bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and risk factors of kidney stone disease in population aged 40–70 years old in Kharameh cohort study: a cross-sectional population-based study in southern Iran
Authors: Moftakhar Leila , Jafari Fatemeh , Ghoddusi Johari Masoumeh , Rezaeianzadeh Ramin , Hosseini Seyed Vahid , Rezaianzadeh Abbas 
Published: December 2022

Abstract
Background
Kidney stone is the major cause of morbidity, and its prevalence is increasing in the world. This study aimed to assess the prevalence and risk factors of kidney stone in the adult population of southern Iran based on the data of the Kharameh Cohort Study.

Methods
This cross-sectional study was conducted on 10,663 individuals aged 40–70 years old, using the baseline data of Kharamah cohort study, which started in 2014. Among all participants, 2251 individuals had a history of kidney stone. The participants’ demographic characteristics, behavioral habits, and the history of underlying diseases were investigated. The crude and Age Standardized Prevalence Rate of kidney stones was calculated. Also, logistic regression was used to identify the predictors of kidney stone. To check the goodness of fit index of the model, we used the Hosmer–Lemeshow test. All analyses were performed in STATA software.

Results
The prevalence of kidney stone was estimated 21.11%. Also, the Age Standardized Prevalence Rate in men and women was calculated 24.3% and 18.7%, respectively. The mean age of the participants was 52.15 years. Higher prevalence of kidney stone was seen in women aged 40–50 years (40.47%, p = 0.0001) and moderate level of social economic status (31.47%, p = 0.03), men with overweight (44.69%, p < 0.0001) and those in a very high level of social economic status (35.75%, p = 0.001). The results of multiple logistic regression showed that the chance of having kidney stone was 1.17 times higher in diabetic individuals, 1.43 times higher in hypertensive individuals, 2.21 times higher in individuals with fatty liver, and 1.35 times higher in individuals with overweight. The level of socio economic status, male sex, and age were the other factors related to kidney stone.

Conclusion
In this study, underlying diseases such as fatty liver, diabetes, and hypertension as well as age, male sex, overweight, and high social economic status were identified as important risk factors for kidney stone. Therefore, identifying individuals at risk of kidney stone and providing the necessary training can greatly help to reduce this disease. However, health policymakers should prepare preventive strategies to reduce the occurrence of kidney stone.
Association of cardiometabolic risk factors with insulin resistance in overweight and obese children
Authors: Daneshzad Elnaz , Rostami Sayeh , Aghamahdi Fatemeh , Mahdavi-Gorabi Armita , Qorbani Mostafa 
Published: December 2022

Abstract
Introduction
Regarding the increased prevalence of obesity among children and adolescents, and the impact of obesity on insulin resistance (IR) and other metabolic disorders, this study was performed to determine the association of cardiometabolic risk factors (CMRFs) with IR in overweight and obese children.

Method
In this cross-sectional study 150 overweight and obese children (BMI ≥ 85th and BMI ≥ 95th age-sex specific percentile) and adolescents were selected via convenient sampling method from Endocrinology clinic in Karaj; Iran in 2020. Anthropometric indices, lipid profile, fasting blood glucose (FBG), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) were evaluated. IR was defined as HOMA-IR ≥ 2.6. Multivariable linear and logistic regression model was used to assess the association of CMRFs with insulin level and IR respectively.

Results
The mean age of children was 10.37 (± 2.6) years. Fifty-four percent of the participants were girls. IR was increased through increasing age (P < 0.001). In the multivariate logistic regression model, by increasing each unit increment in waist circumference (OR: 1.03, 95% CI: 1.01–1.06), wrist circumference (OR: 1.47, 95% CI: 1.06–2.02) total cholesterol (OR: 1.01, 95% CI: 1.003–1.03) and FBG (OR: 1.11, 95% CI: 1.05–1.18) the odds of IR increased significantly. Moreover, in the adjusted linear regression model, HOMA-IR was associated significantly with waist to height ratio (β: 2.45), and FBG (β: 0.02).

