bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and internal and external validation of a nomogram model for frailty risk among hospitalised older people using comprehensive geriatric assessment data
Authors: Lyu Hong , Jiang Wenhui 
Published: November 2023

Abstract
Background
Currently, there are few such studies about establishing the frailty prediction model on the basis of the research on the factors influencing frailty in older patients, which can better predict frailty and identify its risk factors, and then guide the formulation of intervention measures precisely, especially in the hospital setting in China. Meanwhile, comprehensive geriatric assessment (CGA) can provide measurable and substantial health improvements for frail older people. The study aimed to develop a nomogram model for frailty risk among hospitalised older people using CGA data and validated its predictive performance for providing a basis for medical staff to grasp the risk and risk factors of older inpatients’ frailty conveniently and accurately, and to formulate reasonable nursing intervention plan.

Methods
We used CGA data of individuals over age 64. Demographic characteristics, geriatric syndrome assessment, and frailty assessment based on the FRAIL scale were included as potential predictors. Significant variables in univariate analysis were used to construct risk models by logistic regression analysis. We used the root mean square (rms) to develop the nomogram prediction model for frailty based on independent clinical factors. Nomogram performance was internally validated with Bootstrap resampling. The final model was externally validated using an independent validation data set and was assessed for discrimination and calibration.

Results
Data from 2226 eligible older inpatients were extracted. Five hundred sixty-two older inpatients (25.25%) suffered from frailty. The final prediction model included damaged skin, MNA-SF, GDS-15, Morse risk scores, hospital admission, ICI-Q-SF, Braden score, MMSE, BI scores, and Caprini scores. The prediction model displayed fair discrimination. The calibration curve demonstrated that the probabilities of frailty predicted by the nomogram were satisfactorily matched.

Conclusions
The prediction model to identify hospitalised older people at high risk for frailty using comprehensive geriatric assessment data displayed fair discrimination and good predictive calibration. Therefore, it is inexpensive, easily applied, and accessible in clinical practice, containing variables routinely collected and readily available through consultation. It will be valuable for grasp older inpatients at high risk of frailty and risk factors in hospital setting to guide the formulation of intervention measures precisely for reversing and preventing frailty.
The effects of transcranial direct-current stimulation (tDCS) on pain intensity of patients with fibromyalgia: a systematic review and meta-analysis
Authors: Moshfeghinia Reza , Shekouh Dorsa , Mostafavi Sara , Hosseinzadeh Mehrnaz , Bahadori Amir Reza , Abdollahifard Saeed , Razmkon Ali 
Published: November 2023

Abstract
Introduction
Fibromyalgia (FM) is a chronic pain condition that affects millions of people worldwide. Transcranial Direct Current Stimulation (tDCS) is a non-invasive brain stimulation technique that has shown promise as a potential treatment for FM by modulating pain perception and reducing symptoms, such as fatigue and depression. We aimed to systematically review studies that assess the effect of tDCS on pain reduction in FM patients.

Methods
Seven electronic databases (PubMed, Scopus, Embase, PsycINFO, Web of Science, Cochrane, and CINAHL Complete) were searched for records in English. Studies that measured the effect of tDCS on pain intensity in FM patients were included. The Cochrane Collaboration’s tool was used to assess the quality of the included studies. A random-effect model was preferred, and statistical analysis was performed by Stata software version 17.

Results
Twenty studies were included for qualitative, and eleven for quantitative analysis. Out of 664 patients included in the study, 443 were in the stimulation group. The left M1 area was the most common stimulation target (n = 12), and 2 mA was the most common stimulation amplitude (n = 19). The analysis showed that active tDCS significantly reduced pain intensity in FM patients in comparison to the sham group (SMD= -1.55; 95% CI -2.10, -0.99); also, no publication bias was noted.

