bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and associated factors of healthy aging among community-dwelling older adults in Lishui city, China: a cross-sectional study
Authors: Chen Jian-Hua , Mohd Zain Norhasmah , Yusuf Azlina , Ying Bi-He 
Published: January 2025

Abstract

Background
Identifying the level of healthy aging and exploring its associated factors are prerequisites in the planning of effective measures among the elderly population. Thus, this study aimed to investigate the prevalence of healthy aging and determine its associated factors among community-dwelling older adults from mountain areas in Lishui, China.

Methods
A multicenter cross-sectional survey was conducted. Participants were recruited by a multi-stage stratified cluster-sampling procedure from a mountainous region in Lishui City, Zhejiang Province, China. A validated questionnaire of Healthy Aging Instruments (HAI), Basic Psychological Needs Satisfaction (BPNS), Patient Health Questionnaire (PHQ-9), Ascertain Dementia 8 questionnaire (AD8), Family Adaption Scale (FAS), Community-Based Health Promotion Activity Questionnaires (HPAQ), Social Function Questionnaire for Chinese Older Adults (SFQCOA), Adult Health Self-Management Skills (ability) Rating Scale (AHSMSRS) was incorporated. The questionnaire also captured sociodemographic characteristics, lifestyle behaviors, and Self-Perceived Healthy Ageing (SPHA). Multivariate stepwise linear regression analysis was performed.

Results
The mean score of the Healthy Aging index was 136.5 (18.22). The majority of the participants have a high level of healthy aging (65.5%). Regression analysis showed 12 predictors of healthy aging: self-perceived economic independence, lifestyle-related behaviors, subjective physical health, psychological health, better competence of BPNS, frequency of community-based HPA participation, lower HPA-perceived barriers, social support, social engagement, and Health Self-Management (HSM) ability with two dimensions HSM-Consciousness and HSM-Behavior, as well as SPHA (P < 0.05).

Conclusions
This study contributed to the existing gap in both subjective and objective understanding of healthy aging, especially in terms of its relationship with sociodemographic factors, lifestyle-related behaviors, individual health conditions, environmental coverage, as well as family, community and social support. Both individual-environment interaction factors as better HSM ability as well as SPHA might help predict older adults’ healthy aging in mountainous areas in China. Developing an accurate, reliable health promotion program that provides insights may improve healthy aging changes in mountainous regions for community healthcare staff, especially nurses.
Enhancing prehospital decision-making: exploring user needs and design considerations for clinical decision support systems
Authors: Bai Enze , Zhang Zhan , Xu Yincao , Luo Xiao , Adelgais Kathleen 
Published: January 2025

Abstract

Background
In prehospital emergency care, providers face significant challenges in making informed decisions due to factors such as limited cognitive support, high-stress environments, and lack of experience with certain patient conditions. Effective Clinical Decision Support Systems (CDSS) have great potential to alleviate these challenges. However, such systems have not yet been widely adopted in real-world practice and have been found to cause workflow disruptions and usability issues. Therefore, it is critical to investigate how to design CDSS that meet the needs of prehospital providers while accounting for the unique characteristics of prehospital workflows.

Methods
We conducted semi-structured interviews with 20 prehospital providers recruited from four Emergency Medical Services (EMS) agencies in an urban area in the northeastern U.S. The interviews focused on the decision-making challenges faced by prehospital providers, their technological needs for decision support, and key considerations for the design and implementation of a CDSS that can seamlessly integrate into prehospital care workflows. The data were analyzed using content analysis to identify common themes.

Results
Our qualitative study identified several challenges in prehospital decision-making, including limited access to diagnostic tools, insufficient experience with certain critical patient conditions, and a lack of cognitive support. Participants highlighted several desired features to make CDSS more effective in the dynamic, hands-busy, and cognitively demanding prehospital context, such as automatic prompts for possible patient conditions and treatment options, alerts for critical patient safety events, AI-powered medication identification, and easy retrieval of protocols using hands-free methods (e.g., voice commands). Key considerations for successful CDSS adoption included balancing the frequency and urgency of alerts to reduce alarm fatigue and workflow disruptions, facilitating real-time data collection and documentation to enable decision generation, and ensuring trust and accountability while preventing over-reliance when using CDSS.

