bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring public transport accessibility to fixed activities and discretionary opportunities: a space–time approach
Authors: Dianin Alberto , Gidam Michael , Hauger Georg , Ravazzoli Elisa 
Published: January 2024

AbstractThe Space–Time Accessibility (STA) model is broadly used to measure person-based accessibility based on the space, time, and transport constraints experienced at the individual level in connection to the actual modal choices of observed individuals. In this paper, we propose to adjust the STA model (by introducing a so-called PT-STA model) with three core purposes: (1) focusing on public transport accessibility specifically, (2) measuring accessibility to both fixed activities and discretionary opportunities, and (3) integrating travel-time thresholds in the accessibility measurement. These three elements aim to make the PT-STA model a suitable tool to evaluate the impacts of public transport interventions on person-based accessibility and extend the evaluation of public transport accessibility to its fixed and discretionary dimensions. The PT-STA model is tested with a sample of 118 residents of the rural municipality of Mühlwald (South Tyrol, Italy). Results show that the accessibility to fixed activities and discretionary opportunities are limitedly correlated. It is possible to identify people with high accessibility to fixed activities and poor access to discretionary opportunities (typically pensioners and homemakers living in remote locations) and vice versa (e.g. people with articulated rural–urban commutes but daily visiting locations with several amenities). These results preliminarily confirm the importance of combining both accessibility dimensions in the PT-STA model since they tell complementary and not overlapped stories that are relevant for policymakers to evaluate the pros and cons of alternative public transport interventions.
The effect of doxorubicin curcumin co-loaded lipid nanoparticles and doxorubicin on osteosarcoma before surgery
Authors: Lu Xinyan , Zhang Peng , Li Jun , Zhou Yi , Wang Bangjun , Lu Zhaoli 
Published: January 2024

Abstract
Background
The research aims to observe the difference in the effect of preoperative doxorubicin curcumin co-loaded lipid nanoparticles (DOX+CUR LPNs) and doxorubicin (VAD) in the treatment of osteosarcoma.

Methods
68 patients with osteosarcoma who visited the hospital from January 2020 to December 2022 are chosen. They are separated into VAD group and DOX+CUR LPNs group, with 34 cases in each group. VAD and DOX+CUR LPNs groups VAD chemotherapy, and DOX+CUR LPNs treatment, respectively. All patients receive tumor resection. Comparison is made between the two groups before chemotherapy, at the end of chemotherapy and 1 week after surgery on the changes of vascular endothelial growth factor (VEGF), angiopoietin-2 (Ang-2), galectin-3 (Gal-3), renal function indicators cystatin-C (Cys-C), serum creatinine (Scr), blood urea nitrogen (BUN) in the peripheral blood. The clinical efficacy and adverse reactions are determined by observation and follow-up for 1 month.

Results
The VEGF, Ang-2, and Gal-3 in both groups were significantly lower at 1 week after chemotherapy and surgery compared to before chemotherapy (P < 0.05). The VEGF and Gal-3 in the DOX+CUR LPNs group were lower than those in the VAD group in the same period, with P < 0.05. The Cys-C, Scr, and BUN in both groups of patients after chemotherapy and surgery increased compared to before chemotherapy, with P < 0.05. The Cys-C, Scr, and BUN in the DOX+CUR LPNs group were lower than those in the VAD group during the same period, with P < 0.05. Following up for 1 month, the ORR of the DOX+CUR LPNs group was 94.12% (32/34) higher than that of the VAD group, with P < 0.05. The incidence of adverse reactions in the DOX+CUR LPNs group was 47.05% lower than that in the VAD group, with P < 0.05.

Conclusion
Preoperative application of DOX+CUR LPNs enables effective drug delivery to the tumor section by combining the antibacterial, antioxidant and anti-inflammatory effects of curcumin, which is co-wrapped in nanoparticles. It has the effect of promoting angiogenesis and damage repair, inhibiting inflammation-related factors, and protecting renal function, while adriamycin alone has drug resistance problems and toxic side effects, which can damage the patient's liver and kidney. Therefore, DOX+CUR LPNs are more effective than adriamycin alone, indicating that it can improve the therapeutic effect of the drug and reduce the side effects, which is of great significance for improving the survival rate and quality of life of patients.
Difficult airway simulation-based training for anaesthesiologists: efficacy and skills retention within six months
Authors: Bielka Kateryna , Kuchyn Iurii , Fomina Hanna , Khomenko Olena , Kyselova Iryna , Frank Michael 
Published: January 2024

Abstract
Background
The aim of this study was to evaluate how anaesthesiologists manage a “cannot intubate, can ventilate” (CI) and “cannot intubate, cannot ventilate” (CICV) scenarios, and how following simulation training will affect their guideline adherence, skills and decision-making immediately after training and 6 months later.

