bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between magnetic resonance imaging findings and prognosis of intracranial tuberculosis
Authors: Wu Xuan , Yang Xiuhong , Wang Bo , Yin Nan , Mao Xiaohui , Zhou Jie 
Published: December 2021

Background Intracranial tuberculosis (TB) is an intracranial infection caused by Mycobacterium tuberculosis. Magnetic resonance imaging (MRI), in particular enhanced MRI scan, has the ability to detect characteristic lesions of tuberculous meningitis or cerebral parenchymal TB. Purpose To analyze the relationship between MRI findings and prognosis of patients with intracranial TB. Material and Methods In this retrospective study, a total of 60 patients were confirmed with intracranial TB in the hospital from May 2019 to December 2020. All enrolled patients underwent TB-related laboratory examinations, cranial MRI, and contrast-enhanced MRI. Laboratory tests were analyzed and the relationship between clinical prognosis and cranial MRI features was evaluated. Results Of the 60 patients, 28 (46.67%) had disseminated TB complications, 20 (36.67%) had secondary TB complications, and the remaining 10 (16.66%) had lymphatic TB or spinal TB complications. Of the patients, 25 had good short-term prognosis and 35 had poor short-term prognosis; 44 patients had good long-term prognosis and 16 had poor long-term prognosis. The incidence of cerebral parenchymal tuberculomas on enhanced MRI was significantly higher in the group with good prognosis compared to that in the group with poor prognosis ( P < 0.05). Logistic analysis suggested that hydrocephalus (odds ratio [OR] = 0.057, 95% confidence interval [CI] = 0.003–0.444; P = 0.018) and cistern involvement (OR = 0.100, 95% CI = 0.011–0.581; P = 0.017) were independent risk factors for poor short-term prognosis. Conclusion MRI can display the pathological changes of intracranial TB in detail; hydrocephalus and cistern involvement were independent risk factors for poor short-term prognosis.
Myocardial extracellular volume fraction quantification based on T1 mapping at 3 T: quality optimization by contour-based registration and segmental analysis
Authors: Lin Ling , Zhou Xu-Hui , Zheng Mei , Xie Qiu-Xia , Tao Qian , Lamb Hildo J. 
Published: December 2021

Background Myocardial extracellular volume fraction (ECV) assessment can be affected by various technical and subject-related factors. Purpose To evaluate the role of contour-based registration in quantification of ECV and investigate normal segment-based myocardial ECV values at 3T. Material and Methods Pre- and post-contrast T1 mapping images of the left ventricular basal, mid-cavity, and apical slices were obtained in 26 healthy volunteers. ECV maps were generated using motion correction with and without contour-based registration. The image quality of all ECV maps was evaluated by a 4-point scale. Slices were dichotomized according to the occurrence of misregistration in the source data. Contour-registered ECVs and standard ECVs were compared within each subgroup using analysis of variance for repeated measurements and generalized linear mixed models. Results In all three slices, higher quality of ECV maps were found using contour-registered method than using standard method. Standard ECVs were statistically different from contour-registered ECVs in global (26.8% ± 2.8% vs. 25.8% ± 2.4%; P = 0.001), mid-cavity (25.4% ± 3.1% vs. 24.3% ± 2.5%; P = 0.016), and apical slices (28.7% ± 4.1% vs. 27.2% ± 3.4%; P = 0.010). In the misregistration subgroups, contour-registered ECVs were lower with smaller SDs (basal: 25.2% ± 1.8% vs. 26.7% ± 2.6%; P = 0.038; mid-cavity: 24.4% ± 2.3% vs. 26.8% ± 3.1%; P = 0.012; apical: 27.5% ± 3.6% vs. 29.7% ± 4.5%; P = 0.016). Apical (27.2% ± 3.4%) and basal-septal ECVs (25.6% ± 2.6%) were statistically higher than mid-cavity ECV (24.3% ± 2.5%; both P < 0.001). Conclusion Contour-based registration can optimize image quality and improve the precision of ECV quantification in cases demonstrating ventricular misregistration among source images.
Long-term subjective results and radiologic prognosis of a distal radius fracture in working-aged patients – a prognostic cohort study of 201 patients
Authors: Hevonkorpi Teemu P , Raittio Lauri , Vähä-Tuisku Susanna , Launonen Antti P , Mattila Ville M. 
Published: December 2021

