bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing cost estimates of implementation strategies using Cost-IS: a collective case study
Authors: Donovan Thomasina , Abell Bridget , McPhail Steven M. , Carter Hannah E.
Published: October 2024

Background
There is a lack of pragmatic approaches that standardise the cost estimation of implementation strategies. An instrument for data collection and cost estimation of implementation strategies for digital health innovations (Cost-IS) was recently developed. This study aimed to compare the nature of implementation cost estimates across three case studies. Secondary aims were to investigate the perceived value of these cost estimates to project leads and stakeholders, and to assess the feasibility and generalisability of Cost-IS as a standardised tool to compare the cost estimates of implementation strategies across three case studies.
Methods
An evaluative and descriptive collective case study was conducted to estimate the cost of implementation strategies associated with the introduction of healthcare interventions using the Cost-IS instrument. Eligible case studies included completed implementation projects that had planned to cost implementation and had prospectively collected data on implementation-related resource use throughout the project. Implementation data was separately analysed for each case study. Adaptations to the instrument were made where appropriate and documented. The Cost-IS instrument was tailored in a way that best allowed for meaningful outputs from each case study. The feasibility, generalisability and limitations of Cost-IS were observed by the analyst through the costing process. Feedback on the outputs were obtained from project leads, via questionnaires.
Results
The Cost-IS instrument enabled comparisons of cost estimates of implementation strategies between three real-world implementation case studies. Labour accounted for the majority of implementation costs. Adaptions to Cost-IS during the costing process were made to improve data capture granularity, meaningfully categorise the data, and enhance the instrument’s flexibility for analysis. Implementation cost findings were perceived by project leads to be valuable for reporting and evaluating, should be customised to project context, and include relevant contextual information.
Conclusions
Cost-IS was found to be a flexible instrument that can be tailored to meet the requirements of a range of implementation projects. Challenges during this process included separating implementation-related costs from intervention costs and research-related costs. Cost-IS is limited to costing implementation strategies and thus far has only captured tangible resources.
Predictors of visual outcome in Idiopathic Intracranial Hypertension: observations from a retrospective cohort in Germany
Authors: Knoche Theresia , Varlet Lisa , Pohrt Anne , Danyel Leon Alexander , Haffner Paula , Kowski Alexander Bernhard
Published: October 2024

Background
Idiopathic intracranial hypertension (IIH) is a rare secondary headache disorder. It is characterized by increased intracranial pressure without an identifiable cause and can potentially cause visual impairment due to damage to the optic nerve. This study aimed to evaluate clinical characteristics and to identify risk factors of permanent and progressive deterioration of visual function in a German IIH cohort.
Methods
This is a retrospective observational study of IIH patients who were diagnosed between 2004 and 2020 at our tertiary care neurological department. Ophthalmologic findings, clinical characteristics and treatment strategies were recorded. Visual outcomes were assessed at a minimum follow-up of 6 months after IIH diagnosis. Regression analysis was utilized to evaluate potential risk-factors of poor visual outcome, defined as 1) worsening of ophthalmologic findings and/or 2) persistent visual impairment.
Results
The patient cohort comprised 191 consecutive IIH patients. Cohort characteristics and clinical findings were consistent with prior studies. Ophthalmologic follow-up was available in 90 patients. Here, poor visual outcome occurred in 36% of patients. In regression models, male sex was independently associated with a greater risk for poor visual outcome (OR: 7.2, p = 0.028). Patients with moderate papilledema at baseline had a lower likelihood for poor visual outcome than patients with lower degree papilledema (OR: 0.2, p = 0.016). Surgical intervention (primarily by ventriculo-peritoneal shunt) was associated with a lower risk of poor visual outcome (OR: 0.21, p = 0.09), mediating the relation between papilledema and visual outcome. Neither age, BMI nor cerebrospinal fluid opening pressure were associated with the visual prognosis.
Conclusions
One third of patients in the follow-up cohort experienced worsening of ophthalmologic findings or visual impairment. Male sex may predispose IIH patients to visual impairment. Moderate papilledema at baseline reduced the risk of poor visual outcome, partially due to surgical therapy during the follow-up period. This study highlights the importance of timely intervention in patients with moderate papilledema and the need for reliable outcome predictors in IIH.
Trial registrations: Trial registration is not applicable: This observational study reports retrospective documentations of clinical routine data. It does not classify as a clinical trial.
68Ga-pentixafor PET/CT is a supplementary method for Primary aldosteronism subtyping compared with adrenal vein sampling
Authors: Yi Tieci , Lu Difei , Cui Yonggang , Zhang Zheng , Yang Xing , Zhang Jianhua , Qiu Lin , Weng Haoyu , Liu Lin , Duan Xiaojiang , Zhao Guangyu , Ma Wei , Gao Ying , Fan Yan
Published: October 2024

