bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of lifestyle, physical activity and dietary practices in predicting overweight and obesity among university students in Morocco
Authors: Benchehida Hiba , El Aameri Mohammed , Razzak Sara , Taibi Mariame , Bengueddour Rachid , Taib Bouchra , Taboz Youness 
Published: February 2025

Background The dietary quality of young adults often worsens during the transition to adulthood. University students, especially considering documented gender differences in eating habits, are prime targets for promoting healthy lifestyles to prevent noncommunicable diseases. Objective This study investigates the prevalence of overweight among students and analyzes disparities in physical activity, dietary practices, and the use of complementary medicine across genders, while also exploring factors influencing overweight. Methods A cross-sectional survey of 502 students aged 23 ± 3.67 from Ibn Tofail University was conducted in the spring of 2023. Students completed a self-reported questionnaire addressing various lifestyle habits. Data were analyzed using the Statistical Package for Social Sciences (SPSS v23) to assess weight status, lifestyle habits, and gender differences. Results Results show that 21.10% of students are overweight, while 72.90% are not. A significant association was found between gender and physical activity levels (p <0.0001), as well as gender differences in meal frequency (p <0.01), snacking behaviors (p <0.01), and sleep duration (p <0.0001). Notably, during stressful periods, males and females differed in their consumption of high-fat, high-sodium snacks such as crisps (p <0.01). Additionally, the internet and social media were significantly associated with BMI variations (p <0.01). Logistic regression analysis revealed that participants who reported that the internet influenced their eating habits had 1.68 times higher odds of being overweight compared to those unaffected by the internet (p =0.02). Conclusion These findings underscore the influence of online content on dietary behaviors and highlight the importance of strategies to improve students’ nutritional profiles, potentially reducing health risks associated with unhealthy lifestyles in the Moroccan population.
Safety and efficacy of luspatercept in treating anemia associated with myelodysplastic syndrome with ring sideroblasts in Asian patients who require red blood cell transfusions: a phase II bridging study
Authors: Chang Chunkang , Suzuki Takahiro , Liang Yang , Tong Hongyan , Usuki Kensuke , Liu Qifa , Wu Yu , Fujisaki Tomoaki , Han Bing , Huang Ruibin , Morita Yasuyoshi , Miao Miao , Nakashima Yasuhiro , Tian Yu (Olivia) , Pu Jie , Aggarwal Dimple , Pozharskaya Veronika , Shi Wenhui , Xiao Zhijian , Mitani Kinuko 
Published: February 2025

Background: Patients with lower-risk myelodysplastic syndromes (MDS) may experience anemia and a high transfusion burden, alongside a risk of progression to acute myeloid leukemia. Luspatercept, a recombinant fusion protein that acts as an erythroid maturation agent, was FDA/EMA-approved in 2020 based on the phase III MEDALIST trial. There remains an unmet need for anemia treatment in Asian patients for whom red blood cell (RBC) transfusion is a standard of care, and in whom rates/severity of anemia and serum erythropoietin levels are often higher versus Western patients. Objectives: The objective of this study was to assess the efficacy, safety, and tolerability of luspatercept in Asian patients with anemia due to transfusion-dependent lower-risk MDS with ring sideroblasts. Design: This was a phase II, single-arm, interventional bridging study (NCT04477850). Methods: Patients from China and Japan with very low-, low-, or intermediate-risk MDS with ring sideroblasts who were RBC transfusion-dependent received subcutaneous luspatercept starting at 1.0 mg/kg every 3 weeks. The primary endpoint was RBC transfusion independence (TI) ⩾8 weeks (weeks 1–24). Results: There was a statistically significant, clinically meaningful improvement of anemia in Asian patients; 60% ( n = 18, p < 0.0001) achieved RBC-TI for ⩾8 weeks and 43% ( n = 13) for ⩾12 weeks (weeks 1–24). Safety was consistent with the known profile of luspatercept in MDS. Conclusion: These results support luspatercept as a well-tolerated, efficacious alternative to transfusions for Asian patients with lower-risk MDS, who tend to have more severe anemia. Trial registration: clinicaltrials.gov, NCT04477850.
Conduit Size, Branch Pulmonary Artery Size, and Reoperation in Patients With Truncus Arteriosus
Authors: Mastropietro Christopher W. , Rodenbarger Andrew , Herrmann Jeremy L. 
Published: February 2025

