bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pentraxin-3 as a novel prognostic biomarker in non-neutropenic invasive pulmonary aspergillosis patients
Authors: Sun Chao , Cai Xiaomin , Zhong Huanhuan , Lu Yajie , Li Yuanyuan , Cai Yuchen , Wang Yujie , Zhao Tingting , Cao Min , Wang Li , Feng Chunlai , Sun Wenkui , Chen Cheng , Tao Yujian , Ma Guoer , He Binchan , Wang Xinyu , Zhong Jinjin , Lu Xin , Li Yuanqin , Su Xin 
Published: January 2025

ABSTRACT

The incidence of invasive pulmonary aspergillosis (IPA) in non-neutropenic patients is increasing. This study aimed to evaluate the clinical outcomes and risk factors for mortality in non-neutropenic IPA patients. We conducted a prospective, multicenter study from August 2020 to February 2024, enrolling 565 patients with suspected IPA. The study cohort comprised 195 IPA (non-neutropenic) cases and 370 non-IPA cases. Peripheral blood and bronchoalveolar lavage fluid (BALF) specimens were collected to measure pentraxin-3 (PTX3) levels. Additionally, demographic data, clinical characteristics, and antifungal therapy of each patient were recorded. We analyzed factors associated with 30- and 90-day mortality. IPA patients exhibited higher mortality rates compared to non-IPA patients, with 30-day rates of 26.15% versus 8.38% (
P
< 0.001) and 90-day rates of 34.36% versus 13.24% (
P
< 0.001). Higher plasma and BALF PTX3 levels were associated with poor prognosis in IPA patients. ROC curve analysis identified optimal PTX3 thresholds of 4.29 ng/mL in BALF (sensitivity, 67.1%; specificity, 81.4%) and 7.11 ng/mL in plasma (sensitivity, 73.4%; specificity, 82.8%) for predicting mortality. Multivariate Cox regression analysis confirmed PTX3 levels in plasma (hazard ratio [HR] 3.87, 95%CI [1.87–8.00],
P
＜0.001) and BALF (HR 2.40 [1.19–4.84],
P
= 0.014) were independent prognostic factors for IPA mortality. Additionally, positive galactomannan test results in both BALF and plasma were initially correlated with increased mortality in IPA patients. However, after adjusting for potential confounding factors, this correlation no longer remained statistically significant. In conclusion, PTX3 is a promising prognostic biomarker of mortality in IPA patients.

IMPORTANCE
Studies have confirmed the value of pentraxin-3 (PTX3) in the diagnosis of invasive pulmonary aspergillosis (IPA), yet its prognostic significance in IPA remains unclear. This study found that in non-neutropenic IPA patients, plasma and bronchoalveolar lavage fluid (BALF) levels of PTX3 are independently associated with poor outcomes. Furthermore, the optimal cutoff values of PTX3 for predicting a poor prognosis of IPA are 4.29 ng/mL in BALF and 7.11 ng/mL in plasma. These findings could help us better manage IPA in non-neutropenic patients, potentially enhancing the prognosis of patients with this condition.
An observational study evaluating the epidemiological and entomological impacts of piperonyl butoxide insecticide-treated nets (ITNs) compared to a combination of indoor residual spraying (IRS) plus standard pyrethroid-only ITNs in Amhara Region, Ethiopia, 2019–2023
Authors: Davis Kelly M , Worku Amha , Balkew Meshesha , Mumba Peter , Chibsa Sheleme , Tongren Jon Eric , Assefa Gudissa , Sisay Achamyelesh , Teshome Dawit , Tegegne Banchamlak , Worku Mastewal , Yimer Mulat , Yewhalaw Delenasaw , Yoshimizu Melissa , Zohdy Sarah , Swamidoss Isabel , Mapp Carla , Hwang Jimee , Inouye Wendy , Seyoum Aklilu , Flatley Cecilia , Hilton Emily R , Dengela Dereje , Burnett Sarah M 
Published: January 2025