Conclusion
Our systematic review highlights the potential effect of tDCS on the reduction of pain intensity in FM patients. Additionally, this current evidence could suggest that tDCS applied at an intensity of 2mA to the left M1 is the most effective strategy.
Sex-specific aspects in patients with oropharyngeal squamous cell carcinoma: a bicentric cohort study
Authors: Klasen Charlotte , Wuerdemann Nora , Rothbart Pauline , Prinz Johanna , Eckel Hans Nicholaus Casper , Suchan Malte , Kopp Christopher , Johannsen Jannik , Ziogas Maria , Charpentier Arthur , Huebbers Christian Ulrich , Sharma Shachi Jenny , Langer Christine , Arens Christoph , Wagner Steffen , Quaas Alexander , Klußmann Jens Peter 
Published: November 2023

Background
Oropharyngeal squamous cell carcinoma (OPSCC) is the only subgroup of head neck cancer that presents with an increased incidence. Gender-specific studies in other cancer entities have revealed differences in treatment response and prognosis. However, only limited data in OPSCC according to gender and human papillomavirus (HPV) status exist. Therefore, we aimed to investigate sex-specific differences in OPSCC and how these may be distributed in relation to HPV and other risk factors.

Methods
This retrospective, bicentric study included 1629 patients with OPSCC diagnosed between 1992 and 2020. We formed subgroups based on TNM status, American Joint Cancer Committee 8th edition (AJCC8), HPV status, treatment modality (surgery (± radio(chemo)therapy (RCT) vs. definitive RCT) and patient-related risk factors and investigated gender differences and their impact on patients survival via descriptive-,uni- and multivariate analysis.

Results
With the exception of alcohol abuse, no significant differences were found in risk factors between men and women. Females presented with better OS than males in the subgroup T1-2, N + , independent of risk factors (p = 0.008). Males demonstrated significant stratification through all AJCC8 stages (all p < 0.050). In contrast, women were lacking significance between stage II and III (p = 0.992). With regard to therapy (surgery (± R(C)T) – vs. definitive RCT) women treated with surgery had better OS than men in the whole cohort (p = 0.008). Similar results were detected in the HPV-negative OPSCC sub-cohort (p = 0.042) and in high-risk groups (AJCC8 stage III and IV with M0, p = 0.003).

Conclusion
Sex-specific differences in OPSCC represent a health disparity, particularly according to staging and treatment, which need to be addressed in future studies.
“It’s already in your body and it’s preventing”: a qualitative study of African female adolescent’s acceptability and preferences for proxy HIV prevention methods in Cape Town, South Africa
Authors: Fynn Lauren , Gill Katherine , Wallace Melissa , Atujuna Millicent , Duyver Menna , Ngcobo Penelope , Spiegel Hans , Rinehart Alex , Hosek Sybil , Bekker Linda-Gail 
Published: November 2023

Abstract
Background
Advances in biomedical HIV prevention will soon offer young women a choice of HIV prevention methods, including various pre-exposure prophylaxis (PrEP) modalities such as daily oral pills, dapivirine vaginal ring, and long-acting injectable agents. By understanding preferences for contraceptive methods, we may draw analogies for the HIV prevention needs of young women.
The UChoose Study was an open-label randomised cross-over study designed to evaluate the acceptability and preference for several contraceptive options as a proxy for HIV prevention methods that use similar types of administration. The study enrolled healthy HIV uninfected young women aged 15 to 19 years. At enrolment, participants were randomly assigned to a contraceptive method for a period of 16 weeks in the form of monthly Nuvaring® (vaginal ring), daily combined oral contraceptive (daily pills), or bi-monthly injectable contraceptive (injectable). After 16 weeks, participants crossed over to another contraceptive method, and those who had received the injectable and the daily pills received the vaginal ring for another 16 weeks, whereas those who had received the vaginal ring were able to choose between the injectable and daily pills, to ensure that all participants tried the vaginal ring—the least familiar option to the study population.

Results
Thirty-three participants were purposively recruited to participate in seven focus group discussions (FGD) and completed a pre-survey for their assigned group. Our sample comprised 14 participants randomised to use of the vaginal ring and daily pills and 19 participants randomised to use of the vaginal ring and injectable. For most participants, their preferences for a prevention method were based primarily on their desire to avoid negative aspects of one method rather than their positive user experience with another method. Most participants expressed initial hesitancy for trying new contraception method products; however, a lack of familiarity was moderated by a strong interest in diverse user-controlled prevention methods. Participants valued methods that had infrequent dosing and simplified use requirements. The injection and vaginal ring were preferred over daily pills as a potential HIV prevention method.

