bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-linear association between AKI alert detection rate by physicians and medical costs
Authors: Ai Hai-bo , Jiang En-li , Wang Hai , Yang Qi , Jin Qi-zu , Wan Li , Liu Jing-ying , He Cheng-qi 
Published: February 2025

Background
Acute kidney injury (AKI) is associated with high mortality rates and long-term adverse outcomes and significantly increases medical costs. The AKI electronic alert system built the AKI diagnostic algorithm into the medical system, along with automated collection of key indications and generation of alerts. However, the relationship between the AKI electronic alert system and medical costs is still unknown.

Methods
An exploratory secondary analysis of data from a double-blinded, multicenter, parallel, randomized controlled trial to investigate the association between the AKI electronic alert system and medical costs.

Results
Finally, a total of 6030 patients were enrolled in this study. Multivariate logistic regression analysis revealed that the alert group was not significantly associated with medical costs (all p-values >  0.05). However, the rate of alert detection by an attending physician demonstrated a notable negative correlation with medical costs; adjusted effects for direct and total costs were −126.78$ and −236.82$, respectively. The curve fitting and threshold effect analysis revealed that when the rate of alert detection by an attending physician was between 18% and 59%, each unit increase in the rate corresponded to decreases in direct cost by 363.94 (−463.34, −264.55) $ and in total cost by 698.93 (−885.78, −512.07) $. Our subgroup analysis also found a significant relationship between the rate and medical costs.

Conclusion
The alert group did not significantly reduce medical costs compared to the usual care group. However, the rate of alert detection by an attending physician had a significant negative association with medical costs, and there was a threshold effect between them. When the rate was between 18% and 59%, medical costs decreased as the rate increased, and when the rate was < 18% or ≥  59%, medical costs did not decrease as the rate increased.
Differences in the clinical presentation of sleep apnea patients according to age and gender
Authors: Lyyra Olli , Lammintausta Aino , Gustafsson Per-Erik , Anttalainen Ulla , Saaresranta Tarja 
Published: February 2025

Background
Data on sleep apnea is scarce in the elderly. We aimed to provide insight into the presentation of sleep apnea in people over 70 years of age including gender differences.

Methods
We conducted a registry study in sleep apnea patients >18 years of age diagnosed at Turku University Hospital in 2012–2019. Patients whose sleep apnea was classified at least moderate according to apnea-hypopnea index were included (N = 5870; Men = 65.7%; Mean age 57.5 ± 13.5 years). Data on cardiorespiratory polygraphy (PG) variables, Body Mass Index (BMI), pre-existing depression diagnoses, number of comorbidities, the scores of Epworth Sleepiness Scale (ESS), depression scale (DEPS) and psychological distress (12-item General Health Questionnaire, GHQ-12), and capillary blood gas results were derived from electronic medical records. Patients were stratified into three groups according to age: <70 (young-middle aged), 70–80 (elderly) and >80 years of age (very elderly).

Results
The severity of sleep apnea did not differ between the age groups based on any of the PG variables studied. No significant differences were found in the level of subjective daytime sleepiness between age groups. Women had higher DEPS scores than men in all age groups. Very elderly men had higher DEPS scores compared to men in other age groups (6.3 ± 4.6 vs. 5.6 ± 5.9 vs. 5.1 ± 4.8, p < 0.05) while the differences in DEPS scores did not reach significance among women. Each unit increase in SpO2 was associated with a 22% decrease in the odds of having a DEPS score of ≥9.

Conclusion
The severity of sleep apnea or subjective daytime sleepiness did not differ among age groups in moderate-severe sleep apnea patients. Occurrence of depressive symptoms was consistently more common in women than in men of comparable age. Mental wellbeing was the worst in the very elderly. Higher SpO2 was associated with less depressive symptoms.
Right heart dysfunction does not increase mortality associated with cemented hemiarthroplasty for hip fractures: A retrospective, preliminary analysis
Authors: Coscia Atticus , Kumar Avnee , Jandzinski Michal , Swany Lauren , Fuster Francisco , Ahn Jaimo 
Published: February 2025

Background
Cemented hemiarthroplasty (CH) is the preferred treatment for geriatric intracapsular hip fracture. Historically, there has been concern regarding cardiopulmonary morbidity related to bone cement impaction syndrome (BCIS). Right ventricular dysfunction predisposes to BCIS, though limited data supports this association. The purpose of this study was to evaluate if right heart dysfunction was predictive of mortality and cardiopulmonary morbidity following cemented hip hemiarthroplasty.

