bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pleural effusion in acute pulmonary embolism: characteristics and relevance
Authors: Rodríguez-Núñez Nuria , Gude Francisco , Ferreiro Lucía , Landín-Rey Elisa , Carreiras-Cuiña María , Otero Borja , Carbajales María Cruz , Martínez-Martínez Honorio J , Díaz-Louzao Carla , Soto-Feijoo Roi , Suárez Antelo Juan , Toubes Maria E , Valdés-Cuadrado Luis 
Published: November 2024

IntroductionThe characteristics and clinical relevance of pleural effusion (PLEF) in acute pulmonary embolism (APE) are not fully understood.MethodsA single-centre, retrospective study was performed of patients admitted with APE classified according to the subsequent development or not of PLEF. A model was built to predict PLEF and its impact on 30-day all-cause mortality was investigated.ResultsA total of 1602 patients with APE were included (median age, 74 (61, 82) years; 674 men (42.1%); 382 (23.8%) with PLEF). PLEF was associated with a higher number of comorbidities (p=0.015); more peripheral APE (0.001); a higher frequency of pulmonary infarctions (p<0.001) and higher 30-day all-cause mortality (p=0.004) compared with those without PLEF. Bilateral PLEFs, as compared with unilateral, were associated with a higher number of comorbidities (p=0.009); more severe (simplified Pulmonary Embolism Severity Index ≥1; p<0.001) and higher 30-day all-cause mortality (p<0.001).On multivariate analysis, the presence of PLEF was associated with atrial fibrillation (OR 2.00; 95% CI 1.32 to 3.02), congestive heart failure (OR 3.00; 95% CI 1.81 to 5.00), pulmonary infarction (OR 3.19; 95% CI 2.38 to 4.29) and a Charlson index ≥3 (OR 1.59; 95% CI 1.03 to 2.45). The predictive model for PLEF had a moderate power of discrimination (area under the curve, AUC 0.76; 95% CI 0.73 to 0.79), whereas the predictive model for mortality showed a good predictive power (AUC 0.89; 95% CI 0.86 to 0.93). The presence of PLEF doubles the probability of death (OR 2.02; 95% CI 1.11 to 3.68). When PLEF is bilateral, the probability of death is four times higher, as compared with unilateral PLEF (OR 4.07; 95% CI 1.53 to 10.85; AUC 0.90; 95% CI 0.84 to 0.95).ConclusionsA significant number of APE patients develop PLEF. The model showed a good power of discrimination for the prediction of mortality. The probability of death from APE doubles in the presence of PLEF. Patients with APE and concomitant bilateral PLEF have a fourfold higher risk of mortality, as compared with patients with concomitant unilateral PLEF.
Are there differences in low-acuity emergency department visits between culturally and linguistically diverse migrants and people with English-speaking background: a population-based linkage study of adults over 45
Authors: Ayala-Diaz Flavio , Harris-Roxas Ben , Harris Mark , Barr Margo , Kabir A Y M Alamgir , Conway Damian P , Sharma Anurag 
Published: November 2024

BackgroundGrowing numbers of avoidable low-acuity visits to emergency departments (ED) are a major health policy concern globally and are thought to contribute to ED crowding. This study explores the differences in the utilisation of low-acuity ED visits between culturally and linguistically diverse (CaLD) migrants and English-speaking background (ESB) population.MethodsA study based on a cross-sectional survey of individuals aged 45 or over linked to routinely collected ED visit records in New South Wales. We employed a negative binomial regression model to compare the number of yearly low-acuity ED visits between individuals from ESB and CaLD backgrounds after adjusting for relevant health-related and sociodemographic characteristics.ResultsWe analysed 227 681 individuals with a mean age of 61, two-thirds of whom came from an ESB. Among individuals with a CaLD background, only those born in Australia had comparable rates of low-acuity ED visits as those with an ESB. In contrast, individuals with CaLD backgrounds who were born overseas were significantly less likely to make low-acuity visits to the ED compared with those from an ESB irrespective of year of arrival—for those who had migrated less than 20 years ago (relative risk (RR) 0.72, 95% CI 0.62 to 0.83) and those who migrated more than 20 years ago (RR 0.91, 95% CI 0.88 to 0.95).ConclusionForeign-born migrants aged 45 and over from CaLD backgrounds tend to have the lowest rates of low-acuity ED visits, particularly those who migrated more recently indicating low-acuity visits by CaLD patients are unlikely to contribute to ED crowding.
Impact of the COVID-19 pandemic on incidence of coronary heart disease in Bavaria, Germany: an analysis of health claims data
Authors: Schederecker Florian , Lehner Carolin T , Eberl Marian , Schauberger Gunther , Hansmann Katharina , Donnachie Ewan , Tauscher Martin , König Adriana , Sundmacher Leonie , Klug Stefanie J 
Published: November 2024

