bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is the long-term mortality similar in COVID-19 and community-acquired pneumonia?
Authors: Méndez Raúl , González-Jiménez Paula , Latorre Ana , Mengot Noé , Zalacain Rafael , Ruiz Luis A. , Serrano Leyre , España Pedro P. , Uranga Ane , Cillóniz Catia , Hervás David , Torres Antoni , Menéndez Rosario ,   NEUMONAC,   RECOVID
Published: October 2023

IntroductionThere are no data on the association of type of pneumonia and long-term mortality by the type of pneumonia (COVID-19 or community-acquired pneumonia [CAP]) on long-term mortality after an adjustment for potential confounding variables. We aimed to assess the type of pneumonia and risk factors for long-term mortality in patients who were hospitalized in conventional ward and later discharged.MethodsRetrospective analysis of two prospective and multicentre cohorts of hospitalized patients with COVID-19 and CAP. The main outcome under study was 1-year mortality in hospitalized patients in conventional ward and later discharged. We adjusted a Bayesian logistic regression model to assess associations between the type of pneumonia and 1-year mortality controlling for confounders.ResultsThe study included a total of 1,693 and 2,374 discharged patients in the COVID-19 and CAP cohorts, respectively. Of these, 1,525 (90.1%) and 2,249 (95%) patients underwent analysis. Until 1-year follow-up, 69 (4.5%) and 148 (6.6%) patients from the COVID-19 and CAP cohorts, respectively, died (p = 0.008). However, the Bayesian model showed a low probability of effect (PE) of finding relevant differences in long-term mortality between CAP and COVID-19 (odds ratio 1.127, 95% credibility interval 0.862–1.591; PE = 0.774).ConclusionCOVID-19 and CAP have similar long-term mortality after adjusting for potential confounders.
Casual effects of gut microbiota on risk of infections: a two-sample Mendelian randomization study
Authors: Lyu Beibei , Ma Jinghang , Bai Yongyu , Feng Zhen 
Published: October 2023

BackgroundThe correlation between gut microbiota and infections has garnered significant attention in previous studies; nevertheless, our understanding of the causal relationships and mechanisms between specific microbial species and infections remains limited.MethodsThis study aimed to employ Mendelian randomization (MR) using single-nucleotide polymorphisms (SNPs) and genome-wide association study (GWAS) data of European ancestry to explore the genetic-level relationships between distinct types of gut microbiota and susceptibility to infections. Our analysis encompassed three prevalent infections: intestinal infections, pneumonia, and urinary tract infections, while concurrently examining various types of gut microbiota.ResultsWe identified 18 protective gut microbiotas alongside 13 associated with increased infection risk. Particularly noteworthy are certain microbial communities capable of producing butyrate, such as the Ruminococcaceae and Lachnospiraceae families, which exhibited both favorable and unfavorable effects. Additionally, we observed a few certain communities linked to infection susceptibility, including ErysipelotrichaceaeUCG003 (OR = 0.13, 95% CI: 0.054–0.33, p = 1.24E-05), Collinsella (OR = 3.25, 95% CI: 2.00–5.27, p = 1.87E-06), and NB1n (OR = 1.24, 95% CI: 1.09–1.40, p = 1.12E-03).ConclusionThis study reveals complex relationships between gut microbiota and various infections. Our findings could potentially offer new avenues for exploring prevention and treatment strategies for infectious diseases.
Significant potential of melatonin therapy in Parkinson’s disease – a meta-analysis of randomized controlled trials
Authors: Iftikhar Sadaf , Sameer Hafiz Muhammad , Zainab  
Published: October 2023

