bluuebunny/crossref_metadata_2025_split huggingface dataset:
External Validation of the ICU-Venous Thromboembolism Risk Assessment Model in Adult Critically Ill Patients
Authors: Zhang Lijuan , Chen Fuyang , Hu Su , Zhong Yanxia , Wei Bohua , Wang Xiaopin , Long Ding 
Published: August 2024

Background Currently, no universally accepted standardized VTE risk assessment model (RAM) is specifically designed for critically ill patients. Although the ICU-venous thromboembolism (ICU-VTE) RAM was initially developed in 2020, it lacks prospective external validation. Objectives To evaluate the predictive performance of the ICU-VTE RAM in terms of VTE occurrence in mixed medical-surgical ICU patients. Methods We prospectively enrolled adult patients in the ICU. The ICU-VTE score and Caprini or Padua score were calculated at admission, and the incidence of in-hospital VTE was investigated. The performance of the ICU-VTE RAM was evaluated and compared with that of Caprini or Padua RAM using the receiver operating curve. Results We included 269 patients (median age: 70 years; 62.5% male). Eighty-three (30.9%) patients experienced inpatient VTE. The AUC of the ICU-VTE RAM was 0.743 (95% CI, 0.682-0.804, P < 0.001) for mixed medical-surgical ICU patients. Comparatively, the performance of the ICU-VTE RAM was superior to that of the Pauda RAM (AUC: 0.727 vs 0.583 , P < 0.001) in critically ill medical patients and the Caprini RAM (AUC: 0.774 vs 0.617, P = 0.128) in critically ill surgical patients, although the latter comparison was not statistically significant. Conclusions The ICU-VTE RAM may be a practical and valuable tool for identifying and stratifying VTE risk in mixed medical-surgical critically ill patients, aiding in managing and preventing VTE complications.
Development of a Risk Assessment Tool for Venous Thromboembolism among Hospitalized Patients in the ICU
Authors: Zhang Chuanlin , Mi Jie , Wang Xueqin , Gan Ruiying , Luo Xinyi , Nie Zhi , Chen Xiaoya , Zhang Zeju 
Published: August 2024

Background ICU patients have a high incidence of VTE. The American College of Chest Physicians antithrombotic practice guidelines recommend assessing the risk of VTE in all ICU patients. Although several VTE risk assessment tools exist to evaluate the risk factors among hospitalized patients, there is no validated tool specifically for assessing the risk of VTE in ICU patients. Methods A retrospective corhort study was conducted between June 2018 and October 2022. We obtained data from the electronic medical records of patients with a variety of diagnoses admitted to a mixed ICU. Multivariable logistic regression analysis was used to evaluate the independent risk factors of VTE. Receiver operating characteristic (ROC) curves were used to analyse the predictive accuracy of different tools. Results A total of 566 patients were included, and VTE occurred in 89 patients (15.7%), 62.9% was asymptomatic VTE. A prediction model (the ICU-VTE prediction model) was derived from the independent risk factors identified using multivariate analysis. The ICU-VTE prediction model included eight independent risk factors: history of VTE (3 points), immobilization ≥4 days (3 points), multiple trauma (3 points), age ≥70 years (2 points), platelet count >250 × 103/μL (2 points), central venous catheterization (1 point), invasive mechanical ventilation (1 point), and respiratory failure or heart failure (1 point). Patients with a score of 0–4 points had a low (1.81%) risk of VTE. Patients were at intermediate risk, scoring 5–6 points, and the overall incidence of VTE in the intermediate-risk category was 17.1% (odds ratio [OR], 11.1; 95% confidence interval [CI], 4.2-29.4). Those with a score ≥7 points had a high (44.1%) risk of VTE (OR, 42.6; 95% CI, 16.4-110.3). The area under the curve (AUC) of the ICU-VTE prediction model was 0.838, and the differences in the AUCs were statistically significant between the ICU-VTE prediction model and the other three tools (ICU-VTE score, Z = 3.723, P < 0.001; Caprini risk assessment model, Z = 6.212, P < 0.001; Padua prediction score, Z = 7.120, P < 0.001). Conclusions We identified eight independent risk factors for acquired VTE among hospitalized patients in the ICU, deriving a new ICU-VTE risk assessment model. The model aims to predict asymptomatic VTE in ICU patients. The new model has higher predictive accuracy than the current tools. A prospective study is required for external validation of the tool and risk stratification in ICU patients.
Thermo-elastic vibration analysis and optimization of a nanoresonator composed of a coupled nanotube system for acoustic liner application using the hybrid deep neural network–based white shark algorithm
Authors: Prasanna Kumar TJ , Sivajibabu K , Durga Prasad B 
Published: August 2024

