bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using health economic modelling to inform the design and development of an intervention: estimating the justifiable cost of weight loss maintenance in the UK
Authors: Bates Sarah E. , Thomas Chloe , Islam Nazrul , Ahern Amy L. , Breeze Penny , Griffin Simon , Brennan Alan 
Published: February 2022

Abstract
Background
There is a need to develop cost-effective weight loss maintenance interventions to prolong the positive impact of weight loss on health outcomes. Conducting pre-trial health economic modelling is recommended to inform the design and development of behavioural interventions. We aimed to use health economic modelling to estimate the maximum cost per-person (justifiable cost) of a cost-effective behavioural weight loss maintenance intervention, given an estimated intervention effect for individuals with: i) a Body Mass Index (BMI) of 28 kg/m2 or above without diabetes and ii) a diagnosis of type 2 diabetes prescribed a single non-insulin diabetes medication.

Methods
The School for Public Health Research Diabetes prevention model was used to estimate the lifetime Quality-adjusted life year (QALY) gains, healthcare costs, and maximum justifiable cost associated with a weight loss maintenance intervention. Based on a meta-analysis, the estimated effect of a weight loss maintenance intervention following a 9 kg weight loss, was a regain of 1.33 kg and 4.38 kg in years one and two respectively compared to greater regain of 2.84 kg and 5.6 kg in the control group. Sensitivity analysis was conducted around the rate of regain, duration of effect and initial weight loss.

Results
The justifiable cost for a weight loss maintenance intervention at an ICER of £20,000 per QALY was £104.64 for an individual with a BMI of 28 or over and £88.14 for an individual with type 2 diabetes. Within sensitivity analysis, this varied from £36.42 to £203.77 for the former, and between £29.98 and £173.05 for the latter.

Conclusions
Researchers developing a weight loss maintenance intervention should consider these maximum justifiable cost estimates and the potential impact of the duration of effect and initial weight loss when designing intervention content and deciding target populations. Future research should consider using the methods demonstrated in this study to use health economic modelling to inform the design and budgetary decisions in the development of a behavioural interventions.
The relation between serum uric acid levels and diabetic peripheral neuropathy in type 2 diabetes in Guilan, north of Iran
Authors: Fayazi Haniye Sadat , Yaseri Maryam , Mortazavi Seyyede Sahere , Sharifhassan Zahra , Assadinia Ali-Sina 
Published: February 2022

Abstract
Background
Diabetic peripheral neuropathy (DPN) is one of the most common chronic microvascular complications in type 2 diabetes mellitus (T2DM). Hence, the present study aimed to investigate the association between Serum Uric Acid (SUA) levels and diabetic peripheral polyneuropathy in patients with type 2 diabetes.

Methods
We performed this case–control study during 2019–2020 on individuals with diabetes referring to the Razi clinic of Rasht, in the north of Iran. Polyneuropathy in patients was assessed based on the Neuropathy Disability Score (NDS), Diabetic neuropathy symptom score (DNS) scoring system, and electromyography (EMG)/nerve conduction velocity (NCV). The inclusion criterion for the control group was normal EMG/NCV. Then, the patients were assessed for SUA level and also laboratory results.

Results
In total, 230 patients with type 2 diabetes were examined. The mean SUA level in the DPN group was significantly higher compared to the control group (6.72 ± 1.75 vs. 4.57 ± 1.49 mg/dL). With increasing the SUA, the odds of developing neuropathy increased by 2.2 times (OR = 2.2). The risk factors for diabetic polyneuropathy included gender (male) (OR = 0.347), SBP (OR = 1.1), retinopathy (OR = 3.29), and microalbuminuria (OR = 4.44). The chance of developing polyneuropathy in patients with retinopathy was 3.3 times higher than in the control group, it was 4.4 times in microalbuminuria patients.

