bluuebunny/crossref_metadata_2025_split huggingface dataset:
Site Characterization of Balikesir-Northwest of Turkey: Case Study of Bandirma and Erdek Districts
Authors: Erdönmez Hatice Kübra , Gök Elçin , Erzin Yusuf 
Published: December 2024

Abstract

This study aims to conduct comprehensive site characterization in the Turkish regions of Balıkesir, particularly in the Bandırma and Erdek areas. Microtremor measurements were conducted at predetermined locations in the study area. The research analyzed earthquake dominant periods and amplification values obtained from the seismometers and microtremor measurements. Seismic microzonation maps were created using ArcGIS-integrated parameters such as dominant period, amplification, Vs 30 velocities, and soil classification types following NEHRP (2020) guidelines. These maps assessed the coherence among soil amplification, dominant period values, and depth estimations. Soil amplification and dominant period values were determined to range from 0.4 to 8.22 and 0.065 to 2.1 Hz, respectively, in the Bandırma district study areas. In the Erdek district study areas, soil amplification and dominant period values ranged from 0.97 to 6.14 and 0.051 to 3.1 Hz, respectively.
Assessing the Financial Burden of Multimorbidity Among Patients Aged 30 and above in India
Authors: Shukla Sudheer Kumar , John Pratheeba , Khemani Sakshi , Nair Ankur Shaji , Singh Nishikant , Sadanandan Rajeev 
Published: December 2024

Abstract

Background
Multimorbidity is associated with significant out-of-pocket expenditures (OOPE) and catastrophic health expenditure (CHE), especially in low- and middle-income countries like India. Despite this, there is limited research on the financial burden of multimorbidity in outpatient and inpatient care, and cross-state comparisons of CHE are underexplored.
Methods
We conducted a cross-sectional analysis using nationally representative data from the National Sample Survey 75th Round ‘Social Consumption in India: Health (2017-18)’, focusing on patients aged 30 and above in outpatient and inpatient care in India. We assessed multimorbidity prevalence, OOPE, CHE incidence, and CHE intensity. Statistical models, including linear, log-linear, and logistic regressions, were used to examine the financial risk, with a focus on non-communicable diseases (NCDs), healthcare facility choice, and socioeconomic status and Epidemiological Transition Levels (ETLs).
Results
Multimorbidity prevalence in outpatient care (6.1%) was six times higher than in inpatient care (1.1%). It was most prevalent among older adults, higher MPCE quintiles, urban patients, and those with NCDs. Multimorbidity was associated with higher OOPE, particularly in the rich quintile, patients seeking care from private providers, low ETL states, and rural areas. CHE incidence was highest in low ETL states, private healthcare users, poorest quintile, males, and patients aged 70 + years. CHE intensity, measured by mean positive overshoot, was greatest among the poorest quintile, low ETL states, rural, and male patients. Log-linear and logistic regressions indicated that multimorbidity patients with NCDs, those seeking private care, and those in low ETL states had higher OOPE and CHE risk. The poorest rural multimorbidity patients had the greatest likelihood of experiencing CHE. Furthermore, CHE intensity was significantly elevated among multimorbidity patients with NCDs (95% CI: 19.29–45.79), patients seeking care in private, poorest, and from low ETL states (95% CI: 7.36–35.79).
Conclusions
The high financial burden of OOPE and CHE among multimorbidity patients, particularly those with NCDs, underscores the urgent need for comprehensive health policies that address financial risk at the primary care level. To alleviate the financial burden among multimorbidity patients, especially in low-resource settings, it is crucial to expand public healthcare coverage, incorporate outpatient care into financial protection schemes, advocate for integrated care models and preventive strategies, establish standardized treatment protocols for reducing unnecessary medications linked to polypharmacy, and leverage the support of digital health technologies.
Isolated Restricted Diffusion at admission predicts survival in patients of Glioblastoma (IRD-GB)- A prospective pilot study
Authors: Shankar Jai , Patil Nikunj , Ayroso Marco , Marin Roman , Bigio Marc Del , Pitz Marshall , Beiko Jason , Silvaggio Joseph , Essig Marco , Kakumanu Saranya , Sinha Namita 
Published: December 2024

