bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elevated non-HDL-C/HDL-C ratio increases the 1-year risk of recurrent stroke in older patients with non-disabling ischemic cerebrovascular events: results from the Xi’an Stroke Registry Study of China
Authors: Liu Zhongzhong , Lin Xuemei , Zeng Lingxia , Zhang Huan , Guo Weiyan , Lu Qingli , Huang Congli , Wang Jing , Liu Pei , Chang Qiaoqiao , Zhang Mi , Huo Yan , Wang Yan , Wang Fang , Wu Songdi 
Published: July 2023

Abstract
Background
Few studies have explored the prognostic role of nontraditional lipid-related indicators in non-disabling ischemic cerebrovascular events (NICE). In this study, we aimed to investigate the relationship between the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (non-HDL-C/HDL-C) and the1-year risk of recurrent stroke in patients with NICE.

Methods
Total cholesterol (TC), HDL-C, and patient information were collected at admission. Recurrent stroke events were followed up 3, 6, and 12 months after onset. Non-HDL-C levels were calculated by subtracting HDL-C from TC. The non-HDL-C/HDL-C ratio was treated as a continuous variable and in quartiles (Q1–Q4). Stratified multivariate Cox regression was used to investigate the relationship between the non-HDL-C/HDL-C ratio and the 1-year risk of recurrent stroke in patients with NICE.

Results
Overall, 1,659 patients with NICE were enrolled. For each unit increase in the non-HDL-C/HDL-C ratio, the 1-year risk of recurrent stroke in patients aged ≥ 65 years (older patients) with NICE increased by 64% in the adjusted model (hazard ratio [HR]: 1.64, 95%confidence interval [CI]:1.18–2.27, P = 0.003), and the HRs were 3.21 and 4.24 times higher in the Q3 and Q4 groups than that in the Q1 group, which was considered to be the reference (adjusted model Q3: HR: 3.21, 95%CI: 1.05–9.83, P = 0.041; adjusted model Q4: HR: 4.24, 95%CI: 1.30–13.85, P = 0.017). However, there was no significant difference in patients younger than 65 years. Both curve fitting and Kaplan–Meier cumulative risk analysis showed that an elevated non-HDL-C/HDL-C ratio significantly increased the 1-year risk of recurrent stroke in older patients with NICE. The optimal range for the non-HDL-C/HDL-C ratio should be no higher than the Q2 group (2.256–2.939). Stratified Cox regression analysis showed that these results tended to be stable for different comorbidities (all P for interaction > 0.05).

Conclusions
Elevated non-HDL-C/HDL-C ratios significantly increased the 1-year risk of recurrent stroke in older patients with NICE. Therefore, clinicians need to pay more attention to this indicator when managing older patients with NICE.
A method of motion estimation of segmental ventricular wall with tracking of ultrasonic echocardiogram
Authors: Liu Shanna , Zhang Hao , Li Chang , Dai Weifang , Wu Jinyu , Wu Yuanyuan , Su Wenwen , Xia Bin , Zhou Jiayu , Shen Yuqiang , Zhu Xinjian 
Published: July 2023

AbstractBackgroundUltrasonic echocardiography is commonly used for monitoring myocardial dysfunction. However, it has limitations such as poor quality of echocardiography images and subjective judgment of doctors.MethodsIn this paper, a calculation model based on optical flow tracking of echocardiogram is proposed for the quantitative estimation motion of the segmental wall. To improve the accuracy of optical flow estimation, a method based on confidence-optimized multiresolution(COM) optical flow model is proposed to reduce the estimation errors caused by the large amplitude of myocardial motion and the presence of “shadows” and other image quality problems. In addition, motion vector decomposition and dynamic tracking of the ventricular region of interest are used to extract information regarding the myocardial segmental motion. The proposed method was validated using simulation images and 50 clinical cases (25 patients and 25 healthy volunteers) for myocardial motion analysis.ResultsThe results demonstrated that the proposed method could track the motion information of myocardial segments well and reduce the estimation errors of optical flow caused due to the use of low-quality echocardiogram images.ConclusionsThe proposed method improves the accuracy of motion estimation for the cardiac ventricular wall.
Association between physical activity education and prescription during prenatal care and maternal and fetal health outcomes: a quasi-experimental study
Authors: Saidi Latifa , Godbout Pierre D. , Morais-Savoie Camille , Registe Pierre Philippe Wilson , Bélanger Mathieu 
Published: July 2023