Conclusion
Elevated SUA level increased the chance of developing peripheral polyneuropathy in a person with type 2 diabetes. SUA levels higher than 5.25 mg / dL expose a person with type 2 diabetes to developing peripheral polyneuropathy.
Complementary medicine use in stroke survivors: a US nationally representative survey
Authors: Kohl-Heckl Wiebke K. , Koch Anna K. , Cramer Holger 
Published: February 2022

AbstractBackgroundStroke is the second most common cause of death worldwide. Even after surviving, long-term rehabilitation often becomes necessary and does not always lead to complete recovery. Guidelines focus on prevention of risk factors and present concepts for rehabilitation after a stroke. Additional to these recommendations, complementary medicine (CM) utilization is common among patients with neurological conditions. CM also offers a wide range of therapies for both prevention and rehabilitation in stroke. There is limited information available on CM utilization among stroke survivors and differences to patients without former stroke diagnosis.Methods and resultsThis analysis was based on data of the 2017 National Health Interview survey (NHIS,n = 26,742; response rate 80,7%). We analyzed the prevalence of consultations among stroke patients with CM practitioners within the last 12 months and reasons for utilization. 3.1% of participants reported a stroke, individuals without a prior stroke diagnosis were more likely to have used CM in the past 12 months (31.3% without versus 28.9% with stroke). Consultations with a chiropractor and of using mind-body-medicine was higher in individuals without stroke diagnosis, while more stroke survivors had consulted a naturopath. Equal proportions had consulted a homeopath. Most common therapy approaches among stroke survivors were spiritual meditation (13.7%), progressive relaxation (5.4%), yoga (5.2%), mindfulness meditation (4.3%), mantra meditation (3.1%), guided imagery (2.6%) and tai chi (1.7%). CM use in stroke survivors was associated with female sex (adjusted odds ratio [AOR] = 2.12, 95% confidence interval [CI] = 1.56–2.88) and higher education (AOR = 1.94, CI = 1.42–2.65).ConclusionStroke patients were less likely to take advantage of complementary medicine than the general population. Since there are many safe and beneficial options, stroke survivors might profit from better information about the existing possibilities regarding prevention and rehabilitation.
What is it like to organize a large-scale educational event for fellow students? A qualitative exploration of student participation in curriculum design
Authors: Olthuis Gert , Eggermont Florieke , Schouwenberg Bas , Oerlemans Anke , Tanck Esther 
Published: February 2022

Abstract
Background
Although students are increasingly involved in curriculum design, empirical research on practices of actual student participation is sparse. The purpose of this study is to explore the experiences of students who collaborated in the organizing committee of a large-scale educational event, the Radboud Student Conference (RSC), for fellow students.

Methods
We conducted three focus group interviews, in which 17 (bio) medical students of three different organizing teams shared their experiences regarding the organization of the large-scale teaching event. The analysis was conducted using thematic content analysis, in which the codes and codebook were constructed on the basis of the data.

Results
The following four themes were derived from the data. 1) Collaboration, which concentrated on fellow students, teachers who were involved as supervisors, and persons outside the organizing team such as caterers, educational support office members, lecturers, physicians and researchers. 2) Planning and division of labor, with students experiencing a mutual dependence and noticing a gradual improvement of their skills. 3) Freedom implies responsibility, which indicted that students experienced a significant freedom to develop the RSC week, but at the same time felt the responsibility to deliver a successful final week of the academic year. 4) Personal development, where students mentioned the opportunity to practice skills that differed from standard (bio) medical electives.

Conclusions
We conclude that (bio) medical students are capable of bearing the responsibility to organize a large-scale educational event. Organizing the RSC was an educational experience in the form of cooperative and experiential learning which contributed to students’ personal development. Organizing the event gave students both a sense of freedom and the responsibility to succeed. Supervision of faculty members seemed a prerequisite, and tended to be supportive rather than guiding.
Towards digital health equity - a qualitative study of the challenges experienced by vulnerable groups in using digital health services in the COVID-19 era
Authors: Kaihlanen Anu-Marja , Virtanen Lotta , Buchert Ulla , Safarov Nuriiar , Valkonen Paula , Hietapakka Laura , Hörhammer Iiris , Kujala Sari , Kouvonen Anne , Heponiemi Tarja 
Published: February 2022

Abstract
Background
The COVID-19 pandemic has given an unprecedented boost to already increased digital health services, which can place many vulnerable groups at risk of digital exclusion. To improve the likelihood of achieving digital health equity, it is necessary to identify and address the elements that may prevent vulnerable groups from benefiting from digital health services. This study examined the challenges experienced by vulnerable groups in using digital health services during the COVID-19 pandemic.

