bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment with anticancer drugs for advanced pancreatic cancer: a systematic review
Authors: Salazar Josefina , Bracchiglione Javier , Savall-Esteve Olga , Antequera Alba , Bottaro-Parra David , Gutiérrez-Valencia Marta , Martínez-Peralta Susana , Pericay Carles , Tibau Ariadna , Bonfill Xavier ,   Appropriateness of Systemic Oncological Treatments for Advanced Cancer (ASTAC) Research Group, Acosta-Dighero Roberto , Auladell-Rispau Ariadna , Cantero-Fortiz Yahveth , Hernandez Edgar , Irassar Juan , Meade Adriana-G , Meinardi Pamela , Merchán-Galvis Angela , Meza Nicolas , Quintana María Jesús , Requeijo Carolina , Rodriguez-Grijalva Gerardo , Salas-Gama Karla , Santero Marilina , Savall-Esteve Olga , Selva Anna , Solà Ivan , Urrútia Gerard 
Published: August 2023

Abstract
Background
Patients with advanced pancreatic cancer have a poor prognosis and high burden of cancer-related symptoms. It is necessary to assess the trade-off of clinical benefits and possible harms of treatments with anticancer drugs (TAD). This systematic review aims to compare the effectiveness of TAD versus supportive care or no treatment, considering all patient-important outcomes.

Methods
We searched PubMed, Embase, Cochrane Library, and Epistemonikos. Two reviewers performed selection, data extraction and risk of bias assessment. We assessed certainty of the evidence using the GRADE approach.

Results
We included 14 randomised controlled trials. Chemotherapy may result in a slight increase in overall survival (MD: 2.97 months (95%CI 1.23, 4.70)) and fewer hospital days (MD: -6.7 (-8.3, -5.1)), however, the evidence is very uncertain about its effect on symptoms, quality of life, functional status, and adverse events. Targeted/biological therapy may result in little to no difference in overall survival and a slight increment in progression-free survival (HR: 0.83 (95%CI 0.63, 1.10)), but probably results in more adverse events (RR: 5.54 (95%CI 1.24, 23.97)). The evidence is very uncertain about the effect of immunotherapy in overall survival and functional status.

Conclusions
The evidence is very uncertain about whether the benefits of using treatment with anticancer drugs outweigh their risks for patients with advanced pancreatic cancer. This uncertainty is further highlighted when considering immunotherapy or a second line of chemotherapy and thus, best supportive care would be an appropriate alternative. Future studies should assess their impact on all patient-important outcomes to inform patients in setting their goals of care.
Evaluating the effect of the COVID-19 pandemic on hypertension and diabetes care in South Korea: an interrupted time series analysis
Authors: Sim Boram , Kim Sunmi , Nam Eun Woo 
Published: August 2023

Abstract
Background
Access to healthcare services is important, especially for patients with chronic diseases. We evaluated the effect of the COVID-19 pandemic on outpatient visits and medication for patients with hypertension and diabetes in South Korea.

Methods
Nationwide claims data were extracted for patients with hypertension and diabetes from January 2019 to July 2020. We used an interrupted time series (ITS) analysis to evaluate the pandemic’s impact on outpatient care using the number of outpatient visits and days of medication supplied per visit. We identified the change in the continuity of care in medication, a consequence of the change in outpatient care, using the Medication Possession Ratio (MPR).

Results
The number of outpatient visits for diabetes significantly declined in February 2020, when community transmission began. However, when high-intensity social distancing was relaxed in April 2020, outpatient visits for hypertension and diabetes rebounded significantly. Moreover, when the outpatient visits declined, the number of days of medication supplied per visit increased. Consequently, the average MPRs significantly increased compared to 2019, increasing the ratio of patients with appropriate medication supply (MPR ≥ 0.8).

