bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-effectiveness analysis of sugemalimab vs. chemotherapy as first-line treatment of metastatic nonsquamous non-small cell lung cancer
Authors: Zheng Zhiwei , Zhu Huide , Fang Ling , Cai Hongfu 
Published: September 2022

Objective: Sugemalimab is approved in China as a first-line treatment in combination with chemotherapy for metastatic nonsquamous non-small cell lung cancer (NSCLC). This study aims to evaluate the cost-effectiveness of first-line additional sugemalimab in combination with chemotherapy vs. chemotherapy from the perspective of the Chinese healthcare system.Materials and methods: A three-state Markov model was designed to evaluate the costs and quality-adjusted life years (QALYs) of first-line sugemalimab combination with chemotherapy vs. chemotherapy over a 10-year period. Data on clinical outcomes were obtained from GEMSTONE-302 clinical trials. Costs and health utilities were collected from local databases and published literature. The uncertainty of the model parameters was explored through sensitivity analysis.Results: Compared to chemotherapy, sugemalimab treatment for NSCLC resulted in an extra 0.50 QALYs at an additional cost of $73627.99, with an incremental cost-effectiveness ratio (ICER) of 148354.07/QALY at the willingness-to-pay (WTP) threshold of $37663.26/QALY. One-way sensitivity analysis indicated that the primary motivator in this model was the cost of sugemalimab. However, none of the parameters significantly affected the model’s results.Conclusion: Sugemalimab combination therapy is not economically advantageous for the first-line management of metastatic non-squamous NSCLC, according to the Chinese healthcare system.
Effects of WeChat use on the subjective health of older adults
Authors: Wei Ning , Sun Dingqiang , Huang Wenhao 
Published: September 2022

ObjectivesIn this study, the effect of WeChat use on the subjective health of older adults was examined.MethodsUsing 2018 China Health and Retirement Longitudinal Study (CHARLS) survey data, we attempted to rule out potential endogeneity bias by employing instrumental variable regression to estimate the effects of WeChat use on the health of older individuals. Mobile phone price was chosen as the instrumental variable, and the health of older adults was measured from two aspects: self-rated health and the Center for Epidemiological Studies of Depression Scale (CES-D10).ResultsWeChat use has a significant positive impact on the subjective health of older adults and can significantly improve their self-rated health and mental health status. WeChat use has significant positive effects on the subjective health of both older men and women, but relatively younger older adults obtain more health benefits from WeChat use.ConclusionThe virtual social participation prompted by WeChat use affects the health of older adults. This finding provides a reference for promoting the active integration of older adults into digital life.
Executive functions mediate the association between ADHD symptoms and anxiety in a clinical adolescent population
Authors: Haugan Anne-Lise Juul , Sund Anne Mari , Thomsen Per Hove , Lydersen Stian , Nøvik Torunn Stene 
Published: September 2022

ObjectiveAttention-deficit/hyperactivity disorder (ADHD) is associated with a high prevalence of anxiety disorders in children and adolescents. The reasons for this association are poorly understood. Preliminary findings with young adults have suggested that executive functions and functional impairment may mediate the relationship between symptoms of ADHD and mixed anxiety and depressive symptoms. The objective of this study was to explore whether ADHD symptoms, executive functions and functional impairment predict anxiety in a clinical adolescent population. In addition, we investigated the possible mediating role of executive functions and functional impairment in this relationship.MethodOne hundred adolescents with ADHD and their parents completed the ADHD Rating Scale IV (ADHD RS-IV), the Behavior Rating Inventory of Executive Function (BRIEF), and the Weiss Functional Impairment Rating Scale (WFIRS) in relation to an RCT study. The adolescents also completed the Screen for Child Anxiety-Related Emotional Disorders (SCARED). Analyses were conducted using regression and a serial multiple mediator model.ResultsIn the regression analyses, parent-rated ADHD symptoms were unable to predict anxiety, but ADHD inattention symptoms predicted anxiety in the self-ratings. Executive dysfunction and functional impairment predicted anxiety in both the parent- and self-reports. In the mediation analyses ADHD symptoms alone did not predict anxiety, but executive dysfunction mediated this relationship as expected. Functional impairment mediated this relationship indirectly through executive functions. The results were similar in the parent- and self- reports.ConclusionThe results pinpoint executive dysfunction as an important treatment target for alleviating anxiety in adolescents with impairing ADHD symptoms.
Relationship Between Self-Acceptance and Intention to Stay at Work Among Clinical Nurses in China: A Cross-Sectional Online Survey
Authors: Kong Lingling , Qin Fangxia , Zhou Aiying , Ding Shanju , Qu Hua 
Published: September 2022

