bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the effects of stepwise intracranial decompression and decompressive craniectomy in the treatment of severe traumatic brain injury: A randomized controlled trial
Authors: Liu Chunbo , Jia Geng , Wu Ruhong , Yang Changchun 
Published: December 2023

Background:
To compare the effects of stepwise intracranial decompression (SID) and decompressive craniectomy (DC) on severe traumatic brain injury.

Methods:
This prospective randomized study was conducted at The Third Affiliated Hospital of Soochow University. Ninety two patients were divided into 2 groups according to the random number table method. The study group received SID, whereas the control group received DC. The surgical time and intraoperative bleeding of the 2 groups of patients were recorded, neurological function and glasgow coma score before and after treatment in both groups, incidence of complications, prognostic situation, and levels of brain oxygen metabolism indicators before and after treatment.

Results:
Among the 92 patients who agreed, 46 were assigned to the study and control groups, and 6 patients were excluded. Finally, 86 patients were analyzed, including 43 in the study group and 43 in the control group. After treatment, the glasgow coma score scores of the 2 groups increased compared to before treatment; the study group had a higher score, The National Institutes of Health Stroke Scale score decreased compared to before treatment, and the study group had a lower score (P < .05). The incidence of complications in the study group (4.65%) was significantly lower than that in the control group (18.60%) (P < .05). The good prognosis rate of the research group (41.86%) was significantly higher than that of the control group (16.28%) (P < .05).

Conclusion:
Compared with DC, using SID to treat severe traumatic brain injury can shorten surgical time and reduce intraoperative bleeding, more effectively improve patients neurological function and consciousness state, reduce the incidence of complications, and regulate brain oxygen metabolism status, which is beneficial for improving prognosis and ensuring a good outcome of the disease.
The effects of esketamine on blood pressure and hypotension incidence during induction of bariatric surgery: A randomized controlled trial
Authors: Yang Ting , Mudabbar Muhammad Saqib , Xu Mingxing , Xiang Qingmei , Liu Bin , Fu Qiang 
Published: December 2023

Background:
The prevalence of obesity is high. Bariatric surgery is an effective treatment for severe obesity; however, the induction phase of anesthesia in these patients poses a risk of hypotension. Esketamine, known for its sympathetic nervous system stimulation, may stabilize blood pressure during induction. This study aimed to investigate the effects of esketamine on blood pressure in bariatric surgery patients.

Methods:
This randomized controlled trial included 145 patients undergoing bariatric surgery. Patients were randomly assigned to receive esketamine or a control intervention during induction. Blood pressure and other vital signs were measured and compared between the 2 groups using statistical analyses.

Results:
Administration of esketamine increased blood pressure before intubation (T2). The incidence of hypotension was lower in the esketamine group at multiple time points during induction. Postoperatively, the esketamine group exhibited lower pain scores at 24 hours and a reduced need for rescue analgesics.

Conclusion:
A single dose of 0.2 mg/kg esketamine during the induction phase of bariatric surgery can improve blood pressure stability and decrease the incidence of hypotension. Furthermore, it is associated with reduced postoperative pain. Future studies could explore the effects of higher esketamine doses and validate these findings in a larger and more diverse patient population.
Home-based tele-rehabilitation versus hospital-based outpatient rehabilitation for pain and function after initial total knee arthroplasty: A systematic review and meta-analysis
Authors: Zhang Hui , Wang Junqing , Jiang Zekun , Deng Tao , Li Kang , Nie Yong 
Published: December 2023

Background:
This systematic review and meta-analysis aims to compare the effectiveness of home-based tele-rehabilitation programs with hospital-based rehabilitation programs in improving pain and function at various time points (≤6 weeks, ≤14 weeks, and ≤ 52 weeks) following the initial total knee arthroplasty.

Methods:
This study used PRISMA and AMSTAR reporting guidelines. We systematically searched 5 databases (PubMed, Embase, Web of Science, Cochrane Library, and Medline) to identify randomized controlled trials published from January 1, 2019, to January 1, 2023. The primary outcomes were pain, knee injury and osteoarthritis outcome score, and mobility (knee range of motion).

