bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantifying Site Burden to Optimize Protocol Performance
Authors: Florez Maria , Smith Zachary Peter , Olah Zachary , Martin Mike , Getz Kenneth 
Published: October 2023

Abstract
Background:
The increase in protocol complexity—and the resulting rise in the effort required by investigative sites to implement protocols has been well documented, but existing measures of site burden only offer an incomplete view of the burden experienced by site personnel. The introduction of Decentralized Clinical Trials – trials supported by remote and virtual technologies and services – is expected to impact the burden imposed on sites, but this impact has not yet been systematically measured.
Methods:
The Tufts Center for the Study of Drug Development conducted an online survey among clinical research sites worldwide and gathered 355 responses assessing the burden associated with distinct activities and procedures related to the implementation of clinical trial protocols using traditional and decentralized approaches.
Results:
A high percentage of investigative sites (50.5%) have had no experience with DCT solutions and only a small percentage (6.6%) have participated in fully decentralized clinical trials. Overall, half of respondents view DCT solutions as more burdensome than traditional clinical trials. In general, activities related to operational and managerial aspects of trial implementation were viewed as less burdensome when done remotely, while clinical procedures or elements that require study team-patient interactions are viewed as more burdensome when using DCT approaches versus in-person or traditional methods.
Multiple isotopes reveal the nitrate sources in Aojiang River Basin, Eastern China
Authors: Li Jiangnan , Sun Qianhang , Cui Liang , Lei Kun 
Published: October 2023

AbstractExcessive levels of nitrate (NO3−) in water pose a significant environmental challenge on a global scale. Hence, it is of utmost importance to determine the sources of NO3−and evaluate their corresponding contributions as a means to improve aquatic quality. To address this issue, a recent research undertaking was conducted in the Aojiang River basin located in Eastern China. The study involved the collection of surface water samples throughout both the dry and wet seasons. Various hydrochemical indicators, along with dual NO3−isotopes (δ15N–NO3−and δ18O–NO3−), were utilized to determine the sources of NO3−contamination and assess the relative contributions made by various sources. The findings revealed that nitrification, a process involving the conversion of nitrogen, was the primary nitrogen transformation mechanism within the study area throughout the sampling period. According to the isotopic analysis of NO3−, it was revealed that the primary contributors to the elevated NO3−were manure and sewage (M&S), soil nitrogen (SN), and nitrogen fertilizer (NF). Furthermore, the results obtained from the MixSIAR model, a Bayesian model that employs stable isotope analysis within the R software, demonstrated that the proportional contributions of atmospheric deposition (AD), NF, M&S, and SN to NO3−were 2.84%, 19.63%, 44.67%, and 34.87%, respectively, during the dry season. In the wet season, the corresponding contributions were 3.61%, 22.32%, 32.37%, and 41.70%, respectively. This study serves as valuable evidence for advancing our understanding of the sources, transport, and transformation of nitrogen in the Aojiang River basin, thereby facilitating improved management strategies for nitrogen contamination.
Economic growth and healthy eating: some international evidence and implications for emerging countries
Authors: García Carlos J. , González Wildo 
Published: October 2023

Abstract
We analyze the effects of healthy eating on productivity. By using panel data economet-rics (PV AR), we find the impact on productivity is positive and statistically significant worldwide, but it follows a Kuznets curve: its effect decreases as countries’ income increases. Below, in a highly stylized model of economic growth, we show that this productivity impact more than doubles economic growth in a representative emerging economy. The improvement in workers’ health is transmitted throughout the economy, favoring especially the owners of capital and, to a lesser extent, workers with more labor and wages.
JEL Codes: I15; O47; O57.
Development and Validation of the Physical Exercise Program “Active Mums” for Postpartum Recovery. Qualitative study with application of the CReDECI-2 Guidelines
Authors: Brites-Lagos Carla , Maranhão Cristiana , Szumilewicz Anna , Santos-Rocha Rita 
Published: October 2023

