bluuebunny/crossref_metadata_2025_split huggingface dataset:
A prospective study on direct out-of-pocket expenses of hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease in a Philippine tertiary care center
Authors: Ang Blake Warren , Fernandez Lenora 
Published: April 2024

AbstractChronic obstructive pulmonary disease (COPD) is a frequent cause of morbidity and mortality in the Philippines and majority of the economic burden lies in hospitalizations during an exacerbation. Despite coverage of hospitalization cost with the national health insurance system (Phil-Health) for COPD exacerbations, patients often pay out-of-pocket. This study aimed to determine the demographic characteristics of COPD admissions at a Philippine tertiary care center, Philippine General Hospital, and assess mean cost of hospitalization, and identify predictors of prolonged hospitalization and cost > 20,000 Philippine pesos (Php). A prospective cross-sectional study was conducted for 6 months by chart review. Patients were categorized as charity service patients, that is, with no charged professional fees and free medications and private service patients who pay for their health care services. A total of 43 COPD admissions were included. The average daily cost of hospitalization (at peso-dollar rate of 56) for service patients was at $ 75.89 compared to private service patients at $ 285.71. Demographic characteristics and type of accommodation were not significant predictors of prolonged hospital stay nor hospitalization cost of ≥ $ 357. Accommodation cost and professional fees accounted for majority or 61.6% of the overall cost for private patients, while medications and diagnostic tests were the major or 76.01% contributor to the overall cost for charity patients. Despite existence of Phil-health, in-patient coverage for COPD remain insufficient. Measures for maximizing COPD control in the out-patient setting could potentially reduce total cost for this disease.
A data-driven combined prediction method for the demand for intensive care unit healthcare resources in public health emergencies
Authors: Zhang Weiwei , Li Xinchun 
Published: April 2024

Abstract
Background
Public health emergencies are characterized by uncertainty, rapid transmission, a large number of cases, a high rate of critical illness, and a high case fatality rate. The intensive care unit (ICU) is the “last line of defense” for saving lives. And ICU resources play a critical role in the treatment of critical illness and combating public health emergencies.

Objective
This study estimates the demand for ICU healthcare resources based on an accurate prediction of the surge in the number of critically ill patients in the short term. The aim is to provide hospitals with a basis for scientific decision-making, to improve rescue efficiency, and to avoid excessive costs due to overly large resource reserves.

Methods
A demand forecasting method for ICU healthcare resources is proposed based on the number of current confirmed cases. The number of current confirmed cases is estimated using a bilateral long-short-term memory and genetic algorithm support vector regression (BILSTM-GASVR) combined prediction model. Based on this, this paper constructs demand forecasting models for ICU healthcare workers and healthcare material resources to more accurately understand the patterns of changes in the demand for ICU healthcare resources and more precisely meet the treatment needs of critically ill patients.

Results
Data on the number of COVID-19-infected cases in Shanghai between January 20, 2020, and September 24, 2022, is used to perform a numerical example analysis. Compared to individual prediction models (GASVR, LSTM, BILSTM and Informer), the combined prediction model BILSTM-GASVR produced results that are closer to the real values. The demand forecasting results for ICU healthcare resources showed that the first (ICU human resources) and third (medical equipment resources) categories did not require replenishment during the early stages but experienced a lag in replenishment when shortages occurred during the peak period. The second category (drug resources) is consumed rapidly in the early stages and required earlier replenishment, but replenishment is timelier compared to the first and third categories. However, replenishment is needed throughout the course of the epidemic.

