bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new clinical classification of congenital biliary dilatation HUAXI CBD classification
Authors: Xie Zhenyu , Pu Siyu , Jin Shuguang , Xiang Bo , Yang Jiayin , Yan Lvnan 
Published: July 2024

Abstract

Objective
To propose a more concise and more suitable classification of congenital biliary dilatation (CBD), and exploring the feasibility and effectiveness of this classification in diagnosis and treatment.
Methods
Based on the preoperative imaging data of patients with CBD admitted to the Department of Pediatric Surgery of West China Hospital of Sichuan University, from January 2015 to December 2018, a new classification of CBD was accomplished according to the site of bile duct dilatation lesions, which was named HUAXI CBD classification. The CBD was classified into 4 types: type Ⅰ (distal extra-hepatic bile duct dilatation), type Ⅱ (distal extra-hepatic combined with right and left primary hepatic bile duct dilatation), type Ⅲ (extra-hepatic combined with secondary and above hepatic bile duct dilatation), and type Ⅳ (intra-hepatic bile duct dilatation). Meanwhile, the feasibility and reliability of the HUAXI CBD classification were analyzed by analyzing the clinical treatment strategies, perioperative complications and long-term follow-up results of different subtypes.
Results
A total of 300 patients with CBD were included in this study. According to the HUAXI CBD classification method, 240 cases were type Ⅰ, 48 cases were type Ⅱ, 10 cases were type Ⅲ, and 2 cases were type Ⅳ. For type Ⅰ, 236 patients underwent cholecystectomy and Roux-en-Y hepaticojejunostomy and 4 cases were treated non-operatively; For type Ⅱ, 48 patients underwent cholecystectomy, central hepatic duct reconstruction and Roux-en-Y hepaticojejunostomy; For type Ⅲ, 9 patients underwent cholecystectomy and Roux-en-Y hepaticojejunostomy, 5 of which had intrahepatic dilatation confined to part of the liver lobe and underwent partial hepatectomy with intra-hepaticojejunostomy. One case was treated with percutaneous transhepatic cholangial drainage (PTCD) only; two type Ⅳ patients were treated with PTCD only. Patients with type Ⅰ had a normal hepatobiliary function after surgery and a good prognosis; patients with type Ⅱ had good recovery of liver function in 37 cases (77.1%), but 11 cases (22.9%) had postoperative complications during follow-up; patients with type Ⅲ and Ⅳ had high incidence of cholangitis (6/10, 2/2, respectively) and choledocholithiasis (5/10, 2/2, respectively) after surgery, especially those with diffuse intrahepatic dilatation having a poor prognosis, eventually developing cirrhosis and necessitating liver transplantation.
Conclusions
The HUAXI CBD classification is consistent with treatment principles, concise and easy to remember, and more suitable for CBD clinical application.
Elevated serum gamma-glutamyl transferase level as a predictor of mortality in patients with anti-MDA5 antibody-positive dermatomyositis
Authors: Hu Wenlu , Zhang Panpan , Ding Yanxia , Dong Fang , Li Tianqi , Yang Lu , Liu Lijun , Zhang Lijuan , Li Tianfang , Liu Shengyun , Zhang Yusheng 
Published: July 2024