This study explores the potential of nanoresonator systems composed of coupled nanotubes with graphene nanoparticles for enhancing the performance of acoustic liners in aircraft engines. The objective of this study is to develop an analytical model and predict its behavior under various conditions. The acoustic liners consist of perforated metal sheets and honeycomb cavities, which are essential for noise reduction in aircraft engines. The model is tested for variations in natural frequency, mode number (m), size effects (e0a), viscous constant (C), temperature (T), localness factor (L), and stiffness constant (K). A hybrid deep neural network–based white shark algorithm (DNN-WSA) is used to predict and optimize the performance of nanoresonator-coupled nanotube systems. Four theories were compared, such as wave propagation theory, nonlocal elasticity theory, polynomial eigenvalue approach, and governing equations with respect to natural frequencies in nanoresonator-coupled nanotube systems. The wave propagation theory yielded the lowest natural frequency, which was selected for detailed analysis. The optimized values of size effect of 2 nm, temperature of 5 K, and frequency of 1.971975 THz were obtained. When C = 0.3, K = 10, T = 300, and L = 10×e−9, the root mean square error (RMSE) value is 0.8421, which indicates improved predictive performance as it continues to decrease. The study’s findings showed that changes in viscous constants impact natural frequencies, while size effects have a minor influence. Temperature variations also affect natural frequencies, with higher temperatures leading to higher frequencies. The optimized model demonstrates enhanced predictive performance, which contributes to a better understanding of nanoresonator systems and their application in noise reduction for aircraft engines.
Evaluating the Barriers and Facilitators to Implementing a Novel Referral System for Outpatient Geriatric Services: The Geri-Hub Quality Improvement Initiative
Authors: Lim Fat Guillaume , Kokorelias Kristina M , Foronda Erica , Sadasivan Bindhu , Romanovsky Lindy 
Published: August 2024

Background: In healthcare systems prioritizing care of older adults, resource limitations and escalating demand often impede access to outpatient specialized geriatric services. Objectives: This study, theoretically guided by the Consolidated Framework for Implementation Research (CFIR), aimed to explore barriers and facilitators in implementing a centralized “Geri-Hub.” The Geri-Hub is a centralized intake system established within 2 hospital systems to coordinate outpatient and community-based services for older adults, aiming to connect them with the most appropriate care in a timely manner. Methods: Qualitative insights were gathered from healthcare professionals at 2 academic institutions in the process of consolidating services. Through open-ended surveys and semi-structured interviews, we solicited feedback on referral management, waiting times, and overall work experiences. Results: Thirteen frequently referring providers and a cohort of 9 geriatricians, along with 4 administrators, contributed to the study. Geriatricians emphasized streamlined referrals, flexible scheduling for urgent cases, and a target wait time of 3 months. Administrators stressed standardized referral procedures, defined roles, and accessible referral information. Discussion: The findings underscored the need for straightforward referral processes, enhanced communication on referral statuses, and reduced wait times. Optimizing these processes could potentially mitigate resource utilization issues and improve patient outcomes in healthcare systems. This research highlights the critical role of timely access to geriatric services during transformative phases in healthcare delivery.
Influence of Previous Coronary Artery Bypass Grafting on Clinical Outcomes After Percutaneous Coronary Intervention: A Meta-Analysis of 250 684 Patients
Authors: Larik Muhammad Omar , Ahmed Ayesha , Shahid Abdul Rehman , Irfan Hamza , Irfan Areeka , Jibran Muhammad 
Published: August 2024