Methods
Qualitative descriptive design was utilized. Semi-structured interviews were conducted between October 2020 and May 2021. The participants (N = 74) were older adults, migrants, mental health service users, high users of health services, and the unemployed. Qualitative content analysis with both inductive and deductive approach was used to analyze the data. Challenges related to the use of digital health services were interpreted through digital determinants of health from the Digital Health Equity Framework.

Results
For most of the participants the access to digital health services was hampered by insufficient digital, and / or local language skills. The lack of support and training, poor health, as well as the lack of strong e-identification or suitable devices also prevented the access. Digital services were not perceived to be applicable for all situations or capable of replacing face-to-face services due to the poor communication in the digital environment. Fears and the lack of trust regarding digital platforms were expressed as well as concerns related to the security of the services. Contact with a health care professional was also considered less personal and more prone to misunderstandings in the digital environment than in face-to-face services. Finally, digital alternatives were not always available as desired by participants, or participants were unaware of existing digital services and their value.

Conclusion
Several development needs in the implementation of digital health services were identified that could improve equal access to and benefits gained from digital services in the future. While digital health services are increasing, traditional face-to-face services will still need to be offered alongside the digital ones to ensure equal access to services.
Evaluating caregivers’ service quality perceptions: impact-range performance and asymmetry analyses
Authors: Wang Wen-Fu , Chen Chun-Min , Jhang Kai-Ming , Su Yung-Yu 
Published: February 2022

Abstract
Background
This study aimed to analyze family caregivers’ (FCs) dementia care service perceptions to identify the various attributes impacting FCs satisfaction and dissatisfaction.

Methods
This is a cross-sectional survey study using convenience sampling methods. A self-completion questionnaire was developed from the Service Quality scale and distributed using a convenience sampling method to family caregivers in community-based dementia care centers to determine their perceptions of service quality in dementia care. Both exploratory factor analysis and reliability analysis were conducted to confirm the validity and factor structure of the scale. This study employed Impact Range Performance Analysis (IRPA) and Impact Asymmetry Analysis (IAA) to analyze the data obtained from FCs across five attribute dimensions (Tangibles, Reliability, Responsiveness, Assurance, and Empathy). Priorities for service improvement were derived using a three-step analytical framework.

Results
This study reported that the overall perceived performance of service provided is high. The results indicated that practitioners should focus on attributes such as demand coordination, appropriate services, timely service, barrier-free environment, care-giving process, fire and safety compliance, professional knowledge, and reliable services, which have a higher range of impact on customer service and low impact-asymmetry and attribute performance scores.

Conclusion
This study used expectation and perceived performance to suggest that the priorities for improvement and resource allocation in dementia care centers vary across different attributes. Thus, attentiveness toward satisfying user demand could improve patient care and caregiver satisfaction. The dimensions and attributes identified by our study can serve as basic data for future research on the long-term care system.
Severe phenotypes of B3GAT3-related disorder caused by two heterozygous variants: a case report and literature review
Authors: Li Ying , Zhang Chuangwen , Zhang Hongyu , Feng Weiqi , Wang Qiuji , Fan Ruixin 
Published: February 2022

Abstract
Background
Linkeropathies refers to a series of extremely rare hereditary connective tissue diseases affected by various glycosyltransferases in the biosynthesis of proteoglycans. We report for the first time two heterozygous variants of B3GAT3 in a Chinese infant, in whom Marfan syndrome was suspected at birth.

Case presentation
A 2-month-old boy from a non-consanguineous Chinese family without a family history presented severe phenotypes of joint dislocation, obvious flexion contractures of the elbow, arachnodactyly with slightly adducted thumbs, cranial dysplasia, foot abnormalities and aortic root dilation; Marfan syndrome was suspected at birth. Our patient was the youngest, at the age of 2 months, to experience aortic root dilation. Two B3GAT3 variants, NM_012200.2, c.752T>C, p.V251A and c.47C>A, p.S16*, with heterozygosity were identified in the patient by whole-exome sequencing; the variants were inherited from his parents. During close follow-up, significant changes in the cranial profile and obvious external hydrocephalus were present at the age of 7 months, which differs from previously reported cases.

