bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shiftwork and insulin resistance in professional drivers: exploring the association using non-insulin-based surrogate measures
Authors: Tawfik Mirella Youssef , Amer Shaimaa A. A. M. , Fouad Ahmed Mahmoud 
Published: January 2025

Abstract

Background
Previous research has made use of the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index to explore the association between shiftwork (SW) and insulin resistance (IR). However, the limitations of the HOMA-IR index restrict its use. This study aimed to investigate the relationship between SW and IR in professional drivers using four alternative non-insulin-based IR surrogate measures (NIRS), and to determine the predictors of elevated NIRS.

Methods
A comparative cross-sectional study was conducted on professional drivers at four Egyptian companies, where 187 SW were compared to 193 dayworkers (DW). Measurements included: sociodemographic, work, and clinical characteristics. Laboratory and NIRS data included: triglyceride glucose (TyG), triglyceride glucose-body mass index (TyG-BMI), triglyceride to high density lipoprotein cholesterol (TG/HDL-C), and metabolic score of insulin resistance (METS-IR). Further assessments included insomnia severity index (ISI), and perceived stress scale (PSS-10).

Results
Shiftwork-drivers showed significantly higher levels of NIRS compared to DW-drivers. Shiftwork was significantly associated with elevated TyG (OR: 5.04, 95% CI: 1.98–12.84), TyG-BMI (OR: 4.50, 95% CI: 2.45–8.26), and METS-IR (OR: 6.30, 95% CI: 2.72–14.58). Significant interactions between SW and insomnia or meal-timing habits existed, where SW-drivers with clinically significant insomnia had 11 times higher odds of elevated TyG compared to DW drivers without insomnia. Likewise, SW-drivers experiencing poor meal timing habits had 5.5- and 6.8-times higher odds of elevated TG/HDL-C and METS-IR, respectively, compared to DW divers without poor meal timing habits. Other significant predictors for elevated NIRS included: age, income, stress, overweight/obesity, and poor meal timing habits.

Conclusions
This study demonstrates a significant association between shiftwork and elevated insulin resistance in professional drivers. Insomnia and poor meal timing habits significantly increases the odds of insulin resistance among professional drivers, suggesting interventions targeting sleep quality, meal timing, and stress management.
Tattoo ink exposure is associated with lymphoma and skin cancers – a Danish study of twins
Authors: Clemmensen Signe Bedsted , Mengel-From Jonas , Kaprio Jaakko , Frederiksen Henrik , von Bornemann Hjelmborg Jacob 
Published: January 2025

Abstract

Background
We aim to study the potential association between tattoo ink exposure and development of certain types of cancers in the recently established Danish Twin Tattoo Cohort. Tattoo ink is known to transfer from skin to blood and accumulate in regional lymph nodes. We are concerned that tattoo ink induces inflammation at the deposit site, leading to chronic inflammation and increasing risk of abnormal cell proliferation, especially skin cancer and lymphoma.

Methods
We conducted two designs of twin studies to improve confounder control: A cohort study of 2,367 randomly selected twins and a case-control study of 316 twins born in the period 1960–1996. Cancer diagnoses (ICD-10) were retrieved from the Danish Cancer Registry and tattoo ink exposure from the Danish Twin Tattoo survey from 2021. The analysis addressed effects of time-varying exposure.

Results
In the case-control study, individual-level analysis resulted in a hazard of skin cancer (of any type except basal cell carcinoma) that was 1.62 times higher among tattooed individuals (95% CI: 1.08–2.41). Twin-matched analysis of 14 twin pairs discordant for tattoo ink exposure and skin cancer showed HR = 1.33 (95% CI: 0.46–3.84). For skin cancer and lymphoma, increased hazards were found for tattoos larger than the palm of a hand: HR = 2.37 (95% CI: 1.11–5.06) and HR = 2.73 (95% CI: 1.33–5.60), respectively. In the cohort study design, individual-level analysis resulted in a hazard ratio of 3.91 (95% CI: 1.42–10.8) for skin cancer and 2.83 (95% CI: 1.30–6.16) for basal cell carcinoma.

