bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiological and clinical characteristics of hospitalized human metapneumovirus patients in Israel, 2015–2021: A retrospective cohort study
Authors: Jurkowicz Menucha , Cohen Hodaya , Nemet Ital , Keller Nathan , Leibovitz Eugene , Sherman Gilad , Kriger Or , Barkai Galia , Mandelboim Michal , Stein Michal 
Published: June 2024

AbstractThis study evaluated the epidemiological and clinical characteristics of human metapneumovirus (hMPV) infection among hospitalized patients with acute respiratory infections during 2015–2021 and assessed the impact of the coronavirus disease 2019 pandemic on hMPV infection. A single‐center, retrospective cohort study was performed, including pediatric and adult patients with laboratory‐confirmed hMPV. Of a total of 990 patients, 253 (25.6%), 105 (10.6%), 121 (12.2%), and 511 (51.6%) belonged to age groups 0–2, 3–17, 18–59, and ≥60 years, respectively. The highest percentage (23.0%) of patients were hospitalized during 2019 and the lowest (4.7%) during 2020. Patients < 18 years experienced high rates of comorbidities (immunodeficiencies: 14.4% and malignancies: 29.9%). Here, 37/39 (94.9%) of all bronchiolitis cases were diagnosed in patients < 2 years, whereas more patients in older age groups were diagnosed with pneumonia. A greater proportion of hMPV patients diagnosed with viral coinfection (mostly respiratory syncytial virus and adenovirus) were <18 years. The highest percentages of intensive care unit admissions were recorded among patients < 18 years. Our findings demonstrate that hMPV is an important cause of morbidity in young children and a possibly underestimated cause of morbidity among older adults.
Intravenous fluid therapy in hospitalized adult dengue patients without shock: Impact on subsequent severe dengue and potential adverse effects
Authors: Xu Baihui , Tewari Pranav , Thein Tun Linn , Sin Leo Yee , Lye David Chien Boon , Chia Po Ying , Lim Jue Tao 
Published: June 2024

AbstractThere is a lack of evidence on the optimal administration of intravenous (IV) fluids in hospitalized adult dengue patients without compensated and hypotensive shock. This study utilized a well‐established cohort of dengue patients to compare risks of progressing to severe dengue (SD) over time for patients who were administered IV fluid versus others who were not. We included adult patients (n = 4781) who were hospitalized for dengue infection from 2005 to 2008. Cases were patients who developed SD (n = 689) and controls were patients who did not up until discharge (n = 4092). We estimated the hazard ratios (HRs) and risk of SD over time between groups administered different volumes of IV fluids versus the no IV fluid comparison group using Cox models with time‐dependent covariates. The doubly‐robust estimation approach was used to control for the propensity of fluid administration given clinical characteristics of patients. Subgroup analyses by age, sex, and dengue warning signs before IV fluid administration were conducted. High (>2000 mL/day) IV fluids volume was associated with a higher risk of development of SD for those who had warning signs (HR: 1.77 [1.05–2.97], p: 0.0713) and for those below 55 years old (HR: 1.53 [1.04–2.25], p: 0.0713). Low (<1000 mL/day) IV fluids volume was protective against SD for patients without warning signs (HR: 0.757 [0.578–0.990], p: 0.0883), no lethargy (HR: 0.770 [0.600–0.998], p: 0.0847), and females (HR: 0.711 [0.516–0.980], p: 0.0804). Over the course of hospitalization, there were no significant differences in IV fluid administration and SD risk in most subgroups, except in those who experienced lethargy and were administered IV fluid volume or quantity. Administering high volumes of IV fluids may be associated with an increased risk of SD during hospitalization for adult dengue patients without shock. Judicious use of IV fluids as supportive therapy is warranted.
First report of betalain production from endolichenic Bacillus sp. LDAB‐1 from Dirinaria aegilita: Insights from novel quantification methodology of image processing
Authors: Sankar Karthikumar , Samuel Karl Joseph , Rajaram Shyam Kumar , Karuppiah Ponmurugan , Periyasami Govindasami , Karunakaran Gopalu 
Published: June 2024

