bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a frailty index from the Dutch public health monitor 2016 and investigation of its psychometric properties: a cross-sectional study
Authors: Kleinenberg-Talsma Nanda , van der Lucht Fons , Jager-Wittenaar Harriët , Krijnen Wim , Finnema Evelyn 
Published: April 2023

Abstract
Background
Frailty in older adults is an increasing challenge for individuals, health care organizations and public health, both globally and in The Netherlands. To focus on frailty prevention from a public health perspective, understanding of frailty status is needed. To enable measurement of frailty within a health survey that currently does not contain an established frailty instrument, we aimed to construct a frailty index (FI) and investigate its psychometric properties.

Methods
We conducted a cross-sectional study using data from the Dutch Public Health Monitor (DPHM), including respondents aged ≥ 65 years (n = 233,498). Forty-two health deficits were selected based on literature, previously constructed FIs, face validity and standard criteria for FI construction. Deficits were first explored by calculating Cronbach’s alpha, point-polyserial correlations, and factor loadings. Thereafter, we used the Graded Response Model (GRM) to assess item difficulty, item discrimination, and category thresholds.

Results
Cronbach’s alpha for the 42 items was 0.91. Thirty-seven deficits showed strong psychometric properties: they scored above the cutoff values for point-polyserial correlations (0.3) or factor loadings (0.4) and had moderate to very high discrimination parameters (≥ 0.65). These deficits were retained in the scale. Retaining the deficits with favorable measurement properties and removing the remaining deficits resulted in the FI-HM37.

Conclusion
The FI-HM37 was developed, an FI with 37 deficits indicative of frailty, both statistically and conceptually. Our results indicate that health monitors can be used to measure frailty, even though they were not directly designed to do so. The GRM is a suitable approach for deficit selection, resulting in a psychometrically strong scale, that facilitates assessment of frailty levels using the DPHM.
Public private partnerships and water and sanitation infrastructure development in Zimbabwe: what determines financing?
Authors: Mundonde Justice , Makoni Patricia Lindelwa 
Published: April 2023

Abstract
Background
Zimbabwe envisions being an upper-middle-income economy by the year 2030. The vision 2030 has infrastructure development as a stand-out pillar upon which it is founded. The vision envisages well-developed, modern, efficient and resilient infrastructure as paramount to Zimbabwe’s economic recovery. The policy plan seeks to increase infrastructure investments in energy, transport, information technology, tourism, housing, and water and sanitation. However, a still hesitant private sector exists with regard to investment in water and sanitation infrastructure even in developed countries. Thus, the study seeks to analyse determinants of financing water and sanitation public private partnerships in Zimbabwe given that there is no consensus between reseachers on how determinant factors impact PPP investments.

Methods
The study applied Tobit regression methodology on data collected for the 25 years ending 2021 to investigate determinants of financing water sanitation PPPs in Zimbabwe. Tobit regression method is preferred given the censored nature of the investment values of water and sanitation public private partnerships that reached financial closure in Zimbabwe.

Results
In Zimbabwe, financial market development is a key financing determinant of water and sanitation public private partnerships. Both the capital and bank market development influences infrastructure financing in Zimbabwe`s water and sanitation sector. Moreover, foreign direct investment negatively and significantly relates with water and sanitation public private partnership investments.

Conclusion
Attracting private investment into Zimbabwe`s water and sanitation sector requires that policy design targets capital and bank market development. Reforms can be achieved through putting in place sound frameworks that facilitate effective financial intermediation systems, enhance market liquidity and lower cost of capital.
Three Gorges Dam: the changing trend of snail density in the Yangtze River basin between 1990 and 2019
Authors: Gong Yanfeng , Tong Yixin , Jiang Honglin , Xu Ning , Yin Jiangfan , Wang Jiamin , Huang Junhui , Chen Yue , Jiang Qingwu , Li Shizhu , Zhou Yibiao 
Published: April 2023

Abstract
Background
The area of Oncomelania hupensis snail remains around 3.6 billion m2, with newly emerging and reemergent habitats continuing to appear in recent years. This study aimed to explore the long-term dynamics of snail density before and after the operation of Three Gorges Dam (TGD).

Methods
Data of snail survey between 1990 and 2019 were collected from electronic databases and national schistosomiasis surveillance. Meta-analysis was conducted to estimate the snail density. Joinpoint model was used to identify the changing trend and inflection point. Inverse distance weighted interpolation (IDW) was used to determine the spatial distribution of recent snail density.