Abstract
Postnatal physical activity is a public health issue. Reporting on the quality of exercise interventions designs must be ensured in view of the reproducibility and successful implementation of such studies. The objective was to develop and validate a physical exercise program for postpartum recovery, aiming to promoting physical fitness and health of the new mothers. A qualitative pilot study was carried out through the three stages of development, piloting, and evaluation. The Consensus on Exercise Reporting Template (CERT) was used to describe the postpartum exercise program. The Criteria for Reporting the Development and Evaluation of Complex Interventions in Healthcare (CReDECI2) was followed to validate the program. A tailored postpartum exercise program was designed and validated based on evidence-based international recommendations to be implemented by qualified exercise professionals. A pilot intervention of 16 weeks was carried out, engaging a group of postpartum women. The viability of the program was subsequently evaluated by all participants. The presented intervention can assist exercise specialists, health professionals and researchers in the planning, promoting, and implementation of an exercise program for postpartum recovery.
Evaluation of cardiac biomarkers among dead and alive COVID-19 patients in Southwest Iran
Authors: Adel Seyed Mohammad Hassan , Sardabi Ebrahim Heydari , Akiash Nehzat , Mohammadi Mohammad , Sayadian Mona , pour Sanaz Saki , Amini Payam 
Published: October 2023

Abstract
Introduction:
The need to understand the global burden of heart failure following the pandemic has arisen as a result of an increase in papers that support cardiac involvement in coronavirus disease 2019 (COVID-19). Therefore, the current study aims to provide a more thorough explanation of the function and use of cardiac biomarkers in dead and alive COVID-19 patients.
Methods
All patients who were referred and admitted to Razi Hospital, Ahvaz, Iran, from March 2020 to March 2021 with a diagnosis of COVID-19 were included in this study.
Results
During the study period, 753 patients were hospitalized with a diagnosis of COVID-19. In total, 157 cases died from the disease (case fatality rate: 20.84%). Pre-existing cerebrovascular accidents (CVAs) were more frequent in dead cases (14% vs. 6.4%). It was observed that atrial fibrillation was normal in most of the alive cases in comparison to dead patients (p-value = 0.014). Moreover, it was seen that CRP, IL-6, and procalcitonin were increased in dead patients. Also, an association was found between ejection fraction (EF) value and death rate (P-value = 0.035). The higher frequency of positive troponin occurring in the dead group suggested a possible adverse effect on the mortality rate (22.3% vs. 16.4%).
Conclusion
Adults with COVID-19 commonly had cardiac manifestations, including symptoms of myocardial damage. In light of the recognized utility of troponin, ejection fraction, procalcitonin, IL-6, and CRP in COVID-19 patients with suspected myocardial damage, we should develop a safe and precise diagnostic algorithm that may contain patients’ clinical histories and additional variables that may facilitate the prediction of myopericarditis.
Single nucleus RNA-sequencing study revealed expansion of Gpnmb+ microglia in aged mouse spinal cord
Authors: Gao Yajing , Zhang Ziyan , Guo Wuyier , Qian Peipei , Xie Gangcai 
Published: October 2023

Abstract
Neurodegenerative diseases tend to occur later in life, and studies of central nervous system (CNS) aging could deepen our understanding of those diseases. In this study, we profiled the transcriptomes of 71,144 spinal cord cells from both of young and old mice, and identified 1, 215 aging-associated differentially expressed genes, including up regulation of C4b and Gfap. Interestingly, we observed significant expansion of DAM (Disease-Associated Microglia)/ATM (Axon Tract-Associated Microglia)-like Gpnmb+ microglia in old spinal cord, which were enriched with DAM/ATM marker genes of Gpnmb, Spp1, Lpl, Igf1, Itgax, Lgals3, Apoe and displayed highest enrichment with senescent genes. Furthermore, we also discovered 619 age-associated Ligand-Receptor Interaction changes and revealed 1277 age-related DEGs in 30 neuronal subpopulations. Overall, our study provided the first single-cell transcriptomic study of mouse spinal cord aging, and our finding of age-related expansion of Gpnmb+ microglia could have potential implications for the treatment of associated CNS diseases.
Investigation of different parameters on nonlinear dynamic behaviors of vertical rotor system supported by aerostatic bearings
Authors: qiu shun , Ke Changlei , Li Kongrong , Shi Ningyu , Zhang Xiaohua , Dong Bin , Peng Nan , Xiong Lianyou , Liu Liqiang 
Published: October 2023