Methods
A prospective controlled study was conducted from July to December 2022. Anaesthesiologists who applied for the continuous medical education course “Difficult Airway Management” were involved in the study. Each volunteer participated in two simulation scenarios (CI, CICV) with structural debriefing after each scenario. After the first simulation round, volunteers were trained in difficult airway management according to DAS guidelines, using the same equipment as during the simulation. The participants repeated the simulation scenarios the day after the training and six months later. The primary and secondary endpoints were compared between three rounds: initial simulation (Group 1), immediately after training (Group 2), and six months after training (Group 3).

Results
A total of 24 anaesthesiologists consented to participate in the study and completed the initial survey form. During the first session, 83.3% of participants had at least one major deviation from the DAS protocol. During the first CICV scenario, 79% of participants made at least one deviation from the DAS protocol. The second time after simulation training, significantly better results were achieved: the number of anaesthesiologists, who attempted more than 3 laryngoscopies decreased (OR = 7 [1.8–26.8], p = 0.006 right after training and OR = 3.9 [1.06–14.4], p = 0.035 6 month later); the number, who skipped the supralaryngeal device attempt, call for help and failure to initiate surgical airway also decreased. Simulation training also significantly decreases the time to call for help, cricothyroidotomy initiation time, and mean desaturation time and increases the odds ratio of successful cricothyroidotomy (OR 0.02 [0.003–0.14], p < 0.0001 right after training and OR = OR 0.02 [0.003–0.16] 6 months after training).

Conclusions
Anaesthesiologists usually display major deviations from DAS guidelines while managing CI and CICV scenarios. Simulation training improves their guideline adherence, skills, and decision-making when repeating the simulation immediately after training and 6 months later.

Study registration
NCT05913492, clinicaltrials.gov, 22/06/2023.
Ethnic differences in disability-free life expectancy and disabled life expectancy in older adults in Chile
Authors: Sandoval Moisés H. , Portaccio Marcela E. Alvear , Albala Cecilia 
Published: January 2024

Abstract
Background
Although about 10% of the Latin American population is indigenous, ethnic differences in disability-free life expectancy (DFLE) and life expectancy with disability (DLE) are unknown.

Objective
To estimate disability-free life expectancy and disabled life expectancy among Mapuche (the largest indigenous group) and non-indigenous older adults aged 60 years or more in Chile.

Method
Disability was measured following a methodology that combines limitations of daily living, cognitive impairment and dependence previously validated in Chile. Finally, the DFLE was estimated using Sullivan’s method combining life tables by ethnicity and disability proportions from the EDES survey designed for the study of ethnic differentials in health and longevity in Chile.

Results
Non-Indigenous people have a higher total and Disability-free life expectancy compared to Mapuche people at all ages. While at age 60 a Mapuche expects to live 18.9 years, of which 9.4 are disability-free, a non-Indigenous expects to live 26.4 years, of which 14 are disability-free. In addition, although the length of life with disability increases with age for both populations, Mapuche who survive to age 80 or 90 expect to live 84% and 91% of their remaining life with disability, higher proportions compared to non-indigenous people (62.9% and 75%, respectively).

Conclusions
This is the first study addressing inequities in DFLE between the Mapuche and non-Indigenous population, reflected in lower total life expectancy, lower DFLE and higher DLE in Mapuche compared to the non-Indigenous population. Our results underscore the need for increased capacity to monitor mortality risks among older people, considering ethnic differences.
Exploring the experience of appetite loss in older age: insights from a qualitative study
Authors: Dismore Lorelle , Sayer Avan , Robinson Sian 
Published: January 2024

Abstract
Background
Poor appetite is common in older age, with estimated prevalence figures ranging between 15–30% in community-dwelling populations. Despite known links between poor appetite and adverse health outcomes, appetite is not routinely assessed and the causes and impact of appetite loss in older age are not well understood. This study aimed to improve understanding of the influences on, and experiences of, appetite loss among older people who have poor appetite and to consider the implications for prevention and treatment strategies.

