bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-linear Association of Alkaline Phosphatase-to-Albumin Ratio with All-Cause and Cancer Mortality: Evidence from NHANES 2005-2016
Authors: Wang Jiang , Wang Bo , Yuan Shiwang , Cheng Guangyi , Deng Sijia , Wang Yuyan , Shen Yu , Li Liantao 
Published: April 2024

Abstract

Background The relationship between the alkaline phosphatase-to-albumin ratio (APAR) and mortality remains unclear. This research looked into the association between APAR levels and cause-specific mortality in US adults.
Methods A cohort of 7561 participants from NHANES (2005-2016) was analyzed, with mortality outcomes collected from National Death Index (NDI) records. Cox proportional hazards models and restricted cubic spline (RCS) analysis were utilized to determine hazard ratio (HR) and reveal the non-linear relationship between APAR levels and mortality. Inflection points were calculated using a recursive algorithm.
Results Followed for an average 99.41 months, a total of 1048 deaths occurred, including 200 cancer deaths and 348 cardiovascular disease (CVD)-related deaths. Following multivariate adjustment, significant associations were observed between APAR levels and increased all-cause and CVD mortality. Furthermore, non-linear correlations between APAR levels and all-cause and cancer mortality were revealed, characterized by an L-shaped pattern, with mortality rates stabilizing at 1.289 and 2.167, respectively. Participants with APAR levels above the inflection point exhibited a 29.2% increase in all-cause mortality risk per unit increase in APAR levels (HR 1.292, 95% CI 1.217-1.372), and a 38.3% increase in cancer mortality risk (HR 1.383, 95% CI 1.199-1.596).
Conclusion This study demonstrated non-linear associations between APAR levels and all-cause and cancer mortality. Thresholds of 1.289 and 2.167 might serve as potential targets for APAR to reduce all-cause and cancer mortality, respectively. Nevertheless, these findings necessitate validation through large-scale clinical trials for further substantiation.
Development of An Intelligent Mobile Application based on A Cloud Integrated Information System for Car Rental Services.
Authors: Tuyambaze Thacianne , Mkoba Elizabeth , Mgawe Bonny , Mbunda Beatus 
Published: April 2024

Abstract

Car rental companies have used technology to improve their operations, including mobile applications and information management systems. This project addresses the evolving needs of the automobile rental sector, focusing on Solidarity Car Rental company. The Solidarity Car Rental faces challenges such as multiple bookings, inefficient system integration, and managing customer feedback. To tackle these issues, an intelligent mobile application based on a cloud integrated information system was developed. Both Qualitative and quantitative research methods were employed, revealing that the system enables seamless browsing, reservations, and secure payments for customers. Internally, it streamlines operations, automates invoicing, facilitates real-time reporting, and enhances car management. Security measures ensure data protection, with Microsoft Azure used for scalability and integration. This solution reduces delays, boosts client satisfaction, and enhances operational efficiency, optimizing rental processes and ensuring adaptability to industry dynamics. It marks a significant evolution in Tanzania's car rental management systems, enhancing efficiency and competitiveness
Association of Urinary Nitrate with Blood Pressure, Prevalence of Cardiovascular Diseases and Cardiovascular Mortality in Hypertensive Population
Authors: Zhao Wei , Chen Yunlin , Wang Kai , Zhang Bo , Du Huaan , Wang Zihao , Yi Xin , Ling Zhiyu , Yin Yuehui 
Published: April 2024