Conclusion
In conclusion, our study suggests an increased hazard of lymphoma and skin cancers among tattooed individuals, demonstrated through two designs: a twin cohort and a case-cotwin study. We are concerned that tattoo ink interacting with surrounding cells may have severe consequences. Studies that pinpoint the etiological pathway of tattoo ink induced carcinogenesis are recommended to benefit public health.
Dentists’ readiness to accept an electronic oral health surveillance system in Egypt using a modified framework of the unified theory of acceptance and use of technology (UTAUT): a cross-sectional survey
Authors: Abdelrahman Hams H. , Hamza Maha , Essam Wafaa , Adham May 
Published: January 2025

Abstract

Background
Effective public health surveillance is essential for policymaking and resource allocation. The World Health Organization (WHO) supports the integration of mobile technologies to create mobile Oral (m-Oral) Health surveillance systems to enhance disease monitoring. The effectiveness and sustainability of electronic health information initiatives depend on users’ acceptance of new technologies. This research assessed dentists’ acceptance of electronic oral health surveillance systems (EOHSS) and related factors, guided by the Unified Theory of Acceptance and Use of Technology (UTAUT) model.

Materials and methods
A cross-sectional study included 1470 Egyptian dentists in an online survey from November 2023 to May 2024. The dentists were recruited from the five administrative regions in Egypt using convenience and snowball sampling. Participants responded to a questionnaire that was based on the UTAUT model. Structural equation model (SEM) was used for data analysis.

Results
83.4% of dentists intended to use EOHSS. Performance expectancy (PE) (ß = 0.240, 95% CI: 0.182, 0.295), training adequacy (TA) (ß = 0.232, 95% CI: 0.165, 0.291), and effort expectancy (EE) (ß = 0.231, 95% CI: 0.169, 0.289) had the greatest influence on behavioral intention (BI). In contrast, anxiety towards electronic systems (ANX) (ß = -0.140, 95% CI: -0.187, -0.095) had a significant negative effect on BI. Effort Expectancy (EE) had a significantly stronger positive impact on BI of females than males. Moreover, EE had a significantly stronger impact on BI of dentists older than 40 years old than those who were younger than 30 years old.

Conclusions
Egyptian dentists’ intentions to use the EOHSS were influenced by PE, TA, and EE. However, anxiety related to technology may limit its adoption. EE had a greater positive impact on BI in females and in older dentists.
Empowering nurse leaders: readiness for AI integration and the perceived benefits of predictive analytics
Authors: Kotp Mohamed Hashem , Ismail Hossam Ali , Basyouny Hassan Ahmed Awad , Aly Mohamed Ahmed , Hendy Abdelaziz , Nashwan Abdulqadir J. , Hendy Ahmed , Abd Elmoaty Aliaa Ezz Eldin 
Published: January 2025

Abstract

Introduction
Artificial Intelligence (AI) is increasingly being integrated into healthcare, particularly through predictive analytics that can enhance patient care and operational efficiency. Nursing leaders play a crucial role in the successful adoption of these technologies.

Aim
This study aims to assess the readiness of nursing leaders for AI integration and evaluate their perceptions of the benefits of AI-driven predictive analytics in healthcare.

Methods
A descriptive cross-sectional study was conducted among 187 nurse leaders across nine private hospitals in Cairo. The sample was selected using a combination of simple random sampling and non-probability convenience sampling methods to ensure a diverse representation of nursing leadership. Data collection took place from March to May 2024, utilizing a structured questionnaire specifically designed to assess nurse leaders’ readiness for AI integration and their perceptions of AI-driven predictive analytics The data were analyzed using IBM SPSS Statistics, version 26.0. Exploratory Factor Analysis (EFA) was employed to identify underlying factors related to readiness and perceived benefits. Confirmatory Factor Analysis (CFA) was subsequently performed to validate the factor structure. Multiple linear regression analysis was conducted to identify significant predictors of AI readiness and perceived benefits.

Results
The study revealed that over one-third of nurse leaders exhibited high readiness for AI integration. Significant predictors of readiness included age, educational attainment, and employment status. Positive correlations were found between readiness and perceived benefits of AI, particularly in areas such as care planning and decision-making.

