bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wearable equipment-based telemedical management via multiparameter monitoring on cardiovascular outcomes in elderly patients with chronic coronary heart disease: an open-labelled, randomised, controlled trial
Authors: Lu Tingting , Cao Ruihua , Wang Yujia , Kong Xiaoxuan , Wang Huiquan , Sun Guanghua , Gao Shan , Wang Yabin , Yuan Yuan , Shen Xiaoying , Fan Li , Ren Jun , Cao Feng 
Published: December 2024

BackgroundThe prevalence of chronic coronary heart diseases (CHDs) increases with age in the elderly, which represents one of the top-ranked causes of death and disease burden.MethodsThis study aimed to investigate the management efficiency of telemedicine based on the remote multiparameter monitoring in elderly patients with CHD. A total of 1248 elderly patients diagnosed with CHD were enrolled. The subjects were randomly divided into two groups, wearable equipment-based telemedical management (WTM) group and traditional follow-up management (TFM) group. Face-to-face clinical interview at least once every 2 months was required in TFM group to collect the medical records. Patients in WTM group were provided with wearable equipment to complete remote monitoring, real-time alerts and health intervention via virtual consultations and remote medication recommendations.ResultsThe mean age of patients in WTM group and TFM group was 71.1 (68.0–82.0) years and 71.0 (68.0–81.0) years, respectively‏. After a 12-month management, patients in WTM group presented a lower occurrence of hospitalisation (HR 0.59, 95% CI=0.47 to 0.73, p<0.0001) and major adverse cardiac events (HR 0.60, 95% CI=0.44 to 0.82, p=0.0012) compared with patients in TFM group.ConclusionThe multiparameter telemedical management could help with the out-of-hospital management and reduce the incidence of rehospitalisation in elderly patients with CHD.
Six-year performance of risk-based selection for lung cancer screening in the Manchester Lung Health Check cohort
Authors: Goodley Patrick , Balata Haval , Robbins Hilary A , Booton Richard , Sperrin Matthew , Crosbie Philip A J 
Published: December 2024

ObjectiveRisk prediction models are used to determine eligibility for targeted lung cancer screening. However, prospective data regarding model performance in this setting are limited. Here we report the performance of the PLCOm2012risk model, which calculates 6 year lung cancer risk, in a cohort invited for lung cancer screening in a socioeconomically deprived area.Methods and analysisCalibration (expected/observed (E/O) lung cancer diagnoses over 6 years) and discrimination (area under the receiver operating characteristic curve) of PLCOm2012and other models was performed in Manchester Lung Health Check (M-LHC) participants, where PLCOm2012≥1.51% was used prospectively to determine screening eligibility. Lung cancers diagnosed by any route were captured within 6 years of risk assessment, for both screened and non-screened participants. Performance of a range of models was evaluated.ResultsOut of 2541 attendees, 56% were high-risk (n=1430/2541) and offered screening; 44% were low-risk (n=1111/2541) and not screened. Over 6 years, 7.3% (n=105/1430) and 0.9% (n=10/1111) were diagnosed with lung cancer in the high and low-risk cohorts, respectively (p<0.0001). Risk was underestimated in both high-risk, screened (E/O 0.68 (0.57–0.82)) and low-risk, unscreened groups (E/O 0.61 (0.33–1.14)). Most other models also underestimated risk.ConclusionRisk-based eligibility using PLCOm2012successfully classified most eventual lung cancer cases in the high-risk, screened group. Prediction models generally underestimated risk in this socioeconomically deprived cohort, irrespective of screening status. The effect of screening on increasing the probability of lung cancer diagnosis should be considered when interpreting measures of prediction model performance.
What predicts complete immunisation among 18-month to 24-month-old children in the urban slum area of Hlaingthayar Township, Yangon Region, Myanmar? A cross-sectional study
Authors: Lynn Zayar , Han Wai Wai 
Published: December 2024