Purpose
To investigate the diagnostic efficacy of 68Ga-pentixafor positron emission tomography/computed tomography (PET/CT) in primary aldosteronism (PA) subtyping and lateralization of aldosterone secretion in PA patients.
Procedures:
37 patients who were diagnosed with PA, were prospectively enrolled in the study, and underwent adrenal vein sampling (AVS) after 68Ga-pentixafor PET/CT was conducted. Lateralization index (LI), defined as aldosterone/cortisol ratio in the dominant side to the contralateral adrenal vein when bilateral adrenal vein catheterization succeeded, and the aldosterone/cortisol ratio in the left adrenal vein to IVC (LAV/IVC) when the catheterization of right adrenal vein failed, were applied to determine lateralization side. Statistical analysis was performed using SPSS 21.0.
Results
The female proportion of all patients with PA was 32.4% (12/37), and the mean age was 51.3 ± 10.9 years. Patients with bilateral adrenal mass accounted for 54.1% (20/37), and 10 of them (27.0%) had adrenal hyperplasia or adrenal nodules ≤ 1.0 cm. In all 37 patients, the sensitivity, specificity and accuracy of 68Ga-pentixafor PET/CT in distinguishing lateralization by visualization were 89.3%, 77.8% and 86.5%, respectively. The area under the ROC curve for detecting positive lateralization based on the value of 68Ga-pentixafor SUVmax was 0.750 (95%CI 0.578–0.922, p = 0.026). The optimum SUVmax cut-off value was 6.86, with the sensitivity of 78.6%, specificity of 66.7%, and accuracy of 78.4%. Defining SUV ratio as SUVmax/SUV of contralateral adrenal gland, the area under the ROC curve for identifying lateralization based on the SUV ratio was 0.710 (95%CI 0.500-0.921, p = 0.061). The optimum SUV ratio cut-off was 2.40, with the sensitivity of 60.7%, specificity of 88.9%, and accuracy of 67.6%. The consistency of 68Ga-pentixafor PET/CT with AVS was of no significant difference between patients with bilateral adrenal lesions (80.0%, 16/20) and unilateral lesion (94.1%, 16/17; p = 0.737), and no significance was revealed in the consistency between patients with adrenal hyperplasia or adrenal lesion of diameter ≤ 1 cm (81.8%, 9/11) and those with adrenal lesions > 1 cm (88.5%, 23/26; p = 0.884).
Conclusions
68Ga-pentixafor PET/CT showed at least 80% consistency for the lateralization in patients with PA compared with AVS, even in those presented with bilateral adrenal hyperplasia. Visual analysis exhibited better diagnostic efficacy compared with SUVmax or SUVmax/SUV of the contralateral adrenal gland.( ChiCTR2300073049. Registered 30 June 2023. Retrospectively registered)
Machine learning-enhanced clinical and ultrasound technology for early detection of difficult-to-treat rheumatoid arthritis
Authors: Wang Ting , Wang Zhen , Yu Yakun , Huang Lele , Zhu Rong , Jia Yingying , Yin Ci , Wang Yuan , Li Yan , Shen Xuejiao , Wei Jiaqi , Zhang Chunjie , Nie Fang
Published: October 2024

Objectives: This study aimed to examine the clinical features, serological indicators, and ultrasound examination results of individuals with difficult-to-treat rheumatoid arthritis (D2T RA) and non-D2T RA, along with the development and validation of two distinct predictive models for the early detection of D2T-RA.
Methods: Enrolled 85 patients with D2T-RA diagnosed as moderate or high disease activity who completed 24 months of follow-up, and randomly matched 83 non-D2T-RA patients with moderate to high disease activity. Baseline clinical information was collected, and US examinations were performed to record the single scores of gray-scale (GS) and power Doppler (PD) for 16 joints and 10 tendons, as well as the EULAR-OMERACT scores. Univariate analysis identified predictive factors, followed by machine learning to create two models: clinical/serological (Model 1) and clinical/serological/US (Model 2). We evaluated the model performance using 5-fold cross-validation, utilizing the F1 score and AUC.
Results: The univariate logistic analysis showed that EULAR-OMERACT＞1 (6 variables) and clinical and serological characteristics (14 variables) were significant predictors of D2T RA. The random forest model performed best on all models, with the AUC and F1 of test set model 1 divided into 0.81 and 0.67, and the AUC and FI of model 2 with ultrasound data increased to 0.83 and 0.69, respectively.
Conclusion: Multi-joint ultrasound score provides important prediction data for early identification of D2T RA, a random forest model improves prediction efficacy, and evaluating limited joints makes this method more feasible in rheumatism clinical practice.
Dual roles of infrastructure in hearing difficulty disparities across the United States
Authors: Duan Tianle , Li Qingchun , Kim Noori
Published: October 2024

Hearing loss is a critical issue in the United States, affecting more than 15% American adults. Existing research mainly focuses on the physiological and socioeconomic factors for hearing loss. This study explores the roles of infrastructure in hearing difficulty disparities in the United States. We used the Point of Interest data to quantify physical establishments and retrieved data from OpenStreetMap to estimate road density. The urban scaling results show that US county-level infrastructure density and population size follow a power-law relationship (α=0.88). Counties with lower hearing difficulty rates tend to have more infrastructure, with infrastructure density increasing by 81.5%, 79.0%, and 75.3% when the population doubles in counties with low, medium, and high hearing difficulty rates, respectively. However, temporal clustering shows that counties with higher infrastructure density have rising hearing difficulty rates. After controlling for hearing health confounding variables, regression results show that overall infrastructure and hearing risky infrastructure densities significantly increase hearing difficulty rates, while road network density improves hearing health. The study reveals a dual mechanism: infrastructure increases noise exposure and hearing difficulty risk, while road networks could improve access to hearing services, benefiting hearing health.
Computed tomography staging system and Clinicopathology of pulmonary Kaposi's sarcoma associated with acquired immunodeficiency syndrome: a retrospective study of 53 cases
Authors: Wang Yan , Bao Gang , Yu Tian , Wang Bing , Sairen Gaowa
Published: October 2024

