bluuebunny/crossref_metadata_2025_split huggingface dataset:
Artificial intelligence-estimated biological heart age using a 12-lead electrocardiogram predicts mortality and cardiovascular outcomes
Authors: Baek Yong-Soo , Lee Dong-Ho , Jo Yoonsu , Lee Sang-Chul , Choi Wonik , Kim Dae-Hyeok 
Published: April 2023

BackgroundThere is a paucity of data on artificial intelligence-estimated biological electrocardiography (ECG) heart age (AI ECG-heart age) for predicting cardiovascular outcomes, distinct from the chronological age (CA). We developed a deep learning-based algorithm to estimate the AI ECG-heart age using standard 12-lead ECGs and evaluated whether it predicted mortality and cardiovascular outcomes.MethodsWe trained and validated a deep neural network using the raw ECG digital data from 425,051 12-lead ECGs acquired between January 2006 and December 2021. The network performed a holdout test using a separate set of 97,058 ECGs. The deep neural network was trained to estimate the AI ECG-heart age [mean absolute error, 5.8 ± 3.9 years; R-squared, 0.7 (r = 0.84, p &lt; 0.05)].FindingsIn the Cox proportional hazards models, after adjusting for relevant comorbidity factors, the patients with an AI ECG-heart age of 6 years older than the CA had higher all-cause mortality (hazard ratio (HR) 1.60 [1.42–1.79]) and more major adverse cardiovascular events (MACEs) [HR: 1.91 (1.66–2.21)], whereas those under 6 years had an inverse relationship (HR: 0.82 [0.75–0.91] for all-cause mortality; HR: 0.78 [0.68–0.89] for MACEs). Additionally, the analysis of ECG features showed notable alterations in the PR interval, QRS duration, QT interval and corrected QT Interval (QTc) as the AI ECG-heart age increased.ConclusionBiological heart age estimated by AI had a significant impact on mortality and MACEs, suggesting that the AI ECG-heart age facilitates primary prevention and health care for cardiovascular outcomes.
Escherichia coli from biopsies differ in virulence genes between patients with colorectal neoplasia and healthy controls
Authors: Bosák Juraj , Kohoutová Darina , Hrala Matěj , Křenová Jitka , Morávková Paula , Rejchrt Stanislav , Bureš Jan , Šmajs David 
Published: April 2023

IntroductionPathogenic strains of Escherichia coli have been clearly identified as the causative agents of extraintestinal and diarrheal infections; however, the etiopathogenic role of E. coli in other conditions, including colorectal cancer, remains unclear.MethodsThis study aimed to characterize mucosal E. coli isolates (n = 246) from 61 neoplasia patients and 20 healthy controls for the presence of 35 genetic determinants encoding known virulence factors.ResultsVirulence determinants encoding invasin (ibeA), siderophore receptor (iroN), S-fimbriae (sfa), and genotoxin (usp) were more prevalent among E. coli isolated from patients with neoplasia compared to the control group (p &lt; 0.05). In addition, the prevalence of these virulence determinants was increased in more advanced neoplasia stages (padj &lt; 0.0125). Compared to patients with advanced colorectal adenoma and carcinoma, the ibeA gene was rarely found in the control group and among patients with non-advanced adenoma (p &lt; 0.05), indicating its potential as the advanced-neoplasia biomarker. Patients with neoplasia frequently had E. coli strains with at least one of the abovementioned virulence factors, whereby specific combinations of these virulence factors were found.DiscussionThese findings suggest that E. coli strains isolated from patients with colorectal neoplasia possess several virulence factors, which could contribute to the development of neoplastic processes in the large intestine.
Application of the pressure cooker technique for transarterial embolization of brain arteriovenous malformations: Factors affecting obliteration and outcomes
Authors: Lu Dan , Li Yuqian , Yang Zijian , Zhao Zhenwei , Fang Wei , Chen Lei , Ma Tao , Wang Naibing , Li Xueliang , Zhang Tao , Deng Jianping 
Published: April 2023

