bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical features and associated factors of impaired ventilatory efficiency: findings from the ECOPD study in China
Authors: Deng Zhishan , Wu Fan , Wan Qi , Dai Cuiqiong , Lu Lifei , Peng Jieqi , Zhou Kunning , Wu Xiaohui , Tang Gaoying , Huang Suyin , Cai Guannan , Huang Peiyu , Wang Zihui , Zheng Youlan , Yang Huajing , Zhao Ningning , Xiao Shan , Wen Xiang , Sun Ruiting , Yang Changli , Huang Yongqing , Chen Rongchang , Zhou Yumin , Ran Pixin 
Published: July 2024

BackgroundImpaired ventilatory efficiency during exercise is a predictor of mortality in chronic obstructive pulmonary disease. However, little is known about the clinical features and associated factors of impaired ventilatory efficiency in China.MethodsWe conducted a cross-sectional community-based study in China and collected demographic and clinical information, cardiopulmonary exercise testing, spirometry, and CT data. Impaired ventilatory efficiency was defined by a nadir ventilatory equivalent for CO2production above the upper limit of normal. Multivariable linear and logistic regression models were used to explore the clinical features and associated factors of impaired ventilatory efficiency.ResultsThe final analyses included 941 subjects, 702 (74.6%) of whom had normal ventilatory efficiency and 239 (25.4%) had impaired ventilatory efficiency. Participants with impaired ventilatory efficiency had more chronic respiratory symptoms, poorer lung function and exercise capacity, and more severe emphysema (natural logarithm transformation of the low-attenuation area of the lung with attenuation values below −950 Hounsfield units, logLAA−950: 0.19±0.65 vs −0.28±0.63, p<0.001) and air trapping (logLAA−856: 1.03±0.65 vs 0.68±0.70, p<0.001) than those with normal ventilatory efficiency. Older age (60–69 years, OR 3.10 (95% CI 1.33 to 7.21), p=0.009 and 70–80 years, OR 6.48 (95% CI 2.56 to 16.43), p<0.001 vs 40–49 years) and smoking (former, OR 3.19 (95% CI 1.29 to 7.86), p=0.012; current, OR 4.27 (95% CI 1.78 to 10.24), p=0.001 vs never) were identified as high risk factors of impaired ventilatory efficiency.ConclusionsImpaired ventilatory efficiency was associated with poorer respiratory characteristics. Longitudinal studies are warranted to explore the progression of individuals with impaired ventilatory efficiency.
Concealed firearm carrying laws and defensive firearm use in public locations of US metropolitan areas, 1986–2004
Authors: Koper Christopher S , Lu Yi-Fang , Dong Beidi 
Published: July 2024

ObjectivesThere has been extensive debate in the USA as to how laws regulating the carrying of concealed firearms affect crime and public safety. This study examines whether US state laws making it easier for civilians to obtain permits to carry concealed handguns in public increase defensive gun uses against violent threats and attacks in public.MethodsWe used National Crime Victimization Survey data from 39 metropolitan statistical areas (MSAs) in the USA over a 19-year period (1986–2004) to examine whether laws making it easier for civilians to obtain concealed carry permits are linked to higher levels of defensive gun use against violence in public spaces of metropolitan areas. Bivariate χ2tests and multivariate logistic regression models (controlling for actor and situational characteristics) were used with 7196 public incidents to examine whether the likelihood of the victim using a gun against an attacker(s) varied based on the type of concealed carry law in the MSA at the time of the incident.ResultsThe prevalence of self-defensive gun use in this sample was not clearly related to the passage of permissive gun carrying laws. Although defensive gun use was more common in MSAs with permissive gun carrying laws, this difference was not consistently related in magnitude or statistical significance to the passage of those laws or the length of time they had been in effect.ConclusionsPermissive concealed carry permit laws do not produce evident increases in self-defensive gun uses against crime in public locations.
Validation of the hotspot for dorsolateral subthalamic nucleus targeting in deep brain stimulation surgery for Parkinson’s disease: a post hoc analysis of a randomised controlled trial
Authors: Bolier Erik , Holewijn Rozemarije , De Bie Rob M A , Beudel Martijn , van den Munckhof Pepijn , Schuurman Richard , Bot Maarten 
Published: July 2024