Abstract

Background: Although the association of dietary nitrate intake and improved blood pressure and cardiovascular outcomes has been confirmed in healthy individuals and non-cardiovascular disease (CVD) population, it still remains uncertain whether the protective effect of inorganic nitrate remains significant in the hypertensive population.
Methods: This study analyzed health data of 5,989 hypertensive participants based on the National Health and Nutrition Examination Survey (NHANES) database between 2005 and 2014. The correlation between urinary nitrate and blood pressure, the prevalence of CVD subtypes and cardiovascular mortality were assessed respectively. Mediating effect analysis and subgroup analysis was performed.
Results: Within a range of 0-4.34 mg/dL, an inverse linear correlation between urinary nitrate and systolic blood pressure (SBP) was observed (β= -0.84; 95% CI -1.28, -0.41; P<0.001). The increase in urinary nitrate was associated with a decreased prevalence of heart failure (OR=0.914; 95% CI 0.859, 0.972; P=0.006). Urinary nitrate was inversely associated with cardiovascular mortality (HR=0.906; 95% CI 0.864, 0.951; P<0.001). Neither SBP nor coexisting heart failure at baseline mediated the association between urinary nitrate and cardiovascular mortality. Subgroup analysis showed that the inverse association between urinary nitrate and cardiovascular mortality was influenced by smoking, coexisting coronary heart disease and heart failure at baseline.
Conclusions: In hypertensive individuals, an appropriate increase in urinary nitrate was associated with a reduction in SBP, a diminished incidence of heart failure, and a mitigated risk of cardiovascular mortality. These findings suggested urinary nitrate as a plausible marker for monitoring cardiovascular health.
Protective effects of sitagliptin on cholemic nephropathy: the role of sesterin2, and Nrf2/SOD pathway
Authors: akhbari Mohammad , Khaksari Mohammah , Askaripour Majid , Jafari Elham , Saberi Shadan 
Published: April 2024

Abstract

Background
Cholestasis or bile duct ligation (BDL) could develop cirrhosis and may lead to other organ dysfunction, including kidneys which, is called cholemic nephropathy (CN). Hyperbilirubinemia, bile acid accumulation, renal hypoperfusion, oxidative stress, and inflammation are implicated in the pathogenesis of CN. Sitagliptin is an oral antihyperglycemic drug with anti-inflammatory and anti-oxidative effects. The effects of sitagliptin on CN is unknown.
Methods
BDL was performed to induce CN model in 42 male Wistar rats (200–250 gr), which were divided equally into six groups: sham-operated received distilled water as the vehicle (sham + veh), sham received 50mg/kg sitagliptin (sham + sit 50), BDL group, BDL + sit 10, BDL + sit 50, BDL + sit 100 groups, received sitagliptin 10, 50, and 100mg/Kg respectively for 14 days by gavage. Aspartate transferase, alkaline phosphatase, total bilirubin (T-Bil), serum and urine biomarkers of renal function, redox system status, TNF-α, and renal histopathology were assessed.
Results
Induction of BDL increased serum liver enzymes, T-Bil, creatinine (Cr), urea, urine Cr, albumin to Cr ratio, and decreased Cr clearance. Renal sestrin2, malondialdehyde, TNF-α, renal index, and kidney tissue injury score were elevated, while superoxide dismutase activity, total antioxidant capacity, and nuclear factor erythroid 2–related factor 2 (Nrf2) were reduced. Treatment with sitagliptin especially in low dose reverse these effects.
Conclusions
Sitagliptin improves renal injury and function via ameliorating inflammation and oxidative stress by activating Nrf2/SOD pathway in BDL rats. Sitagliptin might be helpful in treating renal complications in cirrhosis and severe liver disease.
Psychometric Properties of the Arabic Translation of the Psy-Flex Scale in a sample of Lebanese Adolescents
Authors: Topalian Michael , Mir Rita El , Malaeb Diana , Sakr Fouad , Dabbous Mariam , Hallit Souheil , Fekih-Romdhane Feten , Obeid Sahar 
Published: April 2024

Abstract

Background:Psychologic flexibility, integral to mental wellbeing, has gained popularity for its role in fostering adaptive coping mechanisms. However, research on this subject in the Middle Eastern population, particularly among adolescents, is limited. This study aimed to examine the psychometric properties of an Arabic translation of the Psy-Flex Scale in a sample of Lebanese adolescents.
Methods: Using a cross-sectional design, 793 adolescents form all districts/governorates participated in the study conducted in November 2023 using a snowball sampling technique. The Psy-Flex Scale and the Depression Anxiety Stress Scale were used in this study.
Results: CFA indicated that the fit of the one-factor model of the Psy-Flex Scale was modest: RMSEA = .109 (90% CI .090, .130), SRMR = .039, CFI = .948, TLI = .914. The modification index between items 3 and 6 was high; after adding a correlation between those residuals, the fit indices improved: RMSEA = .089 (90% CI .069, .112), SRMR = .033, CFI = .969, TLI = .942. The composite reliability of scores was adequate in the total sample (ω = .84 / α = .84). We were able to show the invariance across sex at the configural, metric, and scalar levels. No significant difference was seen between males and females in terms of psychological flexibility scores (17.91 ± 4.90 vs 17.40 ± 4.34; t(791) = 1.50; p = .134). Concurrent validity was shown since higher psychological flexibility was significantly associated with lower depression (r = -.08; p = .024) and lower anxiety (r = -.10; p = .004), but not stress (r = .06; p = .090).
Conclusion: The validation of the Arabic Psy-Flex Scale represents a significant contribution to Arab mental health research, providing a culturally sensitive tool to assess psychological flexibility in adolescents and explore its associations with psychological distress.
Study on the Thermal Characteristics of a Turning and Milling Machine Using Taguchi-FEM with ANOVA-Driven Search
Authors: Wu Chen-Zhe , Hsieh Wen-Hsin , Kuo Tzu-Chien , Chang Yu-Hao , ZHUANG Jyun-Rong 
Published: April 2024