Abstract
A common issue associated with gas bearings is the tendency to generate self-excited vibrations, leading to instability. In this paper, the fluid-structure coupling dynamic model of aerostatic bearing-rotor system is established to address this problem, and a hybrid method including the finite difference method and direct integration method are employed to simultaneously solve the transient Reynolds equation and rotor dynamic equation. Furthermore, based on the orbit of rotor center, frequency spectrum diagram, Poincaré map, waterfall diagram and bifurcation diagram, the effects of rotational speed, rotor mass, orifice diameter and bearing clearance on the nonlinear dynamic behaviors of the bearing-rotor system are investigated. The results reveal that the system has abundant nonlinear behavior with the increasing of rotational speed and rotor mass, including typical half-speed whirl. But the nonlinear vibration of the system can be restricted by selecting appropriate bearing structural parameters, which can provide the theoretical guidance for the design of the aerostatic bearing-rotor system.
Plasma Phosphoethanolamine Levels as a Biomarker for Monitoring Major Depressive Disorder
Authors: Kawamura Noriyuki , Nakata Akinori , Harada Tsuyoto , Ohashi Yoshiaki , Sato Hajime , Sasaki Kazunori , Higuchi Teruhiko 
Published: October 2023

Abstract
This study is the first to identify a promising candidate monitoring biomarker for major depressive disorder (MDD), plasma phosphoethanolamine (PEA) concentrations. A naturalistic observational study in clinical psychiatry was conducted with Japanese subjects between 2011 and 2020. Out of the 576 patients, 295 had depressive disorders, 264 had psychiatric disorders other than depression, and 17 had physical disorders without psychiatric disorders. In 170 patients with MDD only, in whom remission was easily identified, plasma PEA levels were measured at two or more time points. These levels dropped significantly in depressive episodes, increased as remission approached and were significantly higher in remission. Psychiatric diagnosis alone explained 38% of the variance in plasma PEA concentrations. Receiver operating characteristic (ROC) curve analysis also showed sufficient discriminatory power to detect depression, with an area under the curve (AUC) of 0.84 (95% confidence interval (CI): 0.80-0.87). Further researches are needed.
High neutrophil-lymphocyte ratio indicates a worse response to ursodeoxycholic acid in primary biliary cholangitis: a retrospective cohort study
Authors: Zhu Huiling , Zheng Mengyao , He Haiyu , Lei Hongtao , Tai Wenlin , yang jinhui 
Published: October 2023

Abstract
Background: Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease characterized by inflammation of the interlobular bile ducts. Ursodeoxycholic acid (UDCA) is the only FDA approved first-line therapy for PBC, but up to 40% of patients with PBC have an incomplete response to UDCA. Neutrophil-to-lymphocyte (NLR) has been used to predict prognosis in various liver diseases. There is limited evidence on the treatment response to UDCA in PBC patients. The aim of this study was to elucidate the changes in NLR in response to one-year UDCA treatment of PBC patients.
Methods:A total number of 257 primary biliary cholangitis (PBC) patients treated with UDCA (13–15 mg/kg/d) were enrolled in this retrospective study. The response to treatment was evaluated based on alkaline phosphatase levels < 1.67 times the upper limit of the normal value after 12 months of UDCA treatment. Multivariable logistic regression analysis was performed to investigate the association between NLR at baseline and the response to 12- month UDCA treatment after adjusting for important confounding variables. The quartiles of increased baseline NLR was assessed as a predictor of future nonresponse to UDCA treatment. The stability of the results was evaluated by unadjusted and adjusted models.
Results: The result of multiple regression analysis showed that NLR at baseline was positively associated with the nonresponse to UDCA treatment after adjustments for potential confounders (age, sex, BMI, hypertension, arterial plaque,thyroid disease, jaundice, albumin, globulin, total bile acid, ALP, GGT, LDLC, total cholesterol, hemoglobin, and APTT) (OR = 1.370, 95% CI 1.066-1.761). When NLR was translated into a categorical variable, the OR and 95% CI in the fourth quartile versus the first quartile was OR = 3.782, 95% CI 1.094-13.073, respectively (P for trend = 0.036). These results reveal that NLR is an independent risk factor of UDCA treatment nonresponse.
Conclusions: Our results suggest that NLR is an independent risk factor of UDCA treatment nonresponse.
The Effects of Lockdown during the Covid Pandemic on Fetal Movement Profiles
Authors: Reissland N. , Ustun Beyza , Einbeck J. 
Published: October 2023

