bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study protocol for leaving care—A comparison study of implementation, change mechanisms and effectiveness of transition services for youth
Authors: Skoog Therése , Bergström Martin , Karlsson Matilda , Olsson Tina M. 
Published: February 2024

Introduction
Youth placed in out-of-home care is a large and highly vulnerable group at high risk of negative developmental outcomes. Given the size and extent of negative developmental outcomes for youth placed in out-of-home care, interventions to help this vulnerable group navigate successfully towards independent living and promote wellbeing across a spectrum of outcome areas are needed. To date, there is a lack of such interventions, particularly in Sweden. Importing interventions from other societies and cultures is associated with difficulties. The aim of the research project is to implement, test, and evaluate interventions that have been recently developed in Swedish practice to close this gap.

Methods
The project has an ambitious and complex data collection and analysis strategy using qualitative, quantitative, and multiple information methods (hybrid effectiveness-implementation study) over the course of two years. Both the implementation and effectiveness of the interventions will be evaluated. The recently developed My Choice-My Way! leaving care program for youth aged 15+ will be the primary focus of the project and will be compared to usual services.

Conclusions
The project has the potential to offer novel insights into how society can promote wellbeing across a spectrum of outcome areas for the high-risk group of youth transitioning from out-of-home care to independent living. As such, the project will have important implications for both research and practice.

Trial registration
ClinicalTrials.gov Identifier: NCT05813197.
Machine learning-based models for prediction of the risk of stroke in coronary artery disease patients receiving coronary revascularization
Authors: Lin Lulu , Ding Li , Fu Zhongguo , Zhang Lijiao 
Published: February 2024

Background
To construct several prediction models for the risk of stroke in coronary artery disease (CAD) patients receiving coronary revascularization based on machine learning methods.

Methods
In total, 5757 CAD patients receiving coronary revascularization admitted to ICU in Medical Information Mart for Intensive Care IV (MIMIC-IV) were included in this cohort study. All the data were randomly split into the training set (n = 4029) and testing set (n = 1728) at 7:3. Pearson correlation analysis and least absolute shrinkage and selection operator (LASSO) regression model were applied for feature screening. Variables with Pearson correlation coefficient<9 were included, and the regression coefficients were set to 0. Features more closely related to the outcome were selected from the 10-fold cross-validation, and features with non-0 Coefficent were retained and included in the final model. The predictive values of the models were evaluated by sensitivity, specificity, area under the curve (AUC), accuracy, and 95% confidence interval (CI).

Results
The Catboost model presented the best predictive performance with the AUC of 0.831 (95%CI: 0.811–0.851) in the training set, and 0.760 (95%CI: 0.722–0.798) in the testing set. The AUC of the logistic regression model was 0.789 (95%CI: 0.764–0.814) in the training set and 0.731 (95%CI: 0.686–0.776) in the testing set. The results of Delong test revealed that the predictive value of the Catboost model was significantly higher than the logistic regression model (P<0.05). Charlson Comorbidity Index (CCI) was the most important variable associated with the risk of stroke in CAD patients receiving coronary revascularization.

Conclusion
The Catboost model was the optimal model for predicting the risk of stroke in CAD patients receiving coronary revascularization, which might provide a tool to quickly identify CAD patients who were at high risk of postoperative stroke.
Impact of coronavirus disease 2019 on cancer care: How the pandemic has changed cancer utilization and expenditures
Authors: Sim Jinah , Shin Jihye , Lee Hyun Jeong , Lee Yeonseung , Kim Young Ae 
Published: February 2024

Purpose
Since identified in December 2019, the novel coronavirus disease 2019 (COVID-19) has had a global impact on medical resource use and costs for patients with cancer in South Korea. This study aimed to identify the medical use and costs among patients with cancer during the COVID-19 pandemic, to predict these patterns in South Korea in the future.

Methods
We conducted a secondary claims data analysis using the National Health Insurance Service database for the calendar period of 2019–2020. Monthly relative percent changes in cancer incidence, medical use, and billing costs for medical care utilization by cancer type were calculated. Then, the medical use and costs after January 2020 were predicted using a time series model with data before the COVID-19 outbreak (2014–2019).