Abstract

Turning and milling machines (TMMs) have diverse and complex heat sources, which pose challenges to understanding and accurately predicting their thermal behavior. This study established a transient 3D thermal model of the TMM using the Finite Element Method (FEM) to predict the temporal evolution of temperature and deformation fields. The FEM predictions were then compared with the experimental results from five machining scenarios for model validation, demonstrating accurate prediction of temperature and deformation with average errors of 0.9% and 5.59 μm, respectively. A comprehensive procedure was proposed to explore the thermal characteristics of TMMs and identify thermally critical components. This study employed a Taguchi-FEM approach along with sensitivity analysis to evaluate the significant contributing boundary conditions of TMMs to tool center point (TCP) deformation in the X, Y, and Z directions. An ANOVA-driven search was further proposed to identify thermal key points significantly impacting TCP deformation across directions and time intervals. Integrating both methods facilitated the identification of the TMM thermal critical regions. The spindle TCP’s thermal critical regions were most significantly influenced by the spindle component, followed by the milling cutter shaft component and then the right side of the base bed. Similarly, for the sub-spindle TCP, the highest impact came from the sub-spindle components, followed by the right side of the base bed and the milling cutter shaft components. The proposed procedure identified the significant regions for assisting evaluation in TMMs and reduced the number of required temperature monitoring points while optimizing their placements to minimize measurement costs.
Understanding Post-Operative Refractive Outcome in Pediatrics After IOL Implementation: Factors and Predictors
Authors: AlObaisi Saif , Alnasser Bashair N. , Almuhawas Hana A. , Alhoshan Saja A. , Aldebasi Mohammed H. , Alshaye Rana , Aldakhil Suliman , Alrasheed Saif H. 
Published: April 2024

Abstract

BACKGROUND: In pediatric ophthalmology, calculating intra-ocular lens (IOL) power can be challenging. It is important to predict if the post-surgery refractive error (RE) will meet the intended refractive goal. In this study, we aimed to investigate the factors and predictors influencing RE outcomes in children undergoing IOL implantation.
METHODS This was a retrospective cross-sectional cohort study that involved 47 eyes with congenital cataracts underwent IOL implantation. Each patient underwent follow-up visits at two months and two years’ post-surgery. The IOL power calculations were conducted using the Holladay 1 formula, and both the prediction error (PE) and absolute prediction error (APE) were calculated.
RESULTS: The mean age was 6.52± 4.61 years, with an age range of 1 to 15 years. The mean IOL power was 20.31 ± 6.57 D, and the mean post-operative refraction was 1.31 ± 2.65 D. The mean of PE and APE were 0.67 ± 1.77 and 1.55 ± 1.06 D, respectively. Whereas PE was correlated to axial length with an R-value of -0.29 (p = 0.04). The calculation method had a significant negative relationship with APE and PE, with coefficients of -1.05 (p = 0.009) and -1.81 (p = 0.009), respectively.
CONCLUSION: High astigmatism was associated with greater errors in the refractive outcome. The calculation methods had the most considerable impact on the post-operative RE. The customization of surgical approaches to accommodate individual characteristics is crucial. Further research with diverse subgroups is needed to comprehensively understand the influence of each factor.
Sublingual sufentanil for patient-controlled analgesia during labor induction for pregnancy termination: an effective and well-tolerated approach
Authors: Fierro Giulia , Milan Barbara , Buelli Elena , Bugada Dario , Casarotta Erika , Rizzo Francesco , Ongaro Laura , Gritti Paolo , Previdi Fabio , Lorini Ferdinando Luca 
Published: April 2024

