bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hemoglobin mediates the link between 'weekend warrior' activity pattern and diabetic retinopathy
Authors: Li Baohua , Ning Bobiao , Hou Xinyue , Shi Yipeng , Kang Zefeng 
Published: October 2024

Abstract

Diabetic retinopathy (DR), the leading cause of vision loss in the elderly, coupled with limited treatment options, has prompted efforts to identify modifiable risk factors associated with DR. The purpose of this study was to explore the association between WW physical activity patterns and DR risk in US adults and to examine how Hb levels mediate this relationship. Cross-sectional study data were obtained from nationally representative NHANES data from 2007-2018. PA patterns were categorized according to inactive, insufficiently active, WW, and regularly active (RA). Multivariate logistic regression models adjusting for demographics, behavioral factors, and health conditions were used to explore the association between PA patterns and DR. Finally, mediation analyses verified whether Hb mediated the relationship between PA and DR. The study ultimately included 5092 U.S. adults, including 857 participants with DR and 4235 participants with DM without DR. Multivariate logistic regression modelling indicated that both WW (OR=0.601, 95% CI=0.452-0.798, P<0.001) and RA (OR=0.728, 95% CI=0.554-0.956, P=0.023) were significant protective factors for DR when compared to inactive adults, and the association between RA insufficiently active, WW did not show a significant association with DR. Mediation analysis showed a significant mediation effect of Hb on the association between PA patterns and DR risk, with a mediation ratio of 5.23%. Our study reveals that WW and RA activity patterns are protective factors for DR and that Hb levels mediate this association. This suggests that WW activity patterns are more cost-effective for the prevention of DR.
Comparing cost estimates of implementation strategies using Cost-IS: a collective case study
Authors: Donovan Thomasina , Abell Bridget , McPhail Steven M. , Carter Hannah E. 
Published: October 2024

Abstract

Background
There is a lack of pragmatic approaches that standardise the cost estimation of implementation strategies. An instrument for data collection and cost estimation of implementation strategies for digital health innovations (Cost-IS) was recently developed. This study aimed to compare the nature of implementation cost estimates across three case studies. Secondary aims were to investigate the perceived value of these cost estimates to project leads and stakeholders, and to assess the feasibility and generalisability of Cost-IS as a standardised tool to compare the cost estimates of implementation strategies across three case studies.
Methods
An evaluative and descriptive collective case study was conducted to estimate the cost of implementation strategies associated with the introduction of healthcare interventions using the Cost-IS instrument. Eligible case studies included completed implementation projects that had planned to cost implementation and had prospectively collected data on implementation-related resource use throughout the project. Implementation data was separately analysed for each case study. Adaptations to the instrument were made where appropriate and documented. The Cost-IS instrument was tailored in a way that best allowed for meaningful outputs from each case study. The feasibility, generalisability and limitations of Cost-IS were observed by the analyst through the costing process. Feedback on the outputs were obtained from project leads, via questionnaires.
Results
The Cost-IS instrument enabled comparisons of cost estimates of implementation strategies between three real-world implementation case studies. Labour accounted for the majority of implementation costs. Adaptions to Cost-IS during the costing process were made to improve data capture granularity, meaningfully categorise the data, and enhance the instrument’s flexibility for analysis. Implementation cost findings were perceived by project leads to be valuable for reporting and evaluating, should be customised to project context, and include relevant contextual information.
Conclusions
Cost-IS was found to be a flexible instrument that can be tailored to meet the requirements of a range of implementation projects. Challenges during this process included separating implementation-related costs from intervention costs and research-related costs. Cost-IS is limited to costing implementation strategies and thus far has only captured tangible resources.
Predictors of visual outcome in Idiopathic Intracranial Hypertension: observations from a retrospective cohort in Germany
Authors: Knoche Theresia , Varlet Lisa , Pohrt Anne , Danyel Leon Alexander , Haffner Paula , Kowski Alexander Bernhard 
Published: October 2024