Results
A total of 3777 snail survey sites with a precise location of village or beach were identified. For the downstream area, snail density peaked in 1998 (1.635/0.11 m2, 95% CI: 1.220, 2.189) and fluctuated at a relatively high level before 2003, then declined steadily from 2003 to 2012. Snail density maintained lower than 0.150/0.11 m2 between 2012 and 2019. Joinpoint model identified the inflection of 2003, and a significant decreasing trend from 2003 to 2012 with an annual percentage change (APC) being − 20.56% (95% CI: − 24.15, − 16.80). For the upstream area, snail density peaked in 2005 (0.760/0.11 m2, 95% CI: 0.479, 1.207) and was generally greater than 0.300/0.11 m2 before 2005. Snail density was generally lower than 0.150/0.11 m2 after 2011. Snail density showed a significant decreasing trend from 1990 to 2019 with an APC being − 6.05% (95% CI: − 7.97, − 7.09), and no inflection was identified. IDW showed the areas with a high snail density existed in Poyang Lake, Dongting Lake, Jianghan Plain, and the Anhui branch of the Yangtze River between 2015 and 2019.

Conclusions
Snail density exhibited a fluctuating downward trend in the Yangtze River basin. In the downstream area, the operation of TGD accelerated the decline of snail density during the first decade period, then snail density fluctuated at a relatively low level. There still exists local areas with a high snail density. Long-term control and monitoring of snails need to be insisted on and strengthened.

Graphical Abstract
Cataracts in Havanese: genome wide association study reveals two loci associated with posterior polar cataract
Authors: Bellamy Kim K. L. , Lingaas Frode 
Published: April 2023

Abstract
Background
Cataract is considered an important health issue in Havanese, and studies indicate a breed predisposition. Possible consequences of cataracts include lens induced uveitis, reduced eyesight, and blindness in severe cases. Reducing the prevalence of cataracts could therefore improve health and welfare significantly. The most frequently diagnosed forms of cataract in Havanese are cortical- and anterior suture line cataract, but cases of posterior polar cataract are also regularly reported. Out of the three, posterior polar- and cortical cataracts are considered the most clinically relevant.

Results
We performed a genome wide association study that included 57 controls and 27 + 23 + 7 cases of cortical-, anterior suture line- and posterior polar cataract, respectively. An association analysis using a mixed linear model, revealed two SNPs on CFA20 (BICF2S23632983, p = 7.2e-09) and CFA21 (BICF2G630640490, p = 3.3e-09), that were significantly associated with posterior polar cataract, both of which are linked to relevant candidate genes. The results suggest that the two variants are linked to alleles with large effects on posterior polar cataract formation, possibly in a dominant fashion, and identifies regions that should be subject to further sequencing.
Promising regions on CFA4 and CF30 were also identified in the association analysis of cortical cataract. The top SNPs on each chromosome, chr4_12164500 (p = 4.3e-06) and chr30_28836339 (p = 5.6e-06), are located within, or in immediate proximity to, potential cataract candidate genes.
The study shows that age at examination is strongly associated with sensitivity of cataract screening. Havanese in Norway are on average 3.4 years old when eye examinations are performed: an age where most dogs that are genetically at risk have not yet developed clinically observable changes. Increasing the average age of breeding animals could increase accuracy of selection, leading to improved health.

Conclusions
The study identified two loci, on CFA20 and CFA21, that were significantly associated with posterior polar cataract in Havanese. SNPs that showed putative association with cortical cataracts, were observed on CFA4 and CFA30. All the top SNPs are located in close proximity to cataract candidate genes. The study also show that sensitivity of cataract screening is highly dependent on age at examination.
Cardiac and noncardiac biomarkers in patients undergoing anthracycline chemotherapy – a prospective analysis
Authors: Dean Matthew , Kim Min Jung , Dimauro Sharon , Tannenbaum Susan , Graham Garth , Liang Bruce T. , Kim Agnes S. 
Published: April 2023

Abstract
Background
Biomarkers represent a potential tool to identify individuals at risk for anthracycline-induced cardiotoxicity (AICT) prior to symptom onset or left ventricular dysfunction.

