bluuebunny/crossref_metadata_2025_split huggingface dataset:
The independent and joint relationships between dietary antioxidant intake with risk of chronic obstructive pulmonary disease and all-cause mortality: insights from NHANES
Authors: Xu Yifeng , Yan Zhaoqi , Li Keke , Liu Liangji , Xu Lei 
Published: January 2025

BackgroundNumerous studies have indicated that a diet rich in antioxidants can prevent Chronic Obstructive Pulmonary Disease (COPD). However, the relationship between combined dietary antioxidant intake and the risk of COPD remains unclear. The Comprehensive Dietary Antioxidant Index (CDAI) is a composite score of various dietary antioxidants, including vitamins A, C, E, zinc, selenium, and carotenoids. In this study, we examined the independent and joint associations of CDAI with the risk of COPD and all-cause mortality.MethodsThe analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2013 to 2018. Multivariable weighted logistic and Cox regression models were employed to evaluate the correlations of CDAI (including vitamins A, C, E, zinc, selenium, and carotenoids) with the risk of COPD and all-cause mortality. Restricted cubic spline models were used to examine potential non-linear relationships. Sensitivity and stratified analyses were conducted to assess the robustness of the results.ResultsIn this study, compared to the lowest quartile, the highest quartile of CDAI levels was significantly negatively associated with the risk of COPD (Odds Ratio [OR]: 0.47; 95% Confidence Interval [CI]: 0.22–0.97), exhibiting a non-linear relationship. Additionally, vitamins A, C, E, zinc, selenium, and carotenoids were also negatively associated with the risk of COPD. Furthermore, dietary antioxidant zinc in the second quartile (Hazard Ratio [HR]: 0.25; 95% CI: 0.10–0.62) was negatively associated with the risk of all-cause mortality compared to the lowest quartile. Subgroup analysis results remained stable, and sensitivity analysis did not support the association between selenium and the risk of COPD, with no substantial changes in the remaining associations.ConclusionHigher CDAI is inversely associated with the risk of COPD, and appropriate intake of the dietary antioxidant zinc may reduce all-cause mortality in COPD patients.
Centering community-based maternal and child nutrition services in Bangladesh’s rural primary healthcare: what has potential to scale
Authors: Abdulloeva Safina , Bhanot Arti , Khan Mohd. Aziz , Bulbul Md. Mofijul Islam , Rahman Mijanur , Afsana Kaosar , Forissier Thomas , Sharma Deepika , Alam Abul Bashar Mohammad Khurshid 
Published: January 2025

IntroductionThe extensive network of community health workers in rural Bangladesh has the potential to deliver maternal and child nutrition services, while promoting linkages with healthcare facilities. A strategy for strengthening community-based nutrition services was developed and tested.MethodsThe three-phased strategy included review of existing community-based systems, co-designing service package with multi-sector government representatives, and testing implementation feasibility. Integrated health and nutrition service delivery, supportive supervision, and increased accountability of local government were core components of the service package being implemented in selected geographies since March 2023. The assessment followed a mixed-method design with household survey of 1,166 pregnant women, mothers of children under-6 months and 6–23 months, and observations of 965 service delivery points along with qualitative study.ResultsA higher proportion of children received growth monitoring and promotion (GMP) services through expanded program on immunization (EPI) sessions, with better compliance to service delivery protocol in intervention areas compared with controls. Maternal nutrition services of gestational weight gain monitoring and distribution of supplements were better available in intervention areas. However, minimum dietary diversity among pregnant women (69% intervention, 72% control), early initiation of breastfeeding (55% intervention, 51% control), and complementary feeding practices were comparable in intervention and control areas. Nutrition services were successfully integrated in supervision which earlier covered EPI and family planning. The local government contributed to strengthening nutrition services but at a small scale.DiscussionThere is potential to scale-up GMP services through EPI and merging antenatal clinics with GMP and EPI such that all maternal and childcare services are available at the same place and same time. A coordinated investment and oversight from multiple national government departments is needed. At district and sub-district levels, scale-up requires joint annual planning of nutrition and EPI services, strengthened management of nutrition services, bridging health worker vacancies, introducing volunteers in sites with high EPI case load, capacity building, and supportive supervision. Replacement of multiple health and nutrition records with a single mother and child health and nutrition card is also feasible. However, behavior change interventions through home visits and courtyard meetings need more testing before recommending scale-up.
How do families access holiday activities and food programmes and other support? Learnings from the Borough of Southwark holiday activities and food club’s evaluation
Authors: McSweeney Lorraine , Sewornu Anita , Goffe Louis , Arnott Bronia , Adamson Ashley 
Published: January 2025

