bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tracking of anthropometric characteristics from childhood to adolescence: an 8-year follow-up findings from the Czech ELSPAC study
Authors: Zvonar Martin , Štefan Lovro , Kasović Mario , Piler Pavel 
Published: April 2022

Abstract
Background
Although evidence suggests that obesity track well from childhood to adolescence, most of the research has been done in Western and high-income countries. Moreover, most of the studies have tracked body-mass index, as a proxy of nutritional status, while tracking characteristics of circumferences and skinfold thicknesses have been less studies. Therefore, the main purpose of the study was to explore tracking characteristics of complete anthropometric data from childhood to adolescence.

Methods
This sub-study was part of the Czech ELSPAC study. In the present 8-year longitudinal study, we collected information from pediatrician’s medical records at the ages of 8 y (n = 888), 11 y (n = 1065), 13 y (n = 811) and 15 y (n = 974), including circumferences (head, chest, waist, hips, and arm), indices (body-mass index, waist-to-hip ratio and waist-to-height ratio) and skinfold thicknesses (biceps, triceps, subscapula, suprailiaca, thigh and the sum of 5 skinfolds). Participants were recruited from the two selected regions of the Czech Republic (Brno and Znojmo). Linear generalized estimating equations were conducted to analyze tracking patterns over an 8-year follow-up period for all anthropometric measurements.

Results
Tracking coefficients were moderate to strong, ranging from 0.40 to 0.62 for circumferences, 0.41 to 0.74 for indices and 0.72 to 0.86 for skinfolds. According to body-mass index and waist circumference standards, overweight/obese children and children with abdominal obesity at the age of 8 y were 11.31 (95% CI = 8.41 to 15.22, p < 0.001) and 10.73 (95% CI = 7.93 to 14.52, p < 0.001) more likely to remain overweight/obese and to have abdominal obesity at the age of 15 y.

Conclusions
Findings show moderate to strong tracking of anthropometric characteristics, i.e. circumferences track moderately well, while strong tracking for indices and skinfold thicknesses is observed. Moreover, strong tracking of general overweight/obesity and abdominal obesity between ages 8 y and 15 y indicates that the detection of these risk factors at the beginning of primary school should be advocated.
Severe asthma as the initial clinical manifestation of IgG4-related disease: a retrospective clinical study
Authors: Liu Xiangning , Shao Chi , Yu Chen , Huang Hui , Pan Ruili , Xu Kai , Zhang Xin , Xu Zuojun 
Published: April 2022

Abstract
Background
Respiratory involvement is common in immunoglobulin G4-related disease (IgG4-RD). However, severe asthma as the initial clinical manifestation of IgG4-RD is rare and might be neglected by respiratory clinicians. We aimed to explore the clinical characteristics and prognoses of patients with immunoglobulin G4-related disease (IgG4-RD) manifesting as severe asthma.

Methods
A retrospective analysis of the clinical characteristics and prognoses of patients with severe asthma who were eventually diagnosed with IgG4-RD was performed in the Peking Union Medical College Hospital from 2013 to 2019.

Results
Twelve patients (5males, 7 females) were included. The mean age at enrollment and age of asthma onset were 59.4 ± 10.1 and 53.8 ± 10.4 years, respectively. The mean duration of asthma symptoms was 5.7 ± 2.0 years. In all patients, the proportion (25.1 ± 10.3%) and count (2.0 ± 1.1) × 109/L of eosinophils in peripheral blood increased. Additionally, all patients exhibited elevated total immunoglobulin E [IgE, (1279.3 ± 1257.9) KU/L] and IgG4 (9155.8 ± 9247.6) mg/dL. Bronchial wall thickening (n = 11) and mediastinal/hilar lymphadenopathy (n = 11) were major chest CT manifestations. All were pathologically diagnosed through surgical biopsy; submandibular gland (n = 8), supraclavicular lymph node (n = 2), stomach (n = 1), rashes (n = 1), lacrimal gland (n = 1) and thoracoscopic lung (n = 1) biopsies were performed. Asthma was well controlled by oral glucocorticoids (GCs), but some patients relapsed during tapering (n = 11). The refractory condition was controlled after increasing the dosage of GCs and add-on immunosuppressants.