Results:
We included 9 studies involving 1944 patients. Low-quality evidence showed hospital-based rehabilitation was better than home-based tele-rehabilitation in knee injury and osteoarthritis outcome score (mean difference [MD], −2.62; 95% confidence interval [CI], −4.65 to −0.58; P = .01) at ≤ 14 weeks after total knee arthroplasty. Based on low-quality evidence, home-based tele-rehabilitation was better than hospital-based rehabilitation in knee range of motion (MD, 2.00; 95% CI, 0.60 to 3.40; P = .005). There was no significant difference between hospital-based rehabilitation and home-based tele-rehabilitation in knee pain at ≤ 6 weeks (MD, 0.18; 95% CI, −0.07 to 0.42; P = .16), 14 weeks (MD, 0.12; 95% CI, −0.26 to 0.49; P = .54), and ≤ 52 weeks (MD, 0.16; 95% CI, −0.11 to 0.43; P = .24).

Conclusion:
Home-based tele-rehabilitation and hospital-based rehabilitation programs showed comparable long-term outcomes in pain, mobility, physical function, and patient-reported health status after primary total knee arthroplasty. Considering the economic costs, home-based tele-rehabilitation programs are recommended as a viable alternative to hospital-based rehabilitation programs.
Combined gastric and colorectal cancer endoscopic screening may be cost-effective in Europe with the implementation of artificial intelligence: an economic evaluation
Authors: Libanio Diogo , Antonelli Giulio , Marijnissen Fleur , Spaander Maanon CW , Hassan Cesare , Dinis-Ribeiro Mario , Areia Miguel 
Published: December 2023

Background/aims
Endoscopic screening for gastric cancer (GC) is not recommended in low-intermediate incidence countries. Artificial intelligence (AI) has high accuracy in GC detection and might increase the cost-effectiveness of screening strategies. We aimed to assess the cost-effectiveness of AI for GC detection in settings with different GC incidence and different accuracies of AI systems.

Methods
Cost-effectiveness analysis (using Markov model) comparing different screening strategies (no screening versus single esophagogastroduodenoscopy (EGD) at 50 years versus stand-alone EGD every 5/10 years versus combined EGD and screening colonoscopy once or twice per decade in Netherlands, Italy and Portugal) with variable AI accuracy settings. The primary outcome was the incremental cost-effectiveness ratio of the different strategies versus no screening. Deterministic and probabilistic sensitivity analyses were conducted.

Results
Without AI, one single EGD at 50 years (Netherlands, Italy, Portugal), EGD combined with screening colonoscopy once per decade (Italy and Portugal) and EGD combined with screening colonoscopy twice per decade (Portugal) are cost-effective when compared with no screening. If AI increases the accuracy of EGD by at least 1% in comparison to the accuracy of white-light endoscopy accuracy (89%), combined screening twice per decade also becomes cost-effective in Italy. If AI accuracy reaches at least 96%, combined screening once per decade is also cost-effective in the Netherlands.

Discussion
In European countries, AI-assisted EGD may improve the cost-effectiveness of GC screening with combined EGD and screening colonoscopy. The actual effect of AI on cost-effectiveness may vary dependent on the accuracy and costs of the AI system.
Preexposure prophylaxis availability among health facilities participating in the global International epidemiology Databases to Evaluate AIDS (IeDEA) consortium
Authors: Kebede Samuel , Brazier Ellen , Freeman Aimee M. , Muwonge Timothy R. , Choi Jun Yong , de Waal Renee , Poda Armel , Cesar Carina , Munyaneza Athanase , Kasozi Charles , Pasayan Mark Kristoffer U. , Althoff Keri N. , Shongo Alisho , Low Nicola , Ekouevi Didier , Veloso Valdiléa G. , Ross Jonathan 
Published: December 2023

Background:
While recognized as a key HIV prevention strategy, preexposure prophylaxis (PrEP) availability and accessibility are not well documented globally. We aimed to describe PrEP drug registration status and the availability of PrEP services across HIV care sites participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) research consortium.

Methods:
We used country-level PrEP drug registration status from the AIDS Vaccine Advocacy Coalition and data from IeDEA surveys conducted in 2014, 2017 and 2020 among participating HIV clinics in seven global regions. We used descriptive statistics to assess PrEP availability across IeDEA sites serving adult patients in 2020 and examined trends in PrEP availability among sites that responded to all three surveys.

