bluuebunny/crossref_metadata_2025_split huggingface dataset:
Synthesizing and Evaluating the Photocatalytic and Antibacterial Ability of TiO2/SiO2 Nanocomposite for Silicate Coating
Authors: Le Manh-Cuong , Le Thu-Huong , Bui Thi Thanh-Huyen , Nguyen Quang-Dat , Do Thi Thanh-Ha , Tran Thi Minh-Nguyet 
Published: September 2021

The TiO2/SiO2 nanocomposite has been synthesized by a sol-gel method and investigated the effect of the SiO2 content (0, 5, 10, 15, 20, and 50%) on the rutile-to-anatase phase transition of TiO2 NPs. In order to increase the photocatalytic efficiency of the nanocomposite and decrease the price of material, the TiO2/SiO2 Nc with content SiO2 of 15% sample is chosen for preparing silicate coating. The efficiency of photocatalytic MB and antibacterial ability in the air of W silicate coating (adding TiO2/SiO2 Nc (15%)) achieve almost 100% for 60 h and 94.35% for 3 h, respectively. While the efficiency of photocatalytic MB and antibacterial ability of WO silicate coating (adding commercial TiO2/SiO2) is about 25–30% for 60 h and 6.02% for 3 h, respectively. The presence of TiO2/SiO2 Nc (15%) with a larger surface area in W silicate coating can provide increased centers for absorption, photocatalytic reaction, and the contact between sample and bacteria lead to enhance the photocatalytic and antibacterial ability of W silicate coating.
Management and 30-Day Mortality of Acute Coronary Syndrome in a Resource-Limited Setting: Insight From Ethiopia. A Prospective Cohort Study
Authors: Fanta Korinan , Daba Fekede Bekele , Asefa Elsah Tegene , Melaku Tsegaye , Chelkeba Legese , Fekadu Ginenus , Gudina Esayas Kebede 
Published: September 2021

Background: Despite the fact that the burden, risk factors, and clinical characteristics of acute coronary syndrome (ACS) have been studied widely in developed countries, limited data are available from sub-Saharan Africa. Therefore, this study aimed at evaluating the clinical characteristics, treatment, and 30-day mortality of patients with ACS admitted to tertiary hospitals in Ethiopia.Methods: A total of 181 ACS patients admitted to tertiary care hospitals in Ethiopia were enrolled from March 15 to November 15, 2018. The clinical characteristics, management, and 30-day mortality were evaluated by ACS subtype. The Cox proportional hazards model was used to determine the predictors of 30-day all-cause mortality. A p-value &lt; 0.05 was considered statistically significant.Results: The majority (61%) of ACS patients were admitted with ST-segment elevation myocardial infarction (STEMI). The mean age was 56 years, with male predominance (62.4%). More than two-thirds (67.4%) of patients presented to hospital after 12 h of symptom onset. Dyslipidemia (48%) and hypertension (44%) were the most common risk factors identified. In-hospital dual antiplatelet and statin use was high (&gt;90%), followed by beta-blockers (81%) and angiotensin-converting enzyme inhibitors (ACEIs; 72%). Late reperfusion with percutaneous coronary intervention (PCI) was done for only 13 (7.2%), and none of the patients received early reperfusion therapy. The 30-day all-cause mortality rate was 25.4%. On multivariate Cox proportional hazards model analysis, older age [hazard ratio (HR) = 1.03, 95% CI = 1.003–1.057], systolic blood pressure (HR = 0.99, 95% CI = 0.975–1.000), serum creatinine (HR = 1.32, 95% CI = 1.056–1.643), Killip class &gt; II (HR = 4.62, 95% CI = 2.502–8.523), ejection fraction &lt;40% (HR = 2.75, 95% CI = 1.463–5.162), and STEMI (HR = 2.72, 95% CI = 1.006–4.261) were independent predictors of 30-day mortality.Conclusions: The 30-day all-cause mortality rate was unacceptably high, which implies an urgent need to establish a nationwide program to reduce pre-hospital delay, promoting the use of guideline-directed medications, and increasing access to reperfusion therapy.
Machine Learning Models for Predicting In-Hospital Mortality in Acute Aortic Dissection Patients
Authors: Guo Tuo , Fang Zhuo , Yang Guifang , Zhou Yang , Ding Ning , Peng Wen , Gong Xun , He Huaping , Pan Xiaogao , Chai Xiangping 
Published: September 2021

