bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the role of postoperative radiotherapy in locally invasive thymoma: A propensity-matched study based on the SEER database
Authors: Lin Li-mei , Li Yi-min , Huang Yun-xia , Zhang Zong-kai , Dai Ya-qing , Liu Jun , Lin Qin 
Published: April 2023

Objectives
No consensus was reached on the efficacy of postoperative radiotherapy (PORT) in locally invasive thymomas because of the rarity of the thymic epithelial and the variations of study results. Therefore, we aimed to explore the efficacy of PORT in locally invasive thymomas using the Surveillance, Epidemiology, and End Results (SEER) database.

Methods
Patients diagnosed with thymomas from 2004 to 2016 were identified using the SEER database. Prognostic factors of cancer-specific survival (CSS) and overall survival (OS) were identified using univariate and multivariate Cox regression analyses.Propensity score matching (PSM) was performed to balance the baseline characteristics.

Results
A total of 700 eligible patients were identified. After PSM, 262 paired patients were selected from the two groups, those who received or did not receive PORT. Receiving PORT improved CSS and OS before and after PSM. In the matched population, the multivariate analyses showed that tumour invasion into adjacent organs/structures and non-utilisation of PORT were independent poor prognostic factors for CSS, whereas age ≥62 years,tumour invasion into adjacent organs/structures, and non-utilisation of PORT were independently associated with poorer OS. The subgroup analysis revealed that PORT improved CSS and OS in Masaoka-Koga stage III thymoma, but showed no OS benefit in Masaoka-Koga stage IIB thymoma.

Conclusion
Based on the SEER database, we found that PORT provides a significant survival benefit in Masaoka-Koga stage III thymoma with complete or incomplete resection. The role of PORT in thymoma requires further evaluation.
Predictors of discharge disposition and mortality following hospitalization with SARS-CoV-2 infection
Authors: Ikramuddin Farha , Melnik Tanya , Ingraham Nicholas E. , Nguyen Nguyen , Siegel Lianne , Usher Michael G. , Tignanelli Christopher J. , Morse Leslie 
Published: April 2023

Importance
The SARS-CoV-2 pandemic has overwhelmed hospital capacity, prioritizing the need to understand factors associated with type of discharge disposition.

Objective
Characterization of disposition associated factors following SARS-CoV-2.

Design
Retrospective study of SARS-CoV-2 positive patients from March 7th, 2020, to May 4th, 2022, requiring hospitalization.

Setting
Midwest academic health-system.

Participants
Patients above the age 18 years admitted with PCR + SARS-CoV-2.

Intervention
None.

Main outcomes
Discharge to home versus PAC (inpatient rehabilitation facility (IRF), skilled-nursing facility (SNF), long-term acute care (LTACH)), or died/hospice while hospitalized (DH).

Results
We identified 62,279 SARS-CoV-2 PCR+ patients; 6,248 required hospitalizations, of whom 4611(73.8%) were discharged home, 985 (15.8%) to PAC and 652 (10.4%) died in hospital (DH).
Patients discharged to PAC had a higher median age (75.7 years, IQR: 65.6–85.1) compared to those discharged home (57.0 years, IQR: 38.2–69.9), and had longer mean length of stay (LOS) 14.7 days, SD: 14.0) compared to discharge home (5.8 days, SD: 5.9).
Older age (RRR:1.04, 95% CI:1.041–1.055), and higher Elixhauser comorbidity index [EI] (RRR:1.19, 95% CI:1.168–1.218) were associated with higher rate of discharge to PAC versus home. Older age (RRR:1.069, 95% CI:1.060–1.077) and higher EI (RRR:1.09, 95% CI:1.071–1.126) were associated with more frequent DH versus home. Blacks, Asians, and Hispanics were less likely to be discharged to PAC (RRR, 0.64 CI 0.47–0.88), (RRR 0.48 CI 0.34–0.67) and (RRR 0.586 CI 0.352–0.975). Having alpha variant was associated with less frequent PAC discharge versus home (RRR 0.589 CI 0.444–780).
The relative risks for DH were lower with a higher platelet count 0.998 (CI 0.99–0.99) and albumin levels 0.342 (CI 0.26–0.45), and higher with increased CRP (RRR 1.006 CI 1.004–1.007) and D-Dimer (RRR 1.070 CI 1.039–1.101). Increased albumin had lower risk to PAC discharge (RRR 0.630 CI 0.497–0.798. An increase in D-Dimer (RRR1.033 CI 1.002–1.064) and CRP (RRR1.002 CI1.001–1.004) was associated with higher risk of PAC discharge. A breakthrough (BT) infection was associated with lower likelihood of DH and PAC.