BackgroundVisualisation of the dorsolateral subthalamic nucleus (STN) remains challenging on 1.5 and 3Tesla T2-weighted MRI. Our previously defined hotspot, relative to the well-visualised medial STN border, serves as an MRI landmark for dorsolateral STN identification in deep brain stimulation (DBS). We aimed to validate this hotspot in a separate trial cohort of Parkinson’s disease (PD) patients and refine its location.MethodsIn this post hoc analysis of a randomised controlled trial, in which the hotspot was taken into account during target planning, responses to DBS were evaluated using hemibody improvement on the Movement Disorder Society–Unified Parkinson’s Disease Rating Scale motor examination and compared with our historical cohort, as well as dopaminergic medication reduction. Then, a refined hotspot was calculated and the Euclidean distance from individual active contacts to the refined hotspot was correlated with motor improvement.ResultsThe first quartile of the hemibodies (poor responders) showed an average improvement of 13%, which was higher than the —8% in the historical control group (p=0.044). Dopaminergic medication reduction was greater in the current cohort compared with the historical cohort (p=0.020). Overall variability of hemibody motor improvement was reduced in the current cohort compared with the historical control group (p=0.003). Motor improvement correlated to the Euclidean distance from active contact to the refined hotspot (2.8 mm lateral, 1.1 mm anterior and 2.2 mm superior to the medial STN border) (p=0.001).ConclusionWe validated the hotspot for dorsolateral STN targeting in DBS for patients with PD and showed an improved motor response in poor responders, a reduced variability in motor improvement and a greater dopaminergic medication reduction. We then refined the hotspot at 2.8 mm lateral, 1.1 mm anterior and 2.2 mm superior relative to the medial STN border, which visualises a readily implementable target within the dorsolateral STN on lower field strength MRI.
Socioeconomic burden of AQP4-antibody seropositive NMOSD: a nationwide registry-based study
Authors: Papp Viktoria , Wandall-Holm Malthe , Bacher Svendsen Kristina , Frederiksen Jette , Sellebjerg Finn , Illes Zsolt , Magyari Melinda 
Published: July 2024

BackgroundAQP4-antibody seropositive (AQP4-Ab+) neuromyelitis optica spectrum disorder (NMOSD) may cause reduced work capability due to disability. Here, we evaluated the socioeconomic status of patients with AQP4-Ab+NMOSD in off-label therapy era compared with the general population.MethodsA longitudinal nationwide population-based study including all Danish patients with AQP4-Ab+NMOSD and matched controls from the general population. The cohort was linked to other Danish nationwide population-based databases. The study period was from 1992 to 2021. The main outcomes were loss of income from salary, limited work capability, disability pension and civil status. The longitudinal risks of outcomes were presented in cumulative incidence curves. Fisher’s exact test, χ2test or Wilcoxon test were applied for comparison.ResultsWe included 65 patients with a median follow-up of 8.6 years. Annual income declined significantly after disease onset (index year) compared with the general population. One year after the index year, the median annual income in 2015-indexed Euro for patients averaged 13 285 (IQR: 139 to 36 336) versus controls 33 035 (IQR: 6870 to 45 978); p=0.04. Five years postindex year, the average income for patients further dropped to 276 (IQR: 0 to 23 691) versus controls 22 141 (IQR: 0 to 42 986); p=0.03. At the end of follow-up, significantly higher proportion of patients were either in ‘flexjob’ (36.9% patients vs 14% controls, p<0.00) or receiving disability pension (16.9% patients vs 4.3% controls, p<0.00).ConclusionsThe socioeconomic status of patients with AQP4-Ab+NMOSD deteriorates rapidly following disease onset. A substantial proportion of these patients lose their work capacity leading to increased financial burden on both their families and society.
External workload and cognitive performance of a tactical military scenario-based field exercise
Authors: Walker Faye S , Needham-Beck S C , Vine C A J , Blacker S D , Greenlees I , Sharpe B T , Siddall A G , Maroni T , Ashdown K M , Hinde K L , Elliott E , Rayson M , Knight E , Myers S D 
Published: July 2024

