bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiclass risk models for ovarian malignancy: an illustration of prediction uncertainty due to the choice of algorithm
Authors: Ledger Ashleigh , Ceusters Jolien , Valentin Lil , Testa Antonia , Van Holsbeke Caroline , Franchi Dorella , Bourne Tom , Froyman Wouter , Timmerman Dirk , Van Calster Ben 
Published: November 2023

Abstract
Background
Assessing malignancy risk is important to choose appropriate management of ovarian tumors. We compared six algorithms to estimate the probabilities that an ovarian tumor is benign, borderline malignant, stage I primary invasive, stage II-IV primary invasive, or secondary metastatic.

Methods
This retrospective cohort study used 5909 patients recruited from 1999 to 2012 for model development, and 3199 patients recruited from 2012 to 2015 for model validation. Patients were recruited at oncology referral or general centers and underwent an ultrasound examination and surgery ≤ 120 days later. We developed models using standard multinomial logistic regression (MLR), Ridge MLR, random forest (RF), XGBoost, neural networks (NN), and support vector machines (SVM). We used nine clinical and ultrasound predictors but developed models with or without CA125.

Results
Most tumors were benign (3980 in development and 1688 in validation data), secondary metastatic tumors were least common (246 and 172). The c-statistic (AUROC) to discriminate benign from any type of malignant tumor ranged from 0.89 to 0.92 for models with CA125, from 0.89 to 0.91 for models without. The multiclass c-statistic ranged from 0.41 (SVM) to 0.55 (XGBoost) for models with CA125, and from 0.42 (SVM) to 0.51 (standard MLR) for models without. Multiclass calibration was best for RF and XGBoost. Estimated probabilities for a benign tumor in the same patient often differed by more than 0.2 (20% points) depending on the model. Net Benefit for diagnosing malignancy was similar for algorithms at the commonly used 10% risk threshold, but was slightly higher for RF at higher thresholds. Comparing models, between 3% (XGBoost vs. NN, with CA125) and 30% (NN vs. SVM, without CA125) of patients fell on opposite sides of the 10% threshold.

Conclusion
Although several models had similarly good performance, individual probability estimates varied substantially.
Attitudes and barriers to resistance exercise training for older adults living with multiple long-term conditions, frailty, and a recent deterioration in health: qualitative findings from the Lifestyle in Later Life – Older People’s Medicine (LiLL-OPM) study
Authors: Hurst Christopher , Dismore Lorelle , Granic Antoneta , Tullo Ellen , Noble Jane M. , Hillman Susan J. , Witham Miles D. , Sayer Avan A. , Dodds Richard M. , Robinson Sian M. 
Published: November 2023

AbstractBackgroundMany older adults live with the combination of multiple long-term conditions (MLTC) and frailty and are at increased risk of a deterioration in health requiring interaction with healthcare services. Low skeletal muscle strength is observed in individuals living with MLTC and is central to physical frailty. Resistance exercise (RE) is the best available treatment for improving muscle strength, but little is known about the attitudes and barriers to RE in this group of older adults. This study therefore aimed to explore the knowledge of and attitudes towards RE, as well as the barriers and enabling factors, in older adults living with MLTC, frailty and a recent deterioration in health.MethodsFourteen participants aged 69–92 years (10 women) from the Lifestyle in Later Life – Older People’s Medicine (LiLL-OPM) study were recruited from an Older People’s Medicine Day Unit in Newcastle, UK. Participants were invited to take part in a semi-structured interview exploring their knowledge and attitudes as well as barriers and enabling factors to RE. Data were analysed using thematic analysis.ResultsThe analysis generated three themes (1) a lack of awareness and understanding of RE, (2) a self-perceived inability to perform RE; physical and psychological barriers and (3) willingness to perform RE under expert guidance. There was a general lack of awareness and understanding of RE, with most participants having never heard of the term and being unaware of its potential benefits. When RE was described, participants stated that they would be willing to try RE, but it was apparent that an individualised approach underpinned by expert guidance would be required to support engagement.ConclusionsOlder adults living with MLTC, frailty and a recent deterioration in health lack awareness and understanding of RE. Despite a range of barriers, this group appear willing to engage in RE if they are appropriately supported. There is a need to co-design and deliver effective strategies, including education, to raise awareness and understanding of RE, as well as promote engagement in RE, in this group of older adults.
Association between BMI trajectories in late-middle age and subsequent dementia risk in older age: a 26-year population-based cohort study
Authors: Qin Zijian , Liu Zheran , Li Ruidan , Luo Yaxin , Wei Zhigong , He Ling , Pei Yiyan , Su Yonglin , Hu Xiaolin , Peng Xingchen 
Published: November 2023

Abstract
Background
The association between body mass index (BMI) and dementia risk differs depending on follow-up time and age at BMI measurement. The relationship between BMI trajectories in late-middle age (50–65 years old) and the risk of dementia in older age (> 65 years old) has not been revealed.

