bluuebunny/crossref_metadata_2025_split huggingface dataset:
DT4CCU – A Digital Twins framework for Critical Care Unit
Authors: Appuhamilage Gayan Dihantha Kuruppu Kuruppu , Hussain Maqbool , Zaman Mohsin , Khan Wajahat Ali 
Published: October 2024

Abstract

Digital twins, long utilized in industries for enhancing efficiency, maintenance, real-time monitoring, and sustainability, are now gaining traction in healthcare, particularly with a disease-focused approach. This paper presents our journey towards the realization of a Digital Twin framework specifically designed for Critical Care, emphasizing patient safety, operational efficiency, and sustainability. Our Digital Twin architecture is uniquely structured with a dual-layer approach: a physical twin monitors real-time activities, while a conceptual twin represents ideal workflows. In Phase 1 of our research work, we aim to establish a methodology for live activity tracking. Our findings indicate that by reviewing documentation alone, we could successfully track 72% of tasks performed by nursing staff and physicians in real time. These results underscore the potential of Digital Twins to transform critical care delivery by bridging the gap between actual and ideal clinical practices.
A study of the impact of social participation on the subjective well-being of low-vision older adults in western China in the context of healthy aging
Authors: Zhong Zhu , Luo Xu , Huang Jinyu , Li Yajiang , Luo Yu 
Published: October 2024

Abstract

Background Low vision represents a significant global health issue, and its effects on the physical and mental health of the elderly have been extensively researched. However, the relationship between social participation and the subjective well-being of elderly individuals with low vision in China remains underexplored. This study focuses on the elderly with low vision residing in the main urban area of Chongqing, Western China, to investigate the impact and pathways of subjective well-being at both subjective and objective levels of social participation.
Methods Purposive and convenience sampling methods were employed to select 274 elderly individuals with low vision who were monitored at the ophthalmology clinics of two tertiary hospitals in Chongqing, western China, as the subjects of this survey. The study utilized the Memorial University of Newfoundland Happiness Scale, the Social Participation Scale, and the Social Support Scale, along with a visual function-related quality of life scale to collect relevant data. Pearson correlation analysis was conducted to examine the relationships among the research variables. Based on the theoretical model, a multiple mediating effect prediction model was established to assess the impact of social participation on subjective well-being. Linear regression analysis and the Bootstrap method were applied to evaluate the mediating effects within the prediction model.
Results The overall average subjective well-being of elderly individuals with low vision in western China is measured at 24.75 ± 8.02 points, which indicates a lower-middle level of well-being. participation in social activities is a positive predictor of subjective well-being, whereas individuals' subjective feelings of social participation can negatively impact it. social support and quality of life related to visual functioning were identified as mediating factors influencing the relationships between social participation activities, feelings of social participation, and subjective well-being.
Conclusion This study highlights the subjective well-being of elderly individuals with low vision in western China, as well as the pathways influencing the relationship between social participation-both subjective and objective-and their subjective well-being. It is recommended that healthcare professionals prioritize long-term care strategies for elderly patients experiencing low vision.
Impact of nucleos(t)ide analogues on the risk of hepatocellular carcinoma in chronic hepatitis B patients: A time-dependent Cox regression analysis
Authors: Moriyama Makoto , Tateishi Ryosuke , Kinoshita Mizuki Nishibatake , Fukumoto Tsuyoshi , Yamada Tomoharu , Wake Taijiro , Nakagomi Ryo , Nakatsuka Takuma , Minami Tatsuya , Sato Masaya , Fujishiro Mitsuhiro , Koike Kazuhiko 
Published: October 2024