IntroductionMilitary personnel must manage a multitude of competing physiological and cognitive stressors while maintaining high levels of performance. Quantifying the external workload and cognitive demands of tactical military field exercises closely simulating operational environments, will provide a better understanding of stressors placed on personnel to inform evidence-based interventions.MethodsThirty-one soldiers completing a dismounted 48 hours tactical field exercise, participated in the study. External workload was quantified using a wrist-worn triaxial accelerometer, with cognitive function (Go-/No-Go, N-back, psychomotor vigilance task and subjective workload ratings (NASA-TLX) assessed pre-exercise, mid-exercise and postexercise. Physical activity was described using Euclidian Norm Minus One (mg), with moderate vigorous physical activity (MVPA) and sedentary light physical activity (SLPA) as ≥ or <113 mg, respectively. Changes in general cognitive performance (total accuracy-speed trade-off (ASTO) % change) and function outcome variables (overall mean reaction time, ASTO and number of correct and missed responses) were calculated for each assessment from pre-exercise, to mid-exercise and postexercise.ResultsFor the exercise duration (50:12±02:06 hh:mm) participants spent more time completing SLPA compared with MVPA (1932±234 vs 1074±194 min;p<0.001), equating to 33% of the time spent completing MVPA. Overall cognitive performance decreased over the exercise (pre-to-post: −249). However, the largest decrement was observed pre-to-mid (−168). Perceived mental demand associated with the cognitive assessments significantly increased over the duration of the exercise (pre-: 33; mid-: 38 and post-: 51; χ2F(2)= 26.7,p= <0.001, W=0.477) which could suggest that participants were able to attenuate a further decline in cognitive performance by investing more effort/mental resources when completing assessments.ConclusionThe study successfully quantified the physical activity, and subsequent impact on cognitive function, in soldiers completing a 48 hours tactical field exercise. Further research is needed to better understand how physiological stressors interact with cognitive function during military operations.
Clinical Characteristics, Predictors for Mortality and Comparison of the Birmingham Vasculitis Activity Score and the Five-Factor Score on Survival in ANCA-Associated Vasculitis in Hong Kong
Authors: Yeung Joshua Ka Ho , Young Joyce Kit Yu 
Published: July 2024

Objective: To describe the clinical profile and predictors of mortality of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients in Hong Kong. To compare the accuracy of the latest Five-Factor Score (FFS-2009) and the Birmingham Vasculitis Activity Score (BVAS) in prediction of survival with this local cohort. Methods: A retrospective observational study on newly diagnosed AAV patients, from January 1, 2011 to March 31, 2022, managed in the Kowloon West Cluster (KWC) hospitals in Hong Kong. Demographic and baseline characteristics, clinical profile, and treatment profile were reviewed. Factors associated with mortality were analyzed with the Cox proportional hazards model. The performances of FFS and BVAS in mortality prediction were analyzed by receiver operating characteristic (ROC) curves. Results: A total of 83 AAV patients were included in the study. The median age was 70.5 years at diagnosis. Microscopic polyangiitis (MPA; 69.9%) was the most common AAV subtype. The median FFS and BVAS were 2 and 20, respectively. The overall mortality was 45.6% across the study period. Multivariate Cox regression identified age at diagnosis (HR 1.043, [Formula: see text]), stabilized peak serum creatinine (HR 1.002, [Formula: see text]), hemoglobin level (HR 0.754, [Formula: see text]), cardiac involvement (HR 3.862, [Formula: see text]), and use of maintenance therapy (HR 0.261, [Formula: see text]) as independent predictors of overall survival. Both FFS and BVAS were significant predictors of overall survival. The areas under the curve (AUC) of ROC curves suggested FFS was a good prediction tool for early mortality in 1 year, with an AUC value of 0.874. Conclusion: Despite the advances in treatment, AAV still carried significant morbidities with high mortality. Clinical predictors and existing scoring systems showed good predictive power on mortality.
Endodontic Treatment of Maxillary Premolar With Three Roots: A Case Report
Authors: Jiannan Chen , Yangpeng Zhao , Huanhuan Sun , Qiang Zhu 
Published: July 2024

