bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reductions in hospitalisations and emergency department visits with early antibiotic initiation in nontuberculous mycobacterial lung disease
Authors: Winthrop Kevin , Waweru Catherine , Hassan Mariam , Burns Sara , Lucci Matthew , Chatterjee Anjan 
Published: March 2024

BackgroundWhile antibiotics are recommended for treatment of nontuberculous mycobacterial lung disease (NTMLD), the impact of early antibiotic initiation on healthcare resource utilisation is unclear. This study compared healthcare resource utilisation with earlyversusdelayed antibiotic initiation in NTMLD.MethodsA retrospective, claims database study (Merative MarketScan) of patients diagnosed with NTMLD between 1 July 2015 and 30 June 2019. Patients were divided into early antibiotic initiation,i.e.≤3 months after the first medical claim for NTMLD (index date), and delayed antibiotic initiation groups. Hospitalisations and outpatient visits during a 2-year post-index period were compared to baseline per treatment group; a difference-in-difference analysis compared early and delayed antibiotic initiation groups adjusting for confounding.ResultsOut of 481 NTMLD treated patients, 364 (76%) and 117 (24%) comprised the early and delayed antibiotic initiation groups, respectively. The early antibiotic initiation group showed significant reductions from baseline in hospitalisations (all-cause, respiratory) and emergency department (ED) visits at follow-up. A significant increase from baseline in mean number of hospitalisations per patient was observed in the delayed antibiotic initiation group in year 1 post-index. Compared to delayed antibiotic initiation, the early antibiotic initiation group showed significantly greater reductions in all-cause hospitalisations in years 1 and 2 post-index (relative risk 0.62 (95% CI 0.41–0.95) and 0.62 (95% CI 0.39–0.98), respectively), and in respiratory-related hospitalisations.ConclusionsThe early antibiotic initiation group showed significant reductions from baseline in hospitalisations and ED visits over time. Compared to delayed antibiotic initiation, early antibiotic initiation was associated with significantly greater reductions in hospitalisations.
Total sputum nitrate/nitrite is associated with exacerbations andPseudomonas aeruginosacolonisation in bronchiectasis
Authors: Zhou Yaya , He Xinliang , Tang Jian , Zhang Dongmei , Liu Yao , Xue Yu'e , Jiang Nanchuan , Zhang Jianchu , Wang Xiaorong 
Published: March 2024

BackgroundSputum nitrate/nitrite, which is the main component of reactive nitrogen species, is a potential biomarker of disease severity and progression in bronchiectasis. This study aimed to determine the association between nitrate/nitrite and exacerbations and airway microbiota in bronchiectasis.MethodsWe measured total nitrate/nitrite concentration in sputum samples collected from 85 patients with stable bronchiectasis, performed 16S ribosomal RNA sequencing of sputum samples and predicted the denitrification ability of airway microbiota using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt). Relationships between sputum total nitrate/nitrite and disease severity, exacerbations and airway microbiota were examined.ResultsHigher total sputum nitrate/nitrite was associated with more severe bronchiectasis defined by E-FACED (exacerbation, forced expiratory volume in 1 s, age, chronic colonisation byPseudomonas aeruginosa, radiological extension and dyspnoea) (p=0.003) or Bronchiectasis Severity Index (p=0.006) and more exacerbations in the prior 12 months (p=0.005). Moreover, total sputum nitrate/nitrite was significantly higher in patients with worse cough score (p=0.03), worse sputum purulence score (p=0.01) and worse Medical Research Council dyspnoea score (p=0.02). In addition, the total sputum nitrate/nitrite of theP. aeruginosacolonised (PA) group was higher than that of the non-P. aeruginosacolonised (NPA) group (p=0.04), and the relative abundance ofP. aeruginosawas positively correlated with total nitrate/nitrite (r=0.337, p=0.002). Denitrification module (M00529) was also significantly enriched in the PA group compared to the NPA group through PICRUSt analyses. Using receiver-operating characteristic analysis, total nitrate/nitrite was associated with exacerbations during 1-year follow-up (area under the curve 0.741, p=0.014).ConclusionsSputum nitrate/nitrite is a biomarker of disease severity and associated withP. aeruginosacolonisation in bronchiectasis.
Prolonged lung-to-finger circulation time indicates an increased risk of intermittent hypoxaemia in sleep apnoea patients
Authors: Pahari Purbanka , Korkalainen Henri , Arnardóttir Erna Sif , Islind Anna Sigridur , August Elias , Oksenberg Arie , Töyräs Juha , Leppänen Timo , Nikkonen Sami 
Published: March 2024