Abstract
Background
Physical activity (PA) during pregnancy is associated with healthy gestational weight gain (GWG) and a reduced risk of developing gestational diabetes (GD), gestational hypertension (GHT) and fetal macrosomia. However, in Canada, less than 20% of pregnant women meet PA recommendations. This study assessed associations between an intervention including PA education by prenatal nurses and a PA prescription delivered by physicians and fetal and maternal outcomes.

Methods
This is a quasi-experimental study. Two groups of women who received their prenatal care at the obstetrics clinic of a university hospital were created. In the first group, 394 pregnant women followed at the clinic received standard care. In the second group, 422 women followed at the clinic received standard care supplemented with education on the relevance of PA during pregnancy and a prescription for PA. Data for both study groups were obtained from the medical records of the mothers and their newborns. Logistic regressions were used to compare the odds of developing excessive GWG, GD, GHT, and fetal macrosomia between the two study groups.

Results
The addition of PA education and PA prescription to prenatal care was associated with 29% lower odds of developing excessive GWG (adjusted odds ratios (OR) 0.71, 95% confidence intervals (CI) 0.51–0.99), 73% lower odds of developing GHT (0.27, 0.14–0.53), 44% lower odds of fetal macrosomia (> 4 kg) (0.56, 0.34–0.93), and 40% lower odds of being large for gestational age (0.60, 0.36–0.99). The intervention was not associated with a difference in odds of developing GD (0.48, 0.12–1.94).

Conclusions
The inclusion of education and prescription of PA as part of routine prenatal care was associated with improvements in maternal and fetal health outcomes, including significantly lower odds of GWG, GHT and macrosomia.
Developing tumor-specific PRO-CTCAE item sets: analysis of a cross-sectional survey in three German outpatient cancer centers
Authors: Günther Maximilian , Hentschel Leopold , Schuler Markus , Müller Theresa , Schütte Katharina , Ko Yon-Dschun , Schmidt-Wolf Ingo , Jaehde Ulrich 
Published: July 2023

Abstract
Background
To include the patient perspective in the assessment of adverse events in oncology, a patient-reported outcomes (PRO) version of the Common Terminology Criteria for Adverse Events (CTCAE) was developed by the US National Cancer Institute, the so called PRO-CTCAE. The objective of this study was the development of disease-specific PRO-CTCAE item sets for patients with breast cancer (BC), multiple myeloma (MM), and prostate cancer (PC).

Methods
The cross-sectional survey was conducted at three German outpatient cancer centers. Prevalence and importance of the 78 PRO-CTCAE symptoms were assessed using a patient questionnaire. To select the most relevant PRO-CTCAE items for each tumor entity, symptoms were ranked based on patient answers.

Results
101 patients with BC, 107 with MM, and 66 with PC participated. The final item sets contained 21 symptoms (BC) or 19 symptoms (MM and PC), respectively. Eight symptoms (fatigue, muscle pain, insomnia, joint pain, general pain, dizziness, shortness of breath, and swelling) were represented in all three item sets. Fatigue was the symptom with the highest ranking across item sets followed by insomnia. Symptoms with the highest rankings represented in only one item set were symptoms affecting the urogenital system in the PC item set, blurred vision in the BC item set, and decreased appetite in the MM item set.

Conclusions
Individual PRO-CTCAE item sets for a German patient population were developed for the three tumor entities on the basis of patients’ differences in symptom profiles and perceptions. The quality and psychometric criteria of the newly compiled item sets should be evaluated in validation studies.
Treatment compliance among adult cervical cancer patients receiving care at Uganda cancer institute, Uganda: a retrospective data review
Authors: Najjemba Josephine Irene , Ndagire Regina , Mulamira Pius , Kibudde Solomon , Lwanira Catherine Nassozi 
Published: July 2023

Abstract
Background
Cervical cancer is one of the most common cancers and a major cause of morbidity among women globally. Chemoradiation therapy is the preferred standard treatment for women with stage IB to IVA. However, the benefits of this treatment can only be achieved if patients adhere to the treatment guidelines. In this study, the proportion of compliance or adherence to chemo-radiation treatment among cervical cancer patients at Uganda Cancer Institute (UCI) was determined.

