bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of and factors associated with multimorbidity among adults in Kuwait
Authors: Saoud Fajer , AlHenaidi Maryam , AlOtaibi Hajer , AlEnezi Asayel , Mohammed Mariam , AlOtaibi Fatemah , AlShammari Danah , AlKharqawi Sebakah , AlMayas Hadil , AlMathkour Hatoun , Akhtar Saeed 
Published: March 2024

Abstract
Background
This cross-sectional study aimed to assess the prevalence of morbidity i.e., one morbidity and multimorbidity (≥ 2 morbid conditions) among adults in Kuwait and to examine the sociodemographic and lifestyle factors associated with morbidity as a multinomial outcome in the study population.

Methods
The data were collected from January 26, 2021, to February 3, 2021, using an electronic questionnaire, which was distributed on social media platforms. The consent form was attached with the questionnaire and the participants were requested to sign the consent form before completing the questionnaire. The prevalences (%) of each morbidity and multimorbidity were computed. Multivariable polychotomous logistic regression analysis was used to evaluate the association between the demographic and lifestyle factors with morbidity as a multinomial outcome.

Results
Of 3572 respondents included, 89% were Kuwaiti, 78.3% females and 66% were 21- 40 years old. The prevalence of multimorbidity and one morbidity respectively was 27.4% and 29.7%. The prevalence of multimorbidity with two, three, four or five ill-health conditions were 14.3%, 7.4%, 3.5%, and 1.2%, respectively. A higher prevalence of multimorbidity was among respondents over 60 years of age (71%) and Kuwaiti nationals (28.9%). The final multivariable polychotomous logistic regression model revealed that age, sex, nativity, sedentary lifestyle, smoking, and alcohol drinking were significantly (p < 0.05) associated with multimorbidity. However, age and alcohol drinking were significant (p < 0.05) predictors of one morbidity.

Conclusion
This study provides evidence that multimorbidity is more prevalent among the elderly, females, and Kuwaiti nationals. Sedentary behaviour, smoking and alcohol consumption were significantly and independently associated with multimorbidity. These findings highlight the burden of multimorbidity and should be considered in the development of future prevention programs.
KGSCS—a smart care system for elderly with geriatric chronic diseases: a knowledge graph approach
Authors: Li Aihua , Han Che , Xing Xinzhu , Wei Qinyan , Chi Yuxue , Pu Fan 
Published: March 2024

Abstract
Background
The increasing aging population has led to a shortage of geriatric chronic disease caregiver, resulting in inadequate care for elderly people. In this global context, many older people rely on nonprofessional family care. The credibility of existing health websites cannot meet the needs of care. Specialized health knowledge bases such as SNOMED—CT and UMLS are also difficult for nonprofessionals to use. Furthermore, professional caregiver in elderly care institutions also face difficulty caring for multiple elderly people at the same time and working handovers. As a solution, we propose a smart care system for the elderly based on a knowledge graph.

Method
First, we worked with professional caregivers to design a structured questionnaire to collect more than 100 pieces of care-related information for the elderly. Then, in the proposed system, personal information, smart device data, medical knowledge, and nursing knowledge are collected and organized into a dynamic knowledge graph. The system offers report generation, question answering, risk identification and data updating services. To evaluate the effectiveness of the system, we use the expert evaluation method to score the user experience.

Results
The results of the study showed that compared to existing tools (health websites, archives and expert team consultation), the system achieved a score of 8 or more for basic information, health support and Dietary information. Some secondary evaluation indicators reached 9 and 10 points. This finding suggested that the system is superior to existing tools. We also present a case study to help the reader understand the role of the system.

