bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is self-screening for 'at risk of malnutrition' feasible in a home setting?
Authors: Tangvik Randi J. , Skeie Eli , Haugen Arvid Steinar , Harthug Stig , Harris Kristin 
Published: April 2024

Introduction
Despite malnutrition being established as a well-known risk for postoperative complications, the lack of screening for nutritional risk remains a challenge. The aim of this study was to investigate whether self-screening for nutritional risk prior to surgery is feasible in a home setting and if it will increase number of patients screened for nutritional risk, and secondly, to compare their screening results with the “in-hospital assessments” conducted by healthcare professionals.

Materials and methods
This was a prospective study involving patients from six randomly selected surgical wards at two Norwegian hospitals as a part of the “Feasibility study of implementing the surgical Patient Safety Checklist the (PASC)”. This checklist included a self-reported screening tool based on the Nutritional Risk Screening tool (NRS 2002) to identify “at risk of malnutrition” in patients that will undergo surgery the next 3 months or less. The original screening tool (NRS 2002) was used as a standard routine to identify “at risk of malnutrition” by healthcare professionals at hospital. The interrater reliability between these results was investigated using Fleiss multi rater Kappa with overall agreement and reported with Landis and Koch’s grading system (poor, slight, fair, moderate, substantial, and almost perfect).

Results
Out of 215 surgical patients in the home setting, 164 (76.7%) patients completed the self-reported screening tool. A total of 123 (57.2%) patients were screened in-hospital, of whom 96 (44.7%) prior to surgery and 96 (44.7%) were screened both at hospital (pre- and post-surgery) and at home. Self-screening at home improved malnutrition screening participation by 71.9% compared to hospital screening prior to surgery (165 (76.7%) and 96 (44.7%), respectively) and by 34.1% compared to pre- and postoperative in-hospital screening, 165 (76.7%) and 123 (57.2%), respectively). The degree of agreement between patients identified to be “at risk of malnutrition” by the self-reported screening tool and healthcare professionals was poor (κ = - 0.04 (95% CI: -0.24, 0.16), however, the degrees of agreement between the patients and healthcare professionals answers to the initial NRS 2002 questions “low BMI”, “weight loss”, and “reduced food intake” were almost perfect (κ = 1.00 (95% CI: 0,82, 1.18)), moderate (κ = 0.55 (95% CI: 0.34, 0.75)), and slight (κ = 0.08 (95% CI: - 0.10, 0.25) respectively.

Conclusions
Three out of four patients completed the self-screening form and the preoperative screening rate improved with 70%. Preoperatively self-screening in a home setting may be a feasible method to increase the number of elective surgical patients screened for risk of malnutrition.

Trial registration
The trial is registered in ClinicalTrials.gov ID NCT03105713. https://classic.clinicaltrials.gov/ct2/show/NCT03105713.
Age at natural menopause and its determinants in female population of Kharameh cohort study: Comparison of regression, conditional tree and forests
Authors: Pasokh Zahra , Seif Mozhgan , Ghaem Haleh , Rezaianzadeh Abbas , Ghoddusi Johari Masoumeh 
Published: April 2024

Background
Natural menopause is defined as the permanent cessation of menstruation that occurs after 12 consecutive months of amenorrhea without any obvious pathological or physiological cause. The age of this phenomenon has been reported to be associated with several health outcomes.

Objectives
This study aimed to estimate the Age at Natural Menopause (ANM) and to identify reproductive and demographic factors affecting ANM.

Methods
This cross-sectional, population-based study was conducted on 2517 post-menopausal women aged 40–70 years participating in the first phase of the PERSIAN cohort study of Kharameh, Iran, during 2014–2017. To more accurately detect the determinants of ANM, we applied multiple linear regression beside some machine learning algorithms including conditional tree, conditional forest, and random forest. Then, the fitness of these methods was compared using Mean Squared Error (MSE) and Pearson correlation coefficient.

Results
The mean±SD of ANM was 48.95±6.13. Both applied forests provided more accurate results and identified more predictors. However, according to the final comparison, the conditional forest was the most accurate method which recognized that more pregnancies, longer breastfeeding, Fars ethnicity, and urbanization have the greatest impact on later ANM.