Conclusions
For patients with middle age-onset severe asthma with elevated eosinophils, total IgE and IgG4 levels and available salivary gland ultrasound imaging, ruling out IgG4-RD is recommended. GCs used in combination with immunosuppressants is recommended to prevent relapse.
A prospective observational study on the beneficial effects and tolerability of a cetylated fatty acids (CFA) complex in a patch formulation for shoulder tendon disorders
Authors: Lanzisera Rosaria , Baroni Alessandro , Lenti Gaetana , Geri Elisabetta 
Published: April 2022

Abstract
Background
The advancement of physiopathological knowledge of tendon structures has shown that, in conditions of overload, there is the onset of both degenerative phenomena, such as the production of metalloproteases, apoptosis of tendon cells and neoangiogenesis, and regenerative and protective phenomena, such as the production of IGF-1 and nitric oxide. Tendinopathy results from the imbalance between these two groups of factors, leading to degeneration, weakening, and fissuring of the tendons, with the presence of local pain. The aim of the study was to evaluate the efficacy and tolerability of cetylated fatty acids (CFA) patch formulation in the control of acute localized shoulder pain and recovery of function in patients with tendinopathies.

Methods
A prospective, single-center, no-profit observational study conducted in accordance with Good Clinical Practice. Thirty patients with recent onset shoulder pain symptoms (1–3 months) related to bursitis and tenosynovitis, with a diagnosis of shoulder tendon pathology confirmed by ultrasound examination, was evaluated for shoulder pain and function using the Constant Murley Score. Patients used 1 patch containing CFA for 8 h per day for 10 days. At 10 (V1) and 35 (V2) days after the first visit (V0), the Constant Score, treatment compliance and product tolerability were evaluated.

Results
Thirty patients completed the treatment. At V0 the mean Constant Score (CS) was 32.37 ± 11.86, during V1 the mean CS was 50.68 ± 14.30, and at V3 the mean CS was 51.07 ± 15.29. The CS increased significantly between V0 and V1 (p < 0.0001) but did not vary significantly between V1 and V2 (p = 1). The tolerability of the product was excellent.

Conclusions
Application of the CFA-based patch for 10 consecutive days in patients with shoulder tendinopathies was effective in reducing local pain and resulted in a good recovery of function. The results achieved at day 10 were maintained for 25 days, until the follow-up visit at day 35. CFA-based patch, thanks to their efficacy and tolerability, seems to be a promising solution to improve pain and functionality in subject with shoulder tendinopathy.

Trial registration
The study was approved by the Ethics Committee of Azienda USL Toscana Nord Ovest (protocol code 2018RIAB105) and conducted in accordance with Good Clinical Practice and the ethical principles outlined in the Declaration of Helsinki.
A retrospective study on the effect of the COVID-19 pandemic on dental treatments in adults
Authors: Gómez-Costa Diego , Ramírez Juan Manuel , García Guerrero Iván , Giovannini Giovanni , Rojo Rosa , Gómez-de Diego Rafael 
Published: April 2022

Abstract
Background
The aim was to analyze the prevalence of dental treatments that were not performed in a dental care university referral center in the capital of Spain during the first wave of the COVID-19 pandemic.

Methods
This was a retrospective observational study based on the registry of medical records. Sex, age, nationality, and the type of treatment that was not performed in the service of the Integrated Adult Dental Clinic subject of the Dentistry degree at the Rey Juan Carlos University of Madrid were analyzed.

Results
A total of 392 medical records were analyzed. The prevalence of the treatments that were not performed was 58.67% (95% CI 53.74–63.44) of conservative treatments, 47.45% (95% CI 42.55–52.39) of periodontal treatments, 27.30% (95% CI 23.12–31.91) and 13.52% (95% CI 10.49–17.26) of clinical activities. The patients most affected by the absence of dental treatment ranged in age from 35 to 74 years. Age, sex, and nationality were not influential in not performing dental treatments.

Conclusions
The COVID-19 pandemic could have negatively influenced treatments, such as conservative and periodontal treatments, that increasing the risk of tooth loss in adults.
Situational judgment using ethical reasoning in Saudi undergraduate pharmacy students
Authors: Alkhuzaee Fahad Saleh , Ali Majid , Goh Khang Wen , Al-Worafi Yaser Mohammed , Ming Long Chiau 
Published: April 2022

Abstract
Introduction
There is a paramount need for moral development for pharmacists and pharmacy students to practice the patient-centered profession. We aimed to explore the current situational judgment utilizing ethical reasoning among undergraduate pharmacy students.