ObjectiveThe typical pressure cooker technique (PCT) and several modifications with similar mechanisms have been introduced to enhance the embolization of brain arteriovenous malformations (bAVMs). This study aimed to assess the effectiveness of transarterial embolization of bAVMs with the PCT.MethodFrom January 2019 to December 2021, 125 consecutive patients with bAVM managed by transarterial embolization in the prospective database on cerebral vascular diseases of a single center were retrospectively reviewed. Patient data and lesion characteristics were collected. According to the treatment strategy, the patients were assigned to the PCT group (46 patients) and conventional embolization technique (CET) group (79 patients).ResultsBaseline patient features were comparable between the two groups. After the first procedure, complete obliteration immediately was observed in 61 and 42% of patients in the PCT and CET groups, respectively. The rate was markedly elevated in the PCT group (p = 0.04). In subgroup analysis, the rate of immediate complete obliteration was starkly increased in PCT group patients with Spetzler-Martin grade I/II bAVM (86 and 53% in the PCT and CET groups, respectively; p = 0.0036). The overall complication rates were similar in the two groups (13 and 10% in the PCT and CET groups, respectively; p = 0.77). In multivariable analysis, nidus size &gt;3 cm (OR = 8.826, 95% CI: 1.250–62.312; p = 0.03) and deep location (OR = 8.576, 95% CI: 1.480–49.690; p = 0.02) were significant factors affecting complete obliteration in the PCT group.ConclusionThe PCT may yield a higher rate of immediate complete obliteration with transarterial embolization of bAVMs, without increasing the rate of procedure-related complications.
Plasma lipid profiles and homocysteine levels in anti-N-methyl-D-aspartate receptor encephalitis
Authors: Wang Zhi-hao , Qiao Shan , Wang Lei , Wang Kemo , Zhang Ranran , Jin Yang , Wu Huai-kuan , Liu Xuewu 
Published: April 2023

IntroductionWe aimed to investigate whether lipid profiles and homocysteine levels in patients with anti-N-methyl-D-aspartate receptor encephalitis are related to clinical presentation and prognosis, which may contribute to further research on the pathogenesis and treatment of this disease.MethodsThis study included a total of 43 patients with anti-N-methyl-D-aspartate receptor encephalitis and 43 sex–age-matched healthy controls. Baseline demography, clinical data, patient outcomes, and ancillary examination results were recorded. Patients were followed up every 2–3 months during the first year. The modified Rankin Scale score was used to evaluate the therapeutic effect and clinical outcome.ResultsAmong the 43 patients included in this study, 55.81% were male, the mean age of onset was 27 years old, and the median modified Rankin Scale score on admission was 3.0. Apolipoprotein A-1 was significantly lower in patients with anti-N-methyl-D-aspartate receptor encephalitis compared with healthy controls (p = 0.004). Compared with healthy controls, homocysteine (p = 0.002), apolipoprotein B (p = 0.004), Lpa (p = 0.045), and apolipoprotein B/apolipoprotein A-1 (p = 0.001) were significantly increased in patients with anti-N-methyl-D-aspartate receptor encephalitis. According to the modified Rankin Scale scores, 6 months after discharge, 72.09% of patients had a good prognosis and 27.91% had a poor prognosis. In the good prognosis group, age (p = 0.031), lipoprotein a (p = 0.023), apolipoprotein A-1 (p = 0.027) at baseline, and the modified Rankin Scale score on admission (p = 0.019) were significantly higher than those in the poor prognosis group.ConclusionThis study suggests the possibility that serum lipid profile and homocysteine play an important role in the pathogenesis of anti-N-methyl-D-aspartate receptor encephalitis, providing support for lipid-lowering treatment of anti-N-methyl-D-aspartate receptor encephalitis patients.
Morphometric analysis of tumor microvessels for detection of hepatocellular carcinoma using contrast-free ultrasound imaging: A feasibility study
Authors: Sabeti Soroosh , Ternifi Redouane , Larson Nicholas B. , Olson Michael C. , Atwell Thomas D. , Fatemi Mostafa , Alizad Azra 
Published: April 2023

IntroductionA contrast-free ultrasound microvasculature imaging technique was evaluated in this study to determine whether extracting morphological features of the vascular networks in hepatic lesions can be beneficial in differentiating benign and malignant tumors (hepatocellular carcinoma (HCC) in particular).MethodsA total of 29 lesions from 22 patients were included in this work. A post-processing algorithm consisting of clutter filtering, denoising, and vessel enhancement steps was implemented on ultrasound data to visualize microvessel structures. These structures were then further characterized and quantified through additional image processing. A total of nine morphological metrics were examined to compare different groups of lesions. A two-sided Wilcoxon rank sum test was used for statistical analysis.ResultsIn the malignant versus benign comparison, six of the metrics manifested statistical significance. Comparing only HCC cases with the benign, only three of the metrics were significantly different. No statistically significant distinction was observed between different malignancies (HCC versus cholangiocarcinoma and metastatic adenocarcinoma) for any of the metrics.DiscussionObtained results suggest that designing predictive models based on such morphological characteristics on a larger sample size may prove helpful in differentiating benign from malignant liver masses.
Comparison of pneumonitis risk between immunotherapy alone and in combination with chemotherapy: an observational, retrospective pharmacovigilance study
Authors: Li Huixia , Zheng Yifan , Xu Peihang , Li Zimu , Kuang Yukun , Feng Xiaoqing , He Junhao , Li Jia , Chen Xiao , Bai Lihong , Tang Ke-Jing 
Published: April 2023