Abstract

Background- Glioblastoma (GB) is the most malignant primary brain tumor. Isolated restricted diffusion (IRD) is restricted diffusion outside the confines of enhancing tumor with no corresponding enhancement on post contrast study. The aim of our study was to prospectively assess the incidence of IRD in GB patients, determine how often these foci proceed to contrast enhancement on follow up, and analyze the survival pattern of patients with IRD.
Methods- In a prospective pilot cohort study, consecutive adult patients (≥18 years old) suspected of having GB on initial MRI of brain, were included and screened for the presence of IRD. All images were independently analyzed by two experienced radiologists for inter-rater reliability.
The survival pattern of patients with IRD was assessed with Cox-regression and Kaplan-Meier curve analysis.
Results- Of the 52 patients (median age- 63 years; male-63.5%) included, 21% (11 of 52) exhibited foci of IRD. Inter-rater agreement on the diagnosis of IRD foci was fair (kappa=0.29) between the two readers.
Among the 11 patients with IRD, only 7 (64%) showed enhancement in the IRD focus on imaging at a median follow up time of 110 days. The Kaplan Meier analysis (Figure 3) revealed a significant decrease (p=0.035) in the survival was observed among patients with IRD focus.
Conclusion- In conclusion, IRD foci were seen in 21% of patients with GB, with 64% of these demonstrating enhancement at the IRD focus on follow up imaging. A shorter survival was associated with IRD foci.
Value of Semi-quantitative Scoring Based on Musculoskeletal Ultrasound in Diagnosis and Disease Assessment of Gouty Arthritis
Authors: Zhang Panke , Li Dan , Li Dongyu 
Published: December 2024

Abstract

Objective
To explore value of semi-quantitative scoring based on musculoskeletal ultrasound in diagnosis and disease assessment of gouty arthritis (GA).
Methods
Ninety patients with suspected GA who received in our hospital from January 2022 to December 2023 were retrospectively selected as the study objects. The puncture results of joint synovial fluid or crystal material in the joint cavity were used as the gold standard, and the patients 'joint effusion, synovitis, bone erosion and tenosynovitis were counted. Compare the musculoskeletal ultrasound semi-quantitative score with the puncture results of joint synovial fluid or crystal material in the joint cavity to diagnose different pathological types of GA, and evaluate the diagnostic efficiency of musculoskeletal ultrasound semi-quantitative score in diagnosing different pathological types of GA. Use correlation analysis to analyze the correlation between patients with the musculoskeletal ultrasound semi-quantitative score results, IL-6 and DAS28 scores, and typical musculoskeletal ultrasound and MRI examination results.
Results
There was no significant difference between the musculoskeletal ultrasound semi-quantitative score and the puncture results of joint synovial fluid or crystal material in the joint cavity. There was no significant difference between the examination results of different lesion types (P > 0.05). The puncture results of joint synovial fluid or crystal material in the joint cavity were used as the gold standard, the sensitivity of musculoskeletal ultrasound semi-quantitative scoring in diagnosing synovial thickening, joint effusion, bone erosion, and tendon/tendon sheath inflammation in GA patients was 92.86% (26/28), 96.00% (24/25), 95.24% (20/21), and 75.00% (12/16) respectively. The specificity values were 93.55% (58/62), 96.92% (63/65), 95.65% (66/69), and 98.65% (73/74) respectively. The accuracy rates were 93.33% (84/90), 96.67% (87/90), 95.56% (86/90), and 94.44% (85/90) respectively. According to Pearson linear correlation analysis, as the semi-quantitative scoring increased, there was a positive correlation with erythrocyte sedimentation rate, IL-6, and DAS28 scores (r = 0.729, 0.584, 0.773, P < 0.001). Observation of their serological indicators showed that there were significant differences in serological indicators between patients with different semi-quantitative scores (P < 0.05).
Conclusion
Semi-quantitative scoring based on musculoskeletal ultrasound has high value in the diagnosis and assessment of gouty arthritis, and is worth further use.
Identifying factors for pembrolizumab eligibility in head and neck cancer
Authors: Miyamaru Satoru , Murakami Daizo , Nishimoto Kohei , Orita Yorihisa 
Published: December 2024