Results
The incidence of cancer diagnoses has seen a notable decline since the outbreak of the COVID-19 in 2020 as compared to 2019. Despite the impact of COVID-19, there hasn’t been a distinct decline in outpatient utilization when compared to inpatient utilization. While medical expenses for both inpatient and outpatient visits have slightly increased, the number of patients treated for cancer has decreased significantly compared to the previous year. In June 2020, overall outpatient costs experienced the highest increase (21.1%), while individual costs showed the most significant decrease (-4.9%) in June 2020. Finally, the number of hospitalisations and outpatient visits increased slightly from June–July in 2020, reducing the difference between the actual and predicted values. The decrease in the number of inpatient hospitalisations (-22~-6%) in 2020 was also high.

Conclusions
The overall use of medical services by patients with cancer decreased in 2020 compared with that in the pre-COVID-19 pandemic period. In the future, the government should consider how to recover from the COVID-19 pandemic, and establish permanent health policies for patients with cancer.
German funders’ data sharing policies—A qualitative interview study
Authors: Anger Michael , Wendelborn Christian , Schickhardt Christoph 
Published: February 2024

Background
Data sharing is commonly seen as beneficial for science but is not yet common practice. Research funding agencies are known to play a key role in promoting data sharing, but German funders’ data sharing policies appear to lag behind in international comparison. This study aims to answer the question of how German data sharing experts inside and outside funding agencies perceive and evaluate German funders’ data sharing policies and overall efforts to promote data sharing.

Methods
This study is based on sixteen guided expert interviews with representatives of German funders and German research data experts from stakeholder organisations, who shared their perceptions of German’ funders efforts to promote data sharing. By applying the method of qualitative content analysis to our interview data, we categorise and describe noteworthy aspects of the German data sharing policy landscape and illustrate our findings with interview passages.

Results
We present our findings in five sections to distinguish our interviewees’ perceptions on a) the status quo of German funders’ data sharing policies, b) the role of funders in promoting data sharing, c) current and potential measures by funders to promote data sharing, d) general barriers to those measures, and e) the implementation of more binding data sharing requirements.

Discussion and conclusion
Although funders are perceived to be important promoters and facilitators of data sharing throughout our interviews, only few German funding agencies have data sharing policies in place. Several interviewees stated that funders could do more, for example by providing incentives for data sharing or by introducing more concrete policies. Our interviews suggest the academic freedom of grantees is widely perceived as an obstacle for German funders in introducing mandatory data sharing requirements. However, some interviewees stated that stricter data sharing requirements could be justified if data sharing is a part of good scientific practice.
Training for endovascular therapy of acute arterial disease and procedure-related complication: An extracorporeally-perfused human cadaver model study
Authors: Hartung Viktor , Augustin Anne Marie , Grunz Jan-Peter , Huflage Henner , Hennes Jan-Lucca , Kleefeldt Florian , Ergün Süleyman , Peter Dominik , Lichthardt Sven , Bley Thorsten Alexander , Gruschwitz Philipp 
Published: February 2024

Purpose
The aim of this study was to evaluate the usability of a recently developed extracorporeally-perfused cadaver model for training the angiographic management of acute arterial diseases and periprocedural complications that may occur during endovascular therapy of the lower extremity arterial runoff.

Materials and methods
Continuous extracorporeal perfusion was established in three fresh-frozen body donors via inguinal and infragenicular access. Using digital subtraction angiography for guidance, both arterial embolization (e.g., embolization using coils, vascular plugs, particles, and liquid embolic agents) and endovascular recanalization procedures (e.g., manual aspiration or balloon-assisted embolectomy) as well as various embolism protection devices were tested. Furthermore, the management of complications during percutaneous transluminal angioplasty, such as vessel dissection and rupture, were exercised by implantation of endovascular dissection repair system or covered stents. Interventions were performed by two board-certified interventional radiologists and one resident with only limited angiographic experience.

Results
Stable extracorporeal perfusion was successfully established on both thighs of all three body donors. Digital subtraction angiography could be performed reliably and resulted in realistic artery depiction. The model allowed for repeatable training of endovascular recanalization and arterial embolization procedures with typical tactile feedback in a controlled environment. Furthermore, the handling of more complex angiographic devices could be exercised. Whereas procedural success was be ascertained for most endovascular interventions, thrombectomies procedures were not feasible in some cases due to the lack of inherent coagulation.