IntroductionIn Myanmar, there are significant disparities in the delivery of immunisation services and barriers to service accessibility, particularly in border regions, conflict-affected areas, physically and geographically hard-to-reach areas, urban slums and migratory populations. The study aimed to explore the predictors for complete immunisation among 18-month to 24-month-old children in the urban slum area of Hlaingthayar Township, Yangon Region, Myanmar.MethodsA cross-sectional study was conducted from 21 to 25 July 2018. A total of 298 mothers of 18-month to 24-month-old children were recruited from the urban slum areas under five randomly selected wards by applying the cluster sampling method. Multiple binary logistic regression was performed to explore the predictors for complete immunisation. A significance level of 0.05 was considered statistically significant.ResultsOut of a total of 298 children, 120 (40.3%) children were completely immunised, and the immunisation coverages ranged from 52.7% for the second dose of measles-rubella vaccine to 81.9% for the first dose of oral polio vaccine. Multivariate logistic regression model revealed that mothers having university and above education (AOR=2.65, 95% CI 1.07 to 6.56), mothers with permanent residency (AOR=2.19, 95% CI 1.16 to 4.15), primiparous mothers (AOR=1.76, 95% CI 1.05 to 2.95), mothers with medium knowledge (AOR=2.38, 95% CI 1.07 to 5.30) and high knowledge about childhood immunisation (AOR=5.89, 95% CI 2.23 to 15.60), and mothers with positive perception of childhood immunisation (AOR=2.26, 95% CI 1.33 to 3.85) were the significant predictors for complete immunisation among children.ConclusionThe proportion of complete immunisation was low, and associated with maternal education, residency, parity, knowledge and perception of childhood immunisation. Having a comprehensive understanding of these predictors will facilitate the government and other relevant stakeholders to establish effective strategies promoting access to immunisation services among the urban slum communities in Myanmar.
How many monthly nighttime-sleep opportunities are optimal for recovery from fatigue among shift-working nurses? A 1-month sleep log observational study to test anchor nighttime sleep in Japan
Authors: Kubo Tomohide , Ikeda Hiroki , Izawa Shuhei , Nishimura Yuki 
Published: December 2024

BackgroundGiven that nighttime sleep has more recuperative power than daytime sleep, ensuring the former is important to recovery from work, especially for shift-working nurses. In this 1-month sleep log study, we preliminarily examined how the number of monthly nighttime-sleep opportunities relates to fatigue-related outcomes among shift-working nurses.Methods526 nurses were required to record their daily sleep duration immediately after waking from sleep for 1 month. We analysed the associations among the four sleep groups (ie, ≤ 12, 13–19, 20–24 and≥24 nighttime-sleep opportunities per month) and fatigue-related outcomes. A one-way analysis of covariance or generalised linear mixed model (factor: sleep group) was conducted using R (version 4.2.2.) to test the association.ResultsSignificant differences among the four sleep groups were obtained using the excessive fatigue symptom inventory (EFSI), Pittsburgh sleep quality index (PSQI) and the numbers of near-miss incidents. Moreover, significant linear trends were observed in the EFSI and PSQI scores.ConclusionsShift-working nurses who experienced 12 or fewer monthly nighttime-sleep opportunities showed worse fatigue-related outcomes than those who had sufficient monthly nighttime-sleep opportunities. Therefore, more attention should be paid to ensuring monthly nighttime-sleep opportunities when creating a shift schedule.
Use of emergency services in response to a flood: an account of the aftermath of the May 2023 flood in Romagna, Italy
Authors: Portoraro Andrea , Vallicelli Giorgia , Strada Andrea , Farina Gabriele , De Giorgio Roberto , Rosa Simona , Golinelli Davide , Grilli Roberto 
Published: December 2024

BackgroundExtreme weather events due to human activities have significantly increased the frequency and severity of hydrological disasters like floods, impacting human health and healthcare systems worldwide. This study analyses the patterns of emergency service utilisation of the May 2023 flood in Romagna, Italy, and specifically investigates the differences in emergency department (ED) visits and mortality between individuals exposed and not exposed to the flood.MethodsA retrospective cohort study was conducted including 813 724 citizens of Romagna, Italy, from 15 May to 31 August 2023 (ie, 14 weeks after flood inception). The study differentiated between individuals in flood-affected (exposed) and non-affected (unexposed) areas, assessing ED visit rates (overall and by disease category), hospitalisation odds and mortality. Data were analysed using multivariate regression models, adjusting for demographic variables, comorbidities and social frailty, assessed using the Deprivation Index.ResultsOf the study population, 586 437 were exposed to the flood, while 227 287 were not exposed. ED visits totalled 33 331 for those exposed to the flood and 13 185 for the unexposed group. Overall, 27 527 (4.7%) of those in the exposed group and 10 829 (4.8%) in the unexposed group experienced at least one ED visit (OR 0.98; 95% CI 0.96 to 1.01). Frequency of access with severe triage scores was higher among those exposed as well as rate of hospitalisation after ED visit. Among those exposed, the rate of ED admission was lower for ophthalmology diseases (OR 0.84; 95% CI 0.77 to 0.92) and general disorders and minor problems (OR 0.85; 95% CI 0.78 to 0.93), and higher for trauma (OR 1.22; 95% CI 1.09 to 1.36) and mental health disorders (OR 1.40; 95% CI 1.17 to 1.75). Exposed individuals had a slightly increased risk of death in the subsequent weeks (OR: 1.09; 95% CI 1.00 to 1.19).ConclusionThe May 2023 flood in Romagna revealed enhanced vulnerability of the directly affected population, as shown by higher acuity ED presentations and subsequent hospitalisations, as well as more visits for trauma and mental health.
Mitigating Supply Disruption Risks: Impact of Product Upgrading Strategy
Authors: Yang Lu , Zhang Jun , Shi Xiutian 
Published: December 2024

