bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of type 2 diabetes mellitus on the clinical profile, myocardial fibrosis, and prognosis in non-ischemic dilated cardiomyopathy: a prospective cohort study
Authors: Li Yangjie , Xian Hong , Xu Yuanwei , Li Weihao , Guo Jiajun , Wan Ke , Wang Jie , Xu Ziqian , Zhang Qing , Han Yuchi , Sun Jiayu , Chen Yucheng 
Published: February 2024

Abstract
Background
The impact of the coexistence of type 2 diabetes mellitus (T2DM) in patients with non-ischemic dilated cardiomyopathy (DCM) on clinical profiles, myocardial fibrosis, and outcomes remain incompletely understood.

Method
A total of 1152 patients diagnosed with non-ischemic DCM were prospectively enrolled from June 2012 to October 2021 and categorized into T2DM and non-T2DM groups. Clinical characteristics, cardiac function, and myocardial fibrosis evaluated by CMR were compared between the two groups. The primary endpoint included both all-cause mortality and heart transplantation. Cause of mortality was classified into heart failure death, sudden cardiac death, and non-cardiac death. Cox regression analysis and Kaplan-Meier analysis were performed to identify the association between T2DM and clinical outcomes. Propensity score matching (PSM) cohort including 438 patients was analyzed to reduce the bias from confounding covariates.

Results
Among the 1152 included DCM patients, 155 (13%) patients had T2DM. Patients with T2DM were older (55 ± 12 vs. 47 ± 14 years, P < 0.001), had higher New York Heart Association (NYHA) functional class (P = 0.003), higher prevalence of hypertension (37% vs. 21%, P < 0.001), atrial fibrillation (31% vs. 16%, P < 0.001), lower left ventricular (LV) ejection fraction (EF) (23 ± 9% vs. 27 ± 12%, P < 0.001), higher late gadolinium enhancement (LGE) presence (55% vs. 45%, P = 0.02), and significantly elevated native T1 (1323 ± 81ms vs. 1305 ± 73ms, P = 0.01) and extracellular volume fraction (ECV) (32.7 ± 6.3% vs. 31.3 ± 5.9%, P = 0.01) values. After a median follow-up of 38 months (interquartile range: 20–57 months), 239 patients reached primary endpoint. Kaplan-Meier analysis showed that patients with T2DM had worse clinical outcomes compared with those without T2DM in the overall cohort (annual events rate: 10.2% vs. 5.7%, P < 0.001). T2DM was independently associated with an increased risk of primary endpoint in the overall (Hazard ratio [HR]: 1.61, 95% CI: 1.13–2.33, P = 0.01) and PSM (HR: 1.54, 95% CI: 1.05–2.24, P = 0.02) cohorts. Furthermore, T2DM was associated with a higher risk of heart failure death (P = 0.006) and non-cardiac death (P = 0.02), but not sudden cardiac death (P = 0.16).

Conclusions
Patients with T2DM represented a more severe clinical profile and experienced more adverse outcomes compared to those without T2DM in a large DCM cohort.

Trial registration
Trial registration number: ChiCTR1800017058; URL: https://www.clinicaltrials.gov.
Diagnostic strategy of metagenomic next-generation sequencing for gram negative bacteria in respiratory infections
Authors: Liang Wenyan , Zhang Qun , Qian Qian , Wang Mingyue , Ding Yuchen , Zhou Ji , Zhu Yi , Jin Yu , Chen Xuesong , Kong Hui , Song Wei , Lu Xin , Wu Xiaodong , Xu Xiaoyong , Dai Shanling , Sun Wenkui 
Published: February 2024

Abstract
Objective
This study aims to identify the most effective diagnostic method for distinguishing pathogenic and non-pathogenic Gram-negative bacteria (GNB) in suspected pneumonia cases using metagenomic next-generation sequencing (mNGS) on bronchoalveolar lavage fluid (BALF) samples.

Methods
The effectiveness of mNGS was assessed on BALF samples collected from 583 patients, and the results were compared with those from microbiological culture and final clinical diagnosis. Three interpretational approaches were evaluated for diagnostic accuracy.

Results
mNGS outperformed culture significantly. Among the interpretational approaches, Clinical Interpretation (CI) demonstrated the best diagnostic performance with a sensitivity of 87.3%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 98.3%. CI’s specificity was significantly higher than Simple Interpretation (SI) at 37.9%. Additionally, CI excluded some microorganisms identified as putative pathogens by SI, including Haemophilus parainfluenzae, Haemophilus parahaemolyticus, and Klebsiella aerogenes.