BackgroundDuring the pandemic and with the growing shortage of nurses, the problem of how to retain existing nurses was of paramount importance. However, there is limited evidence on the relationship between nurses' self-acceptance and intention to stay.ObjectivesThis study aimed to investigate the factors influencing nurses' intention to stay at work, and explore the relationship between self-acceptance and their intention to stay.MethodsConvenience sampling was conducted to select nurses who worked in a clinical environment during June 2020, in hospitals in Shandong Province, China. Self-designed basic information and two questionnaires, namely, the “self-acceptance questionnaire” and “intention to stay” were adopted. Mean, median, related analysis, and regression analysis were adopted to describe the relationship of self-acceptance and intention to stay on part of Chinese nurses.ResultsA total of 1,015 clinical nurses participated in the survey. The mean score of intention to stay among participants was 22.00. The multiple regression analysis revealed various factors, such as age, family support the work, interest in work, job suitability, type of employment, professional level, weekly working hours, working department and self-acceptance influenced the nurse's intention to stay (β range from −1.506 to 2.249).ConclusionOur findings identified several factors that are significantly related to and impact the level of intention to stay among clinical nurses.
Association between maternal depression and neonatal outcomes: Evidence from a survey of nationally representative longitudinal studies
Authors: Li Haoran , Ning Wei , Zhang Ning , Zhang Jingya , He Rongxin , Mao Ying , Zhu Bin 
Published: September 2022

Background and aimsMaternal depression before and after delivery has dramatically increased in China. Therefore, this study aimed to examine the association between antepartum and postpartum depression and neonatal outcomes.DesignA population-based retrospective cohort study.SettingChina.ParticipantsData were obtained from China Family Panel Studies (CFPS). Different mother-child/infant samples were included in this study. Mother in CFPS2012 and CFPS2016 were linked with 1–2-year-old children in CFPS2014 and CFPS2018, respectively. Besides, and mothers in CFPS2012, CFPS2016, and CFPS2018 were linked with 0–1-year-old infants in CFPS2012, CFPS2016, and CFPS2018, respectively.MethodsMaternal depression was measured using the Center for Epidemiologic Studies Depression Scale. The neonatal outcomes included duration of gestational days, preterm birth, birth weight, birth weight z-score, weight, weight z-score, illness in the past month, and hospitalization in the past year. Propensity score matching was used to balance maternal, family, and infant/child characteristics between the maternal depression and non-maternal depression groups.ResultsMultivariable regression analysis of matched samples estimated that antepartum depression was associated with a shorter duration of gestation by 3.99 days (95% confidence interval [CI] = −7.21, −0.78). The association between antepartum depression and preterm birth, birth weight and birth weight z-score were not statistically significant. Postpartum depression was associated with more episodes of illness in the last month by 0.23 times (95% CI = 0.11, 0.36) and a higher odd of hospitalization in the previous year (OR = 1.59, 95% CI = 1.15, 2.20). The association between postpartum depression and weight or the weight z-score was not significant.ConclusionMaternal depression appears to be associated with worse neonatal outcomes.
Assessment of influencing factors of hospitalization expenses for Crohn's disease patients: Based on LASSO and linear mixed model
Authors: Wu Li , Lv Zhijie , Lai Linjing , Zhou Penglei 
Published: September 2022

AimsCrohn's disease (CD) is a global disease that is dramatically increasing. This study aimed to identify the primary drivers of hospitalization expenses for CD patients to provide guidance on the allocation and control of health care costs.MethodsThis study retrospectively collected the homepage data of the electronic medical records of CD patients in two tertiary hospitals in Zhejiang Province, China, from January 2016 to December 2021. The influencing factors of hospitalization expenses for CD were analyzed. A linear mixed model with least absolute shrinkage (LASSO-LMM) was used to develop a predictive model for hospitalization expenses for CD patients.ResultsA total of 4,437 CD patients were analyzed in this study. CD patients' age, length of hospital stay, admission route, comorbidities, and main treatment were found to be statistically significant variables for CD patients' hospitalization expenses. The AIC and BIC of LASSO-LMM model were 319.033 and 306.241, respectively. Patients who were older, had a longer hospital stay, and had comorbidities had higher hospitalization expenses. The hospitalization expenses of outpatients were lower than those of emergency patients. The weight of surgical treatment was the highest among three treatments (0.602).ConclusionsIdentifying and examining factors that influence hospitalization expenses for CD patients can help to control healthcare expenditures. Treatment mode was the most important impact on CD hospitalization expenses. Medical security departments can consider implement personalized and precise hospitalization expense compensation scheme base on LASSO-LMM prediction model in the future.
Association between urinary metals and leukocyte telomere length involving an artificial neural network prediction: Findings based on NHANES 1999–2002
Authors: Xia Fang , Li Qingwen , Luo Xin , Wu Jinyi 
Published: September 2022

