bluuebunny/crossref_metadata_2025_split huggingface dataset:
A dynamic routing scheme for underwater acoustic sensor networks in submarine disaster applications
Authors: Jiang Peng , Wang Hao , Xiong Zhiwen 
Published: June 2024

IntroductionThe ocean economy serves as a critical engine for the development of human society and economy, and its stable growth is of utmost importance. However, the frequent and unexpected occurrence of natural disasters, such as submarine disasters, poses significant threats to human society, especially disasters related to wave phenomena like the Ekman current, which has particularly prominent impacts.MethodsThe study proposes a dynamic routing scheme for underwater acoustic sensor networks. It establishes a cone-shaped distributed network, utilizing autonomous underwater vehicles to collect crucial data from nodes deployed on the seabed and transmitting it through the underwater cone-shaped distributed sensor network. Additionally, it adopts source location protection (SLP) technology to ensure the privacy of source locations. To validate the practicality and stability of this scheme, simulation experiments targeting the Ekman current were conducted in MATLAB.ResultsThe experimental results demonstrate that the cone–SLP network significantly reduces the frequency of routing information exchange and energy consumption among acoustic sensors, effectively enhancing the economy and durability of the sensor network. Furthermore, it exhibits robust practicality and high stability in complex and variable submarine environments.DiscussionThis research not only provides a practical method for effectively monitoring submarine disasters but also offers valuable experience and significant reference value for other similar projects, playing a more crucial role in the sustainable development of the ocean economy.
Construction of a preoperative nomogram model for predicting perineural invasion in advanced gastric cancer
Authors: Cong Ruochen , Xu Ruonan , Ming Jialei , Zhu Zhengqi 
Published: June 2024

ObjectiveThis study aimed to develop and validate a clinical and imaging-based nomogram for preoperatively predicting perineural invasion (PNI) in advanced gastric cancer.MethodsA retrospective cohort of 351 patients with advanced gastric cancer who underwent surgical resection was included. Multivariable logistic regression analysis was conducted to identify independent risk factors for PNI and to construct the nomogram. The performance of the nomogram was assessed using calibration curves, the concordance index (C-index), the area under the curve (AUC), and decision curve analysis (DCA). The disparity in disease-free survival (DFS) between the nomogram-predicted PNI-positive group and the nomogram-predicted PNI-negative group was evaluated using the Log-Rank test and Kaplan–Meier analysis.ResultsExtramural vascular invasion (EMVI), Borrmann classification, tumor thickness, and the systemic inflammation response index (SIRI) emerged as independent risk factors for PNI. The nomogram model demonstrated a commendable AUC value of 0.838. Calibration curves exhibited excellent concordance, with a C-index of 0.814. DCA indicated that the model provided good clinical net benefit. The DFS of the nomogram-predicted PNI-positive group was significantly lower than that of the nomogram-predicted PNI-negative group (p &lt; 0.001).ConclusionThis study successfully developed a preoperative nomogram model that not only effectively predicted PNI in gastric cancer but also facilitated postoperative risk stratification.
Does the nurse-led case management benefit rheumatoid arthritis patients in reducing distressing symptoms and C-reactive protein: a 2-year follow-up study in Taiwan
Authors: Chang Wei-Chiao , Livneh Hanoch , Huang Hua-Lung , Li Hsin-Hua , Lu Ming-Chi , Lin Miao-Chiu , Chen Wei-Jen , Tsai Tzung-Yi 
Published: June 2024

BackgroundRheumatoid arthritis (RA) is a chronic disease and may worsen over time. Today, nurse-led case management (NLCM) has been recommended to improve clinical outcomes for chronic disease patients, yet little is known regarding its impact on pain, fatigue, and C-reactive protein (CRP) among RA patients. We aimed to explore this issue among such groups via a two-group pre- and post-test approach.MethodsAll subjects were recruited from one hospital in Taiwan from January 2017 to June 2018 and assigned to either a 6-month NLCM program in addition to usual care or to a control group that received usual care only. All of them were followed for 2 years. Outcomes of interests were compared at four time points: baseline, the third day after NLCM completion, and at 6 and 24 months after NLCM. Effects between them were tested using the generalized estimating equations (GEE) model after adjusting for differences at baseline.ResultsA total of 50 patients in the NLCM group and 46 in the control group were recruited for data analysis. Results from the GEE model indicated that integrating NLCM into conventional care benefited patients in decreasing levels of pain and fatigue, as well as CRP value. These improvements were still observed for 2 years after NLCM.ConclusionNLCM was shown to be helpful in lowering pain, fatigue, and CRP, which implies that NLCM may be a reference in the provision of tailored care for those affected by rheumatism.
Repurposing lipid-lowering drugs as potential treatment for acne vulgaris: a Mendelian randomization study
Authors: Fang Man , Lei Jing , Zhang Yue , Zhang Bo 
Published: June 2024

