bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-effectiveness of left atrial appendage closure for stroke prevention in atrial fibrillation: a systematic review appraising the methodological quality
Authors: Hewage Sumudu A. , Noviyani Rini , Brain David , Sharma Pakhi , Parsonage William , McPhail Steven M. , Barnett Adrian , Kularatna Sanjeewa 
Published: October 2023

Abstract
Background
The increasing global prevalence of atrial fibrillation (AF) has led to a growing demand for stroke prevention strategies, resulting in higher healthcare costs. High-quality economic evaluations of stroke prevention strategies can play a crucial role in maximising efficient allocation of resources. In this systematic review, we assessed the methodological quality of such economic evaluations.

Methods
We searched electronic databases of PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and Econ Lit to identify model-based economic evaluations comparing the left atrial appendage closure procedure (LAAC) and oral anticoagulants published in English since 2000. Data on study characteristics, model-based details, and analyses were collected. The methodological quality was evaluated using the modified Economic Evaluations Bias (ECOBIAS) checklist. For each of the 22 biases listed in this checklist, studies were categorised into one of four groups: low risk, partial risk, high risk due to inadequate reporting, or high risk. To gauge the overall quality of each study, we computed a composite score by assigning + 2, 0, − 1 and − 2 to each risk category, respectively.

Results
In our analysis of 12 studies, majority adopted a healthcare provider or payer perspective and employed Markov Models with the number of health states varying from 6 to 16. Cost-effectiveness results varied across studies. LAAC displayed a probability exceeding 50% of being the cost-effective option in six out of nine evaluations compared to warfarin, six out of eight evaluations when compared to dabigatran, in three out of five evaluations against apixaban, and in two out of three studies compared to rivaroxaban. The methodological quality scores for individual studies ranged from 10 to − 12 out of a possible 24. Most high-risk ratings were due to inadequate reporting, which was prevalent across various biases, including those related to data identification, baseline data, treatment effects, and data incorporation. Cost measurement omission bias and inefficient comparator bias were also common.

Conclusions
While most studies concluded LAAC to be the cost-effective strategy for stroke prevention in AF, shortcomings in methodological quality raise concerns about reliability and validity of results. Future evaluations, free of these shortcomings, can yield stronger policy evidence.
An MRI-based grading system for preoperative risk estimation of positive surgical margin after radical prostatectomy
Authors: Xu Lili , Zhang Gumuyang , Zhang Daming , Zhang Jiahui , Zhang Xiaoxiao , Bai Xin , Chen Li , Peng Qianyu , Xiao Yu , Wang Hao , Jin Zhengyu , Sun Hao 
Published: October 2023

Abstract
Objective
To construct a simplified grading system based on MRI features to predict positive surgical margin (PSM) after radical prostatectomy (RP).

Methods
Patients who had undergone prostate MRI followed by RP between January 2017 and January 2021 were retrospectively enrolled as the derivation group, and those between February 2021 and November 2022 were enrolled as the validation group. One radiologist evaluated tumor-related MRI features, including the capsule contact length (CCL) of lesions, frank extraprostatic extension (EPE), apex abutting, etc. Binary logistic regression and decision tree analysis were used to select risk features for PSM. The area under the curve (AUC), sensitivity, and specificity of different systems were calculated. The interreader agreement of the scoring systems was evaluated using the kappa statistic.

Results
There were 29.8% (42/141) and 36.4% (32/88) of patients who had PSM in the derivation and validation cohorts, respectively. The first grading system was proposed (mrPSM1) using two imaging features, namely, CCL ≥ 20 mm and apex abutting, and then updated by adding frank EPE (mrPSM2). In the derivation group, the AUC was 0.705 for mrPSM1 and 0.713 for mrPSM2. In the validation group, our grading systems showed comparable AUC with Park et al.’s model (0.672–0.686 vs. 0.646, p > 0.05) and significantly higher specificity (0.732–0.750 vs. 0.411, p < 0.001). The kappa value was 0.764 for mrPSM1 and 0.776 for mrPSM2. Decision curve analysis showed a higher net benefit for mrPSM2.

Conclusion
The proposed grading systems based on MRI could benefit the risk stratification of PSM and are easily interpretable.

Critical relevance statement
The proposed mrPSM grading systems for preoperative prediction of surgical margin status after radical prostatectomy are simplified compared to a previous model and show high specificity for identifying the risk of positive surgical margin, which might benefit the management of prostate cancer.