ObjectiveLeukocytes telomere length (LTL) was reported to be associated with cellular aging and aging related disease. Urine metal also might accelerate the development of aging related disease. We aimed to analyze the association between LTL and urinary metals.MethodsIn this research, we screened all cycles of National Health and Nutrition Examination Survey (NHANES) dataset, and download the eligible dataset in NHANES 1999–2002 containing demographic, disease history, eight urine metal, and LTL. The analysis in this research had three steps including baseline difference comparison, multiple linear regression (MLR) for hazardous urine metals, and artificial neural network (ANN, based on Tensorflow framework) to make LTL prediction.ResultsThe MLR results showed that urinary cadmium (Cd) was negatively correlated with LTL in the USA population [third quantile: −9.36, 95% confidential interval (CI) = (−19.7, −2.32)], and in the elderly urinary molybdenum (Mo) was positively associated with LTL [third quantile: 24.37, 95%CI = (5.42, 63.55)]. An ANN model was constructed, which had 24 neurons, 0.375 exit rate in the first layer, 15 neurons with 0.53 exit rate in the second layer, and 7 neurons with 0.86 exit rate in the third layer. The squared error loss (LOSS) and mean absolute error (MAE) in the ANN model were 0.054 and 0.181, respectively, which showed a low error rate.ConclusionIn conclusion, in adults especially the elderly, the relationships between urinary Cd and Mo might be worthy of further research. An accurate prediction model based on ANN could be further analyzed.
Effect of inactivated COVID-19 vaccination on intrauterine insemination cycle success: A retrospective cohort study
Authors: Xu Zijin , Wu Yixuan , Lin Yanshan , Cao Mingzhu , Liang Zhu , Li Lei , Lin Jiali , Chen Qian , Liu Jianqiao , Liu Haiying 
Published: September 2022

BackgroundVaccine hesitancy was found in couples seeking artificial reproductive technology (ART) services. As the main vaccine used in China, investigations into the influence of inactivated coronavirus disease 2019 (COVID-19) vaccines on human fertility is needed.MethodsThis retrospective cohort study included data on COVID-19 vaccination, clinical characteristics, and reproductive outcome of 1,000 intrauterine insemination (IUI) cycles in 653 couples from March 2021 to March 2022 in a single university hospital-based center for reproductive medicine. The IUI cycles were divided into two categories based on sperm source, including 725 cycles in 492 women undergoing artificial insemination with their husband's sperm (AIH) and 275 cycles in 161 women undergoing artificial insemination with donor sperm (AID). Women were then divided into two groups. The vaccine exposed group included women vaccinated prior to insemination and the unexposed group included women who were not vaccinated or vaccinated after insemination. Reproductive outcomes including ongoing pregnancy rate, clinical pregnancy rate, and miscarriage rate were assessed.ResultsInactivated COVID-19 vaccinated women prior to intrauterine insemination in AIH cycles have comparable ongoing pregnancy rate (11.1 vs. 10.3%, P = 0.73), clinical pregnancy rate (12.5 vs. 11.3%, P = 0.60) as compared with unvaccinated counterparts. Similarly, there were no significant differences in ongoing pregnancy rate (20.9 vs. 28.1%, P = 0.17), clinical pregnancy rate (21.7 vs. 28.8%, P = 0.19) between vaccine exposed and unexposed groups in AID cycles. Multivariable logistic regression analyses showed that inactivated COVID-19 vaccination status cannot independently influence the reproductive outcomes of AIH and AID cycles. Subgroup analysis of vaccine exposed cycles showed that doses of vaccination and Interval between the last dose of vaccination and insemination have no influence on the reproductive outcomes of AIH cycles.ConclusionsNo negative effects were found on female fertility in IUI cycles following exposure to the inactivated COVID-19 vaccine. These findings indirectly reflect the safety of inactivated COVID-19 vaccine toward reproductive health and help to mitigate vaccine hesitancy among people planning to conceive.
Association between blood lead levels and hyperlipidemiais: Results from the NHANES (1999–2018)
Authors: Zhang Yangchang , Liu Weiwei , Zhang Wei , Cheng Rui , Tan Andi , Shen Shisi , Xiong Yang , Zhao Limei , Lei Xun 
Published: September 2022

