bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-linear relationship between baseline fasting blood glucose and mortality in peritoneal dialysis patients, a retrospective cohort study
Authors: Li Xiang , Fan Chengjuan , Wang Chen , Zhang Yiming , Niu Lingling 
Published: February 2024

BackgroundThe relationship between baseline fasting blood glucose (bFBG) and mortality in peritoneal dialysis (PD) patients has been the subject of debate, with limited exploration of the non-linear relationship between bFBG and death in these patients.MethodsThis retrospective study categorized patients into four groups based on their bFBG using quartiles. Baseline clinical data at the initiation of dialysis were compared. Survival curves were plotted, and subgroup analyses were stratified by relevant covariates. To address the non-linear relationship, curve fitting and a threshold effect analysis were performed.ResultsThe study included 379 PD patients with a median follow-up of 41.8 (22.6, 60.1) months. The COX proportional hazards model showed an association between bFBG and the risk of death after adjusting for confounding factors [hazard ratio (HR): 1.22, 95% CI: 1.05−1.41, P = 0.009]. Stratified analyses indicated a stable correlation between bFBG and mortality. The Kaplan-Meier curve analysis revealed significant differences in survival rates among different groups based on bFBG levels (P &lt; 0.01). The curve fitting analysis revealed a U-shaped relationship between bFBG and mortality, with an inflection point at approximately 5.1 mmol/L.ConclusionOur study has demonstrated a non-linear relationship between bFBG and mortality in PD patients. Additionally, we have found that the optimal bFBG value associated with the lowest risk of mortality is approximately 5.1 mmol/L.
Factors associated with perinatal and neonatal deaths in Sao Tome & Principe: a prospective cohort study
Authors: Vasconcelos Alexandra , Sousa Swasilanne , Bandeira Nelson , Alves Marta , Papoila Ana Luísa , Pereira Filomena , Machado Maria Céu 
Published: February 2024

BackgroundNeonatal mortality reduction is a global goal, but its factors are seldom studied in most resource-constrained settings. This is the first study conducted to identify the factors affecting perinatal and neonatal deaths in Sao Tome &amp; Principe (STP), the smallest Central Africa country.MethodsInstitution-based prospective cohort study conducted at Hospital Dr. Ayres Menezes. Maternal-neonate dyads enrolled were followed up after the 28th day of life (n = 194) for identification of neonatal death-outcome (n = 22) and alive-outcome groups (n = 172). Data were collected from pregnancy cards, hospital records and face-to-face interviews. After the 28th day of birth, a phone call was made to evaluate the newborn's health status. Crude odds ratios and corresponding 95% confidence intervals were obtained. A p value &lt;0.05 was considered statistically significant.ResultsThe mean gestational age of the death-outcome and alive-outcome groups was 36 (SD = 4.8) and 39 (SD = 1.4) weeks, respectively. Death-outcome group (n = 22) included sixteen stillbirths, four early and two late neonatal deaths. High-risk pregnancy score [cOR 2.91, 95% CI: 1.18–7.22], meconium-stained fluid [cOR 4.38, 95% CI: 1.74–10.98], prolonged rupture of membranes [cOR 4.84, 95% CI: 1.47–15.93], transfer from another unit [cOR 6.08, 95% CI:1.95–18.90], and instrumental vaginal delivery [cOR 8.90, 95% CI: 1.68–47.21], were factors significantly associated with deaths. The odds of experiencing death were higher for newborns with infectious risk, IUGR, resuscitation maneuvers, fetal distress at birth, birth asphyxia, and unit care admission. Female newborn [cOR 0.37, 95% CI: 0.14–1.00] and birth weight of more than 2,500 g [cOR 0.017, 95% CI: 0.002–0.162] were found to be protective factors.ConclusionFactors such as having a high-risk pregnancy score, meconium-stained amniotic fluid, prolonged rupture of membranes, being transferred from another unit, and an instrumental-assisted vaginal delivery increased 4– to 9–fold the risk of stillbirth and neonatal deaths. Thus, avoiding delays in prompt intrapartum care is a key strategy to implement in Sao Tome &amp; Principe.
Physiological responses and transcriptomic analysis of StCPD gene overexpression in potato under salt stresses
Authors: Zhou Xiangyan , Ma Yanming , Miao Rong , Li Caijuan , Liu Ziliang , Zhang Dan , Chen Sijin , Luo Jiaqi , Tang Wenhui 
Published: February 2024