Methods
Thirteen older adults aged 60–93 years (9 women) identified as having poor appetite (Simplified Nutritional Appetite Questionnaire (SNAQ) scores < 14; ranging from 8–11) took part in semi-structured interviews. Open-ended questions focused on influences on and experiences of appetite and appetite loss in older age. Interviews were transcribed; reflective thematic analysis was conducted using an inductive approach.

Results
The analysis generated three themes: 1) a complex web of influences on appetite loss, that include biological, psychological, and social factors; 2) living with poor appetite—variation in perceptions of poor appetite and attitudes to appetite loss; 3) living with poor appetite—the role and importance of the eating environment and social interactions. The themes highlight marked differences in individual ‘journeys’ to poor appetite, with variation in the balance and role of specific causal influences, that impact on the experience of appetite loss and on coping strategies.

Conclusions
A broad range of influences (including biological, psychological and social factors) and experiences of appetite loss in older age were described. Future research should consider person-centred approaches, that take account of individual narratives of appetite loss, in the design of effective strategies to support older adults.
A regimen based on the combination of trimethoprim/sulfamethoxazole with caspofungin and corticosteroids as a first-line therapy for patients with severe non-HIV-related pneumocystis jirovecii pneumonia: a retrospective study in a tertiary hospital
Authors: Li Hao , Lu Yihe , Tian Guoxin , Wu Yongxing , Chen Tianjun , Zhang Jiangwei , Hu Nan , Wang Xiaoning , Wang Yang , Gao Lan , Yan Jinqi , Zhou Linjing , Shi Qindong 
Published: January 2024

Abstract
Background
Pneumocystis jirovecii pneumonia (PJP) is a life-threatening and severe disease in immunocompromised hosts. A synergistic regimen based on the combination of sulfamethoxazole-trimethoprim (SMX-TMP) with caspofungin and glucocorticosteroids (GCSs) may be a potential first-line therapy for PJP. Therefore, it is important to explore the efficacy and safety of this synergistic therapy for treating non-HIV-related PJP patients.

Methods
We retrospectively analysed the data of 38 patients with non-HIV-related PJP at the First Affiliated Hospital of Xi’an Jiaotong University. Patients were divided into two groups: the synergistic therapy group (ST group, n = 20) and the monotherapy group (MT group, n = 18). All patients were from the ICU and were diagnosed with severe PJP. In the ST group, all patients were treated with SMX-TMP (TMP 15–20 mg/kg per day) combined with caspofungin (70 mg as the loading dose and 50 mg/day as the maintenance dose) and a GCS (methylprednisolone 40–80 mg/day). Patients in the MT group were treated only with SMX-TMP (TMP 15–20 mg/kg per day). The clinical response, adverse events and mortality were compared between the two groups.

Results
The percentage of patients with a positive clinical response in the ST group was significantly greater than that in the MT group (100.00% vs. 66.70%, P = 0.005). The incidence of adverse events in the MT group was greater than that in the ST group (50.00% vs. 15.00%, P = 0.022). Furthermore, the dose of TMP and duration of fever in the ST group were markedly lower than those in the MT group (15.71 mg/kg/day vs. 18.35 mg/kg/day (P = 0.001) and 7.00 days vs. 11.50 days (P = 0.029), respectively). However, there were no significant differences in all-cause mortality or duration of hospital stay between the MT group and the ST group.

Conclusions
Compared with SMZ/TMP monotherapy, synergistic therapy (SMZ-TMP combined with caspofungin and a GCS) for the treatment of non-HIV-related PJP can increase the clinical response rate, decrease the incidence of adverse events and shorten the duration of fever. These results indicate that synergistic therapy is effective and safe for treating severe non-HIV-related PJP.
Interpregnancy interval and adverse birth outcomes: a population-based cohort study of twins
Authors: Dhamrait Gursimran , O’Donnell Melissa , Christian Hayley , Taylor Catherine L. , Pereira Gavin 
Published: January 2024

Abstract
Background
To investigate associations between interpregnancy intervals (IPIs) and adverse birth outcomes in twin pregnancies.