Conclusions
This study found a wide range of reproductive and demographic factors affecting ANM. Considering our findings in decision-making can reduce the complications related to this phenomenon and, consequently, improve the quality of life of post-menopausal women.
Immunotherapy utilization patterns in patients with advanced cancer and autoimmune disease
Authors: Li Huaqi , Huntington Scott , Gross Cary , Wang Shi-Yi 
Published: April 2024

Purpose
Immunotherapy has been shown to improve cancer survival, but there are no consensus guidelines to inform use in patients with both cancer and autoimmune disease (AD). We sought to examine immunotherapy utilization patterns between cancer patients with and without AD.

Patients and methods
This retrospective cohort study utilized data from a de-identified nationwide oncology database. Patients diagnosed with advanced melanoma, non-small cell lung cancer, and renal cell carcinoma were included. Outcomes of interest included first-line immunotherapy, overall immunotherapy, and number of immunotherapy cycles. We used logistic and Poisson regression models to examine associations between AD and immunotherapy utilization patterns.

Results
A total of 25,076 patients were included (796 with AD). Patients with AD were more likely to be female, White, receive care at academic centers, and have ECOG ≥ 3. Controlling for demographic and clinical variables, AD was associated with lower odds of receiving first-line (odds ratio [OR] = 0.68, 95% confidence interval [CI] 0.56–0.82) and overall (OR = 0.80, 95% CI 0.67–0.94) immunotherapy. Among patients who received at least one cycle of immunotherapy, there was no difference in mean number of cycles received between patients with and without AD (11.3 and 10.5 cycles respectively). The incident rate of immunotherapy cycles received for patients with AD was 1.03 times that of patients without AD (95% CI 1.01–1.06).

Discussion
Patients with AD were less likely to receive immunotherapy as first-line and overall therapy for treatment of their advanced cancer. However, among those who did receive at least one cycle of immunotherapy, patients with AD received a similar number of cycles compared to patients without AD. This not only indicates that AD is not an absolute contraindication for immunotherapy in clinical practice but may also demonstrate overall treatment tolerability and net benefit in patients with AD.
Protective effect and pharmacokinetics of dihydromyricetin nanoparticles on oxidative damage of myocardium
Authors: Du Lixin , Lu Huiling , Xiao Yifei , Guo Zhihua , Li Ya 
Published: April 2024

Purpose
This study aims to investigate the protective mechanism of dihydromyricetin PLGA nanoparticles (DMY-PLGA NPs) against myocardial ischemia-reperfusion injury (MIRI) in vitro and the improvement of oral bioavailability in vivo.

Methods
DMY-PLGA NPs was prepared and characterized by emulsifying solvent volatilization, and the oxidative stress model of rat H9c2 cardiomyocyte induced by H2O2 was established. After administration, cell survival rate, lactate dehydrogenase (LDH), malondialdehyde (MDA) and superoxide dismutase (SOD) were detected, and the expressions of PGC1α and PPARα were detected by western blot (WB). At the same time, the pharmacokinetics in rats were studied to explore the improvement of bioavailability.

Results
DMY-PLGA NPs can significantly increase cell survival rate, decrease LDH and MDA content, increase SOD content and PGC1α、PPARα protein expression. Compared with DMY, the peak time of DMY-PLGA NPs was extended (P<0.1), and the bioavailability was increased by 2.04 times.

Conclusion
DMY-PLGA NPs has a significant protective effect on H9c2 cardiomyocytes, which promotes the absorption of DMY and effectively improves bioavailability.
Maternal occupational noise exposure during pregnancy and children’s early language acquisition
Authors: Jungewelter Soile , Taskinen Helena , Sallmén Markku , Lindbohm Marja-Liisa , Airo Erkko , Remes Jouko , Huotilainen Minna , Jansson-Verkasalo Eira 
Published: April 2024

Introduction
Noise exposure during pregnancy may affect a child’s auditory system, which may disturb fetal learning and language development. We examined the impact of occupational noise exposure during pregnancy on children’s language acquisition at the age of one.

