bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Eliminating Cost-Sharing by Medicare Beneficiaries for Follow-Up Colonoscopy After a Positive Stool-based Colorectal Cancer Screening Test
Authors: Fendrick A. Mark , Lieberman David , Chen Jing Voon , Vahdat Vahab , Ozbay A. Burak , Limburg Paul J. 
Published: October 2023

Abstract

Medicare coverage of a follow-up colonoscopy after a positive stool-based colorectal cancer screening test with no patient cost-sharing started January 2, 2023, which may favorably affect screening behavior. This analysis estimated the clinical and economic effects of increased colorectal cancer screening participation potentially resulting from this policy change in Medicare beneficiaries. The validated Colorectal Cancer and Adenoma Incidence & Mortality (CRC-AIM) model simulated three guideline-endorsed colorectal cancer screening strategies for average-risk individuals (colonoscopy every 10 years, annual fecal immunochemical test, triennial multitarget stool DNA) from ages 65–75 years. The base-case scenario assumed 0% coinsurance for initial screening and follow-up colonoscopy, real-world screening test use (colonoscopy = 45.3%, stool-based test = 24.4%, unscreened = 30.3%), and real-world follow-up colonoscopy rates. Comparative scenarios assumed an increase in the overall screening rate from 0% to 15% (5% increments) and an increase in the follow-up colonoscopy rate from 0% to 15% (5% increments). The base-case scenario resulted in 128 life-years gained (LYG)/1,000 individuals versus no screening and total screening and treatment costs of $7,938/person. The changes resulted in an increase of up to 26 LYG/1,000 individuals and a decrease in total screening and treatment costs by as much as $128/person. Follow-up colonoscopy at $0 coinsurance became cost-saving with any increase in either overall screening or follow-up colonoscopy. Policies that remove cost barriers to completing colorectal cancer screening may increase rates of screening participation, potentially improving economic and clinical outcomes.

Significance:
A follow-up colonoscopy after a positive stool-based colorectal cancer screening test is necessary to complete the full screening process. Policies that remove cost barriers to completing colorectal cancer screening may lead to increases in overall participation rates and use of follow-up colonoscopy, improving clinical and economic outcomes.
On the Relevance of Posterior and Midfrontal Theta Activity for Visuospatial Attention
Authors: Asanowicz Dariusz , Panek Bartłomiej , Kotlewska Ilona , van der Lubbe Rob 
Published: October 2023

Abstract
The aim of this study was to examine whether oscillatory activity in the theta-band is relevant for selective visuospatial attention when there is a need for the suppression of interfering and distracting information. A variant of the Eriksen flanker task was employed with bilateral arrays: one array consisting of a target and congruent or incongruent flankers and the second array consisting of neutral distractors. The bilateral arrays were preceded either by a 100% valid spatial cue or by a neutral cue. In the cue–target interval, a major burst in medial frontal theta power was observed, which was largest in the spatial cue condition. In the latter condition, additionally a posterior theta increase was observed that was larger over sites ipsilateral to the forthcoming target array. Functional connectivity analyses revealed that this pretarget posterior theta was related to the midfrontal theta. No such effects were observed in the neutral cue condition. After onset of the bilateral arrays, a major burst in posterior theta activity was observed in both cue conditions, which again was larger above sites ipsilateral to the target array. Furthermore, this posterior theta was in all cases related to the midfrontal theta. Taken together, the findings suggest that a fronto-posterior theta network plays an important role in the suppression of irrelevant and conflicting visual information. The results also suggest that the reciprocal relation between visuospatial attention and executive response control may be closer than commonly thought.
Prospective and Retrospective Metacognitive Abilities and Their Association with Impaired Self-awareness in Patients with Traumatic Brain Injury
Authors: Yoshida Kazuki , Sawamura Daisuka , Ogawa Keita , Mototani Takuroh , Ikoma Katsunori , Sakai Shinya 
Published: October 2023