Methods
This was a cross-sectional study that reviewed data retrospectively for 196 cervical cancer patients who were prescribed to chemo-radiation therapy at UCI between November 2020 to May 2021, having been diagnosed with disease stage IB to IVA. Patient data and information on treatment uptake was obtained by review of the patient’s medical records. Treatment compliance was determined by calculating the number of participants who completed the prescribed treatment (definitive pelvic concurrent chemoradiation to 50 Gy external beam radiotherapy with weekly concurrent cisplatin followed by intracavitary brachytherapy 24 Gy in 3 fractions at 8 Gy once a week over 3 weeks). Associations between patient factors and treatment adherence were determined using logistic regression analysis. In all statistical tests, a P- value of < 0.05 was considered as significant.

Results
The proportion of patients who were administered with external beam radiation (EBRT), chemotherapy and brachytherapy were 82.6%, 52.04% and 66.2% respectively. However, only 23 of 196 patients (11.7%) were found to have adhered to the treatment plan by completion of all definitive pelvic concurrent chemoradiation to 50 Gy external beam radiotherapy (5 weeks) with weekly concurrent cisplatin (5 cycles) followed by intracavitary brachytherapy 24 Gy in 3 fractions at 8 Gy once a week over 3 weeks (3 sessions). There were no significant associations between patient factors and treatment adherence after multivariable analysis.

Conclusions
Treatment compliance was found in only 12% of the cohort participants. No association of patient factors with treatment compliance was found. Additional studies on treatment adherence with larger sample sizes are needed to confirm the associations.
The government of masks in sentinel territories against Covid-19: Dakar and Seine-Saint-Denis
Authors: Keck Frédéric , Macia Enguerran 
Published: July 2023

AbstractThe pandemic of Covid-19 has led to reluctance or resistance to wear a mask in countries that made it compulsory. The acceptance to wear a mask against respiratory diseases depends on conceptions of scientific authority and of the personality in the public space. It has material and symbolic dimensions that can be covered under the term “government of masks”. We have questioned populations on these two aspects in territories we call sentinel because they are more exposed than others to emerging infectious diseases: Dakar (Senegal) and Seine-Saint-Denis (France). In France, school students have asked 250 people in public places on their perception of masks following a questionnaire, while in Senegal a team of master students went in 606 people’s houses to ask questions following the same questionnaire. Despite these methodological differences, our results show that the perception of the State in these territories influences the uses of masks against Covid-19 at symbolic and material levels. While in Seine-Saint-Denis, the State provides more masks than in Dakar, the trust in the efficacy of mask wearing is lower. From a symbolic point of view, the mask is for many people an intrusion of the State into the private sphere, which hinders physical contact between family members. On the contrary, from the material point of view, the mask is a need that manifests the presence of the welfare State to watch over the health of the population. This comparative study suggests that a State that is at the same time coercive and protective produces a lower level of adherence to mask-wearing recommendations than a State where religious authorities are included in the prescription and where individuals contribute to making masks.
School health promotion and the consumption of water and sugar-sweetened beverages in secondary schools: a cross-sectional multilevel study
Authors: Vonk Lisanne , Eekhout Iris , Huijts Tim , Levels Mark , Jansen Maria W. J. 
Published: July 2023

Abstract
Background
Overweight among adolescents remains a serious concern worldwide and can have major health consequences in later life, such as cardiovascular diseases and cancer. Still, 33% of secondary school adolescents in the Netherlands consume sugar-sweetened beverages daily and over 26% do not consume water every day. The Dutch Healthy School program was developed to support schools in stimulating healthier lifestyles by focusing on health education, school environments, identifying students’ health problems, and school policy. We examined the variation between secondary schools regarding the daily consumption of water and sugar-sweetened beverages and whether this variation can be explained by differences between schools regarding Healthy School certification, general school characteristics, and the school population.

