bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting risk of maternal critical care admission in Scotland: Development of a risk prediction model
Authors: Cowan Lorna M , Adamestam Imad , Masterson John A , Beatty Monika , Boardman James P , Chislett Louis , Johnston Pamela , Joss Judith , Lawrence Heather , Litchfield Kerry , Plummer Nicholas , Rhode Stella , Walsh Timothy S , Wise Arlene , Wood Rachael , Weir Christopher J , Lone Nazir I 
Published: January 2025

Background: Identifying women at highest or lowest risk of perinatal intensive care unit (ICU) admission may enable clinicians to risk stratify women antenatally so that enhanced care or elective admission to ICU may be considered or excluded in birthing plans. We aimed to develop a statistical model to predict the risk of maternal ICU admission. Methods: We studied 762,918 pregnancies between 2005 and 2018. Predictive models were constructed using multivariable logistic regression. The primary outcome was ICU admission. Additional analyses were performed to allow inclusion of delivery-related factors. Predictors were selected following expert consultation and reviewing literature, resulting in 13 variables being included in the primary analysis: demographics, prior health status, obstetric history and pregnancy-related factors. A complete case analysis was performed. K-fold cross validation was used to mitigate against overfitting. Results: Complete data were available for 578,310 pregnancies, of whom 1087 were admitted to ICU (0.19%). Model performance was fair (area under the ROC curve = 0.66). A comparatively high cut-point of ⩾0.6% for ICU admission risk resulted in a negative predictive value (NPV) of 99.8% (specificity 97.8%) but positive predictive value (PPV) of 0.8% (sensitivity 9.1%). Models including delivery-related factors demonstrated superior discriminative performance. Conclusions: Our model for maternal ICU admission has an acceptable discriminative performance. The low frequency of ICU admission and resulting low PPV indicates that the model would be unlikely to be useful as a ‘rule-in’ test for pre-emptive consideration of ICU admission. Its potential for improving efficiency in screening as a ‘rule-out’ test remains uncertain.
Exploring the Bioactive Constituents, Antibacterial, Antioxidant Potentialities of Aloe officinalis Forssk Flower
Authors: Menachery Santhosh Joseph , Moni Sivakumar S. , Khardali Amani , Elmobark Mohamed Eltaib , Alam Mohammad Firoz , Ali Albarqi Ali Ahmed , Abdallah Hana F. , Daws Dalia , Moochikkal Remesh , Areshyi Razan Willie , Sofyani Hissah Ali 
Published: January 2025

Objectives The aim of this study is to analyze the chemical composition of Aloe officinalis Forssk and to investigate its potential medicinal use, especially as a natural antibacterial agent. Methods The red flowers of Aloe officinalis Forssk were collected from Al Kadimi, Jazan province, Saudi Arabia, and processed into a methanolic extract (MEAOF) by maceration. The extract was comprehensively analyzed by GC-MS, LC-MS, FT-IR, and NMR spectroscopy. The antioxidant activity of MEAOF was evaluated using the DPPH assay, while its antibacterial potential against various human pathogenic bacteria was investigated using the agar well diffusion method. Results The analyzes identified several bioactive compounds in MEAOF, including stearic acid, palmitic acid, 9,12-octadecadienoic acid (Z, Z) and dasycarpidan-1-methanol acetate. MEAOF exhibited significant antibacterial activity against both Gram-positive and Gram-negative bacteria. In addition, MEAOF demonstrated an antioxidant scavenging capacity of 87.96%. Conclusion The study confirms the significant therapeutic potential of the flowers of Aloe officinalis Forssk and emphasizes their strong antibacterial and antioxidant properties. These results support the use of extracts from the flowers of Aloe officinalis Forssk in the development of new drugs to combat antibiotic resistance and reduce oxidative stress and underline their value for medical applications.
Clinical Significance of Respiratory Bacteria and Mycobacteria Isolates in Adult Bronchiectasis in Taiwan
Authors: Chang Chia-Ling , Sheu Chau-Chyun , Wang Ping-Huai , Hsieh Meng-heng , Hsu Wu-Huei , Chen Ming-Tsung , Ou Wei-Fan , Wei Yu-Feng , Yang Tsung-Ming , Lan Chou-Chin , Wang Cheng-Yi , Lin Chih-Bin , Lin Ming-Shian , Wang Yao-Tung , Lin Ching-Hsiung , Liu Shih-Feng , Cheng Meng-Hsuan , Chen Yen-Fu , Cheng Wen-Chien , Peng Chung-Kan , Chan Ming-Cheng , Chen Ching-Yi , Jao Lun-Yu , Wang Ya-Hui , Chen Chi-Jui , Chen Shih-Pin , Tsai Yi-Hsuan , Cheng Shih-Lung , Lin Horng-Chyuan , Chien Jung-Yien , Wang Hao-Chien 
Published: January 2025