Background: Acute aortic dissection is a potentially fatal cardiovascular disorder associated with high mortality. However, current predictive models show a limited ability to efficiently and flexibly detect this mortality risk, and have been unable to discover a relationship between the mortality rate and certain variables. Thus, this study takes an artificial intelligence approach, whereby clinical data-driven machine learning was utilized to predict the in-hospital mortality of acute aortic dissection.Methods: Patients diagnosed with acute aortic dissection between January 2015 to December 2018 were voluntarily enrolled from the Second Xiangya Hospital of Central South University in the study. The diagnosis was defined by magnetic resonance angiography or computed tomography angiography, with an onset time of the symptoms being within 14 days. The analytical variables included demographic characteristics, physical examination, symptoms, clinical condition, laboratory results, and treatment strategies. The machine learning algorithms included logistic regression, decision tree, K nearest neighbor, Gaussian naive bayes, and extreme gradient boost (XGBoost). Evaluation of the predictive performance of the models was mainly achieved using the area under the receiver operating characteristic curve. SHapley Additive exPlanation was also implemented to interpret the final prediction model.Results: A total of 1,344 acute aortic dissection patients were recruited, including 1,071 (79.7%) patients in the survivor group and 273 (20.3%) patients in non-survivor group. The extreme gradient boost model was found to be the most effective model with the greatest area under the receiver operating characteristic curve (0.927, 95% CI: 0.860–0.968). The three most significant aspects of the extreme gradient boost importance matrix plot were treatment, type of acute aortic dissection, and ischemia-modified albumin levels. In the SHapley Additive exPlanation summary plot, medical treatment, type A acute aortic dissection, and higher ischemia-modified albumin level were shown to increase the risk of hospital-based mortality.
The Combined Impact of Female and Male Body Mass Index on Cumulative Pregnancy Outcomes After the First Ovarian Stimulation
Authors: Zhao Zhonghua , Jiang Xue , Li Jing , Zhang Menghui , Liu Jinhao , Dai Shanjun , Shi Hao , Liang Yuling , Yang Li , Guo Yihong 
Published: September 2021

ObjectivesTo evaluate the combined impact of male and female BMI on cumulative pregnancy outcomes after the first ovarian stimulation.DesignRetrospective cohort study.SettingUniversity-affiliated reproductive medicine center.PatientsA total of 15,972 couples undergoing their first ovarian stimulations from June 2009 to June 2016 were included. During the follow-up period between June 2009 and June 2018, 14,182 couples underwent a complete ART cycle involving fresh embryo transfer and subsequent frozen embryo transfers (FETs) after their first ovarian stimulations. Patients with a BMI &lt;24 kg/m2 served as the reference group. Patients with a BMI ≥ 24 kg/m2 were considered to be overweight, and those with a BMI ≥28 kg/m2 were considered to be obese.Intervention(s)None.Primary Outcome MeasureThe primary outcome was the cumulative live birth rate (CLBR), which defined as the delivery of at least one live birth in the fresh or in the subsequent FET cycles after the first ovarian stimulation.ResultsIn the analyses of females and males separately, compared with the reference group, overweight and obese females had a reduced CLBR (aOR 0.83, 95% CI 0.7.92 and aOR 0.76, 95% CI 0.64–0.90). Similarly, overweight males had a reduced CLBR (aOR 0.91, 95% CI 0.83–0.99) compared with that of the reference group. In the analyses of couples, those in which the male was in the reference or overweight group and the female was overweight or obese had a significantly lower CLBR than those in which both the male and female had a BMI &lt;24 kg/m2.ConclusionsThe CLBR is negatively impacted by increased BMI in the female and overweight status in the male, both individually and together.
Efficiency of Air Purifiers at Removing Air Pollutants in Educational Facilities: A Preliminary Study
Authors: Brągoszewska Ewa , Biedroń Izabela 
Published: September 2021

Infectious diseases caused by airborne bacteria and viruses are a major problem for both social and economic reasons. The significance of this phenomenon is particularly noticeable during the time of the coronavirus pandemic. One of the consequences is the increased interest in the air purifier (AP) market, which resulted in a significant increase in sales of these devices. In this study, we tested the efficiency of APs in removing bacterial air contamination in the educational context in the Upper Silesia region of Poland during the “cold season” of 2018/2019. During the 6 months of measuring microbiological air quality, an 18% decrease in the concentration of microbiological pollutants as a result of the action of the APs was recorded. Additionally, the results of the particle size distribution of the bacterial aerosols showed a reduction in the share of the respirable fraction (particles with an aerodynamic diameter below 3.3 µm) by an average of 20%. The dominance of gram-positive cocci in the indoor environment indicates that humans are the main source of most of the bacteria present in the building. We conclude that the use of APs may significantly decrease the level of concentration of microbiological air pollutants and reduce the negative health effects of indoor bioaerosols; however, further work that documents this phenomenon is needed.
Hot Tensile Deformation Behavior of Mg-4Li-1Al-0.5Y Alloy
Authors: Yang Ting , Li Zhuohua , Wang Jinhui , Jin Peipeng 
Published: September 2021