Abstract

Background
Idiopathic intracranial hypertension (IIH) is a rare secondary headache disorder. It is characterized by increased intracranial pressure without an identifiable cause and can potentially cause visual impairment due to damage to the optic nerve. This study aimed to evaluate clinical characteristics and to identify risk factors of permanent and progressive deterioration of visual function in a German IIH cohort.
Methods
This is a retrospective observational study of IIH patients who were diagnosed between 2004 and 2020 at our tertiary care neurological department. Ophthalmologic findings, clinical characteristics and treatment strategies were recorded. Visual outcomes were assessed at a minimum follow-up of 6 months after IIH diagnosis. Regression analysis was utilized to evaluate potential risk-factors of poor visual outcome, defined as 1) worsening of ophthalmologic findings and/or 2) persistent visual impairment.
Results
The patient cohort comprised 191 consecutive IIH patients. Cohort characteristics and clinical findings were consistent with prior studies. Ophthalmologic follow-up was available in 90 patients. Here, poor visual outcome occurred in 36% of patients. In regression models, male sex was independently associated with a greater risk for poor visual outcome (OR: 7.2, p = 0.028). Patients with moderate papilledema at baseline had a lower likelihood for poor visual outcome than patients with lower degree papilledema (OR: 0.2, p = 0.016). Surgical intervention (primarily by ventriculo-peritoneal shunt) was associated with a lower risk of poor visual outcome (OR: 0.21, p = 0.09), mediating the relation between papilledema and visual outcome. Neither age, BMI nor cerebrospinal fluid opening pressure were associated with the visual prognosis.
Conclusions
One third of patients in the follow-up cohort experienced worsening of ophthalmologic findings or visual impairment. Male sex may predispose IIH patients to visual impairment. Moderate papilledema at baseline reduced the risk of poor visual outcome, partially due to surgical therapy during the follow-up period. This study highlights the importance of timely intervention in patients with moderate papilledema and the need for reliable outcome predictors in IIH.
Trial registrations: Trial registration is not applicable: This observational study reports retrospective documentations of clinical routine data. It does not classify as a clinical trial.
68Ga-pentixafor PET/CT is a supplementary method for Primary aldosteronism subtyping compared with adrenal vein sampling
Authors: Yi Tieci , Lu Difei , Cui Yonggang , Zhang Zheng , Yang Xing , Zhang Jianhua , Qiu Lin , Weng Haoyu , Liu Lin , Duan Xiaojiang , Zhao Guangyu , Ma Wei , Gao Ying , Fan Yan 
Published: October 2024

