bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analyzing university students’ mode choice preferences by using a hybrid AHP group-PROMETHEE model: evidence from Budapest city
Authors: Oubahman Laila , Duleba Szabolcs , Esztergár-Kiss Domokos 
Published: January 2024

AbstractOver the last decades, the analysis of mode choice preferences has become a vital aspect of enhancing the quality of public transport services. Most papers aim to derive conclusions from large-scale surveys. However, for specific homogenous patterns, such as university students, a smaller group of evaluators might also be sufficient. Such a survey can rather be considered as an expert survey, in which few representatives might express the preference of a larger community, thus, a different methodology can be more effective than the traditional statistical techniques. This paper aims to introduce a new approach that combines two multi-criteria decision-making methods, the analytic hierarchy process and the preference ranking organization method for enrichment evaluation, for a hybrid consensual model by aggregating the individual priorities defined by each decision-maker. The introduced model presents advantages in terms of reducing time, cost, and effort compared to statistical methods and requires solely necessary information from the users via objective and subjective evaluations. The model’s effectiveness is tested with real-world data from the city of Budapest; highlighting the significant impact of the underground mode on users’ behavior toward public transport. In addition, the outcomes are compared to other existing results of student preference surveys.
Causal association between 637 human metabolites and ovarian cancer: a mendelian randomization study
Authors: Huang Yedong , Lin Wenyu , Zheng Xiangqin 
Published: January 2024

Abstract
Background
Current evidence suggests a significant association between metabolites and ovarian cancer (OC); however, the causal relationship between the two remains unclear. This study employs Mendelian randomization (MR) to investigate the causal effects between different metabolites and OC.

Methods
In this study, a total of 637 metabolites were selected as the exposure variables from the Genome-wide Association Study (GWAS) database (http://gwas.mrcieu.ac.uk/datasets/). The OC related GWAS dataset (ieu-b-4963) was chosen as the outcome variable. R software and the TwoSampleMR package were utilized for the analysis in this study. MR analysis employed the inverse variance-weighted method (IVW), MR-Egger and weighted median (WM) for regression fitting, taking into consideration potential biases caused by linkage disequilibrium and weak instrument variables. Metabolites that did not pass the tests for heterogeneity and horizontal pleiotropy were considered to have no significant causal effect on the outcome. Steiger’s upstream test was used to determine the causal direction between the exposure and outcome variables.

Results
The results from IVW analysis revealed that a total of 31 human metabolites showed a significant causal effect on OC (P < 0.05). Among them, 9 metabolites exhibited consistent and stable causal effects, which were confirmed by Steiger’s upstream test (P < 0.05). Among these 9 metabolites, Androsterone sulfate, Propionylcarnitine, 5alpha-androstan-3beta,17beta-diol disulfate, Total lipids in medium VLDL and Concentration of medium VLDL particles demonstrated a significant positive causal effect on OC, indicating that these metabolites promote the occurrence of OC. On the other hand, X-12,093, Octanoylcarnitine, N2,N2-dimethylguanosine, and Cis-4-decenoyl carnitine showed a significant negative causal association with OC, suggesting that these metabolites can inhibit the occurrence of OC.

Conclusions
The study revealed the complex effect of metabolites on OC through Mendelian randomization. As promising biomarkers, these metabolites are worthy of further clinical validation.
Predicting and optimizing reactive oxygen species metabolism in Punica granatum L. through machine learning: role of exogenous GABA on antioxidant enzyme activity under drought and salinity stress
Authors: Zarbakhsh Saeedeh , Shahsavar Ali Reza , Afaghi Ali , Hasanuzzaman Mirza 
Published: January 2024

Abstract
Background
Drought and salinity stress have been proposed as the main environmental factors threatening food security, as they adversely affect crops' agricultural productivity. As a potential solution, the application of plant growth regulators to enhance drought and salinity tolerance has gained considerable attention. γ-aminobutyric acid (GABA) is a four-carbon non-protein amino acid that accumulates in plants as a response to stressful conditions. This study focused on a comparative assessment of several machine learning (ML) regression models, including radial basis function, generalized regression neural network (GRNN), random forest (RF), and support vector regression (SVR) to develop predictive models for assessing the effect of different concentrations of GABA (0, 10, 20, and 40 mM) on various physio-biochemical traits during periods of drought, salinity, and combined stress conditions. The physio-biochemical traits included antioxidant enzyme activities (superoxide dismutase, SOD; peroxidase, POD; catalase, CAT; and ascorbate peroxidase, APX), protein content, malondialdehyde (MDA) levels, and hydrogen peroxide (H2O2) levels. The non‑dominated sorting genetic algorithm‑II (NSGA‑II) was employed for optimizing the superior prediction model.