The microstructure evolution and deformation mechanism of the as-extruded-annealed Mg-4Li-1Al-0.5Y alloy (denoted as LAY410) were investigated during the hot tensile deformation at the temperatures between 150°C and 300°C with strains from 8 × 10−5 s−1 to 1.6 × 10−3 s−1. The results show that when the strain rate decreases and/or the deformation temperature increases, the peak stress of the alloy gradually decreases, and the elongations to fracture gradually increases. The true stress–strain curves show typical dynamic recrystallization (DRX) softening characteristics. It is observed that the microstructure in the magnesium (Mg) alloy deformed at 150°C is mainly composed of the deformed grains and a few recrystallized grains. The microstructures in the Mg alloy deformed at 200°C consisted of substructures and a slightly increasing number of dynamic recrystallized grains. When the deformation temperature reaches 250°C, the number of recrystallized grains increases significantly, and the microstructures are dominated by recrystallized grains. Moreover, through theoretical calculation and result analysis, the activation energy was about 99.3 kJ/mol, and the hot tensile deformation mechanism was the alternate coordinated deformation mechanism among grain boundary slip (GBS), intragranular slip, and DRX.
Acoustic Wave Reflection Control Based on Broadband Differential Phase Shifters
Authors: Qin Zifu , Liu Xiaohan , Ma Chu 
Published: September 2021

Controlling the flow of acoustic waves has broad applications in acoustic imaging, communication, energy harvesting, audio systems, etc. Metasurfaces have been developed for wave control. In this work we propose the design of broadband differential phase shifters for acoustic reflected waves, which can achieve nearly constant phase shift values over a broad frequency ranges. We further demonstrate the design of a broadband differential π phase shifter that works in the frequency range of (10 kHz, 16 KHz) and its applications in acoustic metasurfaces for steering and focusing of reflected acoustic waves. The metasurfaces we designed have the following advantages: 1) The metasurface is formed with binary patterns instead of more complex phase discretization steps, thus the metasurface realization is less complex for fabrication and assembly. 2) The phase shift values of the two basic phase shifter elements are broadband, thus we do not need to fabricate new elements for each frequency. Rearranging the same elements into different location patterns would allow us to tune the working frequency of the metasurfaces.
Patterns of Comorbidity and In-Hospital Mortality in Older Patients With COVID-19 Infection
Authors: Mahmoud Mona , Carmisciano Luca , Tagliafico Luca , Muzyka Mariya , Rosa Gianmarco , Signori Alessio , Bassetti Matteo , Nencioni Alessio , Monacelli Fiammetta ,   The GECOVID Study Group
Published: September 2021

Introduction: Older adults are more susceptible to severe COVID-19, with increased all-cause mortality. This has been attributed to their multimorbidity and disability. However, it remains to be established which clinical features of older adults are associated with severe COVID-19 and mortality. This information would aid in an accurate prognosis and appropriate care planning. Here, we aimed to identify the chronic clinical conditions and the comorbidity clusters associated with in-hospital mortality in a cohort of older COVID-19 patients who were admitted to the IRCCS Policlinico San Martino Hospital, Genoa, Italy, between January and April 2020.Methods: This was a retrospective cohort study including 219 consecutive patients aged 70 years or older and is part of the GECOVID-19 study group. During the study period, upon hospital admission, demographic information (age, sex) and underlying chronic medical conditions (multimorbidity) were recorded from the medical records at the time of COVID-19 diagnosis before any antiviral or antibiotic treatment was administered. The primary outcome measure was in-hospital mortality.Results: The vast majority of the patients (90%) were &gt;80 years; the mean patient age was 83 ± 6.2 years, and 57.5% were men. Hypertension and cardiovascular disease, along with dementia, cerebrovascular diseases, and vascular diseases were the most prevalent clinical conditions. Multimorbidity was assessed with the Cumulative Illness Rating Scale. The risk of in-hospital mortality due to COVID-19 was higher for males, for older patients, and for patients with dementia or cerebral-vascular disease. We clustered patients into three groups based on their comorbidity pattern: the Metabolic-renal-cancer cluster, the Neurocognitive cluster and the Unspecified cluster. The Neurocognitive and Metabolic-renal-cancer clusters had a higher mortality compared with the Unspecified cluster, independent of age and sex.Conclusion: We defined patterns of comorbidity that accurately identified older adults who are at higher risk of death from COVID-19. These associations were independent of chronological age, and we suggest that the identification of comorbidity clusters that have a common pathophysiology may aid in the early assessment of COVID-19 patients with frailty to promote timely interventions that, in turn, may result in a significantly improved prognosis.
Brain and Muscle Metabolic Changes by FDG-PET in Stiff Person Syndrome Spectrum Disorders
Authors: Wang Yujie , Sadaghiani Mohammad S. , Tian Fan , Fitzgerald Kathryn C. , Solnes Lilja , Newsome Scott D. 
Published: September 2021