Conclusion
The findings suggest that nursing leaders are generally prepared to integrate AI into their workflows, especially those with advanced education and experience. However, further training and policy development are necessary to fully realize the benefits of AI in nursing practice.
The global, regional, and national burden of type 2 diabetes mellitus attributable to low physical activity from 1990 to 2021: a systematic analysis of the global burden of disease study 2021
Authors: Wei Jiehua , Fan Luying , He Zixuan , Zhang Senmao , Zhang Ying , Zhu Xidi , Xia Fan , Song Xinli , Chen Lizhang , Zou Zhiyong , Wang Tingting 
Published: January 2025

Abstract

Background
Low physical activity (LPA) is a leading risk factor for type 2 diabetes mellitus (T2DM). We examine the temporal and spatial trends in the burden of T2DM attributable to LPA at the global, regional, and country scales.

Methods
Data were obtained from the Global Burden of Disease Study 2021. The numbers of deaths and disability-adjusted life years (DALYs) of LPA-related T2DM, and the corresponding age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) were compared across regions and countries by age, sex, and sociodemographic index (SDI). The annual percentage changes (EAPCs) in the ASMR or ASDR were calculated to quantify temporal trends from 1990 to 2021. We also quantified the relationship between SDI and the ASMR and ASDR of T2DM attributable to LPA.

Results
Globally, the number of T2DM deaths and DALYs attributable to LPA were approximately 0.15 million and 5.52 million respectively in 2021, which more than doubled compared to 1990. Over the past 32 years, the global EAPCs of ASMR and ASDR were 0.26 (95% CI: 0.20, 0.31) and 0.97 (95% CI: 0.93, 1.02), respectively. The ASMR or ASDR had a reverse U-shaped relationship with the SDI, with the most severe burden observed in the low-middle and middle SDI regions. The age group older than 60 years had the highest rate of DALYs for LPA-related T2DM in 2021, while the 25–44 age group showed the largest increase between 1990 and 2021.

Conclusions
Over the past 32 years, the global burden of LPA-related T2DM has continued to increase at an alarming rate in almost all countries, particularly in regions with low-middle and middle SDI. Substantial increases in national action are urgently needed to target elder populations especially in low-middle and middle SDI regions, and special efforts should be made to promote physical activity in young adults with LPA.
Epidemiology of transthyretin (ATTR) amyloidosis: a systematic literature review
Authors: Delgado Diego , Dabbous Firas , Shivappa Nitin , Mazhar Faizan , Wittbrodt Eric , Shridharmurthy Divya , Järbrink Krister 
Published: January 2025

Abstract

Introduction
Significant advances in the treatment of transthyretin (ATTR) amyloidosis has led to an evolving understanding of the epidemiology of this condition. This systematic literature review (SLR) aims to synthesize current evidence on epidemiology and mortality outcomes in ATTR amyloidosis, addressing the need for a comprehensive understanding of its current global impact.

Methods
An SLR of the literature from January 2018 to April 2023 was conducted using the Medline and Embase databases. The review followed the PRISMA guidelines. Studies evaluating populations with genotypes and phenotypes of ATTR amyloidosis (variant and wild-type cardiomyopathy, polyneuropathy, and mixed) were included. Observational studies, systematic reviews, and meta-analyses were eligible, while reports, commentaries, clinical trials, and non-ATTR amyloidosis studies were excluded. Extracted data included prevalence, incidence, and mortality rates.

Results
Of the 1,458 studies identified, 113 met the inclusion criteria. Forty-nine studies reported on epidemiology, while 64 focused on mortality rates in cohorts of patients with ATTR amyloidosis from Europe (n = 16), North America (n = 26), Asia (n = 5), and Australia (n = 2). No studies were found that exclusively focused on ATTR amyloidosis in Africa or South America. ATTR prevalence ranged from 6.1/million in the US to 232/million in Portugal with very limited data on ATTR-PN. The 2-year mortality risk ranged from 10 to 30% among wild-type ATTR-CM and from 10 to 50% for variant type of ATTR-CM.

