bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative efficacy of aflibercept and ranibizumab in the treatment of age-related macular degeneration with retinal pigment epithelial detachment: a systematic review and network meta-analysis
Authors: Sun Zuhua , Yang Yating , Lin Bing , Huang Ying , Zhou Rong , Yang Chun , Li Yingzi , Huang Shenghai , Liu Xiaoling 
Published: November 2023

Abstract
Objectives
To evaluate the efficacy of anti-vascular endothelial growth factor (VEGF) in treatment of age-related macular degeneration (AMD) with retinal pigment epithelial detachment (PED).

Methods
Systematic review identifying studies comparing intravitreal ranibizumab (IVR), intravitreal aflibercept (IVA) and intravitreal conbercept (IVC) published before Mar 2022.

Results
One randomized controlled trial and 6 observational studies were selected for meta-analysis (1,069 patients). The change of best corrected visual acuity (BCVA) in IVA 2.0 mg group was better than IVR 0.5 mg (average difference 0.07) and IVR 2.0 mg (average difference 0.10), the differences were statistically significant. The change of the height of PED in IVA 2.0 group was better than IVR 0.5 group (average difference 45.30), the difference was statistically significant. The proportion of patients without PED at last visit in IVA 2.0 group were better than those in IVR 2.0 group (hazard ratio 1.91), the difference was statistically significant. There was no significant difference compared with IVR 0.5 group (hazard ratio 1.45). IVA required fewer injections than IVR, with a mean difference of -1.58.

Conclusions
IVA appears to be superior to IVR in improvement of BCVA, height decrease of PED and regression of PED with less injections in nAMD with PED.
The prevalence of malnutrition among critically ill children: a systematic review and meta-analysis
Authors: Abera Eyob Girma , Sime Habtamu 
Published: November 2023

Abstract
Background
Critically ill children have a lower nutritional reserve, compounding the restricted food intake during intensive care unit (ICU) and hospital stays, and scarce data are available to point out the problem. Therefore, this review aimed to assess the pooled prevalence of malnutrition among critically ill children.

Methodology
This systematic review was conducted in accordance with the JBI methodology for systematic reviews of prevalence and incidence. Databases including, PubMed/MEDLINE, CINAHL/EBSCO, HINARI, Google Scholar, and gray literatures were used to find relevant articles. Eligible studies were critically appraised by two independent reviewers. Systematic review and meta-analysis was conducted using STATA 17 software. Funnel plot and at the 5% significance level, Egger’s test were used to check for publication bias.

Result
From a total of 15 studies with 4331 study participants, the pooled prevalence of malnutrition in critically ill children was 37.19% (95% CI; 35.89–38.49) with a significant statistical heterogeneity (I2 = 98.6, P = < 0.0001). High income countries reported the lower pooled prevalence of malnutrition among critically ill children (30.14%, 95% CI; 28.41, 31.88). No publication bias was reported and sensitivity analysis suggested that no significance difference was shown in the prevalence of malnutrition among critically ill children with the pooled prevalence.

Conclusion
The current systematic review and meta-analysis showed that more than one in three critically ill children was malnourished. Serious medical conditions in children that deserve admission to the intensive care unit could be a complication of malnutrition that may end up in deaths unless the undernutrition is addressed together with critical care intervention. Hence, specific strategies to prevent malnutrition among this neglected segment should be integrated with the existing healthcare systems and nutritional programs.
The smoking and vaping model, A user-friendly model for examining the country-specific impact of nicotine VAPING product use: application to Germany
Authors: Sánchez-Romero Luz María , Liber Alex C. , Li Yameng , Yuan Zhe , Tam Jamie , Travis Nargiz , Jeon Jihyoun , Issabakhsh Mona , Meza Rafael , Levy David T. 
Published: November 2023