Conclusion
Older age, higher EI, CRP and D-Dimer are associated with PAC and DH discharges following hospitalization with COVID-19 infection. BT infection reduces the likelihood of being discharged to PAC and DH.
Income-related inequalities in diagnosed diabetes prevalence among US adults, 2001−2018
Authors: Chen Yu , Zhou Xilin , Bullard Kai McKeever , Zhang Ping , Imperatore Giuseppina , Rolka Deborah B. 
Published: April 2023

Aims
The overall prevalence of diabetes has increased over the past two decades in the United States, disproportionately affecting low-income populations. We aimed to examine the trends in income-related inequalities in diabetes prevalence and to identify the contributions of determining factors.

Methods
We estimated income-related inequalities in diagnosed diabetes during 2001−2018 among US adults aged 18 years or older using data from the National Health Interview Survey (NHIS). The concentration index was used to measure income-related inequalities in diabetes and was decomposed into contributing factors. We then examined temporal changes in diabetes inequality and contributors to those changes over time.

Results
Results showed that income-related inequalities in diabetes, unfavorable to low-income groups, persisted throughout the study period. The income-related inequalities in diabetes decreased during 2001−2011 and then increased during 2011−2018. Decomposition analysis revealed that income, obesity, physical activity levels, and race/ethnicity were important contributors to inequalities in diabetes at almost all time points. Moreover, changes regarding age and income were identified as the main factors explaining changes in diabetes inequalities over time.

Conclusions
Diabetes was more prevalent in low-income populations. Our study contributes to understanding income-related diabetes inequalities and could help facilitate program development to prevent type 2 diabetes and address modifiable factors to reduce diabetes inequalities.
Validated assessment tools for screen media use: A systematic review
Authors: Perez Oriana , Garza Tatyana , Hindera Olivia , Beltran Alicia , Musaad Salma M. , Dibbs Tracey , Singh Anu , Chug Shria , Sisson Amy , Kumar Vadathya Anil , Baranowski Tom , O’Connor Teresia M. 
Published: April 2023

Objective
Accurate measurement of adult and child screen media use are needed to robustly assess its impact on health outcomes. Our objective was to systematically review screen media use measurement tools that have been validated against an objective “gold standard” tool.

Methods
The search strategy was initially conducted in Medline Ovid and translated to Embase, Web of Science, PsychInfo and Cochrane. A modified natural language search was conducted in Google Scholar and IEEE. The initial search was conducted in March 2021, and an updated search was conducted in June 2022. Additional studies were included from the references. Studies had to describe the validation of a tool to measure screen media use on participants of any age against a ‘gold standard’ or comparable objective measure. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) was used to assess the criterion validity. Four authors reviewed the titles in two rounds and extracted data.

Results
Twenty-nine articles were included in the review. Studies measured TV, computer, mobile device and social media site screen media use through: self or parent report, direct or video observation, computer and mobile device use tracking programs, and through other novel devices such as wearable devices and cameras. Correlations of self or parent report of screen media with the gold standard were lower than correlations of technology-based measures, and video observation with the gold standard. The COSMIN criterion validity ratings ranged from poor to excellent; most of the studies received a global score of fair or poor.

Conclusions
Technology based validated tools that more directly measure screen use are emerging that have been validated against a gold standard for measuring screen use. However, practical, objective measures of diverse types of screen media use that have been tested on diverse populations are needed to better understand the impact of screen media use on the development and physical and mental health of children and adults.
Cardiac autonomic modulation in response to postural transition during a virtual reality task in individuals with spinal cord injury: A cross-sectional study
Authors: Papa Denise Cardoso Ribeiro , Menezes Lilian Del Ciello de , Moraes Íbis Ariana Peña de , Silveira Ana Clara , Padula Natalia , Silva Suellen de Oliveira Veronez , Gaspar Roberta Caveiro , Dias Eduardo Dati , Ferreira Celso , Araújo Luciano Vieira de , Astorino Todd A. , Dawes Helen , Monteiro Carlos Bandeira de Mello , Silva Talita Dias da 
Published: April 2023

Purpose
The postural transition from sitting to standing is a moment of dysautonomic occurrence in individuals with Spinal Cord Injury (SCI). Different tools can be used to minimize this event, such as virtual reality. Thus, we aimed to analyze cardiac autonomic modulation in individuals with SCI during postural transition from the sitting to orthostatism position using a cognitive virtual reality (VR) task.