Conclusions
This SLR demonstrated heterogeneity in ATTR epidemiology and mortality rates across global regions. Further investigation is needed to address knowledge gaps of the epidemiology and burden of ATTR, which may improve early diagnosis and management.
A novel “lateral approach short axis in-plane” technique vs. conventional “short-axis out-of-plane approach” for ultrasound-guided internal jugular vein access: a prospective randomized non-inferiority trial
Authors: Kalina Michal , Vargová Patricia , Bubeníková Adéla , Škulec Roman , Černý Vladimír , Astapenko David 
Published: January 2025

Abstract

Background
The cannulation of the internal jugular vein (IJV) is a frequent procedure in critically ill patients. According to the guidelines, real-time ultrasound navigation is recommended. Traditional techniques pose several disadvantages, such as suboptimal needle visualization. Therefore, this non-inferiority trial aimed to describe the novel approach and compare the novel lateral in-plane short-axis approach for IJV access with the conventional short-axis out-of-plane approach.

Objectives
The primary objective of the trial was to prove that the first attempt success rate in the novel technique is non-inferior to the conventional technique. The secondary objectives were to demonstrate that the complication rate and the functional duration of the catheter in the novel technique are not inferior to those in the conventional technique.

Methods
Patients eligible for IJV cannulation were randomly assigned to either the novel technique (Group A) or the conventional one (Group B). The procedure duration, success rate and the number of attempts required were documented. The functionality of the catheter and complications were monitored from insertion until the catheter removal. Standard descriptive statistical methods were employed for the analysis.

Results
A total of 200 subjects were equally divided between Group A and Group B. For the primary outcome, there was no significant difference in first attempt success rate (Group A: 79, Group B: 77, p = 0.434). Secondary outcomes, including complications and catheter functional time, did not differ significantly between the groups. However, the novel technique demonstrated a significantly faster procedure time (Group A: 315 s, Group B: 330 s, p = 0.016). Notably, the novel approach was linked with significantly larger IJV diameter measured during the procedure (Group A: 18.2 mm, Group B: 12.1 mm, p < 0.001).

Conclusion
The novel lateral in-plane short-axis approach for IJV cannulation is a non-inferior alternative with a lower incidence of posterior vessel wall puncture compared to the conventional approach.
Risk of hemorrhagic fever with renal syndrome associated with meteorological factors in diverse epidemic regions: a nationwide longitudinal study in China
Authors: Chang Nan , Huang Wenzhong , Niu Yanlin , Xu Zhihu , Gao Yuan , Ye Tingting , Wang Zihao , Wei Xiaohui , Guo Yuming , Liu Qiyong 
Published: January 2025

Abstract

Background
Hemorrhagic fever with renal syndrome (HFRS) is a climate-sensitive zoonotic disease that poses a significant public health burden worldwide. While previous studies have established associations between meteorological factors and HFRS incidence, there remains a critical knowledge gap regarding the heterogeneity of these effects across diverse epidemic regions. Addressing this gap is essential for developing region-specific prevention and control strategies. This study conducted a national investigation to examine the associations between meteorological factors and HFRS in three distinct epidemic regions.

Methods
We collected daily meteorological data (temperature and relative humidity) and HFRS incidence cases of 285 cities in China from the Resource and Environment Science and Data Center and the Chinese National Notifiable Infectious Disease Reporting Information System from 2005–2022. Study locations were stratified into three distinct epidemic categories (Rattus-dominant, Apodemus-dominant, and mixed) based on the seasonality of peak incidence. The associations between meteorological variables and HFRS incidence were investigated using a time-stratified case-crossover design combined with distributed lag nonlinear modeling for each epidemic category.

Results
The exposure-response relationships between meteorological factors and HFRS incidence revealed significant heterogeneity across epidemic regions, as evidenced by Cochran’s Q test for temperature (Q = 324.40, P < 0.01) and relative humidity (Q = 30.57, P < 0.01). The optimal daily average temperature for HFRS transmission in Rattus-dominant epidemic regions (− 6.6 °C), characterized by spring epidemics, was lower than that observed in Apodemus-dominant epidemic regions (13.7 °C), where primary cases occurred during autumn and winter months. Furthermore, the association between relative humidity and HFRS incidence exhibited as a monotonic negative correlation in Rattus-dominant regions, while Apodemus-dominant regions showed a nonlinear, inverted U-shaped association.