AbstractBackgroundSimulation models play an increasingly important role in tobacco control. Models examining the impact of nicotine vaping products (NVPs) and smoking tend to be highly specialized and inaccessible. We present the Smoking and Vaping Model (SAVM),a user-friendly cohort-based simulation model, adaptable to any country, that projects the public health impact of smokers switching to NVPs.MethodsSAVM compares two scenarios. The No-NVP scenario projects smoking rates in the absence of NVPs using population projections, deaths rates, life expectancy, and smoking prevalence. The NVP scenario models vaping prevalence and its impact on smoking once NVPs became popular. NVP use impact is estimated as the difference in smoking- and vaping-attributable deaths (SVADs) and life-years lost (LYLs) between the No-NVP and NVP scenarios. We illustrate SAVM’s adaptation to the German adult ages 18+ population, the Germany-SAVM by adjusting the model using population, mortality, smoking and NVP use data.ResultsAssuming that the excess NVP mortality risk is 5% that of smoking, Germany-SAVM projected 4.7 million LYLs and almost 300,000 SVADs averted associated with NVP use from 2012 to 2060. Increasing the excess NVP mortality risk to 40% with other rates constant resulted in averted 2.8 million LYLs and 200,000 SVADs during the same period.ConclusionsSAVM enables non-modelers, policymakers, and other stakeholders to analyze the potential population health effects of NVP use and public health interventions.
Determinants of adverse management outcomes of blunt abdominal trauma patients operated at a referral hospital in southern Ethiopia: a retrospective record review
Authors: Abraha Demoz , Gebreyes Essay , Wolka Eskinder , Dender Getahun , Sorsa Abebe , Muhumuza Joshua 
Published: November 2023

Abstract
Background
Abdominal trauma is one of the common reasons for emergency visits yet there is paucity of data about the subject in the horn of Africa. This study was aimed at determining the determinants of adverse management outcomes of blunt abdominal trauma among operated patients at Wolaita Sodo University Teaching and Referral Hospital, Ethiopia.

Methods
This was a three-year retrospective review conducted among 128 patient records selected using purposive sampling in which all records for the patients operated for a diagnosis of blunt abdominal trauma during the study period were included. A pretested checklist was used to extract the data relating to adverse outcomes and characteristics of the patients. A descriptive analysis followed by logistic regression was done.

Results
Of the 128 patients, adverse management outcomes related to blunt abdominal trauma occurred in 52%. Patients residing in rural areas (adjusted odds ratio 3.23, 95% confidence interval: 1.13–9.24) and those with tachycardia, (adjusted odds ratio = 3.25, 95% confidence interval: 1.19–8.83) or tachypnea (adjusted odds ratio 3.25, 95% confidence interval: 1.19–8.83) were more likely to have adverse management outcomes.

Conclusion
Adverse management outcomes are relatively high and associated with rural residence and deranged vital signs (tachycardia and tachypnea). Close monitoring targeting patients from rural residence and those presenting with tachycardia and tachypnea is recommended.
Silver diamine fluoride with sodium fluoride varnish versus silver diamine fluoride in arresting early childhood caries: a 6-months follow up of a randomized field trial
Authors: Abdellatif Enas B. , El Kashlan Mona K. , El Tantawi Maha 
Published: November 2023