Methods and findings
This study was a retrospective chart review and analysis conducted at a tertiary referral medical center. Patients who underwent hemiarthroplasty (cemented or press fit) at a single institution for the treatment of intracapsular hip fracture between January 1, 2013, and January 1, 2021 and had an echocardiogram completed within 90 days of their surgery were retrospectively included. Two groups of patients with right heart dysfunction were evaluated: 1) patients who carried a preexisting diagnosis of pulmonary hypertension prior to hospital admission for hip hemiarthroplasty and, 2) patients with echocardiographic evidence of pulmonary hypertension.
The primary outcomes included intraoperative hemodynamic instability consistent with bone cement impaction syndrome (BCIS), in-hospital mortality, and 1-year mortality. N = 74 patients were included. 45 patients underwent cemented hemiarthroplasty and 29 patients received press-fit stems. Preexisting diagnosis of right heart dysfunction and echocardiographic evidence of right heart dysfunction were not significantly associated with BCIS, in-hospital, nor 1-year mortality. However, cementation was significantly associated with 1-year mortality (p < 0.05).

Conclusions
Right heart dysfunction does not appear to predispose patients to cardiopulmonary complications or early mortality following cemented hip hemiarthroplasty. Cementation was, however, independently associated with 1-year post-operative mortality. These data add to a growing body of literature which suggests that patients with multiple medical comorbidities may be at risk of adverse outcomes related to cementation. BCIS is uncommon, remains poorly understood, and further investigation is warranted.
Morfometri Rajungan (Portunus pelagicus) Berdasarkan Perbedaan Jenis Kelamin, Tingkat Kematangan Gonad, dan Faktor Kondisi di Perairan Pegagan Madura
Authors: Maryani Leni , Sundoko Ahmad , Qomariah Lailatul , Rahmadan Farhan , Santeri Tiara , Susilowati Ragil 
Published: February 2025

Sumber daya rajungan saat ini telah mengalami tekanan terhadap kelangsungan hidup akibat semakin meningkatnya upaya penangkapan di alam. Pengelolaan sumberdaya rajungan diperlukan informasi tentang kondisi biologi rajungan untuk penetapan ukuran, jenis kelamin, dan jumlah yang boleh ditangkap. Penelitian ini bertujuan untuk menganalisis struktur ukuran lebar karapas dalam hubungannya dengan perbedaan jenis kelamin, tingkat kematangan gonad, dan faktor kondisi rajungan. Metode yang digunakan adalah metode observasi melalui pengukuran lebar, berat, dan tingkat kematangan gonad kemudian dianalisis secara deskriptif. Hasil penelitian menunjukkan bahwa berdasarkan ukuran rajungan termasuk dalam kategori rajungan remaja hingga dewasa baik untuk rajungan jantan maupun rajungan betina. Pola pertumbuhan rajungan jantan koefesien nilai b sebesar 3,09 dan rajungan betina 3,14 menunjukkan pola pertumbuhan rajungan di perairan Perairan Pegagan Madura bersifat allometrik positif. Sebagian besar rajungan betina berada pada fase matang gonad sehingga faktor kondisi rajungan betina cenderung lebih rendah dibandingkan rajungan jantan hal ini disebabkan sebagian besar rajungan betina baru melewati fase pemijahan. Perlu adanya perlindungan terhadap rajungan yang semakin menurun dikarenakan penangkapan yang berlebihan. The current blue swimming crab resources have experienced pressure on survival due to increasing fishing efforts in nature. Management of crab resources requires information on the biological conditions of crabs to determine the size, sex, and number that can be caught. This study aims to analyze the structure of carapace width concerning sex differences, gonad maturity levels, and crab condition factors. The observation method is used to measure the width, weight, and gonad maturity levels and then analyze them descriptively. The study results showed that based on the size, the crabs are included in the juvenile to adult crabs category for both male and female crabs. The growth pattern of male crabs with a coefficient of b value of 3.09 and female crabs 3.14 indicates that the growth pattern of crabs in the waters of Pegagan Madura Island is Allometric positive. Most female crabs are in the gonad maturity phase, so the condition factor of female crabs tends to be lower than male crabs because most female crabs have just passed the spawning phase. There needs protection for crabs, which are declining due to excessive fishing.
Flower Representations in the Lyrics of A.A. Fet
Authors: Shashkina Gulzhan , Ibraeva Zhanarka , Tussupova Almagul , Zhapanova Marzhan , Anichshenko Olga 
Published: February 2025