Conclusion
The smart care system provide personalized care guidelines for nonprofessional caregivers. It also makes the job easier for institutional caregivers. In addition, the system provides great convenience for work handover.
Bacterial DnaK reduces the activity of anti-cancer drugs cisplatin and 5FU
Authors: Benedetti Francesca , Mongodin Emmanuel F. , Badger Jonathan H. , Munawwar Arshi , Cellini Ashley , Yuan Weirong , Silvestri Giovannino , Kraus Carl N. , Marini Simone , Rathinam Chozha V. , Salemi Marco , Tettelin Hervé , Gallo Robert C. , Zella Davide 
Published: March 2024

Abstract
Background
Chemotherapy is a primary treatment for cancer, but its efficacy is often limited by cancer-associated bacteria (CAB) that impair tumor suppressor functions. Our previous research found that Mycoplasma fermentans DnaK, a chaperone protein, impairs p53 activities, which are essential for most anti-cancer chemotherapeutic responses.

Methods
To investigate the role of DnaK in chemotherapy, we treated cancer cell lines with M. fermentans DnaK and then with commonly used p53-dependent anti-cancer drugs (cisplatin and 5FU). We evaluated the cells’ survival in the presence or absence of a DnaK-binding peptide (ARV-1502). We also validated our findings using primary tumor cells from a novel DnaK knock-in mouse model. To provide a broader context for the clinical significance of these findings, we investigated human primary cancer sequencing datasets from The Cancer Genome Atlas (TCGA). We identified F. nucleatum as a CAB carrying DnaK with an amino acid composition highly similar to M. fermentans DnaK. Therefore, we investigated the effect of F. nucleatum DnaK on the anti-cancer activity of cisplatin and 5FU.

Results
Our results show that both M. fermentans and F. nucleatum DnaKs reduce the effectiveness of cisplatin and 5FU. However, the use of ARV-1502 effectively restored the drugs' anti-cancer efficacy.

Conclusions
Our findings offer a practical framework for designing and implementing novel personalized anti-cancer strategies by targeting specific bacterial DnaKs in patients with poor response to chemotherapy, underscoring the potential for microbiome-based personalized cancer therapies.
FLASH radiotherapy for the treatment of symptomatic bone metastases in the thorax (FAST-02): protocol for a prospective study of a novel radiotherapy approach
Authors: Daugherty EC , Zhang Y , Xiao Z , Mascia AE , Sertorio M , Woo J , McCann C , Russell KJ , Sharma RA , Khuntia D , Bradley JD , Simone CB , Breneman JC , Perentesis JP 
Published: March 2024

Abstract
Background
FLASH therapy is a treatment technique in which radiation is delivered at ultra-high dose rates (≥ 40 Gy/s). The first-in-human FAST-01 clinical trial demonstrated the clinical feasibility of proton FLASH in the treatment of extremity bone metastases. The objectives of this investigation are to assess the toxicities of treatment and pain relief in study participants with painful thoracic bone metastases treated with FLASH radiotherapy, as well as workflow metrics in a clinical setting.

Methods
This single-arm clinical trial is being conducted under an FDA investigational device exemption (IDE) approved for 10 patients with 1–3 painful bone metastases in the thorax, excluding bone metastases in the spine. Treatment will be 8 Gy in a single fraction administered at ≥ 40 Gy/s on a FLASH-enabled proton therapy system delivering a single transmission proton beam. Primary study endpoints are efficacy (pain relief) and safety. Patient questionnaires evaluating pain flare at the treatment site will be completed for 10 consecutive days post-RT. Pain response and adverse events (AEs) will be evaluated on the day of treatment and on day 7, day 15, months 1, 2, 3, 6, 9, and 12, and every 6 months thereafter. The outcomes for clinical workflow feasibility are the occurrence of any device issues as well as time on the treatment table.

Discussion
This prospective clinical trial will provide clinical data for evaluating the efficacy and safety of proton FLASH for palliation of bony metastases in the thorax. Positive findings will support the further exploration of FLASH radiation for other clinical indications including patient populations treated with curative intent.

Registration
ClinicalTrials.gov NCT05524064.
Long-term outcome in new onset refractory status epilepticus: a retrospective study
Authors: Stretti Federica , Bögli Stefan Yu , Casagrande Francesca , Eisele Amanda , Galovic Marian , Keller Emanuela , Brandi Giovanna 
Published: March 2024

Abstract
Background
New onset refractory status epilepticus (NORSE) is a neurologic emergency without an immediately identifiable cause. The complicated and long ICU stay of the patients can lead to perceiving a prolongation of therapies as futile. However, a recovery is possible even in severe cases. This retrospective study investigates ICU treatments, short- and long-term outcome and ethical decisions of a case series of patients with NORSE.

