bluuebunny/crossref_metadata_2025_split huggingface dataset:
Machine learning for identifying risk of death in patients with severe fever with thrombocytopenia syndrome
Authors: He Qionghan , You Zihao , Dong Qiuping , Guo Jiale , Zhang Zhaoru 
Published: September 2024

BackgroundSevere fever with thrombocytopenia syndrome (SFTS) has attracted attention due to the rising incidence and high severity and mortality rates. This study aims to construct a machine learning (ML) model to identify SFTS patients at high risk of death early in hospital admission, and to provide early intensive intervention with a view to reducing the risk of death.MethodsData of patients hospitalized for SFTS in two hospitals were collected as training and validation sets, respectively, and six ML methods were used to construct the models using the screened variables as features. The performance of the models was comprehensively evaluated and the best model was selected for interpretation and development of an online web calculator for application.ResultsA total of 483 participants were enrolled in the study and 96 (19.88%) patients died due to SFTS. After a comprehensive evaluation, the XGBoost-based model performs best: the AUC scores for the training and validation sets are 0.962 and 0.997.ConclusionUsing ML can be a good way to identify high risk individuals in SFTS patients. We can use this model to identify patients at high risk of death early in their admission and manage them intensively at an early stage.
Changes of regional brain activity following Tuina therapy for patients with painful cervical spondylosis: a resting-state fMRI study
Authors: Song Shilong , Fang Yun , Wan Xing , Shen Lili , Hu Yidan , Lu Chao , Yue Tao , Chen Lu , Chen Jianhuai , Xue Mingxin 
Published: September 2024

BackgroundThe effectiveness of Tuina therapy has been confirmed in treating pain of patients with cervical spondylosis (CS), however, its therapeutic mechanism is still unclear. This study aimed to observe the changes of regional brain activity following Tuina therapy in patients with painful CS based on resting-state functional magnetic resonance imaging (rs-fMRI) data.MethodsA total of 27 patients with CS and 27 healthy subjects (HCs) were enrolled in this study. All patients received Tuina therapy every 2 days for 2 weeks. The clinical manifestations of patients were evaluated by the Visual Analog Scale (VAS) and Neck Disability Index (NDI) before and after treatment. In addition, rs-fMRI data were collected and preprocessed in all patients before and after treatment, as well as HCs. HCs underwent a 1-time rs-fMRI scan, whereas CS patients underwent 2-times of rs-fMRI scan. The measure of regional homogeneity (ReHo) was calculated and compared between groups. Finally, relationships between altered brain regions and clinical characteristics were evaluated by Pearson’s correlation analysis.ResultsAfter Tuina therapy, VAS and NDI scores of patients decreased. Before treatment, CS patients showed higher ReHo values in the left middle temporal gyrus, left thalamus, right anterior and posterior cingulate gyrus, left inferior parietal gyrus and lower ReHo values in the right gyrus rectus when compared with HCs. After treatment, CS patients exhibited higher ReHo values in the left inferior temporal gyrus, right anterior and posterior cingulate gyrus, left inferior parietal gyrus and lower ReHo values in the right rectus gyrus when compared with HCs. CS patients after treatment demonstrated higher ReHo values in the left inferior occipital gyrus when compared with those before treatment. Positive correlations were found between ReHo values of the right rectus gyrus and VAS, NDI scores in CS patients before treatment. Differences of VAS scores between before and after treatment were negatively correlated with ReHo values of the left inferior temporal gyrus in CS patients after treatment.ConclusionThis study demonstrated the presence of asynchronous activity in certain brain regions in CS patients, which might be associated with pain and cervical spine dysfunction. Tuina therapy might modulate asynchronous activity of abnormal brain regions, which might contribute to the effectiveness of Tuina therapy in alleviating pain and cervical spine dysfunction in CS patients.
Metabolomics and gut microbiota analysis reveal the differential efficacy of areca nut and charred areca nut in treating constipation
Authors: Wang Li-sha , Wu Jiao-xia , Zhang Fang , Huang Yan , Jiang Yue-xia , Li Yong-hui 
Published: September 2024