Abstract

Background: Effective pain during labor induction for pregnancy termination is essential. However, to date, no effective treatment has been identified. The primary aim of this study was to measure the analgesic efficacy of a sufentanil sublingual tablet system during pregnancy termination and patient satisfaction by comparing nulliparous and multiparous women. The secondary aims were to characterize the safety profile by reporting any side effects or adverse events and to determine the need for rescue therapy.
Methods: We conducted an observational, retrospective, single-center study involving 48 women. The data retrieved for analysis included thetotal and hourly doses of sublingual sufentanil, evaluations of pain management satisfaction using a five-point rating scale (ranging from 1, indicating “not satisfied” to 5, denoting “completely satisfied”), occurrence of side effects and adverse events, and the rate of rescue analgesic use. Categorical and numerical variables were compared between the two groups and a correlation analysis was performed.
Results: The median total dose of sufentanil required was 60 mcg. Nulliparous women required a higher dose of sufentanil compared with multiparous women (105 mcg vs. 45 mcg; P = 0.01). Additionally, they underwent a longer labor, indirectly measured by the time of device usage (625 min vs. 165 min; P = 0.05). Regarding satisfaction, 40 patients (83.4%) were satisfied or completely satisfied, whereas only eight patients (16.6%) reported dissatisfaction. Multiparous women exhibited higher satisfaction levels than did nulliparous women (P = 0.03). No adverse events were reported, and the most common side effects were nausea and vomiting (31.2%). Four patients (12%) required acetaminophen due to insufficient analgesia, with only one patient necessitating a switch to intravenous morphine.
Conclusions: Sublingual sufentanil was effective in both nulliparous and multiparous women with minimal side effects. Therefore, sublingual sufentanil can be considered a valid strategy for analgesia during labor induction for pregnancy termination.
Influence of high-frequency pulse on droplet transfer process and weld formation in double-wire median pulsed GMAW of aluminum alloy
Authors: Wu Kaiyuan , Lin Jing , Yang Haoran , Wang Yifei , Hong Xiaobin 
Published: April 2024

Abstract

A double-wire median pulsed gas metal arc welding (GMAW) with a high-frequency pulse waveform was developed to study the influence of a high-frequency pulse on the droplet transfer process and weld formation in aluminum (Al) alloy. The droplet transfer process was recorded using a high-speed photography system. At the same time, the influence of a high-frequency pulse at peak stage was investigated. The experimental results demonstrated that stable droplet transfer and continuous welds are obtained by incorporating high-frequency pulses. The high-frequency pulses increase electromagnetic force and facilitate premature detachment of droplets. Especially, at a high frequency of 20 kHz, one drop per pulse (ODPP) droplet transfer mode is achieved, which is the ideal mode. In addition, high-frequency pulses increase axial arc pressure, strengthen convergent flow, and reduce the effect of divergent flow, resulting in increased weld penetration while decreasing weld width and porosity.
Constructing Causal Pathways for Premature Cardiovascular Disease Mortality using Directed Acyclic Graphs: Integrating Evidence Synthesis and Expert Knowledge
Authors: Hasani Wan Shakira Rodzlan , Musa Kamarul Imran , Chen Xin Wee , Cheng Kueh Yee 
Published: April 2024

Abstract

Cardiovascular disease (CVD) is a major global cause of premature mortality. While multiple studies propose CVD mortality prediction models based on regression frameworks, incorporating causal understanding through causal inference approaches can enhance accuracy. This paper demonstrates a methodology combining evidence synthesis and expert knowledge to construct a causal model for premature CVD mortality using Directed Acyclic Graphs (DAGs). The process involves three phases: (1) initial DAG development based on the Evidence Synthesis for Constructing Directed Acyclic Graphs (ESC-DAGs) framework, (2) validation and consensus-building with 12 experts using the Fuzzy Delphi method (FDM), and (3) application to data analysis using population-based survey data linked with death records. Expert input refined the initial DAG model, achieving consensus on 45 causal paths. The revised model guided selection of confounding variables for adjustment. For example, to estimate the total effect of diabetes on premature CVD mortality, the suggested adjustment set included age, dietary pattern, genetic/family history, sex hormones, and physical activity. Testing different DAG models showed agreement between expert ratings and data accuracy from regression models. This systematic approach contributes to DAG methodology, offering a transparent process for constructing causal pathways for premature CVD mortality.
Analyzing the Interest in Digital Wellbeing Services: Are People More Willing to Pay for Them on Social Network Sites or Messaging Platforms?
Authors: Alshakhsi Sameha , Babiker Areej , Al-Thani Dena , Sindermann Cornelia , Montag Christian , Ali Raian 
Published: April 2024