Conclusion
This study provides empirical insights into the challenges and user needs in prehospital decision-making and offers practical and system design implications for addressing these issues.
BMP6, a potential biomarker of inflammatory fibrosis and promising protective factor for dilated cardiomyopathy
Authors: Jiang Feng , Tang Jiayang , Wei Xiaoqi , Pan Hai , Fan Xinyi , Zhang Peng , Guo Shuzhen 
Published: January 2025

Abstract

Background
Dilated cardiomyopathy (DCM) stands as one of the most prevalent and severe causes of heart failure. Inflammation plays a pivotal role throughout the progression of DCM to heart failure, while age acts as a natural predisposing factor for all cardiovascular diseases. These two factors often interact, contributing to cardiac fibrosis, which is both a common manifestation and a pathogenic driver of adverse remodeling in DCM-induced heart failure.

Method
Bulk RNA-seq, single-cell RNA-seq, Mendelian randomization analysis, animal model construction, and BMP6 knockdown were utilized to identify and validate potential specific markers and targets for intervention in DCM heart failure.

Results
We found that DCM hearts exhibit pronounced inflammatory cell infiltration and fibrosis. Both bulk RNA-seq and single-cell RNA-seq analyses revealed aberrant BMP6 expression specifically in fibroblasts. The ROC curve underscores the high specificity of BMP6 in relation to DCM, while Mendelian randomization analysis further confirms BMP6 as a protective factor against DCM. Notably, BMP6 knockdown led to a decrease in SMAD6 expression and a marked elevation in COL1A1 expression levels, indicating its antifibrotic role.

Conclusion
BMP6 emerges as a promising biomarker for DCM, and its functional role in exerting an antifibrotic effect underscores its potential as a therapeutic target.
Trends in views of democracy and society and support for political violence in the USA, 2022–2024: findings from a nationally representative survey
Authors: Wintemute Garen J. , Crawford Andrew , Tomsich Elizabeth A. , Pear Veronica A. 
Published: January 2025

Abstract

Background
In 2022, a nationally representative longitudinal survey in the USA found concerningly high prevalences of support for and personal willingness to engage in political violence, but those prevalences decreased in 2023. This study examines changes in those prevalences from 2023 to 2024, an election year in the USA.

Methods
Participants were members of Ipsos KnowledgePanel. Wave 3 of the survey was conducted May 23-June 14, 2024; invitations to participate were sent to all respondents to prior waves who remained in KnowledgePanel. Outcome measures concern justification for the use of violence to advance any of 17 specified political objectives, personal willingness to engage in political violence at 4 levels of severity and against 9 target populations, and expectation of firearm use in political violence. Outcomes are expressed as weighted proportions. Year-to-year change is based on the means of aggregated individual change scores, which have a potential range from 0 (no change) to ± 2.

Results
The 2024 completion rates were 88.4% (8896 respondents/10,064 invitees) overall, 91.6% (8185 respondents/8932 invitees) for invitees in 2024 who had responded in 2023, and 62.8% (711 respondents/1132 invitees) for invitees in 2024 who had responded in 2022 but not in 2023. After weighting, 50.9% (95% confidence interval (CI) 49.5%, 52.3%) were female; weighted mean (SD) age was 48.5 (24.9) years. From 2023 to 2024, the prevalence of the view that violence was usually or always justified to advance at least 1 political objective did not change (2024: 26.2%, 95% CI 25.0%, 27.5%; 2023: 25.3%, 95% CI 24.1%, 26.5%). There were no changes from 2023 to 2024 in willingness to damage property, threaten a person, injure a person, or kill a person in an act of political violence, and no changes in expectations of firearm use in situations where respondents considered political violence justifiable. Changes on other measures were infrequent (17 of 58 comparisons in the main analysis) and small where they occurred (with 2 exceptions, change < 0.05).

Conclusions
Contrary to expectation, support for and willingness to participate in political violence in this cohort showed little to no change from 2023 to 2024, an election year in the USA. These findings can help guide prevention efforts.
Artificial Intelligence–Powered Human Epidermal Growth Factor Receptor 2 and Tumor Microenvironment Analysis in Human Epidermal Growth Factor Receptor 2–Amplified Metastatic Colorectal Cancer: Exploratory Analysis of Phase II TRIUMPH Trial
Authors: Imai Mitsuho , Nakamura Yoshiaki , Shin Sangwon , Okamoto Wataru , Kato Takeshi , Esaki Taito , Kato Ken , Komatsu Yoshito , Yuki Satoshi , Masuishi Toshiki , Nishina Tomohiro , Sawada Kentaro , Sato Akihiro , Kuwata Takeshi , Yamashita Riu , Fujisawa Takao , Bando Hideaki , Ock Chan-Young , Fujii Satoshi , Yoshino Takayuki 
Published: January 2025