IntroductionNational malaria programmes must weigh the relative benefits of different vector control and elimination tools to prioritise resource allocation with the greatest impact. This study assesses the epidemiological and entomological impacts of piperonyl butoxide insecticide-treated nets (PBO ITN-only arm) compared with the combination of two annual non-pyrethroid indoor residual spraying (IRS) campaigns and standard pyrethroid ITNs (IRS+Standard Pyrethroid ITN arm) in the Amhara region of Ethiopia.MethodsAn open-label, stratified block-cluster randomised trial was designed to compare the impacts of the two intervention arms. ITN distribution took place from June to July 2021. IRS campaigns took place from June to July 2021 and again in June 2022. Confirmed malaria cases reported during the high transmission season (September to December) were compared in the 2 years before (2019 and 2020) vs the 2 years after (2021 and 2022) the 2021 campaigns. The difference inAn. gambiaes.l. vector density per trap and indoor resting density (IRD) was assessed between the two arms during the high transmission seasons 2 years after the 2021 campaigns.ResultsEstimated malaria cases decreased significantly by 53.6% in the postintervention period compared with preintervention in the IRS+Standard Pyrethroid ITN arm (95% CI −72.9%, −29.8%) and by 55.9% in the PBO ITN arm (95% CI −73.0%, −32.5%), with no significant difference between these two arms (95% CI −30.9%, 24.0%). From the first to the second season postintervention, cases decreased non-significantly in the IRS+Standard Pyrethroid ITN arm (incidence rate ratio (IRR) 0.94; 95% CI 0.66, 1.47) but increased significantly in the PBO ITN arm (IRR 1.98; 95% CI 1.49, 2.67). Postintervention vector density and IRD were not found to be significantly different between intervention arms in either 2021 (vector density: IRR 0.78; 95% CI 0.47, 1.31; IRD: IRR 0.80; 95% CI 0.37, 1.75) or 2022 (vector density: IRR 1.27; 95% CI 0.75, 2.12; IRD: IRR 1.02; 95% CI 0.45, 2.28).ConclusionThese findings suggest a positive impact of non-pyrethroid IRS deployed annually alongside standard pyrethroid ITNs in a setting of confirmed pyrethroid resistance. While an overall positive impact of PBO ITNs was detected, a waning impact of the nets 2 years postdistribution was observed.
Self-reported determinants for subjective financial distress: a qualitative interview study with German cancer patients
Authors: Züger Andrea , Mathies Viktoria , Mehlis Katja , Pauge Sophie , Richter Luise , Surmann Bastian , Ernst Thomas , Menold Natalja , Greiner Wolfgang , Winkler Eva 
Published: January 2025

ObjectivesPatient-reported financial effects of a tumour disease in a universal healthcare setting are a multidimensional phenomenon. Actual and anticipated objective financial burden caused by direct medical and non-medical costs as well as indirect costs such as loss of income can lead to subjective financial distress. To better understand subjective financial distress, the presented study explores self-reported determinants for subjective financial distress in German patients with cancer, aiming to inform a new German-language patient-reported outcome measure for determining the financial effects of a tumour disease.DesignSemistructured interviews with n=18 patients with cancer were conducted between May 2021 and December 2021. Patients were recruited based on a purposive sampling strategy in outpatient and inpatient settings. The interviews were audiorecorded, transcribed verbatim and analysed using qualitative content analysis.SettingParticipants were recruited from two German academic cancer centres, that is, the National Center for Tumor Diseases Heidelberg and Jena University Hospital.Participants18 patients who had undergone cancer-related therapy for at least 2 months were interviewed (10 females).ResultsBased on the results of the qualitative content analysis, we developed a multicomponent construct of determinants that could influence subjective financial distress. The self-reported determinants can be classified into material (savings, good salary, shared rent through shared living, employed partner, paid-off house, potential financial support from family and friends, work-related specifics, consumer restrictions, out-of-pocket-costs and anticipated financial changes), social (social support from friends and family), systemic (administrative hurdlers and insurance cover) and inner personal determinants (coping strategies, change of attitude, character traits).ConclusionSubjective financial distress depends not only on material but also on social, systemic and inner personal determinants. Knowledge of these determinants can inform a new comprehensive German-language instrument for measuring self-reported financial effects of a tumour disease.Trial registration numberNCT05319925.
Organisational factors associated with burnout among emergency and internal medicine physicians: a qualitative study
Authors: Ghaseminejad Farhad , Rich Kira , Rosenbaum Debbie , Rydz Emilia , Chow Lawrence , Salmon Amy , Palepu Anita , Dodek Peter , Leitch Heather A , Townson Andrea , Lacaille Diane , Varshney Vishal , Stanger Elizabeth , Khan Nadia 
Published: January 2025