Abstract

The prevalence of social network sites (SNS) and messaging platforms (MSG) has transformed the way people communicate, interact, and share information. However, concerns about digital wellbeing have arisen due to issues such as disclosure of personal information, excessive usage, fake news, extremism, and mental health challenges. This study aims to investigate the level of interest in digital wellbeing services on both SNS and MSG and explore potential differences in willingness to pay (WTP) for these services between the two types of online platforms. The analysis encompasses the demographic factors of age, gender, financial wellness, and education level. Data were collected from 262 participants through an online questionnaire, focusing on ten digital wellbeing services. The findings indicate that overall, the WTP for digital wellbeing services was higher on SNS compared to MSG across the entire sample and among different demographic factors. However, variations were observed at the individual service level. For instance, participants demonstrated greater WTP on MSG for services related to data protection and abstaining from data usage for marketing purposes. On the other hand, they showed a stronger inclination to pay on SNS for services aimed at addressing issues of fake news, radicalization, and excessive online usage. These preferences remained consistent across various demographic factors, with no significant interactions or between-subject effects observed, suggesting that the impact of the platform on WTP was consistent across the demographics studied. The research provides valuable insights into consumers’ valuation of digital wellbeing services, which can guide market players and policy makers in tailoring their offerings and strategies accordingly.
Two Factor Authentication by Using Decentralized File Storage System
Authors: Suresh R , Balachander K , Varman S Logesh , Faris KS Sai 
Published: April 2024

Abstract

In today's digital age, the apps we use for social and business things are getting more advanced, so we need better ways to check if you are really you. Two-Factor Authentication (2FA) is crucial for making the usual way we confirm identities better, but it does have some challenges. Usual 2FA methods have vulnerabilities such as SIM swapping, denial of service (DoS), and man-in-the-middle (MITM)[1] attacks.These issues continue to exist even when services say they have strong encryption. The central system in 2FA is also problematic because if it's breached, an attacker could impersonate an authorized user or mess up the whole service.To tackle these issues, we are proposing decentralized 2FA methods. This means spreading out the authentication process and using public key encryption. In this system, the user's secret keys are encrypted with their wallet's public key, giving users control over their authentication.Users can generate distinct passwords even without their main device. Therefore, as digital security needs grow, the limitations of traditional 2FA are clear. The solution is to shift to decentralized methods, offering better security and more control for users over how they authenticate.
Enhancing Flexural Performance of Self-Compacting Concrete Beams Using Fiber-Reinforced Polymer Composites
Authors: Rakam Abhinay , Sahu Sritam Swapnadarshi 
Published: April 2024

Abstract

This paper presents an extensive experimental investigation into the behavior of beams made of reinforced self-compacting concrete (RSCC). These beams were subjected to strengthening and re-strengthening using various externally bonded sheets made of Carbon Fiber Reinforced Polymer (CFRP) and Glass Fiber Reinforced Polymer (GFRP). The primary aim of this study is to identify an effective wrapping method suitable for RSCC beams that require strengthening and re-strengthening. The experimental program consisted of a control beam and twelve test beams. Among these, six beams (Group-A) were strengthened, and the other six beams (Group-B) were repaired after undergoing 50% preloading using CFRP and GFRP sheets. Three different wrapping configurations were employed: Type 1 involved a single-layer U wrap, Type 2 utilized one layer at the soffit in combination with a single-layer U wrap, and Type 3 entailed a double-layer U wrap with epoxy adhesive. The experimental results revealed that the beam in Group-A, which used the Type 2 wrapping method, demonstrated a remarkable 109% increase in its load-carrying capacity and significantly reduced deflections when compared to the performance of the control beam. Furthermore, the observations from the experiments indicated that wrapping techniques involving CFRP and GFRP sheets outperformed the control specimens. This research provides valuable insights into the effectiveness of different wrapping approaches using CFRP and GFRP sheets in improving the flexural performance of RSCC beams. These findings have the potential to enhance the optimization and practical application of such strengthening and repair methods in RSCC structures.