IntroductionIntermittent hypoxaemia is closely associated with cardiovascular dysfunction and may be a more accurate indicator of obstructive sleep apnoea (OSA) severity than conventional metrics. Another key factor is the lung-to-finger circulation time (LFCt), defined as the duration from the cessation of a respiratory event to the lowest point of oxygen desaturation. LFCt serves as a surrogate marker for circulatory delay and is linked with cardiovascular function. Yet, the specific associations between respiratory and hypoxaemia characteristics and LFCt in patients with OSA remain unclear. This study aims to investigate these associations, ultimately contributing to a more nuanced understanding of OSA severity.MethodsThe study comprised 878 in-lab polysomnographies of patients with suspected OSA. The conventional OSA metrics were computed along with nine hypoxaemia metrics and then divided into quartiles (Q1–Q4) based on respiratory event duration. In addition, these were further divided into subquartiles based on LFCt. The empirical cumulative distribution functions (CDFs) and linear regression models were used to investigate the association between desaturation metrics and LFCt.ResultsThe results showed that prolonged LFCt was associated with increased hypoxic severity. Based on CDFs, the hypoxic severity significantly increased with longer LFCt despite the duration of respiratory events. Furthermore, fall duration was elevated in patients with longer LFCt (Q1- desaturation fall duration (FallDur): 14.6 s; Q4-FallDur: 29.8 s; p<0.0001). The regression models also showed significant association between hypoxic severity and LFCt (Q1-desaturation fall slope (FallSlope): β=−3.224; Q4-FallSlope: β=−6.178; p<0.0001).DiscussionConsidering LFCt along with desaturation metrics might be useful in estimating the association between the severity of OSA, physiological consequences of respiratory events and cardiac health.
Heuristic Expanding Disconnected Graph: A Rapid Path Planning Method for Mobile Robots
Authors: Tao Yong , Duan Lian , Gao He , Zhang Yufan , Song Yian , Wang Tianmiao 
Published: March 2024

AbstractExisting mobile robots mostly use graph search algorithms for path planning, which suffer from relatively low planning efficiency owing to high redundancy and large computational complexity. Due to the limitations of the neighborhood search strategy, the robots could hardly obtain the most optimal global path. A global path planning algorithm, denoted as EDG*, is proposed by expanding nodes using a well-designed expanding disconnected graph operator (EDG) in this paper. Firstly, all obstacles are marked and their corners are located through the map pre-processing. Then, the EDG operator is designed to find points in non-obstruction areas to complete the rapid expansion of disconnected nodes. Finally, the EDG* heuristic iterative algorithm is proposed. It selects the candidate node through a specific valuation function and realizes the node expansion while avoiding collision with a minimum offset. Path planning experiments were conducted in a typical indoor environment and on the public dataset CSM. The result shows that the proposed EDG* reduced the planning time by more than 90% and total length of paths reduced by more than 4.6%. Compared to A*, Dijkstra and JPS, EDG* does not show an exponential explosion effect in map size. The EDG* showed better performance in terms of path smoothness, and collision avoidance. This shows that the EDG* algorithm proposed in this paper can improve the efficiency of path planning and enhance path quality.
Species and structural diversity of trees at the structural type level
Authors: Li Yuanfa , Wei Liting 
Published: March 2024