Conclusion
Expanding the availability of diverse products could provide adolescents with multiple choices in HIV prevention for the uninitiated.

Trial registration
ClinicalTrials.gov (NCT02404038). Registered March 31, 2015—Registered.
Occupational exposure to pesticides and endometrial cancer in the Screenwide case-control study
Authors: Peñalver-Piñol Arnau , Benavente Yolanda , Frias-Gomez Jon , Alguacil Juan , Santibañez Miguel , Contreras-Llanes Manuel , Peremiquel-Trillas Paula , López-Querol Marta , Paytubi Sonia , Pelegrina Beatriz , Onieva Irene , Martínez José Manuel , Fernandez-Gonzalez Sergi , Francisco Javier de , Caño Víctor , Brunet Joan , Pineda Marta , Ponce Jordi , Matias-Guiu Xavier , Bosch Francesc Xavier , Sanjosé Silvia de , Alemany Laia , Costas Laura 
Published: November 2023

Abstract
Background
Endometrial cancer is the most common gynaecological tumour in developed countries and disease burden is expected to increase over the years. Identifying modifiable risk factors may help developing strategies to reduce the expected increasing incidence of these neoplasms.

Objective
This study evaluates the association between occupational exposure to pesticides and endometrial cancer using data from a recent case-control study in Spain.

Methods
The analyses included data from 174 consecutive incident endometrial cancer cases and 216 hospital controls frequency-matched by age. Data were collected through structured epidemiological questionnaires and exposure to pesticides was assessed using a Spanish job-exposure matrix (MatEmESp).

Results
Overall, 12% of controls and 18% of cases were occupationally exposed to pesticides. We observed a positive association between occupational exposure to pesticides and endometrial cancer (OR = 2.08; 95% CI = 1.13–3.88 compared to non-exposed). In general, exposures that occurred farther in the past were significantly associated with endometrial cancer. Exposure to insecticides, fungicides and herbicides were positively associated with endometrial cancer (OR = 2.08; 95% CI = 1.13–3.88, OR = 4.40; 95% CI = 1.65–13.33, and OR = 5.25; 95% CI = 1.84–17.67, respectively). The agricultural, poultry and livestock activities scenario was associated with endometrial cancer (OR = 4.16; 95% CI = 1.59–12.32), while the cleaning exposure scenario was not (OR = 1.22; 95% CI = 0.55–2.67).

Conclusions
Assessment of occupational exposure to pesticides assessed using a Spanish job-exposure matrix revealed a positive association with endometrial cancer. The elucidation of the role of pesticide compounds on endometrial cancer should shed a light on the aetiology of this tumour.
A critical role of outer membrane vesicles in antibiotic resistance in carbapenem-resistant Klebsiella pneumoniae
Authors: Yao Lifeng , Wei Beiwen , Wang Yuanxia , Xu Beihui , Yang Meng , Chen Xu , Chen Fuxiang 
Published: November 2023

Abstract
Background
This study aimed to illustrate the status of carbapenem-resistant Enterobacterales (CRE) infections in a Chinese tertiary hospital and to investigate the role of outer membrane vesicles (OMVs) in antibiotic resistance in carbapenem-resistant Klebsiella pneumoniae (CRKP).

Methods
The data of CRE infections was collected from laboratory records, and the CRE isolates from two distinct periods (2015/07 to 2017/07 and 2020/04 to 2021/04) were enrolled to detect the carbapenemase genes by polymerase chain reaction (PCR). Multilocus sequence typing (MLST) was used to analyze the molecular characterization of CRKP. The conjugation assay was performed to verify the transmission of the antibiotic resistance plasmid. The OMVs of CRKP were isolated with a method combining an electrophoretic technique with a 300 kDa cut-off dialysis bag. The protein components in CRKP OMVs were analyzed by liquid chromatography tandem-mass spectrometry (LC–MS/MS), and the meropenem-hydrolyzing bioactivity of KPC in CRKP OMVs was determined with different treatments in vitro.