Background: Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is the preferred strategy for treating obstructive coronary artery disease. Existing literature suggests the worsening of clinical outcomes in patients with previous coronary artery bypass grafting (CABG) history. In light of this, a comprehensive systematic review and meta-analysis was performed. Methods: Databases including PubMed, Cochrane Library, and ScienceDirect were utilized for the inclusive systematic search dating from inception to September 01, 2023. The risk of bias assessment was performed using the Newcastle-Ottawa scale for cohort studies, and the Cochrane Risk of Bias Tool for randomized controlled trials. Results: Ultimately, there were 16 eligible studies pooled together, involving a total of 250 684 patients, including 231 552 CABG-naïve patients, and 19 132 patients with a prior history of CABG. Overall, patients with CABG history were associated with significantly greater short-term mortality ( P = .004), long-term mortality ( P = .005), myocardial infarction ( P < .00001), major adverse cardiovascular events ( P = .0001), and procedural perforation ( P < .00001). Contrastingly, CABG-naïve patients were associated with significantly greater risk of cardiac tamponade ( P = .02) and repeat CABG ( P = .03). No significant differences in stroke, bleeding, revascularization, or repeat PCI were observed. Conclusion: Comparatively worsened clinical outcomes were observed, as patients with prior CABG history typically exhibit complex coronary anatomy, and have higher rates of comorbidities in comparison to their CABG-naïve counterparts. The refinement of current procedural and surgical techniques, in conjunction with continued research endeavors, are needed in order to effectively address this trend.
A Building Information Modeling driven approach for improving building envelope energy efficiency in hot arid climates
Authors: Eldeeb Sally , Saleh Nada 
Published: August 2024

As a response to growing energy demand and greenhouse gas emissions, enhancing the energy performance of buildings has become a global focus. Studies have shown that building openings are responsible for 40–50% of their energy loss, and these percentages are growing steadily. Silica aerogel represents a potential energy-saving technology for buildings. It has demonstrated its effectiveness as an insulating material in various climates; especially cold climates, however its success in hot arid climates has not been examined yet. Therefore, this paper aims to assess the thermal properties of silica aerogel to determine the dominant parameters that impact its thermal performance in a hot, arid climate. A numerical model of the silica aerogel is conducted using Autodesk Ecotect Analysis. The impact of different factors (thermal conductivity, density, specific heat, and thickness of silica aerogel) on the energy efficiency of the glass window was investigated. Results show that the thickness of silica aerogel has the highest impact on the thermal behavior of silica aerogel, followed by thermal conductivity. Meanwhile, density and specific heat showed a negligible effect on the energy performance of the material. Results showed that a 5 mm-thick aerogel layer and a thermal conductivity of 0.014 W/(mK) exploit the energy performance of the proposed material in hot, arid climates and could provide energy savings of around 63% and 15% in heating and cooling demands, respectively.
The Use of Survival Dose-Rate Dependencies as Theoretical Discrimination Criteria for In-Silico Dynamic Radiobiological Models
Authors: Mingo Barba Sergio , Lobo-Cerna Fernando , Krawczyk Przemek M. , Lattuada Marco , Füchslin Rudolf M. , Petri-Fink Alke , Scheidegger Stephan 
Published: August 2024

Introduction Cell repair dynamics are crucial in optimizing anti-cancer therapies. Various assays (eg, comet assay and γ-H2AX) assess post-radiation repair kinetics, but interpreting such data is challenging and model-based data analyses are required. However, ambiguities in parameter calibration remain an unsolved challenge. To address this, we propose combining survival dose-rate effects with computer simulations to gain knowledge about repair kinetics. Methods After a literature review, theoretical discriminators based on common fractionation/dose-rate-related effects were defined to discard unrealistic model dynamics. The Multi-Hit Repair (MHR) model was calibrated with canine osteosarcoma Abrams cell line data to study the discriminators’ efficacy in scenarios with limited survival data. Additionally, survival dose-rate-dependent data from the human SiHa cervical cancer cell line were used to illustrate the survival behavior at diverse dose-rates and the capability of the MHR to model these data. Results SiHa data confirmed the validity of the proposed discriminators. The discriminators filtered 99% of parameter sets, improving the calibration of Abrams cells data. Furthermore, results from both cell lines may hint universal aspects of cellular repair. Conclusions Dose-rate theoretical discrimination criteria are an effective method to understand repair kinetics and improve radiobiological model calibration. Moreover, this methodology may be used to analyze diverse biological data using dynamic models in-silico.
Female hormonal and reproductive factors and the risk of subarachnoid hemorrhage
Authors: Cao Fang , Liu Junyu , Wang Yuge , He Qingyue , Guo Yuxin , Yan Junxia 
Published: August 2024