Abstract
Cultural connotation, artistic value, and aesthetic significance contained in the images of plants determine the importance of interpreting the images of flowers within the lyrical works, considering their profound conveyance of internal emotions. In addition to their aesthetic appeal, A.A. Fet’s floral imagery employs the “language of flowers,” conveying human emotions and social conventions. This article employs the lens of “plant studies” to examine flowers not only as symbols but as active participants in A.A. Fet’s narrative. This approach contributes to an epistemological discourse that examines the relationship between nature and human experience. The research aims to analyse the peculiarities and frequency of using floral imagery in the lyrical works of A.A. Fet, considering the plant symbolism of other landscape poets. To achieve the research aims, the following methods were used: descriptive, content analysis, and comparative. The study shows how floral imagery in A.A. Fet’s works conveys emotions and experiences alongside landscape elements. The content analysis allowed us to determine that A.A. Fet is the poet who most often uses images of flowers in his poems. The analysis of 806 lyrical works made it possible to identify 15 floral images in Fet’s poetry. To convey appropriate emotions through flowers, A.A. Fet uses metaphorical elements and anthropomorphic mechanisms that endow plants with a unique language and life cycle. This analysis explores the symbolic roles of roses, lilies, violets, and other floral imagery in A.A. Fet’s works.
Development of heterocyclic-based anticancer agents: A comprehensive review
Authors: Al-Jumaili Mohammed Hadi Ali , Bakr Ekhlas Aziz , Huessien Mohanad A. , Hamed Ahmed Solaiman , Muhaidi Mohammed J. 
Published: February 2025

Abstract
This review article summarizes the role of heterocyclic compounds as anticancer drugs used against various human cancers, including doxorubicin, cisplatin, paclitaxel, and resveratrol, which are among the most effective therapeutic agents. Chemotherapy, a treatment modality, exerts its effects on tumor cell DNA and often involves the use of low-molecular-weight medicines to selectively target and destroy cancer cells. However, systemic chemotherapy is associated with several side effects, such as nausea, vomiting, myelosuppression, and cardiotoxicity. Cancer remains one of the most prevalent and lethal diseases, characterized by uncontrolled cell division and abnormal cell growth driven by multiple genetic mutations. The etiopathogenesis of cancer is complex, but significant advancements have been made in treatment, particularly with the discovery of anticancer drugs, including cytotoxic chemotherapy, hormonal agents, and targeted therapies. Anticancer drugs are widely employed for the treatment of various cancers, such as breast, cervical, uterine, and kidney cancers. These drugs are classified into several categories, including alkylating agents, antimetabolites, antibiotics, and topoisomerase inhibitors. Among these, numerous heterocyclic compounds have shown promising anticancer properties. The goal of this review is to compile information on heterocyclic compounds used as anticancer drugs, highlighting their positive effects and therapeutic targets in cancer treatment and chemoprevention.
Longitudinal outcomes among patients with fibromyalgia, chronic widespread pain, or localized chronic low back pain
Authors: Licciardone John C. , Brownell Elizabeth , Nwaichi Uchechi , Patel Arpan , Do Khanh 
Published: February 2025

Abstract

Objectives
The objective of this study was to compare longitudinal outcomes of patients with FM, CWP, or localized chronic low back pain (LBP) to determine whether FM is an extreme manifestation of the CWP continuum.

Methods
A retrospective cohort study was conducted within a national pain research registry from August 2019 to July 2023. A total of 310 participants with FM (and CWP), CWP (without FM), or LBP were followed for 12 months to measure pain intensity, back-related disability, and health-related quality of life (HRQOL). Multivariable analyses were performed with generalized estimating equations (GEEs), including baseline and longitudinal covariates to adjust for potential confounding.