AbstractBackgroundSpecies and structural diversity are important for understanding the formation of forest communities, key ecological processes, and improving forest ecological functions and services, but their spatial characteristics have received little attention. Based on the spatial relationships among neighbouring trees, we proposed to divide trees within a structural unit into 15 structural types, and used the univariate distributions of the uniform angle index (W), mingling (M), and dominance (U), along with four common species diversity indices, to analyse the diversity of structural types in natural forests near the Tropic of Cancer.ResultsOnly a portion of clumped class maintained aggregation, most exhibited a random pattern. Species mixture increased exponentially across distribution classes, and abundance and richness exhibited an initial increase followed by a slight decrease. The distribution patterns of mixture classes varied from highly clustered to random, and M distributions gradually shifted from an inverted J-shaped curve to a J-shaped curve. Abundance and richness exhibited an exponential distribution, whereas the Shannon–Wiener index increased linearly. The W distribution of differentiation classes approximated a normal distribution, whereas M distributions exhibited a J shape. The U distribution of each structure type was approximately 0.2.ConclusionsThese results reveal the species and structural diversity characteristics of trees at the structural type level and expand our knowledge of forest biodiversity. The new method proposed here should significantly contribute to biodiversity monitoring efforts in terrestrial ecosystems, and suggests that higher standards for the simulation and reconstruction of stand structure, as well as thinning in near-natural forests, is warranted.
Assessment of the E-value in the presence of bias amplification: a simulation study
Authors: Barrette Eric , Higuera Lucas , Wherry Kael 
Published: March 2024

Abstract
Background
The E-value, a measure that has received recent attention in the comparative effectiveness literature, reports the minimum strength of association between an unmeasured confounder and the treatment and outcome that would explain away the estimated treatment effect. This study contributes to the literature on the applications and interpretations of E-values by examining how the E-value is impacted by data with varying levels of association of unobserved covariates with the treatment and outcome measure when covariate adjustment is applied. We calculate the E-value after using regression and propensity score methods (PSMs) to adjust for differences in observed covariates. Propensity score methods are a common observational research method used to balance observed covariates between treatment groups. In practice, researchers may assume propensity score methods that balance treatment groups across observed characteristics will extend to balance of unobserved characteristics. However, that assumption is not testable and has been shown to not hold in realistic data settings. We assess the E-value when covariate adjustment affects the imbalance in unobserved covariates.

Methods
Our study uses Monte Carlo simulations to evaluate the impact of unobserved confounders on the treatment effect estimates and to evaluate the performance of the E-Value sensitivity test with the application of regression and propensity score methods under varying levels of unobserved confounding. Specifically, we compare observed and unobserved confounder balance, odds ratios of treatment vs. control, and E-Value sensitivity test statistics from generalized linear model (GLM) regression models, inverse-probability weighted models, and propensity score matching models, over correlations of increasing strength between observed and unobserved confounders.

Results
We confirm previous findings that propensity score methods – matching or weighting – may increase the imbalance in unobserved confounders. The magnitude of the effect depends on the strength of correlation between the confounder, treatment, and outcomes. We find that E-values calculated after applying propensity score methods tend to be larger when unobserved confounders result in more biased treatment effect estimates.

Conclusions
The E-Value may misrepresent the size of the unobserved effect needed to change the magnitude of the association between treatment and outcome when propensity score methods are used. Thus, caution is warranted when interpreting the E-Value in the context of propensity score methods.
Analysis of related factors for sarco-osteoporosis in middle-aged and elderly inpatients and development and validation of a nomogram
Authors: Juan Peng Dao , Gao Feng Qiong , Lou Yijiao , Ma Yan , Xia Tongxia 
Published: March 2024

Abstract
Background
Sarco-osteoporosis is a skeletal muscle disease associated with aging and complex pathological factors. At present, there are few studies on the analysis of its related factors, and a nomogram to estimate the risk of sarco-osteoporosis in middle-aged and elderly patients is not available.

Methods
A total of 386 patients admitted to our hospital from October 2021 to October 2022 were collected, and the general demographic data and clinical data of the patients were collected.386 subjects were enrolled in the study and randomly divided into training set and validation set at a ratio of 7:3. In the training set, the Least absolute shrinkage and selection operator(LASSO)regression technique was used to select the optimal predictive features, and multivariate logistic regression was used to screen the factors associated with sarco-osteoporosis, and a nomogram was constructed using meaningful variables from multivariate analysis. The performance of the nomograms was assessed and validated by Area Under Curve (AUC) and calibration curves.

