bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time to death and predictors of mortality among under-five children with severe acute malnutrition hospitalized at Mulanje District Hospital in Southern Malawi: a retrospective cohort study
Authors: Pajogo Masuzgo , Ndholvu Miriam , Chamambala Prince , Nyondo Wongani 
Published: October 2023

Abstract
Introduction
Severe acute malnutrition (SAM) is a leading cause of inpatient mortality in children in sub-Saharan Africa (SSA). In Malawi, there is limited data that explains why this is the case. Therefore, this study determined the time to death and its predictors among children under five years of age with SAM admitted at Mulanje District Hospital.
Methods
We conducted a retrospective cohort study by reviewing the medical charts of 454 randomly selected children under five years of age who were admitted to Mulanje District Hospital from January 2017 to February 2021. We collected data using data collection forms and analyzed the data with STATA version 16. Cox proportional hazard regression was used to identify predictors of mortality. A statistical significance was declared at a p-value < 0.05
Results
A total of 7,685 children under five years of age were admitted to Mulanje District Hospital between January 2017 and February 2021. We enrolled and analyzed 454 cases, of which 227 were SAM children and the other 227 belonged to non-SAM children. The overall death rate was 14.8%. For SAM children, the death rate was 8.4%, compared to 21.2% for non-SAM children. The median time to death was 5 days (IQR: 2–8) for SAM and 1 day (IQR: 1–2) for non-SAM children. Among SAM children, shock (AHR: 15.3; CI: 2.08–113.42) and not having received amoxicillin (AHR: 4.15; CI: 1.24–13.90) were significant predictors of death. Among non-SAM children, shock (AHR: 2.33; CI: 1.18–4.6), diarrhoea (AHR: 2.07; CI: 1.00–2.30), oxygen therapy (AHR: 3.17; CI: 1.66–6.05), and not having received amoxicillin (AHR: 20.78; CI: 2.81–153.67) were significant predictors of death.
Conclusion
Clinical and nursing interventions should be more focused on predictors of mortality to address the high incidence of deaths among children under five years of age.
Increased Prevalence of Myasthenia Gravis in a Cohort of Patients with Inflammatory Bowel Disease
Authors: Leitão Antônio Miguel Furtado , Gondim Francisco de Assis Aquino , Thomas Florian Patrick , de Souza Marcellus Henrique Loiola Ponte , Braga Lúcia Libanez Bessa Campelo 
Published: October 2023

Abstract
Background. Co-morbid auto-immune disorders may affect 0.2% of the population. We evaluated the association between myasthenia gravis and inflammatory bowel disease.
Methods. We present the epidemiological, clinical and electrodiagnostic findings of one patient with ulcerative colitis and three with Crohn’s disease (from a Brazilian cohort of 606 patients) and co-morbid myasthenia gravis.
Results.Mean age of onset of inflammatory bowel disease was 33.5+2.7, and patients are currently 45.8+7.3 years old. Two patients were acetylcholine receptor antibody positive, one anti-Muscle specific kinase positive and one seronegative. Three had abnormal repetitive nerve stimulation, all four had normal nerve conduction studies, abnormal skin wrinkling test and mild small fiber neuropathy. None had thymoma and/or accepted thymectomy. According to the Myasthenia Gravis Foundation classification, one was class V, one class IVb and two IIa. Myasthenia gravis diagnosis was masked by immunotherapy in all. The Prevalence ratio of having myasthenia gravis in inflammatory bowel disease patients in comparison with the proportion of myasthenia gravis among all patients seen in our center was 8.56 (P<0.0001, CI=3.1-23.5). Considering the lowest and highest prevalence of myasthenia gravis reported in the literature, the Prevalence ratio is 44.0 (P<0.0001, CI:16.3-118.4) and 26.4 (P<0.0001, CI: 9.8-70.6), respectively.
Conclusions. Myasthenia gravis prevalence is higher in inflammatory bowel disease and may include muscle specific kinase positive disease (first report in the literature). In general, myasthenia gravis clinical course was not significantly modified by inflammatory bowel disease relapses and frequently overlaps with other autoimmune conditions and small fiber neuropathy.
The influence of pre-visit anxiety on patient-provider communication and breast cancer patient uncertainty
Authors: Broadbridge Elizabeth , Venetis Maria K. 
Published: October 2023

