bluuebunny/crossref_metadata_2025_split huggingface dataset:
CD4/CD8 ratio and CD8+ T-cell count as prognostic markers for non-AIDS mortality in people living with HIV. A systematic review and meta-analysis
Authors: Ron Raquel , Martínez-Sanz Javier , Herrera Sabina , Ramos-Ruperto Luis , Díez-Vidal Alejandro , Sainz Talía , Álvarez-Díaz Noelia , Correa-Pérez Andrea , Muriel Alfonso , López-Alcalde Jesús , Pérez-Molina José A. , Moreno Santiago , Serrano-Villar Sergio 
Published: February 2024

BackgroundIn people living with HIV (PLHIV), the CD4/CD8 ratio has been proposed as a useful marker for non-AIDS events. However, its predictive ability on mortality over CD4 counts, and the role of CD8+ T-cell counts remain controversial.MethodsWe conducted a systematic review and meta-analysis of published studies from 1996 to 2023, including PLHIV on antiretroviral treatment, and reporting CD4/CD8 ratio or CD8+ counts. The primary outcome was non-AIDS mortality or all-cause mortality. We performed a standard random-effects pairwise meta-analysis comparing low versus high CD4/CD8 ratio with a predefined cut-off point of 0.5. (CRD42020170931).FindingsWe identified 2,479 studies for screening. 20 studies were included in the systematic review. Seven studies found an association between low CD4/CD8 ratio categories and increased mortality risk, with variable cut-off points between 0.4-1. Four studies were selected for meta-analysis, including 12,893 participants and 618 reported deaths. Patients with values of CD4/CD8 ratio below 0.5 showed a higher mortality risk (OR 3.65; 95% CI 3.04 - 4.35; I2 = 0.00%) compared to those with higher values. While the meta-analysis of CD8+ T-cell counts was not feasible due to methodological differences between studies, the systematic review suggests a negative prognostic impact of higher values (&gt;1,138 to 1,500 cells/uL) in the long term.ConclusionsOur results support the use of the CD4/CD8 ratio as a prognostic marker in clinical practice, especially in patients with values below 0.5, but consensus criteria on ratio timing measurement, cut-off values, and time to event are needed in future studies to get more robust conclusions.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020170931, identifier CRD42020170931.
Narrative review of magnetic resonance imaging in quantifying liver iron load
Authors: Feng Qing , Yi Jixing , Li Tao , Liang Bumin , Xu Fengming , Peng Peng 
Published: February 2024

ObjectiveTo summarize the research progress of magnetic resonance imaging (MRI) in quantifying liver iron load.MethodsTo summarize the current status and progress of MRI technology in the quantitative study of liver iron load through reviewing the relevant literature at home and abroad.ResultsDifferent MRI sequence examination techniques have formed a series of non-invasive methods for the examination of liver iron load. These techniques have important clinical significance in the imaging diagnosis of liver iron load. So far, the main MRI methods used to assess liver iron load are: signal intensity measurement method (signal intensity, SI) [signal intensity ratio (SIR) and difference in in-phase and out-of-phase signal intensity], T2/R2 measurement (such as FerriScan technique), ultra-short echo time (UTE) imaging technique, and susceptibility weighted imaging (including conventional susceptibility weighted imaging) (SWI), quantitative susceptibility mapping (QSM), T2*/R2* measurement, Dixon and its derivative techniques.ConclusionMRI has become the first choice for the non-invasive examination of liver iron overload, and it is helpful to improve the early detection of liver injury, liver fibrosis, liver cirrhosis and liver cancer caused by liver iron overload.
Effects of peak ankle dorsiflexion angle on lower extremity biomechanics and pelvic motion during walking and jogging
Authors: Rao Yi , Yang Nan , Gao Tianyu , Zhang Si , Shi Haitao , Lu Yiqun , Ren Shuang , Huang Hongshi 
Published: February 2024