Objectives
The aim of this study is to understand the CT manifestations of pulmonary Kaposi's sarcoma (pKS) through dynamic observation, in order to promote its clinical diagnosis and treatment.
Materials and Methods
Collected medical records and CT images of 93 AIDS-KS patients, 53 of whom had pKS. Two senior physicians analyzed lung CT images respectively which the first time diagnosis of pKS (53 cases) and reexamined after treatment (39 cases).
Results
51 cases had cutaneous KS, 41 cases had digestive tract KS, 3 cases had lymph node KS. According to the evolution of pKS, the CT manifestations of AIDS related pKS can be divided into three stages: I: Bronchial vascular thickening stage (6 cases); II: 24 cases in the nodular stage; III: Fusion consolidation period (23 cases). The complications of pulmonary KS include lymphadenopathy, pleural and pericardial effusion, subcutaneous edema, and bone destruction/metastasis.The prognosis of 39 patients treated with highly active antiretroviral treatment (HAART) and paclitaxel were: I: 100% being remission; II: 70.6% being remission ,23.5% being progression; 5.9% no change after treatment; III: 72.2% being remission; 22.2% being progression; 5.6% no change after treatment.
Conclusions
When AIDS related KS affects the lungs, it often presents as systemic disseminated KS. CT images of pKS could be divided into three stages. Recognizing CT staging of pKS is of help to guide clinical diagnosis early and mastery of the disease course to achieve disease control.
The characteristic of molten pool during laser gas nitriding of titanium alloy surface
Authors: Guo Jinchang , Shi Yu
Published: October 2024

Poor surface mechanical properties are an important factor restricting the wide applications of titanium alloys, while the laser gas nitriding process can effectively improve the surface mechanical properties. The convection behavior on molten pool surface in the nitriding process was captured using a high-speed camera system, the images of the molten pool surface were processed, the special convection behavior was analyzed, and the convection velocity on the molten pool surface was calculated. The forming characteristics of the nitrided layer section were observed, and the relationship between the special convection behavior of the molten pool and the section forming was analyzed. The experimental results show that the nitriding molten pool convection has the characteristics of discontinuity, locality and randomness; the alternating change of the relationship between the melting point and the temperature of the molten pool leads to the discontinuity of the convection , and the segregation of the molten pool composition and the non-uniformity of the parameters lead to the local and random nature of the convection; the special convection behavior of the nitriding molten pool results in the irregular section of the nitrided layer. According to these characteristics, a scheme of controlling the quality of nitrided layer is put forward by using non-uniform heat source.
Improved Survival of Primary-Tumor Resection in Metastatic Thoracic Esophageal Cancer: A Population-Based, Propensity Score Matched Study
Authors: Wu Jiayan , Zheng Haosheng , Wang Gengfeng , Qin Fei , Zheng Yuzhen , Chen Junguo , Liu Zui , Jian Bozhu , Qin Xianyu , Liao Hongying
Published: October 2024

The study aims to assess the survival effect of primary-tumor resection (PTR) on thoracic esophageal cancer with distant metastasis(TECDM). Data of patients with TECDM was collected from the Surveillance, Epidemiology, and End Results database from 2010 to 2020. We used a 1:1 propensity-score matching(PSM) analysis to minimize heterogeneity between different groups. Total 7733 patients with TECDM were included, and 121 patients and 7612 patients underwent primary-tumor resection and did not, respectively. Patients underwent primary-tumor resection had a better median OS and median CSS than those patients did not in overall and PSM cohort. In PSM cohort, the median OS was 11 months (95% CI, 9 months to 13 months) for TECDM patients with PTR and 7 months (95% CI, 5 months to 9 months) for those patients without PTR. Additionally, cox proportional hazard models similarly indicated that PTR was a significantly protective factor for TECDM patients in OS (HR: 0.5529; 95% CI, 0.5196 to 0.7730, P < 0.001) and CSS (HR:0.5869 ; 95% CI, 0.479 to 0.7192, P < 0.001). In conclusion, primary-tumor resection prolongs survival of thoracic esophageal cancer patients with distant metastasis.
Wireless ECG: A Sub mm-Waves, 160GHz, Vital Signs Monitoring IC, in 22nm CMOS FDSOI
Authors: Sanduleanu Mihai , Gebremicheal Mizan
Published: October 2024

This paper presents a sub mm-Waves, 160 GHz Vital-Signs monitoring IC with integrated on-chip antennas. At the receiver (Rx) side, it consists of a low-noise amplifier (LNA), I/Q mixers and a variable-gain amplifier (VGA) whereas at the transmitter (Tx) side is composed of a power amplifier (PA) with I/Q voltage-controlled oscillator (VCO) and an integrated Integer-N phase-locked loop (PLL) with a 5 GHz reference signal. Realized in a 22nm CMOS FDSOI technology, the IC has a DC power consumption of 450 mW, 10 dBm transmitted saturated power (Psat), 30 dB Rx gain with a noise figure (NF) of 8 dB. The measured phase noise of the PLL is -115 dBc/Hz @ 1 KHz and -124 dBc/Hz @ 100 KHz. The chip is followed by a FPGA that runs the detection algorithms. The chip detects the breathing rate and the heart rate of a patient positioned at 2m from an IC mounted on PCB.
Electrokinetics promoted cadmium dissociation, phytoremediation of contaminated plateau red soil and the influence differences between electric field dimensions
Authors: Zhu Xuan , Zhao Ming , Duan Zhengyang , Jiang Chen , Ma Hongyan , Wang Lirong , Jiang Ming , Li Tianguo
Published: October 2024