Objective: To report clinical characteristics and fluorodeoxyglucose positron emission tomography (FDG-PET) findings in the brain and muscles of individuals with stiff person syndrome (SPS) spectrum disorders (SPSSDs).Methods: Retrospective cohort study from 1997 to 2018 at Johns Hopkins Hospital identified 170 individuals with SPS or cerebellar ataxia (CA) associated with anti-glutamic acid decarboxylase (anti-GAD)-65 antibodies. Fifty-one underwent FDG-PET, with 50 involving the body and 30 with dedicated brain acquisition. The clinical and immunological profiles were extracted via medical record review. The brain scans were analyzed quantitatively using the NeuroQ software, with comparison with an averaged normal database. The body scans were reviewed qualitatively by a blinded nuclear medicine radiologist.Results: Mean age of symptom onset was 41.5 years (range 12–75 years). Majority were female (68%) and White (64%). Of the patients, 82% had SPS (majority being classic phenotype), and 18% had CA. Three had a paraneoplastic process. Forty-seven had serum anti-GAD, two with anti-amphiphysin, and one with anti-glycine receptor antibodies. Brain metabolic abnormalities were seen in both SPS and CA, with significant differences between the groups noted in the right superior frontal cortex, right sensorimotor cortex, left inferior parietal cortex, bilateral thalami, vermis, and left cerebellum. Of the patients, 62% demonstrated muscle hypermetabolism, most commonly bilateral, involving the upper extremities or axial muscles. Neither brain nor muscle metabolism was correlated with functional outcomes nor treatments.Conclusions: Metabolic changes as seen by FDG-PET are present in the brain and muscle in many individuals with SPSSD. Future studies are needed to assess whether FDG-PET can help aid in the diagnosis and/or monitoring of individuals with SPSSD.
Goal-Concordant Care After Severe Acute Brain Injury
Authors: Rutz Voumard Rachel , Dugger Kaley M. , Kiker Whitney A. , Barber Jason , Borasio Gian Domenico , Curtis J. Randall , Jox Ralf J. , Creutzfeldt Claire J. 
Published: September 2021

Background: Patients with severe acute brain injury (SABI) lack decision-making capacity, calling on families and clinicians to make goal-concordant decisions, aligning treatment with patient's presumed goals-of-care. Using the family perspective, this study aimed to (1) compare patient's goals-of-care with the care they were receiving in the acute setting, (2) identify patient and family characteristics associated with goal-concordant care, and (3) assess goals-of-care 6 months after SABI.Methods: Our cohort included patients with SABI in our Neuro-ICU and a Glasgow Coma Scale Score &lt;12 after day 2. Socio-demographic and clinical characteristics were collected through surveys and chart review. At enrollment and again at 6 months, each family was asked if the patient would prefer medical care focused on extending life vs. care focused on comfort and quality of life, and what care the patient is currently receiving. We used multivariate regression to examine the characteristics associated with (a) prioritized goals (comfort/extending life/unsure) and (b) goal concordance.Results: Among 214 patients, families reported patients' goals-of-care to be extending life in 118 cases (55%), comfort in 71 (33%), and unsure for 25 (12%), while care received focused on extending life in 165 cases (77%), on comfort in 23 (11%) and families were unsure in 16 (7%). In a nominal regression model, prioritizing comfort over extending life was significantly associated with being non-Hispanic White and having worse clinical severity. Most patients who prioritized extending life were receiving family-reported goal-concordant care (88%, 104/118), while most of those who prioritized comfort were receiving goal-discordant care (73%, 52/71). The only independent association for goal concordance was having a presumed goal of extending life at enrollment (OR 23.62, 95% CI 10.19–54.77). Among survivors at 6 months, 1 in 4 family members were unsure about the patient's goals-of-care.Conclusion: A substantial proportion of patients are receiving unwanted aggressive care in the acute setting after SABI. In the first days, such aggressive care might be justified by prognostic uncertainty. The high rate of families unsure of patient's goals-of-care at 6 months suggests an important need for periodic re-evaluation of prognosis and goals-of-care in the post-acute setting.
Suspected Central Nervous System Infections in HIV-Infected Adults
Authors: Sheybani Fereshte , van de Beek Diederik , Brouwer Matthijs C. 
Published: September 2021