Methods
This study examined the levels of cardiac and noncardiac biomarkers before, after the last dose of, and 3–6 months after completion of doxorubicin chemotherapy. Cardiac biomarkers included 5th generation high-sensitivity cardiac troponin T (cTnT), N-terminal pro-brain natriuretic peptide, growth/differentiation factor-15 (GDF-15), and soluble suppression of tumorigenesis-2 (sST2). Noncardiac biomarkers included activated caspase-1 (CASP-1), activated caspase-3, C-reactive protein, tumor necrosis factor-α, myeloperoxidase (MPO), galectin-3, and 8-hydroxy-2’-deoxyguanosine. Echocardiographic data (LVEF and LVGLS) were obtained at pre- and post-chemotherapy. Subanalysis examined interval changes in biomarkers among high (cumulative doxorubicin dose ≥ 250 mg/m2) and low exposure groups.

Results
The cardiac biomarkers cTnT, GDF-15, and sST2 and the noncardiac biomarkers CASP-1 and MPO demonstrated significant changes over time. cTnT and GDF-15 levels increased after anthracycline exposure, while CASP-1 and MPO decreased significantly. Subanalysis by cumulative dose did not demonstrate a larger increase in any biomarker in the high-dose group.

Conclusions
The results identify biomarkers with significant interval changes in response to anthracycline therapy. Further research is needed to understand the clinical utility of these novel biomarkers.
Vagus nerve stimulation in the non-human primate: implantation methodology, characterization of nerve anatomy, target engagement and experimental applications
Authors: Suminski Aaron J. , Rajala Abigail Z. , Birn Rasmus M. , Mueller Ellie M. , Malone Margaret E. , Ness Jared P. , Filla Caitlyn , Brunner Kevin , McMillan Alan B. , Poore Samuel O. , Williams Justin C. , Murali Dhanabalan , Brzeczkowski Andrea , Hurley Samuel A. , Dingle Aaron M. , Zeng Weifeng , Lake Wendell B. , Ludwig Kip A. , Populin Luis C. 
Published: April 2023

Abstract
Background
Vagus nerve stimulation (VNS) is a FDA approved therapy regularly used to treat a variety of neurological disorders that impact the central nervous system (CNS) including epilepsy and stroke. Putatively, the therapeutic efficacy of VNS results from its action on neuromodulatory centers via projections of the vagus nerve to the solitary tract nucleus. Currently, there is not an established large animal model that facilitates detailed mechanistic studies exploring how VNS impacts the function of the CNS, especially during complex behaviors requiring motor action and decision making.

Methods
We describe the anatomical organization, surgical methodology to implant VNS electrodes on the left gagus nerve and characterization of target engagement/neural interface properties in a non-human primate (NHP) model of VNS that permits chronic stimulation over long periods of time. Furthermore, we describe the results of pilot experiments in a small number of NHPs to demonstrate how this preparation might be used in an animal model capable of performing complex motor and decision making tasks.

Results
VNS electrode impedance remained constant over months suggesting a stable interface. VNS elicited robust activation of the vagus nerve which resulted in decreases of respiration rate and/or partial pressure of carbon dioxide in expired air, but not changes in heart rate in both awake and anesthetized NHPs.

Conclusions
We anticipate that this preparation will be very useful to study the mechanisms underlying the effects of VNS for the treatment of conditions such as epilepsy and depression, for which VNS is extensively used, as well as for the study of the neurobiological basis underlying higher order functions such as learning and memory.
The utility of chemical shift imaging and related Dixon images in evaluation of bone marrow edema-like changes in diabetic foot
Authors: Allam Mohammad Fouad Abdel-Baki , El-Sherif Ashraf Mohamed Hassan , Helmy Amr Hamdy , Abdelgawad Ehab Ali , Mohammad Shimaa Shehata Mohammad , Abdel-Rahman Alshaimaa Mahfouz 
Published: April 2023

Abstract
Background
Magnetic resonance imaging (MRI) is the best diagnostic tool for suspected diabetic foot osteomyelitis (DFO); adding T1-based Dixon to MR technique can identify the bone marrow edema-like signal observed in neuropathic joints and differentiate it from that observed in DFO. The aim of this study was to assess the diagnostic efficacy of chemical shift imaging (T1 in-phase and out-of-phase) and related Dixon sequence in differentiation between infectious edema-like signal found in osteomyelitis and bland edema signals observed in osteomyelitis mimickers (as neuropathic arthropathy). The study was conducted on 50 patients who were referred by surgical outpatient clinics between January 2020 and January 2022; they underwent MRI of the foot including T1-Dixon sequence.