Methods
In the present study, participants from the Health and Retirement Study were included. BMI trajectories were constructed by combining BMI trend and variation information. The association between BMI trajectories at the age of 50–65 years and dementia risk after the age of 65 years was investigated. Participants with European ancestry and information on polygenic scores for cognitive performance were pooled to examine whether genetic predisposition could modify the association.

Results
A total of 10,847 participants were included in the main analyses. A declining BMI trend and high variation in late-middle age were associated with the highest subsequent dementia risk in older age compared with an ascending BMI trend and low variation (RR = 1.76, 95% CI = 1.45–2.13). Specifically, in stratified analyses on BMI trajectories and dementia risk based on each individual's mean BMI, the strongest association between a declining BMI trend with high variation and elevated dementia risk was observed in normal BMI group (RR = 2.66, 95% CI = 1.72–4.1). Similar associations were found when participants were stratified by their genetic performance for cognition function without interaction.

Conclusions
A declining BMI trend and high variation in late-middle age were associated with a higher risk of dementia. Early monitoring of these individuals is needed to prevent dementia in older individuals.
Visceral fat area measured by electrical bioimpedance as an aggravating factor of COVID-19: a study on body composition
Authors: Carvalho Juliana Bonfleur , de Andrade Grasiela Konkolisc Pina , do Nascimento Ludiane Alves , Golin Natalia , Rodrigues Ana Lucia Chalhoub Chediac , Suiter Erika , Soprani Maryana Virginia Orellana , Nadolskis Ariane Severine 
Published: November 2023

Abstract
Introduction
Severe forms of COVID-19 are more common in patients with abnormal fat distribution, particularly high visceral adiposity. The patient’s muscle strength may be reduced during the acute phase of the infection. Electrical bioimpedance (BIA) is a non-invasive method for measuring body compartments and estimating visceral fat area (VFA) that can be used at the bedside.

Objective
To assess the association between several body composition parameters, primarily high adipose tissue and high VFA, in patients with and without a diagnosis of COVID-19 infection, and whether it worsened the severity parameters.

Methods
This retrospective cohort study was conducted in a private hospital in the city of São Paulo from March 2020 to August 2021. The demographic and clinical data was collected from medical reports. Body composition is assessed using the InBODY® model S10 bioelectrical impedance device and a Jamar® digital hydraulic manual dynamometer with a scale from 0 to 90 kg is used to measure handgrip strength (HGS).

Results
A total of 96 patients with a mean age of 69.1 years (SD 15) were divided into two groups of 48 individuals, with and without COVID-19 infection. Body mass index (odds ratio [OR]: 4.47, 95% confidence interval [CI]: 1.69, 11.83), fat mass (OR: 2.03, 95% CI: 0.48, 8.55), and VFA (OR: 1.08, 95% CI: 0.33, 3.53) were all higher in the infection group. When COVID-19 patients were evaluated, those with higher VFA had longer hospital stays (OR: 0.99, 95% CI: 0.97, 1.01) and used more vasoactive drugs (p = 0.043). Patients with COVID-19 with poor handgrip strength were 3.29 times more likely to require a prolonged intensive care unit (ICU) stay.