BackgroundAcne vulgaris, a chronic inflammatory skin condition predominantly seen in teenagers, impacts more than 640 million people worldwide. The potential use of lipid-lowering medications as a treatment for acne vulgaris remains underexplored. This study seeks to investigate the impact of lipid-lowering therapies on the risk of developing acne vulgaris using two-sample Mendelian randomization (MR) analysis.MethodThe two-sample MR method was employed for analysis, and information on lipid-lowering drugs was obtained from the DrugBank and ChEMBL databases. The summary data for blood low-density lipoprotein (LDL) and triglycerides were sourced from the Global Lipids Genetics Consortium, while genome-wide association studies (GWAS) summary data for acne vulgaris were obtained from the FinnGen database. Heterogeneity was examined using the Q-test, horizontal pleiotropy was assessed using MR-Presso, and the robustness of analysis results was evaluated using leave-one-out analysis.ResultsThe MR analysis provided robust evidence for an association between lowering LDL cholesterol through two drug targets and acne vulgaris, with PCSK9 showing an odds ratio (OR) of 1.782 (95%CI: 1.129–2.812, p = 0.013) and LDL receptor (LDLR) with an OR of 1.581 (95%CI: 1.071–2.334, p = 0.021). Similarly, targeting the lowering of triglycerides through lipoprotein lipase (LPL) was significantly associated with an increased risk of acne vulgaris, indicated by an OR of 1.607 (95%CI: 1.124–2.299, p = 0.009).ConclusionThe current MR study presented suggestive evidence of a positive association between drugs targeting three genes (PCSK9, LDLR, and LPL) to lower lipids and a reduced risk of acne vulgaris.
The hospitalization burden of inflammatory bowel disease in a southwestern highland region of China: a territory-wide study from 2015 to 2020
Authors: Tao Yan , Li Maojuan , Gao Huabin , Sun Yang , Zhang Fengrui , Wu Jing , Liang Hao , He Liping , Gong Min , Niu Junkun , Miao Yinglei 
Published: June 2024

BackgroundYunnan, a southwest highland and newly industrialized region of China, has an unknown hospitalization burden of inflammatory bowel disease (IBD). The study was conducted to explore territorial hospitalization burden of IBD.MethodsThe formatted medical records of patients with IBD were collected from a territory-wide database in Yunnan Province, China, from 2015 to 2020. General characteristics of the study population were reported using descriptive statistics. To evaluate the length of stay, hospitalization costs, surgery, complications, and trends in patients with inflammatory bowel disease. The logistic regression analysis was established to explore the factors affecting the hospitalization costs.ResultsA total of 12,174 records from 8192 patients were included. The annual hospitalization cost of IBD in Yunnan Province increased significantly from 2015 to 2020. From 2015 to 2020, the regional hospitalization burden of IBD increased, but it represented a decline in cost per hospitalization (r = −0.024, P = 0.008) and the length of stay (r = −0.098, P &lt; 0.001). Surgery rates for hospitalized patients with Crohn’s disease (CD) did not decrease (r = −0.002, P = 0.932), and even increased for patients with ulcerative colitis (UC) (r = 0.03, P = 0.002). The costs per hospitalization were $ 827.49 (540.11–1295.50) for UC and $ 1057.03 (644.26–1888.78) for CD. Among the identifiable cost items during the period, drug costs accounted for the highest proportion, accounting for 33% and 37.30% in patients with UC and CD, respectively. Surgical intervention [OR 4.87 (3.75–6.31), P &lt; 0.001], comorbidities [OR 1.72 (1.52–1.94), P &lt; 0.001], complications [OR 1.53 (1.32–1.78), P &lt; 0.001], and endoscopy [OR 2.06 (1.86–2.28), P &lt; 0.001] were predictor of high hospitalization costs.ConclusionThe increasing burden of IBD is noteworthy a newly industrialized region of China. Interventions targeting surgery, complications, and comorbidities may be effective means of controlling the increasing hospitalization costs of IBD in the regions.
Obstructive sleep apnea in the hemodialysis population: are clinicians putting existing scientific evidence into practice?
Authors: Burkhalter David Andri , Cartellá Antonio , Cozzo Domenico , Ogna Adam , Forni Ogna Valentina 
Published: June 2024