Results
A total of 178 CRE isolates, including 100 isolates from 2015/07 to 2017/07 and 78 isolates from 2020/04 to 2021/04, were collected for the detection of carbapenemase genes. We found that the carbapenemase gene blaKPC was the most prevalent, followed by blaNDM. By MLST, we found that sequence type (ST) 11 CRKP (96.1%) was the leading type during 2015/07 to 2017/07 and that the ST15 CRKP increased to 46.2% in the late period of 2020/04 to 2021/04. The diameters of Klebsiella pneumoniae OMVs ranged from 100 to 200 nm, and by proteomics analysis the most proteins from OMVs belonged to the “enzyme” group. The KPC enzyme was found in the OMVs from CRKP, and the OMVs could protect inside KPC from proteinase K digestion. Moreover, the KPC enzymes within OMVs, which could be released after Triton X-100 treatment, could hydrolyze meropenem.

Conclusions
CRE has increasingly caused infections in hospitals, and blaKPC-positive CRKP infections have constituted a major proportion of infections in the past decade. The OMVs play a critical role in antibiotic resistance in CRKP.
A potential Chinese medicine monomer against influenza A virus and influenza B virus: isoquercitrin
Authors: Luo Rongbo , Lv Chaoxiang , Wang Tiecheng , Deng Xiuwen , Sima Mingwei , Guo Jin , Qi Jing , Sun Weiyang , Shen Beilei , Li Yuanguo , Yue Donghui , Gao Yuwei 
Published: November 2023

Abstract
Background
Influenza viruses, especially Influenza A virus and Influenza B virus, are respiratory pathogens and can cause seasonal epidemics and pandemics. Severe influenza viruses infection induces strong host-defense response and excessive inflammatory response, resulting in acute lung damage, multiple organ failure and high mortality. Isoquercitrin is a Chinese medicine monomer, which was reported to have multiple biological activities, including antiviral activity against HSV, IAV, SARS-CoV-2 and so on. Aims of this study were to assess the in vitro anti-IAV and anti-IBV activity, evaluate the in vivo protective efficacy against lethal infection of the influenza virus and searched for the more optimal method of drug administration of isoquercitrin.

Methods
In vitro infection model (MDCK and A549 cells) and mouse lethal infection model of Influenza A virus and Influenza B virus were used to evaluate the antiviral activity of isoquercitrin.

Results
Isoquercitrin could significantly suppress the replication in vitro and in vivo and reduced the mortality of mouse lethal infection models. Compared with virus infection group, isoquercitrin mitigated lung and multiple organ damage. Moreover, isoquercitrin blocked hyperproduction of cytokines induced by virus infection via inactivating NF-κB signaling. Among these routes of isoquercitrin administration, intramuscular injection is a better drug delivery method.

Conclusion
Isoquercitrin is a potential Chinese medicine monomer Against Influenza A Virus and Influenza B Virus infection.
MicroRNA-989 controls Aedes albopictus pupal-adult transition process by influencing cuticle chitin metabolism in pupae
Authors: Zhang Ruiling , Liu Wenjuan , Fu Jingwen , Zhang Zhong 
Published: November 2023

Abstract
Background
Aedes albopictus is a vector of numerous devastating arboviruses and places heavy burdens on global public health. Chitin is one of the important components of cuticles and targeting chitin metabolism is a promising strategy for preventing mosquito dispersal and mosquito-borne diseases. Increasing evidence suggests that microRNAs (miRNAs) play crucial roles in various physiological processes of insects.

Methods
A previous analysis suggested that the microRNA miR-989 is potentially involved in chitin metabolism in Ae. albopictus pupae. In the present study, we found that the expression level of miR-989 was significantly overexpressed after injection of agomir. A dual-luciferase assay was used to determine the direct target of miR-989. Survival rate, eclosion rate and malformation rate were statistically analyzed to evaluate the potential effect of miR-989. Hematoxylin–eosin staining and chitin staining were used to evaluate the microstructural changes in the cuticles of Ae. albopictus pupae.

