bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biogeochemical behavior, health risk assessment and source identification of antimony and arsenic in soil from a legacy antimony smelter in Gansu, Northwest China
Authors: Li Qiang , Cao Ying , Meng Tian , He Liansheng , Zhang Sen 
Published: December 2023

AbstractThe study of the contamination patterns and characteristics of Sb and As in the soils of the legacy contaminated sites of antimony smelters is important for the redevelopment and utilization of industrial sites. In this study, 13 heavy metals were determined in the soil and plants of an antimony smelter in Gansu Province to study the biogeochemical behavior, health risk, and pollution source. The results showed that the Nemerow index of Sb (728) exceeded the value of As (43.6) by 17.6 times, and the average geoaccumulation index (Igeo) of Sb and As were 10.1 and 1.97, respectively, categorized as extremely and moderately contaminated classes. Compared to As, Sb had a larger proportion of oxidizable fraction and a smaller proportion of reducible fraction (Fe/Mn oxides), suggesting that Sb possessed a higher content of organic matter and sulfide forms. Even though the bioaccumulation factor (BAF) for As was about 10 times higher than that for Sb, the accumulation of Sb in plants was not negligible. For the USEPA model, the mean hazard quotient (HQ) values of As by oral ingestion, dermal absorption, and inhalation accounted for 99.0%, 0.97%, and 0.0002% of the total, and 54.2%, 45.3%, and 0.51% for MEEPRC model, respectively. There were significant positive correlations between Sb, As, Zn, Se, Cd, and Ba (P < 0.05). The results of the source identification analysis revealed that antimony smelting, solid waste pollution, and natural origin were identified as the main pollution sources. The principal component analysis (PCA) and positive matrix factorization (PMF) methods differed by more than 20% in the analysis of the contribution of antimony smelting activities and solid waste pollution sources, suggesting the differences in the models themselves and in the uncertainty parameters chosen during the application.
Comparison of post-auricular and frontal bispectral index values obtained during renal surgeries
Authors: Abdelrahman Ahmed Mohammed Fetouh , Elbadry Amr Arafa , Omara Amany Faheem 
Published: December 2023

Abstract
Background
The bispectral index (BIS) monitor is one of the EEG-derived monitoring techniques and well-established devices used to measure the depth of anesthesia. This study aimed to assess the agreement of BIS values based on the positions of either post-auricular or frontal sensors in individual patients undergoing renal surgeries while lateral positions at various stages of anesthesia.

Patients and methods
12 patients older than 18 years, ASA I-III patients scheduled for elective renal operations, two BIS were placed on each patient, one on each side of the post-auricular region and one across the forehead, and each sensor was connected to a different BIS monitor. We gathered three pieces of data at each of the six-time points: BIS score, signal quality index (SQI) score calculating the signal’s strength and electromyography (EMG) score: before the onset of anesthesia (awake) when the eyelash reflex is lost (LOC), after intubation (intubation), following the initial surgical incision, each 30 min throughout the procedure (maintenance), and at the moment the patient’s eyes open naturally after waking up from anesthesia (emergence).

Results
The overall BIS value at the frontal position was significantly higher than the post-auricular position (52.5 ± 22.2 and 52.1 ± 22.1, respectively, P = 0.010). On the other hand, the BIS value was comparable between the frontal and post-auricular positions at LOC, intubation, 60, 120, and 80 min and at emergence. A strong link between the two sensor positions, as indicated by the correlation coefficient (r = 0.607, P < 0.001), and the Bland-Altman analysis revealed a small mean difference (-1.8) and a low (9.0/- 12.5) limit of agreement, with just 4.3% of the readings falling outside of it during the anesthetic maintenance period.

Conclusion
Acceptable variation in BIS data was observed when obtained from the two different sensor positions for clinical usage. The post-auricular BIS sensor system may be a suitable substitute for an impractical frontal setup.