Conclusions
Outpatient visits decreased immediately when COVID-19 spread to local communities. However, the number of days of medication supplied per visit increased to compensate for the longer intervals between visits. Rather, the change in the continuity of care in medication improved; thus, the temporary decrease in outpatient visits might have had a limited negative impact on health outcomes.
Effect of multiple chronic conditions on family doctor contracting in the elderly in China: the moderating role of socioeconomic status
Authors: Lv Bo , Zhang Ling , Meng Kai 
Published: August 2023

Abstract
Background
China's family doctor contracting service is an important part of deepening the reform of the healthcare systems, aiming to further develop chronic disease management services, enhance the capacity of primary health care services and improve the health of residents. The purpose of this study was to explore the influence of multiple chronic conditions in the elderly on family doctor contracting and whether socioeconomic status played a moderating role.

Methods
A cross-sectional survey was conducted in Beijing, China. A total of 1814 elderly people over 60 years old were included in this study using a whole-group sampling method. The univariate analysis and logistic regression analysis was used to analyze the data.

Results
21.72% of the elderly signed up with family doctors. The multiple chronic conditions was a factor influencing the elderly to sign up with family doctors (OR = 1.44, 95%CI = 1.28–1.61), and the higher the degree of multiple chronic conditions, the stronger willingness to sign up. Socioeconomic status positively moderates the effect of multiple chronic conditions on signing. Also, physical activity intensity (OR = 1.25, 95%CI = 1.03–1.54) and willingness to first visit primary care facilities (OR = 1.38, 95%CI = 1.25–1.54) influenced the elderly to sign up with family doctors.

Conclusions
The elderly with a high degree of multiple chronic conditions, high activity intensity, and a strong willingness to first visit primary care facilities were more likely to sign up with family doctors. The health literacy of the elderly should be further improved, and publicity on the family doctor contracting service policies for the elderly with lower socioeconomic status should be strengthened to guide them to sign up with family doctors. At the same time, the service capacity of primary care facilities should be further improved to meet the health needs of the elderly.
Clustering of lifestyle behaviors and adiposity in early adolescents in Spain: findings from the SI! Program for Secondary Schools
Authors: Bodega Patricia , Santos-Beneit Gloria , de Cos-Gandoy Amaya , Moreno Luis A. , de Miguel Mercedes , Orrit Xavier , Tresserra-Rimbau Anna , Martínez-Gómez Jesús , Ramírez-Garza Sonia L. , Laveriano-Santos Emily P. , Arancibia-Riveros Camila , Estruch Ramón , Lamuela-Raventós Rosa M. , Fernández-Jiménez Rodrigo , Fernández-Alvira Juan M. 
Published: August 2023

Abstract
Background
Several unhealthy lifestyle behaviors in adolescence are often linked to overweight/obesity. Some of them may be present simultaneously, leading to combined effects on health. Therefore, the clustering of several unhealthy behaviors in adolescents might be associated with adiposity excess.

Purpose
To identify lifestyle patterns and analyze their association with adiposity in early adolescents.

Methods
A cross-sectional cluster analysis was performed in 1183 adolescents (50.5% girls) with a mean age of 12.5 (0.4) years included in the SI! Program for Secondary Schools in Spain to identify lifestyle patterns based on healthy diet, step counts, sleep time, and leisure screen time. Generalized mixed models were applied to estimate the association between lifestyle patterns and adiposity indices.

Results
Four lifestyle patterns were derived: Cluster 1-higher screen time and poorer diet (n = 213), Cluster 2-lower activity and longer sleepers (n = 388), Cluster 3-active and shorter sleepers (n = 280), and Cluster 4-healthiest (n = 302). Except for the number of steps (12,008 (2357) day), the lifestyle behaviors in our sample presented levels far below the recommendations, especially for sleep duration. Cluster 4 included the largest proportion of adolescents from high socioeconomic status families (47.7%) and the lowest prevalence of overweight/obesity (23.1%). Compared to Cluster 4-healthiest, adolescents in the remaining clusters presented a higher prevalence of overweight/obesity and central obesity, showing Cluster 3 the highest prevalences (PR:1.31 [95%CI: 1.31, 1.31] and PR:1.40 [95%CI: 1.33, 1.47]).