Importance: Checkpoint inhibitor pneumonitis (CIP) is a rare but serious adverse event that may impact treatment decisions. However, there is limited information comparing CIP risks between immune checkpoint inhibitor (ICI) monotherapy and combination with chemotherapy due to a lack of direct cross-comparison in clinical trials.Objective: To determine whether ICI combination with chemotherapy is superior to ICI in other drug regimens (including monotherapy) in terms of CIP risk.Study Design and Methods: This observational, cross-sectional and worldwide pharmacovigilance cohort study included patients who developed CIP from the World Health Organization database (WHO) VigiBase and the US Food and Drug Administration Adverse Event Reporting System (FAERS) database. Individual case safety reports (ICSR) were extracted from 2015 to 2020 in FAERS and from 1967 to 2020 in VigiBase. Timing and reporting odds ratio (ROR) of CIP in different treatment strategies were used to detect time-to-onset and the risk of pneumonitis after different immunotherapy regimens.Results: A total of 93,623 and 114,704 ICI-associated ICSRs were included in this study from VigiBase and FAERS databases respectively. 3450 (3.69%) and 3278 (2.86%) CIPs occurred after therapy initiation with a median of 62 days (VigiBase) and 40 days (FAERS). Among all the CIPs, 274 (7.9%) and 537 (16.4%) CIPs were associated with combination therapies. ICIs plus chemotherapy combination was associated with pneumonitis in both VigiBase [ROR 1.35, 95% CI 1.18-1.52] and FAERS [ROR 1.39, 95% CI 1.27–1.53]. The combination of anti-PD-1 antibodies and anti-CTLA-4 antibodies with chemotherapy demonstrated an association with pneumonitis in both VigiBase [PD-1+chemotherapy: 1.76, 95% CI 1.52-2.05; CTLA-4+chemotherapy: 2.36, 95% CI 1.67-3.35] and FAERS [PD-1+chemotherapy: 1.70, 95% CI 1.52-1.91; CTLA-4+chemotherapy: 1.70, 95% CI 1.31-2.20]. Anti-PD-L1 antibodies plus chemotherapy combinations did not show the association.Conclusion: Compared to ICI in other drug regimens (including monotherapy), the combination of ICI plus chemotherapy is significantly associated with higher pneumonitis toxicity. Anti-PD-1/CTLA4 medications in combination with chemotherapy should be obviated in patients with potential risk factors for CIP.Trial Registration: clinicaltrials.gov, ChiCTR2200059067
The associations of decent work with wellbeing and career capabilities: a meta-analysis
Authors: Su Xuebing , Chan Ko Ling 
Published: April 2023

IntroductionAs a global sustainable development goal, the decent work notion has been promoted all over the world at theoretical, practical, and research levels for the purpose of enhancing people's capacity to enjoy freedom, equity, security, and human dignity at work. However, conclusive findings of the impact of decent work on people's wellbeing and longer-term career development are still missing due to a lack of systematic reviews on this topic. This study aims to (a) investigate the associations of decent work with people's wellbeing and their capabilities for sustaining career development and (b) examine the differential associations across different subgroups.MethodsDatabases of literature archived on or before 4 March 2022 were searched. A total of 46 studies met the inclusion criteria and were included in the analysis for the combined Pearson correlation coefficient (r) to estimate the associations of decent work with wellbeing and career capabilities, among which 30 studies (16,026 participants) were used for calculating the association between decent work and wellbeing whereas 26 studies (12,384 participants) were used for decent work and career capabilities.Results and discussionFirst, decent work demonstrates a medium association with wellbeing (r= .48, 95% CI [.45, .51]), and a medium association with career capabilities (r= .44, 95% CI [.40, .49]). Second, no significant differences with respect to the association of decent work with wellbeing and career capabilities were identified across subgroups categorized by developed/developing countries, population type, social status of participants as employee or student, participants from vulnerable/general groups, aspects of wellbeing/career capabilities, and study design. These results pose important implications for informing future research and practice to measure and promote decent work across the world.
Changes in sleep quality and sleep disturbances in the general population from before to during the COVID-19 lockdown: A systematic review and meta-analysis
Authors: Limongi Federica , Siviero Paola , Trevisan Caterina , Noale Marianna , Catalani Filippo , Ceolin Chiara , Conti Silvia , di Rosa Elisa , Perdixi Elena , Remelli Francesca , Prinelli Federica , Maggi Stefania 
Published: April 2023

