bluuebunny/crossref_metadata_2025_split huggingface dataset:
High comorbidity indexes predict 30-day mortality after percutaneous endoscopic gastrostomy
Authors: Kuwai Toshio , Kusunoki Ryusaku , Kuwai Toshio , Tamaru Yuzuru , Mizumoto Takeshi , Semba Shigeaki , Kato Naohiro , Sugata Shuhei , Okuda Yasuhiro , Teraoka Yuji , Yamaguchi Atsushi , Kouno Hirotaka 
Published: January 2024

Abstract
Background
High postoperative mortality rates have been reported for percutaneous endoscopic gastrostomy (PEG), although guidelines recommend PEG for patients anticipated inability of oral intake for more than 4 weeks. Conversely, comorbidity indexes have not been adequately validated among patients who underwent PEG. We evaluated comorbidity indexes and clinical risk factors for 30-day mortality after PEG.
Methods
We retrospectively reviewed 1,395 patients who underwent PEG at our hospital from April 2008 to December 2020. We used the direct introducer procedure to perform PEG and compared preprocedural clinical factors, demographics, comorbidity indexes, (Charlson comorbidity index [CCI] and cumulative illness rating scale [CIRS]), and laboratory data of patients who survived and those who died within 30 days after PEG.
Results
A total of 104 (7.5%) patients died within 30 days after PEG. Multivariate logistic regression analysis revealed association of 30-day mortality with patients’ age of ≥ 80 years, total parental nutrition before PEG, CCI of ≥ 5, CIRS of ≥ 13, and serum C-reactive protein level of ≥ 2.6 mg/dl. The receiver operating characteristics analysis revealed CIRS as the best 30-day mortality predictor (area under the curve: 0.80; 95% CI: 0.75–0.85). The 30-day mortality among the highest quartile of CCI and CIRS groups were 16.9% and 20.3%, respectively. Kaplan–Meyer analysis revealed that multivariable-adjusted hazard ratios are favored lower comorbidity scores.
Conclusion
High comorbidity indexes were associated with 30-day mortality after PEG. Comorbidity indexes must be considered while predicting patients’ prognosis to reduce inappropriate performance of PEG.
The upcoming RSV vaccine: Assessing the potential effectiveness and cost-effectiveness of different vaccination strategies in China
Authors: Zhou Dachuang , Zhou Kejia , Wang Wenjuan , Zhang Di , Fang Hongshu , Tang Wenxi 
Published: January 2024

Abstract
Background Coinciding with the release of the respiratory syncytial virus (RSV) vaccines Arexvy and Abrysvo in Europe and the United States in 2023, and the clinical trials in China for Arexvy, we aimed to evaluate the cost-effectiveness of the diverse vaccination strategies in pregnant women, individuals aged 60, and those in the same age group at high risk with cardiovascular or respiratory diseases in China.
Methods We did a cost-effectiveness analysis in China, in which we developed a decision-making model of RSV to evaluate the effectiveness and incremental cost-effectiveness ratios of 22 intervention strategies, including diverse vaccination coverages (25%, 50%, 75%) of Arexvy and Abrysvo, as well as scenarios without vaccination, from a health-care system perspective with four different scenarios of US vaccine costs (25%/50%/75%/100%). We performed both univariate sensitivity analysis and probabilistic sensitivity analysis to assess the robustness of the model’s findings.
Results Compared with the absence of vaccination, various vaccination strategies would bring an additional cost of $-512.55-2719.8 million and 103.28-28811.06 Disability-Adjusted Life Years (DALYs) averted in the setting cohort over one year. With a willingness-to-pay threshold of three times of the Chinese per-capita gross domestic product (GDP), the most cost-effective strategy would be Abrysvo vaccination for 75% of pregnant women in all price settings with an incremental cost-effectiveness ratio of $-19116.29-21887.62 per DALY compared with no vaccination, and the cost-effectiveness frontier for all strategies further validated its dominance advantage. Consistent results were obtained in multiple extensive sensitivity analysis scenarios.
Conclusion Priority vaccination for pregnant women was the most cost-effective strategy for RSV prevention in China. Additionally, a potentially low RSV vaccine price in China might simultaneously incentivize vaccination in elderly population, especially those at high risk. The findings furnished crucial evidence that informed the development of effective vaccination policies to combat RSV in China.
Assessment of fat mass and fat-free mass in Portuguese youth and adults: calibration of bioelectrical impedance with dual-energy x-ray absorptiometry
Authors: Araujo Joana , Farias Fernanda , Severo Milton , Ramos Elisabete , Lopes Carla , Nogueira Luisa , Araújo Joana 
Published: January 2024

