bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Landscape of Micronutrient Dietary Intake by 15- to 65-Years-Old Urban Population in 8 Latin American Countries: Results From the Latin American Study of Health and Nutrition
Authors: Monge-Rojas Rafael , Vargas-Quesada Rulamán , Previdelli Agatha Nogueira , Kovalskys Irina , Herrera-Cuenca Marianella , Cortés Lilia Yadira , García Martha Cecilia Yépez , Liria-Domínguez Reyna , Rigotti Attilio , Fisberg Regina Mara , Ferrari Gerson , Fisberg Mauro , Gómez Georgina 
Published: December 2023

Background: Latin American countries have shifted from traditional diets rich in micronutrients to a Westernized diet rich in high energy-dense foods and low in micronutrients. Objective: This study aimed to determine the prevalence of adequate micronutrient intakes in urban populations of 8 Latin American countries. Method: Micronutrient dietary intake data were collected from September 2014 to August 2015 from 9216 men and women aged 15.0 to 65.0 years living in urban populations of 8 Latin American countries. Dietary intake was collected using two 24-hour recalls on nonconsecutive days. Micronutrient adequacy of intake was calculated using the Estimated Average Requirement cut-off method. Results: In general terms, the prevalence of inadequate intake of thiamine, riboflavin, niacin, folate, cobalamin, iron, phosphorus, copper, and selenium ranged from 0.4% to 9.9%. In contrast, the prevalence of inadequacy of pyridoxine, zinc, vitamin C, and vitamin A ranged from 15.7% to 51.5%. The nutrients with a critical prevalence of inadequacy were magnesium (80.5%), calcium (85.7%), and vitamin D (98.2%). The highest prevalence of inadequate intakes was observed in the low educational level, participants with overweight/obesity, in men, and varies according to socioeconomic status. Conclusions: There is an urgent need to define direct regional actions and strategies in Latin America aimed at improving micronutrient adequacy, either through staple food fortification programs, agronomic biofortification, or food policies that facilitate economic access to micronutrient-rich foods.
Revolutionizing transportation composite structures: Lightweight, sustainable, and multi-scale hybrid design through waste tire-driven graphene, hemp fiber, and bio-based overmoulding
Authors: Aliyeva Nargiz , Sas Hatice S. , Saner Okan Burcu 
Published: December 2023

The pursuit of lightweight, environmentally friendly composite structures in transportation is crucial for minimizing ecological footprints and promoting energy-efficient manufacturing techniques. This study presents a novel approach by replacing traditional long glass fiber reinforced homopolymer polypropylene (homoPP) compounds with short hemp fiber reinforced homoPP, incorporating graphene nanoplatelets (GNP) derived from recovered carbon black via waste tire pyrolysis, resulting in a remarkable 15% weight reduction. With new compound formulation by adjusting the amounts of compatibilizer and GNP, injection moulding process was integrated with overmoulding process by using bio-based UD prepregs to enhance the adhesion of injected part and interfacial interaction by decreasing the stress concentrations in the structure. This novel hybrid composite design having 40 wt% hemp fiber, 1.0 wt% GNP and 2.7 wt% compatibilizer provided to improve flexural modulus and strength by 169% and 67.9%, respectively, compared to neat homoPP. The overmolding process employed bio-based natural fibers reinforced UD tapes as inserts, leading to an impressive enhancement of 211% in tensile modulus and 93.6% in strength, further surpassing the performance of neat homoPP. This work not only achieves the conversion of conventional composite structures into recyclable, sustainable thermoplastic composites but also introduces multi-scale reinforcements with customizable functionality, demonstrating a significant step forward in the development of environmentally conscious materials and manufacturing methods by adopting Life-Cycle Assessment (LCA) methodology regarding the sustainability of the newly developed composites.
The continuum of liver injury with severity of dengue fever: A retrospective observational study
Authors: Mohindra Ritin , K Divyashree , Kalyan Madhur , Bora Ishani , Soni Roop Kishore , Suri Vikas , Behera Ashish , Saini Neha , Sharma Vishal , Zohmangaihi Deepy 
Published: December 2023