Results
There were no significant differences in baseline characteristic of individuals in training set and validation set, six variables with non-zero coefficients were screened based on LASSO regression in the training set. Multivariate logistic regression analysis showed that the related factors for sarco-osteoporosis in middle-aged and elderly inpatients included age (OR = 1.08, 95%CI 1.03 ∼ 1.14), regular exercise (OR = 0.29, 95%CI 0.15 ∼ 0.56), albumin (OR = 0.9, 95%CI 0.82 ∼ 0.98), height (OR = 0.93, 95%CI 0.88 ∼ 0.99) and lean mass index (OR = 0.66, 95%CI 0.52 ∼ 0.85), and a nomogram was constructed based on the above factors. AUC of nomogram were 0.868(95%CI 0.825 ∼ 0.912) in the training set and 0.737(95%CI 0.646 ∼ 0.828) in the validation set. Calibration curve analysis showed that the predicted probability of sarco-osteoporosis had high consistency with the actual probability, and the absolute error of the training set and verification set was 0.018 and 0.03, respectively.

Conclusions
Our research showed that the occurrence of sarco-osteoporosis was associated with age, regular exercise, albumin, height and lean mass index, and we have developed a nomogram that can be effectively used in the preliminary and in-depth risk prediction of sarco-osteoporosis in middle-aged and elderly hospitalized patients.
Influence of education level and gender of dental students on perception of dental aesthetics
Authors: Kovačić Ines , Miloš Manuela , Kurkutović Matej , Čelebić Asja , Petričević Nikola 
Published: March 2024

Abstract
Background
Fulfilling aesthetic norms is an imperative of modern society. Accordingly, aesthetics has found its important role in dental medicine. The aim was to study whether there is a difference in the perception of tooth shade change and anatomical variations of anterior maxillary teeth among dental students depending on the level of education, gender, and experience in assisting in a dental office.

Methods
The research was conducted among dental students via the Google Forms platform. Students evaluated the aesthetic acceptability of a smile on the unaltered, reference photograph (RP) and on the other 28 photographs in which the tooth shade (lighter and darker teeth), length (shortened central incisors, elongated, and beveled lateral incisors, elongated canines) and position (atypical and typical rotations and diastemas) of the upper maxillary teeth were altered by digital manipulation. The 1–10 assessment scale was used. Statistical analysis comprised one-way Kolmogorov-Smirnov test, X2 tests, t-test, and 3-way MANOVA.

Results
In the research 208 students participated, 113 were preclinical students, 104 assisted in dental office and 175 were females. There were no significant effects of gender regarding length and position modifications (p > .05), while women were stricter in evaluation of lighter shade (p < .05). Clinical students were stricter in evaluating all manipulated photographs (MP) except those towards darker shade modifications, while assisting in a dental office or having a dentist in close family showed no significant effects (p > .05).

Conclusions
With a higher level of targeted academic education, dental students sharpen their ability to notice deviations from the aesthetic norms of a smile.
Core components of end-of-life care in nursing education programs: a scoping review
Authors: Taheri-Ezbarami Zahra , Jafaraghaee Fateme , Sighlani Ali Karimian , Mousavi Seyed Kazem 
Published: March 2024

Abstract
Background
So far, there have been many studies on end-of-life nursing care education around the world, and in many cases, according to the cultural, social, and spiritual contexts of each country, the results have been different. The present study intends to gain general insight into the main components of end-of-life care in nursing education programs by reviewing scientific texts and the results of investigations.

Methods
This study was a scoping review conducted with the Arksey and O’Malley methodology updated by Peters et al. First, a search was made in Wos, ProQuest, Scopus, PubMed, Science Direct, Research Gate, and Google Scholar databases to find studies about end-of-life care education programs. Then, the screening of the found studies was done in four stages, and the final articles were selected based on the inclusion and exclusion criteria of the studies. Due to the nature of the research, editorials, letters, and commentaries were excluded. The screening steps are shown in the PRISMA-ScR diagram.

Results
23 articles related to end-of-life care education programs were reviewed. The studies included eleven descriptive and cross-sectional studies, two qualitative studies, eight interventional studies, one concept analysis article, and one longitudinal study. By summarizing the data from the studies, six themes were obtained as the main components of end-of-life care education: principles of end-of-life care, communication skills, physical considerations, psychosocial and spiritual considerations, ethical considerations, and after-death care.