Abstract

Purpose
To investigate the diagnostic efficacy of 68Ga-pentixafor positron emission tomography/computed tomography (PET/CT) in primary aldosteronism (PA) subtyping and lateralization of aldosterone secretion in PA patients.
Procedures:
37 patients who were diagnosed with PA, were prospectively enrolled in the study, and underwent adrenal vein sampling (AVS) after 68Ga-pentixafor PET/CT was conducted. Lateralization index (LI), defined as aldosterone/cortisol ratio in the dominant side to the contralateral adrenal vein when bilateral adrenal vein catheterization succeeded, and the aldosterone/cortisol ratio in the left adrenal vein to IVC (LAV/IVC) when the catheterization of right adrenal vein failed, were applied to determine lateralization side. Statistical analysis was performed using SPSS 21.0.
Results
The female proportion of all patients with PA was 32.4% (12/37), and the mean age was 51.3 ± 10.9 years. Patients with bilateral adrenal mass accounted for 54.1% (20/37), and 10 of them (27.0%) had adrenal hyperplasia or adrenal nodules ≤ 1.0 cm. In all 37 patients, the sensitivity, specificity and accuracy of 68Ga-pentixafor PET/CT in distinguishing lateralization by visualization were 89.3%, 77.8% and 86.5%, respectively. The area under the ROC curve for detecting positive lateralization based on the value of 68Ga-pentixafor SUVmax was 0.750 (95%CI 0.578–0.922, p = 0.026). The optimum SUVmax cut-off value was 6.86, with the sensitivity of 78.6%, specificity of 66.7%, and accuracy of 78.4%. Defining SUV ratio as SUVmax/SUV of contralateral adrenal gland, the area under the ROC curve for identifying lateralization based on the SUV ratio was 0.710 (95%CI 0.500-0.921, p = 0.061). The optimum SUV ratio cut-off was 2.40, with the sensitivity of 60.7%, specificity of 88.9%, and accuracy of 67.6%. The consistency of 68Ga-pentixafor PET/CT with AVS was of no significant difference between patients with bilateral adrenal lesions (80.0%, 16/20) and unilateral lesion (94.1%, 16/17; p = 0.737), and no significance was revealed in the consistency between patients with adrenal hyperplasia or adrenal lesion of diameter ≤ 1 cm (81.8%, 9/11) and those with adrenal lesions > 1 cm (88.5%, 23/26; p = 0.884).
Conclusions
68Ga-pentixafor PET/CT showed at least 80% consistency for the lateralization in patients with PA compared with AVS, even in those presented with bilateral adrenal hyperplasia. Visual analysis exhibited better diagnostic efficacy compared with SUVmax or SUVmax/SUV of the contralateral adrenal gland.( ChiCTR2300073049. Registered 30 June 2023. Retrospectively registered)
Machine learning-enhanced clinical and ultrasound technology for early detection of difficult-to-treat rheumatoid arthritis
Authors: Wang Ting , Wang Zhen , Yu Yakun , Huang Lele , Zhu Rong , Jia Yingying , Yin Ci , Wang Yuan , Li Yan , Shen Xuejiao , Wei Jiaqi , Zhang Chunjie , Nie Fang 
Published: October 2024

Abstract

Objectives: This study aimed to examine the clinical features, serological indicators, and ultrasound examination results of individuals with difficult-to-treat rheumatoid arthritis (D2T RA) and non-D2T RA, along with the development and validation of two distinct predictive models for the early detection of D2T-RA.
Methods: Enrolled 85 patients with D2T-RA diagnosed as moderate or high disease activity who completed 24 months of follow-up, and randomly matched 83 non-D2T-RA patients with moderate to high disease activity. Baseline clinical information was collected, and US examinations were performed to record the single scores of gray-scale (GS) and power Doppler (PD) for 16 joints and 10 tendons, as well as the EULAR-OMERACT scores. Univariate analysis identified predictive factors, followed by machine learning to create two models: clinical/serological (Model 1) and clinical/serological/US (Model 2). We evaluated the model performance using 5-fold cross-validation, utilizing the F1 score and AUC.
Results: The univariate logistic analysis showed that EULAR-OMERACT＞1 (6 variables) and clinical and serological characteristics (14 variables) were significant predictors of D2T RA. The random forest model performed best on all models, with the AUC and F1 of test set model 1 divided into 0.81 and 0.67, and the AUC and FI of model 2 with ultrasound data increased to 0.83 and 0.69, respectively.
Conclusion: Multi-joint ultrasound score provides important prediction data for early identification of D2T RA, a random forest model improves prediction efficacy, and evaluating limited joints makes this method more feasible in rheumatism clinical practice.
Dual roles of infrastructure in hearing difficulty disparities across the United States
Authors: Duan Tianle , Li Qingchun , Kim Noori 
Published: October 2024