Conclusion
The presented perfusion model is suitable for practicing time-critical endovascular interventions in the lower extremity runoff under realistic but controlled conditions.
Is there a shift from cardiovascular to cancer death in lipid-lowering trials? A systematic review and meta-analysis
Authors: Bolt Lucy , Speierer Alexandre , Bétrisey Sylvain , Aeschbacher-Germann Martina , Blum Manuel R. , Gencer Baris , Del Giovane Cinzia , Aujseky Drahomir , Moutzouri Elisavet , Rodondi Nicolas 
Published: February 2024

Background
Lipid-lowering therapy (LLT) reduces cardiovascular (CV) events, but data are conflicting on all-cause mortality, especially among older adults. Though LLT does not induce cancer, some randomized clinical trials (RCTs) found a pattern of increased cancer death under LLT. Our objective was to assess a possible shift from CV to cancer death in LLT trials (i.e. an increase in cancer and decrease in CV death) and to investigate potential subgroups at risk.

Methods
We performed a systematic review and meta-analysis. We retrieved RCTs from MEDLINE, Embase, and Cochrane Central until 08/2023. We extracted the number of CV and cancer deaths in the treatment vs. in the control arm, calculated the relative risk (RR) by dividing the risk of death in the treatment over the risk of death in the control group and then pooled them using random-effect meta-analysis. We performed subgroup analyses on primary and secondary prevention, and according to different age cut-offs.

Results
We included 27 trials with 188’259 participants (23 statin; 4 ezetimibe trials). The trials reported 4056 cancer deaths, 2061 under LLT and 1995 in control groups. Overall, there was no increased risk of cancer mortality (RR 1.03, 95% confidence interval 0.97–1.10), with no difference between primary and secondary prevention. In the subgroup analyses for RCTs with ≥15% of participants aged ≥75 years, the RR of cancer death was 1.11 (1.00–1.23), while the RR for CV death was 0.96 (0.91–1.01). For RCTs with a mean age ≥ 70 years, the RR for cancer death was 1.21 (0.99–1.47).

Conclusion
LLT does not lead to a shift from CV to cancer death. However, there might be a possible shift with a pattern of increased cancer deaths in trials with more older adults, particularly ≥75 years. Individual participant data from LLT trials should be made public to allow further investigations.

PROSPERO registration
CRD42021271658
Small dense low density lipoprotein predominance in patients with type 2 diabetes mellitus using Mendelian randomization
Authors: Zhang Fengyi , Zhang Yufeng , Zhang Jiayi , Wang Xin , Li Yujie , Wang Wenbo 
Published: February 2024

Background
Patients with T2DM often suffer from CVD-related complications, significantly impacting morbidity and mortality rates. The upsurge in CVD prevalence among them is partly linked to sd LDL particles. Understanding the mechanisms behind elevated sd LDL levels is critical for preventing and managing cardiovascular complications in diabetes.

Methods
MR was employed to identify instrumental variables and establish causality, exploring underlying mechanisms.

Results
Notably, T2DM itself, insulin resistance, and fasting glucose seemingly do not directly impact sd LDL levels. Instead, the presence of T2DM or insulin resistance, leading to reduced HDL cholesterol or elevated TG levels, directly contributes to subsequent sd LDL increases, indicating a comprehensive mediating effect. While LDL cholesterol levels correlate positively with sd LDL, they appear unaffected by T2DM or insulin resistance. Importantly, hypertension induced by T2DM or insulin resistance exhibits a positive effect on sd LDL reversal. Unlike T2DM or insulin resistance, blood glucose levels show no significant impact on all processes.

