bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the pattern of antibiotic resistance of urinary tract infection (UTI)-causing bacteria in the urine culture samples of patients in the infectious ward of Imam Khomeini Hospital, Kermanshah, in Iran from 2016–2018
Authors: Shirvani Maria , Keramati Ali , Esmaeli Mojtaba 
Published: June 2023

Abstract
Background
Increasing resistance of bacteria to antimicrobial agents is a significant problem worldwide. This study aimed to assess the pattern of antibiotic resistance among bacteria that cause urinary tract infections (UTIs) in patients admitted to the infectious ward of Imam Khomeini Hospital in Kermanshah between 2016 and 2018, based on urine culture samples.

Methods
The present study was a cross-sectional and descriptive study. The study’s statistical population included all patients referred to the infectious disease ward of Imam Khomeini Hospital due to urinary tract infections during the project period. Urine samples were collected in sterile containers, and by using a calibrated loop, the urine sample was cultured on EMB and blood agar media under sterile conditions. Microbial sensitivity was performed by standard disk diffusion method, and the results were analyzed using SPSS-V 16 software.

Results
The antibiotic resistance assays showed that the highest resistance included nalidixic acid (73.5%), ciprofloxacin (72.1%), cotrimoxazole (70.6%), and ceftazidime (61.8%), cefixime (57.4%), ceftriaxone (48.5%), gentamicin (32.4%), cephalothin (16.6%), nitrofurantoin (10.3%), norfloxacin (5.9%), cefotaxime (4.4%), imipenem (2.9%), cefepime (2.9%), ampicillin (2.9%), ceftizoxime (1.5%), vancomycin (1.5%), cefazolin (1.5%), and chloramphenicol (1.5%), respectively. In addition, investigating the antibiotic resistance of UTI-causing bacteria according to the gender and age of the patients in the present study showed no significant statistical difference (P > 0.05).

Conclusion
The bacteria causing urinary infections in the study area mainly belonged to the E. coli and Klebsiella families. Considering the determination of antibiotic sensitivity patterns in common organisms in the studied area, its report to doctors can be considered in experimental treatments.
Polypharmacy with potentially inappropriate medications as a risk factor of new onset sarcopenia among community-dwelling Japanese older adults: a 9-year Kashiwa cohort study
Authors: Tanaka Tomoki , Akishita Masahiro , Kojima Taro , Son Bo-Kyung , Iijima Katsuya 
Published: June 2023

Abstract
Background
Clinical evidence demonstrating a longitudinal association between prescribed medications and sarcopenia onset is lacking. We investigated the association of polypharmacy (the use of five or more medications) and potentially inappropriate medications (PIMs) with sarcopenia risk in community-dwelling older adults.

Methods
In this longitudinal population-based cohort study, 2,044 older residents with no long-term care needs were randomly selected from a community in Kashiwa, Japan. Baseline data collection was conducted in 2012, with follow-ups in 2013, 2014, 2016, 2018, and 2021. Prescribed medications and PIMs (drugs listed in the Screening Tool for Older Person’s Appropriate Prescriptions for the Japanese or potentially muscle-wasting drugs) were identified through interviews. New-onset sarcopenia was identified according to the 2019 criteria of the Asian Working Group for Sarcopenia over a 9-year period and analyzed. We used Cox proportional hazards models to test the longitudinal association of prescribed medications with sarcopenia onset.

Results
Of the 1,549 participants without sarcopenia at baseline (mean age, 72.5 ± 5.5 years; 49.1% women; median and interquartile range, 6.0 [4.0–9.0] years), 230 experienced new-onset sarcopenia during the follow-up. After adjusting for confounders, polypharmacy combined with PIM use was strongly associated with new-onset sarcopenia (adjusted hazard ratio, 2.35; 95% confidence interval, 1.58–3.51; P < 0.001). No significant associations were observed for either PIM use or polypharmacy alone.