Abstract
Metacognitive impairment often occurs in patients with traumatic brain injury (TBI) and is associated with clinical problems. The aim of this study was to clarify the pathology of metacognitive impairment in TBI patients using a behavioral task, clinical assessment of self-awareness, and lesion-symptom mapping. Metacognitive abilities of TBI patients and healthy controls were assessed using a modified perceptual decision-making task. Self-awareness was assessed using the Patient Competency Rating Scale and the Frontal Systems Behavior Scale. The associations between estimated metacognitive abilities, self-awareness, and neuropsychological test results were examined. The correspondence between metacognitive disabilities and brain lesions was explored by ROI-based lesion-symptom mapping using structural magnetic resonance images. Overall, 25 TBI patients and 95 healthy controls were included in the analyses. Compared with that in healthy controls, the prospective metacognitive ability of TBI patients was lower, with metacognitive evaluations revealing a bias toward overestimating their abilities. Retrospective metacognitive ability showed a negative correlation with self-awareness but not with neuropsychological test results. In the lesion-symptom mapping analysis, the left pFC was associated with lower retrospective metacognitive ability. This study contributes to a better understanding of the pathology of metacognitive and self-awareness deficits in TBI patients and may explain the cause of impaired realistic goal setting and adaptive behavior in these patients.
The Summer Atmospheric Convection Variability over the Tropical Western North Pacific Independent of and Dependent on the Preceding Winter ENSO
Authors: Chen Peishan , Lu Riyu 
Published: October 2023

Abstract
It has been well known that the preceding winter ENSO affects the atmospheric convection over the tropical western North Pacific (WNP) in summer, which has important impacts on Asian climate. However, more than half of the interannual variance in tropical WNP convection cannot be explained by ENSO. This study separates the WNP convection into two components, namely, independent of and dependent on the preceding winter ENSO, and compares the anomalies associated with these two components. The linear regression results indicate that the independent convection suppression corresponds to significant cyclonic anomalies over East Asia in both the lower and upper troposphere, and correspondingly a southward displacement of upper-tropospheric East Asian westerly jet. By contrast, these circulation anomalies are weakened for the dependent convection suppression, which is more closely related to the lower-tropospheric cyclonic anomalies over the Indian Ocean. Accordingly, the independent and dependent components exert distinct impacts on rainfall and temperature in Asia. Specifically, the independent suppression corresponds to more significantly enhanced rainfall in subtropical East Asia compared with the dependent one. Moreover, there are colder surface air temperatures in the midlatitude East Asia for the independent suppression and warmer temperatures in South and Southeast Asia for the dependent suppression. Further analyses suggest that the circulation and climate anomalies for the independent component are mainly contributed by July and August, while those for the dependent component become weak from June to August. These results can be helpful for a better understanding of summer Asian climate variability and predictability.
Statistical and artificial intelligence techniques to identify risk factors for suicide in children and adolescents
Authors: Servi Michaela , Chiaro Silvia , Mussi Elisa , Castellini Giovanni , Mereu Alberta , Volpe Yary , Pisano Tiziana 
Published: October 2023

Background: Suicidal Behaviors and Thoughts are a relevant public health issue that includes suicidal ideation, non-suicidal self-harm, attempted suicide, and failed suicides. Since there is a progression of suicidal behaviors, whereby suicide is more likely to be completed if there have already been previous behaviors or attempts to harm oneself, WHO has highlighted the need to detect early predictors of such suicidal behaviors, which can help identify individuals at risk, plan prevention strategies and implement specific therapeutic interventions, particularly in young people, thus reducing the number of deaths. This retrospective observational study aimed to identify early predictors of suicidal risk in 237 inpatients admitted for Suicidal Behaviors and Thoughts at Child and Adolescent Psychiatry Emergency Unit of the Meyer Children's Hospital, Florence, Italy. Methods: The study was subdivided into three phases: data collection, statistical analysis, and neural network. For each patient, we collected epidemiological and psychopathological data. We stratified the inpatients into two groups: “suicidal volition patients” and “suicidal motivation patients.” Results: The hospitalization rate for suicidal behaviors and thoughts showed a growing trend from 2016 to 2020 (27.69 to 45.28%). Under 12 years of age, diagnosis of disruptive, impulse-control and conduct disorder, previous specialist care, history of attempted suicide, and intoxication as methods of suicide were statistically correlated to an increased risk of suicidal behaviors. Artificial intelligence, with an accuracy of 86.7%, confirmed these risk factors. Limitations: The most important limitation of the study is its retrospective nature. Conclusions: Our study identifies new early predictors of suicidal risk: age less than 12, diagnosis of disruptive, impulse-control and conduct disorder. In addition, suicidal volition behavior emerges as an important and underestimated risk factor. The use of artificial intelligence methods could be supporting the clinician in assessing suicidal risk.
Comprehensive evaluation of urban development suitability based on constraints and development factors: A case study of the central urban area of Zhengzhou, China
Authors: Shi Zhenqin , Huo Jingeng , Zhu Wenbo , Ma Ran , Xue Hua , Wang Zechen 
Published: October 2023