Protocol Registration
The study was registered in clinicaltrials.gov on 11/07/2022 (trial registration number: NCT05451823).
A Bayesian approach to pilot-pivotal trials for bioequivalence assessment
Authors: Lv Duo , Grayling Michael J. , Zhang Xinyue , Zhao Qingwei , Zheng Haiyan 
Published: December 2023

Abstract
Background
To demonstrate bioequivalence between two drug formulations, a pilot trial is often conducted prior to a pivotal trial to assess feasibility and gain preliminary information about the treatment effect. Due to the limited sample size, it is not recommended to perform significance tests at the conventional 5% level using pilot data to determine if a pivotal trial should take place. Whilst some authors suggest to relax the significance level, a Bayesian framework provides an alternative for informing the decision-making. Moreover, a Bayesian approach also readily permits possible incorporation of pilot data in priors for the parameters that underpin the pivotal trial.

Methods
We consider two-sequence, two-period crossover designs that compare test (T) and reference (R) treatments. We propose a robust Bayesian hierarchical model, embedded with a scaling factor, to elicit a Go/No-Go decision using predictive probabilities. Following a Go decision, the final analysis to formally establish bioequivalence can leverage both the pilot and pivotal trial data jointly. A simulation study is performed to evaluate trial operating characteristics.

Results
Compared with conventional procedures, our proposed method improves the decision-making to correctly allocate a Go decision in scenarios of bioequivalence. By choosing an appropriate threshold, the probability of correctly (incorrectly) making a No-Go (Go) decision can be ensured at a desired target level. Using both pilot and pivotal trial data in the final analysis can result in a higher chance of declaring bioequivalence. The false positive rate can be maintained in situations when T and R are not bioequivalent.

Conclusions
The proposed methodology is novel and effective in different stages of bioequivalence assessment. It can greatly enhance the decision-making process in bioequivalence trials, particularly in situations with a small sample size.
Associations of daytime napping and nighttime sleep quality with depressive symptoms in older Chinese: the Guangzhou biobank cohort study
Authors: Zhang Weisen , Zhou Baijing , Jiang Chaoqiang , Jin Yali , Zhu Tong , Zhu Feng , Cheng Kar Keung , Lam Tai Hing , Xu Lin 
Published: December 2023

Abstract
Background
Poor sleep quality has been linked to depression in older adults, but results of the association between daytime napping and depression remains limited and conflicting. Moreover, whether the association of daytime napping with depression varies by nighttime sleep quality is unclear. Hence, we examined the associations of daytime napping and nighttime sleep quality with depressive symptoms in older Chinese.

Methods
A total of 16,786 participants aged ≥50 from the Guangzhou Biobank Cohort Study second-round examination (2008–2012) were included in this cross-sectional study. Geriatric Depression Scale (GDS-15), Pittsburgh Sleep Quality Index (PSQI), napping and demographic data were collected by face-to-face interview using a computerized questionnaire. Logistic regression was used to calculate odds ratio (OR) of depressive symptoms for napping and sleep quality.

Results
The prevalence of depressive symptoms (GDS score > 5) and poor global sleep quality (PSQI score ≥ 6) was 5.3 and 31.9%, respectively. Compared to non-nappers, nappers showed significantly higher odds of depressive symptoms, with OR (95% confidence interval (CI)) being 1.28 (1.11–1.49). The odds of depressive symptoms for daytime napping varied by nighttime sleep quality (P for interaction = 0.04). In good-quality sleepers, compared to non-nappers, nappers had significantly higher odds of depressive symptoms, with OR (95% CI) being 1.57 (1.23–2.01), whereas no association was found in poor-quality sleepers (OR = 1.13, 0.94–1.36).

Conclusion
Napping was associated with higher odds of depressive symptoms in older people, and the association was stronger in good-quality sleepers.
Associations of inter-annual rainfall decreases with subsequent HIV outcomes for persons with HIV on antiretroviral therapy in Southern Africa: a collaborative analysis of cohort studies
Authors: Trickey Adam , Johnson Leigh F. , Fung Fai , Bonifacio Rogerio , Iwuji Collins , Biraro Samuel , Bosomprah Samuel , Chirimuta Linda , Euvrard Jonathan , Fatti Geoffrey , Fox Matthew P. , Von Groote Per , Gumulira Joe , Howard Guy , Jennings Lauren , Kiragga Agnes , Muula Guy , Tanser Frank , Wagener Thorsten , Low Andrea , Vickerman Peter 
Published: December 2023

Abstract
Background
Periods of droughts can lead to decreased food security, and altered behaviours, potentially affecting outcomes on antiretroviral therapy (ART) among persons with HIV (PWH). We investigated whether decreased rainfall is associated with adverse outcomes among PWH on ART in Southern Africa.

