bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mortality and Length of Stay Implications of Deterioration-Associated Transfer to the Intensive Care Unit over Different Time Frames
Authors: Belk Kathy W , Beals Joseph , McInnis Samantha J 
Published: January 2025

Background: Quality improvement initiatives in the acute care setting often target reduction of mortality and length of stay (LOS). Unplanned care escalations are associated with increased mortality risk and prolonged LOS, but may be precipitated by different factors, including appropriate triage, bed availability, and post-admission deterioration. Objectives: This work evaluates different transfer timeframes to quantify the impact of deterioration-associated unplanned transfers to intensive care (ICU) on mortality and LOS, informing evidence-based interventions to improve patient care. Design: This retrospective analysis examined 519 181 adult inpatients discharged from 15 hospitals in the United States. A propensity matched cohort analysis compared mortality and overall hospital LOS for patients admitted to routine and intermediate care units who did and did not have an unplanned ICU transfer within 12, 12-48, or ⩾48 hours from admission. Methods: Population cohorts were matched on age, sex, admitting unit type, admission type, and admission acuity. Multivariable regression analysis was used to estimate the impact of unplanned transfer on mortality and LOS. Sensitivity sub-analyses compared direct ICU admissions to unplanned ICU transfers using the same transfer timeframes and endpoints. Results: Patients with unplanned transfers in each of three timeframes had statistically higher mortality rates and longer LOS than matched cohorts without unplanned transfer. Differences between cohorts was greatest in patients transferring ⩾48 hours post-admission for both mortality (25.1% vs 1.9%, P < .0001) and LOS ( x¯ = 14.7 vs 5.3, P < .0001). Multivariate analysis showed unplanned ICU transfer significantly increased odds of mortality and prolonged LOS, with later transfers having the most profound influence (19-fold increase in mortality and 2-fold increase in LOS). Sensitivity analyses found a statistically significant increase in mortality and LOS associated with unplanned ICU transfer across all three timeframes. Conclusion: The association of later transfers with elevated mortality and LOS underscores the importance of timely intervention on patient deterioration.
Secondhand Smoke Exposure and Smoking Attitudes and Behaviors Among Adolescents in the Gaza Strip: Findings From the 2019 Global Youth Tobacco Survey
Authors: Maraqa Beesan , Abu Mayaleh Mahmoud , Arafeh Seya , Altell Kenana , Khleif Ahmad , Najjar Abdallah , Abu-Radwan Bayyena 
Published: January 2025

Background Secondhand smoke (SHS) exposure remains a critical public health concern, especially for adolescents, who are more susceptible to its harmful effects and may initiate smoking as a result. SHS, comprising both mainstream and sidestream smoke, contains over 7000 chemicals, many of which are carcinogenic. Adolescents exposed to SHS are more likely to experiment with smoking due to environmental influences, peer pressure, and familial smoking behavior. Objective This study aims to examine the relationship between SHS exposure and smoking attitudes and behaviors among adolescents aged 13-15 in the Gaza Strip, where SHS exposure and tobacco use remain prevalent. Methods Data were obtained from the 2019 Global Youth Tobacco Survey (GYTS), a cross-sectional, school-based survey targeting students in Gaza. The study employed a two-stage cluster sampling design to ensure a representative sample. SHS exposure was assessed in multiple contexts, including home, public enclosed spaces, and outdoor areas. Smoking attitudes, initiation behaviors, and demographic variables were also analyzed using descriptive statistics, Chi-square tests, and multivariable logistic regression to identify predictors of smoking behaviors. Results Of the 1536 adolescents surveyed, 62.3% reported SHS exposure at home, and 53.9% reported exposure in enclosed public spaces. Adolescents exposed to SHS were significantly more likely to experiment with smoking, with curiosity (62.2%) and peer influence being key motivators. Additionally, SHS exposure in both indoor and outdoor environments was associated with a higher likelihood of shisha experimentation. Females reported higher SHS exposure rates than males across all environments ( P < .001). Conclusion SHS exposure significantly increases the risk of smoking initiation among adolescents in the Gaza Strip. These findings emphasize the need for targeted public health interventions, including stricter smoke-free legislation, parental education, and awareness campaigns aimed at reducing SHS exposure and preventing smoking uptake in youth.
Resting state EEG in young children with Tuberous Sclerosis Complex: associations with medications and seizures
Authors: Clements Caitlin C. , Engelstad Anne-Michelle , Wilkinson Carol L. , Hyde Carly , Hartney Megan , Simmons Alexandra , Tager-Flusberg Helen , Jeste Shafali , Nelson Charles A. 
Published: January 2025