Abstract

Purpose: Effective communication between cancer patients and providers is critical for addressing psychological distress, reducing uncertainty, and promoting patient well-being. This is particularly relevant during medical appointments that may elicit uncertainty, such as surgical consultations for newly diagnosed women with breast cancer. This study aimed to evaluate how pre-appointment anxiety affects patient-provider communication in breast cancer surgical consultations and subsequent post-appointment well-being. Breast cancer patient anxiety has been studied as an outcome of provider communication, though less is known about the extent to which pre-existing anxiety acts as an antecedent to effective patient-provider communication.
Methods: This study analyzed videorecorded breast cancer surgical consultations (N = 51) and corresponding patient surveys to understand how pre-appointment anxiety influences pre-appointment patient uncertainty, patient-provider communication during the appointment, and subsequent post-appointment uncertainty.
Results: Overall, patients with elevated pre-appointment anxiety (n = 12) did not have more pre-appointment uncertainty but were interrupted by their provider at a higher rate than those without anxiety. The proposed model achieved good fit to the data such that more pre-appointment anxiety was associated with more pre-appointment uncertainty, more pre-appointment anxiety was associated with more empathic opportunities per minute, and more empathic opportunities were associated with less post-appointment uncertainty.
Conclusions: Results provide new understanding for how patient anxiety acts as an antecedent to effective patient-provider communication and how this affects patient uncertainty post-appointment. Assessing breast cancer patients’ psychological well-being is crucial for identifying those at higher risk of poor health outcomes and providing holistic cancer care.
Effects of foam roller on pain intensity in individuals with chronic and acute musculoskeletal pain: a systematic review of randomized trials
Authors: Santos Inaê Silva , Dibai-Filho Almir Vieira , Santos Patrícia Gabrielle dos , Júnior José Djalma Arrais , de Oliveira Daniella Dias , Rocha Daniel Santos , Fidelis-de-Paula-Gomes Cid André 
Published: October 2023

Abstract
Objective To analyze the effects of using foam roller on pain intensity in individuals with chronic and acute musculoskeletal pain.Methods This systematic review was registered in the National Institute for Health Research's prospective online registry of systematic reviews (PROSPERO) under CRD42023456841. The databases Pubmed, Medline (via Ovid), Embase, BVS, and PEDro (Physiotherapy Evidence Database) were consulted to carry out this systematic review. Notably, the records of clinical trials characterized as eligible were manually searched. The search terms were: (foam rolling OR foam rolling vibration) AND (acute musculoskeletal pain) AND (chronic musculoskeletal pain). The search was performed until August 22, 2023. For the analysis of the methodological quality, the PEDro scale was used for each of the manuscripts included in the systematic review. Due to the heterogeneity in the studies included in this systematic review, performing a meta-analysis of the analyzed variables was impossible.Results Only six manuscripts were eligible for data analysis. The type of FR used was non-vibrational, being applied by a therapist in only one of the manuscripts. With an application time ranging from at least 45 seconds to 15 minutes, the non-vibrational FR was applied within a day up to six weeks. Using the PEDro scale, scores were assigned that varied between 4 and 8 points, with an average of 6 ± 1.29 points. Only two randomized clinical trials found a significant benefit in pain intensity of adding FR associated with a therapeutic exercise protocol in individuals with patellofemoral pain syndrome and chronic neck pain.Conclusion the results of this systematic review do not elucidate or reinforce the clinical use of FR in pain intensity in individuals with chronic and acute musculoskeletal pain.
Caregiver burden, mental health, quality of life and self- efficacy of family caregivers of persons with dementia in Malaysia: Baseline results of a psychoeducational intervention study
Authors: Nasreen Hashima E , Tyrrell Marie , Vikström Sofia , Craftman Åsa , Ahmad Sarifah Amirah Binti Syed , Zin Nora Mat , Aziz Karimah Hanim Abd , Tohit Noorlaili Binti Mohd , A Mohd Aznan Md , Kabir Zarina Nahar 
Published: October 2023