BackgroundAreca nut (AN) is a traditional Chinese herbal medicine used for centuries to treat gastrointestinal (GI) disorders. Charred AN (CAN) is a processed product of AN with similar therapeutic effects. This study aimed to investigate the therapeutic mechanisms of AN and CAN for constipation via metabolomics and gut microbiota analysis.MethodsIn this study, the rats were randomly divided into 5 groups (n = 6): control, constipation model, positive drug, AN treatment, and CAN treatment groups. Constipation was induced by intragastric administration of loperamide hydrochloride, followed by 14-day treatment with mosapride, AN, or CAN. The efficacy difference between AN and CAN was assessed by evaluating the weight gain, fecal water content, GI transit rate, colonic histopathology, serum levels of GI hormones, gut microbiota, and fecal metabolites.ResultsThe results demonstrated that both AN and CAN could alleviate loperamide-induced constipation. Furthermore, they significantly elevated the serum levels of motilin, vasoactive intestinal peptide, substance P, and acetylcholine. 16S rRNA analysis revealed that AN regulated the relative abundance of Bacillus, UCG-005, norank_f_Muribaculaceae, Candidatus_Saccharimonas, and Ruminococcus, whereas CAN modulate the relative abundance of Lactobacillus, Bacillus, norank_f_Muribaculaceae, Ruminococcus, unclassified_f_Oscillospiraceae, and unclassified_f_Prevotellaceae. Moreover, the metabolic profile of AN- and CAN-treated rats was also different, where AN treatment involved pathways of citrate cycle (TCA) and tyrosine, alanine, aspartate, and glutamate metabolisms. Whereas CAN treatment involved pathways of steroid and primary bile acid biosynthesis, as well as pyrimidine and purine metabolisms. Spearman correlation analysis indicated a close relationship between gut microbiota and fecal metabolites.ConclusionIn summary, this study revealed that AN may protect GI mucosa, enhance GI motility, and alleviate constipation symptoms by regulating the relative abundance of specific gut microbiota (Bacillus, UCG-005, norank_f_Muribaculaceae, Candidatus_Saccharimonas, Ruminococcus) as well as citrate cycle or tyrosine, alanine, aspartate, and glutamate metabolic pathways. Furthermore, CAN was observed to promote gastric emptying and intestinal propulsion, thereby alleviating constipation, by modulating the relative abundance of specific gut microbiota (Lactobacillus, Bacillus, norank_f_Muribaculaceae, Ruminococcus, unclassified_f_Oscillospiraceae, unclassified_f_Prevotellaceae) as well as steroid and primary bile acid biosynthesis, as well as pyrimidine and purine metabolic pathways.
Establishing a risk stratification model to identify clinically high-risk N0 breast cancer who could benefit from regional nodal irradiation: a single institute analysis
Authors: Qi Wei-Xiang , Cao Lu , Ou Dan , Li Shuyan , Xu Cheng , Cai Rong , Xu Haoping , Cai Gang , Chen Jiayi 
Published: September 2024