Abstract

Purpose
Although immune checkpoint inhibitors (ICIs) are used as first-line treatments for recurrent or metastatic head and neck cancer (R/M HNC), there are many cases where the treatment is ineffective, making the assessment of efficacy crucial. In this study, we examined factors associated with the therapeutic effects of pembrolizumab.
Methods
We retrospectively analyzed 54 patients with R/M HNC treated with pembrolizumab from January 2020 to December 2022. We investigated the relationship between survival rates and various factors such as the combined positive score (CPS), histological subtypes, recurrent lesions, details of administered agents, sequence of administration, history of cetuximab use, and presence of immune-related adverse events (irAEs).
Results
The overall survival rates at 1-, 2, and 3 years were 57.4%, 41.8%, and 32.3%, respectively. The response and disease control rates were 31.5% and 51.9%, respectively. In the univariate analysis, a CPS of 20 or higher, first-line treatment, no history of cetuximab use, and the presence of irAEs was associated with better survival rates, whereas in the multivariate analysis, the first two factors were significantly associated with better survival. In this study, 16 of 20 cases had a CPS of 50 or higher, and 7 had a CPS of 90 or higher, indicating that a large number of high CPS cases were included, which is believed to have contributed to the results of this study.
Conclusion
In patients with a CPS of 20 or higher, pembrolizumab can be administered as first-line treatment, with favorable expected therapeutic effects.
High Implant Failure Rate in Patients with Arthrodesis for Thumb Carpometacarpal Joint Osteoarthritis
Authors: Fujihara Yuki , Niwa Satoshi , Ota Hideyuki , Fujihara Nasa , Kumagai Hiroaki 
Published: December 2024

Abstract

Purpose
Thumb carpometacarpal (CMC) arthrodesis is a common surgical procedure used to treat osteoarthritis. However, the high complication rate can deter surgeons and patients from choosing this procedure. This study aimed to compare the implant failure rates of the different fixation techniques used in thumb CMC arthrodesis.
Methods
This retrospective study included 38 patients who underwent thumb CMC arthrodesis between June 2015 and May 2024. We defined implant failure, including screw dislodgement or locking mechanism failure, as the primary outcome and performed multinomial logistic regression analysis. The outcomes in each implant cohort were compared. Demographics, clinical outcomes, and implant types were analysed.
Results
In the multivariate analysis, implant choice was a significant prognostic factor for implant failure, which occurred in 11 (29%) patients. The APTUS Hand 2.0 plate showed significantly higher implant failure rates (73%) than the VariAx hand 2.3 (0%) and headless screws (0%). Other complications included non-union (11%), nerve injury (3%), and metal allergy (3%). Although the two headless screw cohorts were associated with longer casting times and lower EQ-5D scores, they showed less bone grafting and fewer complications.
Conclusions
The locking mechanism of the APTUS Hand 2.0 plate may be inadequate for the forces applied to the thumb joint, resulting in higher implant failure rates. Future studies are required to evaluate the long-term outcomes and biomechanics of different fixation techniques. Although thumb CMC arthrodesis is an effective treatment modality, careful implant selection is crucial to minimise complications. The study’s findings indicate a preference for headless screws.
Elevated and fluctuating TyG and LAP trajectories are associated with cardiometabolic multimorbidity development in midlife: the CARDIA study
Authors: Zhou Lingqu , Wang Junjie , Zhou Zirui , Wang Liangjiao , Guo Qi , Zeng Hui , Zhong Ziyue , Zhang Yinyin 
Published: December 2024