Conclusion
Proper interpretation of mNGS data is crucial for accurately diagnosing respiratory infections caused by GNB. CI is recommended for this purpose.
Outpatient hysteroscopy impact on subsequent assisted reproductive technology: a systematic review and meta-analysis in patients with normal transvaginal sonography or hysterosalpingography images
Authors: Hou Jung-Hsiu , Lu Buo-Jia , Huang Ya-Li , Chen Chih-Heng , Chen Chi-Huang 
Published: February 2024

Abstract
Background
Standard management for intrauterine lesions typically involves initial imaging followed by operative hysteroscopy for suspicious findings. However, the efficacy of routine outpatient hysteroscopy in women undergoing assisted reproductive technology (ART) remains uncertain due to a lack of decisive high-quality evidence. This study aimed to determine whether outpatient hysteroscopy is beneficial for infertile women who have unremarkable imaging results prior to undergoing ART.

Methods
A systematic review and meta-analysis were conducted following PRISMA guidelines, incorporating data up to May 31, 2023, from databases such as PubMed, Embase, and the Cochrane Library. The primary outcome assessed was the live birth rate, with secondary outcomes including chemical pregnancy, clinical pregnancy rates, and miscarriage rates. Statistical analysis involved calculating risk ratios with 95% confidence intervals and assessing heterogeneity with the I2 statistic.

Results
The analysis included ten randomized control trials. Receiving outpatient hysteroscopy before undergoing ART was associated with increased live birth (RR 1.22, 95% CI 1.03–1.45, I2 61%) and clinical pregnancy rate (RR 1.27 95% CI 1.10–1.47, I2 53%). Miscarriage rates did not differ significantly (RR 1.25, CI 0.90–1.76, I2 50%). Subgroup analyses did not show a significant difference in clinical pregnancy rates when comparing normal versus abnormal hysteroscopic findings (RR 1.01, CI 0.78–1.32, I2 38%). We analyzed data using both intention-to-treat and per-protocol approaches, and our findings were consistent across both analytical methods.

Conclusions
Office hysteroscopy may enhance live birth and clinical pregnancy rates in infertile women undergoing ART, even when previous imaging studies show no apparent intrauterine lesions. Treating lesions not detected by imaging may improve ART outcomes. The most commonly missed lesions are endometrial polyps, submucosal fibroids and endometritis, which are all known to affect ART success rates. The findings suggested that hysteroscopy, given its diagnostic accuracy and patient tolerability, should be considered in the management of infertility.

Database registration
The study was registered in the International Prospective Register of Systemic Review database (CRD42023476403).
Acceptability to donate human milk among postnatal mothers at St. Francis hospital Nsambya, Uganda: a mixed method study
Authors: Ahmed Mohammed A. M. , Namisi Charles Patrick , Kirabira Nakibuuka Victoria , Lwetabe Micheal Webba , Rujumba Joseph 
Published: February 2024

Abstract
Background
The World Health Organization recommends the use of donated human milk (HM) as the second-best option for mothers who are temporarily unable to provide sufficient breast milk to meet the needs of their infants. However, HM donation is yet to become an accepted practice in Uganda. We assessed the level of, and factors associated with acceptability to donate HM among postnatal mothers at St. Francis Hospital Nsambya (SFHN).

Methods
A cross-sectional sequential explanatory mixed method study was conducted between October 2018 and March 2019. A questionnaire on sociodemography, awareness and likely acceptability to donate HM was administered to 410 postnatal mothers at SFHN. Multivariate logistic regression analysis was undertaken to determine factors associated with acceptance of HM donation. Focus Group Discussions (4) and Key Informants Interviews (4) were used to explore factors influencing behaviours to donate human milk. Qualitative data were analysed using a content thematic approach.

Results
Overall acceptance of donating the HM was 77.6%, and the significant factors were: willingness to express the HM (AOR 7.5; 95% CI 3.01, 18.68); wet-nursing knowledge (AOR 2.3; 95% CI 1.1, 5.0) and visit to under-5 years’ clinic (AOR 21.3; 95% CI 2.3, 196.9). The major themes in relation to accepting to donate HM were wet nursing experience, and confidence in donating the HM, and its perceived effectiveness. There were concerns about the safety and adequacy of HM and fear of transmitting criminal behaviours and mental illness through human milk.