Conclusion
End-of-life care is one of the most challenging nursing care in the world. Since many nurses are not prepared to provide such care, the information obtained from this review can help nursing education and treatment managers develop more comprehensive training programs to improve the quality of end-of-life care.
Insight into antioxidant-like activity and computational exploration of identified bioactive compounds in Talinum triangulare (Jacq.) aqueous extract as potential cholinesterase inhibitors
Authors: Afolabi Olakunle Bamikole , Olasehinde Oluwaseun Ruth , Owolabi Olutunmise Victoria , Jaiyesimi Kikelomo Folake , Adewumi Funmilayo Deborah , Idowu Olajumoke Tolulope , Mabayoje Samson Olatunde , Obajuluwa Adejoke Olukayode , Akpor Oghenerobor Benjamin 
Published: March 2024

Abstract
Background
Recent reports have highlighted the significance of plant bioactive components in drug development targeting neurodegenerative disorders such as Alzheimer’s disease (AD). Thus, the current study assessed antioxidant activity and enzyme inhibitory activity of the aqueous extract of Talinum triangulare leave (AETt) as well as molecular docking/simulation of the identified phytonutrients against human cholinesterase activities.

Methods
In vitro assays were carried out to assess the 2,2- azinobis (3-ethyl-benzothiazoline-6-sulfonic acid) (ABTS) cation radicals and cholinesterase inhibitory activities of AETt using standard protocols. High performance liquid chromatography coupled with diode-array detection (HPLC–DAD) was employed to identify compounds in AETt. Also, for computational analysis, identified bioactive compounds from AETt were docked using Schrodinger's GLIDE against human cholinesterase obtained from the protein data bank (https://www.rcsb.org/).

Results
The results revealed that AETt exhibited a significant concentration-dependent inhibition against ABTS cation radicals (IC50 = 308.26 ± 4.36 µg/ml) with butylated hydroxytoluene (BHT) as the reference. Similarly, AETt demonstrated a significant inhibition against acetylcholinesterase (AChE, IC50 = 326.49 ± 2.01 µg/ml) and butyrylcholinesterase (BChE, IC50 = 219.86 ± 4.13 µg/ml) activities with galanthamine as the control. Molecular docking and simulation analyses revealed rutin and quercetin as potential hits from AETt, having showed strong binding energies for both the AChE and BChE. In addition, these findings were substantiated by analyses, including radius of gyration, root mean square fluctuation, root mean square deviation, as well as mode similarity and principal component analyses.

Conclusion
Overall, this study offers valuable insights into the interactions and dynamics of protein–ligand complexes, offering a basis for further drug development targeting these proteins in AD.
A closer look: obsessive-compulsive symptoms among intern nurses amidst COVID-19 pandemic
Authors: El-Sayed Mona Metwally , Elhay Eman Sameh Abd , Hawash Manal Mohammed , Sonbol Hassan Mohammed , Taha Samah Mohamed 
Published: March 2024

Abstract
Background
The distinctive circumstances and socio-cultural context in Egypt make it crucial to explore the psychological well-being of intern nurses amid the COVID-19 pandemic, with a specific focus on obsessive-compulsive symptoms. This study aimed to investigate the influence of fear of COVID-19 on obsessive-compulsive symptoms among intern nurses.

Methods
A cross-sectional survey involving 375 randomly recruited intern nurses was conducted. Data collected included the Fear of COVID-19 Scale and the Short Version of the Arabic Obsessive-Compulsive Scale.

Results
A significant relationship was found between the fear of COVID-19 and the severity of obsessive-compulsive symptoms among the participants (r = 0.472, p = 0.000). A stepwise regression analysis indicated that the fear of COVID-19, living in urban regions, frequency of COVID-19 infection, and increased number of infected family members may contribute to the severity of Obsessive-Compulsive Symptoms with adjusted R2 value = 27.5%.

Conclusion
The findings suggest that the COVID-19 pandemic has had significant psychological impacts on newly qualified nurses during their internship training period, including the manifestation of mental health symptoms such as Obsessive-Compulsive Symptoms. It was observed that urban residents, intern nurses with recurrent COVID-19 infections, and those with more infected family members exhibited a higher severity of OCS. These findings underscore the need for further research to investigate additional factors that may influence OCS severity.