Objectives: To study the differential diagnosis of HIV-infected patients with suspected central nervous system (CNS) infections and the association of CD4 counts with the final diagnosis.Methods: We analyzed HIV-infected patients from a prospective cohort study on the diagnostic accuracy of clinical and laboratory characteristics in adults with suspected CNS infections in an academic hospital in Amsterdam, the Netherlands, who underwent cerebrospinal fluid (CSF) examination.Results: Thirty-four (9.4%) out of 363 patients with suspected CNS infections were HIV-positive of whom 18 (53%) were diagnosed to have CNS infection, with median CD4 counts of 255 cells/μl. The spectrum of CNS infections consisted of progressive multifocal leukoencephalopathy in three patients (17%); cryptococcal meningoencephalitis, toxoplasma encephalitis, angiostrongylus eosinophilic meningitis, and HIV encephalitis each in two (11%); and cytomegalovirus encephalitis, neurosyphilis, tuberculous meningoencephalitis, histoplasma encephalitis, and varicella-zoster virus meningitis each in one (6%). Clinical characteristics and blood parameters did not differ between HIV-infected patients with CNS infections and other diagnoses. The best predictor for CNS infections was the CSF leukocyte count (AUC = 0.77, 95 CI% 0.61–0.94). The diagnosis of CNS infection was not associated with the CD4 count (median 205 vs. 370, p = 0.21). Two patients (11%) with CNS infections died and two (11%) had neurological sequelae.Conclusions: Half of the patients with suspected CNS infections are diagnosed with a CNS infection, and this was not related to CD4 counts. The best predictor for CNS infections was the CSF leukocyte count.
Radiomics Analysis of Fat-Saturated T2-Weighted MRI Sequences for the Prediction of Prognosis in Soft Tissue Sarcoma of the Extremities and Trunk Treated With Neoadjuvant Radiotherapy
Authors: Chen Silin , Li Ning , Tang Yuan , Chen Bo , Fang Hui , Qi Shunan , Lu Ninging , Yang Yong , Song Yongwen , Liu Yueping , Wang Shulian , Li Ye-xiong , Jin Jing 
Published: September 2021

PurposeTo create a prognostic prediction radiomics model for soft tissue sarcoma (STS) of the extremities and trunk treated with neoadjuvant radiotherapy.MethodsThis study included 62 patients with STS of the extremities and trunk who underwent magnetic resonance imaging (MRI) before neoadjuvant radiotherapy. After tumour segmentation and preprocessing, 851 radiomics features were extracted. The radiomics score was constructed according to the least absolute shrinkage and selection operator (LASSO) method. Survival analysis (disease-free survival; DFS) was performed using the log-rank test and Cox’s proportional hazards regression model. The nomogram model was established based on the log-rank test and Cox regression model. Harrell’s concordance index (C-index), calibration curve and receiver operating characteristic (ROC) curve analysis were used to evaluate the prognostic factors. The clinical utility of the model was assessed by decision curve analysis (DCA).ResultsThe univariate survival analysis showed that tumour location (p = 0.032), clinical stage (p = 0.022), tumour size (p = 0.005) and the radiomics score were correlated with DFS (p &lt; 0.05). The multivariate analysis showed that tumour location, tumour size, and the radiomics score were independent prognostic factors for DFS (p &lt; 0.05). The combined clinical-radiomics model based on the multivariate analysis showed the best predictive ability for DFS (C-index: 0.781; Area Under Curve: 0.791). DCA revealed that the use of the radiomics score-based nomogram was associated with better benefit gains relative to the prediction of 2-year DFS events than other models in the threshold probability range between 0.12 and 0.38.ConclusionThe radiomics score from pretreatment MRI is an independent prognostic factor for DFS in patients with STS of the extremities and trunk. The radiomics score-based nomogram could improve prognostic stratification ability and thus contribute to individualized therapy for STS patients.