Background Optimal right ventricle-to-pulmonary artery (RV-PA) conduit size for patients with truncus arteriosus is controversial. We aimed to determine the relationship between branch PA size and the need for conduit reoperation following repair of truncus arteriosus. Methods We performed a single-center chart review of patients who underwent truncus arteriosus repair from January 2009 to December 2023. Branch PAs were measured in systole, at the narrowest point if focal stenosis was present. For branch PA diameter analyses, the smaller diameter PA was used. Univariate Cox proportional hazards regression analysis was performed to determine hazard ratios (HRs) with 95% confidence intervals (CIs) for echocardiographic measures and conduit reoperation. Results We included 33 patients. Median age at surgery was 23 days (range: 3--34). Thirty-two patients received a bovine jugular vein graft, one patient received an aortic homograft. Mean RV-PA conduit Z-score was 2.7 ± 0.5 and mean preoperative conduit-to-PA ratio 2.6 ± 0.6. Postoperative diameter of at least one branch PA was decreased in 31 patients (93.9%); mean change was −19% ± 17%. Mean postoperative conduit-to-PA ratio was 3.3 ± 0.9. Conduit reoperation occurred in 19 patients (58%); median time to reoperation was 1.6 years (range: 0.4-10.4). Conduit reoperation was not associated with conduit diameter or Z-score. Conduit reoperation was significantly associated with truncus type A2 or A3 PA anatomy (HR: 3.53; 95%CI: 1.14-10.94) and conduit-to-PA ratio ≥ 4 (HR: 4.94; 95%CI: 1.63-14.97). Conclusion In a single-center cohort of children who underwent repair of truncus arteriosus, RV-PA conduit diameter was not associated with increased conduit longevity. Rather, larger postoperative RV-PA conduit to branch PA diameter ratio was significantly associated with greater hazard for conduit reoperation.
Cartilaginous Endplate Damage May be a Root Pathology Underlying Modic Changes on Lumbar Spine MR Images
Authors: Feng Zhiyun , Ding Shuchen , Wu Honghao , Liu Miao , Hu Xiaojian , Chen Lunhao , Wu Kai , Battie´ Michele C. , Wang Yue 
Published: February 2025

Study Design Rabbit model study. Objective To examine whether cartilaginous endplate (CEP) destruction leads to endplate and vertebral marrow signal changes (Modic changes, MCs) on MR images. Methods Sixteen adult rabbits were used in the study and underwent an anterolateral procedure to expose the L2-6 intervertebral discs. The L4/5, L3/4 and L2/3 discs underwent annulotomy, annulotomy and CEP curettage, or annulotomy and chemonucleolysis, respectively, while the L5/6 disc served as a shame control. MR imaging was performed preoperatively and at 1, 3, and 6 months postoperatively to evaluate the presence or absence of MCs. After the last imaging, animals were sacrificed for histological study, focusing on endplate pathologies and their associations with MCs. Results Among the 64 endplates that underwent CEP curettage or were exposed to chemonucleolysis, there were 6 (9.4%), 19 (29.7%), and 32 (50%) endplates with MCs at 1, 3 and 6 months, respectively. No MCs developed in the sham controls. Both surgical curettage and chymopapain injection successfully induced CEP destruction. Endplates with full layer CEP defects were most likely to develop MCs (59.6% vs 11.4%, P < 0.001). Moreover, endplates with MCs had a greater histological degeneration score than those without (8.97 ± 1.92 vs 5.35 ± 2.28, P < 0.001) and higher expression levels of inflammatory factors (IL-1β, TNF-α, and IL-6, P < 0.05 for all) in the subchondral vertebral marrow. Conclusions CEP destruction, induced either by physical curettage or chemical lysis, can lead to long-lasting inflammation in the vertebral marrow and Modic-like signal changes on MR images. CEP destruction may be a root pathology underlying MCs.
Quality of Life, Self-Esteem, and Stress among First-Semester Student Nurses in Indonesia: A Cross-Sectional Study
Authors: Komariah Maria , Eriyani Theresia , Rahayuwati Laili , Agustina Hana Rizmadewi , Nurhakim Furkon , Somantri Irman , Qadous Shurouq Ghalib , Janmanee Aurawan , Gartika Nina 
Published: February 2025