Background: The aim of this case was to understand and treat the intricate root canal anatomy observed in complex maxillary first premolars, particularly those exhibiting three root canals, emphasizing the significance of understanding root canal morphological variations in their treatment.Conclusions: This case reported the methods of treating three‐root canal maxillary first premolars, including warm vertical compression technique, root canal microsurgery, and the application of rubber dam. The utilization of dental operating microscopes, various surgical strategies, and key assessments of X‐rays and cone beam computed tomography (CBCT) scans were all essential steps for achieving accurate and safe root canal therapy.
Blood Magnesium Level and Risk of Hepatocellular Carcinoma in a Prospective Liver Cirrhosis Cohort
Authors: Zhang Xinyuan , Zhao Longgang , Dai Qi , Hou Tao , Danford Christopher J. , Lai Michelle , Zhang Xuehong 
Published: July 2024

Abstract

Background:
Higher magnesium intake was linked to a lower risk of hepatocellular carcinoma (HCC). However, the relationship between blood magnesium level and HCC has not been fully characterized, especially among patients with liver cirrhosis who are at a higher risk for HCC.

Methods:
In the Mass General Brigham Biobank, we developed a new prospective cohort of 1,430 patients with liver cirrhosis without liver cancer history using the validated International Classification of Diseases codes. We used Cox proportional hazards models to generate hazard ratios (HRs) with 95% confidence intervals (CI) for incident HCC and used generalized estimating equations to compare changes in liver biomarkers according to baseline blood magnesium, adjusting for age, sex, race, lifestyles, body mass index, type 2 diabetes, model for end-stage liver disease score, and hepatitis infection.

Results:
During a median follow-up period of 4.26 years, 109 patients developed HCC. Magnesium deficiency (&lt;1.70 mg/dL; N = 158) was associated with a higher risk of HCC (HR = 1.93; 95% CI, 1.12–3.30) compared with magnesium sufficiency (≥1.70 mg/dL; N = 1282). This association remained robust in the 1-year lag analysis (HR = 2.18; 95% CI, 1.11–4.28) and in sensitivity analysis excluding patients with alcoholic liver disease (HR = 2.41; 95% CI, 1.23–4.74). Magnesium in the lowest quartile was associated with a faster increase in alanine transaminase (β = 4.35; 95% CI, 1.06–7.63), aspartate aminotransferase (β = 6.46; 95% CI, 0.28–12.6), direct bilirubin (β = 0.18; 95% CI, 0.01–0.35), and total bilirubin (β = 0.21; 95% CI, 0.03–0.39), compared with the highest quartile.

Conclusions:
Lower blood magnesium level is associated with higher HCC risk and unfavorable liver biomarker changes.

Impact:
If confirmed, our findings may potentially enable better identification of high-risk patients for HCC and inform better management strategies for liver cirrhosis.
Nomenclatural notes on type materials of fourteen names in Lythraceae
Authors: PRASANTH ARUN , SARDESAI MILIND M. 
Published: July 2024

In the present study, we designate lectotypes and epitypes for fourteen names (for accepted names/basionyms/synonyms) of three genera Ammannia, Lagerstroemia, and Rotala of family Lythraceae, to facilitate the correct application of these names. Lectotypes are designated for three names in Ammannia, three names in Rotala, and four names in Lagerstroemia. Second-step lectotype are designated for two names in Rotala and one name in each Ammannia and Lagerstroemia. Further, an epitype for the name Rotala floribunda is assigned.
Protocolized Gastrointestinal Fistula Management is Superior to Historic Data and National Averages: A Retrospective Review of an Enterocutaneous Fistula Registry
Authors: Moore Lucie , Entelisano Trina , McKean Jordan , Vanzant Erin , Rosenthal Martin 
Published: July 2024