IntroductionThe school holidays can be a challenging time for many families especially for those reliant on free school meals. The Holiday Activities and Food (HAF) programme aims to provide disadvantaged families across England with healthy meals and enriching activities for children and young people. The clubs are usually in the form of a network of independent clubs and often depends on local partnerships and connections, such as the voluntary, community, social and enterprise sectors. In 2023 Southwark Council, interested in building on the findings of a national evaluation and providing more context specific insights relating to access to and use of their clubs, approached the Public Health Intervention Responsive Studies Teams scheme to collaborate in a service provision evaluation.MethodsAs part of the wider evaluation, a qualitative study was conducted. Semi-structured interviews were conducted with parents/carers of HAF eligible children and semi-structured interviews/focus groups were held with children and young people (CYP) attending a HAF club. Recruitment was through the clubs. The transcripts were coded by two independent researchers and thematic analysis applied.ResultsNine parent/carers and two young people took part in an interview. Six discussion groups with 4–6 young people in each took place. Most participants heard about the club they attended through word of mouth from friends and family, through the child’s school or by seeing a flyer/newsletter advert. Many participants were unaware of the variety and number of different clubs available to families. Finding out about the clubs online was reported to be time-consuming and websites not user-friendly. Parents/carers spoke of the frustration in trying to navigate booking systems. There was also a lack of awareness of the types of other support/signposting available from clubs.DiscussionThe evaluation highlighted the low-level of family awareness of all available HAF activities across the borough. Furthermore, navigating the system was reported as challenging. Southwark Council reviewed and revised its online provision to create a centralised repository accessible to families that aimed to improve awareness and ease the club booking process. Further work is required to improve signposting to support services and provision for parents/carers.
Rotavirus infections in the pediatric population: a comparative study of pre-COVID and COVID-19 pandemic periods
Authors: Öztelcan Gündüz Bahar , Kutlutürk Kazım , Ünay Bülent 
Published: January 2025

BackgroundThis study investigates the impact of the COVID-19 pandemic on the incidence and clinical outcomes of rotavirus infections in the pediatric population.MethodsThis retrospective study was conducted at the Pediatrics Clinic of Gülhane Research and Training Hospital, analyzing data from the pre-COVID-19 period (January 1, 2017 – January 1, 2020) and during the COVID-19 pandemic period (March 11, 2020 – August 31, 2022). Patient data, including demographic characteristics, presenting complaints, laboratory results, and hospitalization status, were collected from hospital records. Statistical comparisons were made to evaluate changes in rotavirus infection patterns between the two examined periods.ResultsThe data of a total of 3,915 pediatric patients with diarrhea were included, with 468 (6.8%) testing positive for rotavirus. Three hundred and forty of these cases (72.6%) were detected during the COVID-19 pandemic period, while 128 cases (27.4%) were detected before the pandemic period. The median age of the patients was 2 years, while 62.7% were under 2 years of age. Significant differences were found between the pre-COVID-19 and COVID-19 periods in terms of the number of emergency department visits (p = 0.003), the duration of emergency observations (p = 0.001) and the rates of patient visits from urban or rural centers (p = 0.001). Laboratory parameters, including blood sodium levels (p = 0.02), neutrophil counts (p = 0.02), base excess (p = 0.03), and bicarbonate levels (p = 0.05), also showed significant differences. Factors influencing hospitalization were found to be emergency department observation time (hours) with an OR of 0.91, 95% CI (0.867–0.974) (p = 0.005), blood glucose levels with an OR of 1.03, 95% CI (1.02–1.05) (p = 0.002), serum potassium levels with an OR of 2.36, 95% CI (1.14–4.87) (p = 0.02), and CRP levels with an OR of 1.02, 95% CI (1.01–1.03) (p = 0.006).ConclusionThe results of this study emphasize the need for targeted interventions to manage rotavirus infections, particularly in the context of ongoing public health challenges. Understanding the COVID-19 pandemic’s effects on rotavirus epidemiology is crucial for developing effective strategies to mitigate severe outcomes in vulnerable pediatric populations.
Integrating retrieval-augmented generation for enhanced personalized physician recommendations in web-based medical services: model development study
Authors: Zheng Yingbin , Yan Yiwei , Chen Sai , Cai Yunping , Ren Kun , Liu Yishan , Zhuang Jiaying , Zhao Min 
Published: January 2025