Results:
Of 199 sites that completed the 2020 survey, PrEP was available in 161 (81%). PrEP availability was highest at sites in North America (29/30; 97%) and East Africa (70/74; 95%) and lowest at sites in Central (10/20; 50%) and West Africa (1/6; 17%). PrEP availability was higher among sites in countries where PrEP was officially registered (146/161; 91%) than where it was not (14/32; 44%). Availability was higher at health centers (109/120; 90%) and district hospitals (14/16; 88%) compared to regional/teaching hospitals (36/63). Among the 94 sites that responded to all three surveys, PrEP availability increased from 47% in 2014 to 60% in 2017 and 76% in 2020.

Conclusion:
PrEP availability has substantially increased since 2014 and is now available at most IeDEA sites. However, PrEP service provision varies markedly across global regions.
Variations in the results of nutritional epidemiology studies due to analytic flexibility: Application of specification curve analysis to red meat and all-cause mortality
Authors: Wang Yumin , Pitre Tyler , Wallach Joshua D. , de Souza Russell J. , Jassal Tanvir , Bier Dennis , Patel Chirag J. , Zeraatkar Dena 
Published: December 2023

AbstractObjectiveTo present an application of specification curve analysis—a novel analytic method that involves defining and implementing all plausible and valid analytic approaches for addressing a research question—to nutritional epidemiology.Data sourceNational Health and Nutrition Examination Survey (NHANES) 2007 to 2014 linked with National Death Index.MethodsWe reviewed all observational studies addressing the effect of red meat on all-cause mortality, sourced from a published systematic review, and documented variations in analytic methods (e.g., choice of model, covariates, etc.). We enumerated all defensible combinations of analytic choices to produce a comprehensive list of all the ways in which the data may reasonably be analyzed. We applied specification curve analysis to NHANES data to investigate the effect of unprocessed red meat on all-cause mortality, using all reasonable analytic specifications.ResultsAmong 15 publications reporting on 24 cohorts included in the systematic review on red meat and all-cause mortality, we identified 70 unique analytic methods, each including different analytic models, covariates, and operationalizations of red meat (e.g., continuous vs. quantiles). We applied specification curve analysis to NHANES, including 10,661 participants. Our specification curve analysis included 1,208 unique analytic specifications. Of 1,208 specifications, 435 (36.0%) yielded a hazard ratio equal to or above 1 for the effect of red meat on all-cause mortality and 773 (64.0%) below 1, with a median hazard ratio of 0.94 [IQR: 0.83 to 1.05]. Forty-eight specifications (3.97%) were statistically significant, 40 of which indicated unprocessed red meat to reduce all-cause mortality and 8 of which indicated red meat to increase mortality.ConclusionWe show that the application of specification curve analysis to nutritional epidemiology is feasible and presents an innovative solution to analytic flexibility.LimitationsAlternative analytic specifications may address slightly different questions and investigators may disagree about justifiable analytic approaches. Further, specification curve analysis is time and resource-intensive and may not always be feasible.
A systematic review and meta-analysis of school-based preventive interventions targeting e-cigarette use among adolescents
Authors: Gardner Lauren A. , Rowe Amy-Leigh , Newton Nicola C. , Egan Lyra , Hunter Emily , Devine Emma K. , Aitken Tess , Thornton Louise , Teesson Maree , Stockings Emily , Champion Katrina E. 
Published: December 2023

AbstractObjectiveTo examine the efficacy of school-based e-cigarette preventive interventions via a systematic review and meta-analysis.Data sourcesWe searched MEDLINE, Embase, PsycINFO, Scopus, CINAHL, Cochrane and clinical trials registries for studies published between January 2000-June 2023 using keywords for e-cigarettes, adolescents, and school.Study selectionOf 1566 double-screened records, 11 met criteria of targeting adolescents, evaluating an e-cigarette preventive intervention, being conducted in a secondary school, using a randomised controlled trial (RCT), cluster RCT or quasi-experimental design, and comparing an intervention to a control.Data extractionPre-specified data pertaining to the study design, outcomes, and quality were extracted by one reviewer and confirmed by a second, and where necessary, third reviewer.Data synthesisOur narrative synthesis showed some school-based interventions prevented or reduced e-cigarette and/or tobacco use, however some increased use. Meta-analyses on a subsample of studies found that, overall, school-based interventions were not associated with the prevention of e-cigarette (OR=0.43, 95%CI=0.16, 1.12; p=0.09) or tobacco (OR=1.01, 95%CI=0.65, 1.59, p=0.95) use, however were associated with reductions in past 30-day tobacco use (OR=0.59, 95%CI=0.39, 0.89, p=0.01) which encompassed e-cigarettes in some studies. School-based interventions were also associated with improved knowledge (SMD=-0.38, 95%CI=-0.68, -0.08, p=0.01), intentions (SMD=-0.15, 95%CI=-0.22, -0.07, p=0.0001), and attitudes (SMD=-0.14, 95%CI=-0.22, -0.06; p=0.0007) in the short-term. Overall, the quality of evidence was low-to-moderate.ConclusionsSchool-based interventions hold potential for addressing e-cigarette use, however, can have null or iatrogenic effects. More high-quality research is needed to develop efficacious interventions, and schools must be supported to adopt evidence-based programs.
LEPROSY RELAPSE AFTER POLYCHEMOTHERAPY: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Verônica da Silva Fabiane , Santos de Sousa Gutembergue , Ferreira Elena Alves Benevides , de Souza Silva Pãmela Rodrigues , Takahashi Juliana Akie , Espinosa Omar Ariel , Ignotti Eliane , Olmo Roberta Pinheiro , de Araújo Püschel Vilanice Alves , Anastácio Zélia Ferrreira Caçador , Ferreira Silvana Margarida Benevides 
Published: December 2023