Conclusion
There was a significant association between some CMRFS with IR in overweight and obese children.
Association of monocyte/high-density lipoprotein cholesterol ratio and the carotid intima-media thickness in diabetic patients
Authors: Amouzegar Atefeh , Mirzaasgari Zahra , Mehrabi Ali , Malek Mojtaba , Alaei-Shahmiri Fariba , Najafi Laily , Khajavi Alireza 
Published: December 2022

Abstract
Objectives
The goal of this study was to see whether there was a link between the monocyte/high-density lipoprotein cholesterol ratio (MHR) and carotid intima-media thickness (CIMT) in people with type 2 diabetes.

Methods
Duplex ultrasonography parameters and demographic, physical, and paraclinical assessments were recorded. Using the t-test, the MHR and CIMT were compared between the two groups. Regression models were also constructed.

Results
A total of 118 diabetics and 126 non-diabetics were included in the cross-sectional research. According to the stated diabetes duration, the observed age difference of 7 years might be considered. The MHR and CIMT were not substantially different between the two groups. In the DM and non-DM groups, the Spearman correlations between MHR and CIMT were 0.32 and − 0.08, respectively (p-values = 0.001 and 0.379). Thus, regression models (stratified for DM/non-DM and male/female) revealed that the MHR is a significant predictor of CIMT, but only in the case of male DM individuals, when crudely adjusted for confounders.

Conclusions
In diabetes mellitus, the current investigation found a direct link between MHR and CIMT. In addition, in male diabetic subjects, MHR was demonstrated to be a predictor of CIMT.
Evaluation of interprofessional student teams in the emergency department: opportunities and challenges
Authors: Hood Kerry , Cross Wendy M. , Cant Robyn 
Published: December 2022

Abstract
Background
Interprofessional education opportunities are commonly university-based and require further development during clinical practice. Many clinical contexts offer the potential for meaningful learning of both collaborative and discipline-specific practice. The emergency department (ED) demands efficient teamwork, so presents a logical location for interprofessional learning.

Methods
An interprofessional clinical placement program was implemented with the aim to enhance students’ capacity and self-efficacy for collaborative practice. Fifty-five medical and nursing students participated as interdisciplinary pairs in a two-week clinical placement in the ED. Students’ perceptions of the learning environment were measured pre- and post-placement with the Self-efficacy for Interprofessional Experiential Learning Scale and the Interprofessional Clinical Placement Learning Inventory was completed post-placement. Non-parametric tests were used to establish change differences.

Results
The Placement Learning Inventory revealed positive outcomes; the majority (16/19) agreed/agreed strongly that the placement provided sufficient learning opportunities, was interesting, and made them feel as if they belonged and most (14/19) reported they achieved the discipline specific learning objectives set by the university. Self-efficacy improved significantly (p = 0.017), showing promise for future use of the placement model Challenges were identified in the organisation and supervision of students. In the absence of additional dedicated student supervision, this model of interprofessional student pairs in the ED was challenging.

Conclusions
Interprofessional clinical placements in ED are an effective clinical learning approach for final year undergraduate medicine and nursing students. Recommendations for improvements for students’ clinical supervision are proposed for the placement model.
Burden of informal caregivers of people without natural speech: a mixed-methods intervention study
Authors: Zinkevich Anna , Uthoff Sarah Anna Katharina , Wirtz Markus Antonius , Boenisch Jens , Sachse Stefanie Kalén , Bernasconi Tobias , Feldhaus Michael , Ansmann Lena 
Published: December 2022