Aims The enhanced performance of electrokinetics(EK) on the cadmium (Cd) dissociation, redistribution and phytoremediation of Cd-contaminated plateau red soil has been investigated based on the application of electric field in different dimensions.
Methods After Sedum plumbizincicola cutting growth for 30 d, periodic reversal direct-current (DC) electric fields were applied during 150 days for 10.5 cycles.
Results Unlike the uniform distribution change of pH in P1–P9 of the 1D treatment, more soil points (P1–P9) of multidimensional electric fields were exposed to the influence of anode. In electrokinetic–assisted phytoremediation (EKPR), Sedum plumbizincicola can alleviate soil acid-alkalization caused by EK, especially the acidification effect of anode under high voltage (10–20 V). Cd speciation and dissociation studies show that EK promotes Cd dissociation into soil pore water, which is conducive to Cd phytoextraction. The periodic reversal DC electric fields enhanced the height more significantly than biomass of Sedum plumbizincicola and with inconspicuous among difference regions. Overall, EKPR (voltage of 5–10 V) can promote soil Cd phytoremediation effectively due to the synergistic effect of directly interface action and indirectly influence of electric field to improve the Cd speciation evolution, dissociation, and bioavailability at the soil–water interface. The appropriate electric field arrangement and voltage were EKPR2 and 5 V for Sedum plumbizincicola, respectively.
Conclusions EK-induced heavy metals speciation evolution and effective dissociation is one of the important ways to promote the remediation performance, and it is necessary to regulate the arrangement and intensity of electric field to ensure the strengthening effect of EKPR.
Adoption, Acceptability, and Effectiveness of Community Software LINE Official Account for Oncological Case Management of Patients with Oral Cancer at Medical Center
Authors: Hsieh Ming- Hsin , Chang Ying-Ying , Wu Hsing-Ling Carol , Chou Yu-Shu , Chang Chia-Hui
Published: October 2024

Background: Cancer patients require cross-professional care during the diagnosis and treatment periods. Moreover, patients who recover from oral cancer often require an interdisciplinary team during the rehabilitation and tracking periods. Therefore, methods for effectively carrying out case management are essential to tumor care.
Purpose: To investigate the effects of using the community software LINE Official Account on oncological case management with oral cancer, with the app providing self-care information and health-care advice. Methods: An experimental design was used; 100 patients with oral cancer participated. The patients were randomly divided into two groups by using a computer-generated random number table. The experimental group comprised 55 patients, whereas the control group included 45 patients. The experimental group used LINE Official Account, which gave them self-care information, timely messages, and one-on-one health-care consultations. The control group followed standard health-care practices.
Results: In total, 40 patients in the experimental group were satisfied with the self-care information provided by LINE Official Account (86.9%). In total, 42 patients regularly checked the self-care information (89.4%). Among these patients, 25 of them would check the information when receiving a push notification (54.3%). Ten patients used the one-on-one health-care consultation system (20.0%). Their questions concerned oral infection, language and swallowing problems, nutrition, chemotherapy, psychological support, and registration problems. LINE Official Account had a significant effect on the rate of participation in support groups. Generalized estimating equations indicated a significant difference between the two groups regarding overall quality of life over 7 days (P = 0.023).
Conclusion: Community software applications used in oncological case management can improve the self-management of patients and empower them. Moreover, applications also enable to track long-term follow-up effectiveness and reinforce the case manager’s role as a family therapist. Case managers are professionals to which patients can turn without needing to register or be referred. Therefore, this study recommends that case manager systems be incorporated into mobile applications to increase the sustainable management, accessibility, effectiveness, and satisfaction of oncological management systems. This study also provides the value of Sustainable Development Goals (SDGs) with Good Health and Well-being, and decreased social withdrawal among patients with oral cancer.
SIRT2 Inhibition Enhances Mitochondrial Apoptosis in Brucella-Infected Bovine Placental Trophoblast Cells
Authors: Zhang Mengyu , Qi Lin , Li Junmei , Yuan NingQiu , Zhai Yunyi , Hao Mingyue , Zhou Dong , Liu Wei , Jin Yaping , Wang Aihua
Published: October 2024

Brucella being a successful pathogen, employs a plethora of immune evasion mechanisms. This contributes to pathogenesis, persistence and also limits the efficacy of available treatment. Increasing understanding of host-pathogen interactions suggests that integrating host-directed strategies with existing anti-Brucella treatments could lead to more effective bacterial clearance and a reduction in drug-resistant strains. SIRT2 is a nicotinamide adenine dinucleotide (NAD+)-dependent deacetylase found in mammals. It can deacetylate various transcription factors and regulatory proteins, playing a crucial role in host-pathogen interactions and pathogen infection-induced apoptosis. In this study, we investigate the role of SIRT2 in Brucella-induced cell apoptosis using bovine placental trophoblast cells. Our results indicate that B. abortus A19 infection upregulates SIRT2 protein expression and significantly induces mitochondrial apoptosis in these cells. Furthermore, Inhibition of SIRT2 exacerbates B. abortus A19-induced mitochondrial apoptosis and markedly inhibits intracellular bacterial survival. These results prove the role of SIRT2 in Brucella pathogenesis and the mechanism of action.
Treatment of single-segment lumbar tuberculosis by unilateral biportal endoscopic debridement, interbody fusion, and percutaneous pedicle screw fixation
Authors: Wang Xiangbin , Li Tao , Li Yong , Long Yubin
Published: October 2024