Methods
Overall, 283 adults were admitted with status epilepticus (SE) to the Neurocritical Care Unit of the University Hospital Zurich, Switzerland, between 01.2010 and 12.2022. Of them, 25 had a NORSE. We collected demographic, clinical, therapeutic and outcome data. Descriptive statistics was performed.

Results
Most patients were female (68%), previously healthy (Charlson comorbidity index 1 [0–4]) and relatively young (54 ± 17 years). 96% presented with super-refractory SE. Despite extensive workup, the majority (68%) of cases remained cryptogenic. Most patients had a long and complicated ICU stay. The in-hospital mortality was 36% (n = 9). The mortality at last available follow-up was 56% (n = 14) on average 30 months after ICU admission. The cause of in-hospital death for 89% (n = 8) of the patients was the withholding/withdrawing of therapies. Medical staff except for one patient triggered the decision. The end of life (EOL) decision was taken 29 [12–51] days after the ICU admission. Death occurred on day 6 [1–8.5] after the decision was taken. The functional outcome improved over time for 13/16 (81%) hospital survivors (median mRS at hospital discharge 4 [3.75–5] vs. median mRS at last available follow-up 2 [1.75–3], p < 0.001).

Conclusions
Our data suggest that the long-term outcome can still be favorable in NORSE survivors, despite a prolonged and complicated ICU stay. Clinicians should be careful in taking EOL decisions to avoid the risk of a self-fulfilling prophecy. Our results encourage clinicians to continue treatment even in initially refractory cases.
Epidemiological and transcriptome data identify shared gene signatures and immune cell infiltration in type 2 diabetes and non-small cell lung cancer
Authors: Yuan Qian , Li Long , Wang Liu-shun , Xing Shi-gui 
Published: March 2024

Abstract
Background
Numerous previous studies have reported an association between type 2 diabetes mellitus (T2DM) and lung cancer risk, but the underlying mechanism of the interaction remains unclear. This study aimed to investigate the shared genetic features and immune infiltration processes between lung cancer and T2DM.

Methods
Epidemiological data from the National Health and Nutrition Examination Survey (NHANES) 2000–2018 was used to explore the relationship between lung cancer and diabetes systematically. In addition, we also used bioinformatics methods to analyze the transcriptome data from the Gene Expression Omnibus (GEO) to explore the potential functional mechanisms from the perspective of genes and immune infiltration.

Results
Logistic regression analysis showed that prediabetes (OR = 3.289,95%CI 1.231, 8.788, p = 0.01760, model 3)and type 2 diabetes (OR = 3.032 95%CI,1.015, 9.054, p = 0.04689) were significantly associated with an increased risk of lung cancer after adjusting for multiple covariates. Data from NHANES showed an inverted U-shaped relationship between fasting blood glucose and glycosylated haemoglobin and the risk of lung cancer (P for non-linear < 0.001). Transcriptome data showed that we screened 57 co-DEGs, of which 25 were up-regulated co-DEGs and 32 were down-regulated. Ten core DEGs were identified by bioinformatics analysis, which were SMC6, CDC27, CDC7, RACGAP1, SMC4, NCF4, NCF1, NCF2, SELPLG and CFP. Correlation analysis showed that some core DEGs were significantly associated with simultaneous dysregulation of immune cells.

