bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimizing survivorship care
Authors:   , de Beijer Ismay Anna Elisa 
Published: January 2025

Each year, 400,000 children and adolescents up to the age of 19 are diagnosed with cancer worldwide. In high-income countries, more than 80% of these patients survive, thanks to advancements in treatment. However, many survivors face long-term health problems. These problems can include, for example, heart disease, fertility problems, and the development of secondary cancers. Within 30 years of their initial diagnosis, 75% of survivors will experience at least one chronic condition, with 25% of these being severe or life-threatening. This underscores the critical importance of high-quality follow-up care for childhood cancer survivors. Unfortunately, such care is often inadequate globally, hindered by gaps in knowledge, awareness, and a lack of standardized long-term care protocols.

This thesis offers four solutions to optimize survivorship care:
1.	More knowledge: Our research shows that survivors have three times more health problems than their siblings without cancer. Hormone problems are especially common. This indicates that long-term, specialised care is needed.

2.	New guidelines: We have developed European guidelines to better monitor survivors for health problems after their treatment up to 5 years after cancer diagnosis.

3.	SurPass: This digital care plan provides personalized care and is designed to improve long-term survivorship care in Europe. The research in this thesis showed how implementation could be improved, for example through access to medical records and more time for preparation.

4.	Healthy behaviors: Finally, a systematic review in preparation for a health promotion guideline shows that many survivors struggle with adopting and maintaining healthy behaviours, such as sufficient physical activity and a healthy diet. Barriers such as fatigue and time constraints require targeted support and guidance.
The findings of this thesis are helping to optimize the long-term care of survivors. This thesis provides more knowledge, better guidelines and digital tools. All this contributes to a better quality of life for survivors, in the Netherlands and abroad.
Manajemen Puskesmas Terhadap Mutu Pelayanan Puskesmas di Kota Padang
Authors: Asyari Dian Paramitha , Azkha Nizwardi 
Published: January 2025

Mutu pelayanan merupakan faktor penting yang dapat membentuk kepercayaan pasien kepada Puskesmas sehingga tercipta loyalitas mereka sebagai konsumen jasa pelayanan kesehatan. Tercatat sepanjang tahun 2023 mutu pelayanan Puskesmas di Kota Padang masih bermasalah terutama pada bagian sarana prasarana dan kualitas layanan yang diberikan. Tentunya hal ini dapat teratasi jika pelaksanaan manajemen di Puskesmas juga baik dan terstandar. Penelitian ini bertujuan untuk melihat hubungan antara manajemen puskesmas terhadap mutu pelayanan di 23 puskesmas dengan jumlah sampel 46 orang di Kota Padang. Metode yang digunakan adalah pendekatan Kuantitatif dengan teknik penentuan sampel secara total sampling di 23 Puskesmas Kota Padang. Analisis data menggunakan analisis Bivariate dan uji Korelasi Pearson. Hasil penelitian menunjukkan adanya hubungan positif yang signifikan antara manajemen Puskesmas dan mutu pelayanan, dengan nilai korelasi Pearson sebesar 0,68 (p < 0,01).
Technology usage and glycaemic outcomes in a single tertiary centre with an ethnically diverse and socioeconomically deprived cohort of children with type 1 diabetes mellitus
Authors: Dickinson India , Gupta Ankita , Lau Gar Mun , Iyer Pranav Viswanath , Pemberton John Stuart , Uday Suma 
Published: January 2025