Methods
Individuals with and without SCI were positioned on the Easy Stand® device, sitting at rest, at 0° considering the angle between the seat and the floor, elevation at 45°, and orthostatism at 90°, for 5 minutes in each position. Heart rate variability (HRV) measures of sympathovagal balance were collected (heart rate receiver: Polar V800). The groups were subdivided into two groups, one that performed VR as an intervention during the postural angle changes and another group that did not perform VR.

Results
We evaluated 76 individuals, 40 with a medical diagnosis of SCI and 36 who composed the able-bodied control group without SCI, matched by age and sex. The HRV results showed that the SCI group who performed the task in VR demonstrated no significant difference in parasympathetic activation and global variability between the sitting versus 90° positions. There was better sympathovagal balance in SCI and able-bodied control groups who performed the VR task between the sitting versus 90° positions.

Conclusion
The use of a VR task seems to contribute to better sympathovagal balance, with the potential to reduce dysautonomia during postural changes.
Comparison of survival times of advanced cancer patients with palliative care at home and in hospital
Authors: Hamano Jun , Takeuchi Ayano , Mori Masanori , Saitou Yasuhiro , Yamaguchi Takahide , Miyata Nobuyuki , Shimizu Masakatsu , Yamamoto Ryo , Kimura Yousuke , Kamiyama Yoshiyuki , Arai Yasuyuki , Matsuo Hiroshi , Shishido Hideki , Nakano Kazushi , Nishi Tomohiro , Nagaoka Hiroka , Yokomichi Naosuke , Maeda Isseki , Yamaguchi Takashi , Morita Tatsuya , Shinjo Takuya 
Published: April 2023

Objectives
One primary concern about receiving care at home is that survival might be shortened because the quality and quantity of treatment provided at home will be inferior to that given in the hospital. Although our previous study demonstrated a longer survival of those with home-based palliative care (PC), it lacked adjustment for some potential confounders including symptoms and treatments during the stay. We aimed to compare the survival times among advanced cancer patients receiving home-based and hospital-based PC with adjusting for symptoms and treatments.

Method
We compared survival time of participants who enrolled two multicenter, prospective cohort studies of advanced cancer patients at 45-home-based PC services between July 2017 and December 2017, and at 23-hospital-based PC services between January 2017 and December 2017. We analyzed with stratification by the estimated survival of Days, Weeks, and Months, which were defined by modified Prognosis in Palliative care Study predictor models-A. We conducted a Cox regression analysis with adjusting for potential confounders including symptoms and treatments during the stay.

Results
A total of 2,998 patients were enrolled in both studies and 2,878 patients were analyzed; 988 patients receiving home-based PC and 1,890 receiving hospital-based PC. The survival time of patients receiving home-based PC was significantly longer than that of patients receiving hospital-based PC for the Days Prognosis (estimated median survival time: 10 days [95% CI 8.1–11.8] vs. 9 days [95% CI 8.3–10.4], p = 0.157), the Weeks prognosis (32 days [95% CI 28.9–35.4] vs. 22 days [95% CI 20.3–22.9], p < 0.001), and the Months Prognosis, (65 days [95% CI 58.2–73.2] vs. 32 days [95% CI 28.9–35.4], p < 0.001).