Supply disruption is one of the crucial risks faced by supply chains in the changing external environment. To mitigate supply disruption risk and enhance resilience, product upgrading with Research and Development (R&D) investment is widely adopted by firms. In this paper, we establish a game-theoretic model to study the operation decisions and product upgrading strategies for a supply chain. Specifically, Firm 1 faces supply disruption risks when selling a normal product with a key component sourced from an unreliable supplier. To achieve supply resilience, the firm has an incentive to replace the unreliable supplier with product upgrading supported by R&D. It has an option to make high or low investments in R&D projects, indicating a high or low success rate. Our findings reveal that Firm 1 prefers to make investments in R&D for the upgraded product at a high investment level when the additional production cost of the upgraded product is relatively low or both the upgrading cost and supply disruption risk are relatively high. Extending our model to a duopoly scenario, we investigate the impact of competition on the product upgrading strategy selection. It is shown that a firm with a sufficiently large market share can drive its competitor out of the market by making R&D investments. Compared to the monopoly scenario, Firm 1 has a stronger incentive to upgrade the product under the duopoly scenario if its market share is relatively low. Finally, we identify the conditions where consumers get benefits from product upgrading. Our findings shed light on the importance of product upgrading strategy in a volatile business environment and provide insights into how firms can effectively mitigate supply disruption risk through R&D investments.
Compact Multilayer Reconfigurable Dual-Band Filters using Mixed Resonators
Authors: Radovanović Stefan , Ivaniš Milka Potrebić , Tošić Dejan V. , Tatović Ana 
Published: December 2024

In this paper, we realize a compact reconfigurable dual-band bandpass filter using memristive switches. The filter consists of two fourth-order single-band bandpass filters with mixed resonators. For the filter implementation, we use microstrip technology. In order to miniaturize the footprint area, around two times, we adopt the multilayer technology. The proposed filter has two operating modes: (1) dual-band bandpass (2BP) with both switches in the OFF state, and (2) single-band bandpass (1BP) for the switches in the ON state. A commercial RF memristor is not available yet, so we emulate its ON/OFF state with short- or open-circuit for the filter prototype fabrication. Measurements of the microstrip prototype validate the proposed design and are in good agreement with the 3D EM and circuit simulations. For 2BP mode, the central frequencies are 2.42[Formula: see text]GHz and 5.19[Formula: see text]GHz, while the 3[Formula: see text]dB fractional bandwidths (3dB FBW) are 7.7% and 5.35%, respectively. On the other hand, 1BP mode has a lower central frequency equal to 2.42[Formula: see text]GHz and the 3dB FBW is 7.6%, while the higher passband is suppressed more than 25[Formula: see text]dB. The footprint area is 0.37 [Formula: see text].18 [Formula: see text], when [Formula: see text] is given for the lower central frequency at 2.42[Formula: see text]GHz.
Telerobotic Versus Standard Ultrasound in the Assessment of the Abdomen and Pelvis: A Real‐World Prospective Study
Authors: Luengo Gómez David , Salmerón Ruiz Ángela , Romero Manjón María Isabel , Medina Benítez Antonio , Láinez Ramos-Bossini Antonio Jesús 
Published: December 2024