Methods
Data were combined from 11 clinical cohorts of PWH in Lesotho, Malawi, Mozambique, South Africa, Zambia, and Zimbabwe, participating in the International epidemiology Databases to Evaluate AIDS Southern Africa (IeDEA-SA) collaboration. Adult PWH who had started ART prior to 01/06/2016 and were in follow-up in the year prior to 01/06/2016 were included. Two-year rainfall from June 2014 to May 2016 at the location of each HIV centre was summed and ranked against historical 2-year rainfall amounts (1981–2016) to give an empirical relative percentile rainfall estimate. The IeDEA-SA and rainfall data were combined using each HIV centre’s latitude/longitude. In individual-level analyses, multivariable Cox or generalized estimating equation regression models (GEEs) assessed associations between decreased rainfall versus historical levels and four separate outcomes (mortality, CD4 counts < 200 cells/mm3, viral loads > 400 copies/mL, and > 12-month gaps in follow-up) in the two years following the rainfall period. GEEs were used to investigate the association between relative rainfall and monthly numbers of unique visitors per HIV centre.

Results
Among 270,708 PWH across 386 HIV centres (67% female, median age 39 [IQR: 32–46]), lower rainfall than usual was associated with higher mortality (adjusted Hazard Ratio: 1.18 [95%CI: 1.07–1.32] per 10 percentile rainfall rank decrease) and unsuppressed viral loads (adjusted Odds Ratio: 1.05 [1.01–1.09]). Levels of rainfall were not strongly associated with CD4 counts < 200 cell/mm3 or > 12-month gaps in care. HIV centres in areas with less rainfall than usual had lower numbers of PWH visiting them (adjusted Rate Ratio: 0.80 [0.66–0.98] per 10 percentile rainfall rank decrease).

Conclusions
Decreased rainfall could negatively impact on HIV treatment behaviours and outcomes. Further research is needed to explore the reasons for these effects. Interventions to mitigate the health impact of severe weather events are required.
In vivo characterization of a podocyte-expressed short podocin isoform
Authors: Butt Linus , Unnersjö-Jess David , Reilly Dervla , Hahnfeldt Robert , Rinschen Markus M. , Bozek Katarzyna , Schermer Bernhard , Benzing Thomas , Höhne Martin 
Published: December 2023

AbstractThe most common genetic causes of steroid-resistant nephrotic syndrome (SRNS) are mutations in the NPHS2 gene, which encodes the cholesterol-binding, lipid-raft associated protein podocin. Mass spectrometry and cDNA sequencing revealed the existence of a second shorter isoform in the human kidney in addition to the well-studied canonical full-length protein. Distinct subcellular localization of the shorter isoform that lacks part of the conserved PHB domain suggested a physiological role. Here, we analyzed whether this protein can substitute for the canonical full-length protein. The short isoform of podocin is not found in other organisms except humans. We therefore analysed a mouse line expressing the equivalent podocin isoform (podocinΔexon5) by CRISPR/Cas-mediated genome editing. We characterized the phenotype of these mice expressing podocinΔexon5 and used targeted mass spectrometry and qPCR to compare protein and mRNA levels of podocinwildtype and podocinΔexon5. After immunolabeling slit diaphragm components, STED microscopy was applied to visualize alterations of the podocytes’ foot process morphology.Mice homozygous for podocinΔexon5 were born heavily albuminuric and did not survive past the first 24 h after birth. Targeted mass spectrometry revealed massively decreased protein levels of podocinΔexon5, whereas mRNA abundance was not different from the canonical form of podocin. STED microscopy revealed the complete absence of podocin at the podocytes’ slit diaphragm and severe morphological alterations of podocyte foot processes. Mice heterozygous for podocinΔexon5 were phenotypically and morphologically unaffected despite decreased podocin and nephrin protein levels.The murine equivalent to the human short isoform of podocin cannot stabilize the lipid-protein complex at the podocyte slit diaphragm. Reduction of podocin levels at the site of the slit diaphragm complex has a detrimental effect on podocyte function and morphology. It is associated with decreased protein abundance of nephrin, the central component of the filtration-slit forming slit diaphragm protein complex.
Drug-related problems and associated factors among patients with kidney dysfunction at a tertiary hospital in southwestern Uganda: a prospective observational study
Authors: Kyomya Julius , Atwiine Fredrick , Shegena Efrata Ashuro , Muhindo Rose , Yadesa Tadele Mekuriya 
Published: December 2023