Background: Dengue is a major international health concern prevalent in tropical and sub-tropical countries. There are a paucity of studies on the relationship of hepatic complications with inflammatory parameters in dengue infection. Methods: Single-centre observational study was conducted at the tertiary care centre in North India. Patients (>12 years) diagnosed with dengue infection between August and November 2021 were enrolled in the study. The frequency of hepatic derangements and their associations with inflammatory severity was analysed. Results: Based on the clinical symptoms, 170 patients were classified into three categories, namely, dengue fever, warning dengue and severe dengue. Higher incidence of liver dysfunction was observed in severe dengue patients with median values of aspartate aminotransferase (AST) (3051 U/L, p < 0.001), alanine aminotransferase (ALT) (1792 U/L, p = 0.009), alkaline phosphatase (172 U/L, p = 0.001), T.Bil (34.2 µmol/L, p < 0.001), albumin (30 g/L, <0.001), and gamma-glutamyl transferase (152 U/L, p < 0.001) along with inflammatory marker C-reactive protein (CRP) (43 mg/dL, p < 0.001) highly deranged, in comparison to patients with/without warning signs. Median levels of CRP were found to be positively and significantly correlated with the median levels of AST and ALT ( p < 0.05, r = 0.99) in all three categories of dengue patients. Liver injury was noted in 107 (63%) of the cohort, and mixed type of liver injury involving both hepatocellular and cholestatic patterns was observed as the most common type of injury ( n = 50, 29.4%). Liver injury correlated with the severity of dengue illness as about 85% of severe dengue patients had significant liver injury ( p = 0.014). Conclusion: In dengue patients, the association of the liver injury with inflammatory severity suggests that the mechanism of liver injury may be related to inflammatory response apart from the hepatotropic nature of the virus.
Cardiovascular and renal outcomes of GLP-1 receptor agonists vs. DPP-4 inhibitors and basal insulin in type 2 diabetes mellitus: A systematic review and meta-analysis
Authors: Evans Marc , Kuodi Paul , Akunna Chisom Joyqueenet , McCreedy Nicole , Donsmark Morten , Ren Hongye , Nnaji Chukwudi A 
Published: December 2023

Objective To compare the cardiovascular and renal outcomes of GLP-1 RA versus DPP4i and basal insulin in the management of T2DM. Methods Data from 22 studies involving over 200,000 participants were pooled using the inverse variance method and random-effects meta-analysis. The review was reported in accordance with PRISMA. Results Compared with DPP4i, treatment with GLP-1 RA was associated with a greater benefit on composite cardiovascular outcomes (HR:0.77, 95% CI:0.69–0.87), myocardial infarction (HR:0.82, 95% CI:0.69–0.97), stroke (HR:0.83, 95% CI: 0.74–0.93), cardiovascular mortality (HR:0.76, 95% CI:0.68–0.85) and all-cause mortality (HR:0.65, 95% CI:0.48–0.90). There was no difference in effect on heart failure (HR:0.97, 95% CI:0.82–1.15). Compared with basal insulin, GLP-1 RA was associated with better effects on composite cardiovascular outcomes (HR:0.62, 95% CI:0.48–0.79), heart failure (HR:0.57, 95% CI:0.35–0.92), myocardial infarction (HR:0.70, 95% CI:0.58–0.85), stroke (HR:0.50, 95% CI:0.40–0.63) and all-cause mortality (HR:0.31, 95% CI:0.20–0.48). Evidence from a small number of studies suggests that GLP-1 RA had better effects on composite and individual renal outcomes, such as eGFR, compared with either DPP4i and basal insulin. Conclusion Available evidence suggests that treating T2DM with GLP-1 RA can yield better benefits on composite and specific cardiorenal outcomes than with DPP4i and basal insulin. PROSPERO Registration Number CRD42022335504.
Alterations in circulating mitochondrial signals at hospital admission for COPD exacerbation
Authors: Amado Carlos A , Martín-Audera Paula , Agüero Juan , Ferrer-Pargada Diego , Josa Laorden Begoña , Boucle Daymara , Berja Ana , Lavín Bernardo A , Guerra Armando R , Ghadban Cristina , Muñoz Pedro , García-Unzueta Mayte 
Published: December 2023