Introduction: Telerobotic ultrasound has emerged as a promising technology in medicine, especially in settings with limited medical access or a lack of specialized personnel. However, there are very few studies evaluating its usefulness in real‐world clinical practice.Objective: This study evaluates the usefulness of abdominopelvic telerobotic ultrasound in a real‐world practice setting.Methods: A prospective study was performed in a cohort of adult patients who underwent abdominal ultrasound in a remote secondary hospital for suspected abdominal or pelvic pathology. Examinations were performed by an on‐site technician and a remote abdominal radiologist. Satisfaction of patients and explorers, scan times, quality of visualization of anatomical structures, and ultrasound findings were measured and compared with standard ultrasound examinations performed by an on‐site radiologist blinded to telerobotic ultrasound findings. Multivariate analyses were performed to predict variables related to the visualization quality of abdominopelvic organs.Results: The sample included 40 patients (60% women; mean age, 51.2 ± 16.1 years; 35% overweight and 17.5% obese). Significant differences in ultrasound duration were observed between telerobotic ultrasound and standard ultrasound (27.4 ± 8.3 and 12.7 ± 3.1 min, respectively; p < 0.001). The mean satisfaction of radiologists, technicians, and patients with telerobotic ultrasound was high (7.35 ± 1.14 for radiologists, 7.93 ± 0.83 for technicians, and 8.43 ± 1.38 for patients). Visualization of anatomical structures was acceptable for most organs on telerobotic ultrasound but significantly worse than conventional ultrasound when “excellent visualization” was the reference standard. In addition, telerobotic ultrasound did not identify potentially relevant findings in a significant (70%) proportion of patients.Conclusions: Telerobotic ultrasound offers acceptable results in the assessment of abdominopelvic organs and can help provide adequate healthcare to patients in locations with limited access to radiology specialists. However, there are significant limitations compared to standard ultrasound for their optimal evaluation.
Genome‐Wide European Ancestry Study Identifies Coronary Artery Disease–Associated Loci Through Gene–Sex Hormone Interaction
Authors: Jain Vardhmaan , Dabbs‐Brown Amonae , Liu Chang , Hui Qin , Mehta Anurag , Wilson Peter W.F. , Quyyumi Arshed A. , Sun Yan V. 
Published: December 2024

Background
Although sex differences in coronary artery disease (CAD) risk have been observed, little is known about the role of sex hormones in CAD genetics. Accounting for sex hormone levels may help identify CAD‐risk loci and extend our knowledge of its genetic architecture.

Methods and Results

A total of 365 662 individuals of European ancestry enrolled in the UK Biobank were considered. Genetic interaction of total testosterone, bioavailable testosterone, and SHBG (sex hormone‐binding globulin) were evaluated. Gene–environment interactions in millions of samples software was used to conduct sex‐stratified genome‐wide interaction analysis with prevalent CAD as the outcome. Participant age at enrollment and principal components 1 to 10 were adjusted as covariates. We identified 45 loci in men and 8 loci in women that reached genome‐wide significance (
P
< 5 × 10
−8
) for CAD. Ten of the loci identified (5 loci in both men and women) were through joint effects and would not have been picked up using a traditional genome‐wide association study. Two of the joint effect loci in women were independently identified with significant single nucleotide polymorphism‐total testosterone interactions.

Conclusions
This genome‐wide gene–sex hormone interaction study identified genomic‐risk loci that may contribute to the differential CAD risk between men and women, which otherwise would not have been discovered in a traditional genome‐wide association study solely including marginal genetic effects.
Long‐Term Statin Use Is Associated With Reduced Rates of Adverse Events in Patients With Newly Diagnosed Atrial Fibrillation
Authors: Huang Ting‐Chun , Yap Li‐Hao , Chen Chao‐Yu , Lin Hui‐Wen , Lin Sheng‐Hsiang , Li Yi‐Heng 
Published: December 2024

Background
The effectiveness of statin use in preventing adverse cardiovascular events in individuals with atrial fibrillation (AF) has remained uncertain. This study aimed to assess whether statin use could lead to better outcomes among individuals with AF.

Methods and Results

We enrolled 397 787 patients with AF from January 1, 2012 to December 31, 2020. Patients with AF were divided into 2 groups (statin user and statin nonuser), and the risks of composite outcomes (including ischemic stroke, hemorrhagic stroke, and transient ischemic attack), all‐cause death, and major adverse cardiovascular events (which encompassed cardiovascular death, myocardial infarction, stroke, and heart failure hospitalization) were analyzed. We analyzed 288 958 patients with newly diagnosed AF (mean age, 73 years; 44% women; mean CHA
2
DS
2
‐VASc score, 3.5). Compared with patients without statin use, statin users had lower risks of composite end points (adjusted hazard ratio [HR], 0.91 [95% CI, 0.87–0.94];
P
<0.01). In regard to all‐cause death, statin users exhibited a 67% risk reduction compared with statin nonusers (adjusted HR, 0.33 [95% CI, 0.32–0.33];
P
<0.01). Statin use was also associated with reduced incidence of major adverse cardiovascular events (adjusted HR, 0.64 [95% CI, 0.63–0.66];
P
<0.01). In the subgroups stratified by CHA
2
DS
2
‐VASc score, statin therapy was particularly effective for patients with CHA
2
DS
2
‐VASc scores 0 to 3 for composite end points but consistently reduced all‐cause mortality and major adverse cardiovascular events across all score categories.