BackgroundThe UK National Paediatric Diabetes Audit (NPDA) data reports disparities in Haemoglobin A1c (HbA1c) levels among children and young people (CYP) with Type 1 Diabetes (T1D), with higher levels in those of Black ethnic background and lower socioeconomic status who have less access to technology. We investigate HbA1c differences in a T1D cohort with higher than national average technology uptake where &gt; 60% come from an ethnic minority and/or socioeconomically deprived population.Design &amp; methodsRetrospective cross-sectional study investigating the influence of demographic factors, technology use, and socioeconomic status (SES) on glycaemic outcomes. The study population was 222 CYP with T1D who attended the diabetes clinic in 2022 at a single tertiary paediatric diabetes centre.ResultsAmong 222 CYP, 60% were of ethnic minority (Asian, Black, Mixed and Other were 32%, 12%, 6% and 10% respectively) and 40% of white heritage. 94% used Continuous Glucose Monitoring (CGM) and 60% used Continuous Subcutaneous Insulin Infusion (CSII) via open or closed loop. 6% used Self-Monitoring of Blood Glucose (SMBG) and Multiple Daily Injections (MDI), 34% used CGM and MDI, 38% used CGM and CSII and 22% used Hybrid Closed-Loop (HCL) systems. Significant differences in HbA1c across therapy groups (p &lt; 0.001) was noted with lowest HbA1c in HCL group (55 mmol/mol; p &lt;0.001). Despite adjusting for therapy type, the Black group had higher HbA1c than their white and Asian counterparts (p&lt;0.001). CYP from the most deprived tertile had significantly higher HbA1c levels (p &lt; 0.001) but the difference was not sustained after adjusting for therapy type.ConclusionAdvanced diabetes technologies improve glycaemic control. Whilst equalising technology access mitigates socioeconomic disparities in HbA1c, CYP from Black ethnic background continue to display a higher HbA1c. The study underscores the necessity of fair technology distribution and further research into elevated HbA1c levels among Black CYP using advanced diabetes technology.
The type of exercise most beneficial for quality of life in people with atrial fibrillation: a network meta-analysis
Authors: Yang Zhen , Qi Xiaoting , Li Gaopeng , Wu Na , Qi Bingwen , Yuan Mengyang , Wang Yaxin , Hu Guangling , Yang Qiaofang 
Published: January 2025

IntroductionAtrial fibrillation (AF) significantly detracts from health-related quality of life (HRQoL). Despite the promotion of exercise interventions for managing AF, the effectiveness of different exercise modalities remains to be clearly defined. This systematic review and network meta-analysis aims to evaluate the comparative effectiveness of various modes of exercise interventions on HRQoL in AF patients.MethodsA random-effect network meta-analysis was performed. We conducted comprehensive searches across multiple databases, including PubMed, Web of Science, Embase, Cochrane Library, Scopus, and Chinese databases such as CNKI, WanFang Data, and VIP. The review included only randomized controlled trials (RCTs) that investigated the effects of exercise interventions on HRQoL among individuals diagnosed with AF.ResultsThe network meta-analysis (NMA) incorporated 12 studies, of which five presented some concerns regarding risk of bias and one exhibited a high risk of bias. For total HRQoL in AF patients, aerobic exercise, and cardiac rehabilitation (CR) yielded standardised mean differences of 0.60 (95% CI: 0.02–1.13) and 0.59 (95% CI: 0.20–0.99), respectively. For the physical component of HRQoL, CR was most efficacious, demonstrating the highest Surface Under the Cumulative RAnking curve (SUCRA) value of 77%. For the mental component of HRQoL, high-intensity interval training (HIIT) was superior, with the highest SUCRA value of 90.7%.ConclusionsBoth aerobic exercise and CR effectively improve the physical and mental dimensions of HRQoL as well as overall HRQoL in patients with AF. However, for the mental component of HRQoL, HIIT was identified as the most effective intervention.
Association between triglyceride-glucose index and endometriosis: results from a cross-sectional study and Mendelian randomization study
Authors: Xu Ting , Zhuang Yuan , Cao Huabin , Yang Jingqi 
Published: January 2025

BackgroundTriglyceride-glucose (TyG) index has been found to be associated with female reproductive disorders, but its relationship with the risk of endometriosis is unknown. Therefore, the aim of this study was to investigate this relationship.MethodsWe performed a two-sample mendelian randomization(MR) analysis to examine the causal effect of TyG index on endometriosis, and inverse variance weighting(IVW) was the main method of analysis. Then, we selected 1484 participants with endometriosis from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2006. Weighted multivariable-adjusted logistic regression and smoothed curve analysis were used to evaluate the correlation between the TyG index and endometriosis.ResultsThe results of MR analysis confirmed that higher TyG index was causally associated with the risk of endometriosis (OR=1.27, 95%CI: 1.05-1.54, P=0.01). In the cross-sectional study, subjects in the highest quartile of TyG index had the highest risk of incident endometriosis after adjusting for covariates(OR = 2.41, 95% CI:1.31-4.44, P for trend &lt;0.01). The smoothed curve analysis also revealed a positive linear correlation between TyG index and endometriosis.ConclusionOur study confirms that a higher TyG index is associated with an increased risk of endometriosis by MR analysis and cross-sectional study. These findings suggested that TyG index could serve as a biomarker in identifying individuals who may be at a higher risk for developing endometriosis. Further research is needed to explore the potential clinical implications of these findings and to elucidate the underlying mechanisms behind this observed relationship.
Evaluation and improvement of power quality of distribution network: a case study of Covenant University, Ota
Authors: Samuel Isaac A. , Toyin Daudu Afah , Somefun Tobiloba E. , Awelewa Ayokunle A. , Abba-Aliyu Shehu 
Published: January 2025