The overcapacity and overdevelopment of cities have led to various environmental hazards and resource depletion, making it crucial to evaluate the suitability of urban development. This research field provides scientific evidence and policy recommendations to improve land use quality and distribution. However, contemporary studies solely focus on construction land versus non-construction land competition, ignoring potential constraints from agriculture and ecology on parcel development. Using the land use situation of Zhengzhou City, this study comprehensively evaluated urban development suitability through hierarchical analysis, Delphi method, and eight-direction analysis. A multi-attribute overlay was applied with spatial restrictions from ecological protection and agricultural production, combined with urban expansion and development conditions. The results indicated that: (1) Ecological protection was critical for sustainable urban development, and areas like the Yellow River coast, northwest wetland, and southwest woodland were significant for ecological protection. High suitability areas for agricultural production were primarily located within the existing cultivated land. (2) Regarding urban expansion, the southeast of the city center was identified as the most suitable area, mainly covered by dryland. (3) Overall, the unsuitable, basically unsuitable, medium, suitable, and highly suitable areas for urban development covered 244, 921, 3024, 2224, and 944 km2, respectively. (4) The southeast-northwest direction showed prominent spatial characteristics for urban development suitability, while intensive development mode dominated the east-west direction of the city center. These findings provide significant guidance for land development and utilization, optimizing the spatial pattern, and formulating policies in Zhengzhou. Nevertheless, the weight calculation process presents a subjective factor that needs to be addressed in future research. More objective weight calculation results are necessary to achieve a more scientifically rigorous evaluation of urban development suitability.
James Crotty’s Advice to Koreans
Authors: Lee Kang-Kook 
Published: October 2023

The Korean economy achieved rapid economic growth with equal income distribution for over three decades until the late 1990s when, in 1997, a financial crisis occurred. Mainstream economists and the International Monetary Fund (IMF) attributed this crisis to the problem of East Asian crony capitalism. The Korean government accepted this perspective and implemented neoliberal economic restructuring and financial opening after the crisis. However, James Crotty argued that the crisis in Korea was a result of haphazard financial opening and the withdrawal of state intervention. Most importantly, he extensively criticized the post-crisis economic reform in Korea imposed by the IMF. He believed that it would lead to lower economic growth and higher inequality, and he advised Koreans to oppose it. This article examines Crotty’s argument about the Korean economy and how the latter changed in the 21st century. JEL classification: F34, H12, O19, O53
Socioecologic Factors Associated With Obesity in Adolescents With Epilepsy in the United States
Authors: Buro Acadia W. , Sauls Rachel , Salinas-Miranda Abraham , Kirby Russell S. 
Published: October 2023