Conclusions
It is hoped that these insights might influence the treatment of patients with diabetes and the management of blood parameters in clinical practice. Examining the effect of T2DM or insulin resistance on sd LDL within HDL cholesterol and triglycerides pathways might provide valuable insights for targeted cardiovascular treatments. Additionally, the study’s exploration of the potential positive effects of elevated blood pressure on sd LDL reversal may introduce novel considerations for blood pressure management in patients with diabetes.
Hospital-level variation in hospitalization costs for spinal fusion in the United States
Authors: Curry Joanna , Cho Nam Yong , Nesbit Shannon , Kim Shineui , Ali Konmal , Gudapati Varun , Everson Richard , Benharash Peyman 
Published: February 2024

BackgroundWith a growing emphasis on value of care, understanding factors associated with rising healthcare costs is increasingly important. In this national study, we evaluated the degree of center-level variation in the cost of spinal fusion.MethodsAll adults undergoing elective spinal fusion were identified in the 2016 to 2020 National Inpatient Sample. Multilevel mixed-effect models were used to rank hospitals based on risk-adjusted costs. The interclass coefficient (ICC) was utilized to tabulate the amount of variation attributable to hospital-level characteristics. The association of high cost-hospital (HCH) status with in-hospital mortality, perioperative complications, and overall resource utilization was analyzed. Predictors of increased costs were secondarily explored.ResultsAn estimated 1,541,740 patients underwent spinal fusion, and HCH performed an average of 9.5% of annual cases. HCH were more likely to be small (36.8 vs 30.5%, p<0.001), rural (10.1 vs 8.8%, p<0.001), and located in the Western geographic region (49.9 vs 16.7%, p<0.001). The ICC demonstrated 32% of variation in cost was attributable to the hospital, independent of patient-level characteristics. Patients who received a spinal fusion at a HCH faced similar odds of mortality (0.74 [0.48–1.15], p = 0.18) and perioperative complications (1.04 [0.93–1.16], p = 0.52), but increased odds of non-home discharge (1.30 [1.17–1.45], p<0.001) and prolonged length of stay (β 0.34 [0.26–0.42] days, p = 0.18). Patient factors such as gender, race, and income quartile significantly impacted costs.ConclusionThe present analysis identified 32% of the observed variation to be attributable to hospital-level characteristics. HCH status was not associated with increased mortality or perioperative complications.
Intracellular presence of Helicobacter pylori antigen and genes within gastric and vaginal Candida
Authors: Yang Tingxiu , Li Jia , Zhang Yuanyuan , Deng Zhaohui , Cui Guzhen , Yuan Jun , Sun Jianchao , Wu Xiaojuan , Hua Dengxiong , Xiang Song , Chen Zhenghong 
Published: February 2024

Background
Helicobacter pylori infections are generally acquired during childhood and affect half of the global population, but its transmission route remains unclear. It is reported that H. pylori can be internalized into Candida, but more evidence is needed for the internalization of H. pylori in human gastrointestinal Candida and vaginal Candida.

Methods
Candida was isolated from vaginal discharge and gastric mucosa biopsies. We PCR-amplified and sequenced H. pylori-specific genes from Candida genomic DNA. Using optical and immunofluorescence microscopy, we identified and observed bacteria-like bodies (BLBs) in Candida isolates and subcultures. Intracellular H. pylori antigen were detected by immunofluorescence using Fluorescein isothiocyanate (FITC)-labeled anti-H. pylori IgG antibodies. Urease activity in H. pylori internalized by Candida was detected by inoculating with urea-based Sabouraud dextrose agar, which changed the agar color from yellow to pink, indicating urease activity.

Results
A total of 59 vaginal Candida and two gastric Candida strains were isolated from vaginal discharge and gastric mucosa. Twenty-three isolates were positive for H. pylori 16S rDNA, 12 were positive for cagA and 21 were positive for ureA. The BLBs could be observed in Candida cells, which were positive for H. pylori 16S rDNA, and were viable determined by the LIVE/DEAD BacLight Bacterial Viability kit. Fluorescein isothiocyanate (FITC)-conjugated antibodies could be reacted specifically with H. pylori antigen inside Candida cells by immunofluorescence. Finally, H. pylori-positive Candida remained positive for H. pylori 16S rDNA even after ten subcultures. Urease activity of H. pylori internalized by Candida was positive.