Key points
• CCL ≥ 20 mm, apex abutting, and EPE were important MRI features for PSM.
• Our proposed MRI-based grading systems showed the possibility to predict PSM with high specificity.
• The MRI-based grading systems might facilitate a structured risk evaluation of PSM.

Graphical Abstract
Cardiovascular metrics on CT pulmonary angiography in patients with pulmonary hypertension — re-evaluation under the updated guidelines of pulmonary hypertension
Authors: Liu Anqi , Xu Wenqing , Xi Linfeng , Deng Mei , Yang Haoyu , Huang Qiang , Gao Qian , Zhang Peiyao , Xie Wanmu , Huang Zhenguo , Liu Min 
Published: October 2023

Abstract
Purpose
To re-assess cardiovascular metrics on computed tomography pulmonary angiography (CTPA) in predicting pulmonary hypertension (PH) under the 2022 ESC/ERS guidelines.

Materials and methods
This observational study retrospectively included 272 patients (female 143, mean age = 54.9 ± 12.5 years old) with suspected PH. 218 patients were grouped to evaluate cardiovascular metrics on CTPA and develop a binary logistic regression model. The other 54 patients were grouped into the validation group to assess the performance of the prediction model under the updated criteria. Based on mean pulmonary artery pressure (mPAP), patients were divided into three groups: group A consisted of patients with mPAP ≤ 20 mmHg, group B included patients with 20 mmHg < mPAP < 25 mmHg, and group C comprised patients with mPAP ≥ 25 mmHg. Cardiovascular metrics among the three groups were compared, and receiver operating characteristic curves (ROCs) were used to evaluate the performance of cardiovascular metrics in predicting mPAP > 20 mmHg.

Results
The main pulmonary arterial diameter (MPAd), MPAd/ascending aorta diameter ratio (MPAd/AAd ratio), and right ventricular free wall thickness (RVFWT) showed significant differences among the three groups (p < 0.05). The area under curve (AUC) of MPAd was larger than MPAd/AAd ratio and RVFWT. A MPAd cutoff value of 30.0 mm has a sensitivity of 83.1% and a specificity of 90.4%. The AUC of the binary logistic regression model (Z =  − 12.98187 + 0.31053 MPAd + 1.04863 RVFWT) was 0.938 ± 0.018. In the validation group, the AUC, sensitivity, specificity, and accuracy of the prediction model were 0.878, 92.7%, 76.9%, and 88.9%, respectively.

Conclusion
Under the updated criteria, MPAd with a threshold value of 30.0 mm has better sensitivity and specificity in predicting PH. The binary logistic regression model may improve the diagnostic accuracy.

Critical relevance statement
Under the updated criteria, the main pulmonary arterial diameter with a threshold value of 30.0 mm has better sensitivity and specificity in predicting pulmonary hypertension. The binary logistic regression model may improve diagnostic accuracy.

Key points
• According to 2022 ESC/ERS guidelines, a MPAd cutoff value of 30.0 mm has better sensitivity and specificity in predicting mPAP > 20 mmHg
• A binary logistic regression model (Z = − 12.98187 + 0.31053 MPAd + 1.04863 RVFWT) was developed and had a sensitivity, specificity, and accuracy of 92.7%, 76.9%, and 88.9% in predicting mPAP > 20 mmHg.
• A binary logistic regression prediction model outperforms MPAd in predicting mPAP > 20 mmHg.

Graphical Abstract
A predictive model combining clinical characteristics and nutritional risk factors for overall survival after umbilical cord blood transplantation
Authors: Tu Meijuan , Huang Aijie , Ning Lijuan , Tang Baolin , Zhang Chunli , Sun Guangyu , Wan Xiang , Song Kaidi , Yao Wen , Qiang Ping , Wu Yue , Zhu Xiaoyu 
Published: October 2023

Abstract
Background
Umbilical cord blood transplantation (UCBT) is a curable therapy for hematological disease; however, the impact of nutritional status on UCBT outcomes remains controversial. To evaluate the joint effect of clinical characteristics and nutritional status on the prognosis of patients who underwent UCBT, we screened various factors to establish a predictive model of overall survival (OS) after UCBT.

Methods
We performed an integrated clinical characteristic and nutritional risk factor analysis and established a predictive model that could be used to identify UCBT recipients with poor OS. Internal validation was performed by using the bootstrap method with 500 repetitions.

