0.66µg/L, around 1.84% of studied children had elevated BCLs. The median blood Pb concentration was higher in boys (23.90µg/L) than in girls (22.75µg/L) (P<0.001). The median blood Pb concentration was highest in the 3-7 years group (24.51µg/L) and the median blood Cd concentration was highest in the 1-3 years group (0.66µg/L) among all age groups. Both BLLs and BCLs were substantially higher in children in 2020-2022 compared to 2017-2019. Rural children had lower BLLs and higher BCLs. The results of the generalized linear model showed that children in households using Oil, coal, pellet or other wood as a fuel for heating, children with higher frequency of exposure to tobacco smoke and beverage intake had significantly increased chances of elevated BLLs and BCLs.

Conclusions
Pb and Cd exposure of children in this area is relatively low, but associated risk factors continue to exist in vulnerable populations. This study is the first big data analysis of Pb and Cd in children in Henan, China, and provides baseline information for future research.
Respiratory syncytial virus-associated hospitalizations among children: an Italian retrospective observational study
Authors: Fortunato Francesca , Campanozzi Angelo , Maffei Gianfranco , Arena Fabio , Carri Valeria Delli , Rollo Tiziana , Lopalco Pier Luigi , Martinelli Domenico 
Published: March 2024

Abstract
Background
Respiratory syncytial virus (RSV), a single-stranded RNA virus, is a leading cause of hospitalization in infants, especially ≤ 2 months of life. In the light new immunization strategies adoption, we described epidemiological and clinical characteristics of RSV-associated hospitalizations in pediatric and neonatal intensive care units of the Policlinico Foggia Hospital, Apulia Region, Italy.

Methods
Hospitalized children with a laboratory-confirmed RSV infection from 2011 to 2023 were retrospectively evaluated. Clinical information was collected from Hospital Discharge Registry in the period 2011–2020. The proportion of the hospitalization for acute respiratory infections (ARIs) associated to RSV was calculated and the hospitalization cost was analyzed by using the diagnosis-related group reimbursement rate. The anticipated impact of immunization either with monoclonal antibodies or maternal immunization on the number of hospitalizations was estimated. All analyses and quality assessment were performed using STATA/SE15.0.

Results
A total of 1,005 RSV-cases were included in the study, of which 86.3% occurred between December-March. In the period 2011–2020, 832 RSV-cases were matched with the corresponding hospital admissions; 75.2% were aged < 1 year (49.6% 0–2 months). Bronchiolitis was the most frequent admission diagnosis occurring in 63.3% of patients; 25% of children were affected by a very severe RSV-disease. Younger age ≤ 2 months (OR:14.8, 95%CI:8.30–26.31, p = 0.000), higher length-of-hospital-stay (OR:1.01, 95%CI:1.0–1.02, p = 0.030) and history of prematurity (OR:4.4, 95%CI:1.57–12.11, p = 0.005) were associated with a higher disease severity. RSV caused 48.9% of ARIs among children < 1 year. The mean cost of an RSV-associated hospitalization was 3,036 euros/year, with the higher cost in the 0–2 months age group (4,225 euros/year). Immunization programs with nirsevimab could prevent 51.4 RSV hospitalizations/year and 18.1 very severe RSV disease/year in infants < 1 year of age. RSV vaccine could prevent 46.1 of hospitalizations/year caused by RSV within 180 days after birth.

Conclusions
Our study contributes to outlining the baseline profile of RSV-associated hospitalizations among Italian children by providing epidemiological/clinical/economic estimates. While awaiting new recommendations on immunization, healthcare-workers should persist in implementing public health measures and appropriate case management to control RSV seasonal epidemics. Strengthened laboratory RSV surveillance is needed to inform the implementation of the new immunization strategies.
Healthcare migration in Italian paediatric haematology-oncology centres belonging to AIEOP
Authors: Rondelli Roberto , Belotti Tamara , Masetti Riccardo , Locatelli Franco , Massimino Maura , Biffi Alessandra , Dufour Carlo , Fagioli Franca , Menna Giuseppe , Biondi Andrea , Favre Claudio , Zecca Marco , Santoro Nicola , Russo Giovanna , Perrotta Silverio , Pession Andrea , Prete Arcangelo 
Published: March 2024

Abstract
Background
In Italy, there is a network of centres headed by the Italian Association of Pediatric Hematology and Oncology (AIEOP) for the diagnosis and treatment of paediatric cancers on almost the entire national territory.
Nevertheless, migration of patients in a hospital located in a region different from that of residence is a widespread habit, sometimes motivated by several reasons.
The aim of this paper is to assess the impact of migration of children with cancer to AIEOP centres in order to verify their optimal distribution throughout the national territory.