Conclusion
The first category of resources (human resources) requires long-term planning and the deployment of emergency expansion measures. The second category of resources (drugs) is suitable for the combination of dynamic physical reserves in healthcare institutions with the production capacity reserves of corporations. The third category of resources (medical equipment) is more dependent on the physical reserves in healthcare institutions, but care must be taken to strike a balance between normalcy and emergencies.
Factors associated with the risk of malaria among children: analysis of 2021 Nigeria Malaria Indicator Survey
Authors: Isiko Isaac , Nyegenye Simon , Bett Daniel Kiprotich , Asingwire Jackson Micheal , Okoro Lenz Nwachinemere , Emeribe Nana Awaya , Koech Catherine Chepkoskei , Ahgu Ovye , Bulus Naya Gadzama , Taremwa Kelly , Mwesigwa Aaron 
Published: April 2024

Abstract
Background
Malaria remains a burden globally, with the African region accounting for 94% of the overall disease burden and deaths in 2019. It is the major cause of morbidity and mortality among children in Nigeria. Though different environmental factors have been assessed to influence the distribution and transmission of malaria vectors, there is a shortage of information on how they may influence malaria transmission among under-fives in Nigeria.

Methods
This study was based on the secondary data analysis of the Nigeria Malaria Indicator Survey 2021. The study sample comprised 10,645 women (aged 15–49) who delivered a child in the 2 years preceding the survey. The study was restricted to under-fives. Logistic regression was used to identify factors associated with the risk of malaria.

Results
There was a positive association between the risk of malaria and heard/seen malaria messages in the last 6 months (AOR 1.39, 95% CI 1.19–1.62), houses with walls built using rudimentary materials (AOR = 1.38, 95% CI 1.04–1.83), at least 6 children living in the house (AOR 1.22, 95% CI 1.00–1.49), children being 1 or 2 years old was associated with increased odds (AOR 1.89, 95% CI 1.50–2.34 and AOR 1.89, 95% CI 1.52–2.36), children from households with only treated nets (AOR 1.23, 95% CI 1.04–1.46) and those from the North West or South East regions (AOR 1.50, 95% CI 1.10–2.05 and AOR 1.48, 95% CI 1.01–2.16), respectively. All other predictors were not associated with the risk of malaria.

Conclusion
The factors associated with the risk of malaria in this study included sleeping under treated mosquito nets, the age of the children, residing in the northwest and southeast regions, wall construction material, 6 children and above in the household and hearing/seen malaria messages in the last 6 months. Continuous health education and public health interventions, such as the provision of LLITNs, will reduce the risk of malaria and improve the health and well-being of children under 5 years of age.
The global diet quality score as an indicator of adequate nutrient intake and dietary quality – a nation-wide representative study
Authors: Norde Marina M. , Bromage Sabri , Marchioni Dirce M. L. , Vasques Ana Carolina , Deitchler Megan , Arsenaut Joanne , de Carvalho Aline M. , Velloso Lício , Willett Walter , Giovannucci Edward , Geloneze Bruno 
Published: April 2024

Abstract
Background
The Global Diet Quality Score (GDQS) was developed to be a simple, timely and cost-effective tool to track, simultaneously, nutritional deficiency and non-communicable disease risks from diet in diverse settings. The objective was to investigate the performance of GDQS as an indicator of adequate nutrient intake and dietary quality in a national-representative sample of the Brazilian population.

Methods
Nationally-representative data from 44,744 men and non-pregnant and non-lactating women aging ≥ 10 years, from the Brazilian National Dietary Survey were used. Dietary data were collected through two 24-h recalls (24HR). The GDQS was calculated and compared to a proxy indicator of nutrient adequate intake (the Minimum Dietary Diversity for Women—MDD-W) and to an indicator of high-risk diet for non-communicable diseases (caloric contribution from ultra-processed foods—UPF). To estimate the odds for overall nutrient inadequacy across MDD-W and GDQS quintiles, a multiple logistic regression was applied, and the two metrics’ performances were compared using Wald’s post-test.

Results
The mean GDQS for Brazilians was 14.5 (0–49 possible range), and only 1% of the population had a low-risk diet (GDQS ≥ 23). The GDQS mean was higher in women, elderly individuals and in higher-income households. An inverse correlation was found between the GDQS and UPF (rho (95% CI) = -0.20(-0.21;-0.19)). The odds for nutrient inadequacy were lower as quintiles of GDQS and MDD-W were higher (p-trend < 0.001), and MDD-W had a slightly better performance than GDQS (p-diff < 0.001). Having a low-risk GDQS (≥ 23) lowered the odds for nutrient inadequacy by 74% (95% CI:63%-81%).