Results
The mean age of the participants was 52.3 (standard deviation [SD], 13.6) years, and 238 (76.8 %) were female. There were 64 (20.6 %) participants with FM, 56 (18.1 %) with CWP, and 190 (61.3 %) with LBP. There were no differences in pain intensity among the groups. Compared with back-related disability in the LBP group (mean, 12,7; 95 % confidence interval [CI], 11.4–14.1), the FM group (mean, 15.3; 95 % CI, 13.7–17.0; p=0.006) and CWP group (mean, 16.2; 95 % CI, 14.8–17.7; p<0.001) had greater disability. There were no clinically relevant differences in pain and disability between the FM and CWP groups. Compared with the LBP group, the FM group had worse outcomes on five HRQOL scales, and the CWP group had worse outcomes on all seven scales. Clinically relevant HRQOL differences between the FM and CWP groups involved anxiety and depression, with results favoring the FM group.

Conclusions
These findings do not support the view that FM is an extreme manifestation of the CWP continuum, involving greater pain, disability, or HRQOL deficits.
Echo answers
Authors: Fang Hongmei 
Published: February 2025

Abstract
The topic of echo answers is vastly understudied in typology, with descriptive grammars primarily addressing how questions are formed rather than how they are answered. This paper offers a cross-linguistic investigation into the accessibility of echo answering strategies, specifically focusing on affirmative echo answers to affirmative polar questions. Based on questionnaire-elicited data from a convenience sample of 26 languages displaying echo answers, it has been found that, cross-linguistically, repeating the verbal predicate, either fully or partially, from the question, is the dominant echo answering strategy, and that there are two Echo-ability Hierarchies that impose constraints on which elements from the antecedent question can be repeated in an echo answer. After discussing the definition of echo answers, several related issues are also explored in detail, including the distinction between echo and repetitional answers, the polarity-based nature of the echo system, the range of accessible echo answering strategies across the world’s languages, the cross-linguistic gradience of pragmatic markedness in repetitional/echo answers, and potential explanations for the predicate-dominance in echo answering strategies.
Niche partitioning between two marsupials inhabiting the Yungas of Northwestern Agentina: overlapping diets in non-overlapping lifestyles?
Authors: Martin Gabriel M. , Omad Guillermo , Cáceres Nilton C. 
Published: February 2025

Abstract

Marmosa rapposa and Thylamys sponsorius were captured in syntopy in the locality of Isla de Cañas Salta province, Argentina. We studied the stomach contents of 7 M. rapposa and 10 T. sponsorius and identified arthropods and plant material as the main items. Niche overlap was studied using the Pianka index. We found that arthropods were the most abundant items in both species (67 % in M. rapposa, 63.5 % in T. sponsorius), and plant material represented 29.6 % and 35.5 %, respectively. Insects were the main item in both species (45 % in M. rapposa, 58.5 % in T. sponsorius), while spiders were more abundant in the diet of M. rapposa (21.7 % vs. 5 % in T. sponsorius). The dietary overlap between the two species was high (91.1 %); a similar result was found between males and females of M. rapposa (74.2 %) and T. sponsorius (77.4 %). Non-parametric analyses using PERMANOVA and Principal Coordinate Analysis showed the same pattern, with broad overlap in the diets of the species. The coexistence of these two species may be due to temporal segregation (which we could not study) or different habitat use (more prominent palmar and plantar calluses in M. rapposa indicate a more arboreal lifestyle than that of T. sponsorius).
Mathematical Modelling In Addiction Cases Online Games Using The SEIRS Model In Middle School Sivaliputta
Authors: Setiawan Novyanto , Prihandono Bayu , Pasaribu Meliana 
Published: February 2025