BackgroundInconsistent findings about the impact of the COVID-19 pandemic on cardiovascular disease diagnosis and consultations have been reported internationally. The objective of this study was to analyse the impact of the pandemic period (2020–2021) on the incidence rate of coronary heart disease (CHD) compared with the pre-pandemic period (2012–2019) in Bavaria, Germany.MethodsWe used health claims data of around 9 million statutorily insured residents (≥20 years) of Bavaria, Germany. We calculated quarterly age-standardised incidence rates for men and women diagnosed with CHD using the European Standard Population 2013. Interrupted time series regression models were used to analyse possible pandemic effects on the CHD incidence rates.ResultsOverall, 797 074 new CHD cases (47% women) were diagnosed from 2012 to 2021. Both pre-pandemic and pandemic incidence rates for women were lower than for men. Regression models showed decreasing incidence rates in the pre-pandemic period in men (−5.2% per year (p.a.), 95% CI: −5.7% to −4.7%) and in women (−6.6% p.a., 95% CI: −7.3% to −6.0%) and seasonal effects (higher in quarter 4 compared with Q1–Q3). During the pandemic period, there was no clear evidence of a level change in the incidence rates both in women and men. However, there are indications of a smaller decline in the incidence during the pandemic compared with the pre-pandemic period, in particular in women (−0.7% p.a., 95% CI: −6.0% to 4.8%) and less prominent in men (−1.7% p.a., 95% CI: −6.0% to 2.8%).ConclusionsAn overall decreasing CHD incidence rate was observed in men and women in the past decade but no clear impact of the pandemic was seen. These results show the importance of incidence monitoring beyond the pandemics to maintain chronic disease care.
Likelihood of fitness improvements during a standardised physical fitness programme in US Army trainees of different fitness levels
Authors: Pierce Joseph R , Cohen BS , Hauret KG , Sharp MA , Redmond JE , Foulis SA , Jones BH 
Published: November 2024

IntroductionUS Army Initial Entry Training (IET) aims to develop general fitness and conditioning among large groups of trainees. Despite group mean improvement in physical fitness during IET, some trainees experience substantial gains and others experience no improvement or even declines in fitness. The purpose of this study was to examine the associations between trainee baseline fitness (Army Physical Fitness Test (APFT), the primary fitness assessment at the time of data collection) or estimated baseline body fat (%BF) and the change in fitness by the end of IET.MethodsTrainee (n=774 men, 195 women) APFT performance data were obtained, and baseline anthropometrics were used to estimate %BF. APFT performance change (final−baseline) was analysed directly (t-tests) or by quartiles of baseline APFT performance or %BF (analysis of variance). Cochran-Armitage χ2for linear trend test and risk ratios allowed for comparison against the lowest initial performance referent quartile (Q1), providing the likelihood of fitness improvements. Significance was set at p≤0.05.ResultsPerformance improved (p<0.01) on all final APFT events for men and women, respectively (push-ups: +38.4% and +91.8% repetitions; sit-ups: +26.8% and +33.5% repetitions; 2-mile run: −9.6% and −10.4% time). Significant trends in both sexes indicated that moving from low-to-high initial APFT fitness quartiles, trainees were increasingly less likely to improve their fitness. Specifically, men and women in the highest initial fitness quartiles (Q4) were 22%–32% and 25%–34% less likely (p<0.01) to improve, respectively, versus the within-sex lowest initial fitness quartiles (Q1). Only the male trainee’s 2-mile run time change was related to the initial %BF.ConclusionsAlthough most trainees’ fitness improved by the end of IET, the likelihood and magnitude of improvement were clearly associated with initial fitness levels. Attention to individualised conditioning and training intensity in the physical readiness training programme of instruction may optimise training strategies across all trainee conditioning levels.
Incidence of cervical spine injury in victims of dismounted blast: a systematic review
Authors: Sargent Will , Henson R , Millar R , Ramasamy A , Gibb I , Bull A 
Published: November 2024