Abstract

Background
Tuberous Sclerosis Complex (TSC) is a rare genetic condition caused by mutation to TSC1 or TSC2 genes, with a population prevalence of 1/7000 births. TSC manifests behaviorally with features of autism, epilepsy, and intellectual disability. Resting state electroencephalography (EEG) offers a window into neural oscillatory activity and may serve as an intermediate biomarker between gene expression and behavioral manifestations. Such a biomarker could be useful in clinical trials as an endpoint or predictor of treatment response. However, seizures and antiepileptic medications also affect resting neural oscillatory activity and could undermine the utility of resting state EEG features as biomarkers in neurodevelopmental disorders such as TSC.

Methods
This paper compares resting state EEG features in a cross-sectional cohort of young children with TSC (n = 49, ages 12–37 months) to 49 age- and sex-matched typically developing controls. Within children with TSC, associations were examined between resting state EEG features, seizure severity composite score, and use of GABA agonists.

Results
Compared to matched typically developing children, children with TSC showed significantly greater beta power in permutation cluster analyses. Children with TSC also showed significantly greater aperiodic offset (reflecting nonoscillatory neuronal firing) after power spectra were parameterized using SpecParam into aperiodic and periodic components. Within children with TSC, both greater seizure severity and use of GABAergic antiepileptic medication were significantly and independently associated with increased periodic peak beta power.

Conclusions
The elevated peak beta power observed in children with TSC compared to matched typically developing controls may be driven by both seizures and GABA agonist use. It is recommended to collect seizure and medication data alongside EEG data for clinical trials. These results highlight the challenge of using resting state EEG features as biomarkers in trials with neurodevelopmental disabilities when epilepsy and anti-epileptic medication are common.
Knowledge, attitude and practices regarding vitamin D among adults in Ghana: a cross-sectional study
Authors: Kwabena Abraham Ameyaw , Appiah Benedicta , Danso Samuel Ankomah , Agomuo Samuel Kwame Sopuruchi , Kwarteng Samuel , Senu Ebenezer , Effah Alfred , Sakyi Samuel Asamoah , Fondjo Linda Ahenkorah 
Published: January 2025

Abstract

Background
Vitamin D deficiency is a major public health concern, affecting approximately half of the world's population, partly due to limited public knowledge about vitamin D sources. However, there is lack of data on awareness, knowledge, attitudes, and practices regarding vitamin D in high-risk countries like Ghana. We investigated vitamin D awareness, knowledge and its associated factors in the Ghanaian population.

Methods
This cross-sectional study involved 515 adults from Jaman South Municipal between January and June 2024. Questionnaires were used to obtain data on demographics, clinical characteristics, awareness and knowledge, attitude and practices towards vitamin D. Binary logistic regression analysis was used to determine the independent predictors of knowledge and practices regarding vitamin D. SPSS (version 26.0) was used for all statistical analysis. P < 0.05 was considered statistically significant.

Results
Awareness, knowledge, attitude and practice level towards vitamin D was 61%, 56.9%, 63.7% and 73.2% respectively. Aged between 18–24 yrs [(aOR = 4.106, 95% CI: (1.523–11.072); p = 0.005)], being single [(aOR = 0.243, 95% CI: (0.065–0.904); p = 0.035)], having basic [(aOR = 0.216, 95% CI: (0.068–0.685); p = 0.009)] or secondary education [(aOR = 0.151, 95% CI: (0.073–0.313); p < 0.001)] and speaking English [(aOR = 3.553, 95% CI: (1.519–8.313); p = 0.003)] were the independent predictors of adequate knowledge on vitamin D. Having basic [(aOR = 9.058, 95% CI: (2.449–33.509); p = 0.001)] or secondary education [(aOR = 5.252, 95% CI: (2.508–10.996); p < 0.001)] increased the likelihood of good practices.