BackgroundWeb-based medical services have significantly improved access to healthcare by enabling remote consultations, streamlining scheduling, and improving access to medical information. However, providing personalized physician recommendations remains a challenge, often relying on manual triage by schedulers, which can be limited by scalability and availability.ObjectiveThis study aimed to develop and validate a Retrieval-Augmented Generation-Based Physician Recommendation (RAGPR) model for better triage performance.MethodsThis study utilizes a comprehensive dataset consisting of 646,383 consultation records from the Internet Hospital of the First Affiliated Hospital of Xiamen University. The research primarily evaluates the performance of various embedding models, including FastText, SBERT, and OpenAI, for the purposes of clustering and classifying medical condition labels. Additionally, the study assesses the effectiveness of large language models (LLMs) by comparing Mistral, GPT-4o-mini, and GPT-4o. Furthermore, the study includes the participation of three triage staff members who contributed to the evaluation of the efficiency of the RAGPR model through questionnaires.ResultsThe results of the study highlight the different performance levels of different models in text embedding tasks. FastText has an F1-score of 46%, while the SBERT and OpenAI significantly outperform it, achieving F1-scores of 95 and 96%, respectively. The analysis highlights the effectiveness of LLMs, with GPT-4o achieving the highest F1-score of 95%, followed by Mistral and GPT-4o-mini with F1-scores of 94 and 92%, respectively. In addition, the performance ratings for the models are as follows: Mistral with 4.56, GPT-4o-mini with 4.45 and GPT-4o with 4.67. Among these, SBERT and Mistral are identified as the optimal choices due to their balanced performance, cost effectiveness, and ease of implementation.ConclusionThe RAGPR model can significantly improve the accuracy and personalization of web-based medical services, providing a scalable solution for improving patient-physician matching.
Microbiota, parasitic infections and their relationship with nutritional status and neurocognitive functioning in children from Ecuador—Proyecto Guagua: research protocol for a cross-sectional study
Authors: Abril-Ulloa Sandra Victoria , Carpio-Arias Tannia Valeria , Alvarado-Barba Renata Alejandra , Ríos-Romero Cristina Gabriela , Vinueza-Veloz Pamela , Lima-dos-Santos Sueny Paloma , Astudillo-Skliarova Igor Eduardo , Arias-Gutiérrez Ruth Irene , Pérez-Quintana Manuel , Boele Henk-Jan , Vinueza-Veloz María Fernanda 
Published: January 2025