Abstract

Background
Insulin resistance and central obesity are major risk factors for cardiometabolic diseases. The triglyceride-glucose index (TyG) and lipid accumulation product (LAP) are markers that independently predict cardiometabolic risk. However, their combined long-term trajectories and impact on cardiometabolic multimorbidity (CMM) development remain unclear.
Methods
This cohort study utilized data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, which tracked 3,467 participants at baseline. Dual-trajectory of TyG and LAP were identified using a group-based dual-trajectory model. Cox proportional hazards models were employed to assess the relationships between dual-trajectory groups and primary cardiometabolic outcomes, including first cardiometabolic disease (FCMD), CMM (two or more conditions such as type 2 diabetes, coronary heart disease, or stroke), and all-cause mortality. Multi-state models were performed to assess the associations of dual-trajectory with CMM development.
Results
The study included 3,467 participants with a mean age of 25.08 years (SD = 3.59). Of these, 43.4% (n = 1,505) were male, and 53.2% (n = 1,561) were White. Three distinct dual-trajectory groups were identified: low-increasing (61.5%), high-amplitude fluctuation (7.6%), and high-increasing (30.9%). After multivariate adjustment, compared with the low-increasing group, the high-amplitude fluctuation group exhibited significantly higher risks for FCMD (hazard ratio [HR] 1.38, 95% confidence interval [CI]: 1.08–1.77), CMM (HR 2.63, 95% CI: 1.21–5.71), and all-cause mortality (HR 2.16, 95% CI: 1.30–3.56), as well as elevated risks for transitions from baseline to FCMD (HR: 1.39, 95% CI: 1.09–1.78), FCMD to CMM (HR: 2.31, 95% CI: 1.16–4.62), CMM to death (HR: 3.45, 95% CI: 1.13–10.51). The high-increasing group showed similar results.
Conclusions
Elevated and fluctuating trajectories of TyG and LAP from early adulthood are associated with increased risks of CMM development in midlife.
A Methodological Framework for the Development and Validation of Reliable Artificial Intelligence in Embryo Evaluation
Authors: Gilboa Daniella , Garg Akhil , Shapiro Maya , Meseguer Marcos , Amar Yuval , Lustgarten Nicole , Desai Nina , Shavit Tal , Silva Vladimiro , Papatheodorou Achilleas , Chatziparasidou Alexia , Angras Sameer , Lee Jae Ho , Thiel Larissa , Curchoe Carol Lynn , Tauber Yishay , Seidman Daniel S. 
Published: December 2024

Abstract

Background
Artificial intelligence (AI) models analyzing embryo time-lapse images have been developed to predict the likelihood of pregnancy following in vitro fertilization (IVF). However, limited research exists on methods ensuring AI consistency and reliability in clinical settings during its development and validation process. We present a methodology for developing and validating an AI model across multiple datasets to demonstrate reliable performance in evaluating blastocyst-stage embryos.
Methods
This multicenter analysis utilizes time-lapse images, pregnancy outcomes, and morphologic annotations from embryos collected at 10 IVF clinics across 9 countries between 2018 and 2022. The four-step methodology for developing and evaluating the AI model include: (I) curating annotated datasets that represent the intended clinical use case; (II) developing and optimizing the AI model; (III) evaluating the AI’s performance by assessing its discriminative power and associations with pregnancy probability across variable data; and (IV) ensuring interpretability and explainability by correlating AI scores with relevant morphologic features of embryo quality. Three datasets were used: the training and validation dataset (n = 16,935 embryos), the blind test dataset (n = 1,708 embryos; 3 clinics), and the independent dataset (n = 7,445 embryos; 7 clinics) derived from previously unseen clinic cohorts.
Results
The AI was designed as a deep learning classifier ranking embryos by score according to their likelihood of clinical pregnancy. Higher AI score brackets were associated with increased fetal heartbeat (FH) likelihood across all evaluated datasets, showing a trend of increasing odds ratios (OR). The highest OR was observed in the top G4 bracket (test dataset G4 score ≥ 7.5: OR 3.84; independent dataset G4 score ≥ 7.5: OR 4.01), while the lowest was in the G1 bracket (test dataset G1 score < 4.0: OR 0.40; independent dataset G1 score < 4.0: OR 0.45). AI score brackets G2, G3, and G4 displayed OR values above 1.0 (P < 0.05), indicating linear associations with FH likelihood. Average AI scores were consistently higher for FH-positive than for FH-negative embryos within each age subgroup. Positive correlations were also observed between AI scores and key morphologic parameters used to predict embryo quality.
Conclusions
Strong AI performance across multiple datasets demonstrates the value of our four-step methodology in developing and validating the AI as a reliable adjunct to embryo evaluation.
Genome assisted gene-flow rescued genetic diversity without hindering growth performance of inbred coho salmon (Oncorhynchus kisutch) population selected for high growth phenotype
Authors: Kobayashi Junya , Honda Ryo , Hosoya Sho , Nochiri Yuki , Matsuzaki Keisuke , Sugimoto Koichi , Nagano Atsushi J. , Kumagaya Akira , Kikuchi Kiyoshi , Kurokawa Tadahide 
Published: December 2024