IntroductionHemodialysis (HD) populations have a high prevalence of Obstructive Sleep Apnea (OSA), which was specifically linked with fluid overload. HD fluid management targeting a low dry weight was shown to reduce OSA severity, opening to novel therapeutic options. We assessed nephrologists’ awareness of OSA diagnosis in HD patients and whether they integrate the current knowledge into their fluid management strategy.Material and methodsWe performed a multicenter, cross-sectional study between July 2022 and July 2023, screening all HD patients of four HD units, and included those with confirmed OSA. We collected anthropometric parameters and fluid status from electronic dossiers. Predialysis fluid overload was measured by multifrequency bioelectrical impedance (BCM®). Nephrologists were asked to identify patients with known OSA, without consulting medical dossiers. The fluid management of patients identified as “OSA positive” was compared to that of patients misclassified as “OSA negative”.ResultsAmong 193 HD patients, 23.0% (n=45) had confirmed OSA. The mean age was 76.0 ± 7.5 years, 82.2% were men. Only 60% were correctly identified as “OSA positive” by nephrologists; 14.7% of patients on CPAP were identified. BMI was the only factor associated with correct OSA identification. The predialysis fluid overload tended to be greater in “OSA positive” patients than in the “OSA negative” patients (2.2 ± 1.4 kg vs 1.5 ± 1.3 kg; p=0.08), but there was no difference in postdialysis achievement of dry weight between the groups (residual overweight 0.2 ± 1.0 kg and 0.1 ± 0.7 kg; p= 0.672).ConclusionsOur study suggests that the application of scientific evidence to the management of OSA in dialysis patients is not systematic. However, nephrologists have attempted to strictly achieve dry weight in all patients, regardless of OSA status. Sensibilization of nephrologists on the clinical and diagnostic peculiarities of OSA in HD patients may improve OSA diagnosis and therapeutic care.
The influence of factors associated with past reproductive histories on migraines in middle-aged premenopausal women: a nationwide population-based study in Republic of Korea
Authors: Kim Seonghoon , Na Seunghee , Kim Young-Do , Bae Dae Woong , An Jae Young , Park Jeong Wook 
Published: June 2024

IntroductionWomen can experience various reproductive events, such as pregnancy, childbirth, lactation, and contraception, which cause long-term changes in female hormones. In middle-aged women, the prevalence of migraine is high, and a clear gender difference is evident. This study investigated the effects of factors associated with past reproductive events on the risk of new migraine in middle-aged premenopausal women.MethodsThe influence of reproductive factors on migraine in middle-aged women was investigated using the Korean National Health Insurance Service (KNHIS) and Korean Health Examination (KHE) databases. The reproductive factors of interest were parity, breastfeeding, and oral contraceptive (OC) use. The study included 949,704 middle-aged premenopausal women 40–60 years of age. The study population was divided into two groups based on new diagnosis of migraine during the follow-up period (2009–2018).ResultsThe risk of new migraine tended to increase in the primiparous (hazard ratio, HR: 1.179; 95% confidence interval, CI: 1.137–1.221) and multiparous groups (HR: 1.181; 95% CI: 1.142–1.221) compared with the nulliparous group. The breastfeeding ≥12 months group (HR: 1.071; 95% CI: 1.052–1.091) showed a significantly increased risk of new migraine compared with the non-breastfeeding group. All women in the OC groups (&lt; 1 year, HR: 1.048; 95% CI: 1.028–1.069 and ≥ 1 year, HR: 1.100; 95% CI: 1.067–1.134) showed a higher risk of new migraine than those in the non-OC group.ConclusionThe results of the current study indicate that childbirth, longer breastfeeding, and OC use may be associated with a higher risk of new migraine in middle-aged premenopausal women.
Functional connectivity density aberrance in type 2 diabetes mellitus with and without mild cognitive impairment
Authors: Ge Limin , Cao Zidong , Sun Zhizhong , Yue Xiaomei , Rao Yawen , Zhao Kui , Qiu Wenbin , Li Yifan , Lu Weiye , Qiu Shijun 
Published: June 2024