Results
The GRNN model outperformed the other ML algorithms and was therefore selected for optimization by NSGA-II. The GRNN-NSGA-II model revealed that treatment with GABA at concentrations of 20.90 mM and 20.54 mM, under combined drought and salinity stress conditions at 20.86 and 20.72 days post-treatment, respectively, could result in the maximum values for protein content (by 0.80 and 0.69), APX activity (by 50.63 and 51.51), SOD activity (by 0.54 and 0.53), POD activity (by 1.53 and 1.72), CAT activity (by 4.42 and 5.66), as well as lower MDA levels (by 0.12 and 0.15) and H2O2 levels (by 0.44 and 0.55), respectively, in the ‘Atabaki’ and ‘Rabab’ cultivars.

Conclusions
This study demonstrates that the GRNN-NSGA-II model, as an advanced ML algorithm with a strong predictive ability for outcomes in combined stressful environmental conditions, provides valuable insights into the significant factors influencing such multifactorial processes.
Multimorbidity impacts cardiovascular disease risk following percutaneous coronary intervention: latent class analysis of the Melbourne Interventional Group (MIG) registry
Authors: Ho Chau Le Bao , Si Si , Brennan Angela , Briffa Tom , Stub Dion , Ajani Andrew , Reid Christopher M 
Published: January 2024

Abstract
Background
Multimorbidity is strongly associated with disability or functional decline, poor quality of life and high consumption of health care services. This study aimed (1) To identify patterns of multimorbidity among patients undergoing first recorded percutaneous coronary intervention (PCI); (2) To explore the association between the identified patterns of multimorbidity on length of hospital stay, 30-day and 12- month risk of major adverse cardiac and cerebrovascular events (MACCE) after PCI.

Methods
A retrospective cohort study of the Melbourne Interventional Group (MIG) registry. This study included 14,025 participants who underwent their first PCI from 2005 to 2015 in Victoria, Australia. Based on a probabilistic modelling approach, Latent class analysis was adopted to classify clusters of people who shared similar combinations and magnitude of the comorbidity of interest. Logistic regression models were used to estimate odd ratios and 95% confidence interval (CI) for the 30-day and 12-month MACCE.

Results
More than two-thirds of patients had multimorbidity, with the most prevalent conditions being hypertension (59%) and dyslipidaemia (60%). Four distinctive multimorbidity clusters were identified each with significant associations for higher risk of 30-day and 12-month MACCE. The cluster B had the highest risk of 30-day MACCE event that was characterised by a high prevalence of reduced estimated glomerular filtration rate (92%), hypertension (73%) and reduced ejection fraction (EF) (57%). The cluster C, characterised by a high prevalence of hypertension (94%), dyslipidaemia (88%), reduced eGFR (87%), diabetes (73%) and reduced EF (65%) had the highest risk of 12-month MACCE and highest length of hospital stay.

Conclusion
Hypertension and dyslipidaemia are prevalent in at least four in ten patients undergoing coronary angioplasty. This study showed that clusters of patients with multimorbidity had significantly different risk of 30-day and 12-month MACCE after PCI. This suggests the necessity for treatment approaches that are more personalised and customised to enhance patient outcomes and the quality of care delivered to patients in various comorbidity clusters. These results should be validated in a prospective cohort and to evaluate the potential impacts of these clusters on the prevention of MACCE after PCI.
A comparison of opioid dose between home palliative care and hospital palliative care
Authors: Iwata Hiroyoshi , Hamada Shuhei , Harada Hiroko , Kusaka Katsuhiro 
Published: January 2024

Abstract
Objective
While opioids are a key part of palliative care, few studies have evaluated opioid demand in the home care context. This study aims to compare opioid usage in home care and hospital care settings.

Methods
This cross-sectional study retrospectively recruited patients receiving palliative care in home care and hospital settings, between November 2018 and October 2020. Opioid prescriptions were standardized to oral morphine equivalent (OME) doses at 7 and 14 days prior to death and analyzed. Additional analysis performed multivariable linear regression on the outcome of OME at 7 days, adjusting for medical setting and confounders in patients with opioid prescriptions.