AbstractBackgroundPeople with disabilities and without natural speech often rely on care provided by informal caregivers. The caregiving situation of these informal caregivers has been poorly researched. The objectives of the study are 1) to identify stressors, resources, and coping strategies among informal caregivers of people without natural speech and 2) to examine whether a complex intervention in augmentative and alternative communication (AAC) that is not primarily tailored to the needs of informal caregivers can reduce care-related burden.MethodsThe main components of the AAC intervention were (1) initial counselling session, (2) 4 AAC training sessions, (3) 20 AAC therapy sessions and (4) accompanying case management. The control group received only the initial counselling session. Within a quasi-experimental intervention study, survey data on self-perceived burden (Burden Scale for Family Caregivers, BSFC-s) fromn = 154 informal caregivers of people without natural speech were collected at three time points between June 2018 and April 2021 from a postal survey. Qualitative interviews withn = 16 informal caregivers were conducted.ResultsCaregivers reported various stressors such as limited communication with the cared-for person and concerns about the living situation in adulthood. Diverse resources and effective coping strategies, which the caregivers refer to when dealing with stressors, could also be identified. Burden was significantly reduced in the intervention group compared to the control group. According to the results of the qualitative study, AAC use led to better communication skills and a reduction in behavioural problems and thus a decreased burden.ConclusionsThe AAC intervention seems to have a positive impact on self-perceived burden. Linkages between intervention components and burden reduction as well as stressors and coping strategies could be identified and provide an evidence-based foundation for developing future holistic interventions for families with individuals without natural speech.Trial registrationGerman Clinical Trials Register (DRKS); ID: DRKS00013628 (registered on 05/02/2018).
Continuous process technology for bottom-up synthesis of soluble cello-oligosaccharides by immobilized cells co-expressing three saccharide phosphorylases
Authors: Schwaiger Katharina N. , Nidetzky Bernd 
Published: December 2022

Abstract
Background
Continuous processing with enzyme reuse is a well-known engineering strategy to enhance the efficiency of biocatalytic transformations for chemical synthesis. In one-pot multistep reactions, continuous processing offers the additional benefit of ensuring constant product quality via control of the product composition. Bottom-up production of cello-oligosaccharides (COS) involves multistep iterative β-1,4-glycosylation of glucose from sucrose catalyzed by sucrose phosphorylase from Bifidobacterium adeloscentis (BaScP), cellobiose phosphorylase from Cellulomonas uda (CuCbP) and cellodextrin phosphorylase from Clostridium cellulosi (CcCdP). Degree of polymerization (DP) control in the COS product is essential for soluble production and is implemented through balance of the oligosaccharide priming and elongation rates. A whole-cell E. coli catalyst co-expressing the phosphorylases in high yield and in the desired activity ratio, with CdP as the rate-limiting enzyme, was reported previously.

Results
Freeze-thaw permeabilized E. coli cells were immobilized in polyacrylamide (PAM) at 37–111 mg dry cells/g material. PAM particles (0.25–2.00 mm size) were characterized for COS production (~ 70 g/L) in mixed vessel with catalyst recycle and packed-bed reactor set-ups. The catalyst exhibited a dry mass-based overall activity (270 U/g; 37 mg cells/g material) lowered by ~ 40% compared to the corresponding free cells due to individual enzyme activity loss, CbP in particular, caused by the immobilization. Temperature studies revealed an operational optimum at 30 °C for stable continuous reaction (~ 1 month) in the packed bed (volume: 40 mL; height: 7.5 cm). The optimum reflects the limits of PAM catalyst structural and biological stability in combination with the requirement to control COS product solubility in order to prevent clogging of the packed bed. Using an axial flow rate of 0.75 cm− 1, the COS were produced at ~ 5.7 g/day and ≥ 95% substrate conversion (sucrose 300 mM). The product stream showed a stable composition of individual oligosaccharides up to cellohexaose, with cellobiose (48 mol%) and cellotriose (31 mol%) as the major components.

Conclusions
Continuous process technology for bottom-up biocatalytic production of soluble COS is demonstrated based on PAM immobilized E. coli cells that co-express BaScP, CuCbP and CcCdP in suitable absolute and relative activities.
Intersectionality, health equity, and EDI: What’s the difference for health researchers?
Authors: Kelly Christine , Dansereau Lisette , Sebring Jennifer , Aubrecht Katie , FitzGerald Maggie , Lee Yeonjung , Williams Allison , Hamilton-Hinch Barbara 
Published: December 2022