Conclusion
There is high awareness but reduced knowledge on Vitamin D among the general public in Jaman South. Age, education, employment status, language were the factors associated with knowledge and practice regarding vitamin D. There is need for extensive health educational campaigns to the public to boost the knowledge levels on the importance of Vitamin D.
Parental psychosocial factors and children’s oral health-related quality of life: Data from a caries prevention study with phone-based support
Authors: Brännemo Ida , Levinsson Anna , Hasselblad Tove , Dahllöf Göran , Tsilingaridis Georgios 
Published: January 2025

Abstract

Background
Caries burden in children disproportionately affects minority and socioeconomically disadvantaged populations. Severe early childhood caries requiring general anesthesia (GA) is a significant concern, with high caries relapse rates in subsequent years.

Aim
To examine associations between parental psychosocial factors, children’s caries burden, and oral health-related quality of life (OHRQoL), including group differences, following a phone-based parental support intervention for children treated under GA for severe Early Childhood Caries (ECC).

Methods
Data were collected during a randomized controlled trial examining a phone-based parental support program. Parental stress was assessed using the Swedish Parenthood Stress Questionnaire (SPSQ), dental fear was measured with the Corah Dental Anxiety Scale (CDAS), and dental attitudes were evaluated using the Dental Beliefs Survey (DBS-R). Children’s OHRQoL was assessed using the Parental-Caregivers Perception Questionnaire (P-CPQ) and the Family Impact Scale (FIS). The Total Observed Caries Experience index was used to calculate the child’s cumulative caries burden. Unadjusted analyses were performed using t-tests, with effect sizes calculated as Cohen’s d. A two-step path analysis examined how parental factors, intervention, and baseline caries influenced caries burden at a one-year follow-up, while also assessing caries burdens impact on children's well-being.

Results
At the one-year follow-up, the intervention group demonstrated significantly improved OHRQoL with lower mean scores on the P-CPQ and FIS compared to the control group, indicating fewer oral health issues and less impact on family life. No statistical differences were found in parental stress, dental fears, or dental beliefs between groups. Path analysis identified baseline caries and treatment group as significant predictors of caries burden, while intervention group predicted better OHRQoL outcomes. The model explained 86.2% of caries burden variance and 12.9% of OHRQoL variance.

Conclusion
A phone-based parental support program significantly improved children’s OHRQoL, even with a higher caries burden in the intervention group at the one-year follow-up. Parental stress, dental fears, and attitudes showed no differences and did not predict caries burden. Preventing early childhood caries in high-risk groups remains challenging, highlighting the importance of preventive initiatives that empower parents and foster collaboration with key stakeholders to reduce severe ECC.
Registered at https://clinicaltrials.gov/ Identifier: NCT02487043.
Cortisol regulates neonatal lung development via Smoothened
Authors: Lu Shanshan , Chen Yifei , Song Jiawen , Ren Liangliang , Du Jun , Shen Donglai , Peng Jiayin , Yin Yao , Li Xia , Wang Yuqing , Gao Yan , Han Siman , Jia Yichang , Zhao Yun , Wang Yizheng 
Published: January 2025

Abstract

Background
Neonatal respiratory distress syndrome (NRDS), one of the main causes of neonatal death, is clinically characterized by progressive dyspnea and cyanosis 1 to 2 h after birth. Corticosteroids are commonly used to prevent NRDS in clinical. However, the protective mechanism of the corticosteroids remains largely unclear.