Conclusions
Polypharmacy combined with PIM use, but not polypharmacy alone, was associated with an increased risk of new-onset sarcopenia over the 9-year follow-up period among community-dwelling older adults. Limiting polypharmacy and imposing the prescription of appropriate medications may facilitate sarcopenia prevention.
Organism type of infection is associated with prognosis in sepsis: an analysis from the MIMIC-IV database
Authors: Guo Qiuping , Qu Peng , Cui Wanfu , Liu Mingrong , Zhu Huiling , Chen Weixin , Sun Nan , Geng Shiyu , Song Weihua , Li Xu , Lou Anni 
Published: June 2023

Abstract
Background
Sepsis has a high mortality rate, which is expensive to treat, and is a major drain on healthcare resources; it seriously impacts the quality of human life. The clinical features of positive or non-positive blood cultures have been reported, but the clinical features of sepsis with different microbial infections and how they contribute to clinical outcomes have not been adequately described.

Methods
We extracted clinical data of septic patients with a single pathogen from the online Medical Information Mart for Intensive Care(MIMIC)-IV database. Based on microbial cultures, patients were classified into Gram-negative, Gram-positive, and fungal groups. Then, we analyzed the clinical characteristics of sepsis patients with Gram-negative, Gram-positive, and fungal infections. The primary outcome was 28-day mortality. The secondary outcomes were in-hospital mortality, the length of hospital stay, the length of ICU stay, and the ventilation duration. In addition, Kaplan–Meier analysis was used for the 28-day cumulative survival rate of patients with sepsis. Finally, we performed further univariate and multivariate regression analyses for 28-day mortality and created a nomogram for predicting 28-day mortality.

Results
The analysis showed that bloodstream infections showed a statistically significant difference in survival between Gram-positive and fungal organisms; drug resistance only reached statistical significance for Gram-positive bacteria. Through univariate and multivariate analysis, it was found that both the Gram-negative bacteria and fungi were independent risk factors for the short-term prognosis of sepsis patients. The multivariate regression model showed good discrimination, with a C-index of 0.788. We developed and validated a nomogram for the individualized prediction of 28-day mortality in patients with sepsis. Application of the nomogram still gave good calibration.

Conclusions
Organism type of infection is associated with mortality of sepsis, and early identification of the microbiological type of a patient with sepsis will provide an understanding of the patient's condition and guide treatment.
Risk factors associated with vitamin D deficiency in preterm neonates: a single-center step-wise regression analysis
Authors: Jamali Zahra , Ghorbani Fereshteh , Shafie’ei Mohammad , Tolooefar Fatemeh , Maleki Elham 
Published: June 2023

AbstractBackgroundVitamin D deficiency is particularly concerning in pregnant women, leading to various health-related issues in mothers and their babies, especially those born prematurely, including neonatal skeletal and respiratory disorders. In addition, there have been several reports indicating the presence of multiple impactful factors in the development of vitamin D deficiency. Therefore, we aimed to evaluate the vitamin D level in very preterm and moderately preterm newborns and investigate its association with presumed influential factors.MethodsThis cross-sectional descriptive study was performed on 54 mothers and their preterm neonates with gestational ages less than 34 weeks at delivery (i.e., very preterm and moderately preterm). After the serum vitamin D levels were determined from samples obtained in the first 24 h after birth, the babies were divided into two groups based on the presence or absence of deficiency. The relationship between several factors and the neonatal serum vitamin D level was investigated separately and in a linear step-wise regression model.ResultsThe differences between the groups regarding maternal age, gestational age, neonate's gender, birth weight, and delivery method with neonatal vitamin D levels were not statistically significant. However, maternal vitamin D levels strongly correlated with neonatal vitamin D levels (P-value < 0.001,r = 0.636). The regression model also yielded a strong predictive capability (P-value < 0.001, AdjustedR2 = 0.606), with the maternal vitamin D level demonstrating a significant impact.ConclusionsLow vitamin D levels in pregnant mothers correlate with deficient levels in their preterm neonates. Therefore, as vitamin D deficiency significantly affects both the mother's and newborn's health, it is recommended that healthcare providers provide comprehensive plans for vitamin D supplementation during pregnancy.
Perceived inequality in society may not motivate increased food intake in the absence of personal socioeconomic disadvantage
Authors: Cheon Bobby K. , Low Xenia , Wijaya Darren Jeffian , Lee Albert 
Published: June 2023

Abstract
Background
Greater levels of socioeconomic inequality across societies have been associated with higher rates of obesity and cardiometabolic disease. While these relationships could be attributed to poorer quality of health services and lower access to healthier lifestyles among disadvantaged groups in societies with greater economic inequality, this explanation does not account for those who experience relative economic security in such unequal societies (e.g., the middle and upper classes). Here, we tested whether perceptions of greater disparities between social classes in one’s society (i.e., perceived societal inequality) may promote eating behaviors that risk excess energy intake.