Methods
A cohort study was conducted among women working in the food industry, as kindergarten teachers, musicians, dental nurses, or pharmacists who had a child aged <1 year. The analyses covered 408 mother-child pairs. Language acquisition was measured using the Infant-Toddler Checklist. An occupational hygienist assessed noise exposure individually as no (N = 180), low (70–78 dB; N = 108) or moderate/high exposure (>79 dB; N = 120).

Results
Among the boys, the adjusted mean differences in language acquisition scores were -0.4 (95% CI -2.5, 1.8) for low, and -0.7 (95% CI -2.9, 1.4) for moderate/high exposure compared to no exposure. Among the girls the respective scores were +0.1 (95% CI -2.2, 2.5) and -0.1 (95% CI -2.3, 2.2). Among the children of kindergarten teachers, who were mainly exposed to human noise, low or moderate exposure was associated with lower language acquisition scores. The adjusted mean differences were -3.8 (95% CI -7.2, -0.4) for low and -4.9 (95% CI -8.6, -1.2) for moderate exposure.

Conclusions
In general, we did not detect an association between maternal noise exposure and children’s language acquisition among one-year-old children. However, the children of kindergarten teachers exposed to human noise had lower language acquisition scores than the children of the non-exposed participants. These suggestive findings merit further investigation by level and type of exposure.
The correlation of obesity status with serum 25-hydroxyvitamin D in US Asian adults: NHANES 2011–2018
Authors: Qiu Linjie , Ren Yan , Li Jixin , Li Meijie , Li Wenjie , Qin Lingli , Zhang Jin , Gao Feng 
Published: April 2024

Background
There is a correlation between obesity and 25-hydroxyvitamin D (25OHD) that tends to be negative. However, this relationship varies among different races. In this study, Asian adults with and without obesity were compared in terms of their levels of 25OHD.

Methods
We carried out a cross-sectional analysis on 2664 non-Hispanic Asian adults who participated in the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2018. To examine the connection between obese status, body mass index (BMI), waist circumference (WC) and weight, and 25OHD, we ran multivariate linear regression models and multivariate logistic regression models.

Results
After adjusting for all confounding factors, obesity status shows a significant positive correlation with vitamin D deficiency (model 3: OR = 2.318, 95% CI:1.317, 4.082). This positive correlation remains significant in males (males: OR = 2.713, 95% CI: -13.398, 5.217). In all three models, a negative association was observed between obesity status and 25OHD (model 1: β = -4.535, 95% CI: -6.987, -2.083; model 2 β = -4.249, 95% CI: -6.549, -2.039; model 3 β = -1.734, 95% CI: -7.285, 3.816). After controlling for covariates, there was a significant negative correlation between WC and 25OHD when stratified by gender and obesity status in both males with and without obesity (males with obesity: β = -1.461, 95% CI: -2.485, -0.436; males without obesity: β = -0.855. 95% CI: -1.499, -0.210). In males with obesity, there was a very strong positive connection between body weight and 25OHD (β = 0.912, 95% CI: 0.227, 1.597). In addition, neither gender’s obese individuals showed a significant link between BMI and 25OHD.

Conclusion
This study demonstrated a positive correlation between obesity and vitamin D deficiency and a negative correlation between obesity and 25OHD in Asian American adults. Additionally, among male obese individuals, there was a significant negative correlation between WC and 25OHD, an observation that needs to be validated in further prospective studies.
Intra-abdominal hematomas and identifiable risk factors in patients receiving subcutaneous enoxaparin
Authors: Lager Stephanie , Balakrishnan Gautam , Eiberger Riley 
Published: April 2024

Background
Low molecular weight heparin has proven to be safe and effective but is not without potential risks such as spontaneous bleeding in the abdominal cavity. There is limited evidence evaluating the true incidence of this potential risk and the available literature is primarily via case reports.