Conclusion
The GDQS is a good indicator of overall nutrient adequacy, and correlates well with UPF in a nationally representative sample of Brazil. Future studies must investigate the relationship between the GDQS and clinical endpoints, strengthening the recommendation to use this metric to surveillance dietary risks.
Klotho-mediated activation of the anti-oxidant Nrf2/ARE signal pathway affects cell apoptosis, senescence and mobility in hypoxic human trophoblasts: involvement of Klotho in the pathogenesis of preeclampsia
Authors: Xu Baomei , Cheng Fang , Xue Xiaolei 
Published: April 2024

AbstractThe anti-aging gene Klotho is implicated in the pathogenesis of preeclampsia (PE), which is a pregnancy disease characterized by hypertension and proteinuria. Oxidative stress is closely associated with the worse outcomes in PE, and Klotho can eliminate Reactive Oxygen Species (ROS), but it is still unclear whether Klotho regulates PE pathogenesis through modulating oxidative damages. Here, by analyzing the clinical data, we found that Klotho was aberrantly downregulated in PE umbilical cord serum and placental tissues, compared to their normal counterparts. In in vitro experiments, the human trophoblasts were subjected to hypoxic pressure to establish the PE models, and we confirmed that hypoxia also decreased the expression levels of Klotho in those trophoblasts. In addition, through performing functional experiments, we confirmed that hypoxia promoted oxidative damages, cell apoptosis and senescence, whereas suppressed cell invasion in human trophoblasts, which were all reversed overexpressing Klotho. The following mechanical experiments verified that Klotho increased the levels of nuclear Nrf2, total Nrf2, SOD2 and NQO1 to activate the anti-oxidant Nrf2/ARE signal pathway, and silencing of Nrf2 abrogated the protective effects of Klotho overexpression on hypoxic human trophoblasts. Consistently, in in vivo experiments, Klotho overexpression restrained oxidative damages and facilitated cell mitosis in PE rats’ placental tissues. In conclusion, this study validated that Klotho activated the Nrf2/ARE signal pathway to eliminate hypoxia-induced oxidative damages, cell apoptosis and senescence to recover normal cellular functions in human trophoblasts, and our data supported that Klotho could be used as novel biomarker for PE diagnosis and treatment.
Chylous leakage after esophagectomy for esophageal cancer: a systematic review
Authors: Zheng Xing , Yang Xi , Lei Sujuan 
Published: April 2024

Abstract
Background
Chylous leakage is a rare complication following esophagectomy; however, it can lead to mortality. We aimed to systematically evaluate the factors that may lead to increased chylous leakage after esophagectomy.

Methods
Three databases (PubMed, Embase, and Cochrane Library) were systematically searched for all studies investigating the occurrence of chylous leakage after esophagectomy.

Results
A total of 32 studies were identified, including 26 randomized controlled trials and 3 cohort and case–control studies, each. The overall incidence of chylous leakage was 4.7% (278/5,971 cases). Analysis of preoperative, intraoperative, and postoperative factors showed that most of the qualitative analysis results did not significantly increase the incidence of chylous leakage. In some quantitative analyses, the chylous leakage rate was significantly lower in the thoracic duct mass ligation group than in the conservative treatment group (relative risk [RR] = 0.33; 95% confidence interval [CI], 0.13–0.83; I2 = 0.0%; P = 0.327). Direct oral feeding significantly reduced chylous leakage compared with jejunostomy (RR = 0.06; 95% CI 0.01–0.33; I2 = 0.0%; P = 0.335). However, preoperative inspiratory muscle training (RR = 1.66; 95% CI, 0.21–12.33; I2 = 55.5%; P = 0.134), preoperative chemoradiotherapy (RR = 0.99; 95% CI, 0.55–1.80; I2 = 0.0%; P = 0.943), and robotic assistance (RR = 1.62; 95% CI, 0.92–2.86; I2 = 0.0%; P = 0.814) did not significantly reduce the incidence of chylous leakage.