ABSTRACTPigments are widely used in food supplements envisaging attractive colors along with health benefits. The desired advancements in the nutraceutical and antioxidant properties of pigments utilized in food products necessitate the search for novel additives. The present study is the first in the field to report the pigment‐producing endolichenic bacteria, Bacillus sp. LDAB‐1 from Dirinaria aegilita. Morphological, biochemical, and molecular characterization of the bacterium emphasizes that ideal pigment production occurs when utilizing sucrose and sodium nitrate. The pigment was salted out and dialyzed for further qualitative characterization using ultraviolet–visible, fluorescence, and Fourier transform infrared spectra and the results corroborated the presence of betalains. The antioxidant activity of betalain is closer to the efficiency of α‐tocopherol, which confers the pigment properties for antioxidant and nutraceutical significance. An optimal methodology for pigment affirmation is an issue when using an alternative methodology. Hence, the present assessment employs a comparative analysis of findings from both a spectrophotometric method and image processing technology encompassing RGB, CMYK, YCbCr, and L*a*b* color space models. Amongst these, the L*a*b* model potentially provides an effective modality for determining the pigment concentration. Bland–Altman plot analysis indicates similar consistency levels in betalain quantification by both methods at 95% confidence intervals, affirming the integrity and consistency of color image processing technology. Consequently, the present study represents novelty and innovativeness in reporting endolichenic Bacillus sp. LDAB‐1 from D. aegilita and a rational image optimization protocol for pigment elucidation characteristics.
The influence of ESG score on financial performance: Evidence from the European health care industry
Authors: Candio Paolo 
Published: June 2024

AbstractCompany managers are increasingly recognizing that sustainable practices are not just ethical imperatives but potential drivers of long‐term value. To determine the degree to which this is grounded in business reality, a growing body of empirical studies have examined whether higher environmental, social, and governance (ESG) performance predicts better financial performance. However, conflicting findings have emerged, with reviews highlighting the role that methodological choices, normative setting, and industry can play in moderating that relationship. Unlike other industries, health care has been the focus of only a handful of heterogeneous quantitative studies. To contribute to this evidence base for the European context, the present study comprehensively examined whether and how ESG score can influence both accounting‐ and market‐based measures of financial performance. Company data from the top health care companies listed in the STOXX 600 Index over the last decade (2012–2022) were gathered and analyzed. The analysis results confirmed that a marked heterogeneity of effects across the different ESG scores and measures of financial performance exists, which is not merely due to differences in empirical strategy, with modest positive effects being estimated in most cases. Of the three pillars, the governance score consistently predicted more positive financial performance among the sample of listed European companies. The environmental pillar score only influenced accounting‐based measures, though inconsistently, whereas the social pillar did not seem to have any predicting role for accounting‐based measures. Future research should consider replicating the proposed analytical framework in other data settings and normative contexts to strengthen the current evidence base and therefore deepen our understanding of the mechanisms underlying the investigated relationships in the health care industry.
Regulation of gut microbiota and serum neurotransmitters in mice by Streptococcus thermophilus GA8‐ and Lacticaseibacillus rhamnosus HAO9‐fermented milk containing high levels of gamma‐aminobutyric acid
Authors: Han Mei , Dong Yao , Wang Shuo , Huang Xiaohui , Bai Chen , Gai Zhonghui 
Published: June 2024