AbstractBackgroundEarly childhood caries (ECC) is the most prevalent chronic health problem in young children, and it can be arrested using professionally applied fluoride such as Sodium fluoride (NaF) varnish and Silver Diamine Fluoride (SDF). This trial compared two interventions to arrest ECC lesions: 38% SDF combined with 5% NaF varnish versus 38% SDF and assessed whether the arrest rate was affected by baseline lesion severity measured by ICDAS.MethodsChildren aged ≤ 4 years from 4 nurseries in a rural area in Alexandria, Egypt joined the study in March 2022. They were included if they had at least one active carious lesion with ICDAS codes ≥ 3. They were randomized to receive either 38% SDF with 5% NaF varnish or 38% SDF alone. In both groups, the agents were applied at baseline and after 6 months on the caries lesions. NaF was additionally applied on all teeth in the oral cavity, and it was also applied after three months. The primary outcome was lesion arrest status after six months. Parents’ satisfaction with their children’s appearance was the secondary outcome. Pearson Chi-Square test was used for bivariate comparison and multi-level multiple logistic regression was used to assess the effect of the intervention on caries arrest controlling for confounders. The interaction between the intervention and baseline lesion severity (categorized into moderate and severe lesions) was assessed and the p value was calculated.ResultsThe study included 1606 lesions in 220 children, median (IQR) age = 48(9) months. The percentages of arrested lesions after the application of SDF + NaF and SDF only were 77.7% and 73.2% (p = 0.035). In multivariable analysis, SDF + NaF had significantly greater caries arrest effect than SDF alone (AOR = 2.12, p = 0.03) with significant difference (p = 0.03) between moderate (AOR = 4.10, p = 0.005) and advanced (AOR = 1.92, p = 0.08) lesions. Most parents were satisfied with their children’s appearance with no significant difference between groups (SDF + NaF = 84.5%, SDF = 78.18%, p = 0.23).ConclusionSDF + NaF had a higher arrest rate than SDF alone and this difference was significant in moderate but not advanced lesions. The findings have implications for the non-invasive management of ECC.Trial registrationThis trial was registered in the clinicaltrials.gov registry (#NCT05642494).
Sensitivity and specificity of the ICDAS II system and bitewing radiographs for detecting occlusal caries using the Spectra™ caries detection system as the reference test in children
Authors: Caceda Jorge H. , Jiang Shuying , Calderon Victor , Villavicencio-Caparo Ebingen 
Published: November 2023

Abstract
Background
Most studies assessing the sensitivity and specificity of caries detection methods have been performed in vitro using the histological method as the gold standard showing inconsistent values. The aim of this study was to compare the sensitivity and specificity in detecting occlusal caries using the International Caries Detection and Assessment System (ICDAS II) with the radiographic method (RM), while using the Spectra™ Caries Detection System (SCDS) as the reference test.

Methods
One hundred sixty children, ages 7–12 years, participated in the study. Five zones in the occlusal surfaces of 859 primary and 632 first permanent molars were examined visually using ICDAS-II, the RM using bitewing radiographs and SCDS. The descriptive statistics of sensitivity and specificity were calculated and compared.

Results
For all molars combined and for primary molars only, the sensitivity of ICDAS II was higher for detecting total caries (p < 0.001), caries in enamel (p < 0.001), and caries in dentin (p = 0.016), but it was not different for detecting caries in the dentin of permanent first molars (p = 0.214), and primary second molars (p = 0.761). The specificity of RM was higher for detecting total caries, caries in enamel for all molars combined and for permanent first molars (p < 0.001). For caries in dentin, the specificity of ICDAS II was higher for all molars combined and for primary molars only (p < 0.001). For total caries in primary molars only, and caries in dentin of permanent first molars only, the specificity was not different (p = 0.156 and p = 0.181 respectively).

Conclusions
The sensitivity and specificity of ICDAS II and RM changes depending on whether the carious lesion compromises the enamel or dentin, and if the caries detection is performed in the primary molars or permanent first molars.
Does maxillary sinus proximity affect molar root resorption during distalization using Invisalign? a CBCT study
Authors: Elfouly Dina , El-Harouni Nadia M. , Ismail Hanan A. , El-Bialy Tarek , Ghoneima Ahmed 
Published: November 2023

Abstract
Background
This study aimed to assess the correlation between maxillary sinus proximity to root apices of maxillary molars and root resorption during molar distalization using clear aligner therapy (CAT).

Materials and methods
Thirty-eight cone beam computed tomography scans (CBCTs) obtained pre- (T0) and post-treatment (T1) from 19 adult patients (36.68 ± 13.50 years), who underwent maxillary molar distalization using Invisalign® aligners (Align Technology, Inc., San José, CA, USA) with a minimum of 2 mm distalization, were evaluated in this study At least 22 h of aligner wear per day was a main inclusion criterion. Sinus proximity and changes in root lengths were measured for 61 molars (183 roots). Spearman coefficient analysis was used for assessing correlation between sinus proximity and root resorption. The level of significance was set at p ≤ 0.05. The reproducibility of measurements was assessed by intraclass correlation coefficient (ICC).

Results
Spearman coefficient revealed no significant correlation between sinus proximity and molar root resorption for mesiobuccal, distobuccal or palatal roots (p = 0.558, p = 0.334, p = 0.931, respectively).