Abstract
Background
Kidney dysfunction is a common, progressive condition that is increasingly becoming a global public health issue. Because the kidneys are the major route for drug excretion, impaired renal function can change the pharmacokinetics and pharmacodynamics of drugs that are renally excreted. Additionally, patients with kidney dysfunction often have co-morbidities and the associated use of multiple medications which increases the risk of drug-related problem (DRP) occurrence. This study aimed to determine the prevalence, types, and factors associated with DRPs in patients with kidney dysfunction.

Method
We conducted a prospective observational study over 3 months among hospitalized patients diagnosed with acute kidney injury or chronic kidney disease who were hospitalized in the medical ward, and patients attending the renal outpatient clinic at Mbarara Regional Referral Hospital. A total of 183 participants were enrolled through the use of a consecutive sampling technique. DRPs were classified according to the PCNE classification version 9.1. Data analysis was carried out using SPSS version 25.

Results
A total of 174 patients with kidney dysfunction were included in the study with a mean ± SD age of 50.34 ± 18.13 years. A total of 219 DRPs were incurred by 138 (79.3%) study participants. The most common DRPs were ‘Untreated symptoms or indication’ (35.6%) followed by ‘adverse event (possibly) occurring’ (28.3%), and ‘effect of drug treatment not optimal’ (23.3%). Antimicrobials were the most involved drugs in suboptimal drug treatment (31.3%) and unnecessary drug treatment (32.1%). The study showed that length of hospital stay ≥ 5 days (AOR = 6.39, 95% CI: 1.75–23.27; p-value = 0.005) significantly increased the risk of DRP occurrence.

Conclusion
The current results, in agreement with previous literature, showed a high burden of DRPs among patients with kidney dysfunction. Antimicrobials were the most involved drugs in suboptimal as well as in unnecessary drug treatment. Longer hospital stay significantly increased the risk of DRPs. The high prevalence of DRPs in patients with kidney dysfunction and the potential impact on antimicrobial resistance underscores the importance of regular medication reviews and close monitoring of patients with renal dysfunction.
Case series of branch retinal vein occlusion secondary to rhegmatogenous retinal detachment and its surgical management
Authors: Choi Youna , Kim Sung Jun , Lee Jae Jung , Zaidi Moosa Hasan , Shin Yong Un , Byon Ik Soo , Lee Ji Eun , Park Sung Who 
Published: December 2023

Abstract
Background
To review cases of branch retinal vein occlusion (BRVO) secondary to rhegmatogenous retinal detachment (RRD) and its surgical management and presume their mechanism.

Methods
Medical records of patients who underwent surgery for RRD between 2015 and 2019 at a single tertiary care center were retrospectively reviewed. New BRVO secondary to RRD or its surgical procedure was diagnosed based on the fundus examination and its clinical course.

Results
A total of 734 RRD surgeries were performed for five years, and six cases of new BRVOs were noticed in the first year after surgery (incidence was 0.68%: six cases of BRVO / 734 cases of surgical RRD); five cases occurred after vitrectomy, and one occurred after scleral buckling. In three cases, retinal veins were presumed to already be partially occluded related due to a kink of the retinal vein seen before surgery. In the other three cases, the retinal veins were presumed to have incurred damage during vitrectomy.