BackgroundResearch on the association between blood lead (Pb) and lipid biomarkers have yielded inconsistent results, and epidemiological studies on blood Pb levels and hyperlipidemia are scarce. The present study aimed to examine the association between blood Pb levels and hyperlipidemia in adults from the National Health and Nutrition Examination Survey (NHANES).MethodsA total of 43,196 participants in the NHANES from 1999 to 2018 were included in the final analysis. Hyperlipidemia was determined based on the National Cholesterol Education Program guidelines. Blood Pb levels were assessed using inductively-coupled plasma mass spectrometry. Weighted multivariable logistic regression analysis and subgroup analysis were conducted to determine the correlation between blood Pb levels and hyperlipidemia.ResultsIn the multivariable logistic regression model, high blood Pb levels were significantly associated with hyperlipidemia after adjusting for confounders (OR 1.41; 95%CI: 1.18–1.67). Furthermore, elevated blood Pb levels were associated with an increased risk of hyperlipidemia across the four quartile (Q) groups (Q1: OR 1.00; Q2: OR 1.16 [95%CI: 1.04–1.29]; Q3: OR 1.39 [95%CI: 1.21–1.59]; and Q4: OR 1.33 [95%CI: 1.15–1.54]; P for trend &lt;0.05). Significant moderating effects were found in the subgroup analysis stratified by age, education, hypertension, and diabetes (P &lt; 0.05). In sensitivity analysis, the ORs for hyperlipidemia across the quartiles of blood Pb levels were 1.00, 1.17 (95%CI: 1.05–1.30), 1.42 (95%CI: 1.24–1.62), and 1.38 (95%CI: 1.19–1.60) for Q1, Q2, Q3, and Q4, respectively (P for trend &lt;0.001) after removing adults with arteriosclerotic cardiovascular disease, and the ORs were 1.00, 1.13 (95%CI: 1.01–1.25), 1.38 (95%CI: 1.21–1.56), and 1.32 (95%CI: 1.16–1.52) for Q1, Q2, Q3, and Q4, respectively (P for trend &lt;0.001) after including pregnant women.ConclusionThe current study showed a positive association between blood lead levels and hyperlipidemia.
The endoscopic prediction model of simple endoscopic score for Crohn’s disease (SES-CD) as an effective predictor of intestinal obstruction in Crohn’s disease: A multicenter long-term follow-up study
Authors: Xu Weimin , Hua Zhebin , Wang Yaosheng , Gu Yubei , Zhong Jie , Cui Long , Du Peng 
Published: September 2022

BackgroundThe simple endoscopic score for Crohn's disease (SES-CD) is a widely used index to evaluate clinical and endoscopic activity. However, the association and predictive value of SES-CD for intestinal obstruction in Crohn's disease (CD) remains unclear. We aimed to establish the best cut-off indicators of SES-CD for early clinical intervention and subsequent prevention of intestinal obstruction in CD.MethodsData on patients with CD evaluated at our institute from January 2016 to January 2022 were retrospectively collected. The SES-CD and Crohn's Disease Activity Index scores used in the analysis indicated the results of the first clinical and colonoscopy evaluations after hospitalization. The primary outcome was the occurrence of intestinal obstruction during admission and follow-up.ResultsA total of 248 patients with a median follow-up time of 2 years [interquartile range: 1.0–4.0] were enrolled, of which 28.2% developed intestinal obstruction. An SES-CD score of 8 was the most significant threshold evaluation, and SES-CD ≥8 had the largest area under the receiver operating characteristic curve (0.705), with a sensitivity of 52.9% and specificity of 88.2% in predicting intestinal obstruction. Furthermore, SES-CD ≥8 had the greatest risk factor for intestinal obstruction (odds ratio: 7.731; 95% confidence interval: 3.901–15.322; p &lt; 0.001) and significantly decreased the overall intestinal obstruction-free survival (p &lt; 0.001).ConclusionThe SES-CD endoscopic prediction model could be an effective predictor of intestinal obstruction in patients with CD. More frequent follow-up and colonoscopic surveillance should be considered in patients with SES-CD score ≥8 to prevent the development of intestinal obstruction.
Oncological outcomes of rectal cancer patients with anastomotic leakage: A multicenter case-control study
Authors: Peltrini Roberto , Carannante Filippo , Costa Gianluca , Bianco Gianfranco , Garbarino Giovanni Maria , Canali Giulia , Mercantini Paolo , Bracale Umberto , Corcione Francesco , Caricato Marco , Capolupo Gabriella Teresa 
Published: September 2022