IntroductionThis systematic review and meta-analysis aims to explore changes in sleep quality and sleep disturbances in the general population from before to during the COVID-19 lockdown.MethodsThe protocol was registered in PROSPERO (CRD42021256378) and the PRISMA guidelines were followed. The major databases and gray literature were systematically searched from inception to 28/05/2021 to identify observational studies evaluating sleep changes in the general population during the lockdown with respect to the pre-lockdown period. A random effects meta-analysis was undertaken for studies reporting (a) the means of the Pittsburgh Sleep Quality Index (PSQI) global scores or the means of the sleep onset latency (SOL) times (minutes - min) before and during the lockdown, (b) the percentages of poor sleep quality before and during the lockdown, or (c) the percentages of changes in sleep quality. Subgroup analysis by risk of bias and measurement tool utilized was carried out. A narrative synthesis on sleep efficiency, sleep disturbances, insomnia and sleep medication consumption was also performed.ResultsSixty-three studies were included. A decline in sleep quality, reflected in a pooled increase in the PSQI global scores (standardized mean difference (SMD) = 0.26; 95% CI 0.17–0.34) and in SOL (SMD = 0.38 min; 95% CI 0.30–0.45) were found. The percentage of individuals with poor sleep quality increased during the lockdown (pooled relative risk 1.4; 95% CI 1.24–1.61). Moreover, 57.3% (95% CI 50.01–61.55) of the individuals reported a change in sleep quality; in 37.3% (95% CI 34.27–40.39) of these, it was a worsening. The studies included in the systematic review reported a decrease in sleep efficiency and an increase in sleep disturbances, insomnia, and in sleep medication consumption.DiscussionTimely interventions are warranted in view of the decline in sleep quality and the increase in sleep disturbances uncovered and their potentially negative impact on health. Further research and in particular longitudinal studies using validated instruments examining the long-term impact of the lockdown on sleep variables is needed.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021256378, identifier CRD42021256378.
Pharmacy-based immunization: a systematic review
Authors: Romero-Mancilla Marisol S. , Mora-Vargas Jaime , Ruiz Angel 
Published: April 2023

BackgroundThe coronavirus disease 2019 pandemic has prompted the exploration of new response strategies for such health contingencies in the near future. Over the last 15 years, several pharmacy-based immunization (PBI) strategies have emerged seeking to exploit the potential of pharmacies as immunization, medication sale, and rapid test centers. However, the participation of pharmacies during the last pandemic was very uneven from one country to another, suggesting a lack of consensus on the definition of their roles and gaps between the literature and practice.PurposeThis study aimed to consolidate the current state of the literature on PBI, document its progress over time, and identify the gaps not yet addressed. Moreover, this study seeks to (i) provide new researchers with an overview of the studies on PBI and (ii) to inform both public health and private organization managers on the range of possible immunization models and strategies.MethodologyA systematic review of scientific qualitative and quantitative studies on the most important scientific databases was conducted. The Preferred Reporting Items for Systematic Reviews and Meta-analyzes guidelines were followed. Finally, this study discusses the trends, challenges, and limitations on the existing literature on PBI.FindingsMust studies concluded that PBI is a beneficial strategy for the population, particularly in terms of accessibility and territorial equity. However, the effectiveness of PBI is affected by the economic, political, and/or social context of the region. The collaboration between the public (government and health departments) and private (various pharmacy chains) sectors contributes to PBI's success.OriginalityUnlike previous literature reviews on PBI that compiled qualitative and statistical studies, this study reviewed studies proposing mathematical optimization methods to approach PBI.
Bacterial Contamination of Antiseptics, Disinfectants, and Hand Hygiene Products Used in Healthcare Settings in Low- and Middle-Income Countries—A Systematic Review
Authors: Lompo Palpouguini , Agbobli Esenam , Heroes Anne-Sophie , Van den Poel Bea , Kühne Vera , Kpossou Cyprien M. Gutemberg , Zida Adama , Tinto Halidou , Affolabi Dissou , Jacobs Jan 
Published: April 2023