Abstract

Background and Aims:
The preventive effect of nucleos(t)ide analog (NA) use on HCC development in patients with chronic hepatitis B (CHB) is controversial due to the difficulty of conducting randomized controlled trials.
Approach and Results:
In this single-center, retrospective study, NA-naïve CHB patients without a history of HCC were enrolled and followed-up from the first visit on or after January 2000 to December 2020. Patients were categorized into the NA group, including those who started NA after study enrollment, and the non-NA group, including patients to whom NA was never administered during the follow-up period. After propensity score matching (PSM) to balance the confounding factors, we applied a multivariable time-dependent Cox proportional regression analysis with the initiation of NA as a time-dependent covariate. We further performed a subgroup analysis according to the presence or absence of cirrhosis. The baseline characteristics of 212 pairs of patients retrieved by PSM were comparable. During the mean follow-up of 12.9 and 6.8 years in the NA and non-NA groups, respectively, 25 and 28 patients developed HCC, respectively. Multivariable analysis with time-dependent covariates showed that NA did not affect HCC risk (HR, 0.68; 95% CI, 0.36–1.31; p = 0.25) after adjusting for other risk factors, including age, sex, and HBV viral load. Subgroup analysis showed that NA use significantly reduced the risk of HCC in cirrhotic patients (HR, 0.26; 95% CI, 0.08–0.85; p = 0.03).
Conclusions
The preventive effect of NA on hepatocarcinogenesis may be limited to cirrhotic patients.
Liver Tumor Imaging Staging: A Multi-Institutional Study of a Preoperative Staging Tool for Hepatocellular Carcinoma
Authors: Liu Qiupng , Li Xiang , Yang KaiLan , Sun ShuWen , Xu Xun , Qu Kai , Xiao Jiaqi , Liu Chenyue , Yu HangQi , Lu YinYing , Qu JinRong , Zhang YuDong , Zhang Yuelang 
Published: October 2024

Abstract

Background & Aims:
The current staging system has limitations in preoperatively assessing hepatocellular carcinoma (HCC) and in precise detailed treatment allocation. This study aims to propose a new Liver Tumor Imaging Staging (LTIS) method for HCC.
Methods
1295 patients who underwent CT or MRI and curative liver resection during January 2012 and October 2020 were retrospectively recruited from three independent institutions. LTIS was designed to discriminate low-grade (absence of microvascular invasion [MVI] and Edmondson-Steiner grade III/IV), intermediate (MVI + or Edmondson-Steiner grade III/IV but not both) and high-grade HCC (MVI + and Edmondson-Steiner grade III/IV) upon CT and MRI. Model was constructed in 578 derivation cohort (center 1) and validated in internal center 1 test cohort (n = 291), and external center 2 (n = 226) and center 3 (n = 200), respectively. Net clinical benefit of LTIS on recurrence-free survival (RFS) and overall survival (OS) was analyzed with a Cox proportional hazards model.
Results
In independent test, LTIS achieved agreement of 73.2% (281/384), 18.9% (100/528), and 69.2% (265/383) for determining low, intermediate, and high-grade HCCs with “ground truth” results. In the Cox analysis, LTIS was comparable to “ground truth” grade for predicting RFS (hazards ratio (HR), 1.30 vs ground truth grade, 1.36 and 1.56) and OS (HR, 1.76 vs ground truth grade, 2.00 to 3.03) of patients after surgery. In patients conventionally classified as having low-grade tumors (serum α-fetoprotein < 40 ng/mL, stage T1), 47.4% and 35.6% were reclassified as high-grade tumors upon LTIS restaging. The resulting LTIS subgroups showed a significant difference in RFS and OS at Kaplan-Meier analysis (Log-rank test, p < 0.001).
Conclusion
LTIS provides a potential noninvasive way to precisely stage HCC using CT and MRI.
Morphological, Cytological, and Molecular Characterization of Interspecific Cotton Hybrids Derived from Gossypium hirsutum and G. arboreum Crosses
Authors: Mondal Saptarshi , Pathak Dharminder , Jindal Salil , Agrawal Neha , Gupta Mehak , Rathore Pankaj 
Published: October 2024