Objective To investigate long-term outcomes associated with distal radius fracture (DRF) in working-aged patients. The authors hypothesized that the majority of patients experience no permanent loss of function when measured with patient-rated wrist evaluation (PRWE). Methods This was a retrospective cohort study of patients with a DRF aged between 18 and 65 years. The primary outcome measure was PRWE score at a minimum of 4 years after DRF. Secondary outcome measures were pain catastrophizing scale (PCS) and radiographic measurements. Results Of 201 patients included, 179 were primarily treated non-operatively with a 5-week cast treatment and 22 were primarily operated. The mean follow-up duration was 5 years. The mean PRWE score was 10.9 (95% confidence interval 8.4, 13.4) and median PRWE was 3.5 (interquartile range, 0.0–13.0). There was minor correlation between PCS and PRWE score (correlation coefficient [CC] 0.3), and between PRWE score and dorsal angulation of the fracture measured after closed reduction (CC 0.2) and in one-week follow-up radiographs (CC 0.2). Conclusions Working-aged patients seem to gain nearly normal wrist function after DRF in longer follow-up. Pain catastrophizing appears to correlate with long-term treatment outcome.
Optimal design of the disc vents for high-speed railway vehicles using thermal-structural coupled analysis with genetic algorithm
Authors: Song Ji-Hun , Kang Seong-Woong , Kim Youn-Jea 
Published: December 2021

Braking devices are devices that convert kinetic energy into thermal energy using frictional force. A disc-type brake uses the frictional force to brake and can be used in a wide range of applications, such as automobiles, railway vehicles, and aircraft. However, heat dissipation of the disc has been considered a major problem. High temperatures during the braking process cause thermal stress and deformation problems of the disc because the physical properties of metal composing the disc change drastically with temperature. In this study, vents were applied on the disc surface to increase their heat dissipation performance. In general, vents are structurally susceptible to stress and deformation. However, heat dissipation is essential because the disc surface rises to high temperatures. Therefore, a thermal-structural coupled analysis was performed using the computational fluid dynamics and finite element method methods. Five different rotational speeds and surface temperatures of the disc were considered. Design of experiments was used to determine an optimized design utilizing the data from the coupled analysis, and Latin hypercube sampling was used to generate samples from a set of N regions. And the genetic algorithm was used to conduct a sensitivity analysis of the design parameters. The optimized design was determined for harsh conditions. The diameters of vents were selected 6.87 mm, 6.12 mm, and 5.99 mm in a radial direction through the optimization. Thermal stress and deformation acting on the disc were reduced in the optimally designed disc. The optimized disc model experiences a 7.01% decrease in maximum equivalent stress when compared to the original disc. The model also decreased by 7.63% in maximum equivalent elastic strain. So, through enhanced convection-induced heat dissipation, the vents can be considered as a new way to prevent problems with the thermal stress and deformation that were apparent at high temperatures.
Counting, Coping, and Navigating the Flux: A Focused Ethnographic Study of HIV and Diabetes Self-Management
Authors: Ohueri Chelsi W , García Alexandra A. , Zuñiga Julie A. 
Published: December 2021

Approximately 10–15% of people living with HIV are also diagnosed with diabetes. To manage their two chronic conditions, people must undertake certain activities and adopt behaviors. Due to overlapping symptoms, complex medication regimens, and heavy patient workloads, implementing these self-management practices can be difficult. In this focused ethnography, data were collected from semi-structured interviews and limited participant-observation with a selected subset of participants to gain insight into self-management challenges and facilitators. We conducted interviews and multiple observations with 22 participants with HIV+T2DM over the period of 9 months. Participants experienced numerous barriers to self-management in the areas of diet, medication adherence, and mental health. Social and familial support, as well as consistent access to care, were facilitators for optimal self-management. At the same time participants’ lives were in a unique flux shaped by the dual diagnoses, and therefore, required constant mental and physical adjustments, thus illustrating challenges of managing chronicity.
Evaluation of early de-escalation of empiric antimicrobial therapy in acute leukemia patients with febrile neutropenia at a large academic medical center
Authors: Ly Whitney J , Brown Erin E , Pedretti Zachary , Auten Jessica , Wilson William S 
Published: December 2021

