bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnetic resonance imaging findings among young adults with low back pain at Nsambya hospital
Authors: Lukecha Komakech Richard , Geoffrey Erem , Gonzaga Mubuuke A. , Sam Bugeza 
Published: June 2022

Abstract
Background
Studies on MRI findings among patients with LBP have been conducted; especially among adolescents and young adult population in developed countries. However, MRI lumbar spine evaluation findings in young adult patients with low back pain in Uganda is not known. The purpose of this study was to determine the MRI findings and their correlation to clinical features in young adult patients with low back pain in Nsambya hospital.

Methods
This was a descriptive cross sectional study. One hundred and fifty-seven patients with low back pain in the 18–39 year age group underwent MRI lumbar spine evaluation. The MRI changes in the lumbar spine and correlation to clinical features were determined. Correlation was assessed by Pearson chi square tests (Fisher’s exact test) and p values reported at 0.05 level of significance.

Results
Of the 157 patients 129 (82.2%) had severe pain, whereas ninety (57.3%) had pain that had lasted more than 10 weeks. Sixty-five (41.4%) patients were found to have MRI evidence of disc desiccation, majority (61%) of whom had multiple level disease, mostly involving the lowest 2 disc levels. Facet joint arthropathy (47.8%), marginal osteophyte (31.8%) and disc contour irregularity [disc bulge] (31.2%) were other common MRI features seen. There was an association between duration of pain and limb weakness, and development of marginal osteophytes. There was also association between clinical presentation and disc bulge.

Conclusions
The MRI finding of disc degeneration among young adult patients with LBP is higher than reported. Age and pain distribution are predictors of developing disc desiccation.
A stratification model of hepatocellular carcinoma based on expression profiles of cells in the tumor microenvironment
Authors: Zeng Chunting , Zhang Linmeng , Luo Chanhua , Yang Chen , Huang Xiaowen , Fan Linfeng , Li Jiarong , Chen Fengsheng , Luo Zelong 
Published: June 2022

Abstract
Background
A malignancy of the liver, hepatocellular carcinoma (HCC) is among the most common and second-leading causes of cancer-related deaths worldwide. A reliable prognosis model for guidance in choosing HCC therapies has yet to be established.

Methods
A consensus clustering approach was used to determine the number of immune clusters in the Cancer Genome Atlas and Liver Cancer-RIKEN, JP (LIRI_JP) datasets. The differentially expressed genes (DEGs) among these groups were identified based on RNA sequencing data. Then, to identify hub genes among signature genes, a co-expression network was constructed. The prognostic value and clinical characteristics of the immune clusters were also explored. Finally, the potential key genes for the immune clusters were determined.

Results
After conducting survival and correlation analyses of the DEGs, three immune clusters (C1, C2, and C3) were identified. Patients in C2 showed the longest survival time with the greatest abundance of tumor microenvironment (TME) cell populations. MGene mutations in Ffibroblast growth factor-19 (FGF19) and catenin (cadherin-associated protein),β1(CTNNB1) were mostly observed in C2 and C3, respectively. The signature genes of C1, C2, and C3 were primarily enriched in 5, 23, and 26 pathways, respectively.

Conclusions
This study sought to construct an immune-stratification model for the prognosis of HCC by dividing the expression profiles of patients from public datasets into three clusters and discovering the unique molecular characteristics of each. This stratification model provides insights into the immune and clinical characteristics of HCC subtypes, which is beneficial for the prognosis of HCC.
A predictive model for advanced oropharyngeal cancer patients treated with chemoradiation
Authors: Lo Wu-Chia , Chang Chih-Ming , Wu Chia-Yun , Hsieh Chen-Hsi , Shueng Pei-Wei , Cheng Po-Wen , Liao Li-Jen 
Published: June 2022

Abstract
Background
To analyze clinical characteristics in the prediction of death within 1 year in advanced oropharyngeal cancer patients treated with chemoradiation.

Methods
One hundred forty-seven advanced oropharyngeal cancer patients who underwent curative-intent chemoradiation treatment were retrospectively enrolled. The pre-treatment clinical parameters including inflammatory markers were reviewed.