Conclusions
Ligation of the thoracic duct and direct oral feeding can reduce the incidence of chylous leakage after esophagectomy in patients with esophageal cancer. Other contributing factors remain unclear and require validation in further high-quality studies.

Graphical Abstract
LapEmerge trial: study protocol for a laparoscopic approach for emergency colon resection—a multicenter, open label, randomized controlled trial
Authors: Grönroos-Korhonen Marie T. , Kössi Jyrki A. O. 
Published: April 2024

Abstract
Background
Due to faster recovery and lower morbidity rates, laparoscopy has become the gold standard in elective colorectal surgery for both the benign and malignant forms of the disease. A substantial proportion of colorectal operations are, however, carried out in emergency settings, and most of the emergency resections are still performed open. The aim of this study is to compare the laparoscopic versus open approach for emergency colorectal surgery.

Method/design
This is a multicenter prospective randomized controlled trial including adult patients presenting with a condition requiring emergency colorectal resection.

Discussion
Previous studies cautiously recommend wider use of laparoscopy in emergency colorectal resections, but all earlier reports are retrospective, are mostly single-center studies, and have limited numbers of patients. Laparoscopy may involve some unpredictable risks that have not yet been reported because of the infrequent use of the techniqueded to assess the safety of laparoscopy as well as the advantages and disadvantages of open compared with laparoscopic emergency surgery.

Trial registration
Trial registration number: ClinicalTrials.gov NCT05005117. Registered on August 12, 2021.
Comparison of statistical low-frequency earthquake activity models
Authors: Nishikawa Tomoaki 
Published: April 2024

AbstractSlow earthquakes are slow fault slip events. Quantifying and monitoring slow earthquake activity characteristics are important, because they may change before large earthquakes occur. Statistical seismicity models are useful for quantifying seismicity characteristics. However, no standard statistical model exists for slow earthquake activity. This study used a high-quality catalog of low-frequency earthquakes (LFEs), a type of slow earthquake, in the Nankai subduction zone from April 2004 to August 2015 and conducted the first comparison of existing statistical LFE activity models to determine which model better describes LFE activity. Based on this comparison, this study proposes a new hybrid model that incorporates existing model features. The new model considers the LFE activity history in a manner similar to the epidemic-type aftershock sequence (ETAS) model and represents the LFE aftershock rate (subsequent LFE occurrence rate) with a small number of model parameters, as in the Omori–Utsu aftershock law for regular earthquakes. The results show that the proposed model outperforms other existing models. However, the new model cannot reproduce a feature of LFE activity: the sudden cessation of intense LFE bursts. This is because the new model superimposes multiple aftershock activities and predicts extremely high seismicity rates during and after the LFE bursts. I suggest that reproducing and successfully predicting the sudden cessation of intense LFE bursts is critical for the further improvement of statistical LFE activity models. In addition, the empirical equations formulated in this study for the LFE aftershock rates may be useful for future statistical and physical modeling of LFE activity.
Graphical Abstract
School readiness among vulnerable children: a systematic review of studies using a person-centered approach
Authors: Garon-Carrier Gabrielle , Mavungu-Blouin Corinne , Letarte Marie-Josée , Gobeil-Bourdeau Jasmine , Fitzpatrick Caroline 
Published: April 2024

Abstract
Background
Research has consistently shown that some children are more vulnerable at the time of school readiness. Better understanding the characteristics of these children is therefore important. Most studies have used a variable-based approach, which may mask the presence of small but important subgroups of children with mixed patterns of readiness strengths and weaknesses. Identifying subgroups with mixed readiness patterns using a person-centered approach matters because their developmental trajectories might differ in important ways from children with broader difficulties across all readiness domains.