Introduction Recent trials have shown early de-escalation of empiric antimicrobial therapy (EAT) in febrile neutropenia has led to less adverse effects with no difference in patient mortality. In 2019, our institution adjusted internal guidelines to de-escalate EAT after 7 days of intravenous anti-pseudomonal therapy in patients with signs of clinical recovery from febrile neutropenia and no evidence of infection. Methods This was a retrospective, single-center, observational, cohort study. Eligible patients were adults with acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) who received induction chemotherapy and developed febrile neutropenia without documented infection. Patients were separated based on EAT duration: ≤ 9 days and > 9 days. Empiric antimicrobial therapy was defined as the initiation of an anti-pseudomonal beta-lactam. The primary outcome was the difference in number of EAT-free days. Secondary outcomes included fever recurrence, ICU admissions, fever duration, infections post de-escalation, and Clostridioides difficile infection (CDI). Results Forty-four encounters met inclusion. The EAT ≤ 9 days group had 7 more EAT-free days compared to the EAT > 9 days group (p < 0.001). No between-group differences were identified in terms of fever after EAT discontinuation (p = 0.335), ICU admission (p = 0.498), or CDI (p = 0.498). The EAT > 9 days group experienced longer initial fever (p < 0.001) and received addition of resistant Gram-positive coverage (p = 0.014). More patients receiving EAT > 9 days had a diagnosis of AML (p = 0.001). Conclusions Shorter EAT duration did not lead to worse outcomes in patients with AML or ALL who received induction chemotherapy and developed febrile neutropenia without a documented infection source.
Stress, Dependence, and COVID-19–related Changes in Past 30-day Marijuana, Electronic Cigarette, and Cigarette Use among Youth and Young Adults
Authors: Clendennen Stephanie L , Case Kathleen R , Sumbe Aslesha , Mantey Dale S , Mason Emily J , Harrell Melissa B 
Published: December 2021

Background Studies show smoking and vaping behaviors increase risk of contracting and worse symptoms of COVID-19. This study examines whether past 30-day youth and young adult users of marijuana, e-cigarettes, and cigarettes self-reported changes in their use of these substances due to the COVID-19 pandemic; and cross-sectional associations between perceived stress, nicotine or marijuana dependence, and COVID-19–related changes in use. Methods Participants were 709 past 30-day self-reported substance users from the Texas Adolescent Tobacco and Marketing Surveillance study (TATAMS; mean age = 19; 58% female; 38% Hispanic, 35% white). Multiple logistic regression models assessed cross-sectional associations between perceived stress and dependence and increased, decreased, or sustained past 30-day use of marijuana, e-cigarettes, and cigarettes due to COVID-19 (e.g., “Has your marijuana use changed due to the COVID-19 outbreak?”). Covariates included age, race/ethnicity, socio-economic status (SES), dependence (exposure: stress), and stress (exposure: dependence). Results Most participants reported sustained (41%, 43%, 49%) or increased (37%, 34%, 25%) use of marijuana, e-cigarettes, and cigarettes due to COVID-19, respectively. Participants who reported symptoms of dependence were significantly more likely than their non-dependent peers to report increasing their marijuana (AOR: 1.66; 95% CI: 1.15–2.39) and e-cigarette (AOR: 2.57; 95% CI: 1.38–4.77) use. Those who reported higher perceived stress were significantly more likely to report increasing their marijuana use (AOR: 1.55; 95% CI: 1.01–2.42). Conclusions Most youth and young adults did not decrease their substance use amid a global, respiratory disease pandemic. Health messaging and interventions that address the health effects of smoking and vaping as well as factors like stress and dependence that may be barriers to decreasing use are vital in curbing the COVID-19 pandemic.
Reducing scrapping of gears by assessment of tip contact threshold torque
Authors: Hjelm Rikard , Ahadi Aylin , Wahlström Jens 
Published: December 2021