Conclusions
Among patients with newly diagnosed AF, statin use was associated with lower risk of ischemic stroke, hemorrhagic stroke, transient ischemic attack, all‐cause mortality, and major adverse cardiovascular events.
Increased Plasma
β
‐Secretase 1 Activity Correlates With Neurodegeneration in Cerebral Small Vessel Disease
Authors: Su Ya , Wang Qiong , Gao Feng , Xu Jiajie , Fu Jiayu , Ying Yunqing , Xia Yiwei , Wang Xiaoxiao , Dong Qiang , Shen Yong , Cheng Xin 
Published: December 2024

Background

β
‐secretase 1 (BACE1) plays a key role in amyloidogenic pathway and is considered a new mechanism for cerebral small vessel disease (CSVD). We explore the potential role of plasma BACE1 in CSVD and the pathological process it may be involved in.

Methods and Results

We enrolled 163 participants with CSVD (114 cerebral amyloid angiopathy and 49 hypertensive hemorrhage), and 96 cognitively unimpaired elders and 40 participants with Alzheimer's disease as controls. We measured BACE1 activity using a synthetic fluorescence substrate enzyme‐linked immunosorbent assay. We used regression models to investigate associations between BACE1 and imaging and blood markers as well as clinical outcomes in CSVD. Plasma BACE1 activity was significantly higher in CSVD (median 862.0 relative fluorescence units [RFU], interquartile range 700.6–1032.9) compared with elder controls (522.5 RFU, 438.3–662.1,
P
<0.001) but lower than Alzheimer's disease (964.0 RFU, 838.4–1225.0,
P
=0.032). For CSVD, there was an association between plasma and cerebrospinal fluid BACE1 activity (β=0.50,
P
=0.030). Plasma BACE1 activity was negatively associated with hippocampal volume (coefficient −2.40,
P
<0.001), and positively associated with blood neurofilament light chain (coefficient 0.08,
P
<0.001) and total tau (coefficient 0.15,
P
=0.006) but not with specific cerebrovascular imaging markers. During 2‐year follow‐up, BACE1 activity was independently related to dementia conversion (odds ratio, 17.72;
P
=0.001) but not stroke in CSVD.

Conclusions
Plasma BACE1 activity is moderately increased and associated with neurodegeneration and cognitive impairment risk in CSVD. It indicates that BACE1 is a promising biomarker especially for CSVD‐related neurodegeneration.
Prognostic Value of Epicardial Adipose Tissue in Heart Failure With Mid‐Range and Preserved Ejection Fraction: A Multicenter Study
Authors: Wang Wenxian , Gao Yan , Wang Jian , Ji Congshan , Gu Hui , Yuan Xianshun , Yang Shifeng , Wang Ximing 
Published: December 2024

Background
Epicardial adipose tissue (EAT) accumulation is thought to play a role in the pathophysiology of heart failure (HF) with mid‐range ejection fraction and HF with preserved ejection fraction, but its effect on outcome is unknown.

Methods and Results

A total of 692 patients with HF with mid‐range ejection fraction or HF with preserved ejection fraction who underwent cardiovascular magnetic resonance at 2 medical centers in China between October 2016 and October 2022 were included in this study. EAT volume and extracellular volume were calculated using cardiovascular magnetic resonance. The main outcome was the composite of all‐cause mortality and first HF hospitalization. Of 692 participants, 41.3% were women. The mean age, body mass index, left ventricular ejection fraction, and EAT volume were 57.0 years, 27.2 kg/m
2
, 50.0%, and 67.1 mL/m
2
, respectively. During a median follow‐up of 34 months, 169 patients (24.4%) died or were hospitalized for HF. EAT volume exhibited a strong unadjusted association with the composite outcome (hazard ratio per 1 mL/m
2
[HR], 1.57 [95% CI, 1.40–1.76],
P
<0.001). After fully adjusting, EAT remained associated with the outcome (HR, 1.62 [95% CI, 1.42–1.86],
P
<0.001). We constructed a baseline multivariable model including comorbidities, New York Heart Association functional class, extracellular volume, age, body mass index, left ventricular ejection fraction, and N‐terminal pro‐brain natriuretic peptide. Addition of EAT volume to the baseline multivariable model significantly improved model performance (C statistic improvement: 0.711–0.760;
P
<0.001).

Conclusions
EAT accumulation is associated with an adverse prognosis in patients with HF with mid‐range ejection fraction and those with HF with preserved ejection fraction. In addition, EAT provides incremental prognostic value beyond left ventricular ejection fraction and New York Heart Association class.