Background: Subarachnoid hemorrhage (SAH), primarily caused by rupture of intracranial aneurysm, has a high incidence rate in women. We aimed to evaluate the association between female hormonal and reproductive factors and SAH. Methods: A prospective cohort of 226,469 participants from the UK Biobank was followed for a median period of 14.75 years. Cox proportional hazards models and restricted cubic splines were used to explore the associations between 13 major factors and SAH, including menarche age, menopausal status, age at menopause, reproductive lifespan, pregnancy history, age at first and last live births, number of live births, adverse fertility outcomes, history of oral contraception or hormone-replacement therapy (HRT) use, and surgical history of hysterectomy or bilateral oophorectomy. Results: SAH occurred in 769 of participants during the follow-up period. Both women with a younger age at menarche (< 12 years) and post-menopausal women had a higher SAH risk (hazard ratio (HR), 1.28; 95% confidence interval (CI), 1.06–1.54) and (HR, 1.48; 95% CI, 1.10–1.99), respectively. A higher risk of SAH was identified in those with an earlier age at menopause (< 40 years: HR, 2.09; 95% CI, 1.43–3.06; 40–44 years: HR, 1.68; 95% CI, 1.23–2.29). A shorter reproductive lifespan (< 30 years) was associated with increased SAH risk (HR, 1.64; 95% CI, 1.28–2.11), while a longer reproductive lifespan (> 42 years) showed a protective effect (HR, 0.65; 95% CI, 0.55–0.77). Younger age at first live birth (< 24 years) was associated with SAH (HR, 1.39; 95% CI, 1.13–1.72). Hysterectomy (HR, 2.55; 95% CI, 2.12–3.05) or bilateral oophorectomy (HR, 1.51; 95% CI, 1.14–2.01) also predisposed women to SAH. Age at last live birth, number of live births, pregnancy history, adverse fertility outcomes, and HRT or oral contraceptive use were not associated with SAH. Conclusions: Female hormonal and reproductive factors are important for evaluating SAH risk in women. In particular, earlier menopause is associated with an increased risk of SAH. Data access statement: The data utilized in this study were sourced from a third party and are not publicly accessible. The UK Biobank data that support the findings of this research are available from the UK Biobank (www.ukbiobank.ac.uk), subject to review and approval by the UK Biobank.
Switching related to inefficacy in biologics and targeted synthetic therapies for psoriatic arthritis: a comparative real-life study
Authors: Freites-Nuñez Dalifer , Leon Leticia , Toledano Esther , Candelas Gloria , Martinez Cristina , Rodriguez-Laguna Maria , Rubio Daniel , Fernandez-Gutierrez Benjamin , Abasolo Lydia 
Published: August 2024

Background:Switching between therapies is a recommended strategy for psoriatic arthritis (PsA) patients who experience treatment failure; however, studies including real-life data are scarce.Objectives:To assess the incidence rate (IR) of switching between biologics and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) due to inefficacy in PsA, and to compare the risk of switching due to inefficacy across different b/tsDMARDs groups.Design:A longitudinal retrospective study, spanning from 2007 to 2022, was conducted on patients with PsA treated with b/tsDMARDs at an outpatient rheumatology clinic.Methods:The primary outcome was switching between b/tsDMARDs due to inefficacy. The independent variable was the exposure to b/tsDMARDs during follow-up. As covariates, clinical, treatment-related, and sociodemographic variables were considered. Survival techniques were run to estimate the IR of switching due to inefficacy per 100 patients*year and confidence interval at 95% (95% CI). Cox multivariate regression analyses were run to assess the risk of b/tsDMARDs switching due to inefficacy, expressed as hazard ratio (HR) and 95% CI.Results:In all, 141 patients were included, with 893.09 patients*year follow-ups. 52.48% of them were females in their fifties. In total, 262 courses of treatment were recorded. During the study period, 56 patients presented 121 switches and 103 related to inefficacy (IR: 11.53 (9.51–13.98)). Tumor necrosis factor-alpha inhibitors (TNFi) showed the lowest IR. In the bivariate analysis, all b/tsDMARDs had more risk of switching compared to TNFi (HR: anti-lL-17 vs TNFi: 2.26 (1.17–4.36); others vs TNFi: 3.21 (1.59–6.45)); however, this statistical significance was no longer present in the multivariate analysis once adjustments were made for the covariates. Still, the final model achieved statistical significance in the following variables: gender, clinical symptoms, prescription year, therapy courses, glucocorticoids, and sulfasalazine.Conclusion:In this study, we did not find differences in the rate of switching due to inefficacy among different groups of b/tsDMARDs. Other concomitant treatments, sociodemographic, and clinical variables were identified as risk factors for switching due to inefficacy.
A systematic review on factors influencing Middle Eastern women’s utilization of healthcare services: The promise of mHealth
Authors: Khosravi Mohsen , Mojtabaeian Seyyed Morteza , Aghamaleki Sarvestani Mina 
Published: August 2024