IntroductionThe potato (Solanum tuberosum L.), one of the most vital food crops worldwide, is sensitive to salinity. Brassinosteroids (BRs) are crucial in tolerance to various abiotic stresses. The constitutive photomorphogenesis and dwarf (CPD) gene encodes C-3 oxidase, which is a rate-limiting enzyme that controls the synthesis of BRs.MethodsIn this study, we used StCPD gene overexpression (T) and un-transgenic (NT) plants obtained from our former research to illustrate adaptive resistance to salt stress at levels of phenotype; cell ultrastructure, physiology, and biochemistry; hormone; and transcription.ResultsResults showed the accumulation of 2,4-epibrassionolide (EBL) in T potatoes. We found that under high salt situations, the changed Na+/K+ transporter gene expression was linked with the prevalent ionic responses in T plants, which led to lower concentrations of K+ and higher concentrations of Na+ in leaves. Furthermore, RNA-sequencing (RNA-seq) data elucidated that gene expressions in NT and T plants were significantly changed with 200-mM NaCl treatment for 24 h and 48 h, compared with the 0-h treatment. Functional enrichment analysis suggested that most of the differentially expressed genes (DEGs) were related to the regulation of BR-related gene expression, pigment metabolism process, light and action, and plant hormone signal transduction.DiscussionThese findings suggested that StCPD gene overexpression can alleviate the damage caused by salt stress and enhance the salt resistance of potato plantlets. Our study provides an essential reference for further research on BR regulation of plant molecular mechanisms in potatoes with stress tolerance.
The relationship among positive body image, body esteem, and eating attitude in Iranian population
Authors: Sharif-Nia Hamid , Sivarajan Froelicher Erika , Gorgulu Ozkan , Osborne Jason W. , Błachnio Aleksandra , Rezazadeh Fazeli Azadeh , Goudarzian Amir Hossein , Kaveh Omolhoda 
Published: February 2024

Background and aimThe correlation between eating attitudes, positive body image, and body esteem is a pivotal area of research that has garnered substantial attention in recent years, given its implications for both mental and physical well-being. The objective of this study was to examine the interplay between positive body image, body esteem, and eating attitudes within an Iranian population.Materials and methodsThis study employed a cross-sectional study design and was conducted in the year 2022. A convenience sample of 752 participants residing in Tehran, Iran, was included in the study. The data collection tools were comprised of a demographic registration form, the Adolescence/Adults Scale (PBIAS), the Eating Attitudes Test (EAT), and the Body Esteem Scale (BES) as measurement instruments.ResultsMean age of participants was 26.36 (SD = 8.49). Significant relationships were found among positive body image (B = − 0.095, β = −0.150, p &lt; 0.001), and body esteem (B = 0.175, β = 0.149, p &lt; 0.001) with eating attitudes.ConclusionThese findings suggest that individuals with positive body image and high body esteem may have healthier eating attitudes, while those with negative body image and low body esteem may be more likely to have unhealthy eating attitudes.
Scenario analysis of COVID-19 dynamical variations by different social environmental factors: a case study in Xinjiang
Authors: Fu Ruonan , Liu Wanli , Wang Senlu , Zhao Jun , Cui Qianqian , Hu Zengyun , Zhang Ling , Wang Fenghan 
Published: February 2024

BackgroundWith the rapid advancement of the One Health approach, the transmission of human infectious diseases is generally related to environmental and animal health. Coronavirus disease (COVID-19) has been largely impacted by environmental factors regionally and globally and has significantly disrupted human society, especially in low-income regions that border many countries. However, few research studies have explored the impact of environmental factors on disease transmission in these regions.MethodsWe used the Xinjiang Uygur Autonomous Region as the study area to investigate the impact of environmental factors on COVID-19 variation using a dynamic disease model. Given the special control and prevention strategies against COVID-19 in Xinjiang, the focus was on social and environmental factors, including population mobility, quarantine rates, and return rates. The model performance was evaluated using the statistical metrics of correlation coefficient (CC), normalized absolute error (NAE), root mean square error (RMSE), and distance between the simulation and observation (DISO) indices. Scenario analyses of COVID-19 in Xinjiang encompassed three aspects: different population mobilities, quarantine rates, and return rates.ResultsThe results suggest that the established dynamic disease model can accurately simulate and predict COVID-19 variations with high accuracy. This model had a CC value of 0.96 and a DISO value of less than 0.35. According to the scenario analysis results, population mobilities have a large impact on COVID-19 variations, with quarantine rates having a stronger impact than return rates.ConclusionThese results provide scientific insight into the control and prevention of COVID-19 in Xinjiang, considering the influence of social and environmental factors on COVID-19 variation. The control and prevention strategies for COVID-19 examined in this study may also be useful for the control of other infectious diseases, especially in low-income regions that are bordered by many countries.
Treatable mortality and health care related factors across European countries
Authors: Tavares Aida Isabel 
Published: February 2024