ObjectiveAnkle dorsiflexion during walking causes the tibia to roll forward relative to the foot to achieve body forward. Individuals with ankle dorsiflexion restriction may present altered movement patterns and cause a series of dysfunction. Therefore, the aim of this research was to clearly determine the effects of peak ankle dorsiflexion angle on lower extremity biomechanics and pelvic motion during walking and jogging.MethodThis study involved 51 subjects tested for both walking and jogging. The motion capture system and force measuring platforms were used to synchronously collect kinematics and kinetics parameters during these activities. Based on the peak ankle dorsiflexion angle during walking, the 51 subjects were divided into a restricted group (RADF group, angle &lt;10°) and an ankle dorsiflexion-unrestricted group (un-RADF group, angle &gt;10°). Independent-Sample T-tests were performed to compare the pelvic and lower limb biomechanics parameters between the groups during walking and jogging test on this cross-sectional study.ResultsThe parameters that were significantly smaller in the RADF group than in the un-RADF group at the moment of peak ankle dorsiflexion in the walking test were: ankle plantar flexion moment (p &lt; 0.05), hip extension angle (p &lt; 0.05), internal ground reaction force (p &lt; 0.05), anterior ground reaction force (p &lt; 0.01), pelvic ipsilateral tilt angle (p &lt; 0.05). In contrast, the external knee rotation angle was significantly greater in the RADF group than in the un-RADF group (p &lt; 0.05). The parameters that were significantly smaller in the RADF group than in the un-RADF group at the moment of peak ankle dorsiflexion in the jogging test were: peak ankle dorsiflexion angle (p &lt; 0.01); the anterior ground reaction force (p &lt; 0.01), the angle of pelvic ipsilateral rotation (p &lt; 0.05).ConclusionThis study shows that individuals with limited ankle dorsiflexion experience varying degrees of altered kinematics and dynamics in the pelvis, hip, knee, and foot during walking and jogging. Limited ankle dorsiflexion alters the movement pattern of the lower extremity during walking and jogging, diminishing the body’s ability to propel forward, which may lead to higher injury risks.
The value of CT-based radiomics in predicting hemorrhagic transformation in acute ischemic stroke patients without recanalization therapy
Authors: Huang Yin-hui , Chen Zhen-jie , Chen Ya-fang , Cai Chi , Lin You-yu , Lin Zhi-qiang , Chen Chun-nuan , Yang Mei-li , Li Yuan-zhe , Wang Yi 
Published: February 2024

ObjectiveThe aim of this study is to investigate the clinical value of radiomics based on non-enhanced head CT in the prediction of hemorrhage transformation in acute ischemic stroke (AIS).Materials and methodsA total of 140 patients diagnosed with AIS from January 2015 to August 2022 were enrolled. Radiomic features from infarcted areas on non-enhanced CT images were extracted using ITK-SNAP. The max-relevance and min-redundancy (mRMR) and the least absolute shrinkage and selection operator (LASSO) were used to select features. The radiomics signature was then constructed by multiple logistic regressions. The clinicoradiomics nomogram was constructed by combining radiomics signature and clinical characteristics. All predictive models were constructed in the training group, and these were verified in the validation group. All models were evaluated with the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).ResultsOf the 140 patients, 59 experienced hemorrhagic transformation, while 81 remained stable. The radiomics signature was constructed by 10 radiomics features. The clinicoradiomics nomogram was constructed by combining radiomics signature and atrial fibrillation. The area under the ROC curve (AUCs) of the clinical model, radiomics signature, and clinicoradiomics nomogram for predicting hemorrhagic transformation in the training group were 0.64, 0.86, and 0.86, respectively. The AUCs of the clinical model, radiomics signature, and clinicoradiomics nomogram for predicting hemorrhagic transformation in the validation group were 0.63, 0.90, and 0.90, respectively. The DCA curves showed that the radiomics signature performed well as well as the clinicoradiomics nomogram. The DCA curve showed that the clinical application value of the radiomics signature is similar to that of the clinicoradiomics nomogram.ConclusionThe radiomics signature, constructed without incorporating clinical characteristics, can independently and effectively predict hemorrhagic transformation in AIS patients.
Comparative efficacy of various exercise interventions on sleep in patients with cognitive impairment: a systematic review and meta-analysis
Authors: Zhang Junlei , Liu Yan , Sun Qingling , Shi Jing , Ni Jingnian , Li Ting , Long Ziyi , Wei Mingqing , Tian Jinzhou 
Published: February 2024