Methods
A set of ten ethical dilemmas, representing potential real-life situations that the students come across in the university and may face in the future as a pharmacist were developed by a team of students, academic staff, and stakeholders. These ethical dilemmas were validated, checked for accuracy, and piloted. An online questionnaire was created consisting of these ten scenarios as open-ended questions and administered to fourth year and fifth year PharmD students in a public university located at the city of Mecca, Saudi Arabia, asking them how they would react in that situation. Responses of the participants were analyzed using thematic analysis independently by four researchers and inter-rater agreement were achieved through consensus.

Results
Out of 205, 186 students completed the questionnaire with a response rate of 90.7%. Analysis and resulted in the generation of 32 codes, which were then categorized into seven overarching themes: student engagement, social and professional responsibility, academic integrity, legal obligation, moral obligation, signposting, and moral engagement and patient safety.

Conclusions
Undergraduate pharmacy students experience complex state of mind in connection with ethical reasoning. The participants’ situational judgment were driven by cultural norm, authority, and responsibility. Student engagement is also affected by the state of mind and feelings of mutual trust, perceived cultural influence and peer pressure. The students were prone to seek help from university administrators or teachers when faced with situations in which they were helpless.
Development of a complex intervention to support parents of adolescents with chronic illness transferring from pediatrics to adult care (ParTNerSTEPs)
Authors: Thomsen Ena Lindhart , Esbensen Bente Appel , Hanghøj Signe , Hansson Helena , Boisen Kirsten Arntz 
Published: April 2022

AbstractBackgroundTransition from pediatric to adult care for adolescents with chronic illness is associated with outpatient non-attendance and low treatment adherence in adolescents, and with anxiety and concerns among parents. Recent studies have shown that parent involvement results in better transitions. The aim of this paper was to describe the development, through participatory design, of a comprehensive transfer program targeted to parents of adolescents with chronic illness.MethodsThe study was based on the UK Medical Research Council’s (MRC) framework on developing and testing complex interventions. To increase the program’s feasibility and relevance, participatory design was chosen as the overall method. A collaboration group of parents, young people and health care professionals (HCP) were actively involved in the development of the program. The program was developed in three development stages, in accordance with the MRC framework: 1) identifying the evidence base, 2) identifying theory, and 3) modelling process and outcomes.ResultsTogether with the collaboration group, we developed a comprehensive transfer program targeting parents, by undertaking an iterative process, involving a literature review, individual interviews, workshops and online brainstorms. The program, called ParTNerSTEPs (Parents in Transition – a Nurse-led Support and Transfer Educational Program) comprised three components: 1) an informative website, 2) online educational events for parents, and 3) transfer consultations with providers from both pediatrics and adult care.ConclusionsThe MRC framework was successfully applied to develop a comprehensive transfer program targeting parents of adolescents with chronic ilness. By incorporating the principles of participatory design in the development phase, we ensured that both parents’ and adolescents’ needs were represented and addressed in the program.Trial registrationClinicalTrials.gov ID NCT04969328.
Hospital utilization in Indonesia in 2018: do urban–rural disparities exist?
Authors: Wulandari Ratna Dwi , Laksono Agung Dwi , Nantabah Zainul Khaqiqi , Rohmah Nikmatur , Zuardin Zuardin 
Published: April 2022