Methods
In two studies, participants completed an experimental manipulation that situated them as middle class within a hypothetical society that was presented to have either large disparities in socioeconomic resources between classes (high inequality condition) or low disparities (low inequality condition), while keeping the participants’ objective socioeconomic standing constant across conditions. In Study 1 (pre-registered), participants (n = 167) completed the perceived societal inequality manipulation before a computerized food portion selection task to measure desired portion sizes for a variety of foods. Study 2 (n = 154) involved a similar design as Study 1, but with inclusion of a neutral control condition (no awareness of class disparities) followed by ad libitum consumption of potato chips.

Results
While the high inequality condition successfully elicited perceptions of one’s society as having greater socioeconomic inequalities between classes, it did not generate consistent feelings of personal socioeconomic disadvantage. Across both studies, we observed no differences between conditions in average selected portion sizes or actual energy intake.

Conclusions
Taken together with prior research on the effects of subjective socioeconomic disadvantage on increased energy intake, these findings suggest that perceptions of inequality in one’s society may be insufficient to stimulate heightened energy intake in the absence of personal socioeconomic disadvantage or inadequacy.
Hospital challenges and managerial approaches to combat COVID-19 outbreak: a qualitative study in southeastern Iran
Authors: Ebrahimi Rigi Zahra , Namjoo Zakieh , Jabarpour Maryam , Ahmadinejad Mehdi , Ahmadipour Maryam , Mangolian Shahrbabaki Parvin , Dehghan Mahlagha 
Published: June 2023

Abstract
Background
During the covid-19 pandemic, hospitals have faced several challenges, so they need to identify and address effective management strategies to cope with these challenges that enhance their current knowledge to deal with similar challenges in the future. This study aimed to identify managerial strategies for dealing with Covid-19 pandemic challenges at a hospital in southeastern Iran.

Methods
This qualitative content analysis study used purposive sampling to select eight managers, three nurses, and one worker from Shahid Bahonar Hospital. In this study, semi-structured interviews were used to collect data and Lundman and Graneheim’s approach was used to analyze them.

Results
Three hundred fifty codes remained after constant comparison, compression, and merging. The results demonstrated one theme “Managerial reengineering in the healthcare system during the Covid-19 crisis”, two main categories, seven subcategories and, 19 sub- subcategories. The first main category was “The difficulty of managing challenges,“ including “Insufficient resources and physical space”, “Socio-organizational challenges” and, “Incompetence and unpreparedness of managers.“ The second main category was “Reforming the management duties.“ This category included “Planning and decision-making,“ “Organization,“ “Leadership and motivation,“ and “Monitoring and control.”

Conclusions
Hospitals and managers were less prepared to cope with the Covid-19 crisis challenges due to health system organizations’ less attention to biological crises. Healthcare organizations can carefully evaluate these challenges, and the strategies managers adopt to deal with these problems. They also can identify the strategies’ strengths and weaknesses and propose more effective strategies. As a result, healthcare organizations will be better prepared for similar crises.
Effectiveness of mHealth consultation services for preventing postpartum depressive symptoms: a randomized clinical trial
Authors: Arakawa Yuki , Haseda Maho , Inoue Kosuke , Nishioka Daisuke , Kino Shiho , Nishi Daisuke , Hashimoto Hideki , Kondo Naoki 
Published: June 2023

Abstract
Background
Although many conventional healthcare services to prevent postpartum depression are provided face-to-face, physical and psychosocial barriers remain. These barriers may be overcome by using mobile health services (mHealth). To examine the effectiveness of mHealth professional consultation services in preventing postpartum depressive symptoms in real-world settings, we conducted this randomized controlled trial in Japan, where universal free face-to-face perinatal care is available.