Abstract

Background/Objectives:
Bioelectrical impedance analysis (BIA) is more commonly employed in outpatient evaluations and epidemiological studies, as its costs are lower and it is less time-consuming. So, we aimed to compare fat mass (FM) and fat-free mass (FFM) estimated by BIA and by dual-energy x-ray absorptiometry (DXA), in Portuguese youth, and to calibrate BIA estimates.
Subjects/Methods: We analysed data from two population-based cohorts: EPIPorto (n = 392; <65y) and EPITeen (n = 974; 27y). Both completed single-frequency BIA (Tanita TBF-300) and DXA (QDR 4500A Hologic). Agreement between BIA and DXA (FM/FFM) was evaluated by Bland and Altman. To calibrate the BIA estimates, the coefficients were estimated by linear regression using univariate (FM or FFM, separately) and multivariate models (FM and FFM in the same model).
Results
The correlation between BIA and DXA was high for FFM and for FM (FFM: r = 0.954/r = 0.965; FM: r = 0.939/r = 0.940, for EPIPorto and EPITeen, respectively). However, BIA underestimated FM (14.5% EPIPorto; 28.4% EPITeen) and overestimated FFM (8.7% EPIPorto; 16.4% EPITeen). Using the multivariate constrained model to have an absolute equal intercept for FFM and FM, the following calibration equations for BIA measurements were obtained for EPITeen: FFMcalibrated = -6.621 + 0.984 x FFMBIA; FMcalibrated = + 6.620 + 0.974 x FMBIA; and for EPIPorto: FFMcalibrated = -4.089 + 0.998 x FFMBIA; FMcalibrated = + 4.089 + 0.970 x FMBIA.
Conclusion
FM assessed by BIA was largely underestimated and FFM overestimated, in comparison to DXA, and therefore the calibration should be applied to BIA estimates in clinical settings and research studies.
Effectiveness of Urban Distributed Runoff Model for Discharge and Water Depth Calculation in Urban Drainage Pipe Networks
Authors: Zhou Yang , Leng Yiling , Wang Pengyu , Zhang Shanghong , Zhu Yulong , Yi Yujun 
Published: January 2024

Abstract
Effective urban land-use re-planning and the strategic arrangement of drainage pipe networks can significantly enhance a city's capacity to mitigate flood risks. Aimed at reducing the potential risks of urban flooding, this paper presents a straightforward and efficient approach to make urban land-use re-planning and drainage pipe network layout (ULP-DPNL). To achieve this goal, an urban distributed runoff model (UDRM) is firstly developed to quantify the discharge and water depth within urban drainage pipe networks under varying rainfall intensities and land-use scenarios. The Nash efficiency coefficient of UDRM is greater than 0.9 with high computational efficiency, affirming its potential benefit in predicting urban flooding. Then five different flood recurrence intervals are adopted to predict drainage congestion under both current and re-planned land-use typologies. The findings reveal that the re-planned land-use strategies could effectively diminish flood risk upstream of the drainage pipe network across all five flood recurrence intervals. However, in the case of extreme rainfall events (a 100-year flood recurrence), the re-planned land-use approach fell short of fulfilling the requirements necessary for flood disaster mitigation. In these instances, the adoption of larger-diameter drainage pipes becomes an essential requisite to satisfy drainage needs. Accordingly, the proposed UDRM-based ULP-DPNL approach effectively amalgamates land-use information with pipeline data to provide constructive recommendations for pipeline modification and land-use optimization in combating urban floods. Therefore, this methodology warrants further promotion in the field of urban re-planning.
Clinical significance of circulating biomarkers of immune checkpoint molecules with atezolizumab plus bevacizumab therapy in unresectable hepatocellular carcinoma
Authors: Chuma Makoto , Uojima Haruki , Toyoda Hidenori , Hiraoka Atsushi , Arase Yoshitake , Atsukawa Masanori , Itokawa Norio , Okubo Tomomi , Tada Toshifumi , Numata Kazushi , Morimoto Manabu , Sugimori Makoto , Nozaki Akito , Iwasaki Shuichiro , Yasuda Satoshi , Koshiyama Yuichi , Mishima Yusuke , Tsuruya Kota , Tokoro Chikako , Miura Yuki , Hidaka Hisashi , Kumada Takashi , Kusano Chika , Kagawa Tatehiro , Maeda Shin 
Published: January 2024