Introduction College presents students with various new challenges, including changes in environment, learning methods, friendships, and other unfamiliar situations, potentially triggering mental health issues. Recent epidemiological data show that the prevalence of depression and stress among college students aged 18–24 years is 37.2% and 23.7%, respectively. Objective This study aimed to determine the circumstances and factors affecting the quality of life, self-esteem, and stress of first-year undergraduate nursing students in Indonesia. Methods In total, 300 nursing students were recruited to participate in a quantitative descriptive cross-sectional mental health survey to determine the quality of life, self-esteem, and stress levels of first-semester students across multiple nursing education centers. The instruments used in this study were the WHOQOL-BREF, Rosenberg Self-Esteem Scale (RSES), and Perceived Stress Scale (PSS). Multiple linear regression was conducted to identify significant relationships between the variables. Data were analyzed using univariate and bivariate analyses with Microsoft Excel and SPSS, presenting results as regression coefficients and 95% confidence intervals. Results The results of bivariate analysis in this study showed that health status, relevance of expectations, goals, and standards had a significant influence on quality of life ( p < .05). In addition, our study found that self-esteem had a significant relationship with quality of life in first-semester student nurses ( p = .010). Conclusion Based on the findings that first-semester nursing students experience moderate stress yet generally exhibit good self-esteem and quality of life, universities should prioritize assessments of students’ physical and psychological well-being during their adaptation period. It is recommended to implement counseling services, enhance support from guardian lecturers, and foster positive engagement with parents to address the expectations and goals influencing students’ quality of life. These strategies aim to improve overall well-being and academic success among new nursing students.
Racially Equitable Homeless Services: Exploring Organizational Characteristics
Authors: Thurman Whitney , Heitkemper Elizabeth , Hutson Tara , Wright Summer , Patten Amy , Kaltz Andrea 
Published: February 2025

Purpose Racial disparities in homelessness are pervasive and necessitate sustained effort on improving racial equity in homeless services. This study used a community-engaged approach and qualitative methods to describe the role of informal organizations identified by Black adults with lived experience of homelessness as preferred locations for accessing services and to explore the values and beliefs of these informal organizations. The study included representatives ( N = 19) of community organizations ( N = 17) in one southern city. Most participants ( n = 14, 73.6%) worked in paid positions and included executive directors as well as volunteers. Findings Thematic analysis identified three themes that characterized values and the ways in which these organizations interface with one another and with the formal homelessness response system (HRS): boots-on-the-ground, the homelessness response system is inequitable, and cautious collaboration. Findings reveal avenues through which local collaboration can be improved and potential policies to improve racial equity in homeless services. Conclusions Informal organizations fill critical gaps in services and can reach people experiencing homelessness who are unable or unwilling to access formal services. However, informal organizations often remain disconnected from the larger HRS which can exacerbate racial inequities. Community care hubs are a promising solution to incorporating smaller organizations and building a more integrated and equitable HRS.
Improving genomic prediction of vitamin C content in spinach using GWAS-derived markers
Authors: Rameneni Jana Jeevan , Islam A S M Faridul , Avila Carlos A. , Shi Ainong 
Published: February 2025