Conclusion
We diagnosed a patient with congenital heart defects at an early age with a B3GAT3-related disorder instead of Marfan syndrome and expanded the spectrum of B3GAT3-related disorders. We also provide a literature review of reported B3GAT3 cases; for at least one of the variants, this is the first report of genotype–phenotype correlations in individuals with cardiovascular defects being related to the acceptor substrate-binding subdomain of B3GAT3.
Clinical and economic burden of comorbid coronary artery disease in patients with acute exacerbation of chronic obstructive pulmonary disease: sex differences in a nationwide cohort study
Authors: Cui Yanan , Zhan Zijie , Ma Yiming , Huang Ke , Liang Chen , Mao Xihua , Zhang Yaowen , Ren Xiaoxia , Lei Jieping , Chen Yan , Yang Ting , Wang Chen 
Published: February 2022

Abstract
Background
Coronary artery disease (CAD) is a common comorbidity of chronic obstructive pulmonary disease (COPD). However, data related to the impact of CAD on outcomes of acute exacerbation of COPD (AECOPD) are limited and whether the relationship depends on sex remains unknown. Our aim was to determine the impact of comorbid CAD on clinical outcomes among men and women with AECOPD.

Methods
We used data from the acute exacerbation of chronic obstructive pulmonary disease inpatient registry (ACURE) study, which is a nationwide observational real-world study conducted between September 2017 and February 2020 at 163 centers in patients admitted with AECOPD as their primary diagnosis. Patients were stratified according to the presence or absence of CAD in men and women. The primary outcomes were the length of hospital stay and economic burden during hospitalization.

Results
Among 3906 patients included in our study, the prevalence of CAD was 17.0%, and it was higher in women than in men (19.5% vs. 16.3%; P = 0.034). Age and other cardiovascular diseases were common factors associated with comorbid CAD in men and women, while body-mass index, cerebrovascular disease, and diabetes were determinants in men and pre-admission use of long-acting beta-adrenoceptor agonist and home oxygen therapy were protective factors in women. Only in men, patients with CAD had a longer length of hospital stay (median 10.0 vs. 9.0 days, P < 0.001), higher total cost during hospitalization (median $1502.2 vs. $1373.4, P < 0.001), and more severe COPD symptoms at day 30 compared to those without CAD. No significant difference was found in women. Comorbid CAD showed no relationship with 30-day readmission or death regardless of sex. In our real-world study, mortality/readmission risk within 30 days increased in patients with previous frequent hospitalizations and poorer pulmonary function.

Conclusions
In hospitalized AECOPD patients, comorbid CAD was significantly associated with poorer short-term outcomes in men. Clinicians should have heightened attention for men with comorbid CAD to achieve an optimal management of AECOPD patients.
ZHX2 inhibits thyroid cancer metastasis through transcriptional inhibition of S100A14
Authors: Zhang Yankun , Sun Min , Gao Lifen , Liang Xiaohong , Ma Chunhong , Lu Jinghui , Yue Xuetian 
Published: February 2022

Abstract
Background
Thyroid cancer is the most common malignant endocrine tumour, and metastasis has become the main reason for treatment failure. However, the underlying molecular mechanism of thyroid cancer metastasis remains poorly understood. We investigated the role of the tumour suppressor zinc fingers and homeoboxes 2 (ZHX2) in the metastasis of thyroid cancer.

Methods
To study the role of ZHX2 in thyroid cancer metastasis, we evaluated the EMT process using cell migration, wound healing and lung metastatic tumour formation in vitro and in vivo models.

Results
ZHX2 expression was significantly decreased in thyroid cancer tissues, which correlated with poor prognosis of thyroid cancer patients. ZHX2 knockdown significantly promoted the migration of thyroid cancer cells. Mechanistically, ZHX2 associated with the S100 calcium binding protein A14 (S100A14) promoter to decrease the transcription of S100A14. Moreover, S100A14 was highly expressed in human thyroid cancer samples, and its expression negatively correlated with ZHX2 expression.