Conclusion
In the present cohort, RRD or its related procedures caused BRVO within a year of surgery at an incidence of 0.68%. The proposed mechanisms are kinks of the retinal vein on the detached retina and damage to the retinal vein during vitrectomy.
Knowledge, attitudes and practices of patients with chronic pharyngitis toward laryngopharyngeal reflux in Suzhou, China
Authors: Zhang Qiumin , Huang Haiping , Li Jiachen , Niu Yuyu , Sun Peng , Cheng Fuwei 
Published: December 2023

Abstract
Background
This study aimed to investigate the knowledge, attitudes and practices (KAP) of patients with chronic pharyngitis in Suzhou, China toward laryngopharyngeal reflux (LPR).

Methods
This cross-sectional study was conducted in patients with chronic pharyngitis in Suzhou, China at the otolaryngology outpatient clinic of the First Affiliated Hospital of Soochow University between November, 2022, and May, 2023. Data was collected through a self-designed online questionnaire encompassing the sociodemographic characteristics and three dimensions of KAP. The questionnaire was administered using SoJump, and data were exported from this platform. Subsequently, statistical analysis, including Structural Equation Modeling, was performed using SPSS 22 software to evaluate the KAP scores.

Results
A total of 487 valid questionnaires were collected, with 275 (56.35%) female patients. The mean score of KAP were 4.76 ± 2.93 (possible range: 0–11), 33.10 ± 4.46 (possible range: 8–40), 31.29 ± 6.04 (possible range: 8–40), respectively. Pearson’s correlation analysis showed significant positive correlations between knowledge and attitude dimensions (r = 0.413, P < 0.001), knowledge and practice dimensions (r = 0.355, P < 0.001), and attitude and practice dimensions (r = 0.481, P < 0.001). Structural equation modeling revealed that education exhibited positive effect on knowledge (β = 0.476, P < 0.001) and attitude (β = 0.600, P < 0.001), and having family history of chronic pharyngitis showed positive effect on knowledge (β = 0.580, P = 0.047), experienced with reflux symptoms showed positive effect on knowledge (β = 0.838, P = 0.001) and attitude (β = 0.631, P = 0.085). Moreover, knowledge showed positive effect on attitude (β = 0.555, P < 0.001) and practice (β = 0.351, P < 0.001). Attitude, in turn, showed positive effect on practice (β = 0.511, P < 0.001).

Conclusion
Patients with chronic pharyngitis had inadequate knowledge, positive attitudes and suboptimal practices toward LPR. Education, family history of chronic pharyngitis, experienced with reflux symptoms might have effect on their KAP.
Disability and loneliness in the United Kingdom: cross-sectional and longitudinal analyses of trends and transitions
Authors: Emerson Eric , Stancliffe Roger J. , Aitken Zoe , Bailie Jodie , Bishop Glenda M. , Badland Hannah , Llewellyn Gwynnyth , Kavanagh Anne M. 
Published: December 2023

Abstract
Background
Loneliness can have a detrimental impact on health, yet little is known about the association between disability and loneliness.

Methods
Secondary analysis of three waves of data collected between 2017 and 2020 by the UK’s annual household panel study, Understanding Society. Direct age-standardisation was used to compare the prevalence of loneliness at each wave and the persistence of loneliness across all three waves for participants with/without disabilities aged 16–65 years. Transitional probabilities for the stability of loneliness, the stability of non-loneliness, the onset of loneliness and the offset of loneliness between consecutive waves were also estimated.

Results
At each wave, the prevalence of loneliness was significantly higher among respondents with disabilities than respondents without disabilities; these inequalities persisted with no evidence of change over time. The prevalence of persistent loneliness was 46% for respondents with disabilities compared with 22% for respondents without disabilities. Risk factors for the likelihood of persistent loneliness included disability, financial stress, not living as a couple, living in rented accommodation, being female and not being employed. The probability of the onset and stability of loneliness between successive waves were markedly higher for people with disabilities compared with people without disabilities.

Conclusion
Adults with disabilities were more likely to experience loneliness, become lonely and remain lonely over time than their peers. Policies and interventions aimed at reducing loneliness should ensure that they are accessible and effective for people with disabilities. Further research is needed to explore the health outcomes of persistent loneliness among people with/without disabilities.