Methods
This study included 734 pregnant women living in Yokohama city who could communicate in Japanese, recruited at public offices and childcare support facilities. The participants were randomized to the mHealth group (intervention, n = 365), where they could use a free app-based mHealth consultation service with gynecologists/obstetricians, pediatricians, and midwives whenever and as many times as they wanted between 6 p.m. and 10 p.m. on weekdays throughout their pregnancy and postpartum periods (funded by the City of Yokohama government) or the usual care group (control, n = 369). The primary outcome was the risk of elevated postpartum depressive symptoms, defined as Edinburgh Postnatal Depression Scale score ≥ 9. Secondary outcomes were self-efficacy, loneliness, perceived barriers to healthcare access, number of clinic visits, and ambulance usage. All outcomes were collected three months post-delivery. We also conducted subgroup analyses assessing the differences in the treatment effect by sociodemographic status.

Results
Most women completed all questionnaires (n = 639 of 734, response rate: 87%). The mean baseline age was 32.9 ± 4.2 years, and 62% were primipara. Three months post-delivery, women in the mHealth group had a lower risk of elevated postpartum depressive symptoms (47/310 [15.2%]) compared to the usual care group (75/329 [22.8%], risk ratio: 0.67 [95% confidence interval: 0.48–0.93]). Compared with the usual care group, women in the mHealth group had higher self-efficacy, less loneliness, and fewer perceived barriers to healthcare access. No differences were observed in the frequency of clinic visits or ambulance usage. Furthermore, in the subgroup analyses, we did not find differences in the treatment effect by sociodemographic status.

Conclusions
Local government-funded mHealth consultation services have a preventive effect on postpartum depressive symptoms, removing physical and psychological barriers to healthcare access in real-world settings.

Trial registration
UMIN-CTR identifier: UMIN000041611. Registered 31 August 2021.
Association of Mediterranean diet with survival after breast cancer diagnosis in women from nine European countries: results from the EPIC cohort study
Authors: Castro-Espin Carlota , Bonet Catalina , Crous-Bou Marta , Nadal-Zaragoza Núria , Tjønneland Anne , Mellemkjær Lene , Hajji-Louati Mariem , Truong Thérèse , Katzke Verena , Le Cornet Charlotte , Schulze Matthias B. , Jannasch Franziska , Masala Giovanna , Sieri Sabina , Panico Salvatore , Di Girolamo Chiara , Skeie Guri , Borch Kristin Benjaminsen , Olsen Karina Standahl , Sánchez Maria-Jose , Amiano Pilar , Chirlaque María-Dolores , Guevara Marcela , Sund Malin , Bodén Stina , Gunter Marc J. , Gonzalez-Gil Esther M. , Weiderpass Elisabete , Aguilera-Buenosvinos Inmaculada , Tsilidis Kostas K. , Heath Alicia K. , Aune Dagfinn , Dossus Laure , Agudo Antonio 
Published: June 2023

Abstract

Background
The Mediterranean diet has been associated with lower risk of breast cancer (BC) but evidence from prospective studies on the role of Mediterranean diet on BC survival remains sparse and conflicting. We aimed to investigate whether adherence to Mediterranean diet prior to diagnosis is associated with overall and BC-specific mortality.

Methods
A total of 13,270 incident breast cancer cases were identified from an initial sample of 318,686 women in 9 countries from the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Adherence to Mediterranean diet was estimated through the adapted relative Mediterranean diet (arMED), a 16-point score that includes 8 key components of the Mediterranean diet and excludes alcohol. The degree of adherence to arMED was classified as low (score 0–5), medium (score 6–8), and high (score 9–16). Multivariable Cox proportional hazards models were used to analyze the association between the arMED score and overall mortality, and Fine-Gray competing risks models were applied for BC-specific mortality.

Results
After a mean follow-up of 8.6 years from diagnosis, 2340 women died, including 1475 from breast cancer. Among all BC survivors, low compared to medium adherence to arMED score was associated with a 13% higher risk of all-cause mortality (HR 1.13, 95%CI 1.01–1.26). High compared to medium adherence to arMED showed a non-statistically significant association (HR 0.94; 95% CI 0.84–1.05). With no statistically significant departures from linearity, on a continuous scale, a 3-unit increase in the arMED score was associated with an 8% reduced risk of overall mortality (HR3-unit 0.92, 95% CI: 0.87–0.97). This result sustained when restricted to postmenopausal women and was stronger among metastatic BC cases (HR3-unit 0.81, 95% CI: 0.72–0.91).