Conclusions
Inhibition of S100A14 attenuated the ZHX2 knockdown-induced enhanced metastasis of thyroid cancer cells both in vitro and in vivo. The evidence presented here suggests that ZHX2 inhibits the progression of thyroid cancer by blocking S100A14-mediated metastasis.
Identification of key serum biomarkers for the diagnosis and metastatic prediction of osteosarcoma by analysis of immune cell infiltration
Authors: Chen Zhihao , Li Liubing , Li Ziyuan , Wang Xi , Han Mingxiao , Gao Zongshuai , Wang Min , Hu Gangfeng , Xie Xiaolu , Du Hong , Xie Zonggang , Zhang Haifang 
Published: February 2022

AbstractBackgroundThe role of circular RNAs (circRNAs) and microRNAs (miRNAs) in osteosarcoma (OS) development has not been fully elucidated. Further, the contribution of the immune response to OS progression is not well defined. However, it is known that circRNAs and miRNAs can serve as biomarkers for the diagnosis, prognosis, and therapy of many cancers. Thus, the aim of this study was to identify novel key serum biomarkers for the diagnosis and metastatic prediction of OS by analysis of immune cell infiltration and associated RNA molecules.MethodsHuman OS differentially expressed circRNAs (DEcircRNAs), differentially expressed miRNAs (DEmiRNAs), and differentially expressed mRNAs (DEmRNAs) were identified by analysis of microarray data downloaded from Gene Expression Omnibus (GEO) datasets. Further, characteristic patterns of OS-infiltrating immune cells were analyzed. On this basis, we identified statistically significant transcription factors. Moreover we performed pathway enrichment analysis, constructed protein–protein interaction networks, and devised competitive endogenous RNA (ceRNA) networks. Biological targets of the ceRNA networks were evaluated and potential OS biomarkers confirmed by RT-qPCR analysis of the patients’ serum.ResultsSeven differentially expressed circRNAs, 166 differentially expressed miRNAs, and 175 differentially expressed mRNAs were identified. An evaluation of cellular OS infiltration identified the highest level of infiltration by M0 macrophages, M2 macrophages, and CD8+ T cells, with M0 macrophages and CD8+ T cells as the most prominent. Significant patterns of tumor-infiltrating immune cells were identified by principal component analysis. Moreover, 185 statistically significant transcription factors were associated with OS. Further, in association with immune cell infiltration, hsa-circ-0010220, hsa-miR-326, hsa-miR-338-3p, and FAM98A were identified as potential novel biomarkers for OS diagnosis. Of these, FAM98A had the most promise as a diagnostic marker for OS and OS metastasis. Most importantly, a novel diagnostic model consisting of these four biomarkers (hsa-circ-0010220, hsa-miR-326, hsa-miR-338-3p, and FAM98A) was established with a 0.928 AUC value.ConclusionsIn summary, potential serum biomarkers for OS diagnosis and metastatic prediction were identified based on an analysis of immune cell infiltration. A novel diagnostic model consisting of these four promising serum biomarkers was established. Taken together, the results of this study provide a new perspective by which to understand immunotherapy of OS.
Apoptotic changes and aquaporin-1 expression in the choroid plexus of cerebral malaria patients
Authors: Srisook Charit , Glaharn Supattra , Punsawad Chuchard , Viriyavejakul Parnpen 
Published: February 2022

Abstract
Background
Cerebral malaria (CM) is associated with sequestration of parasitized red blood cells (PRBCs) in the capillaries. Often, the association of CM with cerebral oedema is related with high mortality rate. Morphological changes of the choroid plexus (CP) and caspase-3 expression in CM have not been reported. In addition, limited knowledge is known regarding the role of aquaporin (AQP)-1 in CM. The present study evaluated changes in the CP, explored apoptotic changes and AQP-1 expression in CP epithelial cells (CPECs) in fatal CM patients.

Methods
CP from fatal Plasmodium falciparum malaria patients (5 non-CM [NCM], 16 CM) were retrieved and prepared for histopathological evaluation. Caspase-3 and AQP-1 expressions in CPECs were investigated by immunohistochemistry.

Results
Histologically, apoptotic changes in CPECs were significantly observed in the CM group compared with the NCM and normal control (NC) groups (p < 0.05). These changes included cytoplasmic and nuclear condensation/shrinkage of CPECs and detachment of CPECs from the basement membrane. The apoptotic changes were positively correlated with caspase-3 expression in the nuclei of CPECs. In addition, AQP-1 expression in CPECs was significantly decreased in the CM group compared with the NCM and NC groups (all p < 0.001). A negative correlation (rs =  − 0.450, p = 0.024) was documented between caspase-3 expression in the nuclei of CPECs and AQP-1.

Conclusions
Apoptotic changes and altered AQP-1 expression may contribute to CPEC dysfunction and subsequently reduce cerebrospinal fluid production, affecting the water homeostasis in the brains of patients with CM.