ObjectiveSince its discovery as an antioxidant, melatonin has been increasingly recognized for its therapeutic potential beyond sleep disturbances in neurodegenerative disorders. This study aims to evaluate efficacy of various melatonin doses, treatment durations, and formulations, in alleviating motor symptoms and sleep disturbances in Parkinson’s disease, the second most common neurodegenerative disorder worldwide.MethodsPubMed, Cochrane Library, ClinicalTrials.gov and other databases were systematically searched to retrieve randomized controlled trials (RCTs) administrating melatonin to Parkinson’s disease patients until June 10th, 2023. Outcomes including Unified Parkinson Disease Rating Scale (UPDRS) scores and Pittsburgh Sleep Quality Index (PSQI) scores, were pooled and reported as mean differences (MD) with 95% confidence intervals (CIs). Meta-analysis was performed using an inverse variance random-effects model in Review Manager 5.4 software. Trial Sequential Analysis was performed to avoid false-positive results from random errors.ResultsFive RCTs with a total of 155 patients were included. Statistically significant reductions in UPDRS total scores were observed in groups receiving Melatonin ≥10 mg/day (MD = −11.35, 95% CI: −22.35 to −0.35, I2 = 0%, p = 0.04) and immediate release formulations (MD = −11.35, 95% CI: −22.35 to −0.35, I2 = 0%, p = 0.04). No significant effects on individual UPDRS II, III, and IV scores were observed, regardless of melatonin dosage and treatment duration. Moreover, significant improvements in PSQI scores were observed with only immediate-release melatonin formulations (MD = −2.86, 95% CI: −4.74 to −0.97, I2 = 0%, p = 0.003).ConclusionMelatonin ≥10 mg/day for a minimum duration of ≥12 weeks in immediate-release formulations consistently demonstrated significant therapeutic potential in improving motor symptom and sleep disturbances in Parkinson disease. However, further trials are warranted to investigate its impact when initiated early in the disease course to fully explore its true therapeutic potential.Systematic review registrationUnique identifier: CRD42023427491 (PROSPERO).
Visual bibliometric analysis of electroacupuncture research in stroke treatment: a 20-year overview
Authors: Chun Hyonjun , Shin Woo-Chul , Kim Jong-min , Kim Hyungsuk , Cho Jae-Heung , Song Mi-Yeon , Chung Won-Seok 
Published: October 2023

BackgroundElectroacupuncture has been used as a treatment; however, a visual bibliometric analysis has not yet been performed in this field. In this study, we aimed to suggest future research topics and directions related to the field by examining the last 20 years of research trends and hotspots of electroacupuncture in stroke.MethodsWe searched the Web of Science database on electroacupuncture as a treatment for stroke published from 2003 to 2022. We analyzed the papers by annual publication, research fields, nations, affiliations, authors, journals, and keywords. VOSviewer software was used to visualize the bibliometric analysis and results. A total of 440 papers were included in the analysis.ResultsThe number of publications has gradually increased every year, and neuroscience has become the most actively studied field. Neural Regeneration Research journal and China had the most publications. Fujian University of Traditional Chinese Medicine, as an affiliated institute, published the most articles. Chen Lidian and Tao Jing presented the largest number of papers, making them the leading contributors in this field. Four clusters were created by analyzing keywords, such as “neuroprotection,” “clinical rehabilitation,” “neuroplasticity,” and “pretreatment-induced tolerance”.ConclusionThis study is the first to analyze the research trends in electroacupuncture as a treatment for stroke using the VOSviewer. It shows the current state of research in the field by visualizing research trends and hotspots. This will help offer reference data for future studies.
CritCom: assessment of quality of interdisciplinary communication around deterioration in pediatric oncologic patients
Authors: Rivera Jocelyn , Malone Sara , Puerto-Torres Maria , Prewitt Kim , Counts Lara , Wiphatphumiprates Parima , Sakaan Firas , Al Zebin Zebin , Arias Anita V. , Bhattacharyya Parthasarathi , Gunasekera Sanjeeva , Johnson Sherry , Kambugu Joyce , Kaye Erica C. , Mandrell Belinda , Mack Jennifer , McArthur Jennifer , Mendez Alejandra , Morrissey Lisa , Sharara-Chami Rana , Snaman Jennifer , Sniderman Elizabeth , Luke Douglas A. , Graetz Dylan E. , Agulnik Asya 
Published: October 2023

