bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of humoral responses to the first coronavirus disease booster vaccine and breakthrough infection in central China: a multicentre, prospective, longitudinal cohort study
Authors: Xu Junhong , Yuan Youhua , Chen Guohua , Ma Bing , Zou Yin Long , Wang Baoya , Yan Wenjuan , Zhang Qi , Ma Qiong , Mao Xiaohuan , Wang Huiling , Li Yi , Zhang Xiaohuan 
Published: January 2025

IntroductionThe long-term immunogenicity, adverse effects, influencing factors, and protection from booster vaccines remain unclear. Specifically, little is known regarding the humoral immunity and breakthrough infections associated with COVID-19 booster immunization. Therefore, we evaluated the immunogenicity, reactogenicity, influencing factors, and protective effects of the first coronavirus disease booster vaccine 23 months before and after implementation of dynamic zero epidemic control measures among healthcare staff.MethodsWe prospectively included 389 healthcare staff members in China with negative pre-enrolment severe acute respiratory syndrome coronavirus 2 test results. Neutralising serum antibodies were evaluated every two months till 23 months post-booster vaccination. Breakthrough infection was recorded or confirmed by SARS-CoV-2 specific PCR testing via throat swabs from participants before and after dynamic zero epidemic control measures.ResultsAt 15–30 days after vaccination, the mean concentration of the booster vaccine was 6.4 times above initial concentrations. Poorer antibody responses by booster vaccine correlated with male sex, longer post-booster duration, same-manufacturer vaccines, post-routine epidemic control measures implementation and intervals &gt;210 days between primary and booster vaccinations. Higher breakthrough rates were associated with longer post-booster durations and post-routine epidemic control measures implementation but not associated with levels of neutralising antibodies after booster vaccination from participants. Adverse reactions were non-serious. These booster vaccine doses induced rapid, robust antibody responses, maintained for only 6–7 months.DiscussionNeutralizing antibodies induced by breakthrough infection with SARS-CoV-2 were weaker than those induced by the first COVID-19 booster vaccine, predicting that antibodies induced by SARS-CoV-2 may be very different from those of other known infectious pathogens.
A positive relationship between weight-adjusted waist index and non-alcoholic fatty liver disease: a study on US adolescents
Authors: Cui Xiaoling , Huang Yize , Kang Luyang , Han Lianxiu , Sun Weijie , Han Kexing , Gao Yufeng 
Published: January 2025

BackgroundNon-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver condition in children, underscoring the urgent need for non-invasive markers for early detection in this population.MethodsWe utilized survey data from the National Health and Nutrition Examination Survey (NHANES) 2017–2020 regarding liver ultrasound transient elastography (LUTE) for the diagnosis of NAFLD (dependent variable), and used multiple logistic regression models to explore the association between weight-adjusted waist circumference index (WWI) and the prevalence of NAFLD in US adolescents. Smoothing curves and threshold effect analyses were used to assess the non-linear association between the independent variables and the dependent variable. Subgroup analysis was conducted to pinpoint particularly susceptible subgroups within our study cohort of 1,711 participants.ResultsOur findings indicated a positive correlation between WWI and NAFLD scores. Adjusting for all covariates revealed a significant association between increased WWI and the presence of NAFLD, with an odds ratio of 3.37 (95% CI: 2.74, 4.15). This association proved stronger than those observed with waist circumference, body mass index, and NAFLD. Stratifying WWI into quartiles showed a clear and strong positive correlation (P for trend &lt; 0.0001). The results of smoothing curves and threshold effect analysis showed a non-linear relationship between WWI and NAFLD (LLR &lt; 0.001). Notably, for WWI values below 10.65, a significant correlation was observed (OR = 5.25, 95% CI: 3.77,7.31). Additionally, our subgroup analysis revealed that WWI and NAFLD were associated more positively among male participants aged 16 years and older.ConclusionWWI is positively correlated with NAFLD in American adolescents and offers a straightforward and cost-effective method for identifying hepatic steatosis. The findings highlight the importance of focusing on individuals with a WWI below 10.65, where the risk of NAFLD increases. Priority should be given to the male adolescent population aged 16 and above.
Circulating visfatin concentrations in patients with chronic obstructive pulmonary disease: systematic review and meta-analysis
Authors: Aboutaleb Nahid , Moradi Alireza , Mirshekari Jahangiri Hamzeh , Aslani Mohammad Reza 
Published: January 2025