Results
After 21 exclusions, 209 patients (48 home care and 161 hospital care) were eligible for analysis. The home care group had a higher mean age (74.8 years) and Palliative Prognosis Score (50), than the hospital group (70.1 and 40, respectively). Mean OME at 7 and 14 days before death was numerically higher in the home care group (72.8 mg/day and 53.0 mg/day, respectively) than the hospital care group (57.7 mg/day and 35.7 mg/day). Student’s t-test produced p-values of 0.49 and 0.32, and the Wilcoxon rank sum test found p-values of 0.24 and 0.11 at 7 and 14 days, respectively. Multivariable regression analysis of the home care group found mean OME of 40.7 mg/day; 95% confidence interval [-0.62, 82.0 (mg/day)], p = 0.06. Additional analysis found a p-value of 0.06 for medical setting.

Conclusions
We did not find a statistically significant difference in opioid use between home care and hospital care. However, the numerically higher rate of use in the home care group suggests that further research is warranted.
Understanding paramedic work in general practice in the UK: a rapid realist synthesis
Authors: Stott Hannah , Goodenough Trudy , Jagosh Justin , Gibson Andy , Harris Nicky , Liddiard Cathy , Proctor Alyesha , Schofield Behnaz , Walsh Nicola , Booker Matthew , Voss Sarah 
Published: January 2024

AbstractBackgroundGeneral practice in the UK is under substantial pressure and practices are increasingly including paramedics as part of their workforce. Little is known about how different models of paramedic working may affect successful implementation of the role, as viewed from patient, clinician and system perspectives. This realist synthesis developed theories about ‘models of paramedic working in general practice’ in different UK contexts to understand their impact.MethodsThe rapid realist synthesis comprised data from: (1) empirical and grey literature searches; (2) semi-structured realist interviews with system leaders involved with the implementation of the role; and (3) a stakeholder event with healthcare professionals and the public, to develop initial programme theories that can be tested in future work. Sources were analysed using a realist approach that explored the data for novel or causal insights to generate initial programme theories.ResultsEmpirical sources (n = 32), grey sources (n = 95), transcripts from system leader interviews (n = 7) and audio summaries from the stakeholder event (n = 22 participants) were synthesised into a single narrative document. The findings confirmed the presence of a wide variety of models of paramedic working in UK general practice. The perceived success of models was influenced by the extent to which the paramedic service was mature and embedded in practice, and according to four theory areas: (1) Primary care staff understanding and acceptance of the paramedic role; (2) Paramedic induction process, including access to training, supervision and development opportunities; (3) Patient understanding and acceptance of the role; (4) Variations in paramedic employment models.ConclusionsVariability in how the paramedic role is operating and embedding into general practice across the UK affects the success of the role. These findings provide a theoretical foundation for future research to investigate various ‘models of paramedic working’ in different contexts.
Which factors preceding dementia identification impact future healthcare use trajectories: multilevel analyses in administrative data
Authors: Couret Anaïs , Lapeyre-Mestre Maryse , Gombault-Datzenko Eugénie , Renoux Axel , Villars Hélène , Gardette Virginie 
Published: January 2024

Abstract
Background
Healthcare use patterns preceding a diagnosis of Alzheimer’s Disease and Related Diseases (ADRD) may be associated with the quality of healthcare use trajectories (HUTs) after diagnosis. We aimed to identify determinants of future favorable HUTs, notably healthcare use preceding ADRD identification.

Methods
This nationwide retrospective observational study was conducted on subjects with incident ADRD identified in 2012 in the French health insurance database. We studied the 12-month healthcare use ranging between 18 and 6 months preceding ADRD identification. The five-year HUTs after ADRD identification were qualified by experts as favorable or not. In order to take into account geographical differences in healthcare supply, we performed mixed random effects multilevel multivariable logistic regression model to identify determinants of future favorable HUTs. Analyses were stratified by age group (65–74, 75–84, ≥ 85).