Background: Enterocutaneous fistula (ECF) management remains a complex clinical problem. Prehabilitation (prehab) protocols are becoming more popular. The prehabilitation protocol used in this paper was adopted in 2017 at the University of Florida. The Fistula Registry at University of Florida has captured the efforts of the UFAIR (University of Florida Abdominal Wall Reconstruction and Intestinal Rehab) service. We analyzed if the prehabilitation program is successful in reducing deaths, length of stay, recurrence of fistula, and readmissions to the hospital in our database. Methods: Charts were queried for patients with ECF/EAF from the UFAIR database from January 1, 2017, until present day. Several factors were recorded including: cause of fistula, recurrence of fistula, wound infection, postoperative sepsis, hospital length of stay, postoperative ICU length of stay, postoperative length of stay, death, discharge disposition, and if taken back to surgery. Results: 31 patients underwent prehabilitation while 30 patients underwent standard nutritional therapy. No deaths were reported in the prehab group, compared to 7 deaths in the standard group ( P = .006). The prehab population had an average hospital stay of 15.19 days while the standard group had an average stay of 21.16 days ( P = .045). 2/31 in the prehab protocol had a recurrence of ECF while 10/30 in the standard protocol recurred ( P = .01). Conclusions: Our study showed promising data for the effects of prehabilitation protocol for patients with ECF. The outcomes of those in the prehab protocol surpassed historical outcomes. Our patients had no deaths, shorter hospital stays, and lower rates of recurrence.
Sensorimotor Challenges in Minimally Invasive Surgery: A Theoretically-Oriented Review
Authors: Hewitson Christopher L. , Crossley Matthew J. , Cartmill John , Kaplan David M. 
Published: July 2024

Objective This review surveys the literature on sensorimotor challenges impacting performance in laparoscopic minimally invasive surgery (MIS). Background Despite its well-known benefits for patients, achieving proficiency in MIS can be challenging for surgeons due to many factors including altered visual perspectives and fulcrum effects in instrument handling. Research on these and other sensorimotor challenges has been hindered by imprecise terminology and the lack of a unified theoretical framework to guide research questions in the field. Method We conducted a systematic survey of the MIS literature, focusing on studies investigating sensorimotor challenges affecting laparoscopic performance. To provide a common foundation for cross-study comparisons, we propose a standardized taxonomy that distinguishes between different experimental paradigms used in the literature. We then show how the computational motor learning perspective provides a unifying theoretical framework for the field that can facilitate progress and motivate future research along clearer, hypothesis-driven lines. Results The survey identified diverse sensorimotor perturbations in MIS, which can be effectively categorized according to our proposed taxonomy. Studies investigating monitor-, camera-, and tool-based perturbations were systematically analyzed, elucidating their impact on surgical performance. We also show how the computational motor learning perspective provides deeper insights and potential strategies to mitigate challenges. Conclusion Sensorimotor challenges significantly impact MIS, necessitating a systematic, empirically informed approach. Our proposed taxonomy and theoretical framework shed light on the complexities involved, paving the way for more structured research and targeted training approaches to enhance surgical proficiency. Application Understanding the sensorimotor challenges inherent to MIS can guide the design of improved training curricula and inform the configuration of setups in the operating room to enhance surgeon performance and ultimately patient outcomes. This review offers key insights for surgeons, educators, and researchers in surgical performance and technology development.
Evaluation of multi-walled carbon nanotubes alignment during 3D printing of poly(acrylonitrile-butadiene-styrene) nanocomposite filaments
Authors: Garoosi Keyvan , Ghaffarian Seyed Reza , Razavi-Nouri Mohammad , Rezadoust Amir Masood , Soheilpour Zahra 
Published: July 2024

Nanocomposites incorporated with one-dimensional electrical conductive materials such as carbon nanotubes have been used in many applications in various industries. In this research, the filaments made of poly (acrylonitrile-butadiene-styrene) (ABS) containing 1, 3, and 5 wt% multi-walled carbon nanotubes (MWCNT) were first prepared and then printed in three directions and two printing speeds. The rheological and electrical percolation thresholds were found to take place at 0.32 and 0.96 wt% MWCNT, respectively. Using the Casson plot, it was revealed that the yield stress of the nanocomposites containing 5 wt% MWCNT was 70 times higher than that of the pristine ABS. The results also indicated that the electrical resistance decreased from 17.4 to 6.8 Ω with the increase in printing speed from 4 to 20 mm/s, respectively. The alignment of the nanofillers was examined using X-ray diffraction method. It was found from the azimuth angle that the materials printed at higher printing speed had more orientation, with respect to the director, in comparison with that of printed at lower speed.