BackgroundThe clinical impact of bacterial and mycobacterial isolates on bronchiectasis remains uncertain.Materials and methodsPatients with bronchiectasis at 16 hospitals in Taiwan were recruited with a 1-year follow-up. The patients were classified into six groups: Group 1,Pseudomonas aeruginosa; Group 2,Klebsiella pneumoniae; Group 3, Other bacteria; Group 4, Non-tuberculous mycobacteria (NTM); Group 5, Daily sputum without bacterial or NTM colonization; and Group 6, Dry bronchiectasis.ResultsA total of 1416 patients (mean age, 67 years; males, 43%) were included. The mean modified Reiff score was 5 (range: 1–18). Fifty-nine percent (829 patients) had sputum, whereas the remaining did not. The proportions of bacteria and NTM cultured from sputum within one year of observation were 27% (381/1416) and 15% (202/1416), respectively. The most common bacterial isolate wasP. aeruginosa(13%), followed byK. pneumoniae(7%). Twenty-six percent of the patients experienced severe exacerbations at least once within the year. The one-year all-cause mortality rate was 3%. Patients with sputum exhibited a higher rate of severe exacerbations compared to that in patients with dry bronchiectasis, regardless of the presence of bacteria or NTM (p<0·001). Patients with bacterial colonization had a higher mortality rate (p<0·001). Further, the highest mortality rate was observed among those withK. pneumoniaecolonization (hazard ratio [HR]: 8.39, 95% confidence interval [95% CI]: 2.39–29.49), followed by individuals colonized with other bacteria (HR: 8.04, 95% CI: 2.36–27.38) andP. aeruginosa(HR: 7.83, 95% CI: 2.45–25.03). Additionally, old age was an independent risk factor (HR, 2.72; 95% CI: 1.19–6.18).ConclusionK. pneumoniaewas more frequently isolated from patients with bronchiectasis in Taiwan, compared with Western countries and was associated with unfavorable clinical outcomes.
Long-Term Exercise Capacity in Paediatric Cystic Fibrosis: A Modern Era Perspective
Authors: Gaupmann René , Stöger Laura , Schmidthaler Klara , Pauger Bianca , Mersi Brigitte , Graf Alexandra , Szépfalusi Zsolt , Renner Sabine , Dehlink Eleonora , Gruber Saskia 
Published: January 2025

BackgroundMaintaining good cardiopulmonary fitness is crucial for global health in Cystic Fibrosis (CF), but there is limited knowledge about the longitudinal evolution of fitness measures at young ages, particularly with recent therapeutic advances. We investigated trends in exercise test outcomes in young people with CF (PwCF) and how they are influenced by elexacaftor/tezacaftor/ivacaftor (ETI) and the COVID-19 pandemic.Methods70 young PwCF (12 to 20 years) were included in this retrospective observational single-centre study. We reviewed 177 symptom-limited surveillance cardiopulmonary exercise tests (CPET) conducted on a cycle ergometer between 2010 and 2024. Longitudinal trends in peak oxygen uptake (VO2peak), maximal workload, and ventilation were analysed using linear mixed models, separately for periods before and after the COVID-19 pandemic onset and ETI introduction.ResultsIn ETI-naïve PwCF, VO2peakwas lower, and the increase from 12 to 20 years was smaller than predicted by validated reference data (p<0.001). Forty PwCF started ETI during the observational period with 46/103 tests performed under ETI (median therapy duration 1.6 years, range: 0.4–3.9). After ETI introduction, VO2peakimproved significantly, while ventilation and maximal workload were not relevantly affected. ETI approval coincided with the COVID-19 pandemic, during which a steeper decline of VO2peakin ETI-naïve PwCF was observed. However, this potential confounder did not significantly impact the overall longitudinal improvement in VO2peaktrajectory following ETI introduction (p<0.05).ConclusionThe longitudinal trend in VO2peakprogression from adolescence to young adulthood is impaired in PwCF, but the initiation of ETI can have a positive impact on this trajectory.
Pandemic-disordered sleep: longer illness, more fatigue, but little SARS-CoV-2 effect
Authors: Proctor Simon , Cheetham Nathan J. , Brown Julia R. B. , Bowyer Vicky , Toson Barbara , Harvey Nicholas R. , Leschziner Guy , Joseph Desaline , Hammers Alexander , Sudre Carole H. , Steves Claire J , Mukherjee Sutapa , Duncan Emma L 
Published: January 2025