Power quality is a global concern, particularly as electronic devices are increasingly supporting modern economies. This research evaluates and proposes improvements for power quality of the distribution network at Covenant University, Ota, Nigeria, where electrical equipment usage contributes to power quality challenges. Measurements and evaluations were carried out in three stages: first, measuring power quality at five campus powerhouses using a Circutor aR6 power analyzer; second, assessing these measurements with Power Vision software; third, simulating the evaluated network with NEPLAN software. The study was conducted during an active school session, with measurements taken at 500 kVA, 11 kV/415 V/230 V on the outgoing circuits for each transformer. The results were benchmarked against IEEE power quality standards and identified issues such as harmonics, total harmonic distortion (THD), overload, and a lagging power factor. The proposed improvements, derived from NEPLAN simulation, included active harmonic filters to reduce harmonics, a shunt capacitor for power factor correction, and load sharing for managing transformer overloads. Simulation results demonstrated that THD was significantly reduced across all powerhouses: CDS from 7.28% to 0.91%, EIE from 10.52% to 3.54%, CST from 16.03% to 0.58%, the Library from 11.92% to 0.12%, and the Male Hostel from 16.71% to 0.24%. These adjustments enhanced THD within specified limits. Additionally, the shunt capacitor increased the power factor to 0.96 from −0.96. These enhancements are expected to extend equipment life, reduce heat loss, and lower utility costs.
Adsorption and removal of pentavalent antimony from water by biochar prepared from modified rosa roxburghii residue
Authors: Dai Yong , Zhao Shengmao , Zheng Ruyi 
Published: January 2025

In order to investigate the adsorption properties of modified rosa roxburghii residue biochar to antimony (Sb) in water, the modified rosa roxburghii residue biochar (BC-FeOOH) was prepared from rosa roxburghii residue factory in Guizhou Processing plant. The adsorption characteristics of BC-FeOOH on Sb(V) in water were investigated by batch test experiments with different pH, biochar dosage and adsorption time. The results showed that the best adsorption effect of BC-FeOOH on antimony was achieved at the dosage of 0.05 g and pH 2.0, and the adsorption amount reached 5.7 mg/g. The results of adsorption kinetic modeling showed that the equilibrium time of the adsorption of BC-FeOOH on Sb(V) in water was in the range of 8–10 h, and the mechanism of adsorption was mainly chemical adsorption. Langmuir model can better describe the adsorption process of BC-FeOOH on Sb(V), and the surface adsorption process is monomolecular layer chemisorption. The experimental results showed that BC-FeOOH is a good adsorbent for Sb pollution remediation in water. This study provides n ew insights for the development of Sb contamination removal strategies in water and offers a new way for the resource utilization of prickly pear pomace.
First-line combination therapy of immunotherapy plus anti-angiogenic drug for thoracic SMARCA4-deficient undifferentiated tumors in AIDS: a case report and review of the literature
Authors: Wei Xiaoling , Xing Xiangju , Yao Wei , Wang Changzheng , Xiao Yajie , Du Xianzhi 
Published: January 2025

BackgroundThoracic SMARCA4-deficient undifferentiated tumors (SMARCA4-UT) exhibit a notably aggressive phenotype, which is associated with poor patient survival outcomes. These tumors are generally resistant to conventional cytotoxic chemotherapy, thereby limiting the availability of effective treatment options.Case presentationWe describe a 69-year-old AIDS patient who initially presented with a fused, enlarged lymph node on the right clavicle and mild, unexplained pain under the right axilla that worsened with severe coughing episodes. An initial chest CT scan revealed multiple nodular and mass shadows in the mediastinum and multiple nodules in both lungs, as well as a small amount of pericardial effusion. Additionally, serum biomarkers of lung cancer were abnormal as follows: carcinoembryonic antigen (CEA) at 13.74 ng/mL, cytokeratin 19 fragment (CYFRA21-1) at 6.82 ng/mL, neuron-specific enolase (NSE) at 25.49 ng/mL, and progastrin-releasing peptide precursor (ProGRP) at 89.35 pg/mL. Subsequent pathology confirmed SMARCA4-deficient undifferentiated tumors. Considering that the weak immune status and intermediate PD-L1 level, the patient was treated with a first-line combination therapy of immunotherapy and anti-angiogenic drug instead of chemo-immunotherapy. The patient responded well to immunotherapy combining anti-angiogenic drugs and achieved an overall survival for more than 22 months.ConclusionOur study presented a rare case of thoracic SMARCA4-deficient undifferentiated tumors and AIDS, suggesting that first-line immunotherapy plus anti-angiogenic drugs as a potential therapeutic option for SMARCA4-UT patients under specific conditions.
Macrophage heterogeneity and oncogenic mechanisms in lung adenocarcinoma: insights from scRNA-seq analysis and predictive modeling
Authors: Zhang Han , Dai Jiaxing , Mu Qiuqiao , Zhao Xiaojiang , Lin Ziao , Wang Kai , Wang Meng , Sun Daqiang 
Published: January 2025