IntroductionDismounted blast has the potential to cause life-threatening injuries to multiple simultaneous casualties, including injury to the cervical spine (c-spine). Spinal immobilisation can be costly in terms of time and personnel required to apply and sustain it. C-spine ‘clearing’ tools frequently do not apply to the blast-injured casualty, so clinical judgement must be used to determine those requiring c-spine immobilisation. This will be strongly influenced by the likelihood of such an injury, but currently, the incidence of c-spine injury in dismounted blasts is not known.MethodsWe searched PubMed, EMBASE and the Cumulative Index to Nursing and Allied Health for original research reporting the number of patients suffering c-spine injury as a result of the dismounted blast, as well as indices of injury severity such as incidence of limb amputation. Rates were combined to give an overall incidence. The systematic review was preregistered with PROSPERO (CRD42024527592).Results2775 unique studies were identified, 13 of which were analysed. Reported incidences of c-spine injuries ranged from 0% to 5.85% across all 13 studies, and unstable injuries ranged from 0% to 1.23% in the nine studies in which this could be calculated. After excluding one study due to an overlapping population, in 7889 patients the rate of c-spine injury was 0.89%. In the 4618 patients for which the incidence of unstable c-spine injury could be calculated, the rate was 0.30%. There was no correlation between the rate of amputation and the rate of c-spine injury (Spearman’s ρ=0.226, p=0.667).ConclusionDismounted blasts result in a very low rate of c-spine injury. The populations sampled included a number of seriously injured casualties with potentially life-threatening wounds, such as limb amputation. We recommend deprioritising c-spine control in dismounted victims of the blast in favour of focusing the limited time and resources on addressing potentially life-threatening injuries.
Effect of N,N′-methylenebisacrylamide on properties of porous semi-IPN hydrogels from acrylamide, maleic acid, and its use for urea absorption
Authors: Tuan Huynh Nguyen Anh , Phan Bui Thi Cam , Duy Nguyen Khanh , Chau Le Ngoc , Hoa Huynh , Vinh Luong Chi , Phuc Le Nguyen Minh 
Published: November 2024

Hydrogel is a three-dimensional polymer that can absorb large amounts of reagents while maintaining structural integrity. This material has been applied in many fields especially in smart agriculture. To improve the economic viability, the reusability of hydrogels in agricultural engineering over multiple cycles of adsorption and desorption is an urgent requirement. This can be solved if the crosslinker is used properly. Therefore, in this work, a series of porous semi-interpenetrating polymer network (IPN) hydrogels based on linear polyacrylamide, acrylamide, maleic acid, and N,N′-methylenebisacrylamide (MBA) were synthesized. The hydrogels were evaluated for the impact of MBA content on the characteristics and applicability as a urea fertilizer carrier. The chemical composition, morphology, mechanical, and rheological properties, swelling behavior, urea absorption, and desorption of hydrogels with crosslinker content in the range of 0.5%–2.0% were investigated. The porous structure was confirmed by scanning electron microscopy images. Changing the MBA content significantly affected all characteristics of the hydrogels. In particular, increasing the MBA content decreased the equilibrium swelling ratios in all investigated environments. The maximum amount of urea loaded into the hydrogel was also reduced from 435.88 to 188.50 mg/g. This increase also changed the swelling mechanism from non-Fickian to Fickian, whereas the urea release mechanism changed from Fickian to non-Fickian. Finally, the hydrogels demonstrated stability in soil over multiple cycles of water absorption and release. This study provides valuable insights into designing a semi-IPN hydrogel with desired properties that meet the application requirements of modern farming techniques.
Exploring the Bianchi-IX universe within Brans–Dicke theory and a deceleration parameter
Authors: Mishra R. K. , Sharma Rahul 
Published: November 2024