Abstract
Vitamin C (VC), also known as ascorbic acid and ascorbate, is a water-soluble antioxidant in plants that promotes skin health and immune function in humans. Spinach (Spinacia oleracea L.) is a leafy green widely consumed for its health benefits. Recent reports have shown that nutritional content, including VC, can be improved in spinach. However, due to its complex inheritance, new selection methods are needed to improve selection for cultivar development. In this study, single nucleotide polymorphism (SNP) markers identified by genome-wide association (GWAS) were used for genomic prediction (GP) to improve prediction accuracy (PA) for VC content in spinach. A set of 147,977 SNPs generated from whole genome resequencing was used for GWAS in a panel of 347 spinach genotypes by six GWAS models. Sixty-two SNP markers distributed on all six spinach chromosomes were associated with VC content. PA for the selection of VC content was estimated with fourteen random SNP sets across seven GP models. The results indicated that the PA can be > 40% after using 1,000 or more SNPs in six of the seven models tested; using GWAS-derived significant SNP markers PA increases to a high r-value up to 0.7 when using 62 associated SNP markers in Bayes ridge regression (BRR) model. Upon validation, identified accessions with high VC and high PA genomic selection model can be used in spinach breeding programs to develop high VC content cultivars.
Assessing the representativeness of large medical data using population stability index
Authors: Lu Sheng-Chieh , Song Wenye , Pfob Andre , Gibbons Chris 
Published: February 2025

Abstract

Background
Understanding sample representativeness is key to interpreting findings from epidemiological research and applying these findings to broader populations. Though techniques for assessing sample representativeness are available, they rely on access to raw data detailing the population of interest which are often not readily available and may not be suitable for comparing large datasets. In reality, population-based data are often only available in an aggregated format. In this study, we aimed to examine the capability of population stability index (PSI), a popular metric to assess data drift for artificial intelligence studies, in detecting sample differences using population-based data.

Method
We obtained United States cancer statistics from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database. We queried the SEER 17-registry research database to obtain cancer count data by age, sex, and cancer site groups from the rate sessions of the SEER*State incidence database for 2000 and 2015 – 2020. We then calculated PSI scores to estimate yearly data distribution shift from 2015 to 2020 for each variable. We compared the PSI results to the Chi-Square and Cramér's V tests for the same comparisons.

Results
Scores for PSI comparing age, sex, and cancer site distribution between years ranged widely from 2.96 to less than 0.01. In line with our expectations, we found moderate to substantial differences in cancer population characteristics between 2000 and all other included years using PSI. Despite small effect sizes (Cramér's V 0.01 – 0.09), Chi-Square tests were significant for most comparisons, indicating likely type-I error caused by our large sample.

Conclusions
Population stability index can be used to examine sample differences in healthcare studies where only binned data are available or where large datasets may reduce the reliability of other metrics. Inclusion of PSI in epidemiological research will give greater confidence that results are representative of the general population.
Ganga hospital open injury severity score as a predictor of early failure of limb salvage among gustilo type III A and B tibia fractures in Uganda: a prospective cohort study
Authors: Okuku Maxwel Dancan , Kabuye Umaru , Khadolwa Stephen Angira , Aweis Abubakar Mohamed , Xaviour Okedi Francis , Abraha Demoz , Quealee Charles , Olasinde Anthony Ayotunde , Usman Ibe Michael 
Published: February 2025

Abstract

Background
Despite advances in antibiotic therapy and microsurgery, the management of Gustilo and Anderson type IIIA and B open tibia fractures continues to pose a considerable challenge in developing countries. This has evolved from historical immediate amputation to modern approaches that prioritize both aesthetics and functional outcomes. Nonetheless, a consensus on limb salvage versus amputation remains elusive, prompting the development of prognostic limb scoring systems. Our study assessed the predictive accuracy of the Ganga Hospital Open Injury Severity Score (GHOISS) for early failure of limb salvage in Gustilo type IIIA and B tibia injuries.

Methods
This was a prospective study that examined open tibia fractures at two tertiary hospitals in the emergency and orthopaedic units between June and October 2023. Fifty-three (26 IIIB and 27 IIIA) satisfied the study inclusion and exclusion criteria. Four injuries (type IIIA) in paediatric patients that had met the inclusion criteria were excluded from analysis to ensure homogeneity and generalizability of the results due to their small numbers. The severity of injury for each Gustilo type III A and B tibia fracture was determined using the GHOISS, and limb salvage decisions were made irrespective of the GHOISS. Follow-up was extended for up to fourteen days to assess the necessity of secondary amputation in salvaged limbs.