Case summary
The purpose of this study was to identify the incidence and risk factors associated with enoxaparin use (prophylaxis or treatment) abdominal hematomas in a 350-bed community hospital during an 8-month time period. A total of 44 patients were identified as clinically significant bleeds receiving enoxaparin treatment or prophylactic therapy. Ultimately, 25 patients were excluded from the analysis due to an external cause of the abdominal hematoma or a temporal mismatch in enoxaparin administration and hematoma formation. After exclusion, there were a total of 19 patients that were assessed for the risk factors such as age, gender, renal function, and weight. After evaluation of risks, over half of the patients developing a clinically significant bleed were considered elderly (>65 years of age) and impaired renal function with a creatinine clearance of 60ml/min or less.

Conclusion
Patients at risk for an enoxaparin associated hematoma include female patients with a CrCl <60ml/min and/or BMI >30 kg/m2 receiving enoxaparin treatment dosing.
Exploring coagulation parameters as predictive biomarkers of Plasmodium infection: A comprehensive analysis of coagulation parameters
Authors: Tesfaye Zelalem , Derso Adane , Zeleke Ayalew Jejaw , Addisu Ayenew , Woldu Berhanu , Deress Teshiwal , Mekonnen Gebeyaw Getnet , Tegegne Yalewayker 
Published: April 2024

Background
Malaria affects the intravascular environment, leading to abnormal coagulation activation, prolonged prothrombin time, and activated partial thromboplastin time. Despite the high prevalence of malaria in the study area, there has been little published research on the effects of Plasmodium infection on coagulation parameters.

Objective
The aim was to assess the effect of malaria on basic coagulation parameters among patients attending Dembia Primary Hospital and Makisegnit Health Center.

Methods
A cross-sectional study was carried out from January to March 2020. The study involved 120 participants. Blood specimens were collected, which were analyzed using a Huma Clot Due Plus analyzer. The collected data were entered into EpiData and exported to SPSS version 21 for analysis. Non-parametric statistical methods were employed to analyze the data. The results were considered statistically significant if the p-value was less than 0.05.

Results
Individuals infected with Plasmodium exhibit coagulation disorders with elevated levels of PT (Prothrombin Time), APTT (Activated Partial Thromboplastin Time), and INR (International Normalization Ratio) in comparison to healthy controls. The median PT, APTT, and INR values for infected cases were measured at 20.5 [8.6], 39.5 [17.9], and 1.8 [0.9], respectively, while healthy controls had measurements of 15.1 [2.5], 28.8 [8.3], and 1.3 [0.2] (p ≤ 0.001). The severity of coagulation disorders increased with an increase in parasitemia levels. The type of Plasmodium species present had a significant impact on PT and INR values (p ≤ 0.001), whereas APTT did not show any significant impact across the Plasmodium species (p > 0.05).

Conclusion
The results of this study found that malaria has a substantial impact on various blood clotting parameters, including PT, APTT, and INR. Parasitemia severity is significantly associated with extended PT and INR, implying that the higher the parasitemia, the longer it takes for blood to clot. Furthermore, the study discovered that the PT and INR levels differed based on the type of Plasmodium species responsible for the infection.
Management of Patients Post Laminectomy Decompression Et Causa Spinal Cord Injury Cervical Vertebrae 1-7 with Hyperglikemia in Intensive Care Unit
Authors: Yusuprihastuti Maulitia Neny , Adiyanto Bowo , Arifin Johan 
Published: April 2024