Conclusions
Acceptance to donate HM among postnatal mothers at St. Francis Hospital Nsambya was very high. Willingness to express and store human milk, prior knowledge about wet nursing and a visit to an under-five outpatient clinic were associated with acceptance. Thus, establishing a human milk bank is feasible in the study setting.
Factors influencing health-related quality of life among long-term care residents experiencing pain: a systematic review protocol
Authors: Shrestha Shovana , Cummings Greta , Knopp-Sihota Jennifer , Devkota Rashmi , Hoben Matthias 
Published: February 2024

Abstract
Background
Pain is highly burdensome, affecting over 30% of long-term care (LTC) residents. Pain significantly reduces residents’ health-related quality of life (HRQoL), limits their ability to perform activities of daily living (ADLs), restricts their social activities, and can lead to hopelessness, depression, and unnecessary healthcare costs. Although pain can generally be prevented or treated, eliminating pain may not always be possible, especially when residents have multiple chronic conditions. Therefore, improving the HRQoL of LTC residents with pain is a priority goal. Understanding factors influencing HRQoL of LTC residents with pain is imperative to designing and evaluating targeted interventions that complement pain management to improve residents’ HRQoL. However, these factors are poorly understood, and we lack syntheses of available research on this topic. This systematic review protocol outlines the methods to identify, synthesize, and evaluate the available evidence on these factors.

Methods
This mixed methods review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We will systematically search Medline, EMBASE, PsycINFO, CINAHL, Scopus, Cochrane Database of Systematic Reviews and ProQuest Dissertation and Thesis Global from database inception. We will include primary studies and systematically conducted reviews without restrictions to language, publication date, and study design. We will also include gray literature (dissertation and reports) and search relevant reviews and reference lists of all included studies. Two reviewers will independently screen articles, conduct quality appraisal, and extract data. We will synthesize results thematically and conduct meta-analyses if statistical pooling is possible. Residents and family/friend caregivers will assist with interpreting the findings.

Discussion
This proposed systematic review will address an important knowledge gap related to the available evidence on factors influencing HRQoL of LTC residents with pain. Findings will be crucial for researchers, LTC administrators, and policy makers in uncovering research needs and in planning, developing, and evaluating strategies in addition to and complementary with pain management to help improve HRQoL among LTC residents with pain.

Systematic review registration
PROSPERO CRD42023405425
Serum Elabela expression is decreased in hypertensive patients and could be associated with the progression of hypertensive renal damage
Authors: Tian Geng , Zheng Qian , Zhang Qingru , Liu Xiaoyu , Lu Xuehong 
Published: February 2024

Abstract
Background
Elabela, a recently discovered hormonal peptide containing 32 amino acids, is a ligand for the apelin receptor. It can lower blood pressure and attenuate renal fibrosis. However, the clinicopathological relationship between Elabela level and renal damage caused by benign hypertension (BHT) and malignant hypertension (MHT) has not been elucidated. Therefore, we investigated the clinicopathological correlation between serum Elabela level and renal damage caused by BHT and MHT.

Methods
The participants comprised 50 patients and 25 age-matched healthy adults. The 50 patients were separated into two groups: MHT (n = 25) and BHT groups (n = 25). We analyzed their medical histories, demographics, and clinical examinations, including physical and laboratory tests.

Results
The results showed that serum Elabela level decreased gradually with a continuous increase in blood pressure from the healthy control group, BHT, to MHT. Moreover, Elabela levels negatively correlated with BMI (R =  − 0.27, P = 0.02), SBP (r =  − 0.64, P < 0.01), DBP (r =  − 0.58, P < 0.01), uric acid (r =  − 0.39, P < 0.01), bun (r =  − 0.53, P < 0.01), and Scr (r =  − 0.53 P < 0.01) but positively correlated with eGFR (r = 0.54, P < 0.01). Stepwise multivariate linear regression analysis showed that SBP was the variable most related to Elabela (t =  − 5.592, P < 0.01).