IntroductionThis protocol outlines the Proyecto Guagua, which aims to explore the relationship between the characteristics of the gut microbiota, parasitic infections, nutritional status, and neurocognitive functioning in school-age children in Ecuador.Methods and analysisProyecto Guagua is a cross-sectional observational study funded by the Escuela Superior Politécnica de Chimborazo. It is being carried out in several counties across different geographical regions in Ecuador, including Galápagos. The study targets children regularly attending school, aged 6–12. We aim to recruit 450 children, with data already collected from nearly 300 participants (67%). Enrolled children undergo comprehensive evaluations assessing nutritional status, body composition, motor learning, social skills, cognitive ability, sleep habits, and physical activity. Caretakers and school teachers are interviewed regarding hygiene, eating habits, and food handling. Stool samples are collected to analyze the gut microbiota and determine the presence of parasites. In the analysis phase, we aim to describe differences in microbiota population structure and diversity among undernourished and obese/overweight children, and children with parasitosis compared to their peers. We also plan to test the hypothesis that an altered microbiota mediates the influence of malnutrition on neurocognitive functioning and parasitosis.Ethics and disseminationProyecto Guagua received ethical approval from the Ethics Committee of Universidad de Cuenca in July 2022. Following the pilot phase, an addendum and minor changes to the study design were approved in October 2022. Written consent was obtained from parents before enrolling their children in the study. Parents and children were informed of their right to withdraw from the study at any time. The findings of “Proyecto Guagua” will be disseminated through open-access, peer-reviewed publications and presented at local and international scientific events.
A consensus statement on child and family health during the COVID-19 pandemic and recommendations for post-pandemic recovery and re-build
Authors: Redhead Caroline A. B. , Silverio Sergio A. , Payne Elana , Greenfield Mari , Barnett Sara M. , Chiumento Anna , Holder Beth , Skirrow Helen , Torres Ofelia , Power Carmen , Weiss Staci M. , Magee Laura A. , Downe Soo , Frith Lucy , Cameron Claire 
Published: January 2025

IntroductionAs health systems struggled to respond to the catastrophic effects of SARS-CoV-2, infection prevention and control measures significantly impacted on the delivery of non-COVID children's and family health services. The prioritisation of public health measures significantly impacted supportive relationships, revealed their importance for both mental and physical health and well-being. Drawing on findings from an expansive national collaboration, and with the well-being of children and young people in mind, we make recommendations here for post-pandemic recovery and re-build.MethodsThis consensus statement is derived from a cross-disciplinary collaboration of experts. Working together discursively, we have synthesised evidence from collaborative research in child and family health during the COVID-19 pandemic. We have identified and agreed priorities areas for both action and learning, which we present as recommendations for research, healthcare practice, and policy.ResultsThe synthesis led to immediate recommendations grouped around what to retain and what to remove from “pandemic” provision and what to reinstate from pre-pandemic, healthcare provision in these services. Longer-term recommendations for action were also made. Those relevant to children's well-being concern equity and relational healthcare.DiscussionThe documented evidence-base of the effects of the pandemic on children's and family services is growing, providing foundations for the post-pandemic recovery and re-setting of child and family health services and care provision. Recommendations contribute to services better aligning with the values of equity and relational healthcare, whilst providing wider consideration of care and support for children and families in usual vs. extra-ordinary health system shock circumstances.
Accuracy of smartwatches in predicting distance running performance
Authors: Dai Jiansong , Chen Gangrui , Gu Zhonghe , Qi Yuxuan , Xu Kai 
Published: January 2025

ObjectiveThis study examined the accuracy of smartwatches in predicting running performance.MethodsA total of 154 amateur runners (123 males and 31 females) were recruited. After wearing the HUAWEI WATCH GT Runner for a minimum of six weeks, the runners' actual completion times for 5 km, 10 km, and half marathon distances were measured, resulting in 288 test instances. The predicted completion times for the same distances displayed on the watch on the test day were recorded simultaneously.ResultsThe actual and predicted performances for the 5, 10, and 21.1 km distances were highly correlated, with r ≥ 0.95 (p &lt; 0.001) and r2 ≥ 0.9 for all three distances, an error rate between the measured and predicted values of less than 3%, and intraclass correlation coefficient ≥0.9. The bias ± 95% limits of agreement were −20.4 ± 44.2 s for 5 km, 4.1 ± 299.1 s for 10 km, and 143.8 ± 400.4 s for the half marathon.ConclusionsThis study confirmed that the smartwatch exhibits high precision in predicting 5 km, 10 km, and half marathon performances, with an accuracy exceeding 97%. The performance prediction features of smartwatches can effectively guide amateur runners in setting reasonable competition goals and preparing for races.
Examining Patient Characteristics in Bladder Cancer Clinical Trials Involving Immunotherapy
Authors: Ikhapoh Izuagie , Atairu Usomine , Reich Amanda Jane , Mantia Charlene M. , Wei Xiao X. , Sekar Rishi , Clinton Timothy N. , Mossanen Matthew 
Published: January 2025