The COVID-19 pandemic disturbed sleep globally in both infected and uninfected individuals. Prolonged symptoms (particularly fatigue) after SARS-CoV-2 infection (post-COVID syndrome [PCS]) remains a health issue. Whether there is a relationship between PCS and sleep disturbance is largely unknown, with most studies lacking uninfected controls. We assessed sleep behaviours in a large UK cohort, analysing sleep disruption, fatigue, SARS-CoV-2 infection, and symptom duration.MethodsUK adults previously recruited from the KCL-ZOE COVID Symptom Study to the COVID Symptom Study Biobank, with prospective symptom logging and SARS-CoV-2 testing, were invited to complete online validated questionnaires for sleep (Pittsburgh Sleep Quality Index, Sleep Condition Indicator, STOP-Bang, Epworth Sleepiness Scale), fatigue (Chalder Fatigue Scale), and mental health (GAD-2, PDH2). Data were analysed considering SARS-CoV-2 infection, symptom duration, and co-morbidities including mental health.ResultsQuestionnaires were completed by 3833 of 8355 participants (2089 infected, 1721 uninfected, 23 unknown). Individuals with longer (versusshorter) symptom duration had poorer sleep scores for multiple questionnaires; but SARS-CoV-2 infection had no independent effect on sleep. However, previously infected (versusuninfected) individuals had greater fatigue, over a year since infection. Longer symptom duration, poorer sleep scores, and greater fatigue were also associated with higher contemporaneous levels of anxiety and depression; however, an independent effect of prior SARS-CoV-2 infection on fatigue remained after adjustment. Higher body mass index, greater age, and prior co-morbidities independently worsened sleep scores also.ConclusionsSleep disturbance contributes to long symptoms, irrespective of SARS-CoV-2 infection. Proven sleep interventions may help individuals with post-pandemic fatigue, including PCS.
Psychosocial working conditions and violence prevention climate in German emergency departments – a cross-sectional study
Authors: Reißmann Sonja , Guliani Mannat , Wirth Tanja , Groneberg David A. , Harth Volker , Mache Stefanie 
Published: January 2025

Abstract

Background
Emergency departments (EDs) are high pressure work environments with several psychosocial job demands, e.g., violence, and job resources, e.g., colleague support. So far, the perceptions of working conditions have been compared between doctors and nurses, but there is limited knowledge regarding their respective supervisors. In addition, the violence prevention climate has not been assessed in German EDs before. Thus, the current study focuses on differences in the perceptions of working conditions and the violence prevention climate between the groups of doctor-supervisors, doctor-employees, nurse-supervisors, and nurse-employees within the ED. Further analyses regarding the association between social relations and pressure for unsafe practices are performed, including the moderating role of belonging to one of the aforementioned groups.

Methods
A cross-sectional online survey was carried out among N = 370 participants, who were doctors or nurses from German EDs. The Questionnaire for Psychosocial Risk Assessment (QPRA) and the Violence Prevention Climate Scale (VPCS) were applied. Kruskal-Wallis tests were performed for group comparisons, followed by a hierarchical multiple linear regression model and moderation analyses.

Results
Statistically significant differences between the groups were found for eight out of 13 variables. The highest number of significant pairwise comparisons was found between the groups of doctor-supervisors and nurse-employees. High job demands regarding work intensity and work interruptions became apparent across all groups. Nurse-employees reported the highest social and emotional demands as well as the highest pressure for unsafe practices regarding violence prevention, significantly differing from the other groups on these variables. The variables of supervisor support and social stressors were found to be significantly predictive of pressure for unsafe practices. Furthermore, there was no moderating effect of belonging to one of the above-mentioned groups in the relationships between variables of social relations and pressure for unsafe practices.