Abstract
Background
The aim of this study was to identify clinically significant biomarkers of a response to atezolizumab plus bevacizumab (ATZ + BV) therapy, and to target strategies against unresectable hepatocellular carcinoma (u-HCC).
Method
We first investigated the potential of circulating tumor DNA (ctDNA) to serve as a biomarker for predicting the therapeutic outcome in 24 u-HCC patients treated with ATZ + BV therapy. Next, we analyzed levels of immune-related cytokines in blood samples from 134 u-HCC patients who received ATZ + BV. For this, serum immune-related molecules or cancer immune cycle-related molecules that have been reported in HCC patient sera, namely CD274, LAG-3, CCL2, 4, 5, CXCL1, 9, 10, 12, 13, CX3CL1, CCR5, IFNγ and IL-6, 8 were measured using enzyme-linked immunosorbent assay.
Results
More than 1% of variant read frequency (VRF) mutations were found in TP53, APC, PIK3CA and VHL, although with no correlation with treatment response. Among the 15 cytokines evaluated, CXCL9 and LAG-3 levels were significantly different between patients with objective response (OR), stable disease (SD) and progressive disease (PD) following ATZ + BV treatment. Receiver-operating characteristic curve analyses of CXCL9 (cut-off value: 419.1 (pg/ml) and LAG-3 (3736.3 pg/ml) indicated areas of 0.779 and 0.697 respectively, for differentiating PD from non-PD and OR from non-OR. In multivariate analysis of progression-free survival (PFS) and overall survival (OS), high serum CXCL9 (hazard ratio (HR) and 95% confidence interval (CI): 0.412 (0.251–0.677) (P = 0.0005) for PFS and 0.252 (0.125–0.508) (P = 0.0001) for OS), and low serum LAG-3 (HR and 95% CI: 0.419 (0.249–0.705) (P = 0.0011) for PFS and 0.294 (0.140–0.617) (P = 0.0012) for OS) were independent positive predictive factors.
Conclusion
Although, as far as we examined, no ctDNA mutations in blood were found to be related to ATZ + BV treatment efficacy, serum CXCL9 and LAG-3 levels, which are related to the cancer immune cycle, were associated with treatment efficacy and could be predictive markers of the efficacy of ATZ + BV treatment in HCC patients.
Enhancing the Physical Characteristics and Antibacterial Efficacy of Chitosan via Innovative Methods: Investigation into Chemically Formulated Chitosan-Coated ZnO and the Physical Composite of Chitosan/ZnO
Authors: Ali Sara A. , Ali E. S. , Hamdy G. , El-Sabbagh Inas. A. , El-Fass Magda M. , Badawy Mona Shaban E. M. , Ismail Abdallah R. , Elsawy Moataz A. 
Published: January 2024

Abstract
This study investigates the creation and analysis of chitosan-zinc oxide (CS-ZnO) nanocomposites, exploring their effectiveness in inhibiting bacteria. Two synthesis approaches, physical and chemical, were utilized. The CS-ZnO nanocomposites demonstrated strong antibacterial properties, especially against Staphylococcus aureus, a Gram-positive bacterium. Chemically synthesized nanocomposites (CZ10 and CZ100) exhibited larger inhibition zones (16.4 mm and 18.7 mm) compared to physically prepared CS-Z5 and CS-Z20 (12.2 mm and 13.8 mm) against Staphylococcus aureus. Moreover, CZ nanocomposites displayed enhanced thermal stability, with decomposition temperatures of 281°C and 290°C, surpassing CS-Z5 and CS-Z20 (260°C and 258°C). The residual mass percentages at 800°C were significantly higher for CZ10 and CZ100 (58% and 61%) than for CS-Z5 and CS-Z20 (36% and 34%). UV-Visible spectroscopy revealed reduced band gaps in the CS-ZnO nanocomposites, indicating improved light absorption. Transmission electron microscopy (TEM) confirmed uniform dispersion of ZnO nanoparticles within the chitosan matrix. In conclusion, this research underscores the impressive antimicrobial potential of CS-ZnO nanocomposites, especially against Gram-positive bacteria, and highlights their enhanced thermal stability. These findings hold promise for diverse applications in industries such as medicine, pharmaceuticals, and materials science, contributing to the development of sustainable materials with robust antimicrobial properties.
The most important predictors in hospital mortality of patients with acute ST elevation myocardial infarction (STEMI) - using Yazd Cardiovascular Diseases Registry, YCDR data
Authors: Mohammadi Mohsen , Namayandeh Seyedeh Mahdieh , Mirzaei Masoud , Shahi Mohsen Askari , Sadr Seyed Mahmoud 
Published: January 2024