BackgroundHigh-quality clinical care requires excellent interdisciplinary communication, especially during emergencies, and no tools exist to evaluate communication in critical care. We describe the development of a pragmatic tool focusing on interdisciplinary communication during patient deterioration (CritCom).MethodsThe preliminary CritCom tool was developed after a literature review and consultation with a multidisciplinary panel of global experts in communication, pediatric oncology, and critical care to review the domains and establish content validity iteratively. Face and linguistic validity were established through cognitive interviews, translation, and linguistic synthesis. We conducted a pilot study among an international group of clinicians to establish reliability and usability.ResultsAfter reviewing 105 potential survey items, we identified 52 items across seven domains. These were refined through cognitive interviews with 36 clinicians from 15 countries. CritCom was piloted with 433 clinicians (58% nurses, 36% physicians, and 6% other) from 42 hospitals in 22 countries. Psychometric testing guided the refinement of the items for the final tool. CritCom comprised six domains with five items each (30 total). The final tool has excellent reliability (Cronbach’s alpha 0.81-0.86), usability (93% agree or strongly agree that the tool is easy to use), and similar performance between English and Spanish tools. Confirmatory factor analysis was used to establish the final 6-domain structure.ConclusionsCritCom is a reliable and pragmatic bilingual tool to assess the quality of interdisciplinary communication around patient deterioration for children in diverse resource levels globally. Critcom results can be used to design and evaluate interventions to improve team communication.
Effect of Astragali radix extract on pharmacokinetic behavior of dapagliflozin in healthy and type 2 diabetic rats
Authors: Du Wandi , Hu Jiarong , Liang Jingru , Yang Xiaolei , Fang Boyu , Ma Guo 
Published: October 2023

Objective: This study aimed to investigate effect of antidiabetic herb Astragali Radix (AR) on pharmacokinetic behavior of dapagliflozin (DAPA) in healthy rats and type 2 diabetes mellitus (T2DM) rats.Methods: The T2DM rats were induced by high-fat diet (HFD) and intraperitoneal injection of streptozotocin (STZ). Concentrations of DAPA in healthy and T2DM rat plasma were determined by UPLC-MS/MS method. Effect of AR extract (ARE) on pharmacokinetic behavior of DAPA in healthy and T2DM rats was evaluated, respectively.Results: The diabetes status and co-administrated with ARE significantly affected pharmacokinetic behaviors of DAPA in the rats. Compared to that in healthy rats, tmax of DAPA significantly shortened, its Cmax significantly increased in T2DM rats, and its t1/2, V, AUC, CL and MRT kept unchanged. When ARE was co-administrated with DAPA, Cmax of DAPA significantly increased, its tmax and MRT significantly decreased, and its t1/2, V, AUC and CL kept unchanged in healthy rats. tmax and Cmax of DAPA significantly decreased, its t1/2 and V significantly increased, and its AUC, CL and MRT were unchanged in T2DM rats when ARE was co-administrated with DAPA. Co-administration of DAPA and ARE promoted absorptive rate of DAPA, increased its extravascular tissue distribution, and prolonged its duration of action. ARE did not cause accumulation of DAPA in vivo.Conclusion: Both disease status of T2DM and co-administration of ARE affect pharmacokinetic behavior of DAPA in vivo. Potential pharmacokinetic interactions may occur in vivo when herbs and drugs are co-administrated, which may affect efficacy and safety of drugs.
A retrospective real-world study of early short-course remdesivir in non-hospitalized COVID-19 patients at high risk for progression: low rate of hospitalization or death, regardless of immunocompetence status
Authors: Ramos-Rincón José Manuel , Pinargote-Celorio Héctor , Llenas-García Jara , Moreno-Pérez Oscar , González-Cuello Inmaculada , Gonzalez-de-la-Aleja Pilar , Martínez-López Belén , Reus Sergio , García-López María , Rodríguez Juan Carlos , Boix Vicente , Merino Esperanza 
Published: October 2023