Results
Being a woman, and preventive and specialist care preceding ADRD identification increased the probability of future favorable HUT, whereas institutionalization, comorbidities, medical transportation and no reimbursed drug during [-18;-6] months decreased it. Besides, some specificities appeared according to age groups. Among the 65–74 years subjects, anxiolytic dispensing preceding ADRD identification decreased the probability of future favorable HUT. In the 75–84 years group, unplanned hospitalization and emergency room visit preceding ADRD identification decreased this probability. Among subjects aged 85 and older, short hospitalization preceding ADRD identification increased the probability of future favorable HUTs.

Conclusion
Regular healthcare use with preventive and specialist care preceding ADRD identification increased the probability of future favorable HUTs whereas dependency decreased it.
Associations between air pollutants and acute exacerbation of drug-resistant tuberculosis: evidence from a prospective cohort study
Authors: Zhao Chan-Na , Xu Zhiwei , Wang Peng , Liu Jie , Wang Rong , Pan Hai-Feng , Bao Fangjin 
Published: January 2024

Abstract
Background
Short-term exposure to air pollution may trigger symptoms of drug-resistant tuberculosis (DR-TB) through stimulating lung tissue, damaging tracheobronchial mucosa, the key anti-mycobacterium T cell immune function, and production and release of inflammatory cytokines.

Objective
To investigate the association between acute exacerbations of DR-TB and short-term residential exposure to air pollutants (PM10, PM2.5, SO2, NO2, CO and O3) based on a large prospective cohort in Anhui Province, China.

Method
Patients were derived from a prospective cohort study of DR-TB in Anhui Province. All DR-TB patients underwent drug-susceptibility testing and prefecture-level reference laboratories confirmed their microbiologies. The case-crossover design was performed to evaluate the association between the risk of acute exacerbations of DR-TB and short-term residential exposure to air pollution.

Results
Short-term NO2 exposure was significantly related to an elevated risk of first-time outpatient visit due to acute exacerbations of DR-TB(relative risk:1.159, 95% confidence interval:1.011 ~ 1.329). Stratification analyses revealed that the relationship between the risk of acute exacerbations and NO2 exposure was stronger in the elderly (age ≥ 65) DR-TB patients, and in individuals with a history of TB treatment.

Conclusions
NO2 Exposure was significantly associated with an elevated risk of acute exacerbation of DR-TB in Anhui Province, China.
Willingness to pay for haemodialysis among patients with chronic kidney disease in Abuja, Nigeria
Authors: Agada-Amade Yakubu Adole , Ogbuabor Daniel Chukwuemeka , Obikeze Eric , Eborieme Ejemai , Onwujekwe Obinna Emmanuel 
Published: January 2024

AbstractBackgroundEvidence of willingness to pay for kidney replacement therapy is scarce in low-middle-income countries, including Nigeria’s Formal Sector Social Health Insurance Programme. The study, therefore, assessed the willingness to pay for haemodialysis among chronic kidney disease patients in Abuja, Nigeria.MethodsThe study adopted a cross-sectional survey design. We used the contingent valuation method to estimate the maximum stated willingness to pay (WTP) for haemodialysis among end-stage kidney disease (ESKD) patients. We obtained informed written consent from respondents before data collection. The socio-demographic characteristics and willingness to pay data were summarized using descriptive statistics. We evaluated the mean differences in respondents’ WTP using Mann-Whitney and Kruskal-Wallis tests. All variables that hadp < 0.25 in the bivariate analysis were included in the Generalized Linear Model (gamma with link function) to determine the predictors of the WTP for one’s and another’s haemodialysis. The level of significance in the final model was ρ < 0.05.ResultsAbout 88.3% and 64.8% of ESKD patients were willing to pay for personal and altruistic haemodialysis, correspondingly. The mean annual WTP for haemodialysis for one’s and altruistic haemodialysis was USD25,999.06 and USD 1539.89, respectively. Private hospital patients were likelier to pay for their haemodialysis (β = 0.39, 95%CI: 0.21 to 0.57,p < 0.001). Patients attending public-private partnership hospitals were less likely to pay for altruistic haemodialysis than those attending public hospitals (β = -1.65, 95%CI: -2.51 to -0.79,p < 0.001).ConclusionsThe willingness to pay for haemodialysis for themselves and others was high. The type of facility ESKD patients attended influenced their willingness to pay for haemodialysis. The findings highlight the need for policies to enhance affordable and equitable access to haemodialysis in Nigeria through pre-payment mechanisms and altruistic financing strategies.
Updating the study protocol: Insight 46 – a longitudinal neuroscience sub-study of the MRC National Survey of Health and Development – phases 2 and 3
Authors: Murray-Smith Heidi , Barker Suzie , Barkhof Frederik , Barnes Josephine , Brown Thomas M. , Captur Gabriella , R.E.Cartlidge Molly , Cash David M. , Coath William , Davis Daniel , Dickson John C. , Groves James , Hughes Alun D. , James Sarah-Naomi , Keshavan Ashvini , Keuss Sarah E. , King-Robson Josh , Lu Kirsty , Malone Ian B. , Nicholas Jennifer M. , Rapala Alicja , Scott Catherine J. , Street Rebecca , Sudre Carole H. , Thomas David L. , Wong Andrew , Wray Selina , Zetterberg Henrik , Chaturvedi Nishi , Fox Nick C. , Crutch Sebastian J. , Richards Marcus , Schott Jonathan M. 
Published: January 2024