ObjectiveThe current study was designed with the aim of conducting a systematic review and meta-analysis to determine the circulating levels of visfatin in patients with chronic obstructive pulmonary disease (COPD) compared to healthy individuals.MethodsUntil March 2024, we searched the Web of Science, PubMed/Medline, and Scopus databases. The analysis included case–control studies assessing the association between circulating visfatin and COPD. The random effects model was utilized to analyse the results with the help of Standard Mean of Differences (SMD) and 95% confidence interval (CI). The heterogeneity of the data was assessed using Cochrane Q and I2 values.ResultsSeven studies were eligible to be included in the meta-analysis, with the COPD and healthy (control) groups having 265 and 244 subjects, respectively. The pooled results showed that although the circulating concentration of visfatin was lower in patients with COPD, no significant difference was observed (SMD: −0.48 mg/L; 95% CI: −1.67 to 0.70; p = 0.43). Subgroup analysis revealed that visfatin levels were significantly reduced in FEV1 less than 50% (p &lt; 0.001) and in GOLD grade I-II (p &lt; 0.05). Visfatin was shown to be significantly associated with IL-6 (p &lt; 0.001) and TNF-α (p &lt; 0.01) in the correlation meta-analysis. Meta-regression analysis revealed a significant correlation between the pooled SMD visfatin and pooled SMD age (p &lt; 0.01), BMI (p &lt; 0.001), FEV1 (p &lt; 0.001), and IL-6 (p &lt; 0.001).ConclusionThe findings showed an insignificant decline in visfatin level among COPD patients, but additional research is necessary due to the heterogeneity in study results.Systematic review registrationPROSPERO (CRD42023450851), https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023450851.
Association between nurse turnover and missed nursing care in acute care hospitals in South Korea
Authors: Bae Sung-Heui 
Published: January 2025

ObjectivesHigh nurse turnover during nursing shortages can contribute to missed nursing care. This study investigated the prevalence of missed nursing care and how nurse turnover affects missed nursing care.MethodsA cross-sectional design was adopted to collect data from a convenience sample of nurses working in general hospitals in South Korea. Six-month turnover rates (0%, 1–14%, 15–22%, and 23–50%) and 24 missed nursing care activities were measured. A multivariate regression analysis was performed to examine the relationship between nurse turnover and missed nursing care, after controlling for nurse and work-related characteristics.ResultsThe final sample was 264 nurses. The mean six-month turnover rate was 15.49%. Seven activities (turning patient every 2 h, attending interdisciplinary care conference, ambulation, patient bathing/skin care, emotional support, mouth care, full documentation) had a missed care prevalence of 30% or higher. Nurses in units with moderate turnover rates (15 and 22%) reported more missed nursing care than those in units with zero turnover.ConclusionNurse turnover increases missed nursing care, highlighting the adverse effects of nurse turnover on care processes. Consequently, hospitals and governments should implement policy changes and strategies to prevent nurse turnover.
Removal of an incarcerated intrauterine device reaching the serosal surface of the uterus by hysteroscopy alone: a case report
Authors: You Min , Chen Qin-Fang , Lu Hai-Qian 
Published: January 2025