IntroductionDespite the improvements in European health systems, a large number of premature deaths are attributable to treatable mortality. Men make up the majority of these deaths, with a significant gap existing between women and men’s treatable mortality rate in the EU.AimThis study aims to identify the healthcare-related factors, including health expenditures, human and physical resources, and hospital services use associated with treatable mortality in women and men across European countries during the period 2011–2019.MethodsWe use Eurostat data for 28 EU countries in the period 2011–2019. We estimate a panel data linear regression with country fixed effects and quantile linear regression for men and women.ResultsThe results found (i) differences in drivers for male and female treatable mortality, but common drivers hold the same direction for both sexes; (ii) favorable drivers are GDP per capita, health expenditures, number of physicians per capita, and (only for men) the average length of a hospital stay, (iii) unfavorable drivers are nurses and beds per capita, although nurses are not significant for explaining female mortality.ConclusionPolicy recommendations may arise that involve an improvement in hospital bed management and the design of more specific policies aimed at healthcare professionals.
Comparative outcomes of SARS-CoV-2 primary and reinfection in older adult patients
Authors: Tey Shu-Farn , Tsai Ya-Wen , Wu Jheng-Yan , Liu Ting-Hui , Chuang Min-Hsiang , Hsu Wan-Hsuan , Huang Po-Yu , Lai Chih-Cheng , Hsu Chi-Kuei 
Published: February 2024

BackgroundThe outcomes of older adult people acquiring SARS-CoV-2 reinfection was unclear. This study aimed to compare the outcomes of older adult patients with COVID-19 reinfection and those with primary infection.MethodsThis retrospective cohort study used electronic medical records from the TriNetX Research Network. Older adult patients (aged ≥65 years) with COVID-19 between January 1, 2022, and December 31, 2022, were included in the study. The patients were subsequently categorized into reinfection or primary infection groups, according to whether they manifested two distinct COVID-19 episodes with an intervening period of more than 90 days. Propensity score matching was performed for covariate adjustment between the reinfection and primary infection groups. The primary outcome was a composite outcome, including emergency department visits, hospitalization, intensive care unit admission, mechanical ventilation use, and mortality, following primary infection and reinfection.ResultsAfter matching, 31,899 patients were identified in both the reinfection and primary infection groups. The risk of primary composite outcomes was 7.15% (n = 2,281) in the reinfection group and 7.53% (n = 2,403) in the primary infection group. No significant difference in the primary outcome was observed between groups (HR, 0.96; 95% CI, 0.91 to 1.02, p = 0.17). In addition, there was no significant differences between the reinfection and primary infection groups in terms of emergency department visit (HR, 1.03; 95% CI, 0.95 to 1.11, p = 0.49), all-cause hospitalization (HR, 0.94; 95% CI, 0.86 to 1.02, p = 0.14), intensive care unit admission (HR, 0.92; 95% CI, 0.67 to 1.28, p = 0.62), mechanical ventilation use (HR,1.35 95% CI, 0.69 to 2.64 p = 0.38), and all-cause mortality (HR, 0.94; 95% CI, 0.74 to 1.20, p = 0.62).ConclusionThere were no significant differences in clinical outcomes between older adult patients with COVID-19 reinfection and those with primary infection.
Determinants of HPV vaccine uptake intentions in Chinese clinical interns: an extended theory of planned behavior approach
Authors: Wang Huizi , Xu Yuedong , Zhang Hui , Chen Ning 
Published: February 2024