While striving for more competitive products as well as reaching the Global Sustainable Development Goals, automotive powertrain manufacturers increase the demands on gears, which translates to decreased manufacturing error tolerances. Too tight tolerances may, however, counteract the goal if it leads to increased material and energy consumption due to unjustified scrapping. This paper presents a method to prevent unjustified scrapping by comparing the severity of different manufacturing error tolerances by means of the tip contact threshold torque. Curve fits are shown to be accurate and helpful to assess the outcome of a produced batch of gears. A case study is made where the method is used with measured data from the industry. It can be concluded from the investigation that considerable amounts of scrapping can be avoided by consideration of the threshold torque.
Re-examining the History of Human Resource Development Policy in China: From Local Indigenous Phenomena to Global Human Resource Development Knowledge
Authors: Wang Greg G. , Doty D. Harold , Yang Shengbin 
Published: December 2021

Problem The NHRD conception claimed to be based on multiple country-cases through a constructive/interpretive process. However, four of cases focusing on HRD policy in China presented incomplete history of China’s HRD policies, which may have misled the NHRD conception. Solution We re-examine China’s history of HRD policy as indigenous phenomena in comparison to the four China-cases. Adopting a similar historical method, we fail to identify the policy pattern reported by the previous cases, thus challenge the NHRD’s constructivist embeddedness. We question the credibility and trustworthiness of the country-based studies as well as the sense-making constructive base of the NHRD ideation. From China’s local phenomenon, we derived a set of HRD assumptions contrary to the existing western-centric assumptions to enrich the global HRD knowledge. Stakeholders Theory-minded HRD scholars intended for rigorous and relevant theory development inquiries; practice-oriented HRD practitioners, especially those from western context and working in a non-western HRD context.
Adjunctive Chinese Herbal Medicine Treatment is Associated With an Improved Survival Rate in Patients With Cervical Cancer in Taiwan: A Matched Cohort Study
Authors: Wang Chieh , Lin Kent Yu-Hsien , Wu Mei-Yao , Lin Cheng-Li , Lin Jaung-Geng , Chang Cherry Yin-Yi , Lin Wu-Chou , Yen Hung-Rong 
Published: December 2021

Background Cervical cancer is one of the most common cancers in Taiwan. Some patients take Chinese herbal medicine (CHM). However, very few current studies have ascertained the usage and efficacy of CHM in patients with cervical cancer. The aim of this study was to investigate the benefits of complementary CHM among patients with cervical cancer in Taiwan. Methods We included the newly diagnosed cervical cancer patients who were registered in the Taiwanese Registry for Catastrophic Illness Patients Database between 2000 and 2010. The end of follow-up period was December 31, 2011. Patients who were less than 20 years old, had missing information for age, withdrew from the National Health Insurance (NHI) program during the follow-up period, or only received other TCM interventions such as acupuncture or tuina massage were excluded from our study. After performing 1:1 frequency matching by age and index date, we enrolled 7521 patients in both CHM and non-CHM user groups. A Cox regression model was used to compare the hazard ratios (HRs) of the risk of mortality. The Kaplan-Meier curve was used to compare the difference in survival time. Results According to the Cox hazard ratio model mutually adjusted for CHM use, age, comorbidity, treatment, and chemotherapeutic agents used, we found that CHM users had a lower hazard ratio of mortality risk (adjusted HR = 0.29, 95%CI = 0.27-0.31). The survival probability was higher for patients in the CHM group. Bai-Hua-She-She-Cao ( Herba Oldenlandiae, synonym Herba Hedyotis diffusae) and Jia-Wei-Xiao-Yao-San were the most commonly prescribed single herb and Chinese herbal formula, respectively. Conclusions Adjunctive CHM may have positive effects of reducing mortality rate and improving the survival probability for cervical cancer patients. Further evidence-based pharmacological investigations and clinical trials are warranted to confirm the findings in our study.
Application of Tumor Burden Score for predicting conversion outcome in patients with initially unresectable colorectal liver metastases after first-line systemic therapy
Authors: Peng Jianhong , Liu Yujun , Li Weihao , Lin Yuzhu , Sun Hui , Pan Zhizhong , Wu Xiaojun , Fan Wenhua , Lin Junzhong 
Published: December 2021