AbstractMany countries adopted comprehensive national initiatives to promote equity in higher education with the goal of transforming the culture of research. Major health research funders are supporting this work through calls for projects that focus on equity, resulting in a proliferation of theoretical frameworks including “intersectionality,” “health equity,” and variations of equity, diversity and inclusion, or EDI. This commentary is geared at individual principal investigators and health research teams who are developing research proposals and want to consider equity issues in their research, perhaps for the first time. We present histories and definitions of three commonly used frameworks: intersectionality, health equity, and EDI. In the context of health research, intersectionality is a methodology (a combination of epistemology and techniques) that can identify the relationships among individual identities and systems of oppression; however, it should also be used internally by research teams to reflect on the production of knowledge. Health equity is a societal goal that operationalizes the social determinants of health to document and address health disparities at the population level. EDI initiatives measure and track progress within organizations or teams and are best suited to inform the infrastructure and human resourcing “behind the scenes” of a project. We encourage researchers to consider these definitions and strive to tangibly move health research towards equity both in the topics we study and in the ways we do research.
Serum lipid profile in relation to free thyroxine and the effect of levothyroxine treatment on lipids in patients with isolated hypothyroxinemia during pregnancy: a single-center retrospective study
Authors: Xu Yunyi , Zhao Yiqi , Xu Xiaoqin , Yan Qiqi , Yang Liwei 
Published: December 2022

Abstract
Background
Thyroid function is widely considered a lipid metabolism regulator. However, studies on lipid metabolism in pregnant women with low free thyroxine (FT4) levels are limited and inconclusive. Furthermore, the association between maternal FT4 deficiency and adverse lipid metabolic parameters is unknown. Therefore, we aimed to investigate this association and the effects of levothyroxine (L-T4) treatment on these metabolic indicators.

Methods
This retrospective study included 164 patients with isolated hypothyroidism (IH) (FT4 levels below the 5th percentile with normal thyroid stimulating hormone levels according to the gestational-specific reference range) and 407 euthyroidism patients (control group who had regular antenatal examinations at Zhejiang Provincial People's Hospital, Hangzhou, China) between January 1, 2019, and December 31, 2020. Patients with IH were divided into levothyroxine (L-treatment group, n = 77) and dietary iodine supplement treatment groups (dietary treatment group, n=87) according to the hospital’s treatment policy and clinical experience. The intervention lasted for at least 8 weeks. Metabolic indicators, including thyroid function and lipid parameters, were collected at least twice before and after the intervention. Other data collected included maternal age, history of abortion, prepregnancy BMI, and gestational weight gain (Fig. 1).

Results
Compared with the control group, Patients with IH had a higher degree of dyslipidemia, reflected in elevated total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B (Apo B) levels. In IH patients, an inverse correlation was found between FT4 and TG levels, which remained after adjusting for prepregnancy BMI. The L-treatment group demonstrated a significantly slower rate of hypercholesterolemia progression during pregnancy than the dietary treatment group. In addition, there was a relationship between the therapeutic effect and the degree of disease, with the main factors being FT4, TSH and TG levels prior to starting treatment.

Conclusions
Low FT4 levels were associated with elevated blood lipid levels. Serum FT4 and lipid levels in patients could be improved by medical intervention.
Diagnostic value of an enhanced MRI combined with serum CEA, CA19-9, CA125 and CA72-4 in the liver metastasis of colorectal cancer
Authors: Zhu Hua-qiang , Wang Dong-ye , Xu Lin-shen , Chen Jian-le , Chu Er-wei , Zhou Cai-jin 
Published: December 2022

Abstract
Objective
This paper aims to explore the diagnostic value of enhanced magnetic resonance imaging (MRI) combined with a carcinoembryonic antigen (CEA) and carbohydrate antigen in terms of the liver metastasis of colorectal cancer.

Methods
A total of 167 colorectal cancer patients with liver metastasis and 167 colorectal cancer patients without liver metastasis were selected as the subjects. An automatic electrochemiluminescence analyser was then used to detect the tumour markers CEA, CA19-9, CA125 and CA72-4. The consistency between the MRI examination and clinical pathological examination was also analysed, and the sensitivity, specificity and positive and negative predictive values of various combined detection methods were compared.