Introduction: Unilateral biportal endoscopic (UBE) technique is an emerging minimally invasive spinal surgical technique that has been used to treat a variety of degenerative spinal diseases in recent years, while there are rare reports on the treatment of lumbar tuberculosis (LTB). Consequently, this study intends to investigate the effectiveness and feasibility of UBE debridement, interbody fusion, and percutaneous pedicle screw fixation for single-segment LTB. Methods: A total of 31 patients with single-segment LTB from January 2020 to September 2021 were included. The operative time, estimated blood loss, time to ambulation, postoperative hospital stay, and complications were recorded. Clinical outcomes include erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), the visual analog scale (VAS) score, Oswestry disability index (ODI), American Spinal Injury Association (ASIA) neurological classification, Cobb angle, and lumbar lordotic angle were analyzed. X-rays or computerized tomography (CT) were reviewed 6 months after surgery and at the final follow-up, and surgical segmental fusion was evaluated using Bridwell grading criteria. Results: The mean operative time was 171.61 ± 19.03 minutes, the mean estimated blood loss was 243.87 ± 26.54 ml, the mean time to ambulation was 1.87 ± 0.76 days postoperatively, and the mean postoperative hospital stay was 5.61 ± 1.17 days. There were 4 cases of procedure-related complications and the incidence was 12.9%. The levels of ESR and CRP returned to normal 3 months after the procedure. VAS scores of low back and leg, as well as ODI, were significantly improved postoperatively compared with before the operation, and the differences were statistically significant (P < 0.05). All patients were ASIA grade E at the last follow-up. The postoperative Cobb angle was 9.81 ± 2.4°, the lumbar lordotic angle was 42.59 ± 6.16°, and both had no significant loss of correction during the final follow-up. Bony fusion was achieved in all cases at the final follow-up. Conclusions: UBE debridement, interbody fusion, and percutaneous pedicle screw fixation is a feasible, effective, and safe surgical procedure for the treatment of single-segment LTB.
Prognostic Nutritional Index in Risk of Mortality Following Fulminant Myocarditis
Authors: Doi Shunichi , Ishibashi Yuki , Suzuki Norio , Miyahara Daisuke , Sato Yukio , Kuwata Shingo , Kida Keisuke , Izumo Masaki , Onoue Kenji , Kanaoka Koshiro , Saito Yoshihiko , Akashi Yoshihiro J.
Published: October 2024

Aims
Fulminant myocarditis (FM) is an acute fatal inflammation disease, but its chronic phase is unclear. A Japanese nationwide registry evaluated the long-term mortality in FM patients using a prognostic nutritional index (PNI).
Methods and Results
The retrospective cohort study included patients with clinically suspected or histologically proven FM available for PNI. PNI was assessed on admission and at discharge. We divided patients into two groups based on PNI at discharge (PNI ≤ 40 or PNI > 40) and analyzed the change in PNI and mortality between the groups. Of 323 patients (the median [first-third quartiles] age of this cohort was 50 [37–64] years, and 143 [44%] were female), PNI ≤ 40 at discharge was in 99 (31%) patients. The median PNI in all patients increased from 41 (36– 46) on admission to 43 (39–48) at discharge (P < 0.0001). Patients with PNI ≤ 40 had a lower event-free rate of death or rehospitalization with cardiovascular causes than those with PNI > 40 (log-rank P = 0.0001). When the PNI at discharge, age, sex, left ventricular ejection fraction, and Barthel index were evaluated in a multivariable Cox regression analysis, PNI ≤ 40 had an independent association with the death or rehospitalization with cardiovascular causes (hazard ratio, 2.14 [95% confidence interval, 1.14–4.01]; P = 0.0289).
Conclusions
One-third of FM patients with low PNI at discharge had a higher risk of mortality than those with high PNI in the chronic phase. This study provokes clinical insight into the phenotype of chronic inflammation in FM and optimal follow-up management with low PNI.
Nutritional management and practices in patients with bronchiolitis on non-invasive ventilation using a total face mask: an international survey in French network
Authors: Corbisier Tiphaine , Cousin Vladimir L , Polito Angelo , Bordessoule Alice
Published: October 2024

Purpose
Bronchiolitis is a major cause of respiratory failure in infants, necessitating non-invasive ventilation (NIV). While total face masks (TFM) are an alternative to nasal interfaces for NIV, they pose unique challenges for enteral feeding due to their design, which can limit airway access and increase the risk of complications. This study aimed to investigate the feeding practices of pediatric intensivists managing bronchiolitis patients using TFM for NIV.
Methods
A cross-sectional survey (Survey-Monkey® software (San Matteo, California, USA)) was conducted among pediatric intensivists in the Groupe Francophone de Réanimation et d'Urgences Pédiatrique (GFRUP) across four French-speaking countries. The survey, consisting of 11 multiple-choice questions, assessed clinical practices related to TFM use and enteral feeding, including initiation timing, feeding methods, and associated complications.
Results
From January 2024 to April 2024, 33 intensivists from 10 units and 4 countries (France, Switzerland, Belgium, Canada) answered the survey. All physicians used routinely TFM with 40% of them using it as a first-line NIV interface. Enteral feeding was commonly initiated within 6 hours of TFM initiation, with 72% of clinicians waiting for a stabilization period of 3 to 6 hours. The majority (85%) employed gastric feeding, with a low incidence of severe complications reported. Vomiting was the most frequent issue, while aspiration pneumonia was rare.
Conclusions
Despite the challenges associated with TFM, enteral feeding is widely practiced among pediatric intensivists, with a cautious approach to initiation and a low complication rate. These findings highlight the need for individualized feeding strategies and further research to optimize feeding practices in this population.
An Automatic Recognition of Indian Dish and Allergen Prediction Using DeepLearning
Authors: Kadam Viren , Pambhar Keval , Bachal Tarush , Agarwal Mihir , Thengade Anita
Published: October 2024