PURPOSE

Human epidermal growth factor receptor 2 (HER2)–targeted therapies have shown promise in treating
HER2
-amplified metastatic colorectal cancer (mCRC). Identifying optimal biomarkers for treatment decisions remains challenging. This study explores the potential of artificial intelligence (AI) in predicting treatment responses to trastuzumab plus pertuzumab (TP) in patients with
HER2
-amplified mCRC from the phase II TRIUMPH trial.

MATERIALS AND METHODS
AI-powered HER2 quantification continuous score (QCS) and tumor microenvironment (TME) analysis were applied to the prescreening cohort (n = 143) and the TRIUMPH cohort (n = 30). AI analyzers determined the proportions of tumor cells (TCs) with HER2 staining intensity and the densities of various cells in TME, examining their associations with clinical outcomes of TP.

RESULTS

The AI-powered HER2 QCS for HER2 immunohistochemistry (IHC) achieved an accuracy of 86.7% against pathologist evaluations, with a 100% accuracy for HER2 IHC 3+ patients. Patients with ≥50% of TCs showing HER2 3+ staining intensity (AI-H3-high) exhibited significantly prolonged progression-free survival (PFS; median PFS, 4.4
v
1.4 months; hazard ratio [HR], 0.12 [95% CI, 0.04 to 0.38]) and overall survival (OS; median OS, 16.5
v
4.1 months; HR, 0.13 [95% CI, 0.05 to 0.38]) compared with the AI-H3-low (<50% group). Stratification among patients with AI-H3-high included TME-high (all lymphocyte, fibroblast, and macrophage densities in the cancer stroma above the median) and TME-low (anything below the median), showing a median PFS of 1.3 and 5.6 months for TME-high and TME-low respectively, with an HR of 0.04 (95% CI, 0.01 to 0.19) for AI-H3-high with TME-low compared with AI-H3-low.

CONCLUSION

AI-powered HER2 QCS and TME analysis demonstrated potential in enhancing treatment response predictions in patients with
HER2
-amplified mCRC undergoing TP therapy.
Mean first-passage time of heterogeneous telegrapher's process under stochastic resetting
Authors: Jolakoski P. , Trajanovski P. , Iomin A. , Kocarev L. , Sandev T. 
Published: January 2025

Abstract
We study the first-passage time of the heterogeneous telegrapher's process, which is a stochastic process with a multiplicative dichotomic noise and a position-dependent velocity. As special cases we recover results for heterogeneous diffusion in the Stratonovich interpretation, as well as the standard telegrapher's process with a constant velocity. In the framework of the renewal equation approach, we study the survival probability and the first-passage time density. An exact result for the mean first-passage time in the presence of Poissonian stochastic resetting of the particle to the initial position is obtained as well. An optimal resetting rate is obtained. In this case, the mean first-passage time becomes minimal for every power-law exponent of the power-law position-dependent velocity. We have also observed that the optimal resetting rate increases when the power-law exponent of the velocity decreases.
Relationship Among Fragility Fractures and the Overall Cardiovascular Burden in Endogenous Cushing Syndrome
Authors: Voltan Giacomo , Mazzeo Pierluigi , Cannito Michele , Pinelli Silvia , Barbot Mattia , Scaroni Carla , Ceccato Filippo , Camozzi Valentina 
Published: January 2025

Abstract

Context
Patients with endogenous Cushing syndrome (CS), in addition to significant cardiovascular morbidity, are burdened by a high prevalence of fragility fractures. Bone mineral density (BMD) alone poorly predicts the risk of fracture, and the implementation of trabecular bone score (TBS) is supported only by scant evidence. Indeed, reliable predictors of fractures in endogenous CS are still lacking.

Objective
This work aimed to analyze the prevalence and the potential predictors of fragility fractures in our patients with CS.

Methods
A monocentric, retrospective, cross-sectional study. A total of 51 patients with overt CS were enrolled. Main outcome measures included biochemical evaluation, BMD measurement, TBS evaluation, fracture presence, body composition evaluation, and arterial intima-media thickness (IMT) assessment.