PurposeThe objective of this study was to investigate alterations in functional connectivity density (FCD) mapping and their impact on functional connectivity (FC) among individuals diagnosed with Type 2 diabetes mellitus (T2DM) across different cognitive states. Moreover, the study sought to explore the potential association between aberrant FCD/FC patterns and clinical or cognitive variables.MethodsA total of 211 participants were recruited for this study, consisting of 75 healthy controls (HCs), 89 T2DM patients with normal cognitive function (DMCN), and 47 T2DM patients with mild cognitive impairment (DMCI). The study employed FCD analysis to pinpoint brain regions exhibiting significant FCD alterations. Subsequently, these regions showing abnormal FCD served as seeds for FC analysis. Exploratory partial correlations were conducted to explore the relationship between clinical biochemical indicators, neuropsychological test scores, and altered FCD or FC.ResultsThe FCD analysis revealed an increased trend in global FCD (gFCD), local FCD (lFCD), and long-range FCD (lrFCD) within the bilateral supramarginal gyrus (SMG) among individuals with DMCN. Additionally, significant lFCD alterations were observed in the right inferior frontal gyrus and left precuneus when comparing DMCN to HCs and DMCI.ConclusionWhen comparing individuals with T2DM and healthy controls (HCs), it was revealed that DMCN exhibited significant improvements in FCD. This suggests that the brain may employ specific compensatory mechanisms to maintain normal cognitive function at this stage. Our findings provide a novel perspective on the neural mechanisms involved in cognitive decline associated with T2DM.
Subjective brain fog: a four-dimensional characterization in 25,796 participants
Authors: Alim-Marvasti Ali , Ciocca Matteo , Kuleindiren Narayan , Lin Aaron , Selim Hamzah , Mahmud Mohammad 
Published: June 2024

ImportanceBrain fog is associated with significant morbidity and reduced productivity and gained increasing attention after COVID-19. However, this subjective state has not been systematically characterised.ObjectiveTo characterise self-reported brain fog.DesignWe systematically studied the cross-sectional associations between 29 a priori variables with the presence of “brain fog.” The variables were grouped into four categories: demographics, symptoms and functional impairments, comorbidities and potential risk factors (including lifestyle factors), and cognitive score. Univariate methods determined the correlates of brain fog, with long-COVID and non-long-COVID subgroups. XGBoost machine learning model retrospectively characterised subjective brain fog. Bonferroni-corrected statistical significance was set at 5%.SettingDigital application for remote data collection.Participants25,796 individuals over the age of 18 who downloaded and completed the application.Results7,280 of 25,796 individuals (28.2%) reported experiencing brain fog, who were generally older (mean brain fog 35.7 ± 11.9 years vs. 32.8 ± 11.6 years, p &lt; 0.0001) and more likely to be female (OR = 1.2, p &lt; 0.001). Associated symptoms and functional impairments included difficulty focusing or concentrating (OR = 3.3), feeling irritable (OR = 1.6), difficulty relaxing (OR = 1.2, all p &lt; 0.0001), difficulty following conversations (OR = 2.2), remembering appointments (OR = 1.9), completing paperwork and performing mental arithmetic (ORs = 1.8, all p &lt; 0.0001). Comorbidities included long-COVID-19 (OR = 3.8, p &lt; 0.0001), concussions (OR = 2.4, p &lt; 0.0001), and higher migraine disability assessment scores (MIDAS) (+34.1%, all p &lt; 0.0001). Cognitive scores were marginally lower with brain fog (−0.1 std., p &lt; 0.001). XGBoost achieved a training accuracy of 85% with cross-validated accuracy of 74%, and the features most predictive of brain fog in the model were difficulty focusing and following conversations, long-COVID, and severity of migraines.Conclusions and relevanceThis is the largest study characterising subjective brain fog as an impairment of concentration associated with functional impairments in activities of daily living. Brain fog was particularly associated with a history of long-COVID-19, migraines, concussion, and with 0.1 standard deviations lower cognitive scores, especially on modified Stroop testing, suggesting impairments in the ability to inhibit cognitive interference. Further prospective studies in unselected brain fog sufferers should explore the full spectrum of brain fog symptoms to differentiate it from its associated conditions.
Comparison of venous and pooled capillary hemoglobin levels for the detection of anemia among adolescent girls
Authors: Jenkins Mica , Amoaful Esi Foriwa , Abdulai Mutala , Quartey Veronica , Situma Ruth , Ofosu-Apea Porbilla , Aballo Jevaise , Demuyakor Maku E. , Gosdin Lucas , Mapango Carine , Jefferds Maria Elena D. , Addo O. Yaw 
Published: June 2024