Abstract

Background
Gamma-glutamyl transferase (GGT) has been identified to correlate with systemic inflammation in autoimmune diseases, while the role of GGT in anti-melanoma differentiation-associated protein 5 antibody-positive dermatomyositis (MDA5 + DM) remains unknown. This study aimed to investigate the clinical and prognostic significance of serum GGT in MDA5 + DM patients.
Methods
Patients with MDA5 + DM admitted to the First Affiliated Hospital of Zhengzhou University between February 2019 and May 2023 were retrospectively analyzed. We compared the clinical features and prognosis between MDA5 + DM patients with elevated serum GGT levels and those with normal serum GGT levels. Cox regression analysis was performed to identify independent factors associated with mortality.
Results
A total of 299 MDA5 + DM patients were enrolled in this study. During the median follow-up time of 13.1(4.4–28.1) months, 153(51.2%) patients developed rapidly progressive interstitial lung disease (RP-ILD) and 75(25.1%) patients died within 6 months after disease onset. Serum GGT levels were significantly higher in the death group compared to the survival group [95(56–165) vs 45(26–90) U/L, p<0.001]. Based on the serum GGT levels at the time of diagnosis, we divided all the patients into two groups: normal GGT group (GGT ≤ 58U/L, n = 155) and elevated GGT group (GGT>58U/L, n = 144). Compared with the normal GGT group, patients in the elevated GGT group had increased incidences of skin ulcer and RP-ILD, higher levels of lactate dehydrogenase (LDH), Krebs Von den Lungen-6 (KL-6), ferritin and C-reactive protein (CRP), while lower levels of albumin and lymphocyte counts. Moreover, the Kaplan–Meier survival analysis demonstrated that the cumulative survival rate was significantly lower in the elevated GGT group than that in the normal GGT group (log-rank p < 0.001). Multivariate Cox regression analysis revealed that RP-ILD, GGT>58U/L, LDH>345U/L, CRP>5mg/L and anti-Ro52 antibody positivity were independent risk factors of mortality in MDA5 + DM patients.
Conclusions
Elevated serum GGT level was an independent risk factor for mortality in MDA5 + DM patients. As a novel and readily available predictor, serum GGT level may help clinicians in guiding prognostic stratification and personalized treatment.
WITHDRAWN: Seismic Modelling of Complex Hydrocarbon Traps in Shot Domain and Data Processing to Obtain Stack-Migration Sections
Authors: Boğazkesen Şerife , Karslı Hakan 
Published: July 2024

Abstract

The full text of this preprint has been withdrawn, as it was submitted in error. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.
A Survey of Essential Anatomy from the Perspective of Anesthesiology, Emergency Medicine, Obstetrics and Gynecology, and Orthopedics Resident Physicians
Authors: Harmon Derek J. , Hankin Mark H. , Martindale James R. , Niculescu Iuliana , Aschmetat Adrienne , Hanke Rachel E. , Koo Andrew S. , Carpenter Shannon R. , Emmanuel Pamela E. , Pokropek Catherine M. , Koltun Ksenia 
Published: July 2024

Abstract

Background
Recent changes in anatomy curricula in undergraduate medical education (UME), including pedagogical changes and reduced time, pose challenges for foundational learning. Consequently, it is important to determine the essential content for an effective anatomy curriculum.
Methods
This study surveyed 55 non-primary care residents in anesthesiology (AN; N = 6), emergency medicine (EM; N = 15), obstetrics and gynecology (OB; N = 13), and orthopedics (OR; N = 21) to assess the importance of 907 anatomical structures across all anatomical regions. Survey ratings by participants were converted into a post-hoc classification system to provide end-users of this data with an intuitive and useful classification system for categorizing individual anatomical structures (i.e., essential, more important, less important, not important).
Results
Significant variability was observed in the classifications of essential anatomy: 29.1% of all structures were considered essential by OB residents, 37.6% for AN residents, 41.6% for EM residents, and 72.0% for OR residents. Significant differences (with large effect sizes) were also observed between residency groups: OR residents rated anatomy of the back, limbs, and pelvis and perineum anatomy common to both sexes significantly higher, whereas OB residents rated the pelvis and perineum anatomy common to both sexes and anatomy for individuals assigned female at birth highest. Agreement in classifications of importance among residents was observed for selected anatomical structures in the thorax, abdomen, pelvis and perineum (assigned male at birth-specific anatomy), and head and neck. As with the ratings of anatomical structures, OR residents had the highest classification across all nine tissue types (p < 0.01).
Conclusions
The present study, in combination with Hankin et al. (2023), which surveyed primary care residents, contributes to a database of anatomical structures assessed from a clinical perspective that may be considered when determining foundational anatomy for UME curriculum, as well as for graduate medical education.
PIEZO1 targeting in macrophages boosts phagocytic activity and foam cell apoptosis in atherosclerosis
Authors: Pourteymour Shirin , Fan Jingxue , Majhi Rakesh Kumar , Guo Shuyuan , Sun Xin , Huang Zhen , Liu Ying , Winter Hanna , Bäcklund Alexandra , Skenteris Nikolaos-Taxiarchis , Chernogubova Ekaterina , Werngren Olivera , Li Zhaolong , Skogsberg Josefin , Li Yuhuang , Matic Ljubica , Hedin Ulf , Maegdefessel Lars , Ehrenborg Ewa , Tian Ye , Jin Hong 
Published: July 2024