BackgroundAn intrauterine device (IUD) is a widely used long-term contraceptive device for family planning. However, the IUD can lead to various complications. Severe complications and remedial measures caused by IUDs have been reported in the literature; however, detailed surgical approaches for safely removing the IUD within the minimum surgical range have rarely been described especially in postmenopausal women. Therefore, this article aims to share our surgical experience in removing an IUD that had reached the serosal surface of the uterus using hysteroscopy alone after menopause to provide new clinical ideas.Case introductionWe report the case of a 63-year-old Chinese patient with a 12-year history of menopause. She had an IUD placed after an abortion more than 30 years ago. She came to the hospital because of occasional a small amount of unprovoked vaginal bleeding, the preoperative examination suggested an embedded IUD that appeared to have reached the serosal surface of the uterus. The IUD was not visible during hysteroscopic surgery because of uterine adhesions. Microscissors were employed to cut along the white adhesion band, revealing a faintly visible metal wire. We successfully removed the IUD using hysteroscopy only. The patient has recovered well after surgery and has been in good health for more than 5 months, with no complaints of abdominal pain or vaginal bleeding.ConclusionThis case suggests that hysteroscopic exploration can be performed in patients whose preoperative examination indicates that the IUD has reached or protrudes from the serosal surface of the uterus. If necessary, laparoscopic or open surgery can be performed. For patients whose IUD is not visible in the uterine cavity, preoperative imaging can help assess the thickness of the uterine myometrium and the distance to the serosal surface. Intraoperatively, scissors can cut through tissue or adhesions, and instruments can measure the separation distance or visualize the device within the adhesions. In addition, it is crucial to know the patient’s expectations, assess the pros and cons, and discontinue the procedure if necessary.
Systemic inflammation response index association with gout in hyperuricemic adults: NHANES 2007–2018
Authors: Tian Xiaochan , Zeng Guixing , Wei Junping 
Published: January 2025

BackgroundHyperuricemia is the underlying condition of gout. Previous studies have indicated that specific strategies may be effective in preventing the progression of hyperuricemia to gout. However, there is a lack of widely applicable methods for identifying high-risk populations for gout. Gout is linked to inflammation, especially in the hyperuricemic population. Systemic inflammation response index (SIRI) is a novel method for evaluating an individual’s systemic inflammatory activity. However, the association between SIRI and gout in the hyperuricemic population has not been studied.MethodsThe study utilized data from the National Health and Nutrition Examination Survey (NHANES) 2007-2018.SIRI was log2-transformed before analysis. Multivariable logistic regression, subgroup analysis, and smooth curve fitting were employed to comprehensively evaluate the correlation between SIRI and gout prevalence in the hyperuricemic population. Additionally, we compared SIRI with other inflammatory markers.ResultA total of 6,732 hyperuricemic patients were included, of which 3,764 were men. After adjusting for all covariates, SIRI was found to be significantly positively correlated with gout prevalence in the female group ([OR = 1.385, 95% CI (1.187, 1.615), p &lt; 0.001]), and its diagnostic performance was superior to other inflammatory markers. In the male group, the correlation between log2-SIRI and gout prevalence was not significant ([OR = 0.994, 95% CI (0.892, 1.108), p = 0.916]). But there were significant positive correlations in the 20–45 age group ([OR = 1.362, 95% CI (1.021, 1.818), p = 0.036]). Subgroup analyses revealed that the results were largely consistent when the individuals were divided into different subgroups (FDR adjusted p for interaction &gt;0.05 for all).ConclusionOur study suggests that the Systemic Inflammation Response Index (SIRI) has potential as a predictive marker for gout risk in hyperuricemic women. However, given the higher gout prevalence in men, the potential of SIRI as a predictive marker for gout risk in this population may be limited. Subgroup analyses, however, indicated that the relationship between SIRI and gout prevalence, as well as its statistical significance, varied across different age groups. Future research could further explore this association by investigating the relationship between SIRI and gout prevalence in different age cohorts.
Case report: Transmuscular migration of a solid encircling silicone band through all four rectus muscles
Authors: Gu Ruiping , Wu Kaicheng , Jiang Chunhui 
Published: January 2025

PurposeWe present a case of transmuscular migration of a solid encircling silicone band through all four rectus muscles.ObservationsA 33-year-old male with high myopia presented with a progressively worsening subclinical peripheral rhegmatogenous retinal detachment in his left eye. An encircling silicone band (#240) was placed anterior to the equator, and 5-0 polyester sutures (Ethicon, Inc.) were used to secure the band at all four quadrants. Six months later, the encircling band and suture knots were visible under the bulb conjunctiva, close to the limbus in all four quadrants. One and a half years after the retinal detachment surgery, the encircling band was removed because of a mild foreign body sensation. During that surgery, it was noted that the encircling band was located anterior to the insertion of all four rectus muscles. Throughout the entire follow-up period, the position and movement of the left eye remained normal.Conclusion and importanceA deep and long bite of the sclera should be used to secure the silicone band, especially in cases of high myopia and when the band is placed anterior to the equator. Even if the encircling silicone band cheese wire through the four rectus muscles, ocular motility may still remain normal.
Dissemination of clinical Escherichia coli harboring the mcr-1 gene in Pakistan
Authors: Abdullah Sabahat , Mushtaq Muhammad Ahmad , Ullah Kalim , Hassan Brekhna , Azam Mariya , Zahoor Muhammad Asif , Wang Juan , Xu Jianzhen , Toleman Mark A. , Mohsin Mashkoor 
Published: January 2025