Background/Objectives: Comprehending the patient composition of bladder cancer (BC) clinical trials is crucial for effectively designing clinical trials and contextualizing the generated science. In this study, we reviewed publicly available data and explored the demographic information of BC studies administering immune checkpoint inhibitors (ICIs). Methods: Trial eligibility was irrespective of government or private sponsorship, and trial activation dates were limited to between 2013 and 2023. The main inclusion criteria were use of ICIs and trials reporting endpoints that include progression-free survival (PFS), overall survival (OS), disease-free survival (DFS), and event-free survival (EFS). The key exclusion terms were review articles and meta-analysis. Results: We identified a total of 109 clinical trials with an aggregate total of 8936 enrolled patients. Ninety-six percent identified as Caucasian or White European, and 23% identified as female. Further analyses revealed that 65% of the patients were aged 65 years or older. One-third of the trials listed similar comorbidities, such as cardiovascular disease and diabetes, that were exhibited by approximately 30 percent of the patients. Conclusions: Our data suggest that recruitment strategies should be mindful of comorbidities that may interfere with ICI treatments. Additionally, our results are consistent with findings from other reviews that indicate that certain patient groups may be under-represented in BC trials.
Natural Language Processing Identifies Under-Documentation of Symptoms in Patients on Hemodialysis
Authors: Dai Yang , Wen Huei Hsun , Yang Joanna , Gupta Neepa , Rhee Connie , Horowitz Carol R. , Mohottige Dinushika , Nadkarni Girish N. , Coca Steven , Chan Lili 
Published: January 2025

Background:
Patients on hemodialysis (HD) have a high burden of emotional and physical symptoms. These symptoms are often under-recognized. NLP can be used to identify patient symptoms from the EHR. However, whether symptom documentation matches patient reported burden is unclear.

Methods:
We conducted a prospective study of patients seen at an ambulatory nephrology practice from September 2020 to April 2021. We collected symptom surveys from patients, nurses, and physicians. We then developed a natural language processing (NLP) algorithm to identify symptoms from the patients’ electronic health records (EHR) and validated the performance of this algorithm using manual chart review and patient surveys as a reference standard. Using patient surveys as the reference standard, we compared symptom identification by 1) physicians, 2) nurses, 3) physicians or nurses, and 4) NLP.

Results:
We enrolled 97 patients into our study, 63% were female, 49% were Non-Hispanic Black, and 41% were Hispanic. The most common symptoms reported by patients were fatigue (61%), cramping (59%), dry skin (53%), muscle soreness (43%), and itching (41%). Physicians and nurses significantly under-recognized patients’ symptoms (sensitivity 0.51 (95% CI 0.40-0.61) and 0.63 (95% CI 0.52-0.72) respectively). Nurses were better at identifying symptoms when patients reported more severe symptoms. There was no difference in results by patients’ sex or ethnicity. NLP had a sensitivity of 0.92, specificity of 0.95, PPV of 0.75, and NPV of 0.99 with manual EHR review as the reference standard, and a sensitivity of 0.58 (95% CI 0.47-0.68), specificity of 0.73 (95% CI 0.48-0.89), PPV of 0.92 (95% CI 0.82-0.97), and NPV of 0.24 (95% CI 0.14-0.38) compared with patient surveys.

Conclusions:
While patients on HD report high prevalence of symptoms, symptoms are under-recognized and under-documented. NLP was accurate at identifying symptoms when they were documented. Larger studies in representative populations are needed to assess the generalizability of the results of the study.