In this paper, we have presented the cosmological model in Brans–Dicke theory (BDT) of gravity for a Bianchi type-IX spacetime. We obtained the exact solutions of the field equations by applying the new form of deceleration parameter, i.e. fractional linear varying deceleration parameter (FLVDP) as proposed by R. K. Mishra and A. Chand [Astrophys. Space Sci. 361, 1 (2016)]. In this paper, we have also presented the physical and geometric properties and mathematical analysis of the proposed model. Then we have provided the energy conditions and statefinder diagnostic.
Coupling of Discontinuous Galerkin and Pseudo-Spectral Methods for Time-Dependent Acoustic Problems
Authors: Meyer Rose-Cloé , Bériot Hadrien , Gabard Gwénaël , Modave Axel 
Published: November 2024

Many realistic problems in computational acoustics involve complex geometries and sound propagation over large domains, which requires accurate and efficient numerical schemes. It is difficult to meet these requirements with a single numerical method. Pseudo-spectral (PS) methods are very efficient, but are limited to rectangular shaped domains. In contrast, the nodal discontinuous Galerkin (DG) method can be easily applied to complex geometries, but can become expensive for large problems. In this paper, we study a coupling strategy between the PS and DG methods to efficiently solve time-domain acoustic wave problems. The idea is to combine the strengths of these two methods: the PS method is used on the part of the domain without geometric constraints, while the DG method is used around the PS region to accurately represent the geometry. This combination allows for the rapid and accurate simulations of large-scale acoustic problems with complex geometries, but the coupling and the parameter selection require great care. The coupling is achieved by introducing an overlap between the PS and DG regions. The solutions are interpolated on the overlaps, which allows the use of unstructured finite element meshes. A standard explicit Runge–Kutta time-stepping scheme is used with the DG scheme, while implicit schemes can be used with the PS scheme due to the peculiar structure of this scheme. We present one- and two-dimensional results to validate the coupling technique. To guide future implementations of this method, we extensively study the influence of different numerical parameters on the accuracy of the schemes and the coupling strategy.
Combined Transrectal Ultrasound Five‐Grade Scoring System and Multiparametric MRI PI‐RADS Score for Risk Prediction Modeling of Prostate Cancer and Clinically Significant Prostate Cancer in the PSA Gray Zone
Authors: Dong Qi , Tong Zhen , Xia Jianguo , Yang Wenqi , Liu Guiqin , Wu Guangyu , Xie Shaowei , Li Hongli 
Published: November 2024

Purpose: This study aims to develop and validate predictive nomograms for prostate cancer (PCa) and clinically significant PCa (csPCa) in prostate‐specific antigen (PSA) gray zone of 4−10 ng/mL, utilizing transrectal ultrasound five‐grade scoring system (TRUS‐5), prostate imaging reporting and data system (PI‐RADS) score based on multiparametric magnetic resonance imaging (mpMRI) and clinical parameters.Method: A retrospective analysis was conducted on a cohort of 383 patients with elevated PSA levels in the gray zone who underwent initial TRUS‐guided 12‐core prostate biopsy between January 2018 and December 2020. Multivariate logistic regression analyses were utilized to identify independent predictors for PCa and csPCa and to establish predictive nomograms. The diagnostic performance, calibration ability, and clinical usefulness of each model were assessed through receiver operating characteristic (ROC) curve analysis, calibration curve analysis, and decision curve analysis (DCA), respectively.Results: Two diagnostic nomograms were developed based on five risk factors (age, free/total PSA [(f/t) PSA] ratio, prostate volume [PV], TRUS‐5, and PI‐RADS score) to predict PCa and five risk factors (PSA, (f/t) PSA, PV, TRUS‐5, and PI‐RADS score) for csPCa of PSA gray zone patients. The TRUS‐5/PI‐RADS combined model demonstrated higher area under the curves (AUCs) (0.865 for PCa and 0.910 for csPCa) compared to the models based on PI‐RADS score or TRUS‐5 (p  < 0.05), as well as the greater net benefits across a wide range of threshold probabilities for PSA gray zone patients.Conclusion: The current study presented valuable TRUS‐5/PI‐RADS combined nomograms for predicting PCa or csPCa in patients within the PSA gray zone, which may serve as useful tools for the clinical management of PCa and csPCa.
Prevalence and Associated Factors of Anemia Among Pregnant Women Attending Antenatal Care at Mizan Aman General Hospital, Bench Maji Zone, Southwest, Ethiopia
Authors: Tegegne Kaleab Tesfaye , Abeje Seblework , Tegegne Eleni Tesfaye , Tessema Mekibib Kassa , Wudu Tadele Kassahun 
Published: November 2024