ObjectiveTo identify physician perspectives on factors associated with physician burnout, protective factors against burnout, and to seek potential solutions for this pervasive problem.DesignA qualitative study with semistructured focus group interviews using a systematic framework analysis.Setting and participantsPhysicians from general internal medicine (GIM) and the emergency department (ED) at two urban tertiary care hospitals in Vancouver, Canada, were recruited. Separate GIM and ED physician focus groups were conducted virtually from July 2021 to December 2022, led by an independent facilitator. Audio recordings from focus group sessions were then transcribed for analysis.Results41 physicians (29 GIM and 12 ED) participated in the focus groups. The dominant themes for organisational factors attributed to burnout that were highlighted by both groups included heavy workload and scheduling, frequent interruptions, interdepartmental conflict and feeling undervalued by leadership. Other contributing factors that were only emphasised by GIM physicians were pressure to work out-of-scope of their practice, pressure to admit and discharge patients quickly, as well as sexism in the workplace. Factors unique to ED physicians included experiencing violence in the workplace and having to assess patients in waiting rooms. Protective organisational factors included time to build rapport with patients, staff collegiality, working within their scope of practice, and feeling rewarded and valued by leadership. Interventions suggested by physicians included improving channels of communication between staff, increasing flexibility in scheduling and strengthening hospitalists’ services.ConclusionsMost organisational factors driving burnout were common to both GIM and ED physicians, including heavy workload and scheduling, frequent interruptions, interdepartmental conflict and feeling undervalued by leadership. Leveraging protective factors and intervening on organisational factors attributed to burnout such as improving communication and enhancing support services may be effective in addressing the physician burnout epidemic.
Development and validation of a novel risk-predicted model for early sepsis-associated acute kidney injury in critically ill patients: a retrospective cohort study
Authors: Zhao Cong-Cong , Nan Zi-Han , Li Bo , Yin Yan-Ling , Zhang Kun , Liu Li-Xia , Hu Zhen-Jie 
Published: January 2025

ObjectivesThis study aimed to develop a prediction model for the detection of early sepsis-associated acute kidney injury (SA-AKI), which is defined as AKI diagnosed within 48 hours of a sepsis diagnosis.DesignA retrospective study design was employed. It is not linked to a clinical trial. Data for patients with sepsis included in the development cohort were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The least absolute shrinkage and selection operator regression method was used to screen the risk factors, and the final screened risk factors were constructed into four machine learning models to determine an optimal model. External validation was performed using another single-centre intensive care unit (ICU) database.SettingData for the development cohort were obtained from the MIMIC-IV 2.0 database, which is a large publicly available database that contains information on patients admitted to the ICUs of Beth Israel Deaconess Medical Center in Boston, Massachusetts, USA, from 2008 to 2019. The external validation cohort was generated from a single-centre ICU database from China.ParticipantsA total of 7179 critically ill patients with sepsis were included in the development cohort and 269 patients with sepsis were included in the external validation cohort.ResultsA total of 12 risk factors (age, weight, atrial fibrillation, chronic coronary syndrome, central venous pressure, urine output, temperature, lactate, pH, difference in alveolar-arterial oxygen pressure, prothrombin time and mechanical ventilation) were included in the final prediction model. The gradient boosting machine model showed the best performance, and the areas under the receiver operating characteristic curve of the model in the development cohort, internal validation cohort and external validation cohort were 0.794, 0.725 and 0.707, respectively. Additionally, to aid interpretation and clinical application, SHapley Additive exPlanations techniques and a web version calculation were applied.ConclusionsThis web-based clinical prediction model represents a reliable tool for predicting early SA-AKI in critically ill patients with sepsis. The model was externally validated using another ICU cohort and exhibited good predictive ability. Additional validation is needed to support the utility and implementation of this model.
Social inclusion programming for older adults living in age-friendly cities: a scoping review
Authors: Liougas Madalena Pamela , Fortino Adriana , Brozowski Kari , McMurray Josephine 
Published: January 2025