BackgroundColistin is an antibiotic used as a last resort to treat multidrug-resistant Gram-negative bacterial infections. Plasmid-mediated mobile colistin-resistant (mcr) genes in Escherichia coli (E. coli) are disseminated globally and are considered to be a major public health threat. This study aimed to determine the molecular characteristics of colistin-resistant Escherichia coli isolates in clinical settings in Pakistan.MethodsA total of 240 clinical E. coli strains isolated from urine and pus cultures were collected from two hospitals in Faisalabad and analyzed for phenotypic resistance to colistin by cultivation on CHROMagar plates supplemented with colistin 2 ug/ml. Molecular characteristics of colistin-resistant isolates were analyzed using conventional PCR, whole genome sequencing, and bioinformatics analysis.ResultsPCR and whole genome analysis confirmed the presence of the mcr-1 gene in 10 E. coli isolates. The minimum inhibitory concentration for colistin ranged from 4 ug/ml to 32 ug/ml. ResFinder analysis revealed the presence of multiple resistance determinants conferring co-resistance to β-lactams, aminoglycosides, trimethoprim, sulfonamides, tetracycline, quinolones, florfenicol, and macrolides. Hybrid genomic assembly indicated that mcr-1 is carried on IncI2 plasmids. Plasmid replicon typing indicated that IncI2-type plasmids (n = 10) were the most prevalent plasmids in these strains, followed by IncFIB (n = 8), IncFIC (n = 7), IncFIA (n = 6), IncFII (4), IncQ1 (n = 3), IncI1 (n = 1), IncY (n = 1), and IncN (n = 1). The Achtman MLST typing scheme revealed a large diversity of STs among the mcr-1-positive E. coli. VirulenceFinder analysis revealed the presence of numerous virulence factors ranging from 4 to 19.ConclusionOur study revealed the emergence and dissemination of colistin-resistant E. coli isolates carrying mcr-1 in hospital settings, posing a potential risk to anti-infective therapy. More efforts should be taken to monitor the prevalence of mcr-1-carrying bacteria in Pakistan.
Comparative analysis of anticoagulant influence on PMI estimation based on porcine blood metabolomics profile measured using GC-MS
Authors: Mojsak Patrycja , Samczuk Paulina , Klimaszewska Paulina , Burdukiewicz Michal , Chilimoniuk Jaroslaw , Grzesiak Krystyna , Pietrowska Karolina , Ciborowska Justyna , Niemcunowicz-Janica Anna , Kretowski Adam , Ciborowski Michal , Szeremeta Michal 
Published: January 2025

IntroductionAccurate post-mortem interval (PMI) estimation is essential in forensic investigations. Although various methods for PMI determination have been developed, only an approximate estimation is still achievable, and an accurate PMI indication is still challenging. Therefore, in this study, we employed gas chromatography-mass spectrometry (GC-MS)-based metabolomics to assess post-mortem changes in porcine blood samples collected with and without the addition of anticoagulant (EDTA). Our study aimed to identify metabolites dependent on the EDTA addition and time (taking into account the biodiversity of the studied organism) and those that are time−dependent but resistant to the addition of an anticoagulant.MethodsThe experiment was performed on blood samples collected from 16 animals (domestic pig, breed: Polish Large White), 8 with and 8 without EDTA addition. The moment of death (time 0) and 15 additional time points (from 3 to 168 h after death) were selected to examine changes in metabolites’ levels in specific time intervals. We employed linear mixed models to study the relationship between metabolite intensities, time and presence of EDTA while accounting for the effect of individual pigs.Results and DiscussionWe confirmed that the intensity of 16 metabolites (mainly amino acids) significantly depends on PMI and the presence of EDTA. However, the intensity of the ideal biomarker(s) for PMI estimation should be determined only by the time after death and not by external factors such as the presence of the anticoagulant agent. Thus, we identified 41 metabolites with time−dependent intensities that were not susceptible to EDTA presence. Finally, we assessed the performance of these metabolites in a PMI predictive model. Citraconic acid yielded one of the lowest errors in general PMI estimation (32.82 h). Moreover, similar errors were observed for samples with and without EDTA (33.32 h and 32.34 h, respectively). Although the small sample size and information leak in predictive modelling prevent drawing definite conclusions, citraconic acid shows potential as a robust PMI estimator.
Inclusion of hypocretin-1 improved performance of poor sleep quality prediction for elderly patients with acute ischemic stroke: a prospective cohort study
Authors: Fu Ting , Zhang Weiwei , Guo Rongrong , He Shuang , Yu Saiying , Wang Huiying , Zhang Yunfeng , Wu Ying 
Published: January 2025