Methods
In this study, the simulation of the molecular docking by Autodock, in vitro binding experiments, and Sonic Hedgehog (SHH) pathway examination in cells were performed to study the directly binding of cortisol to Smoothened (SMO). To explore the effect of cortisol action on the SHH pathway on neonatal lung development, we generated a genetic mouse, in which leucine 116 (L112 in human) of SMO was mutated to alanine 116 (L116A, Smo

a/a
) by the CRISPR-Cas9, based on sequence differences between human and mice. Then, we performed morphological analysis, single-cell RNA sequencing (scRNA-seq) on lung tissue and fluorescence in situ hybridization (FISH).

Results
In this study, we reported that cortisol, the endogenous glucocorticoid, inhibited the sonic hedgehog (Shh)/SMO-mediated proliferation of lung fibroblasts to maintain the normal lung development. Specifically, cortisol competed with cholesterol for binding to the cysteine-rich domain (CRD) in SMO to inhibit the activation of Shh/SMO signaling, a critical signaling known for cell proliferation. Cortisol did not inhibit the activation of SMO when L112 in its CRD was mutated to A112. Moreover, Smo

a/a
(L116A) mice exhibited the immature lungs in which over-proliferation of interstitial fibroblasts and reduction in the surfactant protein were evident.

Conclusion
Together, these results suggested that cortisol regulated cholesterol stimulation of SMO by competitively binding to the CRD to regulate neonatal lung maturation in mice.
Diabetes mellitus risk in post-myocardial infarction patients: FINDRISC versus self-assessment—a cross sectional study
Authors: Nölken Karianne , Linseisen Jakob , Raake Philip , Meisinger Christine , Schmitz Timo 
Published: January 2025

Abstract

Background
The aim of this study was to investigate the difference between perceived and calculated diabetes risks among post-myocardial infarction (AMI) patients using the Finnish Diabetes Risk Score (FINDRISC).

Methods
The study population includes individuals from the Myocardial Infarction Registry in Augsburg, Germany, who had not been previously diagnosed with diabetes and who received a postal follow-up questionnaire after hospital discharge. A total of 466 participants completed the questionnaire, which collected information on age, sex, body mass index (BMI), waist circumference, physical activity, eating habits, use of antihypertensive medication, previous hyperglycemia, and family history of diabetes. These factors are components of the FINDRISC score, which estimates the likelihood of developing diabetes within the next 10 years. Furthermore, the participants were asked, how they would rate their personal risk to develop diabetes. The analysis focused on determining how many post-AMI patients correctly estimated their diabetes risk compared to the risk calculated by the FINDRISC score. Furthermore, multivariable logistic regression was used to analyze determinants associated with risk underestimation.

Results
Results showed that a significant proportion of the AMI population (58%) underestimated their diabetes risk. This underestimation was significantly associated with older age, higher BMI, greater waist circumference, elevated blood glucose levels, use of antihypertensive medication and a family history of diabetes. Higher education contributed to more accurate risk perception.

Conclusion
This study contributes to the understanding of diabetes risk perception in AMI patients and highlights the need for improving diabetes risk awareness through targeted education and healthcare communication interventions. These efforts can help patients understand their health risks, which improves health outcomes and preventive care.
Bioprocess exploitation of microaerobic auto-induction using the example of rhamnolipid biosynthesis in Pseudomonas putida KT2440
Authors: Grether Jakob , Dittmann Holger , Willems Leon , Schmiegelt Tabea , Benatto Perino Elvio Henrique , Hubel Philipp , Lilge Lars , Hausmann Rudolf 
Published: January 2025

Abstract

Background
In biomanufacturing of surface-active agents, such as rhamnolipids, excessive foaming is a significant obstacle for the development of high-performing bioprocesses. The exploitation of the inherent tolerance of Pseudomonas putida KT2440, an obligate aerobic bacterium, to microaerobic conditions has received little attention so far. Here low-oxygen inducible promoters were characterized in biosensor strains and exploited for process control under reduction of foam formation by low aeration and stirring rates during biosynthesis of rhamnolipids.