Abstract
Background
Although age is the biggest known risk factor for dementia, there remains uncertainty about other factors over the life course that contribute to a person’s risk for cognitive decline later in life. Furthermore, the pathological processes leading to dementia are not fully understood. The main goals of Insight 46—a multi-phase longitudinal observational study—are to collect detailed cognitive, neurological, physical, cardiovascular, and sensory data; to combine those data with genetic and life-course information collected from the MRC National Survey of Health and Development (NSHD; 1946 British birth cohort); and thereby contribute to a better understanding of healthy ageing and dementia.

Methods/Design
Phase 1 of Insight 46 (2015–2018) involved the recruitment of 502 members of the NSHD (median age = 70.7 years; 49% female) and has been described in detail by Lane and Parker et al. 2017. The present paper describes phase 2 (2018–2021) and phase 3 (2021–ongoing). Of the 502 phase 1 study members who were invited to a phase 2 research visit, 413 were willing to return for a clinic visit in London and 29 participated in a remote research assessment due to COVID-19 restrictions. Phase 3 aims to recruit 250 study members who previously participated in both phases 1 and 2 of Insight 46 (providing a third data time point) and 500 additional members of the NSHD who have not previously participated in Insight 46.

Discussion
The NSHD is the oldest and longest continuously running British birth cohort. Members of the NSHD are now at a critical point in their lives for us to investigate successful ageing and key age-related brain morbidities. Data collected from Insight 46 have the potential to greatly contribute to and impact the field of healthy ageing and dementia by combining unique life course data with longitudinal multiparametric clinical, imaging, and biomarker measurements. Further protocol enhancements are planned, including in-home sleep measurements and the engagement of participants through remote online cognitive testing. Data collected are and will continue to be made available to the scientific community.
Contrast-induced encephalopathy after an embolization procedure for a cerebral aneurysm in a female with subarachnoid hemorrhage: a case report
Authors: Ren Jing , Ge Yinhua , Wen Ruyi , Zhang Yong , Shen Jun , Chen Wenjun 
Published: January 2024

Abstract
Background
Contrast-induced encephalopathy (CIE) is a rare complication during or after angiography, usually transient and reversible. CIE diagnosis is challenging due to the absence of no formal diagnostic criteria. CIE can mimic stroke symptoms, including visual disturbances, seizures, confusion, coma, and focal neurological deficits. This case reports neurological deficit reversal in a CIE patient due to the embolization of an intracranial aneurysm, the second angiographic procedure in six days.

Case presentation
A 77-year-old woman was admitted to the hospital for headaches. The cerebral computed tomography (CT) scan indicated a subarachnoid hemorrhage. The first digital subtraction angiography (DSA) identified an aneurysm of 4 mm ∗ 3 mm in size in the M1 segment of the right middle cerebral artery (MCA). Then, embolization surgery was performed for the cerebral aneurysm, which was successful. However, the patient had post-operative headaches, slurred speech, epilepsy, limb weakness, and delirium post-procedure. The non-contrast cerebral CT indicated widespread edema in the right cerebral hemisphere. The patient was diagnosed with CIE and treated with symptomatic supportive therapy. Eventually, the patient’s neurological deficits and cerebral edema improved significantly.

Conclusions
The current case emphasized the importance of early diagnosis and symptomatic treatment of CIE. Thus, CIE should be the first consideration during the differential diagnosis of a patient having acute neurological impairment after repeated DSA.