BackgroundThis study aims to utilize the extended Theory of Planned Behavior (TPB) model to examine the intentions of clinical interns in China towards Human papillomaviruses (HPV) vaccination. It also fills a significant gap in the literature concerning vaccine acceptance in this specific population.MethodsThis cross-sectional study was carried out with clinical interns in Shandong Province, China, with a total of 1,619 participants. Data were collected through self-reported questionnaires, including demographic characteristics, TPB variables, and HPV-related health knowledge. Hierarchical regression analysis was employed to identify key factors influencing vaccination intentions, and Structural Equation Modeling (SEM) was used to analyze the interrelationships between these factors.ResultsThis study initially identified key predictors affecting clinical interns’ intentions to receive the HPV vaccine through hierarchical regression analysis. The preliminary model, which accounted for demographic factors, revealed foundational impacts of household income and HPV-related clinical experience on intentions. After integrating TPB variables—attitude, subjective norm, perceived behavioral control, and HPV-related health knowledge—the model’s explanatory power was enhanced to 37.30%. SEM analysis focused on the interplay among TPB constructs and extended variables, confirming their significance in forming vaccination intentions, with subjective norm having the most substantial impact (β = 0.375, p &lt; 0.001). The extended TPB model explained over half of the variance in vaccination intentions, substantiating the hypotheses and revealing the psychological determinants behind clinical interns’ decision-making for HPV vaccination.ConclusionThe extended TPB model from this study effectively explains the vaccination intentions among clinical interns for HPV, offering theoretical support for public health strategies and educational interventions targeting this group. These findings are of significant importance for public health practice and future health promotion strategies.
Human respiratory syncytial virus subgroups A and B outbreak in a kindergarten in Zhejiang Province, China, 2023
Authors: Liu Shelan , Pan Jinren , Chen Yin , Ye Ling , Chen Enfu , Wen Xiaosha , Wu Wenjie , Wu Bing , Qi Xiaoqi , Chan Ta-Chien , Sun Wanwan , Yu Zhao , Zhang Tongjie , Yan Jianbo , Jiang Jianmin 
Published: February 2024

BackgroundIn May–June 2023, an unprecedented outbreak of human respiratory syncytial virus (HRSV) infections occurred in a kindergarten, Zhejiang Province, China. National, provincial, and local public health officials investigated the cause of the outbreak and instituted actions to control its spread.MethodsWe interviewed patients with the respiratory symptoms by questionnaire. Respiratory samples were screened for six respiratory pathogens by real-time quantitative polymerase chain reaction (RT-PCR). The confirmed cases were further sequenced of G gene to confirm the HRSV genotype. A phylogenetic tree was reconstructed by maximum likelihood method.ResultsOf the 103 children in the kindergarten, 45 were classified as suspected cases, and 25 cases were confirmed by RT-PCR. All confirmed cases were identified from half of classes. 36% (9/25) were admitted to hospital, none died. The attack rate was 53.19%. The median ages of suspected and confirmed cases were 32.7 months and 35.8 months, respectively. Nine of 27 confirmed cases lived in one community. Only two-family clusters among 88 household contacts were HRSV positive. A total of 18 of the G gene were obtained from the confirmed cases. Phylogenetic analyses revealed that 16 of the sequences belonged to the HRSV B/BA9 genotype, and the other 2 sequences belonged to the HRSV A/ON1 genotype. The school were closed on June 9 and the outbreak ended on June 15.ConclusionThese findings suggest the need for an increased awareness of HRSV coinfections outbreak in the kindergarten, when HRSV resurges in the community after COVID-19 pandemic.
Comparison of machine learning approaches for positive airway pressure adherence prediction in a veteran cohort
Authors: May Anna M. , Dalton Jarrod E. 
Published: February 2024