AbstractBackgroundThe government must ensure equality in health services access, minimizing existing disparities between urban and rural areas. The referral system in Indonesia is conceptually sound. However, there are still problems of uneven service access, and there is an accumulation of patients in certain hospitals. The study aims to analyze the urban–rural disparities in hospital utilization in Indonesia.MethodsThe study used secondary data from the 2018 Indonesian Basic Health Survey. This cross-sectional study gathered 629,370 respondents through stratification and multistage random sampling. In addition to the kind of home and hospital utilization, the study looked at age, gender, marital status, education, occupation, wealth, and health insurance as control factors. The research employed multinomial logistic regression to evaluate the data in the final step.ResultsAccording to the findings, someone who lives in an urban region has 1.493 times higher odds of using outpatient hospital services than someone in a rural area (AOR 1.493; 95% CI 1.489–1.498). Meanwhile, someone who lives in an urban region has 1.075 times higher odds of using an inpatient facility hospital than someone who lives in a rural one (AOR 1.075; 95% CI 1.073–1.077). Furthermore, someone living in an urban region has 1.208 times higher odds than someone who lives in a rural area using outpatient and inpatient hospital services simultaneously (AOR 1.208; 95% CI 1.204–1.212).ConclusionThe study concluded there were urban–rural disparities in hospital utilization in Indonesia.
Organ-specific metastatic landscape dissects PD-(L)1 blockade efficacy in advanced non-small cell lung cancer: applicability from clinical trials to real-world practice
Authors: Ma Si-Cong , Bai Xue , Guo Xue-Jun , Liu Li , Xiao Lu-Shan , Lin Yan , Tan Jia-Le , Cai Xiao-Ting , Wen Yu-Xiang , Ma Hu , Fu Q. John , Leng Meng-Xin , Zhang Yan-Pei , Long Li-Li , Guo Ze-Qin , Wu De-Hua , Zhou Jian-Guo , Dong Zhong-Yi 
Published: April 2022

Abstract
Background
Organ-specific metastatic context has not been incorporated into the clinical practice of guiding programmed death-(ligand) 1 [PD-(L)1] blockade, due to a lack of understanding of its predictive versus prognostic value. We aim at delineating and then incorporating both the predictive and prognostic effects of the metastatic-organ landscape to dissect PD-(L)1 blockade efficacy in non-small cell lung cancer (NSCLC).

Methods
A total of 2062 NSCLC patients from a double-arm randomized trial (OAK), two immunotherapy trials (FIR, BIRCH), and a real-world cohort (NFyy) were included. The metastatic organs were stratified into two categories based on their treatment-dependent predictive significance versus treatment-independent prognosis. A metastasis-based scoring system (METscore) was developed and validated for guiding PD-(L)1 blockade in clinical trials and real-world practice.

Results
Patients harboring various organ-specific metastases presented significantly different responses to immunotherapy, and those with brain and adrenal gland metastases survived longer than others [overall survival (OS), p = 0.0105; progression-free survival (PFS), p = 0.0167]. In contrast, survival outcomes were similar in chemotherapy-treated patients regardless of metastatic sites (OS, p = 0.3742; PFS, p = 0.8242). Intriguingly, the immunotherapeutic predictive significance of the metastatic-organ landscape was specifically presented in PD-L1-positive populations (PD-L1 > 1%). Among them, a paradoxical coexistence of a favorable predictive effect coupled with an unfavorable prognostic effect was observed in metastases to adrenal glands, brain, and liver (category I organs), whereas metastases to bone, pleura, pleural effusion, and mediastinum yielded consistent unfavorable predictive and prognostic effects (category II organs). METscore was capable of integrating both predictive and prognostic effects of the entire landscape and dissected OS outcome of NSCLC patients received PD-(L)1 blockade (p < 0.0001) but not chemotherapy (p = 0.0805) in the OAK training cohort. Meanwhile, general performance of METscore was first validated in FIR (p = 0.0350) and BIRCH (p < 0.0001), and then in the real-world NFyy cohort (p = 0.0181). Notably, METscore was also applicable to patients received PD-(L)1 blockade as first-line treatment both in the clinical trials (OS, p = 0.0087; PFS, p = 0.0290) and in the real-world practice (OS, p = 0.0182; PFS, p = 0.0045).

Conclusions
Organ-specific metastatic landscape served as a potential predictor of immunotherapy, and METscore might enable noninvasive forecast of PD-(L)1 blockade efficacy using baseline radiologic assessments in advanced NSCLC.
Different methods of eubiotic feed additive provision affect the health, performance, fermentation, and metabolic status of dairy calves during the preweaning period
Authors: Stefańska Barbara , Katzer Frank , Golińska Barbara , Sobolewska Patrycja , Smulski Sebastian , Frankiewicz Andrzej , Nowak Włodzimierz 
Published: April 2022