Methods
We performed a cross-sectional multilevel study. We used data from the national Youth Health Monitor of 2019 on secondary schools (grades 8 and 10, age range about 12 to 18 years) of seven Public Health Services and combined these with information regarding Healthy School certification and general school- and school population characteristics. Our outcomes were daily consumption of water and sugar-sweetened beverages. In total, data from 51,901 adolescents from 191 schools were analysed. We calculated the intraclass correlation to examine the variation between schools regarding our outcomes. Thereafter, we examined whether we could explain this variation by the included characteristics.

Results
The school-level explained 4.53% of the variation in the consumption of water and 2.33% of the variation in the consumption of sugar-sweetened beverages. This small variation in water and sugar-sweetened consumption could not be explained by Healthy School certification, yet some general school- and school population characteristics did: the proportion of the school population with at least one parent with high educational attainment, the educational track of the adolescents, urbanicity (only for water consumption) and school type (only for sugar-sweetened beverages consumption).

Conclusions
The low percentages of explained variation indicate that school-level characteristics in general (including Healthy School certification) do not matter substantially for the daily consumption of water and sugar-sweetened beverages. Future research should examine whether school health promotion can contribute to healthier lifestyles, and if so, under which level of implementation and school conditions.
Risk factors for newly-developed cardiovascular disease and quality of life during the COVID − 19 pandemic: an analysis of the English longitudinal study of ageing
Authors: Patel Mubarak , Uthman Olalekan 
Published: July 2023

Abstract
Introduction
The COVID-19 pandemic had a wide range of effects on the English population, including on health and quality of life due to the subsequent lockdown restrictions set.

Aims
To investigate longitudinal changes in developing cardiovascular disease (CVD) and how that affects quality of life from pre-pandemic and during two lockdowns in England, in adults aged 50 years and above, and what factors are associated with this.

Methods
Wave 9 of the core English Longitudinal Study of Ageing (ELSA) and Waves 1 and 2 of the ELSA COVID-19 sub-study were used to investigate the factors associated with developing CVD between timepoints, and what factors alongside CVD are associated with quality of life.

Results
Higher age and depression were associated with newly-developed CVD from pre-COVID to both COVID sub-study waves. Additionally, body mass index (BMI) increased odds of CVD and physical activity decreased odds. Non-White ethnicity, depression, females, and developing CVD were lower associated with quality of life. Decreased age and increased physical activity were associated with higher quality of life.

Discussion
Ethnicity was not associated with newly-developed CVD but was associated with quality of life. Other factors of importance include age, depression, gender, and physical activity. Findings are informative for future risk stratification and treatment strategies, especially while the COVID-19 pandemic is ongoing.
Effects of adverse childhood health experiences on cognitive function in Chinese middle-aged and older adults: mediating role of depression
Authors: Wang Gaoling , Zhou Yuqin , Duan Jing , Kan Qianqian , Cheng Zhaopeng , Tang Shaoliang 
Published: July 2023

Abstract
Background
Adverse childhood experiences are critical factors in depression and cognitive decrease, but the effect of adverse childhood health experiences (ACHEs) on cognitive function and the role of depression have not been fully studied.

Methods
Data were taken from the China Health and Retirement Longitudinal Study (CHARLS) of 2014 and 2018. This study used indicators of situational memory ability and mental status to measure cognitive capacity. Besides analyzing the different types of ACHEs, scores for ACHEs were calculated to represent the severity of ACHEs. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depression. The analysis of this study employed two different analytical strategies in order to examine the mediated effects of depression. We used Sobel’s test and Baron and Kenny’s causal step approach, which utilized a generalized least squares regression model. Furthermore, a logistic regression model was used to evaluate the robustness of the Karlson-Holm-Breen (KHB) approach.