Results
Fragility fractures were found in 62.7% of patients at diagnosis. Fractured patients exhibited lower spine T-score (P = .03), longer disease duration (P = .025), higher waist circumference (P = .006), and predominantly male sex (P = .008). Increased serum uric acid levels (P = .001), greater IMT (P = .017), and higher prevalence of venous thromboembolism events (31.3% vs 5.3%, P = .037) and atherosclerotic plaques (47% vs 5.3%, P = .002) were described in the fracture group.
Multivariable logistic regression identified the presence of atherosclerosis (OR 13.35; 95% CI 1.154-154.34, P = .038) and osteoporosis (OR 11.30; 95% CI 1.55-82.56, P = .017) as independent predictors. TBS values were inversely correlated with body mass index, fat and lean mass, and serum uric acid, and positively correlated with high-density lipoprotein cholesterol.

Conclusion
CS patients with higher overall burden of cardiovascular morbidity are more prone to experience fragility fractures.
The Last Byzantine Military Manuscript: Istanbul TSMK G.İ. 36 and the Taktika of Nikephoros Ouranos
Authors: RANCE Philip 
Published: January 2025

Περίληψη: Το χειρόγραφο Ιstanbul TMSK G.İ. 36 (παλαιότερα γνωστό ως codex Constantinopolitanus / Seragliensis graecus 36) αποτελεί σημαντικό και σε αρκετά χωρία μοναδικό μάρτυρα του κειμένου των Τακτικά του Νικηφόρου Ουρανού, μιας ιδιαιτέρως εκτεταμένης πολεμικής πραγματείας που συντάχθηκε περί το 1000 και παραμένει σε μεγάλο βαθμό ανέκδοτη. Ο κώδικας TSMK G.İ. 36, έργο των αρχών της δεκαετίας του 1430, αποτελεί το τελευταίο παράδειγμα βυζαντινού χειρογράφου του είδους και είναι μια σπάνια περίπτωση κώδικα παλαιότερου του 1453 που διασώθηκε στην οθωμανική σουλτανική βιβλιοθήκη. Αν και εντοπίστηκε στο ανάκτορο του Τοπκαπί το 1887, δυσκολίες στην πρόσβαση εμπόδισαν επί μακρόν την επιστημονική του έρευνα και παραμένει έως σήμερα το λιγότερο μελετημένο χειρόγραφο στον χώρο των βυζαντινών στρατιωτικών πραγματειών. Η παρούσα εργασία είναι η πρώτη συστηματική μελέτη του TSMK G.İ. 36. Αποπειράται μια ολοκληρωμένη κωδικολογική και φιλολογική έρευνα, όπου μελετάται και αναθεωρείται η παλαιότερη βιβλιογραφία, παρέχεται μια λεπτομερής περιγραφή του κώδικα και αξιολογούνται οι ομοιότητες σε επίπεδο κειμένου και η σημασία του για μια πλήρη κριτική έκδοση των Τακτικών του Νικηφόρου Ουρανού
Prohibiting Babel—A call for professional remote interpreting services in pre-operation anaesthesia information
Authors: Gerger Gernot , Graf Nikolaus , Klager Elisabeth , Doppler Klara , Langauer Armin , Albrecht Verena , Bilir Aylin , Willschke Harald , Baron David M. , Kletecka-Pulker Maria 
Published: January 2025

Introduction
Language barriers within clinical settings pose a threat to patient safety. As a potential impediment to understanding, they hinder the process of obtaining informed consent and uptake of critical medical information. This study investigates the impact of the current use of interpreters, with a particular focus on of engaging laypersons as interpreters, rather than professional interpreters potentially affecting patient safety. A further objective is to explore the reliability of phone-based telemedicine in terms of the retention of important medical facts.

Methods
In three groups (N per group = 30), we compared how using lay or professional interpreters affected non-German speaking patients’ subjectively perceived understanding (understood vs. not understood) and recollection (recollected vs. not recollected) of information about general anaesthesia. Proficient German speaking patients served as the control group. Statistical analyses (χ2 tests and binomial) were calculated to show differences between and within the groups.