Conclusions
Consuming a Mediterranean diet before BC diagnosis may improve long-term prognosis, particularly after menopause and in cases of metastatic breast cancer. Well-designed dietary interventions are needed to confirm these findings and define specific dietary recommendations.
Widely targeted quantitative lipidomics and prognostic model reveal plasma lipid predictors for nasopharyngeal carcinoma
Authors: Chen Xi , Li Ying-xue , Cao Xun , Qiang Meng-yun , Liang Chi-xiong , Ke Liang-ru , Cai Zhuo-chen , Huang Ying-ying , Zhan Ze-jiang , Zhou Jia-yu , Deng Ying , Zhang Lu-lu , Huang Hao-yang , Li Xiang , Mei Jing , Xie Guo-tong , Guo Xiang , Lv Xing 
Published: June 2023

Abstract
Background
Dysregulation of lipid metabolism is closely associated with cancer progression. The study aimed to establish a prognostic model to predict distant metastasis-free survival (DMFS) in patients with nasopharyngeal carcinoma (NPC), based on lipidomics.

Methods
The plasma lipid profiles of 179 patients with locoregionally advanced NPC (LANPC) were measured and quantified using widely targeted quantitative lipidomics. Then, patients were randomly split into the training (125 patients, 69.8%) and validation (54 patients, 30.2%) sets. To identify distant metastasis-associated lipids, univariate Cox regression was applied to the training set (P < 0.05). A deep survival method called DeepSurv was employed to develop a proposed model based on significant lipid species (P < 0.01) and clinical biomarkers to predict DMFS. Concordance index and receiver operating curve analyses were performed to assess model effectiveness. The study also explored the potential role of lipid alterations in the prognosis of NPC.

Results
Forty lipids were recognized as distant metastasis-associated (P < 0.05) by univariate Cox regression. The concordance indices of the proposed model were 0.764 (95% confidence interval (CI), 0.682–0.846) and 0.760 (95% CI, 0.649–0.871) in the training and validation sets, respectively. High-risk patients had poorer 5-year DMFS compared with low-risk patients (Hazard ratio, 26.18; 95% CI, 3.52–194.80; P < 0.0001). Moreover, the six lipids were significantly correlated with immunity- and inflammation-associated biomarkers and were mainly enriched in metabolic pathways.

Conclusions
Widely targeted quantitative lipidomics reveals plasma lipid predictors for LANPC, the prognostic model based on that demonstrated superior performance in predicting metastasis in LANPC patients.
Engineering a triple-functional magnetic gel driving mutually-synergistic mild hyperthermia-starvation therapy for osteosarcoma treatment and augmented bone regeneration
Authors: Yu Kexiao , Zhou Hang , Xu Yamei , Cao Youde , Zheng Yuanyi , Liang Bing 
Published: June 2023

AbstractMalignant bone tumors result in high rates of disability and death and are difficult to treat in terms of killing tumors and repairing bone defects. Compared with other hyperthermia strategies, magnetic hyperthermia has become an effective therapy for treating malignant bone tumors due to its lack of depth limitations. However, tumor cells express heat shock protein (HSP) to resist hyperthermia, which reduces its curative effect. Competitive ATP consumption can reduce HSP production; fortunately, the basic principle of starvation therapy by glucose oxidase (GOx) is consuming glucose to control ATP production, thereby restricting HSP generation. We developed a triple-functional magnetic gel (Fe3O4/GOx/MgCO3@PLGA) as a magnetic bone repair hydrogels (MBRs) with liquid‒solid phase transition capability to drive magneto-thermal effects to simultaneously trigger GOx release and inhibit ATP production, reducing HSP expression and thereby achieving synergistic therapy for osteosarcoma treatment. Moreover, magnetic hyperthermia improves the effect of starvation therapy on the hypoxic microenvironment and achieves a reciprocal strengthening therapeutic effect. We further demonstrated that in situ MBRs injection effectively suppressed tumor growth in 143B osteosarcoma tumor-bearing mice and an in-situ bone tumor model in the rabbit tibial plateau. More importantly, our study also showed that liquid MBRs could effectively match bone defects and accelerate their reconstruction via magnesium ion release and enhanced osteogenic differentiation to augment the regeneration of bone defects caused by bone tumors, which generates fresh insight into malignant bone tumor treatment and the acceleration of bone defect repair.