IntroductionBlood source is a known preanalytical factor affecting hemoglobin (Hb) concentrations, and there is evidence that capillary and venous blood may yield disparate Hb levels and anemia prevalence. However, data from adolescents are scarce.ObjectiveTo compare Hb and anemia prevalence measured by venous and individual pooled capillary blood among a sample of girls aged 10–19 years from 232 schools in four regions of Ghana in 2022.MethodsAmong girls who had venous blood draws, a random subsample was selected for capillary blood. Hb was measured using HemoCue® Hb-301. We used Lin’s concordance correlation coefficient (CCC) to quantify the strength of the bivariate relationship between venous and capillary Hb and a paired t-test for difference in means. We used McNemar’s test for discordance in anemia cases by blood source and weighted Kappa to quantify agreement by anemia severity. A multivariate generalized estimating equation was used to quantify adjusted population anemia prevalence and assess the association between blood source and predicted anemia risk.ResultsWe found strong concordance between Hb measures (CCC = 0.86). The difference between mean venous Hb (12.8 g/dL, ± 1.1) and capillary Hb (12.9 g/dL, ± 1.2) was not significant (p = 0.26). Crude anemia prevalence by venous and capillary blood was 20.6% and 19.5%, respectively. Adjusted population anemia prevalence was 23.5% for venous blood and 22.5% for capillary (p = 0.45). Blood source was not associated with predicted anemia risk (risk ratio: 0.99, 95% CI: 0.96, 1.02). Discordance in anemia cases by blood source was not significant (McNemar p = 0.46). Weighted Kappa demonstrated moderate agreement by severity (ĸ = 0.67). Among those with anemia by either blood source (n = 111), 59% were identified by both sources.ConclusionIn Ghanaian adolescent girls, there was no difference in mean Hb, anemia prevalence, or predicted anemia risk by blood source. However, only 59% of girls with anemia by either blood source were identified as having anemia by both sources. These findings suggest that pooled capillary blood may be useful for estimating Hb and anemia at the population level, but that caution is needed when interpreting individual-level data.
Associations of ω-3, ω-6 polyunsaturated fatty acids intake and ω-6: ω-3 ratio with systemic immune and inflammatory biomarkers: NHANES 1999-2020
Authors: Li Yifan , Tang Hao , Yang Xiaotong , Ma Lili , Zhou Hangqi , Zhang Guangjiang , Chen Xin , Ma Lijun , Gao Jing , Ji Wei 
Published: June 2024

BackgroundIn recent years, diseases caused by abnormal immune-inflammatory responses have become increasingly severe. Dietary intervention involving omega-3 polyunsaturated fatty acids (ω-3 PUFAs) has emerged as a potential treatment. However, research investigating the relationship between ω-3, ω-6 PUFAs, and ω-6 to ω-3 ratio with inflammatory biomarkers remains controversial.MethodsTo investigate the correlation between the intake of ω-3 and ω-6 PUFAs and the ratio of ω-6: ω-3 with biomarkers of inflammation, the National Health and Nutrition Examination Survey (NHANES) data (1999 to 2020) was utilized. The systemic immune-inflammation index (SII), platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and white blood cell (WBC) were selected as study subjects. Dietary data for ω-3 and ω-6 PUFAs were collected via two 24-h dietary recall interviews. SII index and other indicators were obtained from the blood routine data. The multiple linear regression and restricted cubic spline models were utilized to evaluate the association of ω-3, ω-6 PUFAs intake, and ω-6: ω-3 ratio to SII and secondary measures.ResultsThis study involved a total of 43,155 American adults. ω-3 and ω-6 PUFAs exhibited negative correlations with SII, PLR, NLR, and WBC. The correlation between ω-6: ω-3 ratio and SII, PLR, NLR, and WBC was not significant. Furthermore, the dose–response relationship showed that the relationship between the intake of ω-3 and ω-6 PUFAs and SII was an “L” pattern.ConclusionIntake of dietary ω-3 and ω-6 PUFAs reduces the levels of several inflammatory biomarkers in the body and exerts immunomodulatory effects.