Online game addiction is a mental illness caused by the habit of playing online games for too long. The average duration of time a person is said to fall into the category of addiction to playing online games is if the duration of time spent is 20-25 hours per week. This research uses the SEIR model, Susceptible (S) is the subpopulation who has online games on their gadgets and plays online games for less than one hour/day, Exposed (E) is the subpopulation who plays online games for one to three hours/day, Infected (I) is the subpopulation who plays online games for more than three hours/day and Recovered (R) is the subpopulation who has stopped playing online games and does not have online games on their gadget. Mathematical models need to be searched and formed using the SEIR model. The research data used data obtained from the activities of Sivaliputta Junior High School students in playing online games.. The steps of this research began by determining the problem of online game addiction in the student population at Sivaliputta Junior High School, making assumptions and identifying variables (susceptible, exposed, infrcted, recovery), forming a mathematical model, determining the equilibrium point, determining basic reproduction value and perform numerical simulations. The solution point will stabilize be asymptotically stable for a certain period of time with a susceptible population of 13 people, an exposed population of 61 people, an infected population of 46 people and a recovered population of 211 people.
Integration or commodification? A critical review of individual-centered approaches in psychedelic healing
Authors: Sanabria Emilia , Tófoli Luís Fernando 
Published: February 2025

AbstractIn this article, we provide a genealogy of the concept of integration and a discussion of the multiplicity of practices it encompasses in the field of psychedelic medicine. Reflecting on our observations of psychedelic integration practices, we make three key observations. The first is that integration services tend to focus on the individual, at the expense of considering how societal factors lead to dis-ease. The second observation is that integration is increasingly rendered in formulaic checklists, at the expense of remaining an open-ended praxis, which runs the risk of emptying it of their potential to bring context-dependent change for people. Our third observation is that integration services are increasingly rendered as marketable services. Understanding how we got here and what is at stake requires a genealogical analysis of integration within the field of psychedelics. This critical review of psychedelic integration discusses the divergence between psychedelic practices in traditional or Indigenous contexts and contemporary psychedelic practices in Western industrialized, capitalist societies. We suggest that this divergence has to do with the degree to which psychedelic experiences are contiguous with everyday sociality and the cosmology that dominates in a given social context. Offering a viewpoint grounded in the Global South, our perspective aims to denaturalize some of the assumptions that prevail in research settings where highly individualized approaches and technological solutionism prevail, such as the USA or Western Europe. We highlighted the dangers of integration becoming too formulaic, commodified, and disconnected from the therapeutic or ceremonial contexts in which psychedelic experiences were carefully curated for millennia. Furthermore, we underscored the importance of critically examining the assumptions underlying the infrastructures of digital psychedelia and app-based integration practices.
Uremic Toxins, Chronic Kidney Disease, and Cognitive Dysfunction
Authors: Andrews Taylor D. , Day Gregory S. , Irani Sarosh R. , Kanekiyo Takahisa , Hickson LaTonya J. 
Published: February 2025

Abstract
Cognitive impairment involves alterations to one’s cognitive status that affects their everyday life. Individuals with chronic kidney disease (CKD), and in particular kidney failure, experience higher rates of cognitive impairment compared to the general population. In CKD, 20-70% of individuals have cognitive impairment, but the highest prevalence is described in kidney failure such that dialysis-dependent patients have twice the prevalence of aged-matched controls. In the past 5 years, the number of investigations examining the “kidney-brain axis”, mechanisms of CKD-related cognitive impairment, and potential therapeutics have exponentially increased. This review article summarizes recent literature on direct and indirect effects of CKD-associated cognitive impairment with emphasis on uremic toxins; brain injury mechanisms; overlap between CKD-associated cognitive impairment, Alzheimer’s disease, and other neurodegenerative diseases; and promising therapeutics. Reviewed therapeutic interventions include: AST-120 [indoxyl sulfate absorbent], CH-223191 [aryl hydrocarbon receptor antagonist], TRAM34 [Kca3.1-specific inhibitor], anakinra [IL-1R inhibitor], marimastat, exercise, supplements, and kidney transplantation. Special focus is placed on translational studies examining uremic toxin-associated pathogenic processes including brain oxidative stress, neuroinflammation, and blood brain barrier dysfunction through in vitro and in vivo models of CKD-associated brain injury. Finally, future research directions are suggested including targeting of cellular senescence abundance with senotherapeutics and capitalizing on anti-inflammatory effects of regenerative, cell-based therapeutics (e.g. mesenchymal stem cells and extracellular vesicles), and use of aged murine models. Collectively, CKD-associated cognitive impairment represents a prevalent condition for which remaining knowledge gaps exist, and scientific advancements are needed to preserve cognitive function and improve the lives of in individuals with CKD.