Methods
This retrospective cohort study of 9,867 twin pregnancies in Western Australia from 1980–2015. Relative Risks (RRs) were estimated for the interval prior to the pregnancy (IPI) as the exposure and after the pregnancy as a negative control exposure for preterm birth (< 37 weeks), early preterm birth (< 34 weeks), small for gestational age (SGA: < 10th percentile of birth weight by sex and gestational age) and low birth weight (LBW: birthweight < 2,500 g).

Results
Relative to IPIs of 18–23 months, IPIs of < 6 months were associated with a higher risk of early preterm birth (aRR 1.41, 95% CI 1.08–1.83) and LBW for at least one twin (aRR 1.16, 95% CI 1.06–1.28). IPIs of 6–11 months were associated with a higher risk of SGA (aRR 1.24, 95% CI 1.01–1.54) and LBW for at least one twin (aRR 1.09, 95% CI 1.01–1.19). IPIs of 60–119 months and ≥ 120 months were associated with an increased risk of preterm birth (RR 1.12, 95% CI 1.03–1.22; and (aRR 1.25, 95% CI 1.10–1.41, respectively), and LBW for at least one twin (aRR 1.17, 95% CI 1.08–1.28; and aRR 1.20, 95% CI 1.05–1.36, respectively). IPIs of ≥ 120 months were also associated with an increased risk of early preterm birth (aRR 1.42, 95% CI 1.01–2.00). After negative control analysis, IPIs ≥ 120 months remained associated with early preterm birth and LBW.

Conclusion
Evidence for adverse associations with twin birth outcomes was strongest for long IPIs.
Radical cystectomy or trimodality therapy for muscle-invasive bladder cancer: a qualitative study exploring patient priorities and counselling needs when making a treatment choice
Authors: Verghote Flor , Van Praet Charles , Berquin Camille , Lumen Nicolaas , Decaestecker Karel , Vanneste Ben , Rammant Elke , Fonteyne Valérie 
Published: January 2024

Abstract
Background
This study aims to explore the priorities and counselling needs of patients with muscle-invasive bladder cancer faced with a decision between radical cystectomy and trimodality therapy.

Methods
We performed a qualitative study according to the phenomenological approach. Sixteen muscle-invasive bladder cancer survivors who underwent radical cystectomy or trimodality therapy completed a semi-structured interview between May 2022 and February 2023. Patients were recruited via Ghent University Hospital and a patient organisation. Data were analysed with inductive thematic analysis by a multi-disciplinary team using an iterative approach and investigators’ triangulation.

Results
Four main priorities determining the treatment decision were identified. (1) curing the disease; (2) health-related quality of life (physical, mental and social); (3) confidence in the treatment, which was mainly based on trust in the clinician; and (4) personal attributes. Trust in the clinician can be achieved by fulfilling the patient’s information needs (accurate, complete, clear, impartial, personalised, realistic, and transparent information), ensuring accessibility of the clinician, and creating a clear and personalised treatment plan, involving patients to the extend they desire. Many patients considered a patient decision aid as a valuable asset in this process.

Conclusion
Priorities vary between patients with muscle-invasive bladder cancer. Identifying individual priorities and offering personalised information about them is crucial for ensuring trust in the clinician and confidence in the treatment. Use of a patient decision aid can be beneficial in this process.
Prevalence of dry eye and Meibomian gland dysfunction in Central and South America: a systematic review and meta-analysis
Authors: Chen Hongan , McCann Paul , Lien Tiffany , Xiao Mengli , Abraham Alison G. , Gregory Darren G. , Hauswirth Scott G. , Qureshi Riaz , Liu Su-Hsun , Saldanha Ian J. , Li Tianjing 
Published: January 2024

Abstract
Background
Dry eye is one of the most common ophthalmic conditions and can significantly impact quality of life. Meibomian gland dysfunction (MGD) is a major cause of evaporative dry eye.
We sought to conduct a systematic review and meta-analysis to estimate the prevalence and incidence of dry eye and MGD in Central and South America and to identify factors associated with disease burden.

Methods
Data sources Ovid MEDLINE and Embase.