Results
There were variable bone and joint affection, and the most common location of bony affection in the study was the hind-foot. Forty-four out of fifty patients had bone marrow edema-like signals. Thirty-seven patients (74%) were diagnosed with osteomyelitis, whereas seven (14%) patients were diagnosed with non-infective/bland bone marrow edema signals which were related to Charcot arthropathy and/or nearby infection. Both visual and quantitative assessments of chemical shift imaging showed high sensitivity and specificity in diagnosis of DFO. The optimal cut-off point of signal intensity ratio for diagnosis of DFO was 1.005 with high sensitivity and specificity.

Conclusions
Chemical shift imaging and related Dixon sequence were reliable methods in diabetic foot evaluation; they could help differentiate infectious edema-like changes of osteomyelitis from and bland edema of osteomyelitis mimickers with high sensitivity and specificity especially on using quantitative analysis of their signal abnormality.
Relationships of 18F-FDG PET with tumor microenvironment immunotypes, especially PD-L1 and CD15 expression, and prognosis in oral squamous cell carcinoma
Authors: Seki Mai , Sano Takaaki , Ogawa Masaru , Yokoo Satoshi , Oyama Tetsunari 
Published: April 2023

Abstract
Background
The relationship between 2-[18F]-fluoro-2-deoxy-d-glucose–positron emission tomography (FDG-PET) findings and programmed death ligand-1 (PD-L1) expression has been reported in several cancers. We investigated the correlations of FDG uptake with immune cell counts, including myeloid-derived suppressor cells (MDSCs), and PD-L1 expression in the tumor microenvironment. We examined 72 patients with oral squamous cell carcinoma (OSCC) with immunohistochemistry data for PD-L1, CD8, S100A8, CD15, and CD33. We used the maximum standardized uptake value (SUVmax) to reflect FDG uptake in each patient.

Results
High SUVmax and high MDSC counts were associated with poor prognosis. Significantly higher SUVmax was found in patients with high PD-L1 expression and in those with a high CD15+ cell density (P = 0.03 and P = 0.02, respectively). In multiple regression analysis, the tumor size had the greatest effect on SUVmax (P < 0.001), followed by PD-L1 (P = 0.014), and when the tumor size was excluded, CD15 (P = 0.02) was included in the prediction equation. FDG uptake in some cold tumor subgroups, low PD-L1 expression, and a low CD8+ cell density was linked to significantly lower SUVmax than the other variables. High SUVmax was clearly associated with high PD-L1 expression and/or a high CD15+ cell density.

Conclusions
FDG uptake was affected by PD-L1 expression and the density of CD15+ cells in cancer tissue. FDG-PET may illuminate the tumor microenvironment immunotypes before biopsy or resection.
Effects of 6 weeks of ankle stability exercises on pain, functional abilities, and flexibility in patients with chronic non-specific low back pain: a randomized controlled trial
Authors: Abdelhaleem Mahmoud D. , Abdelhay Mohamed I. , Aly Sobhy M. , Abdallah Ehab A. , Neamat Allah Neama H. 
Published: April 2023

Abstract
Background
Due to delayed activation of the deep trunk muscles, patients with chronic non-specific low back pain use different adjustment strategies to maintain postural control. Patients with chronic non-specific low back pain maintain a quite standing posture during pain episode and challenging activities by using signals from other joints, mainly the ankle joint. Since proprioceptive signals from the ankle joint reduce postural control variability in patients with chronic non-specific low back pain, this study explored whether ankle stability exercises added to traditional physical therapy exercises would improve the intensity of pain, functional disabilities and lumbar flexion range of motion in patients with chronic non-specific low back pain.

Methods
Sixty patients with chronic non-specific low back pain participated in the current study. Patients were randomly assigned into two groups: group A and group B. Patients in group A received traditional physical therapy exercises for low back pain. Patients in group B received the same traditional physical therapy exercises as patients in group A, plus ankle stability exercises. The intensity of pain, functional disability, and lumbar flexion range of motion were assessed twice before and after a 6-week period during which each group received their interventions.

Results
Mixed design MANOVA revealed a significant decrease in visual analog scale and Oswestry Disability Index in group B compared to group A post treatment (p < 0.05). Moreover, there was a significant increase in the lumbar flexion range of motion in group B compared with group A post treatment (p < 0.05).