Conclusion
There was no correlation between maxillary sinus proximity to root apices of maxillary molars and root resorption.
Metabolomic and microbiome analysis of the protective effects of Puerarin against Salmonella Enteritidis Infection in chicks
Authors: Lu Yu , Ge Shihao , Zhang Haili , Lu Wen , Bao Xiangli , Pan Shiling , Pang Quanhai 
Published: November 2023

Abstract
Background
Salmonella Enteritidis is a zoonotic pathogen and poses a substantial risk to human health, as well as significant financial losses to the livestock and poultry industries. It is currently urgent to identify alternatives to antibiotic treatment.

Results
In this study, we explored the influence of Puerarin on the immunological response, intestinal flora, serum metabolome, and growth performance of chicks infected with Salmonella Enteritidis. Chicks were weighed at specific time points and the average daily gain (ADG) was calculated. Serum, intestinal, and cecal content samples were collected on days 10 and 17. The results showed that 100 mg/kg of Puerarin significantly suppressed inflammation and enhanced immune function. Metabolomic analysis showed significant differences in serum metabolites after Puerarin treatment and suggested that Puerarin may regulate abnormal amino acid and lipid metabolism after Salmonella Enteritidis infection through the autophagic and ABC transporter pathways. In addition, Puerarin suppressed Salmonella Enteritidis-induced intestinal flora dysbiosis through modulation of the microbial community structures (increased Lactobacillus, Faecalibacterium, and Subdoligranulum), as demonstrated by 16S rRNA analysis.

Conclusions
In conclusion, Puerarin can improve growth performance in chicks, suppress the inflammatory response in vivo, enhance immunity, and regulate lipid and amino acid metabolism and the intestinal flora.
Risk of cardiovascular events after an exacerbation of chronic obstructive pulmonary disease: results from the EXACOS-CV cohort study using the PHARMO Data Network in the Netherlands
Authors: Swart Karin M. A. , Baak Brenda N. , Lemmens Louise , Penning-van Beest Fernie J. A. , Bengtsson Camilla , Lobier Muriel , Hoti Fabian , Vojinovic Dina , van Burk Lindy , Rhodes Kirsty , Garbe Edeltraut , Herings Ron M. C. , Nordon Clementine , Simons Sami O. 
Published: November 2023

Abstract
Background
People living with chronic obstructive pulmonary disease (COPD) have an increased risk of experiencing cardiovascular (CV) events, particularly after an exacerbation. Such CV burden is not yet known for incident COPD patients. We examined the risk of severe CV events in incident COPD patients in periods following either moderate and/or severe exacerbations.

Methods
Persons aged ≥ 40 years with an incident COPD diagnosis from the PHARMO Data Network were included. Exposed time periods included 1–7, 8–14, 15–30, 31–180 and 181–365 days following an exacerbation. Moderate exacerbations were defined as those managed in outpatient settings; severe exacerbations as those requiring hospitalisation. The outcome was a composite of time to first severe CV event (acute coronary syndrome, heart failure decompensation, cerebral ischaemia, or arrhythmia) or death. Hazard ratios (HR) were estimated for association between each exposed period and outcome.

Results
8020 patients with newly diagnosed COPD were identified. 2234 patients (28%) had ≥ 1 exacerbation, 631 patients (8%) had a non-fatal CV event, and 461 patients (5%) died during a median follow-up of 36 months. The risk of experiencing the composite outcome was increased following a moderate/severe exacerbation as compared to time periods of stable disease [range of HR: from 15.3 (95% confidence interval 11.8–20.0) in days 1–7 to 1.3 (1.0–1.8) in days 181–365]. After a moderate exacerbation, the risk was increased over the first 180 days [HR 2.5 (1.3–4.8) in days 1–7 to 1.6 (1.3–2.1) in days 31–180]. After a severe exacerbation, the risk increased substantially and remained higher over the year following the exacerbation [HR 48.6 (36.9–64.0) in days 1–7 down to 1.6 (1.0–2.6) in days 181–365]. Increase in risk concerned all categories of severe CV events.