Abstract

Diploid cotton Gossypium arboreum (2n = 2x = 26, AdAd) is a valuable genetic resource to improve widely cultivated American cotton G. hirsutum (2n = 4x = 52, AtAtDtDt). In this study, successful generation of four unique interspecific hybrids (G. hirsutum × G. arboreum) was confirmed through morphological, cytological, and molecular characterization. The morphological evaluation included different stem and leaf characters, trichome density, floral characters, and cotton leaf curl disease reaction. Interspecific hybrids were recorded with either complete dominance of some characters or an intermediate expression. However, variation among the F1s was observed for some traits, especially for pollen size and fertility. Two of the four F1s were found to possess relatively bigger pollen sizes with partial fertility which enabled their utilization as male parents in backcrosses. Mitotic analysis of already established F1s was made possible through the induction of fresh roots by air layering. Of the four hybrid plants, two were triploid (2n = 39) and the other two were tetraploids (2n = 52), the latter case probably was a result of the fusion of normal n (AtDt) gametes from female parent (G. hirsutum) and unreduced gametes 2n (AdAd) from male parent (G. arboreum). Meiotic irregularities in interspecific hybrids were also observed. Successful amplification of polymorphic parental bands in all four F1s using simple sequence repeat markers added another line of evidence supporting their hybridity. Results of this experiment provided useful insight and base material to introgress leaf-hopper tolerance from G. arboreum to G. hirsutum.
Persistence of dysfunctional immune response 12 months after SARS-CoV-2 infection and their relationship with pulmonary sequelae and long covid
Authors: Cruz Tamara , Albacar Núria , Ruiz Estibaliz , Lledo Gema M , Perea Lídia , Puebla Alba , Torvisco Alejandro , Mendoza Núria , Marrades Pau , Sellares Jacobo , Agustí Alvar , Viñas Odette , Sibila Oriol , Faner Rosa 
Published: October 2024

Abstract

Introduction
Most patients recover fully after an acute infection by SARS-CoV-2. Some, however, may develop pulmonary sequelae (PS) and/or long COVID (LC), However, whether these two clinical conditions have similar or different pathogenic mechanisms is unknown.
Methods.
The levels of autoantibodies and 184 inflammatory and organ damage associated proteins in plasma were determined (by immunofluorescence and Olink panels, respectively) 1 year after an acute infection by SARS-CoV-2 in 51 patients with PS (DLCO < 80% ref), 31 patients with LC and 31 patients fully recovered (Rec). PS was defined by the presence of reduced carbon monoxide diffusing capacity (DLCO) lower than 80% ref. LC was defined by the presence of chronic symptoms in the absence of an alternative diagnosis.
Results.
We found that patients with PS or LC both showed increased levels than Rec of anti-microbial, immune cell activation and recruitment related proteins. Patients with PS showed higher levels of anti-nuclear autoantibodies, whereas LC patients had increased levels of organ-damage associated proteins. In patients with PS most of the elevated proteins correlate with the impairment of lung function (DLCO). Finally, in PS we additionally performed the determinations at an earlier time point (6 months) and showed that the expression of CCL20 and IFN-ɣ was already higher at 6 months, while CCL3 and CCL19 increase from 6 to 12 months, suggesting a pathogenic role in PS persistence.
Conclusions.
Patients with PS or LC have abnormal but different persistent circulatory immune and organ damage biomarkers, suggesting different underlying biology of both post-COVID conditions.
Patterns of tuberculosis case notification and treatment outcomes in the context of COVID-19 pandemic: analysis of national surveillance data, January 2019 - June 2021
Authors: Masanja Veronicah , Majwala Robert Kaos , Turyahabwe Stavia , Nsubuga Edirisa Juniour , Gonahasa Doreen Nsimiire , Kwesiga Benon , Kadobera Daniel , Bulage Lilian , Ario Alex Riolexus 
Published: October 2024

Abstract

Background
Tuberculosis case notification is critical for TB control but can be disturbed by interruptions to normal health system functioning. The first major wave of COVID-19 in Uganda occurred during August-December 2020. The government-imposed lockdown measures during March-June 2021 which required residents to stay at home. We determined the effect of COVID-19 and associated lockdown on TB case notification rates (CNR) and treatment success rates (TSR).
Methods
We analysed TB CNR and TSR data for January 2019-June 2021 from the Uganda District Health Information Software version2 (DHIS2) and disaggregated them by region. We also compared data on the COVID-19 cases with the TSR, and CNR trends over the period. We computed the CNR per 100,000 population, defined as number of notified TB cases/100,000 population. TSR was defined as the proportion of patients initiated on TB treatment that successfully completed treatment or cured. We described the quarterly trends and distribution of CNR and TSR pre (January 2019-March 2020) and during COVID-19 (April 2020-June 2021). We used interrupted time series analysis to determine the significance of the trends before and during COVID-19. We defined time periods by year (2019, 2020, or 2021) and quarter.
Results
The overall TB CNR between January 2019 and June 2021, was 165/100,000; TSR was 79.4%. CNR ranged from 166.2/100,000 pre COVID-19 to 164/100,000 during COVID-19. CNR declined significantly by 22% (p = 0.042, CI= [-41.4, -1.1]) from January 2020 to April 2020, concurrent with the lockdown and rising COVID-19 cases and was primarily driven by the sharp decline from 426/100,000 to 265/100,000 in Kampala City. This was followed by a significant quarterly increase in the national CNR of 16/100,000 (p < 0.001, CI= [10.0,21.6]), and 39/100,000 (p = 0.01, CI= [15.66,62.32]) in Kampala. TSR increased significantly by 1.6% (p < 0.0001,95%CI 1.3–1.9%) quarterly.
Conclusion
CNR appeared to be affected by the initial lockdown but recovered quickly. However, this decline was heavily driven by declines in CNR in Kampala City whose trends are not reflective of the rest of the country. TSR increased over time but was still below the 90% target. There is need to focus on continuity of TB care interventions in areas heavily affected by lockdowns.
Recurrent Strokes As The Sole Manifestation of Antineutrophil Cytoplasmic Antibody Associated Vasculitis in a Patient with Panuveitis. A Case Report and review of literature
Authors: Seraj Hadeel , Alshalan Hanan A. , Alemam Reham , Omair Mohammed A. 
Published: October 2024