ObjectivesCreating age-friendly cities (AFCs) is essential for supporting older adults’ well-being. The WHO’s 2007 guide outlines key features of AFCs, including social inclusion. Despite increasing numbers of AFC programmes, diverse experiences of ageing are often overlooked. This scoping review explores innovative programmes implemented by AFCs to enhance social inclusion for older adults.DesignA scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.Data sourcesSystematic searches were conducted between December 2023 and January 2024 across relevant databases (Ovid Medline, OVID Embase, OVID PsycINFO, CINAHL, Web of Science, Cochrane Library and Scopus) and the grey literature.Eligibility criteria for selecting studiesSelection criteria included English language publications describing evaluated age-friendly, social inclusion programmes for older adults.Data extraction and synthesisData extraction followed Gonyea and Hudson’s (2015) framework assessing programmes on population, environment and/or sector inclusion levels. Inductive analysis identified and evaluated aspects of social inclusion.ResultsWe identified 20 peer-reviewed publications and 18 grey literature sources. Most programmes (peer review, n=19, 95.0%; grey, n=18, 100.0%) addressed population inclusion, incorporated environment (peer review, n=10, 50.0%; grey, n=15, 83.3%) and/or sector inclusion (peer review, n=7, 35.0%; grey, n=15, 83.3%). Key outcomes included an improved sense of belonging, increased engagement with community resources and activities, enhanced digital literacy and connectivity, and a reduction in feelings of loneliness and isolation. A notable gap was the absence of studies focused on Indigenous populations.ConclusionWe highlight that programmes addressing population, environment and sectoral inclusion may improve the well-being of older adults in urban settings. Our findings will inform AFC practices and policies by deepening our understanding of how social inclusion can be improved for older adults, including those from under-represented groups, ensuring an equitable approach to enhancing quality of life.
Differential attainment at national selection for higher surgical training: a retrospective cohort study
Authors: Ellis Ricky , Al-Tawarah Yasin , Brennan Peter , Lee Amanda , Hines John , Cleland Jennifer 
Published: January 2025

ObjectivesNational selection for higher surgical specialty training (HST) in the UK is a high-stakes gatekeeping assessment. If barriers, such as differential attainment, exist at HST selection for some groups and not others, then this will have a significant and lasting impact on trainees’ career progression and the diversity of the workforce, which should reflect the population it provides care for. The objective of this study was to characterise the relationship between candidate sociodemographic factors and performance at National Selection for HST in the UK.DesignA retrospective cohort study.SettingNational Selection for HST in the UK.ParticipantsAll UK graduates in the UKMED database (https://www.ukmed.ac.uk) who underwent selection for HST from 2012 to 2019.Outcomes and measuresPerformance at HST Selection for each surgical specialty is measured by assessment of the candidate’s academic portfolio and multiple objective structured clinical examination style stations testing knowledge and skills. Univariate analysis identified differences in success rates at first application. Logistic regression models identified sociodemographic predictors of success after adjusting for prior academic attainment (Membership of the Royal College of Surgeons (MRCS) performance).ResultsOf all applications to HST (n=2875), 66.5% were successful at the first attempt. Females were 32% more likely than males to be successful at selection for HST (OR 1.32 (95% CI 1.05 to 1.67)). MRCS performance was found to be a strong independent predictor of future success at HST selection. Females were more likely to be successful at general surgery selection (OR 2.69 (95% CI 1.63 to 4.45)), older candidates (graduates) were less likely to be successful at ENT selection (OR 0.21 (95% CI 0.05 to 0.95)), and candidates that were the first in their family to attend University were less likely to be successful at urology selection (OR 0.41 (95% CI 0.21 to 0.78)).ConclusionsOur findings highlight few statistically significant associations and no consistent patterns between sociodemographic factors and performance at HST selection once we adjusted for prior academic attainment. This suggests that differences in performance on selection into HST may be more likely due to individual rather than group-level differences.
Clinical implication of NT-proBNP to predict mortality in patients with acute type A aortic dissection: a retrospective cohort study
Authors: Liu Shuai , Bian Xiaohui , Liu Qianqian , Zhang Rui , Song Chenxi , Yuan Sheng , Wang Hao , Liu Weida , Gao Jingjing , Cui Xinming , Qin Sijia , Li Yumeng , Zhu Chengang , Fu Rui , Dou Kefei 
Published: January 2025