Background: Patients with initially unresectable colorectal liver metastases (CRLM) could achieve survival benefit from successful conversion therapy. Recently, Tumor Burden Score (TBS) was proposed as a valuable index to predict outcome following resection of CRLM. The study is aimed to investigate the association of TBS with conversion outcome. Methods: A total of 234 patients who underwent first-line treatment in our center were enrolled as training cohort. The validation cohort was developed from 89 patients in our previous study. Cut-off value of TBS was calculated to stratify patients into two groups. Significance test and logistic regression model were used to examine the prediction value of TBS for conversion outcome after first-line systemic therapy. Kaplan–Meier method and Cox proportional hazard model were applied to assess the prognostic value of TBS. Results: TBS showed good discriminatory power [area under curve (AUC) 0.726, p < 0.001] with cut-off value defined as 14.3 in training cohort, which was validated in the validation cohort. Increasing TBS was related to adverse chemotherapy response and conversion outcome. Low TBS group had three times higher conversion rate than that in high TBS group (57.3% versus 19.0%, p < 0.001). Multivariate analysis indicated that high TBS [odds ratio (OR) = 3.676, 95% confidence interval (CI) 1.671–8.429, p = 0.002], first-line treatment response as stable disease (SD) or progressive disease (PD) (OR = 9.247; 95% CI 4.736–18.846, p < 0.001), and absence of targeted therapy (OR = 2.453, 95% CI 1.139–5.455, p = 0.024) were three independent risk factors for failure conversion outcome. High TBS was significantly associated with conversion outcome whatever chemotherapy response, addition of targeted therapy, and Kirsten rat sarcoma viral oncogene homolog (KRAS) status. High TBS was also associated with worse overall survival. Conclusion: TBS should be applied in clinical practice to predict conversion outcome in patients with initially unresectable CRLM.
Recurrence risk stratification based on a competing-risks nomogram to identify patients with esophageal cancer who may benefit from postoperative radiotherapy
Authors: Chang Xiao , Chen Junqiang , Zhang Wencheng , Yang Jinsong , Yu Shufei , Deng Wei , Ni Wenjie , Zhou Zongmei , Chen Dongfu , Feng Qinfu , Lv Jima , Liang Jun , Hui Zhouguang , Wang Lvhua , Lin Yu , Chen Xiaohui , Xue Qi , Mao Yousheng , Gao Yushun , Wang Dali , Feng Feiyue , Gao Shugeng , He Jie , Xiao Zefen 
Published: December 2021

Background: A reliable model is needed to estimate the risk of postoperative recurrence and the benefits of postoperative radiotherapy (PORT) in patients with thoracic esophageal squamous cell cancer (TESCC). Methods: The study retrospectively reviewed 3652 TESCC patients in stage IB-IVA after radical esophagectomy, with or without PORT. In one institution as the training cohort ( n = 1620), independent risk factors associated with locoregional recurrence (LRR), identified by the competing-risks regression, were used to establish a predicting nomogram, which was validated in an external cohort ( n = 1048). Area under curve (AUC) values of receiver operating characteristic curves were calculated to evaluate discrimination. Risk stratification was conducted using a decision tree analysis based on the cumulative point score of the LRR nomogram. After balancing the baseline of characteristics between treatment groups by inverse probability of treatment weighting, the effect of PORT was evaluated in each risk group. Results: Sex, age, tumor location, tumor grade, and N category were identified as independent risk factors for LRR and added into the nomogram. The AUC values were 0.638 and 0.706 in the training and validation cohorts, respectively. Three risk groups were established. For patients in the intermediate- and high-risk groups, PORT significantly improved the 5-year overall survival by 10.2% and 9.4%, respectively ( p < 0.05). Although PORT was significantly associated with reduced LRR in the low-risk group, overall survival was not improved. Conclusion: The nomogram can effectively estimate the individual risk of LRR, and patients in the intermediate- and high-risk groups are highly recommended to undergo PORT.