Abstract

Background: The majority of persons with dementia (PWD) are mainly cared for by their family members in the home. Evidence is however scarce on family caregivers’ psychosocial burden and quality of life in Asian countries including Malaysia. This study describes the baseline data of a telephone-delivered psychoeducational intervention study and examines the determinants of outcome measures (caregiver burden, depressive and anxiety symptoms, quality of life and caregiving self-efficacy) among Malaysian family caregivers to PWD.
Methods: The study used the baseline data of a randomized control trial of 121 family caregivers recruited from lists of PWD who were registered at memory and psychiatry clinics in three tertiary care hospitals in Malaysia. The participants were assessed for caregiver burden by the Zarit Burden Interview, depressive and anxiety symptoms by the Hospital Anxiety and Depression Scale, quality of life by the Control, Autonomy, Self-Realization, and Pleasure Scale, and caregiving self-efficacy by the Revised Scale for Caregiving Self-Efficacy.
Results: Prevalence of caregiver burden was 69.4%, depressive symptoms 32.2% and anxiety symptoms 32.2%. Family caregivers to PWD having perceived peer support e.g., social/family/friend/significant other supports were less likely to report caregiver burden, depressive and anxiety symptoms, and more likely to report higher levels of quality of life and caregiving self-efficacy. Being married and PWD’s ability to self-care were associated with lesser likelihood of experiencing caregiver burden, depressive and anxiety symptoms. The other determinants of greater probability of reporting better quality of life were caregivers’ employment and having Islamic faith. Marital status (married), PWD’s ability to self-care, spousal relationship with PWD and shared caregiving process were associated with higher likelihood of reporting caregiving self-efficacy.
Conclusion: Caregiver burden, depressive and anxiety symptoms are prevalent in family caregivers to PWD in Malaysia. Social support and caregiving related factors influence family caregivers’ quality of life and caregiving self-efficacy. Implementing psychoeducational intervention and support in the psychiatry and memory clinics may help improve the psychosocial burden, quality of life and caregiving self-efficacy in family caregivers of PWD.
Trial registration: ISRCTN14565552 (retrospectively registered)
Multiomic traits reveal critical irinotecan-related regulators in colorectal cancer, and irinotecan promotes ferroptosis in colorectal cancer by regulating FSTL3
Authors: Huang Chengyi , Tang Bufu , Lan Huiyin , Chen Jinggang , Shen Haixia , Jiang Jin , Zhu Ji 
Published: October 2023

Abstract
Background：Irinotecan is a widely used chemotherapy drug in colorectal cancer (CRC). The evolution and prognosis of CRC involve complex mechanisms and depend on the drug administered, especially for irinotecan. We aim to explore the specific mechanism and multiomic traits of irinotecan-related regulators, which is beneficial for accurate individualized treatment for CRC.
Methods: Bioinformatics analysis was used to explore the multiomic traits of irinotecan-related regulators. RT‒qPCR, western blotting and flow cytometry were used as experimental validations.
Results: Iriscore (irinotecan-related score) was constructed based on irinotecan-related regulators and a high iriscore predicted a poor prognosis, poor therapeutic response and the MSS/MSI-L status. Single-cell analysis revealed that FSTL3 and TMEM98 were mainly expressed in CRC stem cells. Potential transcription factors (E2F1, STAT1, and TTF2) and therapeutic drugs (telatinib) that target irinotecan-related regulators were identified. FSTL3 was the core risk irinotecan-related regulator. Some ferroptosis regulators (GPX4, HSPB1 and RGS4) and related metabolic pathways (lipid oxidation and ROS metabolism) were correlated significantly with FSTL3. In vitro, irinotecan inhibited the expression of FSTL3 and ferroptotic defence proteins (GPX4 and SLC7A11) and induced lipid peroxidation.
Conclusion: We confirmed irinotecan-related regulators, especially FSTL3, have effective prognostic value in CRC and showed that irinotecan promotes ferroptosis by inhibiting FSTL3, which is beneficial for identifying candidate targeted irinotecan-related regulators and accurate individualized treatment strategies for CRC.
Association of serum Asprosin concentrations with heart failure
Authors: Wang Guoan , Fan Chunzhen , Chai Yaru , Yu Xin , Xing Mingqing , Lv Zhihua , Yuan Shanshan , Dai Hongyan 
Published: October 2023