ObjectivesAcute type A aortic dissection is a life-threatening cardiovascular disease commonly seen in emergency department, resulting in substantial mortality and morbidity. We aimed to investigate the prognostic value of N-terminal pro-B type natriuretic peptide (NT-proBNP) among this critically ill population.DesignThe design of this study was a retrospective cohort study.SettingThe study population was recruited in the Emergency Department of Fuwai hospital in China from 2018 to 2020.ParticipantsWe consecutively enrolled 829 patients with acute type A aortic dissection and measurable baseline NT-proBNP.Primary outcomeThe primary endpoint was 1-year all-cause death.ResultsBased on tertiles of NT-proBNP (pg/mL), patients were stratified into low (≤150.3, n=276), intermediate (150.3–667.6, n=277) and high (>667.6, n=276) NT-proBNP groups. Compared with patients with low NT-proBNP, the Kaplan-Meier estimates for primary 1-year mortality were higher in intermediate (32.5% vs 18.1%; HR 1.91, 95% CI 1.35 to 2.69) and high (42.0% vs 18.1%; HR 2.56, 95% CI 1.84 to 3.57) NT-proBNP groups, respectively. After multivariable regression adjusted for confounders, NT-proBNP tertiles were independent predictors for 1-year mortality (adjusted HR for intermediate group 1.52, 95% CI 1.02 to 2.27; adjusted HR for high group 2.17, 95% CI 1.41 to 3.32). Notably, the predictive performance of NT-proBNP for 1-year mortality was greater in patients receiving surgery than conservative treatment (between-cohorts difference in area under the curve 0.13, Delong’s test p=0.04).ConclusionNT-proBNP provides incremental prognostic information for mortality in patients with acute type A aortic dissection who underwent surgical repairment, which could aid in risk stratification as a pragmatic and versatile biomarker in this critically ill population while having limited prognostic value for those receiving conservative treatment.
Understanding neurocognitive recovery in older adults after total hip arthroplasty—neurocognitive assessment, blood biomarkers and patient experiences: a mixed-methods study
Authors: Amirpour Anahita , Bergman Lina , Markovic Gabriela , Liander Karin , Nilsson Ulrica , Eckerblad Jeanette 
Published: January 2025

ObjectiveDelayed neurocognitive recovery, previously known as postoperative cognitive dysfunction, is a common complication affecting older adults after surgery. This study aims to address the knowledge gap in postoperative neurocognitive recovery by exploring the relationship between subjective experiences, performance-based measurements, and blood biomarkers.DesignMixed-methods study with a convergent parallel (QUAL+quan) design.Setting and participantsThe study reports results from 40 older adult patients (52.5% women; mean age 73, SD 6.7) scheduled for total hip arthroplasty at a hospital in Sweden.Outcome measuresNeurocognitive performance was assessed using a standardised test battery, neuroinflammation through blood biomarker analysis and postoperative neurocognitive recovery via semistructured interviews and the Swedish Quality of Recovery questionnaire.ResultsFive patients were classified as having delayed neurocognitive recovery based on performance tests. Qualitative data revealed that most patients reported cognitive symptoms, particularly related to executive functions and fatigue. Psychological factors, including a sense of agency and low mood, significantly influenced cognitive recovery and daily functioning. Elevated inflammatory blood biomarkers were not detected pre- or postoperatively in patients with delayed neurocognitive recovery. The global postoperative recovery score was 40.9, indicating a low quality of recovery.ConclusionMany patients reported subjective cognitive decline that was not corroborated by delayed neurocognitive recovery in the performance-based tests. Psychological factors were influential for neurocognitive recovery and should be routinely assessed. Future research should incorporate longitudinal follow-ups with performance-based measurements, fatigue assessment, evaluations of instrumental activities of daily living and subjective reporting, supported by a multidisciplinary team approach.Trial registration numberNCT05361460.