AbstractBACKGROUNDGamma‐aminobutyric acid (GABA) is an important neurotransmitter in the human body, with several negative emotions reported as being associated with GABA dysregulation. This study investigates the safety and modulatory effects of GABA‐enriched milk, fermented by Streptococcus thermophilus GA8 and Lacticasebacillus rhamnosus HAO9, on the gut microbiota and neurotransmitter profiles in mice.RESULTSThrough rigorous culturing and fermentation processes, we achieved consistent GABA production in milk, with concentrations reaching 4.6 and 8.5 g L−1 for GA8‐fermented and co‐fermented milk, respectively, after 48 h. Using SPF male C57BL/6J mice, we administered either mono‐culture or combined‐culture milk treatments and monitored physiological impacts. The treatments did not affect mouse body weight but induced significant changes in gut microbiota composition. Beta diversity analysis revealed distinct microbial profiles between treatment groups, highlighting fermentation‐specific microbial shifts, such as an increase in Verrucomicrobia for the GA8 group and a modulation in Saccharibacteria_genera_incertae_sedis for the GA8 + HAO9 group. Serum neurotransmitter levels were elevated in both treatment groups, with significant increases in l‐glutamine, l‐tryptophan and, notably, serotonin hydrochloride in the GA8 + HAO9 group. Correlation analysis identified a positive association between specific bacterial genera and neurotransmitter levels, suggesting a probiotic effect on neuroactive substances.CONCLUSIONThese findings suggest that fermented milk has potential as a probiotic supplement for mood improvement and stress relief, highlighting its role in modulating the gut–brain axis. © 2024 Society of Chemical Industry.
Identifying iliotibial band graft length and incision site may minimise the potential risk of harming adjacent structures: A novel approach for surgeon guidance
Authors: Gonera Bartosz , Balcerzak Adrian , Ruzik Kacper , Maślanka Krystian , Zielinska Nicol , Drobniewski Marek , Borowski Andrzej , Olewnik Łukasz 
Published: June 2024

AbstractPurposeThe Iliotibial band (ITB) is a fibrous thickening of the fascia lata originating at the iliac crest and inserting at Gerdy's tubercle on the lateral tibia. The ITB significantly contributes to lateral knee stabilisation. Due to its size, tensile strength and easy access, it is widely used in orthopaedic surgery as an autograft during reconstruction procedures. Although ITB harvesting may result in complications, such as reduced knee extension or hip flexion, no safety margins or guidelines have been proposed for the procedure. Our aim was to determine the maximal safe length of an ITB graft, that is, that does not harm the lateral collateral ligament (LCL), tensor fasciae latae (TFL), gluteus maximus (GM) or adjacent structures, and reduce the complication rate.MethodsThe study included 50 lower limbs of 25 human cadavers, previously fixed in 10% formalin solution. The inclusion criterion was the lack of visible signs of surgical interventions in the study region. Forty lower limbs were included in the study: 16 female (mean age 83.1 ± 3.4 years) and 24 male (mean age 84.2 ± 6.8 years). Dissection was performed with a previously established protocol. Morphometric measurements were then obtained twice by two researchers.ResultsThe mean femur length was 404.8 mm [female (F) = 397.3 mm, male (M) = 409.9 mm, standard deviation (SD): F = 23.8 mm, M = 24.1 mm]. The mean ITB length was 318.9 mm (F = 309.4 mm, M = 325.2 mm, SD: F = 25.7 mm, M = 33.7 mm). Longer femurs were associated with longer ITB (p < 0.05). The mean distance from the insertion of the GM to the myofascial junction of TFL and ITB was 34.6 mm (F = 34.5 mm, M = 34.6 mm, SD: F = 3.2 mm, M = 3.3 mm). The longer femurs or ITBs demonstrated a greater distance from GM insertion to the myofascial junction of the TFL and ITB (p < 0.05).ConclusionITB grafts longer than 21 cm may contribute to the greater risk of TFL rupture. Based on simple measurements of the femur length, the surgeon may assess approximate ITB length, and thus assess the length of the maximal graft length. Moreover, to avoid harming the LCL, the incision should be performed 5 cm proximal to the articular surface of the lateral femoral condyle or 13 mm proximal to the lateral femoral epicondyle. Such preparation and preoperative planning may greatly reduce the risk of complications during ITB harvesting, while performing, for instance, the over‐the‐top technique for anterior cruciate ligament reconstruction in skeletally immature patients.Level of the StudyBasic I.
Nodal Metastases in Stage 3 Head and Neck Melanoma: Patterns of Metastases and Patterns of Failure
Authors: Tzelnick Sharon , de Almeida John R. , Yao Christopher M.K.L. , Kibel Seth , Kuehne Nathan , Grewal Rajan , Butler Marcus O , Saibil Sam , Spreafico Anna , Easson Alexandra , Goldstein David P 
Published: June 2024