Results
The 1-year death rate for all patients was 29% [95% confidence interval (CI): 23–37%]. In multivariate logistic regression analysis, hemoglobulin (Hb) < 13.5 g/dl was an independent indicator of death within 1-year [Odds ratio (OR) 5.85, 95% CI 2.17–15.75, p < 0.001]. Systemic immune inflammation (SII) ≥ 1820 was also a significant factor for prediction of death within 1 year (OR 4.78, 95% CI 1.44–15.85, p = 0.011). We further used gander, age, Hb and SII to develop a nomogram to predict death within 1 year. The c-index of the model was 0.75 (95%CI 0.66–0.83). For patients with low nomogram score (< 14) versus high nomogram score (≥ 14), the 1-year and 2-year OS rates were 91 and 71% versus 53 and 29%, respectively. (p < 0.001). A difference in the disease persistence or recurrence rate between patients with high and low nomogram score was significant (73 and 28%, respectively; p < 0.001).

Conclusions
The pre-treatment Hb < 13.5 g/dl and SII ≥ 1820 are associated with higher risks of death within 1-year in patients with advanced oropharyngeal cancers. Nomogram can aid in patient counseling and treatment modality adjustment. The development of a more effective treatment protocol for patients with high nomogram score will be essential.
Association of polymorphisms in the erythropoietin gene with diabetic retinopathy: a case–control study and systematic review with meta-analysis
Authors: Sesti Luís Fernando Castagnino , Sbruzzi Renan Cesar , Polina Evelise Regina , dos Santos Soares Douglas , Crispim Daisy , Canani Luís Henrique , dos Santos Kátia Gonçalves 
Published: June 2022

Abstract
Background
Diabetic retinopathy (DR) is characterized by ischemia, hypoxia, and angiogenesis. Erythropoietin (EPO), an angiogenic hormone, is upregulated in DR, and the association of EPO genetic variants with DR is still uncertain, as conflicting results have been reported. Therefore, we performed a case–control study followed by a meta-analysis to investigate whether the rs1617640, rs507392, and rs551238 polymorphisms in EPO gene are associated with DR.

Methods
The case–control study included 1042 Southern Brazilians with type 2 diabetes (488 without DR and 554 with DR). Eligible studies for the meta-analysis were searched from electronic databases up to June 1, 2021. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for five genetic inheritance models.

Results
The minor alleles of the EPO polymorphisms had nearly the same frequency in all groups of patients (35%), and no association was detected with DR in the case–control study. The meta-analysis included 14 independent sets of cases and controls with 9117 subjects for the rs1617640 polymorphism and nine independent sets with more than 5000 subjects for the rs507392 and rs551238 polymorphisms. The G allele of the rs1617640 polymorphism was suggestively associated with DR under the dominant (OR = 0.82, 95% CI: 0.68–0.98), heterozygous additive (OR = 0.82, 95% CI: 0.69–0.97), and overdominant (OR = 0.88, 95% CI: 0.79–0.97) models. In the subgroup analyses, the G allele was also suggestively associated with proliferative DR (PDR), non-proliferative DR (NPDR), and DR (PDR + NPDR) among patients with type 1 diabetes (T1DM) or non-Asian ancestry. After considering the Bonferroni correction for multiple comparisons, the G allele remained associated with NPDR and DR in T1DM. Regarding the rs507392 and rs551238 polymorphisms, no association was found between these variants and DR.

Conclusion
Our findings provide additional support to EPO as a susceptibility gene for DR, with the rs1617640 polymorphism deserving further investigation.
Intravitreal ranibizumab improves macular sensitivity in patients with central retinal vein occlusion and macula edema
Authors: Otawa Taro , Noma Hidetaka , Yasuda Kanako , Narimatsu Akitomo , Asakage Masaki , Tanaka Akina , Goto Hiroshi , Shimura Masahiko 
Published: June 2022

Abstract
Background
Patients with central retinal vein occlusion (CRVO) and macular edema often are treated by intravitreal ranibizumab injection (IRI). The role of changes in macular sensitivity in the positive effects of IRI on visual functions is unclear. Therefore, we assessed the relationship between macular sensitivity and improvement of visual functions.

Methods
We included 15 eyes of 15 patients with treatment-naïve CRVO and followed patients for 6 months after pro re nata IRI. IRI was repeated if the central macular thickness was greater than or equal to 300 µm. Microperimetry-3 was used to measure macular sensitivity within the central 1-mm, 3-mm, and 6-mm fields before and monthly for 6 months after IRI.