Background Obesity among youth with epilepsy has multifactorial etiology, yet socioecologic obesity risk factors (eg, neighborhood factors) have not been examined in this population. This study examined (1) the prevalence of obesity adjusting for relevant covariates and (2) socioecologic correlates of obesity in adolescents with epilepsy aged 10-17 years. Methods This cross-sectional study used 2017-2018 National Survey of Children's Health data (total n = 27,094; epilepsy n = 184). Chi-square tests compared weighted prevalence of obesity with relevant covariates among all adolescents and adolescents with epilepsy. Weighted multiple logistic regression models were conducted to adjust for covariates. Results The prevalence of obesity in adolescents with epilepsy was 27.8% (95% confidence interval [CI] 15.4%-40.3%) vs 15.1% (95% CI 14.1%-16.2%) for the non-epilepsy group. Adolescents with epilepsy also had higher odds of obesity after adjusting for age, gender, race/ethnicity, household income, physical activity, and medical home (odds ratio [OR] 2.1, 95% CI 1.2-3.8). Adjusting for sociodemographics, anxiety (OR 4.5, 95% CI 1.3-15.6), 2 or more adverse childhood experiences (OR 7.3, 95% CI 1.6-33.4), neighborhood detracting elements (eg, OR 5.2, 95% CI 1.5-18.5 for 1 detracting element), and forgone care (ie, unmet health care needs) (OR 22.4, 95% CI 3.8-132.8) were associated with obesity in adolescents with epilepsy. Adjusting for multiple comparisons, neighborhood detracting elements ( P < .0001) and forgone care ( P < .0007) remained significant. Conclusion Variables related to mental health, family functioning, built environment, and forgone care were associated with obesity in adolescents with epilepsy, but the association was not fully explained by these factors. Obesity interventions for this population should consider multiple levels of influence including the community and special health care needs of this population.
Factors Associated With Post-Extubation Stridor in Infants Intubated in the Pediatric ICU
Authors: Lewis Deirdre , Khalsa Dev Darshan , Cummings Alexandra , Schneider James , Shah Sareen 
Published: October 2023

Background Post-extubation stridor (PES) is a common problem in the pediatric intensive care unit (PICU) and is associated with extubation failure, longer length of stay, and increased mortality. Infants represent a large proportion of PICU admissions and are at higher risk for PES, making identification and mitigation of factors associated with PES important in this age group. Research Question What factors are associated with PES in infants (age less than 1 year) intubated in the PICU? Study Design & Methods The primary outcome was PES as defined by the need for racemic epinephrine within 6 h of extubation. Secondary outcomes were heliox administration and reintubation. Statistical analyses were performed with Fisher's exact test for univariate analyses and multivariate logistic regression. Results 518 patient charts were retrospectively reviewed. 24.1% of patients developed PES. Duration of mechanical ventilation greater than 48 h was associated with increased risk of PES (odds ratio [OR] = 1.75, 95% confidence interval [CI] 1.13-2.71, P = .01), as was nonelective intubation (OR = 2.92, 95% CI 1.91-4.46, P < .01). The presence of a cuff, gastroesophageal reflux disease, prematurity, and known upper airway abnormality had no association with PES. 4.0 endotracheal tubes (ETTs) had an increased association with PES compared to 3.5 ETTs (OR = 1.96, 95% CI 1.18-3.27, P < .01). There was no difference in risk of PES between 3.5 and 3.0 ETTs. Interpretation In infants intubated in the PICU, mechanical ventilation greater than 48 h and nonelective intubation were associated with PES. 4.0 ETTs were associated with higher risk of PES compared to 3.5 ETTs. These findings may help providers in ETT selection and to identify infants that may be at increased risk of PES.
Biological function of C-X-C Motif Chemokine Ligand 1 gene (CXCL1) in ovarian malignant tumors
Authors: Li Zhuang , Huang Ning , Zhang Wei , Li Li 
Published: October 2023