Background: Anemia is one of the most common nutritional deficiency disorders affecting pregnant women; its prevalence in developed countries is 14% and in developing countries 51%. It is therefore important to understand the prevalence and associated factors of anemia in our study area. This will encourage antenatal caregivers to identify and treat anemia early in pregnancy.Objective: Therefore, the study’s goal was to determine the prevalence of anemia and its contributing factors among pregnant women receiving prenatal care.Methods: Between April 2021 and May 2021, 295 pregnant women attending prenatal care participated in a cross‐sectional facility‐based study. Epidata software was used to enter the data, which were then exported to SPSS software for Windows version 23 for analysis. To determine the factors contributing to anemia in pregnant women, descriptive statistics collected with the study were performed together with bivariable logistic regression and the log‐binomial model.Results: Among the 295 study participants, 24.7% were anemic. Out of these, most were mild types 78.1%. Illiterate pregnant women (ARR 2.89; 95% CI: 1.76–6.43, p value = 0.037), with no iron‐containing food intake per day (ARR 1.74; 95% CI: 1.59–1.95, p value = 0.01), and infected with malaria (ARR 1.58; 95% CI: 1.76–2.53, p value = 0.03) had higher odds of being anemic, compared to their counterpart. Gestational age of the first (ARR 0.21; 95% CI: 0.03–0.98, p value = 0.01), and second (ARR 0.8; 95% CI: 0.43–0.96, p value = 0.013) trimester has lower odds of being anemic compared to their counterpart.Conclusion: Anemia in pregnant women is found to be a moderate public health issue in the research location. It is strongly and independently impacted by malaria infection and iron‐containing meal consumption. Reducing the prevalence of anemia is made possible by improved iron‐containing meal consumption. In addition, it is strongly advised that pregnant women receive education and should take iron supplements during pregnancy visits.
Abstract 4139203: Anatomical Variations in Coronary Arteries and Implications in Spontaneous Coronary Artery Dissection
Authors: Gabaldon Badiola Alvaro , Kir Devika , Tweet Marysia , Donisan Teodora , Alfonso Fernando , Prasad Abhiram , Gulati Rajiv 
Published: November 2024

Introduction:
Spontaneous coronary artery dissection (SCAD) is a poorly understood cause of acute coronary syndrome (ACS), predominantly affecting young women and frequently related to acute stressors. It has been suggested that stress induced cardiomyopathy can cause dissection via mechanical distortion of the vessel at wall-motion hinge points. Whether specific coronary anatomic configurations also predispose to distortion and hence SCAD remains unknown.

Hypothesis:
Patients with left anterior descending (LAD) SCAD have a higher frequency of a “wrap around” (type IV - perfuses >25% of the inferior wall) LAD.

Methods:
Coronary angiograms of patients in the Mayo Clinic SCAD Registry were reviewed. Patients from functional angiogram registry with similar characteristics were used as controls. Patients with an LAD SCAD were compared to patients who never had an LAD SCAD. For identifying predictors of LAD SCAD, patients who never had an LAD SCAD were compared to patients that had an LAD SCAD as a recurrent event, but not as the initial presentation.

Results:
A total of 456 patients with SCAD (46±6 years; 96% women) were included. The control group consisted of 178 patients (44±7 years, 97% women). Type IV LAD was more common in the SCAD cohort (Figure 1), and patients in the LAD SCAD group had a higher proportion of type IV LAD when compared to non-LAD SCAD (47.6% vs 23.0% p < 0.001). Bifurcation involvement was also more frequent (48.6 vs 25.8%, p <0.001).

Individual predictors of an LAD SCAD during follow-up were diagnosis of hypertension, peripartum SCAD, involvement of a bifurcation and type IV LAD. After multivariate analysis, only bifurcation involvement (OR 2.49, p = 0.01) and type IV LAD (OR 2.26, p = 0.02) remained as predictors of LAD SCAD during follow-up.
In patients in whom the PDA perfused the apex (LAD I and II), PDA was more likely to be involved by SCAD (OR 6.17, p<0.001). There were no other differences in coronary distribution after stratifying by LAD types.

Conclusions:
Type IV LAD variant is more common in patients with LAD SCAD. This finding suggests that coronary anatomic variants predispose to SCAD and lend further support to the mechanical distortion hypothesis.