Methods
To this purpose, we used information on 41,205 registered cancer cases in the database of Mod.1.01 Registry from AIEOP centres, with age of less than 20 years old at diagnosis, diagnosed from 1988 to 2017.
Patients’ characteristics were analysed and compared using the X2 or Fisher’s exact test or Mann–Whitney test, when appropriate.
Survival distributions were estimated using the method of Kaplan and Meier, and the log-rank test was used to examine differences among subgroups.

Results
Extra-regional migration involved overall 19.5% of cases, ranging from 23.3% (1988–1997) to 16.4% (2008–2017) (p < 0.001).
In leukaemias and lymphomas we observed a mean migration of 8.8% overall, lower in the North (1.2%) and Centre (7.8%) compared to the South & Isles (32.3%).
In the case of solid tumours, overall migration was 25.7%, with 4.2% in the North, 17.2% in the Centre and 59.6% in the South & Isles.
For regions with overall levels of migration higher than the national average, most migration cases opted for AIEOP centres of close or even neighbouring regions.
Overall survival at 10 years from diagnosis results 69.9% in migrants vs 78.3% in no migrants (p < 0.001).

Conclusions
There is still a certain amount of domestic migration, the causes of which can be easily identified: migration motivated by a search for high specialization, migration due to lack of local facilities, or regions in which no AIEOP centres are present, which makes migration obligatory.
Better coordination between AIEOP centres could help to reduce so-called avoidable migration, but technical and political choices will have to be considered, with the active participation of sector technicians.
Accuracy of respiratory muscle assessments to predict weaning outcomes: a systematic review and comparative meta-analysis
Authors: Poddighe Diego , Van Hollebeke Marine , Choudhary Yasir Qaiser , Campos Débora Ribeiro , Schaeffer Michele R. , Verbakel Jan Y. , Hermans Greet , Gosselink Rik , Langer Daniel 
Published: March 2024

Abstract
Background
Several bedside assessments are used to evaluate respiratory muscle function and to predict weaning from mechanical ventilation in patients on the intensive care unit. It remains unclear which assessments perform best in predicting weaning success. The primary aim of this systematic review and meta-analysis was to summarize and compare the accuracy of the following assessments to predict weaning success: maximal inspiratory (PImax) and expiratory pressures, diaphragm thickening fraction and excursion (DTF and DE), end-expiratory (Tdiee) and end-inspiratory (Tdiei) diaphragm thickness, airway occlusion pressure (P0.1), electrical activity of respiratory muscles, and volitional and non-volitional assessments of transdiaphragmatic and airway opening pressures.

Methods
Medline (via Pubmed), EMBASE, Web of Science, Cochrane Library and CINAHL were comprehensively searched from inception to 04/05/2023. Studies including adult mechanically ventilated patients reporting data on predictive accuracy were included. Hierarchical summary receiver operating characteristic (HSROC) models were used to estimate the SROC curves of each assessment method. Meta-regression was used to compare SROC curves. Sensitivity analyses were conducted by excluding studies with high risk of bias, as assessed with QUADAS-2. Direct comparisons were performed using studies comparing each pair of assessments within the same sample of patients.

Results
Ninety-four studies were identified of which 88 studies (n = 6296) reporting on either PImax, DTF, DE, Tdiee, Tdiei and P0.1 were included in the meta-analyses. The sensitivity to predict weaning success was 63% (95% CI 47–77%) for PImax, 75% (95% CI 67–82%) for DE, 77% (95% CI 61–87%) for DTF, 74% (95% CI 40–93%) for P0.1, 69% (95% CI 13–97%) for Tdiei, 37% (95% CI 13–70%) for Tdiee, at fixed 80% specificity. Accuracy of DE and DTF to predict weaning success was significantly higher when compared to PImax (p = 0.04 and p < 0.01, respectively). Sensitivity and direct comparisons analyses showed that the accuracy of DTF to predict weaning success was significantly higher when compared to DE (p < 0.01).

Conclusions
DTF and DE are superior to PImax and DTF seems to have the highest accuracy among all included respiratory muscle assessments for predicting weaning success. Further studies aiming at identifying the optimal threshold of DTF to predict weaning success are warranted.
Trial registration: PROSPERO CRD42020209295, October 15, 2020.
Statistical analysis plan for the PRO B study: open-label, superiority randomised controlled trial of alarm-based patient-reported outcome monitoring in patients with metastatic breast cancer
Authors: Gebert Pimrapat , Karsten Maria Margarete , Hage Anna Maria , Dordevic Adam David , Grittner Ulrike 
Published: March 2024

Abstract
Background
With an increasing collection of patient-reported outcomes (PROs) to measure health-related quality of life (HRQoL) in oncological patients, there is still a lack of standardised strategies on how to interpret and use these data in patient care. Prior research has shown support for the use of digital PRO monitoring together with alarm systems to notify clinicians when the PRO values are deteriorating. This system has demonstrated advantages in improving HRQoL and increasing survival rates among oncology patients. Hence, we designed the PRO B study, a superiority multi-centre randomised controlled trial, to investigate the effects of alarm-based monitoring in metastatic breast cancer patients in Germany. The study protocol for the PRO B study was published in September 2021, and this manuscript describes a formal statistical analysis plan (SAP) for the PRO B study to improve the transparency and quality of this trial.