BackgroundAdherence to positive airway pressure (PAP) therapy for sleep apnea is suboptimal, particularly in the veteran population. Accurately identifying those best suited for other therapy or additional interventions may improve adherence. We evaluated various machine learning algorithms to predict 90-day adherence.MethodsThe cohort of VA Northeast Ohio Health Care system patients who were issued a PAP machine (January 1, 2010–June 30, 2015) had demographics, comorbidities, and medications at the time of polysomnography obtained from the electronic health record. The data were split 60:20:20 into training, calibration, and validation data sets, with no use of validation data for model development. We constructed models for the first 90-day adherence period (% nights ≥4 h use) using the following algorithms: linear regression, least absolute shrinkage and selection operator, elastic net, ridge regression, gradient boosted machines, support vector machine regression, Bayes-based models, and neural nets. Prediction performance was evaluated in the validation data set using root mean square error (RMSE).ResultsThe 5,047 participants were 38.3 ± 11.9 years old, and 96.1% male, with 36.8% having coronary artery disease and 52.6% with depression. The median adherence was 36.7% (interquartile range: 0%, 86.7%). The gradient boosted machine was superior to other machine learning techniques (RMSE 37.2). However, the performance was similar and not clinically useful for all models without 30-day data. The 30-day PAP data and using raw diagnoses and medications (vs. grouping by type) improved the RMSE to 24.27.ConclusionComparing multiple prediction algorithms using electronic medical record information, we found that none has clinically meaningful performance. Better adherence predictive measures may offer opportunities for personalized tailoring of interventions.
The Maria da Penha Patrol as an affirmation of women’s rights in the State of Paraná
Authors: Pereira Franciele Bestel , Dos Santos Henrique Júlio 
Published: February 2024

Addressing a topic of extreme complexity and topicality, domestic and family violence permeates a historical context that highlights its relevance. This problem has been constantly highlighted in the media, highlighting a phenomenon that, although it has gained greater visibility in recent years, has always existed, but was often covered up by social taboos. Notably, women were the primary victims of this type of violence and were often silenced due to entrenched social conventions. The impacts of domestic and family violence are devastating, affecting countless lives. According to the Atlas of Violence (2023), between 2011 and 2021, the number of murders of women reached an average of 1.2 per 100 thousand women in the country. This alarming data illustrates the seriousness and urgency of tackling this problem effectively. Through data analysis, doctrine and interviews, the objective is to analyze the effectiveness and importance of the Maria da Penha Patrol of the Military Police of the State of Paraná as a crucial tool in the affirmation of women's rights, analyzing the theoretical foundation and the practical implementation of this type of patrol, which, although it acts in an ostensive and uniformed way, Its scope is the optimization of care and greater reception for victims of domestic violence, aiming at the reduction of service rates and the minimization of the number of fatal victims. In this context, the Maria da Penha Patrol in the PMPR emerges as a tool to help meet the established national goals, along with the actions provided for in the internal guidelines of the military organization, playing a fundamental role in the prevention, monitoring and protection of victims.
Verificar a efetividade dos programas de rastreio do papilomavírus humano na atenção primaria para a prevenção do câncer do colo do útero no brasil: uma revisão integrativa
Authors: Miranda Jorlan Antonio Gonçalves , Rodrigues Diego Romani da Costa , Costa Danilo Evangelista , Tavares Daniel Oliveira , De Souza Adão Ferreira , Do Santos Rafaella Casanova Ataíde , Pereira Isabelly Coutinho , Chaves Rafael Oliveira , Rodrigues Leandro Matheus da Costa 
Published: February 2024

Introdução: O câncer de colo uterino tem como principal fator de risco a infecção pelo papiloma vírus humano (HPV) e representa um problema de saúde pública no Brasil. É o terceiro mais comum em mulheres por todo o mundo, com conceitos e tratamentos evoluindo rapidamente nos últimos anos. Objetivos: Este trabalho teve como objetivo verificar a efetividade dos programas de rastreamento do papilomavírus humano (HPV) na Atenção Primaria a Saúde (APS) para a prevenção do câncer cervical. Método e materiais: Trata-se de uma revisão integrativa da literatura, realizada em abril e maio de 2022 no portal de dados PubMed utilizando-se 5 artigos dos últimos 5 anos. Resultados e Discusão: Inicialmente 624 publicações foram pesquisadas, as quais, após a aplicação dos critérios de exclusão e inclusão, foram selecionados 5 trabalhos. Pela análise dos estudos, percebeu-se que ainda há uma resistência para se fazer o exame de colpocitologia oncótica, sendo feito na sua maioria quando as mulheres vão consultar por outras queixas. Fatores de risco como idade, baixa escolaridade e cor da pele fazem parte do escopo de quem tem maiores chances de infecção pelo HPV e evolução para o câncer de colo. As vacinações em meninas e meninos tem se mostrado uma ferramenta importante. Conclusão: O rastreamento na atenção primária á saúde, para detecção precoce de lesões no colo uterino é de fundamental importância. Sendo primordial o investimento em mais informação para população em geral, visando maior consciência para realização de exames espcificos, assim como a vacinação.