Abstract

Hearing loss is a critical issue in the United States, affecting more than 15% American adults. Existing research mainly focuses on the physiological and socioeconomic factors for hearing loss. This study explores the roles of infrastructure in hearing difficulty disparities in the United States. We used the Point of Interest data to quantify physical establishments and retrieved data from OpenStreetMap to estimate road density. The urban scaling results show that US county-level infrastructure density and population size follow a power-law relationship (α=0.88). Counties with lower hearing difficulty rates tend to have more infrastructure, with infrastructure density increasing by 81.5%, 79.0%, and 75.3% when the population doubles in counties with low, medium, and high hearing difficulty rates, respectively. However, temporal clustering shows that counties with higher infrastructure density have rising hearing difficulty rates. After controlling for hearing health confounding variables, regression results show that overall infrastructure and hearing risky infrastructure densities significantly increase hearing difficulty rates, while road network density improves hearing health. The study reveals a dual mechanism: infrastructure increases noise exposure and hearing difficulty risk, while road networks could improve access to hearing services, benefiting hearing health.
Computed tomography staging system and Clinicopathology of pulmonary Kaposi's sarcoma associated with acquired immunodeficiency syndrome: a retrospective study of 53 cases
Authors: Wang Yan , Bao Gang , Yu Tian , Wang Bing , Sairen Gaowa 
Published: October 2024

Abstract

Objectives
The aim of this study is to understand the CT manifestations of pulmonary Kaposi's sarcoma (pKS) through dynamic observation, in order to promote its clinical diagnosis and treatment.
Materials and Methods
Collected medical records and CT images of 93 AIDS-KS patients, 53 of whom had pKS. Two senior physicians analyzed lung CT images respectively which the first time diagnosis of pKS (53 cases) and reexamined after treatment (39 cases).
Results
51 cases had cutaneous KS, 41 cases had digestive tract KS, 3 cases had lymph node KS. According to the evolution of pKS, the CT manifestations of AIDS related pKS can be divided into three stages: I: Bronchial vascular thickening stage (6 cases); II: 24 cases in the nodular stage; III: Fusion consolidation period (23 cases). The complications of pulmonary KS include lymphadenopathy, pleural and pericardial effusion, subcutaneous edema, and bone destruction/metastasis.The prognosis of 39 patients treated with highly active antiretroviral treatment (HAART) and paclitaxel were: I: 100% being remission; II: 70.6% being remission ,23.5% being progression; 5.9% no change after treatment; III: 72.2% being remission; 22.2% being progression; 5.6% no change after treatment.
Conclusions
When AIDS related KS affects the lungs, it often presents as systemic disseminated KS. CT images of pKS could be divided into three stages. Recognizing CT staging of pKS is of help to guide clinical diagnosis early and mastery of the disease course to achieve disease control.
The characteristic of molten pool during laser gas nitriding of titanium alloy surface
Authors: Guo Jinchang , Shi Yu 
Published: October 2024

Abstract

Poor surface mechanical properties are an important factor restricting the wide applications of titanium alloys, while the laser gas nitriding process can effectively improve the surface mechanical properties. The convection behavior on molten pool surface in the nitriding process was captured using a high-speed camera system, the images of the molten pool surface were processed, the special convection behavior was analyzed, and the convection velocity on the molten pool surface was calculated. The forming characteristics of the nitrided layer section were observed, and the relationship between the special convection behavior of the molten pool and the section forming was analyzed. The experimental results show that the nitriding molten pool convection has the characteristics of discontinuity, locality and randomness; the alternating change of the relationship between the melting point and the temperature of the molten pool leads to the discontinuity of the convection , and the segregation of the molten pool composition and the non-uniformity of the parameters lead to the local and random nature of the convection; the special convection behavior of the nitriding molten pool results in the irregular section of the nitrided layer. According to these characteristics, a scheme of controlling the quality of nitrided layer is put forward by using non-uniform heat source.
Improved Survival of Primary-Tumor Resection in Metastatic Thoracic Esophageal Cancer: A Population-Based, Propensity Score Matched Study
Authors: Wu Jiayan , Zheng Haosheng , Wang Gengfeng , Qin Fei , Zheng Yuzhen , Chen Junguo , Liu Zui , Jian Bozhu , Qin Xianyu , Liao Hongying 
Published: October 2024