Conclusion
The identified core genes of NSCLC and T2DM are associated with dysregulated immune cells, which provides a potential research avenue for diagnosing and treating lung cancer combined with diabetes.
Variable Herz–Morrey estimates for rough fractional Hausdorff operator
Authors: Hussain Amjad , Khan Ilyas , Mohamed Abdullah 
Published: March 2024

AbstractAs a first attempt, we obtain the boundedness of the rough fractional Hausdorff operator on variable exponent Herz-type spaces. The method used in this paper enables us to study the operator on some other function spaces with variable exponents.
An exploration of COVID-19 vaccination models for newcomer refugees and immigrants in Calgary, Canada
Authors: Aghajafari Fariba , Wall Laurent , Weightman Amanda M. , Ness Alyssa , Lake Deidre , Anupindi Krishna , Moorthi Gayatri , Kuk Bryan , Santana Maria , Coakley Annalee 
Published: March 2024

Abstract
Background
The World Health Organization stresses the need for tailored COVID-19 models of vaccination to meet the needs of diverse populations and ultimately reach high rates of vaccination. However, little evidence exists on how COVID-19 models of vaccination operated in the novel context of the pandemic, how vulnerable populations, such as refugees, experience COVID-19 vaccination systems in high-income countries, and what lessons may be learned from vaccination efforts with vulnerable populations. To address this gap, this study explored COVID-19 vaccine delivery models available to newcomer refugees and immigrants, and refugee experiences across different COVID-19 vaccine delivery models in Calgary, Canada, and surrounding area in 2021 and 2022, to understand the barriers, strengths, and strategies of models to support access to COVID-19 vaccination for newcomer refugees and immigrants.

Methods
Researchers conducted structured interviews with Government Assisted Refugees (n = 39), and semi-structured interviews with Privately Sponsored Refugees (n = 6), private refugee sponsors (n = 3), and stakeholders involved in vaccination systems (n = 13) in 2022. Thematic analysis was conducted to draw out themes related to barriers, strengths, and strategies of vaccine delivery models and the intersections with patient experiences.

Results
Newcomer refugee and immigrant focused vaccination models and strategies were explored. They demonstrated how partnerships between organizations, multi-pronged approaches, and culturally responsive services were crucial to navigate ongoing and emergent factors, such as vaccine hesitancy, mandates, and other determinants of under-vaccination. Many vaccination models presented through interviews were not specific to refugees and included immigrants, temporary residents, ethnocultural community members, and other vulnerable populations in their design.

Conclusions
Increasing COVID-19 vaccine uptake for newcomer refugees and immigrants, is complex and requires trust, ongoing information provision, and local partnerships to address ongoing and emerging factors. Three key policy implications were drawn. First, findings demonstrated the need for flexible funding to offer outreach, translation, cultural interpretation, and to meet the basic needs of patients prior to engaging in vaccinations. Second, the research showed that embedding culturally responsive strategies within services ensures community needs are met. Finally, collaborating with partners that reflect the diverse needs of communities is crucial for the success of any health efforts serving newcomers.
The cost of the perfect body: influence mechanism of internalization of media appearance ideals on eating disorder tendencies in adolescents
Authors: Bi Xiaoyan , Liang Qian , Jiang Guangyan , Deng Min , Cui Hongbo , Ma Yankun 
Published: March 2024

Abstract
Background
Some studies have examined the relationship between internalization of media appearance ideals and eating disorders. However, few have discussed the relationship between eating disorder tendencies. To fill this research gap, this study was to explore the influencing mechanisms of internalization of media appearance ideals on adolescents’ eating disorder tendencies in Chinese cultural context.

Method
The Sociocultural Attitudes Towards Appearance Questionnaire, Eating Attitude Test-26, Physical Self-Description Questionnaire, Body Image Depression Questionnaire and Multidimensional Scale of Perceived Social Support were employed in this study to investigate 1523 adolescents. The collected data were analyzed using SPSS 26.0 and AMOS 24.0.

Result
The results showed that: (1) internalization of media appearance ideals had a significant positive predictive effect on adolescents’ eating disorder tendencies; (2) internalization of media appearance ideals significantly influenced adolescents’ eating disorder tendencies through the mediating role of body esteem and body image disturbance respectively, and also influenced eating disorder tendencies through the chain mediating of both; and (3) social support played a moderating role between body image disturbance and eating disorder tendency.