Results
Four factors, including disease status, conditioning regimen, calf skinfold thickness and albumin level, were identified and used to develop a risk score for OS, which showed a positive predictive value of 84.0%. A high-risk score (≥ 2.225) was associated with inferior 3-year OS post-UCBT [67.5% (95% CI 51.1–79.4%), P = 0.001]. Then, we built a nomogram based on the four factors that showed good discrimination with a C-index of 0.833 (95% CI 0.743–0.922). The optimism-corrected C-index value of the bootstrapping was 0.804. Multivariate analysis suggested that a high calf skinfold thickness (≥ 20.5 mm) and a low albumin level (< 33.6 g/L) conferred poor disease-free survival (DFS).

Conclusion
The predictive model combining clinical and nutritional factors could be used to predict OS in UCBT recipients, thereby promoting preemptive treatment.
Post-harvest biocontrol of Fusarium infection in tomato fruits using bio-mediated selenium nanoparticles
Authors: Manaa Howaida M. , Hamza Ebtsam M. , Sorour Noha M. 
Published: October 2023

AbstractThe protection of post-harvest infection by Fusarium spp. is a major worldwide demand, especially using effective natural alternatives to chemical fungicides. In this respect, selenium nanoparticles (SeNPs) were biosynthesized using Fenugreek seeds aqueous extract. Bio-mediated SeNPs were characterized using XRD, FTIR, UV–Vis, TEM, and EDX. XRD confirmed the crystalline nature with six characteristic peaks corresponding to Se-nanocrystals. TEM showed spherical-shaped SeNPs with 34.02–63.61 nm diameter. FTIR verified the presence of different bio-functional groups, such as, N–H, O–H, C–N, and C–NH2 acting as stabilizing/reducing agents during the biosynthesis. Bio-mediated SeNPs exhibited excellent biocidal activity against F. oxysporum and F. moniliforme, with MIC of 0.25 and 1.7 mg/mL, respectively. Direct treatment of F. oxysporum with SeNPs led to significant deformation and lysis of the fungal hyphae within 18 h. The treatment of infected fruits with MIC of SeNPs reduced the infection signs by 100% and preserved the fresh-like appearance of treated fruits for 25 and 35 days when stored at 25 °C and 5 °C, respectively. Therefore, SeNPs is considered efficacious fungicidal against Fusarium spp. in-vitro and in-vivo. The treatment of tomato fruits with MIC of SeNPs positively affected its chemical properties, as well as decreased weight loss %, confirming the barrier effect of SeNPs, thus increasing fruits’ shelf-life. Bio-mediated SeNPs appeared safe towards normal HSF and OEC cell lines with IC50> 300 μg/mL. Overall results recommend the usage of bio-mediated SeNPs as safe powerful bioagent against Fusarium infection, maintaining tomato quality, and providing protection from post-harvest invasion and/or destroying existing infections.
Graphical Abstract
Existence and nonexistence of solutions for an approximation of the Paneitz problem on spheres
Authors: Ould Bouh Kamal 
Published: October 2023

AbstractThis paper is devoted to studying the nonlinear problem with slightly subcritical and supercritical exponents $(S_{\pm \varepsilon}): \Delta ^{2}u-c_{n}\Delta u+d_{n}u = Ku^{ \frac{n+4}{n-4}\pm \varepsilon}$
(

S

±
ε

)
:

Δ
2

u
−

c
n

Δ
u
+

d
n

u
=
K

u

n
+
4

n
−
4

±
ε

, $u>0$
u
>
0
on $S^{n}$

S
n

, where $n\geq 5$
n
≥
5
, ε is a small positive parameter and K is a smooth positive function on $S^{n}$

S
n

. We construct some solutions of $(S_{-\varepsilon})$
(

S

−
ε

)
that blow up at one critical point of K. However, we prove also a nonexistence result of single-peaked solutions for the supercritical equation $(S_{+\varepsilon})$
(

S

+
ε

)
.
Exploration of interoceptive capabilities in avoidant/restrictive food intake disorder and anorexia nervosa
Authors: Datta Nandini , Lock James D. 
Published: October 2023

Abstract
Objective
This proof-of-concept study explores the role of aberrant interoception as a possible mechanism underlying restrictive eating symptoms in avoidant/restrictive food intake disorder (ARFID) compared to anorexia nervosa (AN) and healthy comparisons (HC).

Method
We report preliminary normative adolescent interoceptive data in HCs (n = 100) compared to adolescents with ARFID (n = 30) and AN (N = 23). Adolescents (12–18) participated in a one-time virtual visit to assess heartrate guessing accuracy (interoceptive accuracy), correlation between confidence in heartrate guess and accuracy (interoceptive awareness), and self-reported interoception (interoceptive sensibility).