Conclusions
Clustering of lifestyle patterns in early adolescence allows the identification of individuals with excess adiposity, in whom health promotion strategies should be stressed, especially in socioeconomically disadvantaged groups.

Trial registration
Clinical Trial Registry, NCT03504059. Registered 20/04/2018—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03504059.
Prevalence and risk factors of anemia in the mother–child population from a region of the Colombian Caribbean
Authors: Del Castillo Lisetta , Cardona-Castro Nora , Whelan Denis R. , Builes John Paul , Serrano-Coll Héctor , Arboleda Margarita , Leon Juan S. 
Published: August 2023

Abstract
Background
Despite Colombia's robust well-child visits program, Colombian children and mothers still suffer from anemia, especially in populations of lower socioeconomic status. In this study, we aimed to quantify the prevalence and risk factors among mothers and their children attending their well-child visits in Apartadó, a municipality in the Urabá region of the Colombian Caribbean.

Methods
There were 100 mother–child pairs enrolled in this secondary data-analysis study from a health facility in the municipality of Apartadó, Urabá, Colombia, during well-child visits. Self-reported data included child illnesses in the past two weeks (diarrheal, fever, or respiratory symptoms), child feeding practices (breastfeeding, complementary feeding), child vaccinations, and demographic characteristics (mother’s and child’s age, mother’s education, marital status, race, and child sex) and socioeconomic status. Mother and child anthropometry data were collected via standardized weight and height measurements. Mother or child anemia status was collected via a blood test. Chi-squared tests and multivariable logistic regression were used to assess associations between risk factors and anemia.

Result
The anemia prevalence in children (74%) and mothers (47%) was higher than the Colombian national prevalence. Reported child comorbidities in the preceding two weeks were not significantly associated with child anemia and included respiratory illnesses (60%), fever (46%), and diarrhea (30%). Stunting (8%) was not significantly associated with anemia. Wasting (0%) was not observed in this study. Reported child breastfeeding and complementary feeding were also not significantly associated with child anemia. In adjusted models, the child's significant risk factors for anemia included the mother's "Mestiza" race (OR: 4.681; 95% CI: 1.258, 17.421) versus the Afro-Colombian race. Older children (25–60 months) were less likely to develop anemia than younger (6–24 months) children (OR: 0.073; 95% CI: 0.015, 0.360).

Conclusions
The finding of high anemia prevalence in this study advances our understanding of child and maternal anemia in populations of low socioeconomic status where health care is regularly accessed through well-child programs.
The prevalence and economic burden of treatment-resistant depression in Thailand
Authors: Prasartpornsirichoke Jirada , Pityaratstian Nuttorn , Poolvoralaks Chayanit , Sirinimnualkul Naphat , Ormtavesub Tanaporn , Hiranwattana Nimmavadee , Phonsit Sasitorn , Rungnirundorn Teerayuth 
Published: August 2023

Abstract
Background
The objectives of this study were to investigate the proportion of treatment-resistant depression (TRD) among patients with diagnosed major depressive disorder (MDD) and undergoing antidepressant treatment, to estimate the economic cost of MDD, TRD, and non-treatment-resistant depression (non-TRD), and to examine the differences between TRD and non-TRD MDD in a Thai public tertiary hospital.

Methods
This was a combined study between retrospective review of medical records and a cross-sectional survey. The sample size was 500 dyads of antidepressant-treated MDD patients and their unpaid caregivers. MDD patients’ medical records, the concept of healthcare resource utilization, the Work Productivity and Activity Impairment Questionnaire: depression and mood & mental state versions (WPAI: D, MM), the Class Impairment Questionnaire (CIQ), and the Family Experiences Interview Schedule (FEIS) were applied as the tools of the study. Pearson Chi’s square, Fisher’s Exact test, and independent T-test were employed for statistical analysis.