Conclusion
In this cohort of advanced cancer patients with a Weeks or Months prognosis, those receiving home-based PC survived longer than those receiving hospital-based PC after adjusting for symptoms and treatments.
The (dis)engagement of mangrove forests and mangrove rice in academic and non-academic literature on Guinea-Bissau–a systematic review protocol
Authors: Sousa Joana , Campos Rita , Mendes Orlando , Duarte Lopes Paula , Matias Madalena , Rosa Ana Paula , Mendes Fernandes Raul , Cruz Cristina , Indjai Bucar , Infande Adilson , da Costa Maira , Salvaterra Gonçalo , Lourenço Juelson , Tavares Dionísio , Camala Djone , Ainslie Andrew , Catarino Luís 
Published: April 2023

Background
Coastal areas in Guinea-Bissau and elsewhere in West Africa are bordered by mangrove forests. In several of these places, swaths of mangrove forest have been removed and the landscape has been technologically adapted for the production of mangrove rice–a regionally important staple. However, the effects of global warming, in particular sea-level rise, pose challenges to these socioecological environments. In this context, knowledge appears as an important resource and knowing what knowledge has been produced and which perspectives have guided that production may inform future responses to climate change. We have developed a systematic literature review protocol focusing on the main question: “How have mangrove forest and mangrove rice spaces been represented in the literature on Guinea-Bissau?” The main hypothesis is that although they occupy contiguous, interrelated and interactant spaces in coastal environments, mangrove forests and mangrove rice have been studied and analyzed independently in the literature.

Methods
This is a protocol for conducting a systematic review that will include academic and non-academic literature in Portuguese, English and French. The academic literature will be retrieved from both Web of Science and Scopus using Boolean expressions. The non-academic literature will be accessed from relevant institutions, specialized libraries, and reference lists of previously selected items. Data extraction will follow a standard procedure based on an information sheet. Our analysis will be both qualitative (inductive and deductive coding, content analysis) and quantitative (word clouds, descriptive statistics and statistical testing).

Discussion
This systematic review will provide information about the conceptual framework that has been produced through research, policymaking, and conservation and development programs in the management of coastal areas. This study will identify the limitations of previous approaches and contribute to both future research and strategies for planning adaptation to climate change. Finally, the outputs will add to broader debates about people-nature coexistence and climate change adaptation and mitigation.
Nutritional status of under-five aged children of ready-made garment workers in Bangladesh: A cross-sectional study
Authors: Haque Sadika , Al Rafi Dewan Abdullah , Zaman Nafisa , Salman Md. , Al Noman Md. Abdullah , Hoque Md. Nazmul , Bhattacharjee Lalita , Farquhar Samantha , Yasmin Sabina , Hasan Md. Mehedi , Hira Fatema Tuj Zohora , Prithi Aunjuman Ara , Shammi Shamim Ara , Banu Bilkish , Hossain Akbar 
Published: April 2023

Background
The ready-made garment (RMG) sector is a significant contributor to the economic growth of Bangladesh, accounting for 10% of the country’s GDP and more than 80% of its foreign exchange earnings. The workforce in this sector is predominantly made up of women, with 2.5 million women working in the industry. However, these women face numerous challenges in carrying out their culturally-expected household responsibilities, including childcare, due to severe resource constraints. As a result, the children of these working women have a higher incidence of malnutrition, particularly stunted growth. This study aims to identify the factors that contribute to stunting in children under the age of five whose mothers work in the RMG sector in Bangladesh.

Methods
The study collected data from 267 female RMG workers in the Gazipur district of Bangladesh using a simple random sampling technique. Chi-square tests were used to determine the associations between the factors influencing child stunting, and Multinomial Logit Models were used to estimate the prevalence of these factors.

Results
The study found that the prevalence of moderate and severe stunting among the children of RMG workers living in the Gazipur RMG hub was 19% and 20%, respectively. The study identified several significant predictors of child stunting, including the mother’s education level, nutritional knowledge, control over resources, receipt of antenatal care, household size, sanitation facilities, and childbirth weight. The study found that improving the mother’s education level, increasing household size, and receiving antenatal care during pregnancy were important factors in reducing the likelihood of child stunting. For example, if a mother’s education level increased from no education to primary or secondary level, the child would be 0.211 (0.071–0.627) and 0.384 (0.138–1.065) times more likely to have a normal weight and height, respectively, than to be moderately stunted.