Abstract
Background To analyze the association of serum Asprosin concentrations with heart failure (HF).
Methods A total of 103 patients with HF were included in the HF group, and 103 patients with health checkups were included in the non-HF group. The serum Asprosin levels of the two groups were measured, and relevant clinical data were collected for statistical analysis.
Results Compared with the non-HF group, the serum Asprosin concentration was significantly higher in the HF group, and the difference was statistically significant (P<0.001). According to the serum Asprosin levels, we divided all the subjects into three quartiles. We found that the prevalence of HF increased with increasing serum Asprosin levels in the three groups (P<0.001). Serum Asprosin levels were positively correlated with NT-ProBNP (P<0.05) and negatively correlated with LVEF (P<0.001). Dichotomous logistic regression analysis found Asprosin to be an independent risk factor for HF (OR =1.010, 95% CI: 1.003-1.018). Combining Asprosin and NT-proBNP indicators to draw ROC curves can improve the specificity and sensitivity of HF diagnosis.
Conclusions Serum Asprosin levels were significantly elevated in HF patients. The serum Asprosin level is an independent risk factor for HF, and the combined detection of Asprosin and NT-proBNP levels can improve the accuracy of HF diagnosis.
Changes in MRI head motion across development: typical development and ADHD
Authors: Thomson Phoebe , Loosley Vanessa , Friedel Emily , Silk Timothy J. 
Published: October 2023

Abstract

Head motion is a major confounding variable for magnetic resonance imaging (MRI) analysis, and is commonly seen in individuals with neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD). This study investigated the trajectory of change in head motion in typically developing children and children with ADHD, and examined possible altered trajectories in head motion between children with remitted and persistent ADHD. 105 children with ADHD and 84 controls completed diffusion and resting-state functional MRI scans at up to three waves over ages 9–14 years. In-scanner head motion was calculated using framewise displacement, and longitudinal trajectories analyzed using generalized additive mixed modelling. Results revealed a significant age effect on framewise displacement where head motion decreased as age increased during both diffusion (p < .001) and resting-state functional MRI (p < .001). A significant effect of group was also observed; children with ADHD displayed greater framewise displacement than controls over the age range (diffusion MRI p = .036, functional MRI p = .004). Further analyses revealed continued elevation in head motion in children in remission from ADHD (diffusion MRI p = .020, functional MRI p = .011) compared to controls. Rates of change in head motion did not significantly differ between diagnostic groups. Findings indicate a critical link between in-scanner head motion and developmental age within children regardless of ADHD diagnosis, important to consider in studies of neurodevelopment. Findings also suggest change in head motion with age does not differ between individuals with remitted and persistent ADHD, adding further evidence that impairment/behavioral manifestations of ADHD may continue despite clinical remission.
Magmatic degassing and fluid metasomatism promote compositional variation from I-type to peralkaline A-type granite in the late Cretaceous Fuzhou felsic complex, SE China
Authors: Zhang Feng , Guo Feng , Zhang Xiaobing , Zhao Liang 
Published: October 2023