Abstract

The rising incidences of atherosclerosis have necessitated efforts to identify novel targets for therapeutic interventions. In the present study, we observed increased expression of the mechanosensitive calcium channel Piezo1 transcript in mouse and human atherosclerotic plaques, correlating with infiltration of PIEZO1-expressing macrophages. In vitro administration of Yoda1, a specific agonist for PIEZO1, led to increased foam cell apoptosis and enhanced phagocytosis by macrophages. Mechanistically, PIEZO1 activation resulted in intracellular F-actin rearrangement, elevated mitochondrial ROS levels and induction of mitochondrial fragmentation upon PIEZO1 activation, as well as increased expression of anti-inflammatory genes. In vivo, ApoE−/− mice treated with Yoda1 exhibited regression of atherosclerosis, enhanced stability of advanced lesions, reduced plaque size and necrotic core, increased collagen content, and reduced expression levels of inflammatory markers. Our findings propose PIEZO1 as a novel and potential therapeutic target in atherosclerosis.
The value of coronary calcium score in predicting clinical outcomes in patients with chronic coronary syndrome
Authors: Elnagar Basma , Habib Marwa , Elnagar Rehab , Khalfallah Mohamed 
Published: July 2024

Abstract

Background
Coronary artery atherosclerosis and calcification are the precursors to the development of coronary artery disease and its complications. Coronary artery calcium scoring (CACS) is useful as a risk-stratification tool in coronary artery disease.
Objective
The current study was designed to identify the relationship between CACS and major adverse cardiovascular outcomes in patients with stable coronary artery disease.
Methods
The study was conducted on 435 patients with stable ischemic heart disease. The patients were classified into two groups according to their CACS; group I (n: 220 patients) whose calcium score was mild to moderate < 400, and group II (n: 215 patients) whose calcium score was high ≥ 400. All patients were closely monitored for two years to assess major adverse cardiovascular events (MACE).
Results
After 2 years of follow-up, MACE drastically increased in group II in the form of unstable angina, myocardial infarction, demand for PCI, and heart failure. Multivariate regression analysis showed that age ≥ 55 years, Framingham risk score > 10, CACS ≥ 400, body mass index ≥ 30 kg/m2 and the proximal lesions of the vessels were the independent risk factors for major cardiac events.
Conclusion
The coronary calcium score is a distinct feature of coronary atherosclerosis, and a score of 400 or higher is a reliable noninvasive predictor of the progression of coronary artery diseases and their consequences, including MACE.
Blood urea nitrogen to left ventricular ejection fraction ratio: a predictor of in-hospital outcomes in STEMI patients
Authors: Xie Linfeng , Chen Jing , Li Yuanzhu , Shen Jian , Li Xiang , Yang Yuan , Liu Gang , Chen Yintao , Huang Bi , Luo Suxin 
Published: July 2024

Abstract

Background
The in-hospital mortality of ST-elevation myocardial infarction (STEMI) remains as high as 4–12%. Heart and kidney are closely linked, and both renal and cardiac function have been confirmed to be associated with the prognosis in patients with STEMI. This study intends to evaluate the prognostic value of blood urea nitrogen (BUN) to left ventricular ejection fraction (LVEF) ratio (BLR) in STEMI patients.
Methods
From January 2015 to January 2023, 2435 consecutive STEMI patients were enrolled. The primary endpoint was in-hospital all-cause mortality and the second endpoint was major adverse cardiovascular events (MACE) including cardiovascular death, nonfatal stroke, and nonfatal myocardial infarction. The predictive value of BLR was compared with BUN, LVEF, traditional markers and scores (GRACE score and TIMI score) by receiver operating characteristic (ROC) curves, the area under the curve (AUC) were compared by DeLong test. Then patients were divided into two groups based on the cut-off value of BLR determined by Youden index and compared the in-hospital mortality and MACE. The association between BLR and endpoints was investigated by Cox regression.
Results
Totally 2435 patients were included in our study, among which 90 (3.70%) patients died and 110 (4.52%) MACEs were collected. The non-survivors had significantly higher BUN level and lower LVEF value. The AUCs and DeLong test showed that the predictive value of BLR was significantly higher than BUN, LVEF, creatinine, NT-proBNP, and troponin I but was comparable to GRACE score and TIMI scores. The optimal cut-off value of BLR was 12.54 with a sensitivity of 75.6% and a specificity of 67.6%. The in-hospital mortality and MACE was significantly higher in high BLR group (8.23% vs. 1.37% for in-hospital mortality and 9.44% vs. 1.99% for in-hospital MACE, all p < 0.001). After multivariable adjustment, BLR ≥ 12.54 was still independently associated with higher in-hospital mortality (HR = 1.948, 95%CI 1.143, 3.318, p = 0.014) and MACE (HR = 1.720, 95%CI 1.066, 2.774, p = 0.026).
Conclusion
BLR is an important prognostic index to identify patients at high risk of in-hospital prognosis in STEMI patients and the prognostic value was comparable to or even higher traditional scores.
Trial registration
ChiCTR1900028516 (http//www.chictr.org.cn).
High-temperature invariant and Deformation-durable h-BN/PVA Nanocomposite for Highly-reliable Humidity Sensor enabling Morse Code Communication and Real-Time Wireless Respiratory Monitoring
Authors: iqbal shahzad , Khan Shenawar Ali , Ruqia Bibi , Sardar Syed Adil , Kim Woo Young 
Published: July 2024