Objective
This systematic review attempts to synthesize existing profiles of school readiness conducted on preschool-aged children and to describe how these various profiles are associated with children’s academic achievement and social adjustment during their school years. Specifically, we described how the school readiness profiles vary in number of profiles identified and differences in the specific domains of school readiness. We further describe the school readiness profiles and how they predict later academic and social outcomes. Furthermore, we focus on profile differences between at-risk and non-at-risk preschoolers.

Methods
Longitudinal studies published between 2005 and 2022 on profiles of school readiness before school entry and at least one subsequent academic and/or social outcomes were extracted from five databases. Eight articles were included in this systematic review out of the 117 screened peer-reviewed articles.

Results
All the studies incorporated both the cognitive and socioemotional domains of school readiness in their profiles. Fifteen profiles of school readiness at preschool age were identified based on the child level of cognitive and socioemotional skills, with 7 profiles at risk of later academic and social difficulties. Despite variation, children in these at-risk profiles of school readiness shared similar features.

Conclusion
This literature review provides an exhaustive summary on the number of profiles and domains of school readiness most frequently reported in studies using a person-centered approach. Yielding an in-depth description of at-risk profiles of school readiness can help designing early preventive intervention for these children.
Tissue-resident memory T cells: decoding intra-organ diversity with a gut perspective
Authors: Murakami Mari 
Published: April 2024

AbstractTissue-resident memory T cells (TRM) serve as the frontline of host defense, playing a critical role in protection against invading pathogens. This emphasizes their role in providing rapid on-site immune responses across various organs. The physiological significance of TRM is not just confined to infection control; accumulating evidence has revealed that TRM also determine the pathology of diseases such as autoimmune disorders, inflammatory bowel disease, and cancer. Intensive studies on the origin, mechanisms of formation and maintenance, and physiological significance of TRM have elucidated the transcriptional and functional diversity of these cells, which are often affected by local cues associated with their presence. These were further confirmed by the recent remarkable advancements of next-generation sequencing and single-cell technologies, which allow the transcriptional and phenotypic characterization of each TRM subset induced in different microenvironments. This review first overviews the current knowledge of the cell fate, molecular features, transcriptional and metabolic regulation, and biological importance of TRM in health and disease. Finally, this article presents a variety of recent studies on disease-associated TRM, particularly focusing and elaborating on the TRM in the gut, which constitute the largest and most intricate immune network in the body, and their pathological relevance to gut inflammation in humans.
Playing for cognition: investigating the feasibility and user experience of a virtual reality serious game for cognitive assessment in children with congenital heart disease
Authors: van de Wouw C. L. , Bousché E. , van Schooneveld M. M. J. , Breur J. M. P. , Nijenhuis H. P. , Huygelier H. , Nijboer T. C. W. 
Published: April 2024

Abstract
Background
In order to facilitate the development and implementation of innovative technology in clinical practice, it is important to understand the user experience of end-users. Virtual Reality (VR) offers the possibility to assess cognitive functioning in a dynamic environment that simulates real-world situations. The purpose of this cross-sectional study was to investigate the feasibility of a VR Serious Game for cognitive assessment in school-aged children with congenital heart disease (CHD). The sub-aims were two-fold: (1) to objectively evaluate the feasibility of the VR Serious Game in children with CHD in comparison to typically developing (TD) children and (2) to explore the user experience of both groups following their interaction with the VR Serious Game.

Results
A total of 101 children participated in this study; 98 children were included in the final analysis (CHD: n = 54; TD: n = 47). The VR Serious Game appeared feasible for both children with CHD and TD children, with 88% children completing the innovative VR assessment without encountering any issues. There were no discernible differences in completion rates between groups. Children with CHD reported significantly lower scores than TD children on three user experience scales: Engagement, Flow and Presence. Nonetheless, the scores for Engagement and Flow were still considered "moderate to good". Both groups reported minimal adverse physiological reactions.

Conclusions
The findings suggested that the VR Serious Game was feasible for children with CHD and that the user experience was positive. Future research should investigate the effectiveness of the VR Serious Game compared with a conventional or digital neuropsychological assessment, prioritising the development of novel outcome measures that can better estimate and explain the impact of cognitive impairment on daily functioning.