BackgroundSleep disturbances are an early indicator of cognitive impairment and exacerbate its progression. While pharmacological treatments for sleep disorders exist, their side-effect profile includes an increased risk of falls and the potential to exacerbate cognitive impairment. Non-pharmacological treatments such as physical exercise should be considered. However, uncertainties persist. We aimed to assess the potential benefits of exercise interventions on sleep in patients with cognitive impairment and determine the specific effects of various exercise modalities.Materials and methodsA systematic search was performed on seven databases for eligible studies published before Nov 2022. Randomized controlled trials of exercise for patients with cognitive impairment (mild cognitive impairment and Alzheimer’s disease) were included. All analyses were conducted using RevMan version 5.4. Meta-analysis and The Grading of Recommendations Assessment Development and Evaluations (GRADE) quality ratings were performed on sleep quality and objective sleep data.ResultsA total of 8 randomized controlled trials were included with a sample size of 486 subjects. For patients with cognitive impairment, physical exercise had a beneficial effect on sleep quality [MD = −3.55 (−5.57, −1.32), Z = 3.13, p = 0.002] and total sleep time [MD = 33.77 (23.92, 43.62), Z = 6.72, P &lt; 0.00001]. No improvement was found in sleep efficiency and nocturnal awakening time. Subgroup analysis showed that multi-component exercise produced superior results.ConclusionPhysical exercise may improve sleep quality and total sleep time for patients with cognitive impairment. Multi-component exercise designed individually is more effective. Large-scale randomized controlled trials with objective sleep outcome measurements are warranted.Clinical trial registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42022377221.
Development of standardized nursing terminology for the process documentation of patients with chronic kidney disease
Authors: Pu Shi , Peng Hongmei , Li Yang , Huang Xia , Shi Yu , Song Caiping 
Published: February 2024

IntroductionEuropean Nursing care Pathways (ENP) is a professional care language that utilizes software to map care processes and utilize the data for research purposes, process control, and personnel requirement calculations. However, there is a lack of internationally developed terminology systems and subset specifically designed for the nutritional management of CKD. The aim of this study was to create a subset of the standardized nursing terminology for nutrition management in patients with chronic kidney disease (CKD).Materials and methodsAccording to the guidelines for subset development, four research steps were carried out: (i) Translation of version 3.2 of the ENP (chapter on kidney diseases) and understanding of the framework structure and coding rules of the ENP; (ii) Identification of relevant six-dimensional nursing terms; (iii) Creation of a framework for the subset; (iv) Review and validation by experts.ResultsA subset for CKD nutritional care was created as part of this project, comprising 630 terms, with 17 causal relationships related to nursing diagnoses, 115 symptoms, 31 causes, 34 goals/outcomes, 420 intervention specifications and 13 resources, including newly developed care terms. All terms within the subset have been created using a six-step maintenance procedure and a clinical standard pathway for nutrition management in the SAPIM mode.Implications for nursing practiceThis terminology subset can facilitate standardized care reports in CKD nutrition management, which is used to standardize nursing practice, quantify nursing, services, guidance on care decisions, promoting the exchange and use of CKD nutrition data and serve as a reference for the creation of standardized subset of nursing terminology in China.
Maternal cobalt concentration and risk of spontaneous preterm birth: the role of fasting blood glucose and lipid profiles
Authors: Huang Junhua , Zheng Wei , Wang Aili , Han Weiling , Chen Junxi , An Hang , Yan Lailai , Li Zhiwen , Li Guanghui 
Published: February 2024