Conclusion
The study concluded that excess weight and body fat are significantly associated with COVID-19 involvement, but the severity is primarily related to a greater area of visceral fat. The use of bioimpedance for visceral fat measurement was effective, as it is a simple method performed in the hospital setting that does not require the use of radiation.
Epidemiology of neonatal sepsis in two neonatal intensive care units in Krakow, Poland in 2016–2017 years
Authors: Golińska Edyta , Kozień Ł , Tomusiak-Plebanek A , Kędzierska J , Dorycka M , Lauterbach R , Pawlik D , Rzepecka-Węglarz B , Janiszewska M , Heczko PB , Wojkowska-Mach J , Strus M 
Published: November 2023

Abstract
Background
Sepsis in low-birth-weight neonates remains one of the most significant causes of neonatal morbidity and mortality. Approximately 3 million newborns suffer from sepsis globally every year. The aim of this study was to compare demographic and clinical features, as well as etiology and antibiotic susceptibility, of the main pathogens related to neonatal sepsis in two neonatal intensive units during a two-year period.

Methods
We observed early-onset (EO-BSI) and late-onset bloodstream infections (LO-BSI) cases in two high-reference neonatal intensive care units (NICU) over a 24-month period (2016–2017). Samples of patients’ blood were tested for the presence of the microorganisms. All bacterial isolates were tested for susceptibility to antibiotics.

Results
The majority of sepsis cases weighed above 1000 g and were born by cesarean section. About 10% of the EO-BSI group died. There were differences in the EO-BSI /LO-BSI ratio in the compared wards due to differences among the admitted children. The most common pathogens isolated from blood were coagulase-negative staphylococci (CoNS) were represented by two dominating species: S. epidermidis and S. haemolyticus, followed by Klebsiella spp. strains and E.coli, which were mostly found in EO-BSI cases. No single S. agalactiae (GBS) strain was isolated. The majority of CoNS strains were resistant to methicillin, half were resistant to aminoglycosides, and one-third were resistant to macrolides and lincosamides. Half of the Gram-negative rods were resistant to beta-lactams.

Conclusions
The epidemiology of sepsis in two observed NICUs is comparable to data obtained from other studies with a predominance of methicillin-resistant CoNS in LO-BSI and beta-lactam resistant E. coli in EO-BSI. It is of importance that the campaign for controlling GBS carriage in pregnant women in Poland resulted in the disappearance of GBS as a cause of sepsis. Unfortunately, there are no such measures to control E.coli related sepsis.
RTEL1 gene polymorphisms and neuroblastoma risk in Chinese children
Authors: Zhang Ting , Zhou Chunlei , Guo Jiejie , Chang Jiamin , Wu Haiyan , He Jing 
Published: November 2023

Abstract
Background
Neuroblastoma, a neuroendocrine tumor originating from the sympathetic ganglia, is one of the most common malignancies in childhood. RTEL1 is critical in many fundamental cellular processes, such as DNA replication, DNA damage repair, genomic integrity, and telomere stability. Single nucleotide polymorphisms (SNPs) in the RTEL1 gene have been reported to confer susceptibility to multiple cancers, but their contributing roles in neuroblastoma remain unclear.

Methods
We conducted a study on 402 neuroblastoma cases and 473 controls to assess the association between four RTEL1 SNPs (rs3761124 T>C, rs3848672 T>C, rs3208008 A>C and rs2297441 G>A) and neuroblastoma susceptibility.

Results
Our results show that rs3848672 T>C is significantly associated with an increased risk of neuroblastoma [CC vs. TT/TC: adjusted odds ratio (OR)=1.39, 95% confidence interval (CI)=1.02-1.90, P=0.038]. The stratified analysis further indicated that boy carriers of the rs3848672 CC genotype had a higher risk of neuroblastoma, and all carriers had an increased risk of developing neuroblastoma of mediastinum origin. Moreover, the rs2297441 AA genotype increased neuroblastoma risk in girls and predisposed children to neuroblastoma arising from retroperitoneal.

Conclusion
Our study indicated that the rs3848672 CC and rs2297441 AA genotypes of the RTEL1 gene are significantly associated with an increased risk of neuroblastoma in Chinese children in a gender- and site-specific manner.
Prevalence and risk factors of emergence agitation among pediatric patients undergo ophthalmic and ENT Surgery: a cross-sectional study
Authors: Yu Hong , Sun Xiaohui , Li Ping , Deng Xiaoqian 
Published: November 2023

Abstract
Background
Some studies reported that pediatric patients undergoing otorhinolaryngology (ENT) and ophthalmic surgeries have higher incidences of emergence agitation (EA). Children with EA tend to carry the risk of self-harm, have longer periods of recovery and delayed hospital discharge. Consequently, EA needs to be monitored and risk factors ought to be emphasized to implement preventative measures. The objective of this study was to describe EA and to identify risk factors after pediatric ophthalmic or ENT surgery.