Study selection
A search conducted on August 16, 2021, identified studies published between January 1, 2010, and August 16, 2021, with no restrictions regarding participant age or language of publication. Case reports, case series, case–control studies, and interventional studies were excluded.

Data extraction and synthesis
The review was based on a protocol registered on PROSPERO (CRD42021256934). Risk of bias was assessed in duplicate using a risk of bias tool designed for the purposes of descriptive epidemiological studies. Data were extracted by one investigator and verified by another for accuracy. Prevalence of dry eye and MGD were grouped based on study participant characteristics.

Main outcomes and measures
Prevalence and incidence of dry eye and MGD in Central and South America. Summary estimates from meta-analysis with 95% confidence intervals (CI).

Results
Fourteen studies (11,594 total participants) were included. The population prevalence of dry eye was 13% (95% CI, 12%-14%) in Brazil and 41% (95% CI, 39%-44%) in Mexico based on one study each. Meta-analyses suggested that dry eye prevalence was 70% among indoor workers (95% CI, 56%-80%; I2, 82%; 3 studies), 71% among students (95% CI, 65%-77%; I2, 92%; 3 studies), and 83% in general ophthalmology clinics (95% CI, 77%-88%; I2, 88%; 2 studies). MGD prevalence ranged from 23% among indoor workers (95% CI, 16%-31%; 1 study) to 68% in general ophthalmology clinics (95% CI, 62%-72%; 1 study). No studies reported incidence of dry eye or MGD.

Conclusions
This systematic review and meta-analysis demonstrated considerable variation in the published prevalence of dry eye and MGD among the general population and subpopulations in Central and South America. Local and subpopulation estimates of dry eye disease burden may be valuable to assist needs assessments and implementation of measures to mitigate the condition.
Differences in bacterial taxa between treatment-naive patients with major depressive disorder and non-affected controls may be related to a proinflammatory profile
Authors: Knudsen Julie Kristine , Bundgaard-Nielsen Caspar , Leutscher Peter , Hjerrild Simon , Nielsen René Ernst , Sørensen Suzette 
Published: January 2024

Abstract
Background
Major depressive disorder (MDD) is characterized by sadness and anhedonia, but also physical symptoms such as changes in appetite and weight. Gut microbiota has been hypothesized to be involved in MDD through gut-brain axis signaling. Moreover, antidepressants display antibacterial properties in the gastrointestinal tract. The aim of this study was to compare the gut microbiota and systemic inflammatory profile of young patients with MDD before and after initiation of antidepressant treatment and/or psychotherapy in comparison with a non-depressed control group (nonMDD).

Methods
Fecal and blood samples were collected at baseline and at follow-up after four and twelve weeks, respectively. Patients started treatment immediately after collection of the baseline samples. The gut microbiota was characterized by 16 S rRNA gene sequencing targeting the hypervariable V4 region. Plasma levels of 49 unique immune markers were assessed using Mesoscale.

Results
In total, 27 MDD patients and 32 nonMDD controls were included in the study. The gut microbiota in the baseline samples of MDD versus nonMDD participants did not differ regarding α- or β-diversity. However, there was a higher relative abundance of the genera Ruminococcus gnavus group, and a lower relative abundance of the genera Desulfovibrio, Tyzzerella, Megamonas, Olsenella, Gordonibacter, Allisonella and Rothia in the MDD group compared to the nonMDD group. In the MDD group, there was an increase in the genera Rothia, Desulfovibrio, Gordinobacteer and Lactobacillus, while genera belonging to the Firmicutes phylum were found depleted at twelve weeks follow-up compared to baseline. In the MDD group, IL-7, IL-8 and IL-17b levels were elevated compared to the nonMDD group at baseline. Furthermore, MDI score in the MDD group was found to correlate with Bray-Curtis dissimilarity at baseline, and several inflammatory markers at both baseline and after initiation of antidepressant treatment.

Conclusion
Several bacterial taxa differed between the MDD group and the nonMDD group at baseline and changed in relative abundance during antidepressant treatment and/or psychotherapy. The MDD group was furthermore found to have a pro-inflammatory profile compared to the nonMDD group at baseline. Further studies are required to investigate the gut microbiota and pro-inflammatory profile of patients with MDD.