Results
IRI significantly improved mean macular sensitivity over time within the central 1-mm, 3-mm, and 6-mm fields (all P < 0.001). None of the fields showed significant differences in the change of mean macular sensitivity between patients with little improvement in best corrected visual acuity (BCVA; i.e., in patients with a change in logarithm of the minimum angle of resolution [logMAR] BCVA < 0.3) and those with marked improvement in BCVA (change in logMAR BCVA > 0.3). The mean macular sensitivity before IRI showed correlations with the improvement of macular sensitivity in every field.

Conclusion
These findings suggest that IRI improves macular sensitivity in patients with CRVO and macular edema independent of any improvement in BCVA and that macular sensitivity before treatment is associated with improvement of macular sensitivity after treatment.
A study protocol to evaluate the impact of a personal and domestic hygiene intervention on lead exposure in a community next to a mine dump
Authors: Mokoatle Charlotte , Mathee Angela , Street Renee , Nkosi Vusumuzi 
Published: June 2022

Abstract
Background
Lead has been associated with adverse health effects, especially neurocognitive and behavioural effects, in children. Communities living close to mining land are at risk of elevated exposure to lead.

Methods
This paper outlines a before and after intervention study protocol to evaluate the impact of a personal and domestic hygiene intervention on lead exposure in a community located adjacent to a mine dump. In each participating household, parents or guardians will be interviewed using a structured questionnaire to obtain information on socio-demographic characteristics, living conditions, domestic hygiene practices and potential alternative sources of exposure to lead. A registered nurse will collect hand wipe samples from children aged one to five years, for whom parental consent and where possible child assent has been obtained. Environmental dust samples will be collected from the floors and/or windowsills of children’s dwellings for lead content analysis. Soil samples will be collected from yards to determine lead content. An educational intervention will then be applied to the intervention group, including the engagement of households or guardians in an educational discussion on the sources, pathways of exposure, health effects of lead exposure and protective measures, with the aid of a specially designed educational brochure. Data will be analysed for descriptive and inferential statistics using Stata version 16.

Discussion
The study will determine whether the intervention led to a reduction in indoor dust lead levels, and if shown to be effective, will inform the development of an awareness campaign to reduce lead exposure in communities located in close proximity to mine dumps.

Trial registration
The study is retrospectively registered on ClinicalTrials.gov Protocol Registration and Results System with registration number NCT05265572 and first release date of 18th February 2022.
Participation in a food assistance program and excessive weight gain: an evaluation of the Brazilian Worker’s Food Program in male and female manufacturing workers
Authors: Costa Raiane Medeiros , Bezerra Ingrid Wilza Leal , Torres Karina Gomes , Pereira Gabriela Santana , de Souza Anissa Melo , Oliveira Antonio Gouveia 
Published: June 2022

Abstract
Background
Several published studies have reported an association between participation in a food assistance program and greater prevalence of overweight/obesity. Our aim was to compare nutritional status and nutrient consumption between workers from manufacturing companies participant and non-participant in the Brazilian Workers’ Food Program (WFP).

Design
Cross-sectional survey, based on a probability sample of manufacturing workers in Brazil obtained by stratified two-stage sampling, comparative between WFP and non-WFP participating companies. Body mass index (BMI), waist circumference (WC), and nutrient consumption (24-hour recall) were collected by trained nutritionists. Statistical analysis was done separately in each sex with mixed effects multilevel linear regression model including sampling weights and covariate adjustment.

Results
Thirty-three companies were randomly selected from all companies in three different economic activity sectors (food and beverages, non-metallic minerals, and textiles) in North-eastern Brazil, with stratification by company size, and a random sample of 929 workers (484 from non-WFP and 445 from WFP companies) was obtained from those companies. In males, the WFP group had higher BMI (+ 1.08 kg/m2, p < 0.001), greater WC (+ 3.27 cm, p < 0.001) and greater prevalence of obesity (OR 1.67, p < 0.001). In females, no statistical significant differences were observed in anthropometric parameters, but the WFP group had lower prevalence of obesity (OR 0.49, p = 0.05). Among workers in companies that provide lunch, males from WFP companies have greater consumption of carbohydrates (+ 39.5 kcal, p = 0.02) and protein (+ 11.1 kcal, p = 0.08), while females have lower protein consumption (− 14.2 kcal, p = 0.04) and also lower total daily consumption of carbohydrates (− 59.3 Kcal, p = 0.05) and total lipids (− 14.2 Kcal, p = 0.04).