Results
In this study, homologous promoters of P. putida inducible under oxygen limitation were identified by non-targeted proteomic analyses and characterized by fluorometric methods. Proteomics indicated a remodeling of the respiratory chain and the regulation of stress-related proteins under oxygen limitation. Of the three promoters tested in fluorescent biosensor assays, the promoter of the oxygen-sensitive cbb3-type cytochrome c oxidase gene showed high oxygen-dependent controllability. It was used to control the gene expression of a heterologous di-rhamnolipid synthesis operon in an auto-inducing microaerobic two-phase bioprocess. By limiting the oxygen supply via low aeration and stirring rates, the bioprocess was clearly divided into a growth and a production phase, and sources of foam formation were reduced. Accordingly, rhamnolipid synthesis did not have to be controlled externally, as the oxygen-sensitive promoter was autonomously activated as soon as the oxygen level reached microaerobic conditions. A critical threshold of about 20% oxygen saturation was determined.

Conclusions
Utilizing the inherent tolerance of P. putida to microaerobic conditions in combination with the application of homologous, low-oxygen inducible promoters is a novel and efficient strategy to control bioprocesses. Fermentation under microaerobic conditions enabled the induction of rhamnolipid production by low oxygen levels, while foam formation was limited by low aeration and stirring rates.
Multi-gate neuron-like transistors based on ensembles of aligned nanowires on flexible substrates
Authors: Neto João , Dahiya Abhishek Singh , Dahiya Ravinder 
Published: January 2025

Abstract
The intriguing way the receptors in biological skin encode the tactile data has inspired the development of electronic skins (e-skin) with brain-inspired or neuromorphic computing. Starting with local (near sensor) data processing, there is an inherent mechanism in play that helps to scale down the data. This is particularly attractive when one considers the huge data produced by large number of sensors expected in a large area e-skin such as the whole-body skin of a robot. This underlines the need for biological skin like processing in the e-skin. Herein, we present multi-gate field-effect transistors (v-FET) having capacitively coupled floating gate (FG) to mimic some of the neural functions. The v-FETs are obtained by deterministic assembly of ZnO nanowires on a flexible substrate using contactless dielectrophoresis method, followed metallization using conventional microfabrication steps. The spatial summation of two presynaptic inputs (applied at multiple control gates) of the transistor confirm their neuron-like response. The temporal summation (such as paired-pulse facilitation) by presented v-FETs further confirm their neuron-like mimicking with one presynaptic input. The temporal and spatial summation functions, demonstrated by the v-FET presented here, could open interesting new avenues for development of neuromorphic electronic skin (v-skin) with possibility of biological-skin like distributed computing.
Metabolic Effects of Glucagon Stimulations in Type 1 Diabetes and Healthy Controls
Authors: She Rui , Suvitaival Tommi , Andersen Henrik Ullits , Hommel Eva , Nørgaard Kirsten , Wojtaszewski Jørgen F P , Legido-Quigley Cristina , Pedersen-Bjergaard Ulrik 
Published: January 2025

Abstract

Context
Metabolic responses to glucagon beyond the promotion of endogenous glucose production in type 1 diabetes remains poorly explored.

Objective
Therefore, we aimed to investigate the metabolic responses to glucagon stimulation in type 1 diabetes and explore whether recent exposure to hypoglycemia would impact glucagon sensitivity.

Methods
Twenty-nine participants, 19 with type 1 diabetes and 10 healthy controls, underwent a hyperinsulinemic–euglycemic clamp with 5-stepwise ascending glucagon injections. Metabolic responses were assessed before and during each glucagon injection.

Results
During the glucagon injections, the series of the incremental area under the curve of plasma glucose concentration did not differ between the groups. However, during the first injection of 10 μg of glucagon, participants with type 1 diabetes produced a higher incremental area under the plasma glucose concentration curve than healthy controls. Plasma concentration of nonesterified fatty acids, glycerol, and metabolites from metabolomic analyses did not differ between the groups. In participants with type 1 diabetes, exposure to hypoglycemia did not impact the metabolic responses induced by glucagon.

Conclusion
Generally, metabolic responses to glucagon stimulation in type 1 diabetes are similar to healthy controls. However, elevated glucose production was observed following the lowest glucagon dose in participants with type 1 diabetes compared with healthy controls, indicating enhanced glucagon sensitivity to low-dose glucagon stimulations.