Introduction: The evidence for remdesivir therapy in immunocompromised patients is scarce. To evaluate remdesivir (RDV) effectiveness and safety in COVID-19 outpatients at high risk for progression in a real-world setting, we compare the outcome in immunocompromised (IC) patients with that in non-immunocompromised patients.Methods: Two hospitals conducted a retrospective study of all adult patients with mild-to-moderate SARS-CoV-2 infection at high risk for disease progression who were treated as outpatients with a 3-day course of RDV (1st January−30th September 2022). The primary effectiveness endpoint was a composite of any cause of hospitalization or death by day 30. A multiple logistic regression model was built to explore the association between immune status and clinical outcome, estimating adjusted odds ratios [aORs (95% CI)].Results: We have included 211 patients, of which 57% were males, with a median age of 65 years (IQR 53–77), 70.1% were vaccinated (three or four doses), and 61.1% were IC. The median duration of symptoms before RDV treatment was 3 days (IQR 2–5). During follow-up, 14 (6.6%) patients were hospitalized, of which 6 (2.8%) were hospitalized for COVID-19 progression. No patient required mechanical ventilation, and two patients died (non-COVID-19-related). After accounting for potential confounders, only anti-CD20 treatment was associated with the composed outcome [aOR 5.35 (1.02–27.5, 95% CI)], whereas the immunocompetence status was not [aOR 1.94 (0.49–7.81, 95% CI)].Conclusion: Early COVID-19 outpatient treatment with a 3-day course of remdesivir in vaccinated patients at high risk for disease progression during the Omicron surge had a good safety profile. It was associated with a low rate of all-cause hospitalization or death, regardless of immunocompetence status.
Antiosteoporosis medications and cardiovascular disease: a population-based nationwide nested case–control study
Authors: Tsai Wen-Hsuan , Sung Fung-Chang , Muo Chih-Hsin , Tsai Ming-Chieh , Wu Shu-I. 
Published: October 2023

Purpose: Patients with osteoporosis are at an increased risk of cardiovascular disease (CVD). Several antiosteoporosis medications have been demonstrated with the benefit of preventing osteoporosis. Our aim is to assess the CVD risks associated with antiosteoporosis medications using the National Health Insurance Research Database in Taiwan between 2000 and 2016.Methods: Among 41,102 patients of 40+ years old with newly diagnosed osteoporosis, 69.1% (N = 28,387) of patients were included in the user cohort of antiosteoporosis medicines, of whom 13, 472 developed CVD by the end of 2016, while 14,915 did not. Using the nested case–control analysis in the user cohort (88.0% women and 77.4% elderly), we applied conditional logistic regression to estimate odds ratios (ORs) of eight types of CVD for the users of denosumab, bisphosphonate, teriparatide, and hormone replacement therapy (HRT).Results: The adjusted ORs of overall CVDs were 0.13 (95% CI: 0.12–0.15) for denosumab users, 0.52 (95% CI: 0.45–0.61) for teriparatide users, and 0.80 (95% CI: 0.76–0.85) for bisphosphonate users. The HRT users were at higher odds of coronary artery and peripheral artery diseases, heart failure, pulmonary embolism, and deep vein thrombosis.Conclusion: Denosumab, teriparatide, and bisphosphonate may have more protective effects against CVD than hormone therapy. Physicians may take subsequent cardiovascular risks into account when choosing an adequate antiosteoporosis medication for patients with osteoporosis.
Perceptions of registered nurses on facilitators and barriers of implementing the AI-IoT-based healthcare pilot project for older adults during the COVID-19 pandemic in South Korea
Authors: Boo Sunjoo , Oh Hyunjin 
Published: October 2023

ObjectiveThis study explored the perceptions of registered nurses on the facilitators and barriers to implementing an AI/IoT (Artificial Intelligence/Internet of Things)-based healthcare pilot project, designed to prevent frailty and improve health behaviors by providing Bluetooth-enabled smart devices (including blood pressure and blood glucose meters) for the older adults aged over 65 years and above in South Korea.MethodsUsing a qualitative descriptive methodology, interviews and qualitative surveys were conducted with 15 registered nurses from 11 public health centers. Data were analyzed using qualitative content analysis.ResultsThe study found that the AI·IoT-based healthcare pilot project was well received by participants, leading to increased client satisfaction and improved health behaviors. Government support and funding were crucial facilitators of project implementation. However, technical challenges and disparities in digital literacy among older adults pose significant barriers.ConclusionThe findings highlight the potential of AI·IoT technologies in improving the healthcare of older adults. Efforts to address technological challenges and enhance digital literacy among vulnerable populations are necessary for successfully implementing such interventions. Government support and ongoing training for healthcare professionals can help optimize the AI·IoT-based healthcare services for older adults.
DB-COVIDNet: A Defense Method against Backdoor Attacks
Authors: Shamshiri Samaneh , Han Ki Jin , Sohn Insoo 
Published: October 2023