Conclusions
Participation in the WFP is associated with increased BMI and WC among male workers; however, this association was not found in females. Compared to the non-WFP group, in the WFP group, males have greater consumption of carbohydrates and protein at lunch, while women have lower protein intake. These results indicate the need that proposals for public policies aimed to the improvement of the nutritional status of populations take into consideration the different effects of food assistance programs in males and females.
Trends and country-level variation in age at first sex in sub-Saharan Africa among birth cohorts entering adulthood between 1985 and 2020
Authors: Nguyen Van Kính , Eaton Jeffrey W. 
Published: June 2022

Abstract
Background
Debuting sexual intercourse marks exposure to pregnancy or fatherhood and sexually transmitted infections (STIs), including HIV. In sub-Saharan Africa (SSA), sexual debut varies according to cultural, religious, and economic factors, and encouraging delay has been a longstanding component of behavioural HIV prevention strategies. Age at first sex (AFS) is routinely collected in national household surveys, but data are affected by reporting biases, limiting utility to monitor trends and guide sexual health interventions.

Methods
We collated individual-level data from nationally-representative household surveys to analyse timing and national trends in AFS in 42 SSA countries. We used a log-skew-logistic distribution to characterize the time to AFS in a Bayesian spatio-temporal model, providing estimates of the sexual debut rate by sex, age, time, and country. We statistically adjusted for reporting biases by comparing AFS reported by the same birth cohorts in multiple survey rounds, allowing different reporting biases by sex and country.

Results
Median AFS in 2015 ranged from 15.8 among Angolan women to 25.3 among men in Niger. AFS was younger for women than men in 37/40 countries. The gap was largest for Sahel region countries and minimal in southern African countries. The distribution of female AFS was asymmetric with half debuting sex in an age range of 3.9 years [IQR 3.4–5.0 across countries]. Median AFS increased slightly between 1985 and 2020, ranging 0.84 years [IQR 0.11–1.55] and 0.79 [IQR -0.23–1.98] for females and males, respectively. The gender gap changed little over time in most countries. Female teens often reported higher AFS compared to when asked in their late twenties while male teens reported lower AFS; both sexes recalled a higher AFS in older ages compared to their thirties.

Conclusions
AFS increased slightly in most SSA countries, but changes were modest relative to large and persistent variation between countries and sexes, indicating relatively entrenched socio-cultural practices around sexual debut. Sexual health, family planning, and HIV/STI prevention services should adapt to local practices rather than focusing interventions to change AFS. These estimates for rates of sexual debut provide data to guide programmatic prioritization and implementation of sexual health services.
A database of US state policies to mitigate COVID-19 and its economic consequences
Authors: Skinner Alexandra , Flannery Kelsey , Nocka Kristen , Bor Jacob , Dean Lorraine T. , Jay Jonathan , Lipson Sarah Ketchen , Cole Megan B. , Benfer Emily A. , Scheckman Rachel , Raderman Will , Jones David K. , Raifman Julia 
Published: June 2022

Abstract
Background
Since COVID-19 first appeared in the United States (US) in January 2020, US states have pursued a wide range of policies to mitigate the spread of the virus and its economic ramifications. Without unified federal guidance, states have been the front lines of the policy response.

Main text
We created the COVID-19 US State Policy (CUSP) database (https://statepolicies.com/) to document the dates and components of economic relief and public health measures issued at the state level in response to the COVID-19 pandemic. Documented interventions included school and business closures, face mask mandates, directives on vaccine eligibility, eviction moratoria, and expanded unemployment insurance benefits. By providing continually updated information, CUSP was designed to inform rapid-response, policy-relevant research in the context of the COVID-19 pandemic and has been widely used to investigate the impact of state policies on population health and health equity. This paper introduces the CUSP database and highlights how it is already informing the COVID-19 pandemic response in the US.