Conclusions
Differences found in the current study can help tailor preventive measures according to the needs of distinct professions and positions in order to improve working conditions and the violence prevention climate in EDs. Furthermore, supervisor support should be strengthened while social stressors should be resolved in order to decrease pressure for unsafe practices regarding violence prevention.
Diagnostic value of interferon-γ release assay in patients with COPD complicated with pulmonary tuberculosis
Authors: Rong Yanxiao , Wang Haibin , Su Yuanyuan , Wang Qian , Sun Xuepei , Wang Wei 
Published: January 2025

Abstract

Background
The common diagnostic methods for tuberculosis have been showing reduced sensitivity among chronic obstructive pulmonary disease patients. This study was conducted to evaluate and analyse the diagnostic value of an interferon-γ release assay in COPD patients complicated with pulmonary tuberculosis.

Methods
A nested case-control study was conducted on 123 COPD patients hospitalized at the Fifth Hospital of Shijiazhuang, Hebei Province, from January 2019 to June 2021. Thirty-one patients with active pulmonary tuberculosis complicated with COPD composed the observation group (Group A), 31 patients with nonactive pulmonary tuberculosis complicated with COPD composed the COPD control group (Group B), and 31 patients with active pulmonary tuberculosis not complicated with COPD composed the non-COPD control group (Group C). An interferon-γ release assay, a purified protein derivative of tuberculin (PPD) test, an anti-tuberculosis antibody test, a test of Mycobacterium tuberculosis by sputum smear microscopy and a test of Mycobacterium tuberculosis by PCR method were used to test patients in each group. The positive detection rates generated from the five test methods were compared and analysed.

Results
In COPD patients complicated with active pulmonary tuberculosis, the differences in the percentage of patients with positive interferon-γ release between the PPD test, anti-tuberculosis antibody test, Mycobacterium tuberculosis by sputum smear microscopy and PCR test results were statistically significant.

Conclusion
In patients with COPD complicated with active pulmonary tuberculosis, the percentage of patients who were positive according to the interferon-γ release assay was higher than that according to the sputum smear microscopy, PCR detection of Mycobacterium tuberculosis in sputum specimen, and detection of anti-tuberculosis antibodies. COPD-related complications did not affect the T-SPOT; the greater the T-SPOT value was, the greater the likelihood of active TB. For patients who are T-SPOT positive but clinically considered to have inactive tuberculosis, regular follow-ups should be performed to observe changes in the patient’s condition.
Ramadan during pregnancy and the role of dietary intake for neonatal health in Kaduna, Northwestern Nigeria: a cross-sectional study
Authors: Kana Musa Abubakar , Usman Bilkisu , Mohammed-Durosinlorun Amina , Ahmed Jennifer , Abubakar Hassana Habiba , Abdulmalik Yakub , Pradella Fabienne 
Published: January 2025

Abstract

Background
Ramadan during pregnancy is associated with adverse offspring health outcomes. Recent evidence from Europe indicates that maternal diet during non-fasting hours might alleviate these effects. This study describes fasting, diet, and sleep habits among pregnant Muslims in Kaduna, Nigeria, and assesses impacts on neonatal health in this setting.

Methods
Between July 2023 and February 2024, we conducted 1814 interviews with women whose pregnancy overlapped with Ramadan 2023 in Kaduna, northwestern Nigeria (cross-sectional study). We used a structured questionnaire to collect data on fasting, diet and sleep during Ramadan, as well as maternal socio-demographic characteristics. In the analyses of birth outcomes, 1370 mother-newborn pairs were included. We performed multivariate regression analyses to evaluate associations between fasting and birth weight and gestational duration, as well as the interaction of fasting with maternal dietary intake and sleep patterns.

Results
More than 80% of the study participants fasted during pregnancy. Women who fasted had infants with lower birth weights than non-fasting participants (-90.38 g, 95% CI: -173.64 g to -6.12 g). No independent associations were detected between reduced sleep and food intake, and birth weight. Fasting was not associated with gestational duration. Negative effects of fasting on birth weight were consistently concentrated among participants who reduced their dietary or fluid intake during Ramadan.