Abstract

Nowadays, two-dimensional (2D) materials with layered structures and high surface area are highly appealing in humidity sensing applications. Boron nitride emerges as a promising material owing to its exceptional mechanical strength, chemical resistance, and thermal stability. Herein, flexible humidity sensors based on 2D hexagonal boron nitride (h-BN) were synthesized by sonication-assisted exfoliation to introduce oxygen-rich groups to its surface. This process resulted in h-BN nanoflakes with 50–180 nm sizes. Polyvinyl alcohol (PVA), a well-known hydrophilic polymer, was used as the polymer matrix to disperse the h-BN nanoflakes, and the resulting nanocomposite was coated on a flexible interdigitated electrode as a sensing layer. The sensor's response was measured between 10 to 90%RH of humidity levels, and the maximum change in capacitance from 2.2 nF to 79.3 nF, at 1 kHz was recorded with fast response and recovery times of 3.5 s and 4 s, respectively. Moreover, the h-BN/PVA nanocomposite shows remarkable stability under various conditions, such as bending, high temperature, and longer periods, highlighting its durability. The developed sensor was successfully tested in practical applications such as respiratory and proximity-sensing, real-time wireless monitoring for Internet of Things (IoT) applications, and Morse code communication.
Correlation between airway size and imaging examination in OSAHS patients
Authors: Bie Yuanzhi , Zhou Qian , Ding dong , Ren xiuqin , Wan guanglun , Wang yinfeng , Sun jingwu , Sun jiaqiang , Qi xiaoyu 
Published: July 2024

Abstract

Background
The relationship between polysomnography (PSG) and three-dimensional computed tomography (3D-CT) hasn't been well investigated in Obstructive sleep apnea/hypopnea syndrome (OSAHS) .
Objectives
By analyzing PSG and 3D-CT, we obtain anatomical factors that affect the severity of OSAHS.
Methods
78 OSAHS patients were retrospectively analyzed who were admitted to the First Affiliated Hospital of University of Science and Technology of China from January 1, 2022 to November 1, 2023. All of them had completed PSG and upper airway 3D-CT. The correlation between PSG and 3D-CT parameters was analyzed in these OSAHS patients.
Results
The study showed that body mass index (BMI) was significantly correlated with the diameter of soft palate (r = 0.359, p < 0.05). Apnea-hypopnea index (AHI) was significantly correlated with soft palate diameter (r = 0.258, p < 0.05). Mean blood oxygen saturation (MSaO2%) was significantly correlated with the length of soft palate (r= -0.330, p < 0.05). The lowest blood oxygen saturation (LSaO2%) was significantly correlated with the airway area at the level of free edge of epiglottis (r = 0.266, p < 0.05). The cumulative time of oxygen saturation below 90% (CT90) was significantly correlated with the length of soft palate (r = 0.271, p < 0.05). CT90 was positively correlated with the diameter of soft palate (r = 0.269, p < 0.05). Other upper airway anatomical parameters, such as distance from uvula to epiglottis (UED), uvula diameter (UD), posterior pharyngeal wall thickness (PWD), hard palate horizontal airway area (HPA), uvula apex horizontal airway area (UA), hyoid horizontal airway area (HA), were not clearly correlated with AHI and blood oxygen saturation.
Conclusion and significance
The severity of OSAHS is mainly affected by the diameter and length of the soft palate, and the treatment of soft palate is the key to the surgical treatment of OSAHS. In patients with low minimum blood oxygenation, the treatment should focus on expanding the airway area in the plane of the free edge of the epiglottis.
Development of core pain management indicators for hospitalized patients: a Delphi study
Authors: Zhou Yang , Zeng Biyun , Peng Fangmin , Guo Yabin , Liu Xiaotong , zhou Yang 
Published: July 2024