Results
HC adolescents had comparable interoceptive outcomes relative to published adult norms, consistent with existing literature. Data suggest that adolescents with ARFID have poor heartbeat guessing accuracy and experience challenges deciphering interoceptive signals, possibly contributing to symptoms. While adolescents with AN have greater heartbeat guessing accuracy, they cite difficulty trusting body cues, perhaps contributing to their lack of confidence in interoceptive cue detection.

Conclusions
Preliminary results reflect differences in interoception between the three groups.
Determinants of problem sports betting among college students: moderating roles of betting frequency and impulsive betting tendency
Authors: Shen Yawen 
Published: October 2023

Abstract
Purpose
Given the risk and increased incidence of problem betting for young adults, the purpose of the current study was to understand what influences college students’ problem sports betting behavior using the theory of planned behavior (TPB).

Methods
An institutional-based cross-sectional study was conducted. Data were collected from 311 college students in the U.S. using a survey questionnaire and primarily analyzed using the partial least squares structural equation modeling (PLS-SEM) technique to investigate the relationships between the study variables. In addition, multi-group SEM analyses were conducted to investigate the moderating roles of betting frequency and impulsive betting tendencies regarding sports betting.

Results
The results suggested that college students’ sports betting intentions (SBI) were associated with attitude towards sports betting, motivation to comply with others, and subjective norm, in this order, but not with perceived behavioral control (PBC). Problem sports betting (PSB) was significantly positively related to their SBI and negatively correlated with PBC. In addition, multigroup analyses found the moderating roles of betting frequency and impulsive betting tendency, especially in the relationship between SBI and PSB. The SBI-PSB relationship was stronger with the infrequent/low-betting group and low-impulse betting group, compared to the frequent/high-betting and high-impulse betting group.

Conclusion
Overall, the results highlighted the importance of peer influence and attitude formation concerning sports betting. Recognizing what influences PSB and the roles of habitual and impulse sports betting in this population are recommended in developing proper public health programs to mitigate PSB issues.
Test review: a general academic English summative test
Authors: Liu Yunlong , Cui Yaqiong , Yu Hua 
Published: October 2023

AbstractMany Chinese universities are implementing an educational reform to transform their general English courses into academic English courses. Accordingly, how to assess students’ English ability should also be reformed. In this test review, we introduce a school-based general academic English summative test developed by English instructors. An argument-based approach was adopted to analyze the test validity by obtaining students’ test data and their reflective responses to the test. This review can provide a practical reference for the development of a valid general academic English summative test by including practices of course instructors and voices of students, two important test stakeholders, in test design.
Outcomes of management of primary benign aggressive or malignant bone tumors around the elbow by limb‐salvage surgery
Authors: Ebeid Walid Atef , Badr Ismail Tawfeek , Mesregah Mohamed Kamal , Hasan Bahaa Zakarya 
Published: October 2023

AbstractPurposeBone tumors around the elbow are rare, with frequently delayed diagnosis. The current study aimed to assess the functional and oncological outcomes of limb salvage surgery for primary benign aggressive or malignant bone tumors around the elbow.MethodsWe conducted a retrospective review of patients with primary aggressive benign and malignant bone tumors around the elbow treated with limb salvage surgery between 1995 and 2020 at a single musculoskeletal oncology center. The minimum follow‐up period was 24 months. Functional results were assessed using the Musculoskeletal Tumor Society (MSTS) scoring system at the last follow‐up visit. Local recurrence, chest metastasis, and complications were recorded.ResultsThis study included 30 patients, 19 males and 11 females, with a mean age of 25.4 ± 14.2 years. The tumor location was the distal humerus (n = 21), proximal radius (n = 5), and proximal ulna (n = 4). Reconstruction was done by elbow fusion using fibular graft (n = 10), mobile endoprosthesis (n = 9), excision arthroplasty (n = 7), and extracorporeal freezing and reimplantation (n = 4). The mean follow‐up period was 36.2 ± 21.3 months. The median follow‐up MSTS score was 27 [Interquartile range (IQR): 26–30]. Skeletally immature patients had a significantly higher MSTS score. The rate of postoperative complications was 26.7%.ConclusionLimb salvage surgery with different reconstructive options for benign aggressive and malignant bone tumors around the elbow can achieve good functional and oncological outcomes.Level of evidenceLevel IV.
Trends and determinants of anemia in children 6–59 months and women of reproductive age in Chad from 2016 to 2021
Authors: Zavala Eleonor , Adler Sarah , Wabyona Edgar , Ahimbisibwe Martin , Doocy Shannon 
Published: October 2023

Abstract
Background
Hemoglobin assessments in children and women have been conducted annually in Chad since 2016 through the Standardized Monitoring and Assessment of Relief and Transitions (SMART) cross-sectional surveys. This analysis aims to characterize national and sub-national trends in anemia among children under five and women of reproductive age from 2016 to 2021 and to compare risk factors for anemia before and during the COVID-19 pandemic.