Conclusion
The findings of this study revealed that adding ankle stability exercises to the traditional physical therapy exercises significantly improved pain, Oswestry Disability Index, and lumbar flexion range of motion in patients with chronic non-specific low back pain. Thus, ankle strengthening and proprioceptive exercises may be beneficial in the management of chronic non-specific low back pain.
Fluid balance in critically ill children with lower respiratory tract viral infection: a cohort study
Authors: Robino Chiara , Toncelli Guido , Sorrentino Laura Arianna , Fioccola Antonio , Tedesco Brigida , Giugni Cristina , L’Erario Manuela , Ricci Zaccaria 
Published: April 2023

AbstractBackgroundIncreasing evidence has associated positive fluid balance of critically ill patients with poor outcomes. The aim of this study was to explore the pattern of daily fluid balances and their association with outcomes in critically ill children with lower respiratory tract viral infection.MethodsA retrospective single-center study was conducted, in children supported with high-flow nasal cannula, non-invasive ventilation, or invasive ventilation. Median (interquartile range) daily fluid balances, cumulative fluid overload (FO) and peak FO variation, indexed as the % of admission body weight, over the first week of Pediatric Intensive Care Unit admission, and their association with the duration of respiratory support were assessed.ResultsOverall, 94 patients with a median age of 6.9 (1.9–18) months, and a respiratory support duration of 4 (2–7) days, showed a median (interquartile range) daily fluid balance of 18 (4.5–19.5) ml/kg at day 1, which decreased up to day 3 to 5.9 (− 14 to 24.9) ml/kg and increased to 13 (− 11 to 29.9) ml/kg at day 7 (p = 0.001). Median cumulative FO% was 4.6 (− 0.8 to 11) and peak FO% was 5.7 (1.9–12.4). Daily fluid balances, once patients were stratified according to the respiratory support, were significantly lower in those requiring mechanical ventilation (p = 0.003). No correlation was found between all examined fluid balances and respiratory support duration or oxygen saturation, even after subgroup analysis of patients with invasive mechanical ventilation, or respiratory comorbidities, or bacterial coinfection, or of patients under 1 year old.ConclusionsIn a cohort of children with bronchiolitis, fluid balance was not associated with duration of respiratory support or other parameters of pulmonary function.
Increased GH/IGF-I Axis Activity Relates to Lower Hepatic Lipids and Phosphor Metabolism
Authors: Fellinger Paul , Beiglböck Hannes , Semmler Georg , Pfleger Lorenz , Smajis Sabina , Baumgartner Clemens , Gajdosik Martin , Marculescu Rodrig , Vila Greisa , Winhofer Yvonne , Scherer Thomas , Trauner Michael , Kautzky-Willer Alexandra , Krssak Martin , Krebs Michael , Wolf Peter 
Published: April 2023

Abstract

Context
Non-alcoholic fatty liver disease (NAFLD) is a leading causes of liver-related morbidity and mortality. While data on acromegaly, a state of chronic growth hormone (GH)/insulin-like growth factor I (IGF-I) excess, suggest an inverse relationship with intrahepatic lipid (IHL) content, less is known about the impact of the GH/IGF-I axis on IHL, lipid composition, and phosphor metabolites in individuals without disorders of GH secretion.

Objective
The aim was to investigate the relation between activity of the GH/IGF-I axis and IHL content and phosphor metabolism.

Methods
We performed a cross-sectional study in 59 otherwise metabolically healthy individuals (30 females), of which 16 met the criteria of NAFLD with IHL of ≥5.6%. The GH/IGF-I axis was evaluated in a fasting state and during an oral glucose tolerance test (OGTT). Insulin sensitivity was estimated by validated indices. IHL, lipid composition (unsaturation index), and phosphate metabolites were analyzed by using 1H/31P magnetic resonance spectroscopy.

Results
In the overall cohort (40.6 ± 15 years; body mass index: 24.5 ± 3 kg/m2; IGF-I: 68.0 ± 17% upper limit of normal), fasting GH (R = −0.31; P = .02), GH during oral glucose tolerance test (R = −0.51; P &lt; .01), and IGF-I (R = −0.28; P = .03) inversely correlated with IHL. GH levels during OGTT were significantly lower in NAFLD than in controls (47.7 [22; 143] ng/mL/min vs 16.8 [7; 32] ng/mL/min; P = .003). GH/IGF-I axis activity correlated with lipid composition and with phosphor metabolites. In multiple regression analysis, the GH/IGF-I axis activity was a strong predictor for IHL and lipid composition independent from insulin sensitivity.

Conclusion
GH/IGF-I axis activity impacts hepatic lipid and phosphate metabolism in individuals without disorders in GH secretion. Lower GH axis activity is associated with higher IHL and an unfavorable lipid composition, probably mediated by changes in hepatic energy metabolism.