Methods
Between September 2021 and December 2021, a cross-sectional study was conducted in 100 children aged of 0–12 years who underwent ophthalmic or ENT surgery. The Watcha scale was used to observe and record EA, which was defined at levels of 3 or 4 at any time in the post-anesthesia care unit (PACU). The pain intensity was graded with the Face, Legs, Activity, Cry, Consolability (FLACC) Scale after surgery. Patient and surgery-related characteristics, the behavioral criteria of EA, the pharmacologic and non-pharmacologic interventions and recovery outcomes were objectively recorded. A binary logistic regression model was constructed to identify the associated factors of EA.

Results
From the 100 analyzed children, 58 were males and 42 were females, and 44 patients received ophthalmic surgery and 56 ENT surgery. The median age was 6 (IQR 4–7) years. The overall incidence of EA among pediatrics was 30% (34.5% for ENT and 24.4% for ophthalmic surgery). High preoperative modified Yale Preoperative Anxiety scale (m-YPAS) grade (OR = 1.19, 95%CI 1.06–1.33, P = 0.003) and high postoperative FLACC score (OR = 3.36, 95%CI 1.88–6.02, P < 0.001) were risk factors for EA.

Conclusions
This study identified that preoperative anxiety and postoperative pain are associated with EA in children after ophthalmic or ENT surgery. Preoperative anxiety assessment and management, and administration of adjunct analgesic treatments should be considered in the routine care.
Social media use and everyday cognitive failure: investigating the fear of missing out and social networks use disorder relationship
Authors: Montag Christian , Markett Sebastian 
Published: November 2023

Abstract
Background
Nearly five billion individuals worldwide are using social media platforms. While the benefits of using social media, such as fostering social connections, are clear, ongoing discussions are focused on whether excessive use of these platforms might have adverse effects on cognitive functioning. Excessive social media use shares similarities with addictive behaviors and is believed to result from a complex interplay of individual characteristics, emotions, thoughts, and actions. Among these contributing factors, one of particular interest is the Fear of Missing Out (FoMO), a state where an individual apprehends that others are experiencing rewarding moments in their absence (but see more information on the FoMO trait/state debate in this article).

Methods
In this study, we aimed to explore the intricate relationships between FoMO, tendencies towards Social Networks Use Disorder (SNUD), and everyday cognitive failures. To achieve this, we gathered a large sample of N = 5314 participants and administered a comprehensive set of questionnaires. These included a Fear of Missing Out (FoMO) scale, which assessed both trait and state aspects of FoMO, the Social Networking Sites-Addiction Test (SNS-AT), designed to gauge tendencies towards SNUD, and the Cognitive Failure Questionnaire (CFQ), which measured everyday cognitive lapses.

Results
Our findings revealed that among non-users of social media, both FoMO and everyday cognitive failures were at their lowest levels. Further, in the group of social media users, we observed a significant relationship between FoMO and cognitive failures, which was mediated by SNUD tendencies. This mediation was particularly pronounced for the state component of FoMO, which encompasses maladaptive thoughts related to online behavior.

Conclusions
While our study is cross-sectional and thus cannot establish causality, one plausible interpretation of our findings is that higher FoMO tendencies may trigger excessive social media use, which in turn could lead to cognitive failures, possibly due to distraction and reduced attention to everyday tasks.
Escitalopram versus other antidepressive agents for major depressive disorder: a systematic review and meta-analysis
Authors: Yin Juntao , Song Xiaoyong , Wang Chaoyang , Lin Xuhong , Miao Mingsan 
Published: November 2023

Abstract
Background
Escitalopram is selective serotonin reuptake inhibitors (SSRIs) and one of the most commonly prescribed newer antidepressants (ADs) worldwide. We aimed to explore the efficacy, acceptability and tolerability of escitalopram in comparison with other ADs in the acute-phase treatment of major depressive disorder (MDD).

Methods
Medline/PubMed, EMBASE, the Cochrane Library, CINAHL, and Clinical Trials.gov were searched from inception to July 10, 2023. Trial databases of drug-approving agencies were hand-searched for published, unpublished and ongoing controlled trials. All randomized controlled trials comparing escitalopram against any other antidepressant for patients with MDD. Responders and remitters to treatment were calculated on an intention-to-treat basis. For dichotomous data, risk ratios (RRs) were calculated with 95% confidence intervals (CI). Continuous data were analyzed using standardized mean differences (with 95% CI) using the random effects model.