Background Chronic obstructive pulmonary disease (COPD) exacerbation (ECOPD) alters the natural course of the disease. To date, only C-reactive protein has been used as a biomarker in ECOPD, but it has important limitations. The mitochondria release peptides (Humanin (HN), FGF-21, GDF-15, MOTS-c and Romo1) under certain metabolic conditions. Here, we aimed to evaluate the pathophysiologic, diagnostic and prognostic value of measuring serum mitochondrial peptides at hospital admission in patients with ECOPD. Methods A total of 51 consecutive patients admitted to our hospital for ECOPD were included and followed for 1 year; in addition, 160 participants with stable COPD from our out-patient clinic were recruited as controls. Results Serum FGF-21 ( p < .001), MOTS-c ( p < .001) and Romo1 ( p = .002) levels were lower, and GDF-15 ( p < .001) levels were higher, in patients with ECOPD than stable COPD, but no differences were found in HN. In receiver operating characteristic analysis, MOTS-c (AUC 0.744, 95% CI 0.679–0.802, p < .001) and GDF-15 (AUC 0.735, 95% CI 0.670–0.793, p < .001) had the best diagnostic power for ECOPD, with a diagnostic accuracy similar to that of C-RP (AUC 0.796 95% IC 0.735–0.848, p < .001). FGF-21 (AUC 0.700, 95% CI 0.633–0.761, p < .001) and Romo1 (AUC 0.645 95% CI 0.573–0.712, p = .001) had lower diagnostic accuracy. HN levels did not differentiate patients with ECOPD versus stable COPD ( p = .557). In Cox regression analysis, HN (HR 2.661, CI95% 1.009–7.016, p = .048) and MOTS-c (HR 3.441, CI95% 1.252–9.297, p = .016) levels exceeding mean levels were independent risk factors for re-admission. Conclusions Most mitochondrial peptides are altered in ECOPD, as compared with stable COPD. MOTS-c and GDF15 levels have a diagnostic accuracy similar to C-RP for ECOPD. HN and MOTS-c independently predict future re-hospitalization.
COLEC12 Promotes Tumor Progression and Is Correlated With Poor Prognosis in Gastric Cancer
Authors: Sun Xiangfei , Zhang Qiang , Shu Ping , Lin Xiaohan , Gao Xiaodong , Shen Kuntang 
Published: December 2023

Purpose Collectin subfamily member 12, a transmembrane scavenger receptor C-type lectin, is aberrantly expressed in various cancers. However, its physiological role in gastric cancer remains somewhat unclear. This study aimed to investigate the Collectin subfamily member 12 expression pattern in human gastric cancer and its role in gastric cancer progression. Methods The Kaplan-Meier method was used for survival analysis. The univariate and multivariate Cox proportional hazards regression models were used to identify independent predictors for progression-free survival and overall survival. The effects of Collectin subfamily member 12 on gastric cancer cell proliferation, migration, invasion, and apoptosis were detected through the cell counting kit-8 assay, colony formation assay, wound healing assay, transwell assay, and flow cytometry analysis, respectively. Additionally, the correlation between Collectin subfamily member 12 expression and immune cell infiltration was analyzed through bioinformatics. Results Collectin subfamily member 12 was highly expressed in advanced gastric cancer (T3-T4, pathologic stage III-IV). High Collectin subfamily member 12 expression was correlated with a worse progression-free survival and overall survival in the gastric cancer patients. In vitro, cell line studies revealed that Collectin subfamily member 12 promoted gastric cancer cell proliferation, migration, and invasion and inhibited gastric cancer cell apoptosis. The bioinformatics analysis further demonstrated that the Collectin subfamily member 12 expression level positively correlated with infiltration of several immune cells, such as M2 macrophages, dendritic cells, neutrophils, and regulatory T cells, suggesting that Collectin subfamily member 12 may also play a role in suppressing tumor immune response in gastric cancer. Conclusions Collectin subfamily member 12 was identified as a novel predictive marker and target for the clinical treatment of gastric cancer.
Risk–benefit trade-offs and precision utilities in phase I-II clinical trials
Authors: Msaouel Pavlos , Lee Juhee , Thall Peter F 
Published: December 2023