IntroductionSpontaneous preterm birth (SPB) is a significant cause of neonatal mortality, yet its etiology remains unclear. Cobalt, an essential trace element, might be a risk factor for SPB. This study aims to investigate the relationship between maternal serum cobalt concentration and SPB, and to clarify the role of blood lipids and fasting blood glucose (FBG) in this relationship.MethodsWe conducted a nested case-control study within the Beijing Birth Cohort Study. Serum samples were obtained from 222 pregnant women with SPB and 224 controls during the first (7–13 weeks of pregnancy) and third trimesters (32–42 weeks of pregnancy). Serum cobalt concentration was determined using inductively coupled plasma mass spectrometry (ICP-MS). Fasting blood glucose and lipids levels were detected using a fully automated biochemical immunoassay instrument. Logistic regression models and linear regression models were established to explore the association between serum cobalt concentration and the risk of SPB in pregnant women, and to test the mediating effect of fasting blood glucose (FBG) and lipids.ResultsWe found that the serum cobalt concentration in mothers with SPB and controls was similar in the first trimester, with values of 0.79 (0.58–1.10) ng/mL and 0.75 (0.51–1.07) ng/mL, respectively. However, in the third trimester, the cobalt concentration increased to 0.88 (0.59–1.14) ng/mL and 0.84 (0.52–1.19) ng/mL, respectively. In the logistic regression model, when considering the third trimester of pregnancy, after adjusting for ethnicity, pre-pregnancy body mass index (BMI), maternal age, education, income, and parity, it was observed that the medium level of cobalt concentration (0.63–1.07 ng/ml) had a negative correlation with the risk of SPB. The odds ratio (OR) was 0.56, with a 95% confidence interval of 0.34–0.90 ng/mL and a p-value of 0.02. This suggests that cobalt in this concentration range played a protective role against SPB. Additionally, it was found that FBG in the third trimester of pregnancy had a partial intermediary role, accounting for 9.12% of the association. However, no relationship between cobalt and SPB risk was found in the first trimester.ConclusionDuring the third trimester, intermediate levels of maternal cobalt appear to offer protection against SPB, with FBG playing a partial mediating role. To further clarify the optimal cobalt concentrations during pregnancy for different populations, a multi-center study with a larger sample size is necessary. Additionally, exploring the specific mechanism of FBG’s mediating role could provide valuable insights for improving the prevention of SPB.
Predictive value of 18F-FDG PET/CT radiomics for EGFR mutation status in non-small cell lung cancer: a systematic review and meta-analysis
Authors: Ma Ning , Yang Weihua , Wang Qiannan , Cui Caozhe , Hu Yiyi , Wu Zhifang 
Published: February 2024

ObjectiveThis study aimed to evaluate the value of 18F-FDG PET/CT radiomics in predicting EGFR gene mutations in non-small cell lung cancer by meta-analysis.MethodsThe PubMed, Embase, Cochrane Library, Web of Science, and CNKI databases were searched from the earliest available date to June 30, 2023. The meta-analysis was performed using the Stata 15.0 software. The methodological quality and risk of bias of included studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 and Radiomics Quality Score criteria. The possible causes of heterogeneity were analyzed by meta-regression.ResultsA total of 17 studies involving 3763 non-small cell lung cancer patients were finally included. We analyzed 17 training cohorts and 10 validation cohorts independently. Within the training cohort, the application of 18F-FDG PET/CT radiomics in predicting EGFR mutations in NSCLC demonstrated a sensitivity of 0.76 (95% CI: 0.70-0.81) and a specificity of 0.78 (95% CI: 0.74-0.82), accompanied by a positive likelihood ratio of 3.5 (95% CI:3.0-4.2), a negative likelihood ratio of 0.31 (95% CI: 0.24-0.39), a diagnostic odds ratio of 11.0 (95% CI: 8.0-16.0), and an area under the curve (AUC) of 0.84 (95% CI: 0.80-0.87). In the validation cohort, the values included a sensitivity of 0.76 (95% CI: 0.67-0.83), a specificity of 0.75 (95% CI: 0.68-0.80), a positive likelihood ratio of 3.0 (95% CI:2.4-3.8), a negative likelihood ratio of 0.32 (95% CI: 0.24-0.44), a diagnostic odds ratio of 9 (95% CI: 6-15), and an AUC of 0.82 (95% CI: 0.78-0.85). The average Radiomics Quality Score (RQS) across studies was 10.47 ± 4.72. Meta-regression analysis identifies the application of deep learning and regions as sources of heterogeneity.Conclusion18F-FDG PET/CT radiomics may be useful in predicting mutation status of the EGFR gene in non-small cell lung cancer.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier CRD42022385364.
Implementation of a high fidelity simulation based training program for physicians of children requiring long term invasive home ventilation: a study by ISPAT team
Authors: Bas Ikizoglu Nilay , Atag Emine , Ergenekon Pinar , Gokdemir Yasemin , Uyan Zeynep Seda , Girit Saniye , Kilinc Sakalli Ayse Ayzit , Erdem Eralp Ela , Cakir Erkan , Guven Feray , Aksoy Mehmet Emin , Karadag Bulent , Karakoc Fazilet , Oktem Sedat 
Published: February 2024