Abstract

Background
One of the consequences of coronary heart diseases (CAD) is a heart attack, which can sometimes lead to death. In Iran, as well as in most West Asian countries, cardiovascular diseases are the leading cause of death, accounting for 46% of total mortality. This study aims to estimate and identify in hospital mortality predictors or prognostic factors for patients with acute ST elevation myocardial infarction (STEMI).
Methods
This study utilized data from the Yazd Cardiovascular Diseases Registry (YCDR), which is a registry of inpatient ischemic heart disease in Yazd province, Iran. Logistic Regression was used to analyze and adjust for confounding. Variables that were not significant in the univariate analysis (P_value > 0.10) were discarded, and the remaining variables were entered into multivariable analysis. Variables with P_value < 0.05 were retained in the model, while others were discarded.
Results
The study included 1,861 patients with STEMI. Among them, 105 (5.7%) individuals died during admission the hospital. After multivariable logistic regression, the following variables were identified as prognostic factors for in-hospital mortality of STEMI: having a history of CVA (OR: 23.1, 95% CI: 19.2–28.3), lower ejection fraction (OR: 8.6, 95% CI: 7.2–9.8), lower HDL cholesterol (OR: 1.1, 95% CI: 1.01–2.3), being single (OR: 1.4, 95% CI: 1.2–3.1), and lower hemoglobin (OR: 1.4, 95% CI: 1.3–2.9).
Conclusion
We evaluated the most important predictors of in-hospital mortality of STEMI and found that lower ejection fraction, lower hemoglobin levels, having a history of CVA, being unmarried, and low HDL cholesterol levels are important prognostic factors. Health policy in STEMI management must consider these factors to improve hospital prognosis.
Part II: Adaptive designs in pediatric clinical trials: specific examples, comparison with adult trials and a discussion for the child health community
Authors: Ben-Eltriki Mohamed , Chhabra Manik , Rafiq Aisha , Afolabi Michael O.S. , Paul Arun , Prabhu Devashree , Bashaw Robert , Neilson Christine J , Mahmud Salaheddin M , Lacaze-Masmonteil Thierry , Marlin Susan , Offringa Martin , Butcher Nancy J. , Heath Anna , Driedger Michelle , Kelly Lauren E 
Published: January 2024

Abstract

Background
In Part I of this review, we outlined the study characteristics and methodologies utilized in adaptive clinical trials reported in the literature from 2010–2020. Herein, the second part of this analysis presents a secondary analysis of the trials captured within this timeframe that enrolled children.
Methods
This analysis seeks to generate an evidence base that can inform practical recommendations that can shape the design, ethical considerations, and training on methods and reporting for pediatric adaptive design (AD) trials. We performed a secondary analysis of 43 AD trials involving children and compared the study characteristics with those of adult AD trials.
Results
There were one to five arms in these pediatric AD trials, with the most commonly reported adaptive methods being dose modifications (20/43, 46.5%) in dose-finding trials, followed by continual reassessment method (CRM), a model-based Bayesian design, reported in 20 studies (46.5%), and adaptive randomization (9/43, 20.9%). The frequentist framework (68.8%) was most commonly used for statistical analysis. Reporting indicated a lack of patient and parent engagement with clinicians and scientists during the clinical trial (CT) planning process and was only reported in 1 of the reviewed studies (1/43, 2.32%).
Conclusion
We reviewed examples of the most common types of adaptive designs used in pediatric trials and compared the methods used with adults’ trials. Against this background, we provide an overview of the different statistical approaches used and highlight the ethical considerations. The results of this review could serve as a reference for the development of guidelines and training materials to guide clinical researchers and trialists in the use of pediatric adaptive clinical trials.
Study protocol registration: DOI:10.1186/s13063-018-2934-7
Women’s Empowerment and Child Nutritional Outcomes in Rural Burkina Faso
Authors: Nikiema Pouirkèta Rita , KPONOU Monsoi Kenneth Colombiano 
Published: January 2024