Conclusions
Among incident COPD patients, we observed a substantial risk increase of severe CV events or all-cause death following either a moderate or severe exacerbation of COPD. Increase in risk was highest in the initial period following an exacerbation. These findings highlight the significant cardiopulmonary burden among people living with COPD even with a new diagnosis.
Eleven metabolism‑related genes composed of Stard5 predict prognosis and contribute to EMT phenotype in HCC
Authors: Li Dongping , Lin Xiahui , Li Jiale , Liu Xinyi , Zhang Feng , Tang Wenqing , Zhang Si , Dong Ling , Xue Ruyi 
Published: November 2023

Abstract
Background
Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide, with a high mortality and poor survival rate. Abnormal tumor metabolism is considered a hallmark of HCC and is a potential therapeutic target. This study aimed to identify metabolism-related biomarkers to evaluate the prognosis of patients with HCC.

Method
The Cancer Genome Atlas (TCGA) database was used to explore differential metabolic pathways based on high and low epithelial-mesenchymal transition (EMT) groupings. Genes in differential metabolic pathways were obtained for HCC metabolism-related molecular subtype analysis. Differentially expressed genes (DEGs) from the three subtypes were subjected to Lasso Cox regression analysis to construct prognostic risk models. Stard5 expression in HCC patients was detected by western blot and immunohistochemistry (IHC), and the role of Stard5 in the metastasis of HCC was investigated by cytological experiments.

Results
Unsupervised clustering analysis based on metabolism-related genes revealed three subtypes in HCC with differential prognosis. A risk prognostic model was constructed based on 11 genes (STARD5, FTCD, SCN4A, ADH4, CFHR3, CYP2C9, CCL14, GADD45G, SOX11, SCIN, and SLC2A1) obtained by LASSO Cox regression analysis of the three subtypes of DEGs. We validated that the model had a good predictive power. In addition, we found that the high-risk group had a poor prognosis, higher proportion of Tregs, and responded poorly to chemotherapy. We also found that Stard5 expression was markedly decreased in HCC tissues, which was associated with poor prognosis and EMT. Knockdown of Stard5 contributed to the invasion and migration of HCC cells. Overexpression of Stard5 inhibited EMT in HCC cells.

Conclusion
We developed a new model based on 11 metabolism-related genes, which predicted the prognosis and response to chemotherapy or immunotherapy for HCC. Notably, we demonstrated for the first time that Stard5 acted as a tumor suppressor by inhibiting metastasis in HCC.
Evaluating local primary health care actions to address health inequities: analysis of Australia’s Primary Health Networks
Authors: Windle Alice , Javanparast Sara , Freeman Toby , Baum Fran 
Published: November 2023

Abstract
Background
Meso-level, regional primary health care organisations such as Australia’s Primary Health Networks (PHNs) are well placed to address health inequities through comprehensive primary health care approaches. This study aimed to examine the equity actions of PHNs and identify factors that hinder or enable the equity-orientation of PHNs’ activities.

Methods
Analysis of all 31 PHNs’ public planning documents. Case studies with a sample of five PHNs, drawing on 29 original interviews with key stakeholders, secondary analysis of 38 prior interviews, and analysis of 30 internal planning guidance documents. This study employed an existing framework to examine equity actions.

Results
PHNs displayed clear intentions and goals for health equity and collected considerable evidence of health inequities. However, their planned activities were largely restricted to individualistic clinical and behavioural approaches, with little to facilitate access to other health and social services, or act on the broader social determinants of health. PHNs’ equity-oriented planning was enabled by organisational values for equity, evidence of local health inequities, and engagement with local stakeholders. Equity-oriented planning was hindered by federal government constraints and lack of equity-oriented prompts in the planning process.

Conclusions
PHNs’ equity actions were limited. To optimise regional planning for health equity, primary health care organisations need autonomy and scope to act on the ‘upstream’ factors that contribute to local health issues. They also need sufficient time and resources for robust, systematic planning processes that incorporate mechanisms such as procedure guides and tools/templates, to capitalise on their local evidence to address health inequities. Organisations should engage meaningfully with local communities and service providers, to ensure approaches are equity sensitive and appropriately targeted.