Abstract

The study aims to assess the survival effect of primary-tumor resection (PTR) on thoracic esophageal cancer with distant metastasis(TECDM). Data of patients with TECDM was collected from the Surveillance, Epidemiology, and End Results database from 2010 to 2020. We used a 1:1 propensity-score matching(PSM) analysis to minimize heterogeneity between different groups. Total 7733 patients with TECDM were included, and 121 patients and 7612 patients underwent primary-tumor resection and did not, respectively. Patients underwent primary-tumor resection had a better median OS and median CSS than those patients did not in overall and PSM cohort. In PSM cohort, the median OS was 11 months (95% CI, 9 months to 13 months) for TECDM patients with PTR and 7 months (95% CI, 5 months to 9 months) for those patients without PTR. Additionally, cox proportional hazard models similarly indicated that PTR was a significantly protective factor for TECDM patients in OS (HR: 0.5529; 95% CI, 0.5196 to 0.7730, P < 0.001) and CSS (HR:0.5869 ; 95% CI, 0.479 to 0.7192, P < 0.001). In conclusion, primary-tumor resection prolongs survival of thoracic esophageal cancer patients with distant metastasis.
Wireless ECG: A Sub mm-Waves, 160GHz, Vital Signs Monitoring IC, in 22nm CMOS FDSOI
Authors: Sanduleanu Mihai , Gebremicheal Mizan 
Published: October 2024

Abstract

This paper presents a sub mm-Waves, 160 GHz Vital-Signs monitoring IC with integrated on-chip antennas. At the receiver (Rx) side, it consists of a low-noise amplifier (LNA), I/Q mixers and a variable-gain amplifier (VGA) whereas at the transmitter (Tx) side is composed of a power amplifier (PA) with I/Q voltage-controlled oscillator (VCO) and an integrated Integer-N phase-locked loop (PLL) with a 5 GHz reference signal. Realized in a 22nm CMOS FDSOI technology, the IC has a DC power consumption of 450 mW, 10 dBm transmitted saturated power (Psat), 30 dB Rx gain with a noise figure (NF) of 8 dB. The measured phase noise of the PLL is -115 dBc/Hz @ 1 KHz and -124 dBc/Hz @ 100 KHz. The chip is followed by a FPGA that runs the detection algorithms. The chip detects the breathing rate and the heart rate of a patient positioned at 2m from an IC mounted on PCB.
Electrokinetics promoted cadmium dissociation, phytoremediation of contaminated plateau red soil and the influence differences between electric field dimensions
Authors: Zhu Xuan , Zhao Ming , Duan Zhengyang , Jiang Chen , Ma Hongyan , Wang Lirong , Jiang Ming , Li Tianguo 
Published: October 2024

Abstract

Aims The enhanced performance of electrokinetics(EK) on the cadmium (Cd) dissociation, redistribution and phytoremediation of Cd-contaminated plateau red soil has been investigated based on the application of electric field in different dimensions.
Methods After Sedum plumbizincicola cutting growth for 30 d, periodic reversal direct-current (DC) electric fields were applied during 150 days for 10.5 cycles.
Results Unlike the uniform distribution change of pH in P1–P9 of the 1D treatment, more soil points (P1–P9) of multidimensional electric fields were exposed to the influence of anode. In electrokinetic–assisted phytoremediation (EKPR), Sedum plumbizincicola can alleviate soil acid-alkalization caused by EK, especially the acidification effect of anode under high voltage (10–20 V). Cd speciation and dissociation studies show that EK promotes Cd dissociation into soil pore water, which is conducive to Cd phytoextraction. The periodic reversal DC electric fields enhanced the height more significantly than biomass of Sedum plumbizincicola and with inconspicuous among difference regions. Overall, EKPR (voltage of 5–10 V) can promote soil Cd phytoremediation effectively due to the synergistic effect of directly interface action and indirectly influence of electric field to improve the Cd speciation evolution, dissociation, and bioavailability at the soil–water interface. The appropriate electric field arrangement and voltage were EKPR2 and 5 V for Sedum plumbizincicola, respectively.
Conclusions EK-induced heavy metals speciation evolution and effective dissociation is one of the important ways to promote the remediation performance, and it is necessary to regulate the arrangement and intensity of electric field to ensure the strengthening effect of EKPR.