Abstract
Purpose
The current study aimed to investigate the direct impact of the Covid-19 lockdown on fetal movements, addressing a critical research gap. While previous research has predominantly examined the effects of lockdown on maternal health and postnatal outcomes, little attention has been paid to the direct consequences on fetal well-being.
Methods
We conducted a comparative analysis of movement profiles in 20 healthy fetuses during the Covid-19 pandemic lockdown (third national UK lockdown period between January and March 2021) and compared them with 20 healthy fetuses from pre-covid pregnancies, all at 32 weeks gestation. We controlled for maternal stress, depression, and anxiety.
Results
Pregnant mothers during pre-covid compared with those during the Covid-19 lockdown reported similar levels of stress (p = 0.47), depression (p = 0.15), and anxiety (p = 0. 07). Their fetuses, however, differed in their movement profiles with mouth movement frequencies significantly higher during Covid-19 lockdown (Covid-19 lockdown: mean of 5.909; p = 0.029) being compared to pre-Covid pregnancies (mean of 3.308). Controlling for maternal anxiety a regression analysis indicated that fetal mouth movements (p = 0.017), upper face movements (p = 0.008), and touch movements (p = 0.031) were all significantly higher in fetuses observed during lockdown compared to fetuses before the Covid period.
Conclusion
Fetuses show an effect of lockdown independent of maternal anxiety, stress, or depression. These findings contribute to our understanding of fetal development during extraordinary circumstances, raising questions about the potential effects of reduced light exposure and its implications for maternal thyroid function during lockdowns.
Robotic- vs laparoscopic-assisted proctectomy: short-term efficacy and long-term outcomes at a colorectal center in China
Authors: Liu Dunbo , Guo Fangliang , Sun Zhiwei , Zhang Qianshi , Ren Shuangyi 
Published: October 2023

Abstract
Background
The latest statistics indicate a gradual increase in the incidence of rectal cancer, with approximately 60–70% of patients being diagnosed at an advanced stage. Presently, robot-assisted surgery is extensively performed in numerous countries worldwide. To evaluate the short-term efficacy and long-term outcomes of Da Vinci robot in patients with middle and low rectal cancer.
Methods
A case series analysis was conducted on 235 patients with middle and low rectal cancer who were admitted to the First Department of Gastrointestinal Surgery, the Second Affiliated Hospital of Dalian Medical University from January 2020 to March 2023. They were divided into Da Vinci robot-assisted proctectomy group and 3D laparoscopic-assisted proctectomy group, with 125 patients in robot-assisted proctectomy group and 110 patients in 3D laparoscopic-assisted proctectomy group.
Results
Baseline data, perioperative outcomes, morbidity, pathological data, as well as 3-year overall survival and disease-free survival rates were analyzed and compared between the two groups. Intraoperative blood loss was significantly lower in the robot-assisted proctectomy group while hospitalization cost was higher (P < 0.05). No significant differences were observed in exhaust time, catheter removal time, indentation catheter time, postoperative complications or number of lymph nodes dissection between the two groups (P > 0.05). After a follow-up period of 40 months, there were no significant differences in local recurrence, distant metastasis, sexual dysfunction, urinary dysfunction or disease-free survival and overall survival rates (P > 0.05).
Conclusion
Robot-assisted proctectomy is a safe and feasible treatment option for rectal cancer with comparable short-term oncological results.
Degradation of direct black 22 textile dye using the photo-Fenton and electro-Fenton processes: a comparative study
Authors: Santana Ingrid L. da S. , Silva Marina G. , Ourem Gabriel P. , Neves Naiana S. da C. S. , Cavalcanti Vanessa de O. M. , Lucena Alex L. de A. , Duarte Marta M. M. B. , Napoleão Daniella Carla 
Published: October 2023