Abstract

Across developing countries, women play an important role both as producers of major food crops and in improving household nutrition. This research paper aims to assess the effect of improving women's empowerment on the nutritional status of children in rural Burkina Faso. Based on data from the country first Living Standards Measurement Survey, the paper uses variables such as income control, access to land, autonomy in production decisions, access to credit, and social group membership to compute a composite index of women’s empowerment. Accounting for potential endogeneity of empowerment, the study adopts a dual-estimation approach that, first, uses average empowerment by stratum and, second, applies an instrumental variable. The results show a low baseline level of women’s empowerment in rural areas, but an improvement in empowerment has a relatively high and positive correlation with children’s nutritional outcomes. The study suggests that improving women’s empowerment components will translate into significant gains in children’s nutritional outcomes in rural households.
JEL Classification: C26; D13; D16; I12, Q12
A cross-diagnostic cluster analysis of attachment styles in patients with emotional dysregulation
Authors: Kouros Ioannis , Isaksson Martina , Ekselius Lisa , Ramklint Mia 
Published: January 2024

Abstract

Background
Insecure adult attachment has been associated with emotional dysregulation and subsequently with disorders involving this concept, such as borderline personality disorder (BPD), bipolar disorder (BD) and attention deficit/hyperactivity disorder (ADHD). However, little is known about the characteristics related to different attachment patterns. The aim of this study was to identify clusters of adult attachment style in a cross-diagnostic group of patients with BDP and/or BD and/or ADHD and explore the characteristics of these clusters based on temperament profile, childhood trauma and psychiatric diagnoses.
Methods
K-means cluster analysis was used to identify subgroups, based on the Attachment Style Questionnaire Short Form dimensions, in a clinical cohort of 150 young adults (113 women and 37 men, mean age ± SD = 23.3 ± 2.1) diagnosed with BPD, and/or BD, and/or ADHD.
Results
Three distinct clusters were identified: a secure, an insecure/avoidant-anxious and an insecure/avoidant cluster. These three clusters differed in temperament profile and related psychiatric diagnoses.
Conclusions
Assessing attachment might be a tool for identifying the most disordered individuals among patients with emotional dysregulation.
An increase of serum CA-125 to two times of nadir level strongly predicts the image-identified recurrence of serous ovarian cancer
Authors: Du Kaiwen , Yang Qiyu , Huang Jin , Chan David Wai , Li Jinjin , Chang Xiaoxia , Wang Hanjie , Tang Junying 
Published: January 2024

Abstract
Using 35 U/ml as CA125 routine abnormal threshold may result in omissions in the recurrence detection of Ovarian cancer (OvCa). This study aimed to clarify the association between a biochemical recurrence (only the elevation of CA125) and an image-identified recurrence to predict the recurrent lesions better. 86 patients were enrolled from women diagnosed with stage I-IV serous ovarian, tubal, and peritoneal cancers from January 2013 to June 2019 at our center. The median CA125 level from 929.9 U/mL at diagnosis reduced to 7.8 U/mL at nadir during follow-up in all patients, and there was no difference between the neoadjuvant chemotherapy (NACT) and primary debulking surgery (PDS) group after initial treatment. Compared to CA125 level exceeding 35 U/ml, the 2×nadir of CA125 improve the sensitivity and the specificity of image-identified relapse (P<0.001); the 2×nadir value can act as an earlier warning relapse signal with a longer median time to image-identified recurrence (2.7 vs. 0 months, P<0.001). Compared with 35 U/ml, CA125 reaching 2×nadir during the follow-up process might be a more sensitive and early recurrence signal in patients with serous OvCa. This criterion may help guide patients to be recommended for imaging examination to detect potential recurrence in time.
Predicting the probabilities of missed general practice appointments in England and Wales
Authors: Hartmann Morghan , Ling Suping , Exarchakou Aimilia , Rachet Bernard , Belot Aurélien 
Published: January 2024

Abstract
Missing general practice (GP) appointments represent an important challenge for healthcare systems. In England and Wales, reducing the number of missed appointments would benefit both the National Health Service (NHS) and the patients, avoiding delay in diagnosis and treatment. Since the COVID-19 pandemic, appointment mode has shifted substantially, and many GP practices have started scheduling online appointments in place of face-to-face meetings. In this context, our aim was to build and compare prediction models for the probability of missing a GP appointment, as a function of appointment’s characteristics and the level of deprivation of the area where the GP practice is located. We examined all English GP appointments in 2021 and used two different statistical approaches for prediction: a generalized linear model (logistic regression) and a machine learning approach (Extreme gradient boosting). Predictions were further validated with 2022 data. Both approaches provided comparable predictions in term of calibration, with the advantage that results from the logistic regression can be interpreted as odds ratios. Longer time between booking and appointment plays an important role, as well as deprivation. Deprived areas, which already tend to have lower healthcare standards, may also be losing more resources from cancelled and unattended appointments compared to their less deprived counterparts. Investigating the role of contextual factors behind these inequalities (both within and outside the healthcare system) would be an important step forward.