Abstract

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a heterogeneous group of rare, autoimmune conditions characterized by widespread, multisystemic inflammation of small to medium-sized blood vessels. We present a case report of a 46-year-old male with a history of prior ischemic strokes and recurrent bilateral non-granulomatous panuveitis associated with a strongly positive cytoplasmic anti-neutrophil cytoplasmic antibody (c-ANCA) titer. Initial treatment with steroids, methotrexate, and rituximab were ineffective, but the condition responded moderately to cyclophosphamide. This case underscores the importance of considering AAV in patients with unexplained ocular inflammation and highlights the role of c-ANCA testing in diagnosing and managing such cases, even in the absence of classic systemic symptoms.
Lancelot: Towards Efficient and Privacy-Preserving Byzantine-Robust Federated Learning within Fully
Homomorphic Encryption
Authors: Ma Chuan , Jiang Siyang , Yang Hao , Xie Qipeng , Wang Sen , Xiang Tao , Xing Guoliang 
Published: October 2024

Abstract

In sectors such as finance and healthcare, where data governance is subject to rigorous regulatory requirements, the exchange and utilization of data are particularly challenging. Federated Learning (FL) has risen as a pioneering distributed machine learning paradigm that enables collaborative model training across multiple institutions while maintaining data decentralization. This approach inherently heightens data privacy by sharing only model weights, rather than raw data. Despite its advantages, FL is vulnerable to adversarial threats, particularly poisoning attacks during model aggregation, a process typically managed by a central server. To counteract the vulnerabilities of traditional FL frameworks, Byzantine-robust federated learning (BRFL) systems have been introduced, which rely on robust aggregation rules to mitigate the impact of malicious attacks. However, in these systems, neural network models still possess the capacity to memorize and potentially expose individual training instances inadvertently. This presents a significant privacy risk, as attackers could reconstruct private data by leveraging the information contained in the model itself. Existing solutions fall short of providing a viable, privacy-preserving BRFL system that is both completely secure against information leakage and computationally efficient. To address these concerns, we propose Lancelot, an innovative and computationally efficient BRFL framework that employs fully homomorphic encryption (FHE) to safeguard against malicious client activities while preserving data privacy. Lancelot features a novel interactive sorting mechanism called masked-based encrypted sorting. This method successfully circumvents the multiplication depth limitations of ciphertext, ensuring zero information leakage.
Furthermore, we incorporate cryptographic enhancements, such as Lazy Relinearization and Dynamic Hoisting, alongside GPU hardware acceleration, to achieve a level of computational efficiency that makes Lancelot a viable option for practical implementation. Our extensive testing, including medical imaging diagnostics and widely used public image datasets, demonstrates that Lancelot significantly outperforms existing methods, offering more than a twenty-fold increase in processing speed while maintaining data privacy. The Lancelot framework thus stands as a potent solution to the pressing issue of privacy in secure, multi-centric scientific collaborations, paving the way for safer and more efficient federated learning applications.
Diversity and Dynamics of Seasonal Pool Vegetation in Nediyenga, Sreekandapuram, Kannur District, Kerala, India.
Authors: Abhijith Sarga , MV Jeeshna , T Sreelakshmi 
Published: October 2024