The research addresses the issue of image variability in practical settings by introducing a deep learning-based system for allergy prediction and Indian dish recognition. Food plays a big part in supporting a healthy lifestyle, which is becoming more and more popular globally. Recognizing the different types of food and the allergies that are in it is crucial. With the help of convolutional neural networks and visual transformers, the model can predict possible allergies and identify foods with accuracy, which is important for managing diet and raising awareness of allergens. Its uses are extensive in the food service, medical, and nutrition domains, providing workable answers for safer and better-informed nutritional selections in Indian food. Extensive analysis validates the model's effectiveness and potential influence on many sectors. In this study, various CNN architectures, including ResNet50, VGG16, VGG19, and a custom CNN, were employed for Indian Dish Recognition and Allergy Prediction. To enhance model accuracy, techniques such as image augmentation were integrated. While certain models showed promising results, reaching a maximum accuracy of 81%, others did not meet the desired expectations. To improve performance, Vision Transformers (ViTs) were employed, resulting in a remarkable accuracy of 92%.
Resilience as a Mediator of the Relationship between Perceived Social Support and Public Health Emergency-related Post-traumatic Growth among Medical staff
Authors: He Yi , Bai Xue , Dai Yuqian , Cai Ruiting , Yan Shijiao , Zou Li
Published: October 2024

Background
As central participants in Public Health Emergency (PHE), medical staffs may face positive changes, such as post-traumatic growth, while being traumatised. However, previous research remains deficient in factors influencing Post-Traumatic Growth (PTG). The aim of this paper is to examine how resilience mediates the relationship between perceived social support and PTG among medical staff.
Method
Using statistical descriptive and one-way analyses, we investigated the mediating effects of a cross-sectional study with 730 medical staff from a general hospital in Hubei Province, the epicenter of PHE in China, through Structural Equation Modelling(SEM).
Results
The mean PTG score among medical staff was 60.48 (SD = 24.49). The direct impact of perceived social support on PTG was significant (0.218, 95% CI [0.083, 0.361], P < 0.001), constituting 49.98% of the total effect. Moreover, the indirect impact of perceived social support on PTG via resilience was also significant (0.218, 95% CI [0.119, 0.320], P < 0.001), accounting for 50.02% of the total effect.
Conclusion
Our study demonstrated the positive impact of perceived social support on PTG among medical staff, with psychological resilience playing a mediating role. It suggests that interventions should focus on increasing perceived social support and resilience to foster positive psychological changes and improve the quality of healthcare services.
Donor selection in T-cell-replete haploidentical-related donor peripheral blood stem cell transplantation
Authors: Kanda Junya , Wada Fumiya , Iwasaki Makoto , Hirayama Masahiro , Kawamura Koji , Kaida Katsuji , Doki Noriko , Nakamae Hirohisa , Hasegawa Yuta , Fukuda Takahiro , Eto Tetsuya , Hiramoto Nobuhiro , Maruyama Yumiko , Nagafuji Koji , Ota Shuichi , Ishikawa Jun , Ando Toshihiko , Ichinohe Tatsuo , Atsuta Yoshiko , Nakasone Hideki
Published: October 2024

The effects of donor characteristics on outcomes after T-cell-replete (TCR) haploidentical-related donor peripheral blood stem cell transplantation (PBSCT) with post-transplant cyclophosphamide (PTCy) or low-dose antithymocyte globulin (ATG) remain unclear. We evaluated the impact in 1,677 patients who received a PTCy protocol (PTCy-haplo; n = 1,107) or low-dose ATG protocol (ATG-haplo; n = 570). A low CD34+ cell dose (<4 ×106/kg) was the only donor characteristic associated with worse overall survival (OS) after PTCy-haplo (adjusted hazard ratios [aHR] = 1.49, P = 0.008), whereas increased donor age by decade (aHR = 1.12, P = 0.008) and a large number of human leukocyte antigen mismatches (aHR = 1.46, P = 0.010) were associated with worse OS after ATG-haplo. Donor age increased the risk of grade II–IV acute graft-versus-host disease (GVHD) only after ATG-haplo (HR: 1.14, P = 0.018), whereas it increased the risk of grade III–IV acute GVHD both after PTCy-haplo (HR: 1.32, P = 0.009) and ATG-haplo (HR: 1.22, P = 0.006). Offspring donors had better relapse-free survival and GRFS than sibling donors after ATG-haplo. Our data suggest a comprehensive donor selection hierarchy after TCR haploidentical related-donor PBSCT with PTCy or low-dose ATG.
Porosity Prediction using Bagging Ensemble Machine Learning in CCUS Reservoirs. A Case Study: Darling Basin, Australia
Authors: Sandunil Kushan , Bennour Ziad , Sivakumar Saaveethya , Mahmud Hisham Ben , Giwelli Ausama
Published: October 2024