BackgroundThe purpose of this real-world study was to investigate the risk factors for developing recurrence among patients with pathological T1-3N0 breast cancer (BC) treated with breast-conserving surgery (BCS) followed by whole breast irradiation alone (WBI) and identify those clinically high-risk BCs who could benefit from regional nodal irradiation (RNI).Materials and methodsFemale BC patients treated at Shanghai Ruijin hospital from 2009 to 2016 were retrospectively reviewed. The disease-free survival (DFS), breast cancer specific survival (BCSS) and overall survival (OS) were estimated by the Kaplan-Meier method, and survival differences were compared with the log-rank test. Univariate and multivariate analysis was performed using Cox proportional hazards regression analysis. An external validation was conducted by using SEER database.ResultsA total of 622 BC patients treated with BCS+WBI alone were included. With a median follow-up of 82 months, the 7-year OS, BCSS and DFS for the entire cohort was 97%, 99% and 91%, respectively. Multivariable Cox analysis indicated that tumor size (p=0.006), tumor location (p=0.033), lymphovascular invasion (LVI) status (p=0.0028) and Ki-67 index (p=0.051) were independent risk factors for DFS. A scoring system was developed using these four factors and the 7-year DFS and OS were 97% and 96% for patients with 0-1 risk factors, 95% and 82% for patients with ≥2 risk factors (p&lt;0.0001 for DFS, and p=0.0063 for OS). Based on tumor size and tumor location, an external validation by demonstrated that the 7-year OS was 90% and 88% for patients with 0-1 risk factor, which was significantly better than those defined as high-risk BC patients (82%, p&lt;0.0001).ConclusionBy using our institute database, we establish a risk stratification system for identifying sub-group of pN0 BC patients, who are at high risk for developing recurrence. The results of our study support tailored RT decision-making according to individual risks, which needed to be confirmed in further studies.
Disitamab vedotin (RC48) long-term regimen in a post-nephroureterectomy patient with metastases: a case report
Authors: Li Weiping , Jing Suoshi , Zhao Bo , Jiang Wei , Zhang Bin 
Published: September 2024

BackgroundFor patients with metastatic upper tract urothelial carcinoma (UTUC), the preferred first-line treatment is platinum-based chemotherapy. Immunotherapy can be considered a subsequent treatment if the chemotherapy is ineffective or the disease progresses. However, how should treatment be administered if immunotherapy is useless and the patient cannot take chemotherapy? Especially in patients who have metastasized after radical nephroureterectomy (RNU).Case presentationA 68-year-old woman was admitted to the hospital due to left flank pain for two weeks and was diagnosed with metastatic UTUC after RNU. The patient underwent systemic chemotherapy with gemcitabine and cisplatin (GC), as well as reduced-dose GC, but developed myelosuppression. Immunotherapy was ineffective, so Disitamab vedotin (RC48) was chosen.ResultsDisitamab vedotin (RC48) monotherapy was administered for 13 cycles, during which thyroid function remained normal, the patient responded well to the treatment, and the disease was controlled well. In the subsequent two years of follow-up, there was no disease recurrence.ConclusionThe long-term treatment regimen with RC48 is feasible for metastatic UTUC after RNU, and RC48 monotherapy is suitable as first-line therapy for selected patients.
A kinetic study of fusion burn waves in compressed deuterium–tritium and proton–boron plasmas
Authors: Lavell Michael J. , Kish Ayden J. , Sexton Andrew T. , Evans Eugene S. , Mohammad Ibrahim , Gomez-Ramirez Sara , Scullin William , Borscz Marcus , Pikuz Sergey , Mehlhorn Thomas A. , Tabak Max , Ainsworth Greg , Sefkow Adam B. 
Published: September 2024

We present particle-in-cell simulations with Monte Carlo collisions of fusion burn waves in compressed deuterium–tritium and proton–boron plasmas. We study the energy balance in the one-dimensional expansion of a hot-spot by simulating Coulomb collisions, fusion reactions, and bremsstrahlung emission with a Monte Carlo model and inverse bremsstrahlung absorption using a new PIC model. This allows us to self-consistently capture the alpha particle heating and radiative losses in the expanding hot-spot and surrounding cold fuel. After verifying our model in a code-to-code comparison with both kinetic and fluid codes for the case of a deuterium–tritium hot-spot, we simulate the expansion of a proton–boron hot-spot initialized at 200 keV and 1,000 g/cm3. Our model predicts that energy radiated by the hot-spot is recaptured by the surrounding high-density opaque fuel reducing the expansion work done by the propagating burn wave. As a result, we find the net fusion energy produced over the course of $20$∼ps is twice the initial hot-spot energy independent of whether radiation physics is included.
Mental health of individuals at increased suicide risk after hospital discharge and initial findings on the usefulness of a suicide prevention project in Central Switzerland
Authors: Werdin Sophia , Fink Günther , Rajkumar Sarah , Durrer Michael , Gurtner Caroline , Harbauer Gregor , Warnke Ingeborg , Wyss Kaspar 
Published: September 2024