BackgroundHypocretin-1 is a vital neurotransmitter in regulating the sleep–wake cycle and provides neuroprotection against cerebral ischemia. We aims to develop a poor sleep quality predictive model for elderly population with acute ischemic stroke.MethodsA total of 183 consecutively elderly patients were included in the prospective cohort study. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Cerebrospinal fluid samples were taken within 24 h of acute ischemic stroke onset. After selecting optimal predictors via univariate analysis and bootstrapped stepwise logistic regression, the predictive model was developed. The models were internally validated and evaluated comprehensively via discrimination, calibration, and clinical utility.ResultsThe prevalence of poor sleep (PSQI &gt;7) was 64.5% among elderly individuals experiencing acute ischemic stroke. The study developed a predictive model using hypocretin-1, hypertension, stroke history, the National Institutes of Health Stroke score, and depression. Adding hypocretin-1 (as continuous variable) significantly improved the model performance greatly, as the area under the receiver operating characteristic curve increased from 0.799 to 0.845 (p &lt; 0.001). The optimal cutoff value for hypocretin-1 was 74.94 pg/mL. Adding hypocretin-1 (as binary variable) significantly improved the model performance greatly, as the AUC increased from 0.799 to 0.857 (p &lt; 0.001).ConclusionReduced cerebrospinal fluid levels of hypocretin-1 at admission were an independent poor sleep quality predictor and the model demonstrated superior performance. The combination of hypocretin-1 could offer valuable prognostic information for post-stroke sleep quality in elderly patients with acute ischemic stroke.
Transcranial direct current stimulation for patients with walking difficulties caused by cerebral small vessel disease: a randomized controlled study
Authors: Xu Qiaoqiao , Yin Wenwen , Zhou Xia , Wang Shuo , Chen Sishi , Yang Jiajia , Xi Chunhua , Sun Zhongwu 
Published: January 2025

IntroductionCerebral small vessel disease (CSVD) is a chronic systemic degenerative disease affecting small blood vessels in the brain, leading to cognitive impairments. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique that applies low electrical currents to the scalp, shows promise in treating cognitive and movement disorders. However, further clinical evaluation is required to assess the long-term effects of tDCS on neuroplasticity and gait in patients with CSVD. We investigated the effects of long-term, repeated tDCS on local brain perfusion, network connectivity, cognition, and gait in patients with CSVD and gait disorders (CSVD-GD).MethodsThis prospective, single-blind, multicenter, randomized controlled study enrolled 66 patients with CSVD-GD, categorized into the tDCS and Sham groups. Imaging and gait characteristic data were collected over three periods using magnetic resonance imaging and a gait analyzer, along with neuropsychological assessments.ResultsAmong 156 volunteers with CSVD-GD, 66 participated in this study, with 60 completing the entire process. Compared to the Sham group, the tDCS group exhibited a more pronounced increase in the cerebral blood flow to the dural cerebrospinal fluid ratio in regions such as the orbitofrontal cortex and cingulate gyrus (P &lt; 0.05, FDR corrected), along with significantly greater improvements in gait speed and stride length. Tolerance to tDCS was good, with no difference in adverse reactions between the groups, except for a scalp burning sensation reported during the 1st week (24.24% and 6.06% in the tDCS and Sham groups, respectively; P = 0.003).DiscussionLong-term tDCS is effective and safe for improving neuroplasticity and gait cognition in patients with CSVD.