Results
In this study, 6301 individuals who met the requirements of the study were included. We found that being confined to bed (ACHE3) (β=-0.3846, p = 0.022) in childhood had a negative impact on cognitive function. Similarly, ACHEs had a negative effect on cognitive function (β=-0.0819, p = 0.090). And after the depression had been introduced into the model, the regression coefficient of ACHEs on cognitive function was no longer significant (β=-0.0170, p = 0.727). The Sobel test showed that for ACHE3, the mediated proportion of the total effect of depression was 36.92%. While for ACHEs, the proportion of the mediated effect of depression was 70.11%. Finally, a robustness test of the mediating effect using the KHB method revealed that the mediating effect still existed. Further, based on different gender, age, and educational levels, the heterogeneity test indicated that the relationship between ACHEs and cognitive function and mediating effects of the depression were different as well as passing the robustness test of the interaction.

Conclusion
The decline in cognition had been shown to be correlated with ACHEs and depression mediated this relationship. Positive interventions might help to improve cognitive performance in individuals suffering from ACHEs and depression.
Socioeconomic and environmental factors associated with waterpipe tobacco smoking among Iranian adults: a PERSIAN cohort-based cross-sectional study
Authors: Moghadam Telma Zahirian , Zandian Hamed , Fazlzadeh Mehdi , Kalan Mohammad Ebrahimi , Pourfarzi Farhad 
Published: July 2023

Abstract
Background
Waterpipe tobacco smoking (WTS) is associated with several deleterious health outcomes. We sought to estimate the prevalence of WTS and explore socioeconomic inequalities associated with this culturally-rooted tobacco smoking practice among Iranian adults.

Methods
A cross-sectional analysis was conducted among 20,460 adults (ages 18 and older) enrolled in the PERSIAN cohort study during 2020. Data were collected on socioeconomic status (SES), lifestyle, alcohol consumption, cigarette smoking, and several risk factors related to non-communicable diseases. The concentration curve and relative concentration index (RCI) were administered to assess and quantify the SES-based inequality in WTS.

Results
Overall age-adjusted prevalence of past-month WTS was 5.1% (95%CI:4.6–5.8), with about 1% for women and 10.6 for men. Age-adjusted prevalence of WTS was higher among younger adults, men, cigarette smokers, obese adults, and those with higher SES. The RCI estimation showed that WTS is more popular among adults with high income and education. WTS was higher among younger adults, cigarette smokers, obese adults, and those with higher SES.

Conclusion
There is a clear socioeconomic inequality in WTS, with a higher prevalence among adults with higher income and education. The findings suggest the need for targeted interventions to address this inequality and reduce the prevalence of WTS among high-income communities.
High accuracy epidermal growth factor receptor mutation prediction via histopathological deep learning
Authors: Zhao Dan , Zhao Yanli , He Sen , Liu Zichen , Li Kun , Zhang Lili , Zhang Xiaojun , Wang Shuhao , Che Nanying , Jin Mulan 
Published: July 2023

Abstract
Background
The detection of epidermal growth factor receptor (EGFR) mutations in patients with non-small cell lung cancer is critical for tyrosine kinase inhibitor therapy. EGFR detection requires tissue samples, which are difficult to obtain in some patients, costing them the opportunity for further treatment. To realize EGFR mutation prediction without molecular detection, we aimed to build a high-accuracy deep learning model with only haematoxylin and eosin (H&E)-stained slides.

Methods
We collected 326 H&E-stained non-small cell lung cancer slides from Beijing Chest Hospital, China, and used 226 slides (88 with EGFR mutations) for model training. The remaining 100 images (50 with EGFR mutations) were used for testing. We trained a convolutional neural network based on ResNet-50 to classify EGFR mutation status on the slide level.

Results
The sensitivity and specificity of the model were 76% and 74%, respectively, with an area under the curve of 0.82. When applying the double-threshold approach, 33% of the patients could be predicted by the deep learning model as EGFR positive or negative with a sensitivity and specificity of 100.0% and 87.5%. The remaining 67% of the patients got an uncertain result and will be recommenced to perform further examination. By incorporating adenocarcinoma subtype information, we achieved 100% sensitivity in predicting EGFR mutations in 37.3% of adenocarcinoma patients.

Conclusions
Our study demonstrates the potential of a deep learning-based EGFR mutation prediction model for rapid and cost-effective pre-screening. It could serve as a high-accuracy complement to current molecular detection methods and provide treatment opportunities for non-small cell lung cancer patients from whom limited samples are available.