We conducted a systematic review of healthcare-associated outbreaks and cross-sectional surveys related to the contamination of antiseptics, disinfectants, and hand hygiene products in healthcare settings in low- and middle-income countries (PROSPERO CRD42021266271). Risk of bias was assessed by selected items of the ORION and MICRO checklists. From 1977 onwards, 13 outbreaks and 25 cross-sectional surveys were found: 20 from Asia and 13 from Africa. Products most associated with outbreaks were water-based chlorhexidine, chlorhexidine-quaternary ammonium compound combinations (7/13), and liquid soap products (4/13). Enterobacterales (including multidrug-resistant Enterobacter cloacae, Klebsiella pneumoniae, and Serratia marcescens) and non-fermentative Gram-negative rods were found in 5 and 7 outbreaks and in 34.1% and 42.6% of 164 isolates, respectively, from cross-sectional surveys. Risk factors included preparation (place, utensils, or tap water high and incorrect dilutions), containers (reused, recycled, or inadequate reprocessing), and practices (topping-up or too long use). Potential biases were microbiological methods (neutralizers) and incomplete description of products’ identity, selection, and denominators. External validity was compromised by low representativeness for remote rural settings and low-income countries in sub-Saharan Africa. Outstanding issues were water quality, biofilm control, field-adapted containers and reprocessing, in-country production, healthcare providers’ practices, and the role of bar soap. A list of “best practices” to mitigate product contamination was compiled.
Turismo rural na serra do rio do rastro: destacando a região de bom jardim da serra / Rural tourism in the serra do rastro: highlighting the region of good mountain garden
Authors: Cassão Jaqueline Padilha , Bett Eduardo Gonzaga , Coan Deise Viviane , Coelho Luiz Oswaldo , Jung Paulo Andre Doneda 
Published: April 2023

O espaço rural possibilita o desenvolvimento de diversas atividades dentre elas o lazer e o turismo. A atividade turística requer investimentos em infraestrutura de hospedagens e de lazer, que juntamente com o quadro socioambiental, caracterizam os lugares turísticos favorecendo o seu desenvolvimento. Nesse contexto, o turismo passa a ter papel fundamental na produção do espaço e na valorização do rural. O presente estudo tem como objetivo geral identificar os atrativos de Bom Jardim da Serra -SC. Para isso, utilizou-se de análise quantitativa, qualitativa observacional amostral, para determinar em porcentagem o resultado das respostas obtidas na aplicação de um questionário, com intuito de especificar o que o turista deseja encontrar quando pensa na região serrana. Conclui-se que, em geral, a busca pela região se dá principalmente pelas belezas naturais, primeiramente pela Serra do Rio do Rastro, seguindo o Mirante, a Usina Eólica. A busca por aventura também obteve um porcentual significativo.
Metodologia de enseñanza indagatoria para la promocion de aprendizaje significativo en fundamentos de la teoría cuántica / Methodology of indagatory teaching for the promotion of significant learning in basis of the quantum theory
Authors: Córdova Rafael Silva , Donoso Ester López 
Published: April 2023

Las metodologías de enseñanza en las ciencias han sido una permanente preocupación en las investigaciones en enseñanza de la Física, y a la fecha se siguen proponiendo alternativas que puedan mejorar la calidad de los aprendizajes. La presente investigación es una propuesta de enseñanza de los Fundamentos de la Teoría Cuántica, para estudiante del profesorado en Física, que permita mejorar rendimiento académico, promover aprendizaje de calidad, y desarrollar competencias genéricas. La propuesta se fundamenta epistemológicamente en el constructivismo, además, con aportes de Popper, Khun, y Lakatos. Se sustenta en las teorías del aprendizaje significativo de Ausubel, la teoría sociocultural de Vygostky, los Campos conceptuales de Vergnaud, los aportes de Novak y Gowin. La investigación se resuelve mediante una metodología de investigación fundamentalmente cuantitativa con algunos elementos de tipo cualitativo, además, es de tipo cuasi-experimental, con grupo control y experimental. Su estudio es descriptivo, comparativo e interpretativo. Sus principales resultados indican un aumento importante en los rendimientos académicos, del 55% al 67%, los aprendizajes obtenidos son significativos. En lo que es aprendizaje, sus resultados nos indican que mayoritariamente consiguen aprendizaje significativo en los fundamentos que dan origen a mecánica cuántica. Las competencias: cognitivas, metodológicas y sociales superan el 70% de logro. El grado de satisfacción de la propuesta es sobre el 85% por parte de los estudiantes.