BackgroundMacrophages play a dual role in the tumor microenvironment(TME), capable of secreting pro-inflammatory factors to combat tumors while also promoting tumor growth through angiogenesis and immune suppression. This study aims to explore the characteristics of macrophages in lung adenocarcinoma (LUAD) and establish a prognostic model based on macrophage-related genes.MethodWe performed scRNA-seq analysis to investigate macrophage heterogeneity and their potential pseudotime evolutionary processes. Specifically, we used scRNA-seq data processing, intercellular communication analysis, pseudotime trajectory analysis, and transcription factor regulatory analysis to reveal the complexity of macrophage subpopulations. Data from The Cancer Genome Atlas (TCGA) was used to assess the impact of various macrophage subtypes on LUAD prognosis. Univariate Cox regression was applied to select prognostic-related genes from macrophage markers. We constructed a prognostic model using Lasso regression and multivariate Cox regression, categorizing LUAD patients into high and low-risk groups based on the median risk score. The model’s performance was validated across multiple external datasets. We also examined differences between high and low-risk groups in terms of pathway enrichment, mutation information, tumor microenvironment(TME), and immunotherapy efficacy. Finally, RT-PCR confirmed the expression of model genes in LUAD, and cellular experiments explored the carcinogenic mechanism of COL5A1.ResultsWe found that signals such as SPP1 and MIF were more active in tumor tissues, indicating potential oncogenic roles of macrophages. Using macrophage marker genes, we developed a robust prognostic model for LUAD that effectively predicts prognosis and immunotherapy efficacy. A nomogram was constructed to predict LUAD prognosis based on the model’s risk score and other clinical features. Differences between high and low-risk groups in terms of TME, enrichment analysis, mutational landscape, and immunotherapy efficacy were systematically analyzed. RT-PCR and cellular experiments supported the oncogenic role of COL5A1.ConclusionOur study identified potential oncogenic mechanisms of macrophages and their impact on LUAD prognosis. We developed a prognostic model based on macrophage marker genes, demonstrating strong performance in predicting prognosis and immunotherapy efficacy. Finally, cellular experiments suggested COL5A1 as a potential therapeutic target for LUAD.
Immune response profiling of HERV-W envelope proteins in multiple sclerosis: potential biomarkers for disease progression
Authors: Ruberto Stefano , Domınguez-Mozo María I. , Garcıa-Martınez M. Angel , Cossu Davide , Sechi Leonardo A. , Alvarez-Lafuente Roberto 
Published: January 2025

IntroductionThe envelope proteins syncytin-1 and pHERV-W from the Human Endogenous Retroviral family ‘W’ (HERV-W) have been identified as potential risk factors in multiple sclerosis (MS). This study aims to evaluate both humoral and cell-mediated immune response to antigenic peptides derived from these proteins across different clinical forms and inflammatory phases of MS.MethodsIndirect enzyme-linked immunosorbent assay (ELISA) was employed to measure immunoglobulin G (IgG) responses to syncytin-1env 486-500 and pHERV-Wenv 486-504 peptides in MS patients. Discriminant analysis was used to assess whether clinical course prediction could be enhanced by integrating clinical variables with humoral response data against other MS-associated viral factors. Additionally, peripheral blood mononuclear cells from MS patients and healthy controls (HC) were analyzed for inflammatory responses following stimulation with these peptides.ResultsMS patients exhibited significantly elevated antibody titers against -pHERV-Wenv 486-504 and syncytin-1env 486-500 compared to HCs, with the highest levels observed in progressive MS forms. Discriminant analysis accurately predicted the clinical course in 75.3% of the cases, with an 85% accuracy rate for progressive MS. In vitro, stimulation with pHERV-Wenv 486-504 led to a notable increase in pro-inflammatory cytokine production by CD4, CD8, and CD19 cells compared to syncytin-1env 486-500. A strong correlation was found between pHERV- Wenv 486-504 induced cytokine production and EBV and CMV titers in MS patients.DiscussionThese findings suggest that the pHERV-W envelope protein could be a valuable biomarker for monitoring peripheral inflammation in MS.
Low skeletal muscle mass as a proxy marker of sarcopenia is a risk factor for major complications in older patients undergoing curative colon resections for colon cancer
Authors: Tırnova İsmail , Gasimova Maya , Akay Hatice , Sarıtürk Çağla , Güven Mert Aslıhan , Yenidünya Özlem , Karakayalı Feza Yarbuğ 
Published: January 2025