ABSTRACTObjective: To synthesize the best scientific evidence related to estimating the prevalence of leprosy relapse cases after polychemotherapy treatment.Method:A systematic review was conducted following the JBI methodology for systematic reviews of prevalence studies, and the reporting stage adhered to PRISMA-P, with registration No.: CRD42020177141. The inclusion criteria were adopted following the PopCoCo mnemonic (Population, Condition, Context). Population: people of both genders and any age, diagnosed with leprosy relapse, and treated with paucibacillary or multibacillary therapeutic regimes. Condition: leprosy relapse after Polychemotherapy (PCT) estimated as a proportion of cases.Context: studies conducted within the scope of health services. Databases used: Medline, LILACS, Embase, CINAHL, Scopus, WoS, CARPHA; Mendeley reference manager. A random-effects meta-analysis model was applied, and heterogeneity was assessed using the Higgins test.Results: Out of 41 studies included in the review, involving a total of 93,461 patients with leprosy, 4.09% (n=3,830) were eligible for relapse after polychemotherapy. Of them, 69.71% (n=2,670) were treated both with multibacillary and with paucibacillary regimes (72.36%, n=1,932; and 27.64%, n=738, respectively), and with a bacilloscopy index ≥4. Relapse prevalence was observed in males and in people aged over 30 years old. The meta-analysis estimated the global prevalence of leprosy relapse at 11% (95%CI: 0.09-0.12), with higher prevalence rates in Brazil (31%) and India (13%).Conclusion: There is evidence of high global prevalence of leprosy relapse after PCT, with higher estimates in India and Brazil, countries burdened with higher prevalence of the disease.SYNTHESISAlthough leprosy us an ancient disease with a scientifically proven effective treatment, it remains a Public Health problem. This is not only due to the disease high prevalence but also to its potential to cause physical disabilities, leading to emotional and social impacts and, consequently, compromising quality of life. In addition to the new cases of the disease, another concern commonly reported in the literature is leprosy relapse after polychemotherapy, as it has repercussions on therapeutic effectiveness. The relapse causes are usually associated with therapeutic failure due to incomplete treatment, misclassification in the initial treatment, and multidrug resistance. This study provides insights to verify the disease current prevalence based on scientific evidence, which can contribute to expanding the prevention strategies.
MOCAT: Multi-Omics Integration with Auxiliary Classifiers Enhanced Autoencoder
Authors: Yao Xiaohui , Jiang Xiaohan , Luo Haoran , Liang Hong , Ye Xiufen , Wei Yanhui , Cong Shan 
Published: December 2023