Conclusions
Serum Elabela levels decreased in patients with hypertension, especially malignant hypertension, and has the potential to be a marker of hypertension-related kidney damage.
Dietary supplement use among lactating mothers following different dietary patterns – an online survey
Authors: Delgas Franziska , Bitsch Lisa , König Laura Maria , Beitze Damaris Elisabeth , Scherbaum Veronika , Podszun Maren C. 
Published: February 2024

Abstract
Background
Breastfeeding is important for the healthy growth and development of newborns, and the nutrient composition of human milk can be affected by maternal nutrition and supplementation. In Germany, iodine supplementation is recommended for all lactating mothers, and docosahexaenoic acid (DHA) supplementation is recommended for mothers with inadequate or no fish intake. Vitamin B12 supplementation is required for strict vegans during lactation, and other nutrient supplementation may be necessary depending on the individual's nutritional status. To address the lack of data on dietary supplements used by lactating mothers following a vegetarian or vegan diet, an online survey was conducted in Germany, with a focus on iodine, DHA, and vitamin B12.

Methods
Study participants were asked to report whether they followed specific dietary patterns (omnivorous [OM], vegetarian [VT], vegan [VN]) as well as their use of dietary supplements. Relationships between diets and supplement use were analyzed using chi-square tests.

Results
2054 lactating women were included (1240 OM, 410 VT, and 404 VN) in this analysis. Within OM, VT and VN, at least one dietary supplement was taken by 67.3%, 84.9% and 98.0% respectively (p < 0.001). Overall, 53.2% OM, 66.8% VT, 88.4% VN reported taking at least one supplement containing iodine (p < 0.001). 54.6% OM, 61.7% VT and 58.2% VN reported supplements containing vitamin B12, while 34.1% OM, 40.2% VT and 38.6% VN mentioned supplements containing DHA (p < 0.05).

Conclusion
More than half of the participants reported the use of supplements during lactation with the highest proportion in vegans. However, over one third of the mothers did not report supplementing with iodine, regardless of their dietary pattern and most participants also did not report DHA supplements. It is worrisome that a high number of vegans did not report vitamin B12 supplementation, but this could be partly due to issues with reporting. It is crucial to provide further education to breastfeeding mothers about the importance of taking micronutrient supplements, especially for those following a vegetarian or vegan diet. This will help ensure that mothers and their breastfed infants receive optimal nutrition for a healthy development.
Association between dietary carotenoid intakes and abdominal aortic calcification in adults: National Health and Nutrition Examination Survey 2013–2014
Authors: Chen Weidong , Li Yuanqing , Li Min , Li Hai , Chen Caifang , Lin Yanzhao 
Published: February 2024

Abstract
Objective
Abdominal aortic calcification (AAC) is an important marker of subclinical atherosclerosis and a predictor of cardiovascular disease. This study aims to explore the association between carotenoid intakes and AAC.

Methods
We included 2889 participants from the National Health and Nutrition Examination Survey (NHANES). Dietary carotenoid intakes were obtained through 24-h dietary recall interviews. Severe AAC was defined as a Kauppila score > 5. The main analysis utilizes logistic and restricted cubic spline models.

Result
Severe AAC was detected in 378 (13.08%) participants. In fully adjusted models, the odds ratios (OR) with 95% confidence intervals (CI) of α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein with zeaxanthin and total carotenoid intakes for individuals with severe AAC were 0.53 (0.23–0.77), 0.39 (0.19–0.80), 0.18 (0.05–0.62), 0.40 (0.20–0.78), 0.53 (0.32–0.88) and 0.38 (0.18–0.77) in the highest versus lowest quartile intake, respectively. Dose–response analyses revealed that all of the carotenoids were associated with decreased risk of severe AAC in a nonlinear trend. Total carotenoid intakes of at least 100ug/kg/day were associated with decreased odds for severe AAC.

Conclusion
α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein with zeaxanthin and total carotenoids were inversely associated with the risk of severe AAC in adults.
Characteristics and genesis of the Zhongnan Fault Zone in the South China Sea oceanic basin: Insights from an integrated analysis of multibeam bathymetric and 2D multichannel seismic data
Authors: Zou Song , Zhong Guangfa , Zhang Baojin , Geng Minghui , Wang Lijie , Zhang Ruwei 
Published: February 2024