Conclusion
The study highlights the challenges faced by working women in the RMG sector, who often receive minimal wages and have limited access to antenatal care services. To address these challenges, the study recommends policies that support antenatal care for working-class mothers, provide daycare facilities for their children, and implement a comprehensive social safety net program that targets child nutrition. Improving the socioeconomic status of mothers is also critical to reducing child malnutrition in this population.
Patients with infective endocarditis undergoing cardiac surgery have distinct ROTEM profiles and more bleeding complications compared to patients without infective endocarditis
Authors: Breel Jennifer S. , Wensing Agnes G. C. L. , Eberl Susanne , Preckel Benedikt , Schober Patrick , Müller Marcella C. A. , Klautz Robert J. M. , Hollmann Markus W. , Hermanns Henning 
Published: April 2023

Background
The coagulation system is crucial in the pathogenesis of infective endocarditis and undergoes significant changes during course of the disease. However, little is known about the implications of those changes in the perioperative period. Aim of the present study was to delineate the specific coagulation patterns and their clinical consequence in patients undergoing cardiac surgery due to infective endocarditis.

Methods
In this single-centre, exploratory, prospective observational study, we investigated the incidence and degree of coagulopathy in patients with (n = 31) and without infective endocarditis (n = 39) undergoing cardiac valve surgery. The primary outcome was the differences between these two groups in rotational thromboelastometry (ROTEM) results before, during and after surgery. The secondary outcomes were the differences between the groups in heparin sensitivity, bleeding complications, and transfusion requirements.

Results
Most ROTEM parameters in EXTEM, INTEM and FIBTEM assays were significantly altered in patients with infective endocarditis. Clotting time in the EXTEM assay was significantly prolonged in the endocarditis group at all time-points, while all clot firmness parameters (A5, A10 and MCF) were significantly increased. The heparin sensitivity index was significantly lower in the endocarditis group (median index 0.99 vs 1.17s. IU-1.kg-1, p = .008), indicating increased heparin resistance. Patients with infective endocarditis had more bleeding complications as assessed by the universal definition of perioperative bleeding score (OR 3.0, p = .018), and more patients with endocarditis underwent early re-exploration (p = .018).

Conclusions
The findings of this exploratory investigation show significantly altered coagulation profiles in patients with infective endocarditis, with concomitant hyper- and hypocoagulability. Furthermore, the incidence of bleeding complications and transfusion requirements were increased in patients with endocarditis. These results show the potential of ROTEM to detect coagulation abnormalities in patients with infective endocarditis. Existing point-of-care coagulation testing guided algorithms for optimizing perioperative coagulation management possibly need to be adjusted for these high-risk patients undergoing cardiac surgery.
L-type calcium channel blocker increases VEGF concentrations in retinal cells and human serum
Authors: Kumar Anmol , Mutter Stefan , Parente Erika B. , Harjutsalo Valma , Lithovius Raija , Mathavan Sinnakaruppan , Lehto Markku , Hiltunen Timo P. , Kontula Kimmo K. , Groop Per-Henrik 
Published: April 2023

Objective
Vascular endothelial growth factor (VEGF) plays a key role in diabetic retinopathy (DR). Previously, we have reported an association between mutations in a gene coding for the L-type calcium channel subunit, VEGF and DR. L-type calcium channel blockers (LTCCBs) have been widely used as antihypertensive medication (AHM), but their association with VEGF and DR is still unclear. Therefore, we explored the effect of LTCCBs compared to other AHMs on VEGF concentrations in retinal cells and human serum. Furthermore, we evaluated the association between the use of LTCCBs and the risk of severe diabetic eye disease (SDED).

Research design and methods
Müller cells (MIO-M1) were cultured as per recommended protocol and treated with LTCCBs and other AHMs. VEGF secreted from cells were collected at 24 hours intervals. In an interventional study, 39 individuals received LTCCBs or other AHM for four weeks with a four-week wash-out placebo period between treatments. VEGF was measured during the medication and placebo periods. Finally, we evaluated the risk of SDED associated with LTCCB usage in 192 individuals from the FinnDiane Study in an observational setting.

Results
In the cell cultures, the medium VEGF concentration increased time-dependently after amlodipine (P<0.01) treatment, but not after losartan (P>0.01), or lisinopril (P>0.01). Amlodipine, but no other AHM, increased the serum VEGF concentration (P<0.05) during the interventional clinical study. The usage of LTCCB was not associated with the risk of SDED in the observational study.

Conclusions
LTCCB increases VEGF concentrations in retinal cells and human serum. However, the usage of LTCCBs does not appear to be associated with SDED in adults with type 1 diabetes.