Methods and design
The trial aimed to recruit 1000 patients with metastatic breast cancer. However, as of the completion of recruitment on June 15, 2023, we have successfully enrolled 924 patients from 52 breast cancer centres. Patients were 1:1 stratified randomised to the intervention and control groups. App-based PRO questionnaires are sent weekly to the intervention group and every 3 months to the control group. Only patients in the intervention group trigger an alarm if their PRO scores deteriorate, and they are subsequently contacted by the local care team within 48 h. The primary outcome is the fatigue score at 6 months, and secondary outcomes are other HRQoL and overall survival. Evaluation of the superiority of the intervention will be done using a linear mixed model with random intercepts for study centres.

Conclusion
This detailed SAP defines the main components of the statistical analysis for the PRO B study to assist the statistician and prevent bias in selecting analysis and reporting findings. Version 1 of the SAP was finalised on January 18, 2024.

Trial registration
DRKS (German Clinical Trials Register) DRKS00024015. Registered on February 15, 2021.
Exploring the potential of fully automated LUMIPULSE G plasma assays for detecting Alzheimer’s disease pathology
Authors: Silva-Spínola Anuschka , Leitão Maria João , Nadal Alicia , Le Bastard Nathalie , Santana Isabel , Baldeiras Inês 
Published: March 2024

Abstract
Background
LUMIPULSE G-automated immunoassays represent a widely used method for the quantification of Alzheimer’s disease (AD) biomarkers in the cerebrospinal fluid (CSF). Less invasive blood-based markers confer a promising tool for AD diagnosis at prodromal stages (mild cognitive impairment (MCI)). Highly sensitive assays for the quantification of amyloid-beta (Aβ) and phosphorylated Tau-181 (p-Tau181) in the blood are showing promising results. In this study, we evaluated the clinical performance of the recently available fully automated LUMIPULSE plasma marker assays for detecting brain AD pathology and for predicting progression from MCI to AD dementia stage.

Methods
A retrospective exploratory cohort of 138 individuals (22 neurological controls [NC], 72 MCI, and 44 AD dementia patients) was included. Data regarding baseline CSF concentrations of Aβ42, Aβ40, t-Tau, and p-Tau181 was available and used to establish the presence of AD brain pathology. Baseline Aβ42, Aβ40, and p-Tau181 concentrations were determined in stored plasma samples using high-throughput fully automated LUMIPULSE assays. Progression from MCI to AD dementia was evaluated during follow-up (mean 6.4 ± 2.5 years). Moreover, a prospective validation cohort of 72 individuals with memory complaints underwent AD biomarker quantification, closely mirroring typical clinical practice. This cohort aimed to confirm the study’s main findings.

Results
In the exploratory cohort, correlations between CSF and plasma were moderate for p-Tau181 (ρ = 0.61, p < 0.001) and weak for Aβ42/Aβ40 ratio (ρ = 0.39, p < 0.001). Plasma p-Tau181 and p-Tau181/Aβ42 concentrations were significantly increased while Aβ42/Aβ40 was significantly decreased (p < 0.001) in patients with AD dementia and prodromal AD, as well as in individuals with CSF abnormal amyloid concentrations (A +). Plasma p-Tau181 showed a robust performance in differentiating patients clinically diagnosed as AD (AUC = 0.89; 95% CI 0.83–0.94); A + vs. A − (AUC = 0.84, 95% CI 0.77–0.91) and also in predicting conversion to AD dementia in MCI patients (AUC = 0.89, 95% CI 0.81–0.96). When tested in the validation cohort, plasma p-Tau181 displayed 83.3% of the overall percentage of agreement according to amyloid status.