The Zhongnan Fault Zone (ZFZ) is a large-scale tectonic belt in the South China Sea (SCS) oceanic basin and plays an important role in the formation and evolution of the basin. Despite numerous studies over the past few decades, debates persist regarding its location, orientation, nature, time of activity, and genesis. In this study, we evaluate our findings on the characteristics and origin of the fault zone through an integrated analysis of multibeam bathymetric and 2D multichannel seismic data. Our results reveal the ZFZ as a fault zone approximately 400 km long and 50–90 km wide, situated between the east subbasin (ESB) and southwest subbasin (SWSB) of the SCS. The fault zone is oriented N8°W, roughly perpendicular to and laterally displacing the relict spreading center and related spreading lineaments. Bounded by discontinuous linear seamounts, the fault zone comprises two V-shaped subparallel pull-apart basins and a separating basement high. Steeply dipping (>60°) normal basement-involved faults bound these pull-apart basins, forming typical negative flower structures. Numerous northeast-oriented en-echelon linear bathymetric highs within the fault zone are identified as secondary antithetic shears (P′ shears). These shears are characterized by their orientation relative to the principal displacement zones defined along the pull-apart basins. The ZFZ exhibits differences from the adjacent subbasins in water depth, basement burial, stratal thickness, and seismic stratigraphic characteristics. Five seismic sequences (S1–S5 upward) in the ZFZ and nearby ESB and SWSB are defined, dating to the Early Miocene synspreading (S1) and the Middle Miocene to Recent postspreading (S2–S5) stages, respectively. The difficulty in correlating seismic facies in sequences S1–S3, compared with the comparable seismic facies in sequences S4–S5 between the ZFZ and adjacent subbasins, suggests a horizontal displacement during the synspreading and early postspreading stages. We propose that the ZFZ functioned as a right-lateral transform fault zone during the synspreading period (the Early Miocene, approximately 24–16 Ma) of the SWSB and transitioned into a left-lateral strike-slip fault zone during the successive early postspreading period (the Middle-Late Miocene, approximately 16–5.3 Ma).
A Swamp in Name Only: Imagined Geography, Abandonment, and the Archive in W. E. B. Du Bois's The Quest of the Silver Fleece
Authors: Callahan Clare 
Published: February 2024

Abstract
This article illustrates how Black literary production in the Jim Crow era grappled with the necessity of seeking representation shaped by a historically dispossessory archive. In The Quest of the Silver Fleece (1911) the reinvention of swampland by an abandoned Black woman into a farmable and habitable settlement constitutes a form of recovery that would secure representation for Black tenant farmers. At the same time, the article argues, this act of recovery, much like the multigeneric and multivocal form of the novel itself, ultimately exceeds the forms of representation that, for W. E. B. Du Bois, both make Black subjectivity possible and seek to regulate it.
Incidental osteoarthritis: risk factors, prevalence and clinical evidence in rabbits
Authors: Bagha Fatima , Keeble Emma 
Published: February 2024

Aim: The objective of this retrospective cohort study was to evaluate the prevalence, risk factors and level of clinically apparent disease associated with appendicular osteoarthritis in a population of rabbits under veterinary care. Method: Computed tomography reports of 311 rabbits taken for any reason over a 4-year period were evaluated for recorded evidence of appendicular osteoarthritis and the joint(s) affected. Risk factors including age, weight, body condition, breed, sex and neuter status were investigated. In rabbits with evidence of osteoarthritis, clinical notes were examined to evaluate if the condition was clinically apparent. Findings: Out of 311 computed tomography reports, 61 described evidence of osteoarthritis (19.6%). The most common joints affected were the elbow and stifle. No significant relationship between sex, body condition and neuter status in males and presence of osteoarthritis was found. A statistically significant relationship between greater age, greater weight and neuter status in females and the presence of osteoarthritis was found. Only 9 out of 61 (14.8%) of the rabbits with computed tomography evidence of osteoarthritis had clinical signs of osteoarthritis recorded in the clinical notes. Conclusions: Following the results of this study, it may be concluded that greater age and weight, as well as female neuter status, are related to increased risk of appendicular osteoarthritis in rabbits, but changes on imaging may relate poorly to clinically apparent disease.
A crucial determinant of health
Authors: Allen Kirstie 
Published: February 2024

Kirstie Allen discusses children's dental care and the importance of an integrated and collaborative approach. Aim To discuss the relationship between dental health, social determinants of health and life outcomes for children and their families. Objectives To understand the variety of public services involved in promoting good dental health in children and families. To present the theory of the social determinants of health in the context of children's dental care and the impact this has across childhood and into adult life. To understand how these outcomes can be improved through early intervention. This article meets GDC development outcomes A, C and D.