Results
All three groups indicated similar, high self-reported levels of having understood the medical information provided. This was in stark contrast to the assessed objective recollection data. In the lay interpreter group, recollection of anaesthesia facts was low; only around half of participants recalled specific facts. For patients supported by professional interpreters, their recollection of facts about anaesthesia was significantly enhanced and elevated to the same level of the control group (fluent in German). Moreover, for these patients, providing information by means of phone-based telemedicine before anaesthesia yielded high levels of understanding and recollection of anaesthesia facts.

Conclusion
Phone-based telemedicine is a safe and reliable method of communication in the professional interpreter group and German speaking control group, but not in the lay interpreter group. Compared to lay interpreters, professional interpreters significantly improve patients’ uptake of critical information about general anaesthesia, thus highlighting the importance of professional interpreters for patient safety and informed consent.
Pooled prevalence and subgroup variations of Tetralogy of Fallot among children and adolescents with congenital heart defect in Sub-Saharan Africa: A systematic review and meta-analysis
Authors: Geleta Biniam Endale , Mulu Abay 
Published: January 2025

Background
Tetralogy of Fallot is one of the critical congenital heart defects needing intervention within the first year of life.

Objective
This review aims to systematically assess the prevalence of Tetralogy of Fallot among children and adolescents with congenital heart defects in Sub-Saharan Africa from January 2000 to January 2024.

Methods
All original observational studies focused on children and adolescent population diagnosed with congenital heart defects within Sub-Saharan Africa; reported the primary outcome of interest were included. Prisma guidelines were utilized to perform this systematic review and meta-analysis. Electronic databases including Medline (PubMed), Scopus, Google Scholar, and African Index Medicus were searched. A weighted inverse variance random-effects model was employed to estimate the pooled prevalence of Tetralogy of Fallot.

Results
Thirty-one studies included encompassing a total of 11,265 participants from 15 Sub-Saharan African countries with representation from Southern (4 studies, 619 participants), Central (5 studies, 2,220 participants), Eastern (11 studies, 3,384 participants), and Western (11 studies, 5,042 participants). Cross-sectional studies comprised (25 studies, 8,909 participants), and cohort design (6 studies, 2,356 participants). The analysis revealed a pooled prevalence of 10% (95% CI: 9%; 12%) with I2 (77%, p-value < 0.01). The subgroup analysis based on geographic regions revealed statistically significant difference.

Conclusions and future implications
The prevalence of Tetralogy of Fallot observed was found considerably higher compared to global estimate and reports of developed countries. In a subgroup analysis based on the geographic region, a surprisingly high prevalence was reported across all regions of Sub-Saharan Africa. The substantial disparities and high prevalence observed underscores the complex interplay of factors influencing occurrence of Tetralogy of Fallot. Identifying the true scope of Tetralogy of Fallot burden may help policymakers and healthcare providers to prioritize interventions, optimize resource allocation, and potentially improve its outcomes in Sub-Saharan Africa.
Investigation of the trends and associated factors of ovarian cancer in Indonesia: A systematic analysis of the Global Burden of Disease study 1990–2021
Authors: Tjokroprawiro Brahmana Askandar , Novitasari Khoirunnisa , Ulhaq Renata Alya , Sulistya Hanif Ardiansyah , Martini Santi 
Published: January 2025

Introduction
Ovarian cancer is one of the most lethal gynecological cancers. Despite diagnosis and treatment advances, survival rates have not increased over the past 32 years. This study estimated and reported the global burden of ovarian cancer during the past 32 years to inform preventative and control strategies.

Methods
We examined ovarian cancer incidence, mortality, and disability-adjusted life years (DALYs) using age-standardized rates from the Global Burden of Disease, Injuries, and Risk Factors Study 2021. high body mass index and occupational asbestos exposure were linked with death and DALYs. Data are presented as averages with 95% uncertainty intervals (UIs).

Results
Indonesia had 13 250 (8 574–21 565) ovarian cancer cases in 2021, with 5 296 (3 520–8958) deaths and 186 917 (121 866–309 820) DALYs. The burden increased by 233.53% for new cases, 221.95% for mortalities, and 206.65% for DALYs. The age-standardized rate also increased from 1990 to 2021. Ovarian cancer burden increased with age but declined in the 50+ year age group. According to the sociodemographic index, the gross domestic product per capita and number of obstetricians and oncologic gynecologists in provinces showed different trends.

Conclusions
Indonesian ovarian cancer rates are rising despite gynecologic oncologists in 24 of 34 provinces. These findings will help policymakers and healthcare providers identify ovarian cancer prevention and control gaps.