Results
Overexpression of miR-989 resulted in a significantly reduced survival rate and eclosion rate of pupae and an elevated malformation rate of adults. The results suggested that miR-989 acted as a regulator of chitin metabolism in Ae. albopictus pupae by affecting the transcript levels of the Ae. albopictus genes encoding chitin synthase 1 (AaCHS1) and chitinase 10 (AaCht10). The altered expression levels of the two chitin metabolism-related enzymes (CHS1 and Cht10, respectively) caused the structural changes in cuticles and further affected the pupal-adult transition process of Ae. albopictus. XM_029863591.1 was proven to be the target gene of miR-989 and displayed similar effects on pupae as miR-989.

Conclusions
The microRNA miR-989 was found to be essential for chitin metabolism in old and new cuticles of Ae. albopictus pupae. The results of the current study suggested that miR-989 could be used as a potential target to control Ae. albopictus.

Graphical Abstract
Efficacy and safety of tofacitinib in patients with rheumatoid arthritis by previous treatment: post hoc analysis of phase II/III trials
Authors: Tesser John , Gül Ahmet , Olech Ewa , Oelke Kurt , Lukic Tatjana , Kwok Kenneth , Ebrahim Abbas 
Published: November 2023

Abstract
Background
This study sought to evaluate the efficacy and safety of tofacitinib in patients with rheumatoid arthritis with distinct treatment histories.

Methods
Pooled phase II/III trial data from patients who received tofacitinib 5 or 10 mg twice daily or placebo, as monotherapy or with conventional synthetic (cs) disease-modifying antirheumatic drugs (DMARDs), were analyzed post hoc. Separate evaluations were conducted for populations with a prior inadequate response (IR) to: 1) non-methotrexate (MTX) csDMARDs only (non-MTX csDMARD-IR; n = 537); 2) MTX (MTX-IR; n = 3113); and 3) biologic (b)DMARDs (bDMARD-IR; n = 782). Efficacy outcomes included rates of response (American College of Rheumatology 20/50/70% response criteria) and remission (Disease Activity Score in 28 joints derived from 4 measures, erythrocyte sedimentation rate [DAS28-4(ESR)] < 2.6) at month 3, and changes from baseline in DAS28-4(ESR) and Health Assessment Questionnaire–Disability Index scores. Safety was assessed up to month 24.

Results
At month 3, efficacy was generally improved with tofacitinib (both doses) vs placebo in each population. Generally, efficacy outcomes with tofacitinib were numerically more favorable in non-MTX csDMARD-IR vs MTX-IR or bDMARD-IR patients. Over 24 months, crude incidence rates for adverse events (AEs), serious AEs, and discontinuations due to AEs were generally numerically lower in non-MTX csDMARD-IR and MTX-IR vs bDMARD-IR populations; rates for AEs of special interest were generally similar across populations.

Conclusions
Tofacitinib provided clinical benefit across patients with rheumatoid arthritis with a range of prior treatment experience but may have greater efficacy and an improved benefit/risk profile in those with fewer prior treatments.

Trial registration
NCT00147498/NCT00413660/NCT00550446/NCT00603512/NCT00687193/NCT00976599/NCT01359150/NCT00847613/NCT00814307/NCT00853385/NCT00960440/NCT01039688/NCT00856544.
A proposal for further developing fatigue-related post COVID-19 health states for burden of disease studies
Authors: Wyper Grant M. A. , McDonald Scott A. , Haagsma Juanita A. , Devleesschauwer Brecht , Charalampous Periklis , Maini Rishma , Smith Pierre , Pires Sara M. 
Published: November 2023

AbstractPrevious efforts to estimate the burden of fatigue-related symptoms due to long COVID have a very high threshold for inclusion of cases, relative to the proposed definition from the World Health Organization. In practice this means that milder cases, that may be occurring very frequently, are not included in estimates of the burden of long COVID which will result in underestimation. A more comprehensive approach to modelling the disease burden from long COVID, in relation to fatigue, can ensure that we do not only focus on what is easiest to measure; which risks losing focus of less severe health states that may be more difficult to measure but are occurring very frequently. Our proposed approach provides a means to better understand the scale of challenge from long COVID, for consideration when preventative and mitigative action is being planned.