Conclusions
Dietary intake during non-fasting hours might mitigate potential adverse effects of Ramadan fasting on birth weight. With more than 25% of the global population adhering to Islam, this study highlights the need for additional research on Ramadan during pregnancy across different settings.
Sex-based disparities in the association between uric acid levels and anxiety: a cross-sectional analysis of nationwide data in Korea
Authors: Park Soohyun , Kim Joo O. , Park Gyu Nam , Oh Jae Won , Lee San 
Published: January 2025

Abstract

Background
Uric acid has antioxidant properties, and several studies have suggested its neuroprotective effects. Despite reports of increased oxidative damage and decreased antioxidants in anxiety disorders, findings remain inconclusive. This study investigated the association between serum uric acid levels and anxiety symptoms, stratified by sex, using nationwide data from South Korea.

Methods
Data were derived from the Korea National Health and Nutrition Examination Survey, which included 2,228 males and 2,805 females. Presence of anxiety symptoms was defined as a Generalized Anxiety Disorder 7-item scale (GAD-7) score of ≥ 10. Study participants were categorized into three groups based on serum uric acid levels: 1 (lowest) to 3 (highest). Multivariable logistic regression analyzed the association between uric acid levels and anxiety symptoms, stratified by sex.

Results
Compared to reference group 2, females in group 1 had increased anxiety symptoms (odds ratio (OR) 2.28, 95% confidence interval (CI) 1.48–3.49). When anxiety symptoms were defined as a GAD-7 score of ≥ 5, females in groups 1 (OR 1.68, 95% CI 1.30–2.16) and 3 (OR 1.35, 95% CI 1.04–1.74) both showed more anxiety symptoms than group 2, with a U-shaped relationship between uric acid levels and anxiety symptoms. In males, uric acid levels weren't significantly linked to anxiety symptoms.

Conclusions
This study indicates that low serum uric acid levels are associated with a higher prevalence of anxiety symptoms only in females, suggesting involvement of oxidative stress in anxiety disorders and its sex-based variation.
Challenges and possibilities when doing research on active school travel interventions in a school setting - a non-randomized pilot study assessing feasibility of an evaluation design
Authors: Andersson Mathias , Tseli Elena , Lindqvist Anna-Karin , Rutberg Stina , Palstam Annie 
Published: January 2025

Abstract

Background
A wide range of school interventions have been launched to increase childrens’ physical activity. Evaluation of the effectiveness of interventions requires suitable study designs and feasible quantitative evaluations relating to the school setting. The purpose of this study was to assess the evaluation design and methods for data collection, in order to make decisions about approaching forthcoming studies of the effectiveness of active school travel (AST) interventions.

Methods
Children from four Swedish schools in fifth grade (11–12 years old) participated in this non-randomized pilot study, two schools received an AST intervention and two schools were controls. The school-based AST intervention Sustainable Innovation for Children Transporting Actively (SICTA) was conducted by teachers in the classroom setting during four weeks. To assess feasibility of the evaluation design and methods for data collection a combination of quantitative and qualitative methods were applied, using participation- and response rates, a feasibility questionnaire and focus group interviews.

Results
Out of 25 potential schools, four schools accepted participation with explicit allocation requests preventing randomization. Out of 181 children, 107 children (59%) accepted participation. A total of 82% of the participating children reported active travel before the AST intervention, and 80% found reporting of daily school travels in the web-based survey to be easy. The children were in general positive about participating in the study and the methods for data collection were considered easy for the participating children to conduct and to blend well with usual school activities. There was an imbalance in reporting rates between intervention and control schools as well as a decrease in reporting rates during the study period.

Conclusions
Our results highlight the complexity and challenges in conducting controlled research among school children. Although children were positive about participation and found reporting to be easy, our results invoke the need to use alternative research designs and recruitment strategies that also attract children using non-active modes of travel when evaluating AST interventions in school contexts.

Trial registration
The study is registered 2023/11/02 with Researchweb, the Swedish Register for Research with registration number 281,543. The registration can be reached via this link: https://www.researchweb.org/is/sverige/project/281543.