Results
A total of 30 studies were included in this meta‑analysis, among which sixteen trials compared escitalopram with another SSRI and 14 compared escitalopram with a newer AD. Escitalopram was shown to be significantly more effective than citalopram in achieving acute response (RR 0.67, 95% CI 0.50—0.87). Escitalopram was also more effective than citalopram in terms of remission (RR 0.53, 95% CI 0.30—0.93).

Conclusions
Escitalopram was superior to other ADs for the acute phase treatment of MDD in terms of efficacy, acceptability and tolerability. However, no significant difference was found between escitalopram and other ADs in early response or follow-up response to treatment of MDD.
Perceived health inequalities: are the UK and US public aware of occupation-related health inequality, and do they wish to see it reduced?
Authors: Bridger Emma K. , Tufte-Hewett Angela , Comerford David A. 
Published: November 2023

Abstract
Background
One underexamined factor in the study of lay views of socioeconomic health inequalities is occupation-related health. Examining health by occupational social class has a long history in the UK but has been comparatively overlooked in US public health literatures, where the relationship between health and work has attended more to hazard exposure.

Methods
Representative samples of the UK and US indicated the perceived and ideal lifespan of people working in “higher managerial/professional” and “routine” occupations. We examine perceptions of inequality and desires for equality across occupation groups as a function of country and key socio-demographic variables.

Results
67.8% of UK and 53.7% of US participants identified that professionals live longer than routine workers. Multivariate models indicated that US participants were markedly less likely to be aware of occupation-related inequalities after controlling for age, gender, and education. Awareness was negatively related to age (in the US) and recent voting behaviours (both samples). Desiring equal life expectancy was less likely in the US sample, and less likely across both samples among older participants and those with lower levels of education.

Conclusion
Employing a novel approach to measuring perceived and ideal life expectancy inequality, this is the first study to examine perceptions of lifespan inequality by occupational groups. It reports widespread understanding of the occupation-related gradient in lifespan and a desire that these inequalities be eliminated in the UK, but considerably less awareness and desire for equality in the US. Greater tolerance for social status inequalities in the US than other similar countries appear to also extend to differences in life expectancy.
Ukrainian migrants’ and war refugees’ admissions to hospital: evidence from the Polish Nationwide General Hospital Morbidity Study, 2014–2022
Authors: Lewtak Katarzyna , Poznańska Anna , Kanecki Krzysztof , Tyszko Piotr , Goryński Paweł , Jankowski Krzysztof , Nitsch-Osuch Aneta 
Published: November 2023

Abstract
Background
Considering the rapid influx of Ukrainian migrants and war refugees into Poland, the knowledge of their health condition is becoming increasingly important for health system policy and planning.
The aim of the study was to assess war-related changes in the frequency and structure of hospitalizations among Ukrainian migrants and refugees in Poland.

Methods
The study is based on the analysis of hospital admission records of Ukrainian patients, which were collected in the Nationwide General Hospital Morbidity Study from 01.01.2014 to 31.12.2022.

Results
In the study period, 13,024 Ukrainians were hospitalized in Poland, 51.7% of whom had been admitted to hospital after February 24, 2022. After the war broke out, the average daily hospital admissions augmented from 2.1 to 21.6 person/day. A noticeable increase in the share of women (from 50% to 62%) and children (from 14% to 51%) was also observed. The average age of patients fell from 33.6 ± 0.2 years to 24.6 ± 0.3 years. The most frequently reported hospital events among the migrants until 23.02.2022 were injuries (S00-T98) – 26.1%, pregnancy, childbirth and the puerperium (O00-O99) – 18.4%, and factors influencing health status and contact with health services (Z00-Z99) – 8.4%. After the war started, the incidence of health problems among migrants and war refugees changed, with pregnancy, childbirth and the puerperium (O00-O99) being the most common – 14.9%, followed by abnormal clinical and lab findings (R00-R99) – 11.9%, and infectious and parasitic diseases (A00-B99) – 11.0%.

Conclusions
Our findings may support health policy planning and delivering adequate healthcare in refugee-hosting countries.