AbstractBackgroundIntegrating multi-omics data is emerging as a critical approach in enhancing our understanding of complex diseases. Innovative computational methods capable of managing high-dimensional and heterogeneous datasets are required to unlock the full potential of such rich and diverse data.MethodsWe propose a Multi-Omics integration framework with auxiliary Classifiers-enhanced AuToencoders (MOCAT), for comprehensive utilization of both intra- and inter-omics information. Additionally, attention mechanisms with confidence learning are incorporated for enhanced feature representation and trustworthy prediction.ResultsExtensive experiments were conducted on four benchmark datasets to evaluate the effectiveness of our proposed model, including BRCA, ROSMAP, LGG, and KIPAN. Our model significantly improved most evaluation measurements and consistently surpassed the state-of-the-art methods. Ablation studies showed that the auxiliary classifiers significantly boosted classification accuracy in both the ROSMAP and LGG datasets. Moreover, the attention mechanisms and confidence evaluation block contributed to improvements in the predictive accuracy and generalizability of our model.ConclusionsThe proposed framework exhibits superior performance in disease classification and biomarker discovery, establishing itself as a robust and versatile tool for analyzing multi-layer biological data. This study highlights the significance of elaborated designed deep learning methodologies in dissecting complex disease phenotypes and improving the accuracy of disease predictions.
COMBINED EFFECTS OF AMBIENT TEMPERATURE AND FOOD AVAILABILITY ON INDUCED INNATE IMMUNE RESPONSE OF A FRUIT-EATING BAT (CAROLLIA PERSPICILLATA)
Authors: Viola Matheus F. , Herrera M. L. Gerardo , Cruz Ariovaldo P. 
Published: December 2023

ABSTRACTResilience of mammals to anthropogenic climate and land-use changes is associated with the maintenance of adequate responses of several fitness-related traits such as those related to immune functions. The combined effects of decrease in food availability (Fa) and an increase in ambient temperature (Ta) can lead to immunosuppression and greater susceptibility to disease. In this study, we measured how selected physiological and behavioral components associated with the innate immune system of fruit-eating bats (Carollia perspicillata) respond to isolated and combined effects of changes in Ta and Fa. We tested the general hypothesis that decreased Fa, increased Ta and the combined effect of both factors would affect bat immune performance. Physiological (fever, leukocytosis and neutrophil/lymphocyte ratio) and behavioral (food intake) components of the acute phase response (APR), as well as bacterial killing ability of the plasma (BKA) were assessed after immune challenge with lipopolysaccharide (LPS: 10 mg/kg) in experimental groups kept at different short-term conditions of Fa (ad libitum diet or 50% food-deprived) and Ta (27 and 33°C). Our results indicate that magnitude of increase in body temperature was not affected by Fa, Ta or the interaction of both factors, but the time to reach the highest increase took longer in LPS-injected bats that were kept under food restriction. The magnitude of increased neutrophil/lymphocyte ratio (N/L) was affected by the interaction between Fa and Ta, but food intake, total white blood cell count and BKA were not affected by any factor or interaction. Overall, our results suggest that BKA and most components of APR examined are not affected by short-term changes in Fa and Ta within the range evaluated in this study, and that the increase of the N/L ratio when bats are exposed to low Fa and high Ta might represent an enhancement of cellular response to deal with infection.
Shieldin and CST co-orchestrate DNA polymerase-dependent tailed-end joining reactions independently of 53BP1-governed repair pathway choice
Authors: King Ashleigh , Reichl Pia , Metson Jean S. , Parker Robert , Munro Daniella , Oliveira Catarina , Becker Jordan R. , Biggs Daniel , Preece Chris , Davies Benjamin , Chapman J. Ross 
Published: December 2023

Abstract53BP1 regulates DNA end-joining in lymphocytes, diversifying immune antigen receptors. This involves nucleosome-bound 53BP1 at DNA double-stranded breaks (DSBs) recruiting RIF1 and shieldin, a poorly understood DNA-binding complex. The 53BP1-RIF1-shieldin axis is pathological inBRCA1-mutated cancers, blocking homologous recombination (HR) and driving illegitimate non-homologous end-joining (NHEJ). However, how this axis regulates DNA end-joining and HR suppression remains unresolved.We investigated shieldin and its interplay with CST, a complex recently implicated in 53BP1-dependent activities. Immunophenotypically, mice lacking shieldin or CST are equivalent, with class-switch recombination co-reliant on both complexes. ATM-dependent DNA damage signalling underpins this cooperation, inducing physical interactions between these complexes that reveal shieldin as a DSB-responsive CST adaptor. Furthermore, DNA polymerase ζ functions downstream of shieldin, establishing DNA fill-in synthesis as the physiological function of shieldin-CST. Lastly, 53BP1 suppresses HR and promotes NHEJ in BRCA1-deficient mice and cells independently of shieldin. These findings showcase the resilience of the 53BP1 pathway, achieved through the collaboration of chromatin-bound 53BP1 complexes and DNA end-processing effector proteins.