BackgroundSupporting individuals in managing their suicidality can prevent suicidal behavior. This study evaluated the suicide prevention project SERO, which was launched in Central Switzerland in 2021. SERO comprises four components: the suicide risk assessment technique PRISM-S, a personal safety plan, mental health first aid courses for relatives, and a self-management app. We assessed the mental health of individuals at increased suicide risk after hospital discharge and evaluated the usage and usefulness of SERO components.MethodsA cross-sectional study targeted former patients of Lucerne Psychiatry with an increased suicide risk. Between March 2023 and March 2024, we collected data from 24 individuals through a questionnaire administered six months post-discharge. Descriptive statistics characterized sociodemographics, assessed self-efficacy, self-management, and health literacy, and analyzed the usage and usefulness of SERO components. Associations between the usage of SERO components and mental health outcomes were investigated using Wilcoxon rank sum tests.ResultsMental health assessments indicated, on average, low to moderate levels of self-efficacy, self-management, and health literacy, with substantial variations across individuals. Participants’ exposure to SERO components varied: 83% used PRISM-S for suicide risk assessment, 67% developed a personal safety plan, 38% used the SERO app, and 8% reported that their relatives participated in a mental health first aid course. 50% of safety plan users and 44% of SERO app users found the tools helpful before or during a suicidal crisis. 78% of SERO app users would recommend the app to others.ConclusionLow to moderate levels of self-efficacy, self-management, and health literacy underscore the need for targeted interventions to support individuals at suicide risk. Positive feedback on the personal safety plan and the SERO app suggests their potential effectiveness in helping individuals manage their suicidality. Therefore, integrating structured measures for promoting self-management into standard care protocols in psychiatric hospitals and into patients’ lives may contribute to preventing suicides. The main limitation of our study is its small sample size. Future larger-scale studies should investigate user experiences in detail, assess the causal effects of SERO components on specific mental health and suicide outcomes, and evaluate the cost-effectiveness of each component separately and in combination.
Exploring the neural link between childhood maltreatment and depression: a default mode network rs-fMRI study
Authors: Lin Jian , Huang Jialing , Wu Yun , Zhou Linqi , Qiao Changyuan , Xie Jian , Hu Changchun 
Published: September 2024

BackgroundChildhood maltreatment (CM) is increasingly recognized as a significant risk factor for major depressive disorder (MDD), yet the neural mechanisms underlying the connection between CM and depression are not fully understood. This study aims to deepen our understanding of this relationship through neuroimaging, exploring how CM correlates with depression.MethodsThe study included 56 MDD patients (33 with CM experiences and 23 without) and 23 healthy controls. Participants were assessed for depression severity, CM experiences, and underwent resting-state functional MRI scans. Independent Component Analysis was used to examine differences in functional connectivity (FC) within the Default Mode Network (DMN) among the groups.ResultsMDD patients with CM experiences exhibited significantly stronger functional connectivity in the left Superior Frontal Gyrus (SFG) and right Anterior Cingulate Cortex (ACC) within the DMN compared to both MDD patients without CM experiences and healthy controls. FC in these regions positively correlated with Childhood Trauma Questionnaire scores. Receiver Operating Characteristic (ROC) curve analysis underscored the diagnostic value of FC in the SFG and ACC for identifying MDD related to CM. Additionally, MDD patients with CM experiences showed markedly reduced FC in the left medial Prefrontal Cortex (mPFC) relative to MDD patients without CM experiences, correlating negatively with Childhood Trauma Questionnaire scores.ConclusionOur findings suggest that increased FC in the ACC and SFG within the DMN is associated with CM in MDD patients. This enhanced connectivity in these brain regions is key to understanding the predisposition to depression related to CM.
The impact of internet usage on the mental health of older adults in China: empirical analysis from a multi-dimensional perspective
Authors: Lu Wanjun 
Published: September 2024