Background: In the United States, in 2008 of 100,000 cases of spinal cord injury, 2/3 were cases of cervical injury. Patients who experience cervical to thoracic Spinal Cord Injury (SCI) above T8, usually have impaired function of the diaphragm and intercostal muscles which causes respiratory failure. Neurogenic shock occurs in patients who experience SCI above T6 which causes vasodilation, hypotension and severe bradycardia or asystole when stimulating vagal reflexes such as laryngoscopy or suctioning.Case: The patient was diagnosed with SCI cervical vertebrae 1-7. The patient underwent decompressive laminectomy et causa SCI cervical vertebrae 1-7 and hyperglycemia. Management includes surgical therapy, management of respiratory failure in the Intensive Care Unit (ICU), pharmacological therapy include insulin for hyperglicemia control, and support for neurogenic shock and physioterapy.Discussion: Patients with SCI require laminectomy, supportive therapy, pharmacotherapy include insulin, neurogenic shock, and respiratory support if there is respiratory failure. In cases of injury to cervical vertebrae 1-7, the patient requires ventilator support to assist the function of the diaphragm and intercostal muscles, pharmacological supportive therapy for neurogenic shock, as well as care from a sub-endocrine specialist to treat hyperglycemia. Stress-induced hyperglycemia was occurred due to CNS injury.Conclusion: Spinal Cord Injury (SCI) is a disorder of the spinal cord or spinal cord with neurological symptoms ranging from motor, sensory and autonomic function. Respiratory failure in SCI above thoracic 8, is due to disturbances in the function of the diaphragm and intercostal muscles. The occurrence of neurogenic shock in SCI cases, especially above thoracic 6, manifests in the form of vasodilation, hypotension and severe bradycardia or asystole. Management in the ICU includes hemodynamic monitoring, respiratory failure, prevention of neurogenic shock, and pharmacology to treat hyperglycemia. Biochemical parameters, nutritional status, and respiratory function were also monitored.
Divine Madness in Plato’s Phaedrus
Authors: Shelton Matthew 
Published: April 2024

Abstract
Critics often suggest that Socrates’ portrait of the philosopher’s inspired madness in his second speech in Plato’s Phaedrus is incompatible with the other types of divine madness outlined in the same speech, namely poetic, prophetic, and purificatory madness. This incompatibility is frequently taken to show that Socrates’ characterisation of philosophers as mad is disingenuous or misleading in some way. While philosophical madness and the other types of divine madness are distinguished by the non-philosophical crowd’s different interpretations of them, I aim to show that they are not, in fact, presented as incompatible. Socrates’ pair of speeches demonstrates that madness can be divided into harmful and beneficial kinds, and in Socrates’ key discussion of philosophical madness (249c4-e4), I argue that the crowd correctly recognises that the philosopher is mad on the basis of his eccentricity, but wrongly assumes that the philosopher’s madness is of the harmful type because it fails to realise that the philosopher is enthused. Socrates’ second speech provides information about human souls and gods which shows that philosophical madness belongs to the beneficial type and so falls under the heading of divine enthusiasm after all. Importantly, human souls and gods are shown in the speech to be roughly isomorphic. Both philosophical and other kinds of divine madness involve having something divine inside a human body (entheos): in the former a human soul has become godlike; in the latter a human soul has been displaced by a god. Because of this, I propose that philosophy is presented as a genuine form of divine madness alongside the other more conventional examples.
Asymmetric Performance Evaluation Under Quantity and Price Competition with Managerial Delegation
Authors: Hamamura Jumpei , Ramani Vinay 
Published: April 2024

Abstract
In this paper, we consider asymmetric performance evaluation contracts under different product market configurations with managerial delegation and specify the optimal decision-making by the social and relative performance evaluation firms. We present a reversal result on the owner’s choice of the social performance and relative performance evaluation contract as the product market competition type changes from quantity to price competition. Surprisingly, results indicate that the consumer surplus increases as the degree of product substitution increases under quantity competition in a specific economic environment. A firm that considers social performance evaluation produces less, charges a higher price, and earns a lower profit than a firm that uses relative performance evaluation. We also endogenize the choice of performance evaluation systems. While relative performance emerges as the endogenous choice under both modes of product market competition, it leads to lower consumer surplus and social welfare in comparison to an asymmetric performance evaluation system.
On the complexity of implementation of a system of three monomials of two variables by composition circuits
Authors: Korneev Sergey A. 
Published: April 2024

Abstract
We study the complexity of implementation of systems of monomials by composition circuits. Here, by the complexity we mean the smallest possible number of operations required for computation of the system of monomials from the variables;
under this approach, results of intermediate computations can be used several times. The main result of this paper establishes, for an arbitrary system of three monomials of two variables without zeroth powers, a formula for the complexity of their joint implementation by composition circuits with an additive error which is either 1 or 0.