IntroductionThe number of children requiring long-term invasive home ventilation (LTIHV) has increased worldwide in recent decades. The training of physicians caring for these children is crucial since they are at high risk for complications and adverse events. This study aimed to assess the efficacy of a comprehensive high-fidelity simulation-based training program for physicians caring for children on LTIHV.MethodsA multimodal training program for tracheostomy and ventilator management was prepared by ISPAT (IStanbul PAediatric Tracheostomy) team. Participants were subjected to theoretical and practical pre-tests which evaluated their knowledge levels and skills for care, follow-up, and treatment of children on LTIHV. Following the theoretical education and hands-on training session with a simulation model, theoretical and practical post-tests were performed.ResultsForty-three physicians from 7 tertiary pediatric clinics in Istanbul were enrolled in the training program. Seventy percent of them had never received standardized training programs about patients on home ventilation previously. The total number of correct answers from the participants significantly improved after the theoretical training (p &lt; 0.001). The number of participants who performed the steps correctly also significantly increased following the hands-on training session (p &lt; 0.001). All of the 43 participants who responded rated the course overall as good or excellent.ConclusionThe knowledge and skills of clinicians caring for children on LTIHV can be enhanced through a comprehensive training program consisting of theoretical training combined with hands-on training in a simulation laboratory.
Differential effects of attachment security on visual fixation to facial expressions of emotion in 14-month-old infants: an eye-tracking study
Authors: Gonçalves Joana L. , Fuertes Marina , Silva Susana , Lopes-dos-Santos Pedro , Ferreira-Santos Fernando 
Published: February 2024

IntroductionModels of attachment and information processing suggest that the attention infants allocate to social information might occur in a schema-driven processing manner according to their attachment pattern. A major source of social information for infants consists of facial expressions of emotion. We tested for differences in attention to facial expressions and emotional discrimination between infants classified as securely attached (B), insecure-avoidant (A), and insecure-resistant (C).MethodsSixty-one 14-month-old infants participated in the Strange Situation Procedure and an experimental task of Visual Habituation and Visual Paired-Comparison Task (VPC). In the Habituation phase, a Low-Arousal Happy face (habituation face) was presented followed by a VPC task of 6 trials composed of two contrasting emotional faces always involving the same actress: the one used in habituation (trial old face) and a new one (trial new face) portraying changes in valence (Low-Arousal Angry face), arousal (High-Arousal Happy face), or valence + arousal (High-Arousal Angry face). Measures of fixation time (FT) and number of fixations (FC) were obtained for the habituation face, the trial old face, the trial new face, and the difference between the trial old face and the trial new face using an eye-tracking system.ResultsWe found a higher FT and FC for the trial new face when compared with the trial old face, regardless of the emotional condition (valence, arousal, valence + arousal contrasts), suggesting that 14-month-old infants were able to discriminate different emotional faces. However, this effect differed according to attachment pattern: resistant-attached infants (C) had significantly higher FT and FC for the new face than patterns B and A, indicating they may remain hypervigilant toward emotional change. On the contrary, avoidant infants (A) revealed significantly longer looking times to the trial old face, suggesting overall avoidance of novel expressions and thus less sensitivity to emotional change.DiscussionOverall, these findings corroborate that attachment is associated with infants’ social information processing.
Mapping autism’s research landscape: trends in autism screening and its alignment with sustainable development goals
Authors: Nedungadi Prema , Shah Selina Marianna , Stokes Mark Andrew , Kumar Nair Vinith , Moorkoth Ajit , Raman Raghu 
Published: February 2024

IntroductionAutism Spectrum Disorder is a complex neurodevelopmental syndrome that profoundly affects social interactions, communication, and sensory perception. The research traced the evolution of autism research from 2011-2022, specifically focusing on the screening and diagnosis of children and students.MethodsThrough an analysis of 12,262 publications using the PRISMA framework, bibliographic coupling, science mapping, and citation analysis, this study illuminates the growth trajectory of ASD research and significant disparities in diagnosis and services.ResultsThe study indicates an increasing trend in autism research, with a strong representation of female authorship. Open Access journals show a higher average citation impact compared to their closed counterparts. A keyword co-occurrence analysis revealed four central research themes: Child Development and Support Systems, Early Identification and Intervention, Prevalence and Etiology, and Mental Health. The pandemic’s onset has prioritized research areas like mental health, telehealth, and service accessibility.DiscussionRecommendations on a global level stress the importance of developing timely biological markers for ASD, amplifying Disability Inclusion research, and personalizing mental health services to bridge these critical service gaps. These strategies, underpinned by interdisciplinary collaboration and telehealth innovation, particularly in low-resource settings, can offer a roadmap for inclusive, context-sensitive interventions at local levels that directly support SDG3’s aim for health and well-being for all.