Results
The proportion of TRD was 19.6% among antidepressant-treated MDD patients in a Thai tertiary public hospital. The results of the study indicated that several factors showed a statistically significant association with TRD criteria. These factors included younger age of MDD patients, a younger age of onset of MDD, lower body mass index (BMI), a history of suicide attempts and self-harm, as well as frequent smoking behavior. The annualized economic cost of TRD was 276,059.97 baht per person ($7,668.33), which was significantly higher than that of cost of non-TRD (173,487.04 baht or $4,819.08). The aggregated economic costs of MDD were 96.8 million baht annually ($2.69 M) if calculated from 500 MDD patients and unpaid caregivers. This contributed to the economic cost of TRD 27.05 million baht (98 respondents) and the economic cost of non-TRD 69.74 million baht (402 respondents).

Conclusions
The economic burden associated with TRD was significantly higher compared to non-TRD among antidepressant-treated MDD patients. Specifically, both direct medical costs and indirect costs were notably elevated in the TRD group.
Socioeconomic inequality, health inequity and well-being of transgender people during the COVID-19 pandemic in Nigeria
Authors: Folayan Morenike Oluwatoyin , Yakusik Anna , Enemo Amaka , Sunday Aaron , Muhammad Amira , Nyako Hasiya Yunusa , Abdullah Rilwan Mohammed , Okiwu Henry , Lamontagne Erik 
Published: August 2023

AbstractBackgroundWe aimed to explore socioeconomic inequality, health inequity, and the well-being of transgender people during the COVID-19 crisis in Nigeria.MethodsBetween June and December 2021, a cross-sectional survey was conducted collaboratively with community-based organisations in Nigeria. Participants living with or at risk of HIV were recruited voluntarily, online and face-to-face, using a combination of venue-based and snowball sampling. We assessed the association between gender identity (transgender and vulnerable cisgender women), and (i) socioeconomic inequality measured with socioeconomic status, social status, economic vulnerability, macrosocial vulnerability; (ii) health inequity measured with self-assessment of health, recency of HIV test, access to HIV and sexual and reproductive health services, gender-affirming care, financial and non-financial barriers to accessing health services; and (iii) well-being, measured with gender-based violence, mental health, psychoeconomic preferences. We used multivariable logistic regressions and controlled for interactions and confounders.ResultsThere were 4072 participants; 62% were under 30, and 47% reported living with HIV. One in ten (11.9%;n = 485) was transgender, and 56.5% reported living with HIV. Compared to vulnerable cisgender women, the results showed significantly higher odds (aOR:3.80) of disruption in accessing HIV services in transgender participants; gender-based violence (aOR:2.63); severe (aOR:2.28) symptoms of anxiety and depression. Among the barriers to accessing health and HIV services, transgender had three-time higher odds of reporting additional non-official fees compared to vulnerable cisgender women. The disclosure of their gender identity or sexual orientation was the most important non-financial barrier to accessing health services (aOR:3.16). Transgender participants faced higher housing insecurity (aOR: 1.35) and lower odds of using drugs (aOR:0.48). Importantly, they are more likely to have performed a recent HIV test and less likely to not know their HIV status (aOR:0.38) compared to vulnerable cisgender women.ConclusionsSocioeconomic inequality, health and well-being inequity in transgender people appear to be exacerbated by the COVID-19 pandemic in Nigeria. Interventions are necessary to mitigate socioeconomic challenges, address structural inequality, and ensure equitable access to health services to meet the Sustainable Development Goals for transgender people.
Demographic and clinical profile of an inception cohort of road trauma survivors
Authors: Pei Lulu X. , Chan Herbert , Shum Leona K. , Jae Lina , Staples John A. , Taylor John A. , Harris Devin R. , Brubacher Jeffrey R. 
Published: August 2023

Abstract
Background
Road trauma is a major public health concern, often resulting in reduced health-related quality of life and prolonged absenteeism from work even after so-called ‘minor’ injuries that do not result in hospitalization. This manuscript compares pre-injury health, sociodemographic characteristics and injury details between age, sex, and road user categories in a cohort of 1,480 road trauma survivors.