Results
Among 49 Gustilo type IIIA and B tibia fractures, 43 were successfully salvaged, while 6 necessitated amputation (4 primary, 2 secondary). A GHOISS of 13 demonstrated maximum specificity (90.7%) and sensitivity (83.3%) in predicting amputation, with an AUC of 0.923 (95% CI 0.804–0.977), indicating strong discriminatory accuracy.

Conclusion
The GHOISS reliably predicted outcomes in patients with Gustilo type IIIA and B tibia fractures, with a score of 13 demonstrating optimal sensitivity and specificity above which early failure of limb salvage is anticipated.
Phase one of a hybrid effectiveness-implementation study to assess the feasibility, acceptability and effectiveness of implementing seasonal malaria chemoprevention in Nampula Province, Mozambique
Authors: Baker Kevin , Pulido Tarquino Ivan Alejandro , Aide Pedro , Bonnington Craig , Rassi Christian , Richardson Sol , Nnaji Chuks , Roca-Feltrer Arantxa , Rodrigues Maria , Sitoe Mercia , Enosse Sonia , McGugan Caitlin , Saute Francisco , Matambisso Gloria , Candrinho Baltazar 
Published: February 2025

Abstract

Background
Seasonal malaria chemoprevention (SMC) is a highly effective intervention for malaria prevention in high burden areas with seasonal transmission, historically implemented in the Sahel. Mozambique contributes to 4% of global malaria cases. Malaria Consortium, in partnership with the National Malaria Control Programme, conducted a two-year phased SMC study in Nampula province using sulfadoxine-pyrimethamine (SP) plus amodiaquine (AQ), or SPAQ, in children under five. Phase one results presented here highlight acceptability, feasibility, and protective effect of SMC.

Methods
A pragmatic type II hybrid effectiveness-implementation study design was adopted, using mixed methods. The study was conducted in three districts, utilizing: (1) non-randomized controlled trial reporting on malaria incidence; (2) drug resistance molecular marker study reporting on resistance marker changes over time; (3) coverage and quality assessment on the SMC distribution; and (4) a qualitative acceptability and feasibility assessment with stakeholders.

Results
Children who received SMC had 86% (hazard ratio 0.14, 95% CI 0.09–0.24) lower hazards of developing clinical malaria during the peak transmission season compared with children in the comparison district. Prevalence of SP molecular markers associated with resistance was high at baseline (K540E 66.1%). SMC achieved high coverage of eligible children over four cycles (87.7%, 95% CI 83.9–90.8%). Qualitative results indicate SMC was positively accepted by the targeted community.

Conclusions
Results suggest that SMC was effective at preventing clinical malaria, did not significantly impact resistance profile, and was feasible and acceptable in the context. Phase two will assess SMC impact in reducing malaria incidence and if chemoprevention efficacy of SPAQ is impacted by drug resistance and drug concentrations.
Improving research and development of wearable assistive and rehabilitation technologies: a systematic review on diversity factors
Authors: Lorke Mariya , Stefanou Thekla 
Published: February 2025

Abstract
This paper analyses diversity and intersectionality aspects in the R&D of wearable assistive and rehabilitation technologies (WEARTechs). We advocate for inclusive, innovative research that we hope will help bridge the gap between laboratories and the real world and reduce disparities in healthcare and technology development. We performed a systematic literature review of the intersections between assistive technologies and diversity and conducted a thematic analysis of the diversity factors identified in the literature. In addition, we carried out a supplementary literature search on WEARTechs to discover which, if any, diversity aspects are currently being reported on. Our findings indicate that diversity has not been addressed in the field of WEARTechs. There is not sufficient knowledge to determine, which diversity-related aspects researchers must consider when evaluating the performance of any specific WEARTech device. Nor about how these can be properly addressed in the R&D process. We, therefore, provide actionable recommendations on how to integrate diversity-relevant aspects at different R&D stages. We hope that our review will help scientists rethink and reformulate approaches to the R&D of WEARTechs and build the way towards more inclusive solutions. It is our belief that this will spark innovation and enhance discovery potential in the field.