Abstract
A-type granites generally have much lower water, higher temperature, and incompatible element concentrations than I-type granitoids. Yet it remains unclear why I-A-type granitic complexes occur in convergent plate margins. Here we conduct geochemical analyses on apatite and mafic minerals from the late Cretaceous I-A-type granitic complex in Fuzhou area, SE China, aiming to decipher differentiation, fluid metasomatism, and degassing that primarily control the compositional diversity of felsic magmas. Apatites in both rock types are F-rich and show large H2O and δD variations, i.e., 341–3892 ppm H2O and –325 to +336‰ δD in I-type granitoids; 67–1366 ppm H2O and –251 to +1439‰ δD in A-type granites. H2O in apatite is negatively correlated with La/Sm and Sr/Y in the I-type granitoids, whereas it is positively correlated with Ce and total rare earth element (REE) concentrations in the A-type granites. Once H2O increases up to hundreds of ppm, both rock types show a rapid decrease of H2O/Ce, an increase of F/Cl, and extensive H isotope fractionation.
Arfvedsonite occurs as a late crystallizing mineral in the A-type granite and has much higher contents of Na2O, K2O, F, and high field strength elements (HFSE) than hornblende in the I-type granitoids, indicating the addition of F-HFSE-rich alkaline fluids during its magmatic evolution. The consumption of arfvedsonite and formation of aegirine further indicate the role of fluid metasomatism and H2 degassing via a reaction of 3Na3Fe5Si8O22(OH)2 + 2H2O = 9NaFeSi2O6 + 2Fe3O4 + 6SiO2+5H2.
The combined geochemical data demonstrate that the systematic differences in mineral assemblage, whole-rock composition, magma temperature, H2O content, and δD of apatite between the I- and A-type granites are likely attributed to varying degrees of differentiation, fluid metasomatism and magmatic degassing. The I-type granitoids experienced hornblende, biotite, plagioclase, K-feldspar, and apatite fractionation and close-system degassing. The A-type granite was likely formed from the I-type monzogranitic magma that was metasomatized by the mantle-derived F-HFSE-rich alkaline fluids to produce the peralkaline magma, which further experienced K-feldspar + plagioclase + biotite + apatite fractionation and open-system degassing. Further numerical estimation indicates that the primary magma of Fuzhou granitic complex contained ~3.0 wt% H2O, and the lower water content of A-type granite was likely attributed to strong degassing during its emplacement. Our results indicate that some peralkaline A-type granites can be generated from relatively water-poor I-type granitic magmas by fluid metasomatism and degassing.
Ocrelizumab Extended Interval Dosing in Primary Progressive Multiple
Sclerosis: An Italian Experience
Authors: Zanghì Aurora , Ferraro Diana , Callari Graziella , Valentino Paola , Granella Franco , Patti Francesco , Lus Giacomo , Bonavita Simona , Moretti Maria Claudia , Avolio Carlo , D’Amico Emanuele 
Published: October 2023

Background:
The intervals between two courses of anti CD20 therapies in the COVID19
pandemic era provided the opportunity to individually delay therapy, known as extended interval dosing
(EID).

Materials and Methods:
We collect real-world data on patients with primary progressive MS (PPMS)
treated with Ocrelizumab (OCR) during the COVID’19 pandemic. The observation period in which
the standard interval dosing (SID) or EID occurred (always a maintenance cycle, 600 mg) was from
January 2020 to June 2021. All patients had two infusions during the observation period. Our first aim
was to compare confirmed disability progression (CDP) between SID and EID patients.

Results:
From a total cohort of 410 patients treated with OCR, 96 patients fulfilled the inclusion criteria.
All patients received two infusions during the index window, 71 received only SID infusions
whilst 25 received at least one EID infusion throughout the entire follow-up. During the entire available
follow-up (median 10 months, IQR 7-11), CDP was recorded in 5 patients (3/71, 4.2% SID and
2/25, 8% EID, V-Cramer = 0.141, p-value = 0.167). EID regimen did not influence the risk of CDP
during the investigated follow up.

Conclusion:
In our multicentre real-world cohort, the EID regimen in PPMS patients did not result in
increased CDP during the available follow-up.
Exogenous crisis and the resilience of SMEs: exploring Open Innovation in the COVID-19 Pandemic
Authors: Vasi Melissa , English Vincent 
Published: October 2023

Open innovation is one of the most discussedthemes in managerial literature. However, there are still many questions that scholars have not yet answered. A research question of particular relevance today is: How can open Innovation help SMEs overcome and manage the economic crises caused by a pandemic? In 2020, a global coronavirus pandemic (COVID-19) emerged that has damaged several sectors, particularly by weakening the economy of small and medium-sized businesses. This paper addresses this issue by examining the literature available to date and provides a theoretical answer by investigating the influence of open innovation on the resilience of SMEs during the COVID-19 outbreak. The paper shows that several companies have leveraged open innovation to address the economic crisis caused by the pandemic. Moreover, open innovation can represent a winning strategy for SMEs in surviving extremely uncontrollable turbulences. A collaborative approach and an open mindset can be the right innovative strategy for SMEs to overcome a crisis caused by unpredictable exogenous factors.