Abstract

Background: Pain is one of the most common symptoms of hospitalized patients. Currently, the hospital-wide incidence of pain ranges from 37.7% to 84%, and the severity of pain during hospitalization is closely related to the prognosis and the quality of hospital care. Effective and accurate monitoring of pain occurrence and intervention is an indispensable step to improve overall performance and patient satisfaction. Currently, the pain management system in the nursing field has not been integrated with the information system, and there are too many indicators, different grading standards, and clinical generalization is not strong. The existing indicators lack specificity and sensitivity, lack of pain management for hospitalized patients related indicators, prone to the problem of imbalance in pain care management.
Objective: To construct high-sensitivity, concise, scientific, and easy-to-implement pain management core indicators for hospitalized patients, providing a reference basis for standardizing pain management during hospitalization.
Methods: First, based on the literature review and hospital evaluation criteria, the core indexes of pain management were collected, screened, and determined, and the framework of the index system was established to form the draft of the core indexes of pain management. Then, core indicators of inpatient pain management were determined by Delphi expert correspondence.
Results: Two rounds of expert consultation were issued 16 questionnaires, all recovered, with a questionnaire response rate of 100%. The results show that the experts are highly motivated. In addition, the average authority coefficient (CR) of 16 experts was 0.972, indicating consistency between expert opinions used and determined. The concordance of the two rounds of expert correspondence was 0.170~0.279 (p < 0.05), and the range of the coefficient of variation (CV) was 0~0.3, which indicated that the concordance among the members of the expert group was excellent and the results were reliable. After 2 rounds of Delphi expert letters, the final determination of 6 in-patient pain management core indicators, included pain screening rate within 8hours of admission, incidence of Pain, Incidence of moderate to severe pain, intervention rate for moderate to severe pain, reassessment rate of moderate to severe pain, and patient satisfaction with pain management.
Conclusion: This study Delphi method to identify six key indicators of pain management in hospitalized patients. The indicators were specific, scientific, concise, and useful for clinical practice, the indexes were extracted and monitored automatically, which provided the basis for improving the quality of pain nursing.
Knowledge of self-care intervention on sexual and reproductive health and its associated factors among women in internally displaced persons camps of North Central Nigeria
Authors: Okorafor Kwala Adline , OYINLOLA FUNMILOLA FOLASADE , ADETUTU OLUFEMI MAYOWA , Leopold Ouedraogo 
Published: July 2024

Abstract

Background
This study assessed individual and household characteristics associated with knowledge and use of self-care practices, including condom use to prevent pregnancies, test blood pressure, use emergency contraception, and pregnancy test among women in IDP camps in FCT Abuja and Benue State. There is limited information on the knowledge and use of self-care practices for women in displaced populations and increased adverse maternal and child health outcomes in this context.
Methods
This was a cross-sectional study which used a quantitative approach. We purposively selected IDP camps in Abuja and Benue State as the main IDP camps for people displaced by the Boko Haram insurgency and farmers-herders crises in the northern parts of Nigeria. A systematic random sampling was used to select women of reproductive age (15-49 years) in this study. The sample size was 842. Data collection was collected through a survey and an interviewer-administered questionnaire. Data were analysed using SPSS statistical software through frequency distribution, Chi-square statistical test and binary logistic regression model.
Results
More than three-quarters of the respondents knew about self-care interventions for sexual and reproductive health interventions, with 44% self-testing for pregnancy, 77% for use of condom for preventing STI/HIV, and 17% for emergency contraception. The results showed that individual and household characteristics were associated with the different self-care practices for SRH needs. At the multivariable analysis, the results indicated that age of respondents (aOR=0.52; CI=0.28-0.99), Islamic religion (aOR=2.42, CI: 1.69-3.45), unemployed women (aOR=10.95, CI: 2.33-51.63), and at the household level, women whose husbands’ earnings were less than #35,000 were significantly associated with self-care practices for SRH needs (aOR=2.62; CI:1.59-4.32).
Conclusion
The study revealed that self-care practices of women in IDP camps in northern Nigeria were influenced by their individual and household socio-economic and demographic characteristics. Although, women who lived in the IDP camp knew about self-care intervention but very few knew about self-testing for pregnancies. It is therefore recommended that people who live in the IDPs should be educated on pregnant self-testing to meet their sexual reproductive health needs.