Results
The abnormal rates of CEA, CA19-9, CA125 and CA72-4 in the two groups were statistically significant (P < 0.05), while the results of the enhanced MRI and clinicopathological examination for liver metastasis in patients with colon cancer were largely consistent (Kappa coefficient = 0.788, P < 0.000). However, the two methods were inconsistent. The false positive rate of the enhanced MRI examination was 15.3%, while the false negative rate was 6.0%. The specificity (94.61%), positive predictive value (92.68%) and positive likelihood ratio (12.67%) were the highest for the MRI combined with serial CEA, while the sensitivity (98.80%) and negative predictive value (97.22%) were the highest with the MRI combined with parallel CEA, and this combination returned the lowest negative likelihood ratio (0.03).

Conclusion
The combination of MRI and CEA excludes non-metastatic patients and identifies colorectal liver metastasis cancer patients. Overall, it has a higher diagnostic value.
A rare case of bladder cancer that metastasized to brain, heart, and lung lymph nodes benefited from immunotherapy
Authors: Zhu Lian-kai , Li Zhong-jian , Wang Zhi-bo , Chen Jin-tao , Zhang Hua-jun , Zhao Xu-wei , Liu Hong-yao 
Published: December 2022

AbstractBladder cancer is a common malignant tumor of the genitourinary system, with the primary cause of death being metastasis. The most common metastatic sites are the lymph nodes, liver, lung, bone, peritoneum, pleura, kidney, adrenal gland, and the intestine. Brain and heart metastases are rare. In this report, we describe a patient who had pulmonary lymph node metastases more than a year after being diagnosed with bladder cancer, followed by brain and cardiac metastases more than two years later. Following the failure of standard first-line chemotherapy, the patient accepted 6 cycles of tislelizumab immunotherapy. The re-examination revealed that the bilateral frontal brain metastases had vanished, the right temporal lobe metastases had been greatly decreased, the neurological symptoms had been alleviated, and the cardiac metastases had disappeared. This is a rare clinical case with encouraging effects of tislelizumab and can serve as a model for the treatment of similar patients.
Barriers to sustainable health research leadership in the Global South: Time for a Grand Bargain on localization of research leadership?
Authors: Abouzeid Marian , Muthanna Ahlam , Nuwayhid Iman , El-Jardali Fadi , Connors Phil , Habib Rima R. , Akbarzadeh Shahram , Jabbour Samer 
Published: December 2022

Abstract
Background
Strong Global South (GS) health research leadership, itself both dependent on and a requisite for strong health research systems, is essential to generate locally relevant research and ensure that evidence is translated into policy and practice. Strong GS health research systems and leadership are important for health development and in turn for strong health systems. However, many GS countries struggle to produce research and to improve performance on widely used research metrics measuring productivity and reflecting leadership. Drawing on literature from a rapid review, this viewpoint paper considers the barriers to GS health research leadership and proposes strategies to address these challenges.

Findings
GS researchers and institutions face numerous barriers that undermine health research leadership potential. Barriers internal to the GS include researcher-level barriers such as insufficient mentorship, limited financial incentives and time constraints. Institutional barriers include limited availability of resources, restrictive and poorly developed research infrastructures, weak collaboration and obstructive policies and procedures. Structural barriers include political will, politicization of research and political instability. External barriers relate to the nature and extent of Global North (GN) activities and systems and include allocation and distribution of funding and resources, characteristics and focus of GN-GS research collaborations, and publication and information dissemination challenges.

Conclusions
Strengthening GS health research leadership requires acknowledgement of the many barriers, and adoption of mitigating measures by a range of actors at the institutional, national, regional and global levels. Particularly important are leadership capacity development integrating researcher, institutional and systems initiatives; new GN–GS partnership models emphasizing capacity exchange and shared leadership; supporting GS research communities to set, own and drive their research agendas; addressing biases against GS researchers; ensuring that GS institutions address their internal challenges; enhancing South–South collaborations; diversifying research funding flow to the GS; and learning from models that work. The time has come for a firm commitment to improving localization of research leadership, supported by adequate funding flow, to ensure strong and sustainable research systems and leadership in and from the GS. Just as the humanitarian donor and aid community adopted the Grand Bargain commitment to improve funding flow through local and national responders in times of crisis, we strongly urge the global health research community to adopt a Grand Bargain for research leadership.