Abstract
Background
This study aimed to evaluate whether different methods of providing eubiotic feed additives to neonatal calves, during the preweaning period, can improve the calves’ health, performance, ruminal fermentation, and metabolic status. Forty-four (3-day-old) Holstein–Friesian dairy calves (22 female and 22 male) were divided into four treatment groups for the duration of the 8-week trial. The eubiotic feed additive consisted of a combination of probiotic Lactobacillus spp. (multiple-strains at a dose of 250 mg/calf/day) and phytobiotics containing rosmarinic acid, as the main bioactive compound (at a dose of 50 mg/calf/day). The groups were named: CON (control, without eubiotic in either the milk replacer or the starter feed), MR (eubiotic in the milk replacer), SF (eubiotic in the starter feed), MRS (eubiotic in both the milk replacer and the starter feed). The individual intake of starter feed and the fecal scores were measured daily, and body weight and biometric measurements were taken weekly until calves were 56 days of age. Blood samples were collected on day 3 and then every 14 days to determine concentrations of insulin-like-growth-factor-I, β-hydroxybutyrate, non-esterified fatty acids, and blood urea nitrogen. Ruminal fluid was collected on days 28 and 56 for short-chain fatty acids, NH3-N, and pH measurements.

Results
The body weight of the calves of the MR treatment group was higher compared to all other groups on days 28 and 56. Including the eubiotic feed additive in the milk replacer increased average daily gain, starter intake, and total dry matter intake from day 29 to day 56 and the overall experimental period compared to the CON group. The calves with MR treatment had lower fecal scores from days 3 to 28, a number of parasite oocysts/cysts per gram of feces on day 28, and the occurrences of fecal consistency scores of 3 (mild diarrhea) and 4 (severe diarrhea) were 3.2 and 3.0 times lower, respectively, compared with the CON group. The MR group had higher ruminal concentrations of short-chain-fatty-acids, propionate, and butyrate on day 56 than the CON group. Adding eubiotics into milk replacer resulted in the highest concentrations of blood insulin-like-growth-factor-I and β-hydroxybutyrate from days 29 to 56 and the overall experimental period.

Conclusion
The addition of eubiotic feed additives into the milk replacer can improve health, performance, ruminal fermentation, and biochemical blood indices in dairy calves during the preweaning period.
Classification of colorectal carcinoma subtypes based on ferroptosis-associated molecular markers
Authors: Yue Qingfang , Zhang Yuan , Wang Fei , Cao Fei , Duan Xianglong , Bai Jun 
Published: April 2022

Abstract
Background
Ferroptosis is associated with the development of many cancers; the molecular features of colorectal carcinoma (CRC) based on ferroptosis-related genes (FRGs) remain unknown. Herein, we aimed to identify ferroptosis-associated molecular subtypes of CRC based on the expression profiles of FRGs.

Methods
To explore ferroptosis-associated subtypes of CRC, the gene expression data and clinical information of 682 patients were extracted from The Cancer Genome Atlas and Gene Expression Omnibus databases. We performed consensus clustering to identify robust clusters of patients. Then the distribution of the subtypes in terms of prognosis significance, transcriptome features, immune microenvironment, drug sensitivity, gene mutations, and copy number alternations (CNAs) were evaluated respectively. In addition, we analyzed the correlation of these ferroptosis-associated molecular subtypes with the distribution of conventional clinical indicators in CRC.

Results
Four subtypes of CRC (C1, C2, C3, and C4) were identified in which the prognosis, immune cell infiltration, immune score, stromal score, and tumor purity were significantly different between the four subtypes. The C3 subtype had a higher infiltration of B cells, M2 macrophages, resting mast cells, monocytes, natural killer cells, plasma cells, and CD8 T cells. The C3 subtype had the highest immune and stromal scores and the lowest tumor purity. In contrast, the C4 subtype demonstrated the lowest immune and stromal scores and the highest tumor purity. Programmed cell death ligand 1 (PD-L1), an immune checkpoint protein, was differentially expressed in the four subtypes (P < 2e–16) and was significantly correlated with the expression of several FRGs in all subtypes. Significant differences in stem cell indices (P < 0.01) and drug sensitivity (P < 0.01) were observed in the four subtypes. Additionally, gene mutations analysis showed that FRGs such as TP53 had a high frequency of mutation in the four subtypes (49%, 62%, 61%, and 71%, respectively), and the CNAs showed significant difference among all subtypes (P < 0.001).

Conclusion
In summary, the ferroptosis-associated subtypes could serve as an independent biomarker for estimating oncological outcomes in patients with CRC. Our results demonstrated that the high level of heterogeneity in the expression of FRGs might be useful for the stratification of patients with CRC and the implementation of individualized therapeutic strategies.