Conclusion
Our findings suggest distinct pathways through which internalization of media appearance ideals may influence adolescents’ eating disorder tendencies. It is suggested that reducing body image disturbance and enhancing social support can help reducing eating disorder tendency.
A multiscalar methodology for holistic analysis of prehistoric rock carvings in Scotland
Authors: Barnett Tertia , Valdez-Tullett Joana , Bjerketvedt Linda Marie , Alexander-Reid Frederick , Hoole Maya , Jeffrey Stuart , Robin Guillaume 
Published: March 2024

Abstract
Prehistoric rock carvings are one of Scotland’s most enigmatic and poorly understood monument types. This article discusses the pioneering approach used by Scotland’s Rock Art Project to enhance understanding of the abstract motifs through multiscalar computational analyses of a large dataset co-produced with community teams. The approach can be applied to suitable rock art datasets from other parts of the world and has international relevance for rock art reserach. Our analysis incorporates data from across Scotland in order to investigate inter-regional differences and similarities in the nature and contexts of the carvings. Innovative application of complementary analytical methods identified subtle regional variations in the character of the rock art and motif types. This variability suggest an understanding of the rock art tradition that was widely shared but locally adapted, and reflects connections and knowledge exchange between specific regions.
Influence of snowmelt on increasing Arctic river discharge: numerical evaluation
Authors: Park Hotaek , Kim Youngwook , Suzuki Kazuyoshi , Hiyama Tetsuya 
Published: March 2024

AbstractSnow is the most important component of the Arctic climatic and hydrological system and is directly vulnerable to climate change. In recent decades, observations have indicated significant decreases in the Arctic snow cover and snowfall rate, whereas water discharge from circumpolar Arctic river basins into the Arctic Ocean has increased. To evaluate the contribution, not well quantified, of snow to the river discharge increase, we conducted sensitivity simulations with surface air temperature and precipitation as climatic treatment variables, combining a land surface model and a distributed discharge model. Variables were treated assuming higher climate variations in the Arctic cold season in 1979–2018. The surface and subsurface runoffs simulated by the land surface model were set as inflows in the discharge model to estimate river discharge. Snowmelt mostly converted to surface runoff, accounting for 73.6% of the anomalous surface runoff increase and inducing the simulated peak discharge in spring and early summer. This relationship was enhanced by the winter precipitation increase. Snow loss induced by higher air temperature contributed to the decrease in the peak and annual discharges, but caused the peak discharge to occur earlier. Additionally, warmer temperature increased the proportion of rainfall in the partitioning of precipitation, causing more subsurface runoff, particularly in autumn and winter. These results provide a first separate evaluation of factors influencing Arctic water discharge, including seasonal hydrographs, and illustrate the influence of climate warming-induced snowfall and rainfall variations on the circumpolar Arctic river discharge.
The combination of preoperative celiac axis stenting and neoadjuvant chemotherapy in an elderly patient with pancreatic cancer: a case report
Authors: Doita Susumu , Aoki Hideki , Kajioka Hiroki , Tanakaya Kohji , Kawamoto Kenji 
Published: March 2024

Abstract
Background
Celiac axis stenosis (CAS) is frequently observed in patients undergoing pancreaticoduodenectomy (PD). This poses challenges because of the potential disruption of the hepatic arterial blood flow.

Case presentation
We present the case of an 81-year-old woman diagnosed with pancreatic head cancer and severe CAS caused by calcification. The patient received neoadjuvant chemotherapy (NAC) and underwent preoperative endovascular stenting of the celiac axis to restore blood flow. After two cycles of NAC, subtotal stomach-preserving PD was performed. An intraoperative assessment of the hepatic arterial blood flow determined that it was well maintained. PD was performed using the standard technique; specialized techniques were not necessary. Importantly, no ischemic complications were encountered.

Conclusion
This case report describes the successful combination of preoperative celiac axis stenting, NAC, and surgical intervention for the management of CAS in an elderly patient with pancreatic cancer. This approach offers a potential solution for maintaining the hepatic arterial blood flow in the presence of CAS without vascular reconstruction, particularly in elderly individuals.