Background: Identifying optimal doses in early-phase clinical trials is critically important. Therapies administered at doses that are either unsafe or biologically ineffective are unlikely to be successful in subsequent clinical trials or to obtain regulatory approval. Identifying appropriate doses for new agents is a complex process that involves balancing the risks and benefits of outcomes such as biological efficacy, toxicity, and patient quality of life. Purpose: While conventional phase I trials rely solely on toxicity to determine doses, phase I-II trials explicitly account for both efficacy and toxicity, which enables them to identify doses that provide the most favorable risk–benefit trade-offs. It is also important to account for patient covariates, since one-size-fits-all treatment decisions are likely to be suboptimal within subgroups determined by prognostic variables or biomarkers. Notably, the selection of estimands can influence our conclusions based on the prognostic subgroup studied. For example, assuming monotonicity of the probability of response, higher treatment doses may yield more pronounced efficacy in favorable prognosis compared to poor prognosis subgroups when the estimand is mean or median survival. Conversely, when the estimand is the 3-month survival probability, higher treatment doses produce more pronounced efficacy in poor prognosis compared to favorable prognosis subgroups. Methods and Conclusions: Herein, we first describe why it is essential to consider clinical practice when designing a clinical trial and outline a stepwise process for doing this. We then review a precision phase I-II design based on utilities tailored to prognostic subgroups that characterize efficacy–toxicity risk–benefit trade-offs. The design chooses each patient’s dose to optimize their expected utility and allows patients in different prognostic subgroups to have different optimal doses. We illustrate the design with a dose-finding trial of a new therapeutic agent for metastatic clear cell renal cell carcinoma.
Isolated renal and urinary tract aspergillosis: a systematic review
Authors: Bongomin Felix , Morgan Bethan , Ekeng Bassey E. , Mushi Martha F. , Kibone Winnie , Olum Ronald , Meya David B. , Hamer Davidson H. , Denning David W. 
Published: December 2023

Background: Aspergillosis localized to the kidneys and the urinary tract is uncommon. We conducted a comprehensive systematic review to evaluate risk factors and clinical outcomes of patients with isolated renal and genito-urinary tract aspergillosis. Methods: We systematically searched Medline, CINAHL, Embase, African Journal Online, Google Scholar, and the Cochrane Library, covering the period from inception to August 2023 using the key terms ‘renal’ OR ‘kidney*’ OR ‘prostate’ OR ‘urinary bladder’ OR ‘urinary tract*AND ‘aspergillosis’ OR ‘aspergillus’ OR ‘aspergilloma’ OR ‘mycetoma’. We included single case reports or case series. Review articles, guidelines, meta-analyses, animal studies, protocols, and cases of genitourinary and /or renal aspergillosis occurring as a part of disseminated disease were excluded. Results: We identified 91 renal and urinary aspergillosis cases extracted from 76 publications spanning 1925–2023. Among the participants, 79 (86.8%) were male, with a median age of 46 years. Predominantly, presentations consisted of isolated renal infections (74 instances, 81.3%), followed by prostate (5 cases, 5.5%), and bladder (7 cases, 7.7%) involvement. Aspergillus fumigatus (42.9%), Aspergillus flavus (9.9%), and Aspergillus niger/glaucus (1.1% each) were isolated. Underlying risk factors included diabetes mellitus (29.7%), HIV (12.1%), haematological malignancies (11%), and liver cirrhosis (8.8%), while common symptoms encompassed flank pain (36.3%), fever (33%), and lower urinary tract symptoms (20.9%). An autopsy was conducted in 8.8% of cases. Diagnostic work-up involved histopathology (70.5%), renal CT scans and urine microscopy and culture (52.6% each), and abdominal ultrasound (17.9%). Treatments included amphotericin B (34 cases, 37.4%) and azole-based regimens (29 cases, 31.9%). Nephrectomy was performed in 16 of 78 renal cases (20.5%). All-cause mortality was 24.4% (19 cases). No significant mortality rate difference was observed among antifungal regimens ( p = 0.739) or nephrectomy status ( p = 0.8). Conclusion: Renal and urinary aspergillosis is an important cause of morbidity and mortality, particularly in immunocompromised and people with diabetes mellitus. While varied treatment strategies were observed, mortality rates showed no significant differences based on treatments or nephrectomy status. Further research is needed to refine diagnostics, optimize treatments, and enhance awareness among clinicians for early detection and management. PROSPERO registration number: CRD42023430959.
Infective Endocarditis in an Intravenous Drug User Leading to Myocardial Rupture and Hemopericardium
Authors: Cao Cathy , Herath Jayantha 
Published: December 2023