Conclusion
CUSP is the most comprehensive publicly available policy database of health, social, and economic policies in response to the COVID-19 pandemic in the US. CUSP documents widespread variation in state policy decisions and implementation dates across the US and serves as a freely available and valuable resource to policymakers and researchers.
Age, sex, residence, and region-specific differences in prevalence and patterns of multimorbidity among older Chinese: evidence from Chinese Longitudinal Healthy Longevity Survey
Authors: Han Siyue , Mo Guangju , Gao Tianjing , Sun Qing , Liu Huaqing , Zhang Min 
Published: June 2022

Abstract
Background
Multimorbidity among older adults, which is associated with added functional decline and higher health care utilization and mortality, has become increasingly common with the dramatic acceleration of ageing in China. The purpose of this study was to reveal age, sex, residence, and region- specific prevalence and patterns of multimorbidity among older adults in China.

Methods
This study is based on the 2018 Chinese Longitudinal Health Longevity Survey (CLHLS), the most recent edition of this national survey, and involved analysis of 15,275 participants aged 65 years and older. Multimorbidity was defined as an individual who has two or more chronic diseases or conditions and was divided into two types for analysis: ≥2 (MM2+) and ≥ 3 (MM3+). Fourteen chronic diseases or conditions surveyed were used to assess patterns of multimorbidity through association rule mining.

Results
Among the 15,275 participants, the largest proportion (39.9%) was 90 years old and over, while the distribution of sex and residence is roughly the same. Overall, the prevalence of multimorbidity was 44.1% for MM2+ and 22.9% for MM3+. The most frequently occurring patterns were two or three combinations between hypertension, cardiovascular diseases and affective disorders. Cardiovascular diseases combined with diabetes or dyslipidemia showed the most predominant association in different age groups. Moreover, the prevalence of the hypertension +diabetes pattern decreased with age. The strongest associations were found for the clustering of hypertension + cardiovascular diseases + respiratory diseases in males, however, among females it was the cardiovascular diseases + diabetes cluster. Cardiovascular diseases + rheumatoid arthritis + visual impairment was observed in urban areas and hypertension + cardiovascular diseases + affective disorders in rural areas. The most distinctive association rule in Northern China was {cardiovascular diseases, hypertension, visual impairment} = > {diabetes}. Respiratory disease was more prevalent in combination with other systemic disorders in Western China, and affective disorders in Southern China.

Conclusions
The prevalence of multimorbidity among older Chinese was substantial, and patterns of multimorbidity varied by age, sex, residence, and region. Future efforts are needed to identify possible prevention strategies and guidelines that consider differences in demographic characteristics of multimorbid patients to promote health in older adults.
The association between major dietary patterns and severe mental disorders symptoms among a large sample of adults living in central Iran: Baseline data of YaHS-TAMYZ cohort study
Authors: Shams-Rad Shamim , Bidaki Reza , Nadjarzadeh Azadeh , Salehi-Abargouei Amin , de Courten Barbora , Mirzaei Masoud 
Published: June 2022

Abstract
Background
The diet’s role in developing psychological disorders has been considered by researchers in recent years.

Objective
To examine the association between major dietary patterns and severe mental disorders symptoms in a large sample of adults living in Yazd city, central Iran.

Methods
This cross-sectional study used the baseline data of a population-based cohort study (Yazd Health study: YaHS). Dietary intakes were assessed by a multiple-choice semi-quantitative food frequency questionnaire (FFQ, Yazd nutrition survey called TAMYZ). Psychological assessments were also done by using the depression, anxiety, and stress scale-21 (DASS-21) questionnaire. Major dietary patterns were identified using principal component analysis (PCA). Analysis of covariance (ANCOVA) and logistic regression analyses were used to evaluate the relationship between dietary patterns and mental disorders symptoms.

Results
A total of 7574 adults were included in the current analysis. Four major dietary patterns were identified: "Sugar and Fats”, “Processed Meats and Fish”, "Fruits" and “Vegetables and Red Meat”. After adjustment for all confounding variables, participants in the fifth quintile of “Fruits” dietary pattern which was highly correlated with dried fruits, canned fruits, fruit juice, olive, hydrogenated fats and fruits intake, had a lower odds of severe depression (OR=0.61, 95% CI: 0.45–0.81, p for trend=0.057), anxiety (OR=0.64, 95% CI: 0.50–0.80, p for trend=0.007), and stress, (OR=0.45, 95% CI: 0.30–0.68, p for trend=0.081).

Conclusions
The intake of a dietary pattern high in dried fruits, canned fruits, fruit juice, olive, hydrogenated fats, and fruits might be inversely associated with depression, anxiety, and stress symptoms. Future prospective studies are needed to warrant this finding.