IntroductionVarious reports have confirmed that low skeletal muscle mass, a proxy marker of sarcopenia, can be a risk factor for surgical and oncological outcomes in colon cancer. We aimed to investigate the effects of skeletal muscle mass index (SMMI) on postoperative complications, overall survival (OS), and disease-free survival (DFS) in older patients with colon cancer who underwent elective curative colon resections.Materials and methodsPatients over 65 years old with stage I-III colon cancer who underwent elective curative colon resections between January 2015 and December 2023 were included in this single-center retrospective longitudinal study. Demographics, comorbidities, laboratory data, pathological features, malignant lymph node ratio (MLNR), OS, and DFS were recorded. Controlling Nutritional Status (CONUT) Score was used to assess the nutritional status. An axial portal-phase image was obtained at the level of the third lumbar vertebra, and muscle areas were calculated. SMMI was calculated by dividing the muscle area (cm2) by the square of the patient’s height (m2). Low SMMI was defined as SMMI&lt;41 cm2/m2 in women and &lt; 43 cm2/m2 in men with body mass index (BMI) &lt;25 kg/m2, and as SMMI &lt;53 cm2/m2 in patients with a BMI &gt;25 kg/m2. Postoperative complications were classified according to the Clavien-Dindo system. Univariate and multivariate analyses were performed to investigate the factors related to the postoperative complications, OS and DFS.ResultsIn total, 98 cases (mean age 75.2 ± 6.9, 55.1% male) were included in the study. The median follow-up time was 38.3 (0.5–113) months. There were 64 patients (65.3%) in the Low SMMI group and 34 patients (34.7%) in the Normal SMMI group. Logistic regression analysis demonstrated that low SMMI was associated with a higher risk of major complications, with an odds ratio of 5.3 (95% CI, 1.1–20.1; p = 0.037). Cox regression analysis revealed no significant differences in OS and DFS.ConclusionLow SMMI as a proxy marker of sarcopenia was found to be an independent risk factor for postoperative major complications. Additional prospective studies are warranted to obtain more reliable results.
Prognostic value of HSP27 in 28-day mortality in septic ICU patients: a retrospective cohort study
Authors: Yao Lihua , Fan Zaiwei , Yao Fangyi , Wang Xiaozhong 
Published: January 2025

BackgroundThis study aimed to investigate the association between serum heat shock protein 27 (HSP27) levels and 28-day mortality in patients with sepsis.MethodsThis retrospective study analyzed the clinical data of 76 septic patients admitted to the intensive care unit (ICU). Fifty non-septic ICU patients and 50 healthy individuals served as control groups. Serum HSP27 levels were measured on the day of ICU admission and compared to sepsis severity and survival outcomes.ResultsMedian serum HSP27 levels in septic patients (4.70 ng/mL, IQR: 2.10–13.48 ng/mL) were significantly higher than those in both non-septic ICU controls and healthy controls (all p &lt; 0.05). Moreover, non-survivors exhibited significantly higher median HSP27 levels (9.30 ng/mL, IQR: 3.62–25.91 ng/mL) compared to survivors (3.03 ng/mL, IQR: 1.48–7.39 ng/mL, p &lt; 0.05). Multivariate logistic regression analysis confirmed the association between HSP27 levels and 28-day mortality in sepsis patients. Receiver operating characteristic (ROC) curve analysis revealed an area under the curve (AUC) of 0.720 (95% CI: 0.605–0.817, p &lt; 0.001) for HSP27 in predicting sepsis prognosis. Survival analysis demonstrated that patients with high serum HSP27 levels (≥2.61 ng/mL) had a worse prognosis than those with low levels (&lt;2.61 ng/mL).ConclusionHSP27 shows potential as a biomarker for the diagnosis and prognosis of sepsis, however, further research is necessary to solidify its clinical utility.