Methods
Hemoglobin concentrations were measured in approximately half of the 12,000 to 15,000 included households each year, except for 2020 when hemoglobin tests were omitted. For children 6 to 59 months of age, anemia was defined as hemoglobin less than 11.0 g/dL. Anemia was defined as hemoglobin less than 11.0 g/dL and 12.0 g/dL for pregnant women and non-pregnant women, respectively. Trends were stratified by agroecological zone, and tests of proportions were used to assess statistical significance. Simple and multivariate logistic regression models were conducted for 2019 and 2021 to identify risk factors for anemia.

Results
Reductions in anemia over the 6-year period were significant among women (47.6–30.8%, p = 0.000) and children (68.6–59.6%, p = 0.000). The Sudanian zone had consistently higher rates, particularly in children, compared to the Sahelian and Saharan zones. Significant declines in women’s anemia were observed in all zones from 2019 to 2021, but this global decline was not observed among children, where rates in the Saharan zone significantly increased. In 2019, only minimum dietary diversity significantly reduced the odds of anemia in children (AOR: 0.65, 95%CI: 0.46–0.92), whereas in 2021, improvements in all diet indicators were associated with lower odds of anemia. Improved household socio-economic factors, including head of household literacy, were associated with lower odds of anemia in children (2019 AOR: 0.76, 95%CI: 0.67, 0.88) and women (2019 AOR: 0.75, 95%CI: 0.65, 0.87; 2021 AOR: 0.81, 95%CI: 0.70, 0.93).

Conclusions
Anemia declined significantly in Chad among women of reproductive age and children from 2016 to 2021, but the national prevalence of 60% among children remains unacceptably high. Sub-national differences in anemia rates underline the need to identify and address regional causes of anemia while strengthening national level programs.
GM-CSF augmented the photothermal immunotherapeutic outcome of self-driving gold nanoparticles against a mouse CT-26 colon tumor model
Authors: Dai Jie , Li Jianmei , Zhang Yuqin , Wen Qian , Lu Yun , Fan Yu , Zeng Fancai , Qian Zhiyong , Zhang Yan , Fu Shaozhi 
Published: October 2023

Abstract

Background
Hypoxia is a frequent characteristic observed in solid tumors and is strongly associated with tumor metastasis, angiogenesis, and drug resistance. While the vasculature of hypoxic tumor tissues poses obstacles to the efficient administration of conventional drugs, it may prove advantageous in sustaining hyperthermia. Photothermal therapy (PTT) offers a promising treatment strategy that utilizes the activation of photosensitizers to produce heat, thus facilitating the selective ablation of tumor tissues.

Method

To enhance the accumulation of photothermal agents in tumor tissue and improve the effectiveness of PTT, we developed a self-propelled hybrid called Bif@PAu-NPs. This hybrid consists of polydopamine (PDA)-coated gold nanoparticles (Au-NPs) loaded onto the anaerobic
Bifidobacterium infantis
(Bif).

Results
The Bif@PAu-NPs actively aggregated at the tumor site because the ability of Bif can target hypoxic regions, and PAu-NPs achieved precise PTT due to their high photothermal conversion efficiency (η = 67.8%). The tumor tissues were ablated by PTT, resulting in the release of antigens through immunogenic cell death (ICD), which stimulates an immune response. The inclusion of GM-CSF enhanced the immune response by recruiting dendritic cells and initiating long-term anti-tumor immunity.

Conclusion
The Bif@PAu-NPs hybrid effectively suppressed the growth of both primary tumors and re-challenged tumors. The utilization Bif@PAu-NPs in conjunction with GM-SCF exhibits great potential as a photothermal-immunotherapeutic strategy for precisely treating solid tumors.

Graphical Abstract
In this study, the bacterial Bif@PAu-NPs biohybrid is exploited the self-driving ability of anaerobic Bifidobacterium infantis to deliver polydopamine-modified gold nanoparticles to hypoxic region of tumor. Under irradiation with 808 nm NIR laser, the hybrid exerts precise photothermal therapy to stimulate the immune response, which is further enhanced by GM-CSF, leading to recruitment of dendritic cells and initiation of a long-term anti-tumor immunity remember to prevent tumor recurrence.