Abstract

The present study was conducted in the seasonal pond at Nediyenga, Sreekandapuram (Northern side of Kannur District), Kerala, India during June 2022 - October 2023. The pond is renowned for the range of microhabitats and temporal dynamics that support a broad diversity of vascular plants. A total of 53 plant species were recorded and herbs dominated with a share of about (48 spp.) Of these, 16 species were endemic and many highly threatened as per the IUCN Red List criteria. Results of soil analysis were high organic carbon, enough magnesium (Mg), copper (Cu) and zinc (Zn) low potassium (K), sulfur(S) and boron(B); there are above resistance iron(Fe) and above tolerance levels of manganese (Mn). It indicates the potential anthropogenic impacts. The water analysis revealed a pH that was slightly acidic, and total dissolved solids were low with moderate conductivity and nutrient levels of the irrigation solution. These findings underscore the ecological significance of the Nediyenga pond, highlighting the need for targeted conservation efforts to manage soil nutrient imbalances and maintain water quality to supports its unique biodiversity.
Attention Deficit Hyperactivity Disorder Risk Factors Assessment and Correlation with Symptomatology among Children in Al Dakahlya Governorate
Authors: Soliman Amir , Hamdy Reem , Hasan Judy 
Published: October 2024

Abstract

Background
Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder that primarily manifests during childhood, characterized by persistent patterns of inattention, hyperactivity, and impulsivity that are inappropriate for the child's developmental level.
Objectives
to assess and investigates the relationship between sociodemographic factors, prenatal influences, and ADHD symptom severity among children in Al Dakahlya Governorate, Egypt.
Methods
This cross-sectional study included 375 children with ADHD in Al Dakahlya Governorate, data were collected using standardized questionnaires and diagnostic tools such as the DSM-V criteria and Conners’ Rating Scale.
Results
Significant correlations were found between ADHD severity and several factors, including socioeconomic status, parental education, paternal smoking, parental consanguinity, and maternal folic acid intake. Children from lower socioeconomic backgrounds and those with less educated parents exhibited more severe ADHD symptoms. Additionally, paternal smoking and parental consanguinity were associated with greater ADHD severity, while maternal folic acid intake showed a protective effect.
Conclusion
The findings underscore the importance of socioeconomic and prenatal factors in influencing ADHD symptomatology and highlight potential areas for public health interventions aimed at improving maternal nutrition and reducing exposure to harmful prenatal conditions.
Association between nutrition-related indicators and non-alcoholic fatty liver disease and advanced liver fibrosis: evidence from NHANES 2017-2020
Authors: Wei Shouxin , Yu Sijia , Lan Yunsheng , Jia Yingdong , Yang Ningbo 
Published: October 2024

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide, and its incidence has been rising in parallel with the prevalence of obesity and diabetes. A critical marker for the progression of NAFLD is advanced hepatic fibrosis (AHF), which can result in cirrhosis and hepatocellular carcinoma. This study sought to investigate the potential associations between five nutrition-related indices—the geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), controlled nutritional score (CONUT), triglyceride-total cholesterol-body mass index (TCBI), and albumin/globulin ratio (AGR)—and the progression of NAFLD and AHF.
Methods: This study analyzed the association between five nutrition-related indicators and the occurrence of NAFLD and AHF by utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020.03. After adjusting for demographic, lifestyle, clinical, and laboratory-related factors, the associations were examined employing various statistical techniques, including multivariate logistic regression, subgroup analysis, and smooth curve fitting analysis.
Results: This study included 5,514 subjects, of whom 2,088 were diagnosed with NAFLD and 359 with AHF. After adjusting for potential confounding factors using multivariate logistic regression analysis, the results revealed that GNRI, PNI, and TCBI were positively associated with the incidence of NAFLD, while CONUT and AGR demonstrated negative associations with NAFLD. Additionally, GNRI, CONUT, and TCBI were positively associated with the incidence of AHF, while AGR demonstrated a negative association with AHF.
Conclusions: The study demonstrates that nutritional status plays a dual role in the progression of NAFLD and AHF, serving as both a risk and protective factor. These findings offer a scientific foundation for the early identification of high-risk populations and the development of individualized nutritional intervention strategies.