IntroductionThis study aimed to evaluate the impact of anastomotic leakage (AL) on oncological outcomes after restorative rectal cancer surgery.MethodsPatients who underwent anterior resection for rectal adenocarcinoma between January 2011 and December 2017 were retrospectively reviewed. Data were collected from three colorectal surgery centers. Patients with grade B and C leaks according to the International Study Group of Rectal Cancer classification were identified and compared with the control group. Estimated recurrence and survival rates were compared using the log-rank method and Cox regression analysis.ResultsA total of 367 patients were included in the study, with a mean follow-up of 59.21 months. AL occurred in 64 patients (17.4%). Fifteen patients with AL (23.5%) developed local recurrence (LR) compared to 17 (4.8%) in the control group (p &lt; 0.001). However, distant recurrence rates were similar (10.9% vs. 9.6%; p = 0.914) between the groups. Kaplan-Meier curves showed that patients with AL had a reduced 5-years local recurrence-free survival (96% vs. 78%, log-rank p &lt; 0.001). AL (OR 4.576; 95% CI, 2.046–10.237; p &lt; 0.001) and node involvement (OR 2.911; 95% CI, 1.240–6.835; p = 0.014) were significantly associated with LR in multivariate analysis. AL was significantly associated with DFS only at univariate analysis (HR 1.654; 95% CI: 1.024–2.672; p = 0.037), with a difference between 5-year DFS of patients with and without AL (71.6% vs. 86.4%, log-rank p = 0.04). Only male gender, pT3-4 stage, and node involvement were identified as independent prognostic factors for reduced DFS in the multivariate Cox regression analysis.ConclusionIn this cohort of patients, AL was associated with a significant risk of LR after rectal cancer surgery.
O ensino de matemática para surdos
Authors: Santos Carolaine Souza , Mazzuco Neiva Gallina 
Published: September 2022

Este artigo objetiva refletir sobre como ocorre a aprendizagem da Matemática por alunos surdos, principalmente nos anos iniciais do Ensino Fundamental. O aluno surdo deveria dominar uma língua diferente da do ouvinte, a Língua Brasileira de Sinais (Libras), porém, geralmente, quando a criança tem pais ouvintes, há uma dificuldade de aceitação de seus limites, por isso, matriculam seus filhos em escolas regulares. A demora para a criança surda ter acesso à Libras faz com o seu desenvolvimento escolar e cognitivo seja prejudicado, já que a linguagem é essencial para a mediação do conhecimento. Ainda há casos de surdos que não adquirem a língua de sinais em momento nenhum, sendo apenas oralizados. Como ponto de partida, é importante considerar sempre a cultura do aluno surdo e suas especificidades linguísticas. No entanto, a legislação vigente aponta para a expansão do ensino bilíngue, que até então é considerado o melhor método de aprendizagem dos surdos, pois considera a Libras como primeira língua e a Língua Portuguesa como segunda língua. O ensino de Matemática, tanto para alunos ouvintes quanto para alunos surdos, deve ocorrer conforme os pressupostos do Currículo para a Rede Pública de Ensino de Cascavel e da Proposta Pedagógica Curricular da Rede Pública Municipal - Região da Associação dos Municípios do Oeste do Paraná (AMOP), documentos que se fundamentem na Pedagogia Histórico-Crítica e consideram, sobretudo, a resolução de problemas como ponto central para a apreensão dos conceitos matemáticos. No caso de alunos surdos, é imprescindível a utilização de material concreto em associação com a Libras, cujo encaminhamento tem sido utilizado por professores bilíngues que ensinam seus alunos surdos.