Introduction: Infective endocarditis (IE) is an infectious disorder of the innermost lining of the heart that can be fatal if left untreated. Infective endocarditis can spread beyond the endocardium into the myocardium and cause arrhythmias and myocardial wall rupture. Individuals with a history of intravenous drug use are at increased risk of developing IE and are at higher risk of dying, given their limited access to health care and adherence to treatment. Methods: A medicolegal autopsy was performed on a 30-year-old woman with a history of intravenous drug use and recent assault after a hospital admission during which she did not survive resuscitation. Results: The cause of death was found to be myocardial rupture in the setting of transmural IE. Postmortem imaging showed hemopericardium which was identified grossly with valvular vegetations in the heart. A ventricular wall defect along with transmural abscess formation was identified. Perimortem toxicology was positive for fentanyl, methamphetamine, and benzoylecgonine, a metabolite of cocaine. Postmortem blood cultures were positive for coagulase-negative Staphylococci, Staphylococcus aureus, Candida tropicalis, and Viridians group Streptococci. Postmortem tissue cultures taken from the heart was positive for Candida glabrata and Streptococcus mitis. Discussion: The decedent had significant risk factors for IE, such as intravenous drug use and a prior admission to hospital for IE. The organisms identified on culture are in-keeping with the gross findings of IE and the terminal event of myocardial rupture was likely the result of tissue damage resulting from IE.
The association of technology acceptance and physical activity on frailty in older adults during the COVID-19 pandemic period
Authors: Kwan Rick Yiu Cho , Yeung Joanna Wing Yan , Lee Janet Lok Chun , Lou Vivian W. Q. 
Published: December 2023

Abstract
Background
Physical activity was known to be the protective factor against frailty. Technology acceptance is associated with behavioural intention to technology usage. Technology has been effective in promoting healthy behaviour of physical activity. The purposes of this study were to examine the association between physical activity and technology acceptance with frailty and examine the moderation effect of technology acceptance on physical activity and frailty. We hypothesize that 1) physical activity and technology acceptance are associated with frailty, and 2) technology acceptance moderates the association of physical activity with frailty.

Methods
This study employed a cross-sectional design and was conducted in the community settings of Hong Kong in 2021. Eligible participants were old people aged ≥60 and were community-dwelling. Key variables included physical activity measured by Rapid Assessment of Physical Activity (RAPA), social network measured by Lubben Social Network Scale-Six items (LSNS-6); depressive symptoms measured by Patient Health Questionnaire-Nine items (PHQ-9), technology acceptance measured by Senior Technology Acceptance Model-14 items (STAM-14) and frailty measured by Fatigue, Resistance, Ambulation, Illnesses, & Loss of Weight scale (FRAIL). Ordinal logistic regression was employed to test the hypotheses. The moderation effect was examined by introducing an interaction term formed by the multiplication of an independent variable (i.e., physical activity) and a moderating variable (i.e., technology acceptance).

Results
This study recruited 380 eligible participants with a mean age of 66.5 years. Technology acceptance (Beta = − 0.031, p < 0.001, Pseudo-R2 = 0.087) and physical activity (Beta = − 0.182, p = 0.003, Pseudo-R2 = 0.027) were associated with frailty in the unadjusted models. Technology acceptance (Beta = − 0.066, p < 0.001) and physical activity (Beta = − 1.192, p < 0.001) were also associated with frailty in the fully adjusted model (Pseudo-R2 = 0.352). Interaction term formed by the multiplication of technology acceptance and physical activity (Beta = 0.012, p = 0.001) was associated with frailty. Physical activity was significantly associated with frailty in the lower technology acceptance subgroup (Beta = − 0.313, p = 0.002) in the subgroup analysis. However, in the subgroup of higher technology acceptance, the association of physical activity (Beta = 0.104, p = 408) on frailty became positive but not significant.

Conclusions
This study showed that physical activity and technology acceptance were associated with frailty, and technology acceptance moderated the association of physical activity with frailty. This study recommends engaging older adults in physical activity to combat frailty preferentially in those with a lower level of technology acceptance.