Conclusions
Our results show that the measurement of p-Tau181 in plasma has great potential as a non-invasive prognostic screening tool for implementation in a clinical setting.
Comparative analysis of the vaginal bacteriome and virome in healthy women living in high-altitude and sea-level areas
Authors: Li Chaoran , jin Song , Lv Oingbo , Wang Guangyang , Zhang Yue , Li Shenghui , zhang Wei , Long Fang , Shen Zhuowei , Bai Siqi , Zhaxi Duoii , Kong Fandou , Yan Qiulong , Xiao Zhen 
Published: March 2024

AbstractThe vaginal microbiota plays an important role in the health of the female reproductive tract and is closely associated with various pregnancy outcomes and sexually transmitted diseases. Plenty of internal and external factors have strong influence on the changes in a woman's vaginal microbiome. However, the effect of a high-altitude on female vaginal microbiota has not been described. In this study, we characterized the vaginal bacteriome and virome of 13 and 34 healthy women living in high-altitude and sea-level areas, using whole-metagenome shotgun sequencing of their vaginal mucus samples. The results revealed that the vaginal bacteriomes of high-altitude individuals are featured by a significant increase of species diversity, depletion of Lactobacillus crispatus, and more abundant of some anaerobic bacteria, such as Chlamydia trachomatis, Mageeibacillus indolicus, Dialister micraerophilus, and Sneathia amnii). In addition, the vagina samples of sea-level subjects harbor more Lactobacillus strains, whereas the anaerobic bacteroidetes strains mostly appeared in high-altitude subjects. Identified and assembled 191 virus operational taxonomic units (vOTUs), there were significant differences in the abundance of 107 vOTUs between the two groups. Together, the results of this study raised the understanding of bacteriome and virome in the vagina of women at different elevations, and demonstrated that the vaginal microbiome is related to the high-altitude geographic adaptation.
Distinct associations between gratitude, self-esteem, and optimism with subjective and psychological well-being among Japanese individuals
Authors: Nawa Norberto Eiji , Yamagishi Noriko 
Published: March 2024

Abstract
Background
Mounting evidence suggests that the effectiveness of positive psychology interventions is influenced by a variety of factors, including cultural context. Identifying intervention targets that can effectively contribute to improving individual well-being under these boundary conditions is a crucial step when developing viable interventions. To this end, we examined how gratitude disposition, self-esteem, and optimism relate to the subjective well-being (SWB) and psychological well-being (PWB) of Japanese individuals.

Methods
Multivariate regression analysis was employed to quantify the unique relationships between the three potential intervention targets and both SWB and PWB, while accounting for the influence of other variables. Participants (N = 71) also engaged in a 4-week experience sampling study to explore how gratitude, self-esteem and optimism shape the link between momentary affective states in everyday life and evaluations of day satisfaction.

Results
Multivariate regression analysis revealed that self-esteem was predominantly more strongly associated with SWB compared to gratitude disposition, whereas gratitude disposition was more strongly associated with the PWB dimensions, particularly personal growth, positive relations with others and purpose in life. Experience sampling data indicated that while both gratitude disposition and self-esteem moderated the association between momentary positive affect and day satisfaction evaluations, they did so in opposite ways; greater gratitude disposition strengthened the association, while greater self-esteem weakened it.

Conclusions
Overall, the current results suggest that while gratitude, self-esteem, and optimism influence individual well-being as a whole, they likely play distinct roles in facilitating SWB and PWB in the studied cohort.
Spatial comparison of inland water observations from CYGNSS, MODIS, Landsat, and commercial satellite imagery
Authors: Pavur G. K. , Kim H. , Fang B. , Lakshmi V. 
Published: March 2024

AbstractAccurate and timely inland waterbody extent and location data are foundational information to support a variety of hydrological applications and water resources management. Recently, the Cyclone Global Navigation Satellite System (CYGNSS) has emerged as a promising tool for delineating inland water due to distinct surface reflectivity characteristics over dry versus wet land which are observable by CYGNSS’s eight microsatellites with passive bistatic radars that acquire reflected L-band signals from the Global Positioning System (GPS) (i.e., signals of opportunity). This study conducts a baseline 1-km comparison of water masks for the contiguous United States between latitudes of 24°N-37°N for 2019 using three Earth observation systems: CYGNSS (i.e., our baseline water mask data), the Moderate Resolution Imaging Spectroradiometer (MODIS) (i.e., land water mask data), and the Landsat Global Surface Water product (i.e., Pekel data). Spatial performance of the 1-km comparison water mask was assessed using confusion matrix statistics and optical high-resolution commercial satellite imagery. When a mosaic of binary thresholds for 8 sub-basins for CYGNSS data were employed, confusion matrix statistics were improved such as up to a 34% increase in F1-score. Further, a performance metric of ratio of inland water to catchment area showed that inland water area estimates from CYGNSS, MODIS, and Landsat were within 2.3% of each other regardless of the sub-basin observed. Overall, this study provides valuable insight into the spatial similarities and discrepancies of inland water masks derived from optical (visible) versus radar (Global Navigation Satellite System Reflectometry, GNSS-R) based satellite Earth observations.