Objectives: The 2030 Sustainable Development Agenda stresses a feminist approach for healthcare services. Cultural and religious influences impact utilization of healthcare services by Muslim women within the Middle East, posing unique challenges. This paper aimed to investigate the factors influencing Middle Eastern women’s utilization of healthcare services within the region. Methods: In the year 2024, a systematic review was conducted. PubMed, Scopus, ProQuest, and the Cochrane Database of Systematic Reviews were searched for this purpose. The quality of the included articles was assessed using the Accuracy, Coverage, Objectivity, Date, Significance (ACODS) checklist. Subsequently, the Joffe method of thematic analysis was employed to analyze the data obtained from the review. Results: A final selection comprising 59 studies was made for inclusion in the research. The studies demonstrated a high level of quality, and the risk of bias within them was deemed acceptable. The thematic analysis revealed seven principal themes, which encompassed Demographic Factors, Level of Education and Awareness, Sources of Information, Risk Factors, Personal Factors, Level of Service Access and Quality, and Organizational Factors. Conclusions: This study highlighted key factors influencing women’s utilization of healthcare in the Middle East and potentially the healthcare systems with a large number of Middle Eastern female immigrants around the globe: educational factors such as awareness campaigns and patient education, and personal barriers like fear and cultural norms. Moreover, Telehealth, particularly mHealth, was suggested to enhance women’s participation and utilization of healthcare services. Further research is needed to explore this assertion with greater precision.
Load Changes on a Short-Segment Posterior Instrumentation After Transosseous Disruption of L3 Vertebra – A Biomechanical Human Cadaveric Study
Authors: Heumann Maximilian , Jacob Alina , Gueorguiev Boyko , Richards R. Geoff , Benneker Lorin M. 
Published: August 2024

Study Design Biomechanical Cadaveric Study. Objectives Following the successful use of a novel implantable sensor (Monitor) in evaluating the progression of fracture healing in long bones and posterolateral fusion of the spine based on implant load monitoring, the aim of this study was to investigate its potential to assess healing of transosseous fractures of a lumbar vertebra stabilized with a pedicle-screw-rod construct. Methods Six human cadaveric spines were instrumented with pedicle screws and rods spanning L3 vertebra. The spine was loaded in Flexion-Extension (FE), Lateral-Bending (LB) and Axial-Rotation (AR) with an intact L3 vertebra and after its transosseous disruption, creating an AO B1 type fracture. The implant load was measured on the one rod using the Monitor and on the contralateral rod by strain gauges to validate the Monitor’s measurements. In parallel, the range of motion (ROM) was assessed. Results ROM increased significantly in all directions in the fractured model ( P ≤ 0.049). The Monitor measured a significant increase in implant load in FE ( P = 0.002) and LB ( P = 0.045), however, not in AR. The strain gauge – aligned with the rod axis and glued onto its posterior side – detected an increased implant load not only in FE ( P = 0.001) and LB ( P = 0.016) but also in AR ( P = 0.047). Conclusion After a complete transosseous disruption of L3 vertebra, the implant load on the rods was considerably higher vs the state with an intact vertebral body. Innovative implantable sensors could monitor those changes, allowing assessment of the healing progression based on quantifiable data.