Abstract

Selective breeding is a powerful tool for improving aquaculture production. A well-managed breeding program is essential, as populations can otherwise lose genetic diversity, leading to reduced selection response and inbreeding excesses. In such cases, genetic diversity in broodstock must be restored by introducing individuals from external populations. However, this can reduce the accumulated genetic gains from selective breeding. On the other hand, selectively introduction of individuals with superior phenotypes will allow restoration of genetic diversity without sacrificing these gains. In this study, we demonstrated this possibility using a selectively bred (SB) and a randomly bred (RB) population of coho salmon (Oncorhynchus kisutch). Forty males with superior growth were selected from RB population using genomic selection and crossed with 127 randomly collected females from SB to produce a newly bred (NB) population. Genetic diversity, assessed from population statistics such as effective number of alleles, allele richness, and observed heterozygosity of 11 microsatellite markers, was higher in NB than in SB and RB. Additionally, folk length and body weight were compared among the three populations after a 12-month communal culture from fertilization. The least-squares means of folk length and body weight were similar between NB (164.9 mm and 57.9 g) and SB (161.1 mm and 53.7 g), while both were significantly larger than those of RB (150.4 mm and 43.0 g). Our results highlight the effectiveness of the genome-assisted gene flow in restoring the genetic diversity of SB populations without compromising their accumulated genetic gain in growth.
Enhancing storability of Etmany guava (Psidium guajava L.) with edible coating materials
Authors: Hussein Shams A. , Ghany Nazmy A. Abdel , Bondok Ahmed , Nasser Mohamed A. 
Published: December 2024

Abstract

Guava is a tropical fruit that can be consumed unpeeled. However, it is prone to physical and biological deterioration during distribution and storage. The aim of this study applies an edible coating method to minimize quality loss, biological deterioration and postharvest spoilage, to extend shelf-life in cultivar " Etmany" guava. Guava was coated by chitosan and edible oil such as Moringa oil, lemon grass oil, Marjoram oil, Rosemary oil. Chitosan at 2% and moringa oil at 1% and 2% extended the cold storage of fruits by up to 24 days. Moringa oil treatment at 1% and 2% resulted in less weight loss than 1% chitosan on day 24 of storage, with the fruits exhibiting superior quality characteristics (total soluble solids, L-Ascorbic Acid, total sugars, reduced and non-reduced sugars). The results indicated that H2O2 levels in fruits treated with 2% Chitosan and 1% or 2% moringa oil were lower than in other treatments, attributed to enhanced peroxidase (POD) enzyme activity. Moreover, chitosan and oils coating substantially decreased bacteria and yeasts/molds on the fruit. Generally, moringa oil was the best treatment that increased the physiological and chemical characteristics in addition reduced the post-harvest disease soilage.
Nonlinear Adaptive Controller Design for Frequency Variation in Pulse Width Modulation for DC-DC Buck Converter via Experimental Evaluation
Authors: Eghlim Armin Lotfi , Basci Abdullah 
Published: December 2024

Abstract

This paper presents a novel adaptive backstepping control to deal with the frequency variations of Pulse Width Modulation signals in DC-DC buck converters. The traditional control methods, such as Sliding Mode Control and Feedback Linearization, are prone not to maintain stable output voltage when the input changes significantly and unforeseen switching frequency variations that eventually lead to system instability. To overcome these limitations, the adaptive backstepping controller is designed to handle the estimation and compensation of the switching frequency variations to ensure robust voltage regulation. Practical experiments are performed to validate the performance of the controller using an ESP32-S2 microcontroller; in addition, dynamic and steady-state responses show their effectiveness in keeping stability under different operating conditions such as load variations, input voltage fluctuations, and random switching frequency variations. The suggested approach not only strengthens the system’s stability and robustness but also decreases the chattering and steady-state errors associated with traditional control methods. These findings indicate the adaptive backstepping control technique provides a credible solution for frequency variation control in power electronic systems, which are ideal for renewable energy systems, electric vehicles, and other high-performance electronics.