Abstract
The dyes present in textile effluents have a complex structure and low biodegradability, making it necessary to use efficient treatments such as advanced oxidation processes (AOP). The aim of this study was to compare the efficiency of photo-Fenton (PF) and electro-Fenton (EF) AOPs in the degradation of direct black dye 22 (PD22), defining the best experimental conditions and evaluating the kinetics and toxicity of the proposed treatments. Initially, for the PF system, using UV-C and sunlight radiation, 99.08% and 99.98% degradations were reached, respectively for [H2O2] = 20 mg·L− 1 and [Fe] = 1.0 mg·L− 1. From the volume variation study, it was observed that the increase in volume did not compromise the degradation of the dye. For the EF process, the [Fe] that promoted the highest percentage of degradation (95.16%) was equal to 1 mg·L− 1. The volume study for the EF process also did not interfere significantly in the efficiency of the process. The PF and EF systems presented satisfactory adjustments to the proposed kinetic models, suggesting that the treatment follows a pseudo-first-order kinetics. The ecotoxicological tests showed no toxicity for the thyme seed after using the EF process. Therefore, it is evident that different AOP techniques can be applied in the treatment of PD22.
Hospital Overcrowding and Care of Stroke Patients. Irish National Audit of Stroke
Authors: Harbison Joseph , McCormack Joan , Brych Olga , Collins Ronan , Cassidy Tim 
Published: October 2023

Abstract

Introduction: Hospital overcrowding where patient admissions exceed capacity is associated with worse outcomes in Emergency Department. Developments in emergency stroke care have been associated with improvements in stroke outcome but are dependent on effective, organised care. We examined if overcrowding in the hospital system was associated with negative changes in stroke outcome.
Methods Data on overcrowding were obtained from the Irish Nurses and Midwives Organisation (INMO) ‘Trolley Count’ database recording the number of patients cared for on trolleys/chairs in all acute hospitals each midnight. These were compared with quarterly data from the Irish National Audit of Stroke from 2013 to 2021 inclusive. Variables analysed were inpatient mortality rate, thrombolysis rate for ischaemic stroke, median door to needle time and median length of stay.
Results: 579449 patient episodes were recorded by Trolley Watch over the period, (Quarterly Median 16719.5, range 3389-27015). Average Quarterly Thrombolysis rate was 11.3% (sd 1.3%) Median Quarterly Inpatient Mortality rate was 11.8% (Range 8.9%-14.0%). Median Quarterly Length of stay was 9 days (8-11 days). Median quarterly door to needle was 65 minutes (45-80 minutes). Q1 was typically the worst for overcrowding with on average 19777 incidences (sd 4786). This was significantly higher than for Q2 (mean 13540 (sd 4785) p =0.005 t-test) and for Q3 (mean 14542 (sd 4753) p=0.03). No significant correlation was found between quarterly Trolley watch episodes and inpatient mortality (r=0.084, p=0.63), median length of stay r=-0.15, p= 0.37) or thrombolysis rate (r=0.089 p=0.61). There was an unexpected significant negative correlation between trolley watch data and median door to needle time (r=-0.36, p=0.03).
Conclusion. Despite increasing hospital overcrowding, stroke services still managed to preserve standard of care. We could find no association between levels of overcrowding and deterioration in selected indices of patient care
Bridging the Intention–Behavior Gap in eHealth Use among Chinese Medical Students: The Role of Trust and Privacy Risk Perception
Authors: Meng Yao , Zhu Junhua , Yang Rumei , Jiang Yun 
Published: October 2023

Abstract

Background
eHealth utilizes technology to enhance healthcare services, but its adoption is hindered by the intention-behavior gap (IBG). It is important to understand the intention-behavior use of eHealth among medical students, who can play a significant role in the promotion of eHealth use.
Objective
1) whether there is an IBG in eHealth use among Chinese medical students; 2) whether intuitive (e.g., trust in eHealth information) and deliberate (e.g., eHealth literacy) processes are mediators in the intention-behavior use of eHealth, and 3) how the motivation processes (e.g., privacy risk perception of eHealth) potentially moderate the eHealth use intention and intuitive or deliberate processes relationship.
Methods
All measures were self-reported by 363 Chinese medical students. SPSS macro-PROCESS was used to explore mediation and moderation effects between the intention to use and actual use of eHealth.
Results
Only 22% of students who reported eHealth use intention used eHealth services, particularly telemedicine. Trust in eHealth information mediated the relationship between use intention and actual use of eHealth (95% CI [0.003, 0.048]). Privacy risk perception of eHealth moderated this mediation relationship (95% CI [0.09, 0.009]). However, eHealth literacy did not mediate the relationship between use intention and actual use of eHealth.
Conclusion
The association between Chinese medical students’ eHealth use intention and actual eHealth use is partially mediated by their trust in eHealth information, which is moderated by their privacy risk perceptions. Enhancing students’ trust in eHealth information and reducing their concerns about privacy risks can be integrated into future medical training programs.