Machine learning (ML), a subset of artificial intelligence, has been utilised in many engineering fields, such as computer engineering, electrical engineering, civil engineering petroleum engineering. Bagging ensemble algorithms have been employed for parameter prediction, as they theoretically outperform traditional ML algorithms. Carbon dioxide capture and storage (CCS) is a strategy implemented to mitigate carbon dioxide emissions. A vital aspect of CCS assessment is determining carbon storage capacity, which estimates the amount of CO2 that can be stored in the subsurface. Porosity is a critical parameter in calculating this capacity. In this study, the applicability of regression friendly bagging ensemble ML models; random forest regression (RFR) and extra tree regression (ETR) to estimate porosity of a sandstone layer as part of a CCS program was investigated. RFR models were developed considering caliper log (CAL), gamma ray log (GR), neutron log (NPHI), photoelectric factor log (PE) and deep laterolog (LLD) input features and calculated porosity as targets. Moreover, four traditional (classical) ML models, multilayer perceptron (MLP), support vector regression (SVR), k-nearest neighbor (KNN) and decision tree regression (DTR), were developed to compare them with the bagging ensemble models. The results showed that the RFR model achieved a testing model R2 value of 0.9668, while ETR model achieved a resting model R2 value of 0.9569. The higher R2 value of the RFR model makes it a better choice for predicting porosity in CCS assessment projects. However, if computational time is a critical factor, ETR could be preferable, as it required only1/3 of the computational time that of the RFR model. Furthermore, when the performance of these models was compared with the four traditional ML models the two bagging ensembles distinctly outperformed the traditional models.
Who’s Using What? An Investigation of Drug Use Among First-Time Arrestees from 25 County Jails Across the United States in 2023
Authors: Schumacher Joseph E. , Ahsan Abdullah , Simpler Amber H. , Natoli Adam P. , Cain Bradley J.
Published: October 2024

Conducting research within a carceral health care context offers a unique view into the nature of drug use among arrestees with enormous potential to identify and prevent acute drug use consequences such as drug withdrawal and overdose. The purpose of this study was to characterize the nature and extent of drug use among contemporary first-time jail arrestees to inform the detection, treatment, and prevention of adverse consequences associated with drug use. This study utilized a naturalistic research design to collect de-identified urine drug screens (UDS), jail characteristics, and arrestee demographic variables from 25 jails across the United States in 2023 through a confidential data sharing agreement with NaphCare, Inc. using its proprietary electronic health record operating system. Descriptive statistics were used to detail the features of the dataset, Pearson’s chi-square tests of independence were performed to statistically analyze associations between UDS results and jail characteristics and arrestee demographics, and significant chi-square test results were further investigated by examining standardized residuals to clarify the nature and significance of within-group differences in proportions. Of the 43,553 UDS cases comprising the final sample (28.8% of total arrestees), 74.8% were positive for one or more drugs, and 25.2% of UDS cases were negative for all drugs. Positivity was 69.0% for cannabis, 54.8% for stimulants, 29.6% for opioids, and 12.4% for sedatives. Arrestees were positive for multiple drugs half the time, with combinations of cannabis, stimulants, and opioids most common. Several significant associations between drug use and both jail characteristics and arrestee demographics were found. Though drug use is not a recent phenomenon, the lethality potential of the drugs being used today is relatively new. The record-breaking number of deaths due to overdose and withdrawal has moved drug use beyond “public enemy number one” to a public health crisis, a crisis most evident among correctional populations. While we have the capacity to disrupt this crisis and prevent withdrawal-related fatalities with evidence-based clinical assessment tools and pharmacological agents, we need to further develop policies to allow arrestees to safely and securely convey all of their health care needs.
Real-world safety and efficacy of neoadjuvant docetaxel, cisplatin, and 5-fluorouracil therapy for locally advanced esophageal squamous cell carcinoma
Authors: Tamba Mikako , Osumi Hiroki , Ogura Mariko , Fukuoka Shota , Okamura Akihiko , Kanamori Jun , Imamura Yu , Takahari Daisuke , Yoshino Koichiro , Udagawa Shohei , Wakatsuki Takeru , Shinozaki Eiji , Watanabe Masayuki , Yamaguchi Kensei , Chin Keisho , Ooki Akira
Published: October 2024

Background
Neoadjuvant chemotherapy with docetaxel, cisplatin plus 5-FU (DCF) has become the new standard of care for locally advanced esophageal squamous cell carcinoma (ESCC). In a real-world setting, the efficacy, recurrence, and adverse events (AEs) remain unclear.
Methods
This retrospective cohort study included 86 patients who received neoadjuvant DCF followed by esophagectomy for resectable ESCC.
Results
Following neoadjuvant DCF treatment, 75 patients underwent R0 curative resection. At the median follow-up of 19.2 months, the median disease-free survival (DFS)/recurrence-free survival (RFS) was not yet reached, with estimated 3-year DFS/RFS rates of 65.2%, respectively. The incidence of primary tumor regression grading (TRG) grade 1a and pathological complete response (pCR) were 21.3% (16/75) and 14.7% (11/75), respectively. The estimated 3-year DFS/RFS rates were 93.8% for primary TRG grade 1a and 100% for pCR. Baseline elevated serum SCC-antigen levels were inversely associated with achieving primary TRG grade 1a or pCR. In 64 patients who did not achieve pCR, residual tumor cells in the lymph nodes (ypN; HR, 16.96; 95% CI, 2.11-136.12; P < 0.01) and Glasgow prognostic score (GPS; HR, 8.34; 95% CI, 1.73–40.31; P < 0.01) were independent predictors of shorter DFS/RFS. The most common grade 3–4 adverse events were neutropenia (61.6%) and febrile neutropenia (26.7%), which were not associated with clinicopathological factors.
Conclusions
Neoadjuvant DCF was effective and well-tolerated in real-world ESCC patients. Primary TRG grade 1a or pCR showed a favorable DFS/RFS, while positive ypN and GPS were independent risk factors for worse DFS/RFS.
Utilizing serum and urine metabolomics for diagnosing acute intra- abdominal infection in the early stage
Authors: Dong Zhenhua , Zhang Shaopeng , Zhang Hongwei , Yu Kai , Wang Daguang
Published: October 2024