Methods
This was a prospective observational inception cohort study of road trauma survivors recruited between July 2018 and March 2020 from three trauma centres in British Columbia, Canada. Participants were aged ≥ 16 years and arrived in a participating emergency department within 24 h of involvement in a motor vehicle collision. Data were collected from structured interviews and review of medical records.

Results
The cohort of 1,480 road trauma survivors included 280 pedestrians, 174 cyclists, 118 motorcyclists, 683 motor vehicle drivers, and 225 passengers. Median age was 40 (IQR = [27, 57]) years; 680 (46%) were female. Males and younger patients were significantly more likely to report better pre-injury physical health. Motorcyclists and cyclists tended to report better physical health and less severe somatic symptoms, whereas pedestrians and motor vehicle drivers reported better mental health. Injury severity and hospital admission rates were higher in pedestrians and motorcyclists and lower in motorists. Upper and lower extremity injuries were most common in pedestrians, cyclists and motorcyclists, whereas neck injuries were most common in motor vehicle drivers and passengers.

Conclusions
In a large cohort of road trauma survivors, overall injury severity was low. Motorcyclists and pedestrians, but not cyclists, had more severe injuries than motorists. Extremity injuries were more common in vulnerable road users. Future research will investigate one-year recovery outcomes and identify risk factors for poor recovery.
Does the use of intraoperative measurement reduce limb length discrepancies after total hip arthroplasty?
Authors: Wu Junzhe , Zhuang Xunrong , Lin Chaohui , He Lijiang , Zhang Rongmou 
Published: August 2023

Abstract
Purpose
Postoperative limb length discrepancy (LLD) is a common complication of total hip arthroplasty, and several methods exist to prevent LLD, but each has its benefits and drawbacks. The study investigates the application of intraoperative lower limb length measurement in preventing postoperative LLD.

Methods
This study retrospectively analyzed 70 patients who underwent total hip arthroplasty from October 2018 to July 2022. The length of the lower limb on the operated side was measured intraoperatively using a sterilized paper ruler after the fitting of the trial mould and compared with the healthy side. Then the prosthesis size, depth and neck length were adjusted accordingly.

Results
The absolute value of postoperative LLD was found to be 6.68 ± 4.48 mm, of which 53 cases (75.7%) were less than or equal to 10 mm, while 30 patients (42.9%) were less than or equal to 5 mm.

Conclusion
The use of intraoperative measurement is effective in reducing LLD after total hip arthroplasty.
Breast conservation therapy decreased heart-specific mortality in breast cancer patients compared with mastectomy
Authors: Li Zhi , Zhao Ruipeng 
Published: August 2023

Abstract
Aim
To investigate the impacts of breast conservation therapy (BCT) and mastectomy on heart-specific mortality in breast cancer patients.

Methods
Patients with primary breast cancer registered in the Surveillance, Epidemiology, and End Results (SEER) database between Jan 1998 and Dec 2015 were included. Patients were divided into either breast conservation therapy or mastectomy group. To compare mortality caused by heart diseases in breast cancer patients with BCT or mastectomy, univariate and multivariate regression after propensity score matching (PSM) were performed. Kaplan-Meier analysis was also used to evaluate heart-specific survival between two groups.

Results
132,616 patients with breast cancer were enrolled in this study. After PSM, four risk factors including age, race, marital status and types of surgery were identified significantly associated with death from heart diseases. Heart-specific survival analysis further showed that overall, BCT poses a lower risk to heart-specific mortality compared with mastectomy.

Conclusion
Compared with mastectomy, BCT significantly decreased heart-specific mortality in breast cancer patients.