BackgroundThe process of population aging in China is currently undergoing rapid acceleration. Simultaneously, the swift advancement of digitalization is fundamentally transforming individuals’ lifestyles. The usage of the internet and mobile internet tools by the older adults population is relatively inadequate. The issue of digital exclusion and its impact on the life quality of the older adult population has received significant attention.ObjectiveThis study utilized microdata from the China Health and Retirement Longitudinal Study (CHARLS 2020) to empirically investigate the impact of internet usage on the mental health of older adult individuals. The depression index was utilized to assess the mental health, while four variables were employed to evaluate internet usage among the older adults in this study.MethodsThe Center for Epidemiological Studies Depression Scale (CES-D) in CHARLS data was used to measure the depression index of older adults. Four variables including usage of internet, usage of WeChat, usage of WeChat moments and usage of mobile payment were used to represent the internet use of older adults, and there was progressive relationship between these four variables. In the empirical study, multiple regression analysis was adopted to empirically analysis the impact of internet usage on the mental health of older adults. In order to reduce the influence of endogenous problems on regression results, the propensity score matching method was used to verify the validity and robustness of regression results.Results(1) Internet usage can significantly reduce the psychological depression of older adults and promote the formation of positive psychology; (2) With the increase of the depth of internet usage, especially the use of mobile internet and mobile payment, the internet use will have greater improvement effect on the depression; (3) The heterogeneity test found that there were certain differences in the impact of internet usage on different older adult groups; (4) Through a step-by-step analysis of 10 sub-indicators of depression index, the study found that Internet use mainly affected four indicators: “life hope,” “happiness,” “loneliness” and “life confidence,” while demonstrating no significant effect on other sub-indicators.ConclusionAccording to the research, internet usage can significantly reduce the psychological depression index of the older adults and promote the formation of positive psychology. In China, digital exclusion is more prevalent in rural areas and among the less educated older adults. Public policies can be formulated to enhance internet adoption among these older adults population.
A longitudinal mixed methods evaluation of a facilitation training intervention to build implementation capacity
Authors: Costea Veronica-Aurelia , Bäck Annika , Bergström Anna , Lundin Andreas , Hasson Henna , Eriksson Leif 
Published: September 2024

BackgroundThere is a demand for facilitators who can ease the collaboration within a team or an organization in the implementation of evidence-based interventions (EBIs) and who are positioned to build the implementation capacity in an organization. This study aimed to evaluate the results the Building implementation capacity for facilitation (BIC-F) intervention had on the participants' perceived knowledge, skills, and self-efficacy to facilitate implementation and the normalization of a systematic implementation model into their work routines, and its use into their respective organizations.MethodsThe BIC-F intervention was delivered to 37 facilitators in six workshops, which focused on teaching participants to apply a systematic implementation model and various facilitation tools and strategies. A longitudinal mixed methods design was used to evaluate the intervention. Data was collected pre- and post-intervention using questionnaires and semi-structured interviews grounded on the Normalization Process Theory (NPT). Quantitative data were analyzed using descriptive (mean, SD) and inferential (paired t-tests) methods. Qualitative data were analyzed using deductive content analysis according to NPT.ResultsAn increase in the participants' perceived knowledge, skills, and self-efficacy was observed post-intervention. Normalization of the systematic implementation model in the participants' work routines was in an early phase, facilitated by high coherence, however, other NPT mechanisms were not sufficiently activated yet to contribute to full normalization. In the organizations where participants initiated the normalization process, they were still working towards achieving coherence and cognitive participation among relevant stakeholders.ConclusionThe intervention had positive results on the participants' perceived knowledge, skills, and self-efficacy and these recognized the value of a systematic implementation model for their practice. However, further efforts are needed to apply it consistently as a part of their work routines and in the organization. Future interventions should provide long-term support for facilitators, and include methods to transfer training between organizational levels and to overcome contextual barriers.