Conclusion
In the form of BLBs, H. pylori can internalize into gastric Candida and even vaginal Candida, which might have great significance in its transmission and pathogenicity.
“[...] o negócio sempre acaba no médico”
Authors: Franchini da Silva Bianca 
Published: February 2024

Sob a mirada da arqueogenealogia foucaultiana, estimada pelos estudos do campo discursivo e pela Linguística Aplicada (LA) Contemporânea, associada a estudos feministas e de gênero, este artigo objetiva analisar os discursos sobre as mulheres cisgênero que inseriram (ou que pretendem inserir) o Dispositivo Intrauterino (DIU) de cobre, tendo em vista os efeitos inventariados por esses discursos na relação médico-enfermeiro-paciente. O corpus é formado por excertos de duas entrevistas semiestruturadas: uma realizada com um médico ginecologista-obstetra; e outra com uma técnica em enfermagem – ambos funcionários do (microespaço) Serviço de Atendimento à Saúde da Comunidade Universitária (SASC), do Hospital Universitário (HU), da Universidade Federal de Santa Catarina (UFSC). A partir dos conceitos de discurso, dispositivo e biopolítica de Foucault, em diálogo com a farmacopornografia de Preciado, as regularidades discursivas apontadas nas entrevistas analisadas possibilitam defender – tanto na construção de si que o médico faz como perito que ocupa um lugar estratégico de diferente quanto na sobrevivência de estratégias de poder pastoral nos discursos da técnica de enfermagem – o funcionamento do dispositivo microprotético DIU. Este, transitando entre discursos e práticas agonísticos/ambíguos, produz marcas de objetivação e subjetivação às mulheres que o aderem, forjando tecnobiodiscursivamente determinadas corporalidades a elas.

Palavras-chave: Biopolítica; Dispositivos; Tecnobiodiscurso; Saúde reprodutiva das mulheres; Dispositivo microprotético DIU.
Trans‐spinal magnetic stimulation induces co‐activation of the diaphragm and biceps in healthy subjects
Authors: Ren Ming‐Yue , Liou Li‐Min , Vinit Stéphane , Lee Kun‐Ze 
Published: February 2024

AbstractThe present study was designed to examine the effect of trans‐spinal magnetic stimulation on bilateral respiratory and forelimb muscles in healthy subjects. Two wings of a figure‐of‐eight magnetic coil were placed on the dorsal vertebrae, from the fifth cervical to the second thoracic dorsal vertebra with a center at the seventh cervical vertebra. The surface electromyograms of bilateral diaphragm and biceps were recorded in response to trans‐spinal magnetic stimulation with 20%–100% maximum output of the stimulatory device in male (n = 12) and female participants (n = 8). Trans‐spinal magnetic stimulation can induce a co‐activation of bilateral diaphragm and biceps when the stimulation intensity is above 60%. The onset latency was comparable between the left and right sides of the muscles, suggesting bilateral muscles could be simultaneously activated by trans‐spinal magnetic stimulation. In addition, the intensity–response curve of the biceps was shifted upward compared with that of the diaphragm in males, indicating that the responsiveness of the biceps was greater than that of the diaphragm. This study demonstrated the feasibility of utilizing trans‐spinal magnetic stimulation to co‐activate the bilateral diaphragm and biceps. We proposed that this stimulatory configuration can be an efficient approach to activate both respiratory and forelimb muscles.
Perceived teacher feedback practices, student feedback motivation and engagement in English learning: a survey of Chinese university students
Authors: Gan Zhengdong , Wang Xianrong 
Published: February 2024

Abstract
Drawing on recent theorizing of feedback in educational assessment and psychology, the current study aimed to examine the links between perceived teacher feedback practices, student feedback motivation and engagement in English learning. Seven hundred and sixty-four Chinese university students attending a tertiary-level English enhancement course (N = 764; age: M = 19.45, SD = 0.88; 57.3 % female) participated in this study. The students completed surveys measuring their perceived teacher feedback practices, feedback motivation and engagement. Scaffolding feedback, verification feedback, and criticism were found to significantly predict student feedback motivation. Feedback enjoyment significantly predicted student feedback engagement, but there was no positive significant relationship between perceived feedback usefulness and feedback engagement. Indirect effects testing provided empirical evidence that student feedback motivation mediated the impact of teacher feedback on student feedback engagement in a university English enhancement course context.