Background:
Acute intra-abdominal infection (IAI), a normal disease of general surgery, is an important reason for patients’ death. However, owing to the defects of medical laboratory science and imaging tests, we can’t identify the patients with IAI timely. So, the metabolomics is applied to explore early biomarkers for IAI.
Methods:
A total of 30 IAI patients and 20 healthy volunteers are analyzed by liquid chromatography-mass spectrometry (LC-MS). First, we utilize total ion chromatography (TIC) and principal component analysis (PCA) to judge whether differential metabolites exist. Then student t test, partial least squares discriminant analysis (PLS-DA) and support vector machine (SVM) are performed to identify differential metabolites. We further use fisher discriminant analysis and hierarchical clustering analysis to observe the distinguishing effect of chosen metabolites. last, we select most eligible biomarkers based on receiver operating characteristic curve (ROC).
Results:
Finally, we identify 6 and 2 metabolites as biomarkers for IAI in serum and urine respectively.
Conclusions:
There are differential metabolites between healthy people and IAI patients. We could identify IAI patients more conveniently by detecting these biomarkers regularly.
Cavernosal venous occlusive dysfunction caused by enhanced sympathetic activity of cavernous smooth muscle: Identification and exploratory study
Authors: Chen Huirong , Meng Zizhou , Bai Haowei , Zhi ER lei , Tian Ruhui , Yao Chencheng , LI Peng , Huang yuhua , Zhao Fujun , Li Zheng
Published: October 2024

Cavernosal venous occlusive dysfunction (CVOD) accounts for the most common etiology of erectile dysfunction (ED) among non-responders to phosphodiesterase type 5 inhibitors (PDE5is). How to identify CVOD caused by hypersympathetic activity of cavernous smooth muscle (HS-CVOD) and effectively treat HS-CVOD non-responded to PDE5is have not been fully studied. A total of 166 patients with ED were assessed and grouped by nocturnal penile tumescence rigidity test (NPTR) and color duplex Doppler ultrasound (CDDU). The sympathetic activity of cavernous smooth muscle (amplitude and duration) were determined by corpus cavernosum electromyography (CC-EMG). Patients diagnosed with CVOD by CDDU and with psychological ED by NPTR were considered as HS-CVOD. HS-CVOD patients non-responded to PDE5is were treated by PDE5is combined trazodone for 4 weeks. There were 27 cases of HS-CVOD were considered. The CC-EMG amplitude of HS-CVOD group (302.65 ± 195.01 uv) were significantly greater than that of psychological ED combined with non-vascular ED group (183.71 ± 112.42 uv), organic ED combined CVOD group (162.67 ± 91.17 uv), organic ED combined CVOD group (162.67 ± 91.17 uv), and organic ED combined arterial or mixed ED group (145.67 ± 75.29 uv), respectively. 8 in 11 patients with HS-CVOD non-responded to PDE5is were successfully treated by PDE5is combined trazodone. These findings underscore that HS-CVOD can be preliminary considered by NPTR and CDDU, and assessed by CC-EMG with enhanced sympathetic activity of cavernous smooth muscle. The therapy of PDE5is combined trazodone could be an effective treatment strategy for HS-CVOD non-responded to PDE5is.
Uterine rupture and intestinal injury resulting from postpartum penetrating placental implantation: a case report
Authors: Zhang Qingge , Liu Zongyu , Zhao Ruimin , Wu Fei , Fan Limei
Published: October 2024

Background
The refractory obstetric hemorrhage that can occur as a result of placental implantation remains a major cause of maternal mortality. Abnormal placental implantation rates have risen markedly in recent years, with the increasing frequency of cesarean sections and other procedures such as myomectomy having contributed to uterine scarring. Penetrating placental implantation resulting in uterine rupture, however, is far less common. This report describes a case of postpartum penetrating placenta implantation leading to uterine rupture and intestinal injury.
Case:
A 38-year-old G2P1 female presented to the hospital 34 days following a normal delivery with symptoms including 10 days of irregular vaginal bleeding and a 1-day history of fever. She had previously undergone surgical treatment for multiple smooth muscle uterine tumors. Ultrasound and magnetic resonance imaging findings were indicative of myometrial occupancy, prompting speculation that placental implantation may have occurred. Following anti-infection treatment and the correction of anemia, open exploratory surgery was performed. During this procedure, the placenta was found to have penetrated the uterus and caused small bowel erosion. A subtotal hysterectomy and partial small bowel resection were performed, and postoperative pathology confirmed a case of penetrating placenta implantation.
Conclusion
Penetrating placenta implantation is a rare complication for which few additional testing options are available, complicating the diagnostic process. Greater awareness of this condition should thus be emphasized to minimize the incidence of adverse pregnancy outcomes.