Conclusions
This study highlights the heterogeneous effects of meteorological factors on HFRS incidence across different epidemic regions. Targeted preventive measures should be taken during cold and dry spring days in Rattus-dominant regions, and during warm and moderately humid winter days in Apodemus-dominant regions. In mixed epidemic regions, both scenarios require attention. These findings provide novel scientific evidence for the formulation and implementation of region-specific HFRS prevention policies.

Graphical Abstract
Space-based long term condition monitoring of cold region pavement with PS-InSAR
Authors: Jiang Yusheng , Yu Xiong 
Published: January 2025

Abstract
The durability of cold-climate pavement is affected by ground frost heave and thaw settlement. Field monitoring of pavement elevation changes remain challenging and expansive. This study demonstrates space-based Interferometric Synthetic Aperture Radar (InSAR) technology as a potential way to monitor seasonal pavement elevation change in cold region. Traditional InSAR applications, which were designed for geoscience scales, do not achieve the needed sensitivity or spatial resolution for pavement engineering applications. The testbed used is a cold-region airport located in Qinghai Province, China. The site contains heterogeneous ground conditions in an area of 4km

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6km. Analyses were conducted using 132 ascending and 149 descending C-band InSAR images from the Sentinel-1 satellite. InSAR algorithm based on Persistent scatterers (PS-InSAR) were implemented for data analyses. Time series displacement across five distinct persistent scatterers (PSs) groups at different locations were obtained. From these, three main seasonal vertical ground deformation patterns were identified, each reflecting the diverse subsurface soil characteristics across the sites. The ground elevation changes were decomposed into baseline trend and seasonal changes. The results of seasonal ground deformations allowed to differentiate the ground soils as frost-susceptible and non-frost-susceptible, an important information for geotechnical site investigation. This helps identify areas of pavement subjected to frost heave and thaw weakening. The study demonstrates that potential of space-based InSAR technology to achieve spatial resolution and sensitivity for monitoring the performance of cold region pavement. The results allow to identify areas of pavement vulnerable to cold region climate and climate change.
Single cell-derived multicellular meristem: insights into male-to-hermaphrodite conversion and de novo meristem formation in Ceratopteris
Authors: Yang Xi , Yan An , Liu Xing , Volkening Alexandria , Zhou Yun 
Published: January 2025

ABSTRACT
Land plants alternate between asexual sporophytes and sexual gametophytes. Unlike seed plants, ferns develop free-living gametophytes. Gametophytes of the model fern Ceratopteris exhibit two sex types: hermaphrodites with pluripotent meristems and males lacking meristems. In the absence of the pheromone antheridiogen, males convert to hermaphrodites by forming de novo meristems, although the mechanisms remain unclear. Using long-term time-lapse imaging and computational analyses, we captured male-to-hermaphrodite conversion at single-cell resolution and reconstructed the lineage and division atlas of newly formed meristems. Lineage tracing revealed that the de novo-formed meristem originates from a single non-antheridium cell: the meristem progenitor cell (MPC). During conversion, the MPC lineage showed increased mitotic activity, with marginal cells proliferating faster than inner cells. A mathematical model suggested that stochastic variation in cell division, combined with strong inhibitory signals from dividing marginal cells, is sufficient to explain gametophyte dynamics. Experimental disruption of division timing agreed with the model, showing that precise cell cycle progression is essential for MPC establishment and sex-type conversion. These findings reveal cellular mechanisms governing sex conversion and de novo meristem formation in land plants.
A case for broadening our view of mechanism in developmental biology
Authors: Özpolat B. Duygu , Arur Swathi , Srivastava Mansi 
Published: January 2025

ABSTRACT
Developmental biologists can perform studies that describe a phenomenon (descriptive work) and/or explain how the phenomenon works (mechanistic work). There is a prevalent perception that molecular/genetic explanations achieved via perturbations of gene function are the primary means of advancing mechanistic knowledge. We believe this to be a limited perspective, one that does not effectively represent the breadth of work in our field. We surveyed a representative and diverse group of colleagues to share their views on what it takes to infer mechanism. Here, we briefly examine the factors that have shaped the dominant view of mechanism, summarize responses to the survey, present our views, and suggest a path forward that embraces a broad outlook on the diversity of studies that advance knowledge in our field.