With the emergence of COVID-19 disease in 2019, machine learning (ML) techniques, specifically deep learning networks (DNNs), played a key role in diagnosing the disease in the medical industry due to their superior performance. However, the computational cost of deep learning networks (DNNs) can be quite high, making it necessary to often outsource the training process to third-party providers, such as machine learning as a service (MLaaS). Therefore, careful consideration is required to achieve robustness in DNN-based systems against cyber-security attacks. In this paper, we propose a method called the dropout-bagging (DB-COVIDNet) algorithm, which works as a robust defense mechanism against poisoning backdoor attacks. In this model, the trigger-related features will be removed by the modified dropout algorithm, and then we will use the new voting method in the bagging algorithm to achieve the final results. We considered AC-COVIDNet as the main inducer of the bagging algorithm, which is an attention-guided contrastive convolutional neural network (CNN), and evaluated the performance of the proposed method with the malicious COVIDx dataset. The results demonstrated that DB-COVIDNet has strong robustness and can significantly reduce the effect of the backdoor attack. The proposed DB-COVIDNet nullifies backdoors before the attack has been activated, resulting in a tremendous reduction in the attack success rate from 99.5% to 3% with high accuracy on the clean data.
Exploring the feasibility of outdoor indigenous games and songs to enhance play-based pedagogy in early childhood education
Authors: Matafwali Beatrice , Mofu Mubanga 
Published: October 2023

Indigenous play activities are crucial to cross-cultural knowledge and practice and are gaining ground as a pedagogical approach in early childhood education settings. The study aimed at systematically documenting culturally and developmentally appropriate outdoor indigenous games that could serve as resource materials for play-based learning in ECE centres. Participants comprising teachers, parents, grandparents, and adolescent girls and boys were drawn from Lufwanyama district of Zambia. Data was generated through Participatory Action Research to allow inter-cultural dialogue. Data was analysed using thematic categorisation. Results showed that documentation of indigenous games can serve as a resource capital for enhancing play-based learning practice in an early childhood education setting. The study further revealed that integrating indigenous games can strengthen home-school linkages through active community engagement. The study recommends that teachers can effectively implement play-based learning when the reservoir of developmentally appropriate indigenous games is easily accessible to them. We further argue for rethinking early childhood education pedagogical practice so that learning and development are seen as being influenced more by contextually responsive play and exploration, than by direct instruction and teaching.
Parenting styles and the connection with nature: A look into a nature program
Authors: Figueiredo Aida , Raposo Rosa , Bem-Haja Pedro , Costa Maria 
Published: October 2023

Currently, there seems to be a decline in direct experiences of nature, with a consequent decrease in connection with nature, which could unavoidably result in negative consequences, especially in what concerns children. With the goal of narrowing this ever-growing gap, as well as raising awareness for the importance of outdoor spaces/nature as promoters of development and learning, the Invisible Limits Project (IL) was founded. Thus, the present investigation aimed to better understand the enrollment motives, sociodemographic variables, parenting styles and Nature Relatedness (NR) of parents who enrolled their children in IL, as well as to analyze these same variables and identify parent profiles based on NR and frequency of nature contact, while additionally attempting to ascertain the role of contact with nature as a predictor of NR, all in an effort to rethink and improve existing educational offers. The investigation follows a comparative typology, counting 286 total participants, divided into an experimental group (n=135) - comprised of those who enrolled their children in IL - and a control group (n=151), to which the previous criterion did not apply. For the statistical analysis of the collected data, IBM SPSS Statistics v25, jamovi v1.6, JASP 0.16.1.0 and MaxQDA v2020.4 were used. In what pertains to the results, the main reason for parents to enrol their children in an educational experience in nature was the promotion of contact with nature. Additionally, there were no observable differences between groups, regarding both parenting styles and NR. Concomitantly, frequent contact with nature (both during childhood and throughout life) was determined to be a predictor of a higher NR. In view of the results and in view of the current climate changes, as well as life’s sustainability on the planet, further studies are required, in order to better understand one’s connection with nature.