Objective To determine the function of the chemokine (C-X-C motif) ligand 1 (CXCL1) gene in ovarian cancer cells and to investigate the relationship between CXCL1 gene mRNA expression and ovarian tumor clinical pathology. Methods Using bioinformatics methods to identify common differentially expressed genes associated with ovarian cancer in the GEO database. Growth curves of A2780 cells with or without CXCL1 expression were plotted by MTT assay. Cell cycles were measured by flow cytometry. Cell colony formation was enumerated in Transwell chambers. Migration and invasion in vitro were investigated using Cell Counting Kit-8 (CCK8), wound healing and Transwell, respectively. The relationship between CXCL1 gene mRNA expression and ovarian tumor clinical pathology was analyzed. Results CXCL1 was found to be one of the co-upregulated differentially expressed genes in the GEO database. The migration of A2780 cells expressing CXCL1 was significantly higher than that of A2780 cells without CXCL1 expression. CXCL1 mRNA expression in ovarian malignancy was significantly higher than those in benign lesions and the normal control ( p < .01). In advanced ovarian cancer (Stages III-IV), CXCL1 mRNA expression was also significantly higher than that in patients with early-stage ovarian cancer (Stages I-II) ( p = .005). Kaplan-Meier survival curve showed no correlation between CXCL1 mRNA expression and ovarian cancer prognosis. A Cox proportional hazard model also showed that CXCL1 expression was not an independent prognostic factor for ovarian cancer patients. Conclusions CXCL1 gene could promotes ovarian cancer A2780 cell proliferation and invasion in vitro, and contributed theoretical knowledge for the target selection in molecular targeted therapy. CXCL1 mRNA over-expression may be correlated with the occurrence and development of ovarian malignancy. Level of plasma CXCL1 might serve as a biomarker for prognosis in ovarian carcinoma patients.
Chemotherapy regimen for recurrent uterine leiomyosarcoma
Authors: Hu Fang , Ye Yiqing , Begum Hazeera 
Published: October 2023

Introduction Uterine leiomyosarcoma is a rare gynecological malignancy, the limited literature indicated that doxorubicin alone or gemcitabine/docetaxel combination is the preferred chemotherapy regimen. Given the rarity of the disease and the lack of high-level clinical evidence, there is no consensus on the best treatment. Case report We report a case of a patient with uterine leiomyosarcoma who recurred after adjustment treatment with doxorubicin, gemcitabine, docetaxel, and anlotinib; and required a new chemotherapy regimen. Management and outcomes The follow-up chemotherapy regimen was doxorubicin-liposome 40 mg/m2 on one day in combination with dacarbazine 250 mg/m2 on one to five days of intravenous infusion every 21 days. We monitored adverse effects during chemotherapy and the process was smooth. Discussion It is important to comprehensively consider the patient's condition, and fully consider the efficacy, dosage, and adverse reactions of the chemotherapy regimen to determine the appropriate plan, in order to achieve the best therapeutic benefits for patients.
Preclinical In-Vivo Safety and Toxicokinetics of D-PLEX100 in an Abdominal Surgery Incision Model in Juvenile Miniature Swine
Authors: Ramot Yuval , Nyska Abraham , Dvir Meidan , Nedvetzki Shlomo , Rosenfeld Sefi , Emanuel Noam 
Published: October 2023

D-PLEX100 (D-PLEX) is a novel product candidate made of a polymer-lipid-based matrix (PLEX platform) which contains doxycycline that is being released at a constant rate for 30 days. D-PLEX was developed to prevent surgical site infections, which are a major global health challenge. Previous studies have shown its safety in adult humans, adult swine, and adult rabbits. The aim of this study was to assess the toxicity and safety of D-PLEX also in juvenile animals to support future clinical trials in pediatric patients. Yucatan miniature swine were selected as a model, primarily due to their relatively larger mass. D-PLEX or placebo (formulation without doxycycline) was administered locally to abdominal incisions, and the animal's safety parameters were followed for 9 months and compared to sham-control swine. There was no evidence of any systemic safety concern or local toxicity at the incision site in D-PLEX-treated animals. D-PLEX was detected after 1 month and was fully resorbed at the 3-month time point. The surgical incision sites were fully healed at the 6-month time point in all D-PLEX-treated animals. Toxicokinetic (TK) assessments revealed that doxycycline exhibited low Cmax and therefore minimal systemic exposure following a single dose of local administration. This study provides evidence for the safety of D-PLEX and PLEX-based formulation in juvenile miniature swine and supports its further testing in clinical pediatric population. In addition, it can be used as a reference for future preclinical studies aiming to evaluate the safety of other PLEX-based product candidates for the pediatric population.