ObjectiveStage 3 patients with clinically positive nodal metastasis are treated with therapeutic neck dissection and adjuvant systemic therapy. The aim of our study was to examined the predictability of pre‐operative CT as a nodal drainage assessment tool.MethodsRetrospective review of all patients with clinically positive head and neck cutaneous melanoma between 2010 and 2019. Clinical disease was diagnosed as radiological suspicious, biopsy‐proven node. A pre‐operative CT evaluation for nodal metastasis was compared to pathology report.ResultsA total of 53 patients were included. Forty patients (75.5%) were males with a mean age of 59 (SD 15.52). The majority of patients (26.4%) had an unknown primary site. The most common sites for primary were the cheek in eight patients (15.1%) followed by forehead (9.4%) and lateral neck (9.4%). Preoperative CT predicted nodal disease in 84.6% of cases. The primary region that mainly failed from the previously described clinical prediction was the upper anterior neck with 83.3% parotid involvement. A total of 10 patients (18.9%) were diagnosis with non‐clinical nodes on pathology with a median non‐clinical node of 1 (range 1–2). Of them, 9 (90%) were in the same clinical levels detected by CT. Pre‐operative CT was associated with a neck level accuracy of 98.1%.ConclusionStage 3 head and neck melanoma with clinically positive nodal metastasis that are eligible for an adjuvant systemic treatment, may benefit from a highly selective neck dissection according to their pre‐operative imaging studies. This should be further evaluated in a large‐scale clinical trial.Level of Evidence3 Laryngoscope, 134:4292–4297, 2024
The Digital Twin Framework for the Physical Wideband and Long‐Haul Optical Fiber Communication Systems
Authors: Yang Hang , Niu Zekun , Fan Qirui , Li Lyu , Shi Minghui , Zeng Chuyan , Xiao Shilin , Hu Weisheng , Yi Lilin 
Published: June 2024

AbstractDigital twin (DT) modeling is essential to optical fiber communication systems, particularly for enhancing system performance, controlling the system in real time, and understanding signal nonlinearity. Conventional split‐step Fourier method ‐based simulations, however, struggle with wide‐band transmissions, plagued by increasing complexity and inherent biases due to inconsistent link parameter availability. Addressing these challenges, a hybrid data‐driven and model‐driven DT approach for the wide‐band and long‐haul physical systems with various system effects is developed. The approach utilizes a neural network (NN) to capture fiber nonlinear features as well as biased perturbations as “lumped” stochastic noises while offloading the linear effects to modules described by physical models of link elements. The model, tested in a 30.5‐Tbps 1200 km fiber transmission link with 40 channels, achieves a mean Q factor error of less than 0.1 dB and a maximum runtime of 1.3 s for NN processing under various launch powers, transmission lengths, and optical signal‐to‐noise ratios. Furthermore, the study has implemented a nonlinear compensation algorithm on the DT model, yielding a consistent enhancement in experimental data. The accuracy and adaptability of the DT model underline its suitability for planning, design, and optimization within the physical optical fiber communication systems.
Low‐Migration Compounds with Amine Functionality as Coinitiators of Radical Polymerization
Authors: Chen Hong , Schmitt Michael , Graff Bernadette , Morlet‐Savary Fabrice , Hahn Christoph , Kelch Hauke , Maletz Reinhard , Willner Alexander , Lalevée Jacques 
Published: June 2024

AbstractThe utilization of two‐component systems comprising camphorquinone (CQ) and aromatic amines has become prevalent in the photopolymerization. However, there are still concerns about the safety of this CQ/amine system, mainly because of the toxicity associated with the leaching of aromatic amines. In light of these concerns, this study aims to develop novel coinitiator combinations featuring CQ and amines which cannot be leached out of materials, enabling free radical polymerization of representative dentalmethacrylate resins under blue light irradiation. This approach involves the initial design and analysis of hydrogen donors with low C─H bond dissociation energy through molecular modeling. Subsequently, copolymerizable methacrylate functional groups are incorporated via chemical modification, allowing it to act as both coinitiator and copolymerization monomer to achieve low migrationand leachability properties. This work presents, for the first time, the synthesis of the innovative coinitiator and compares its performance with the benchmark CQ/ethyl‐4‐dimethylaminobenzoate (EDB)‐based photoinitiation system (PIS). The results demonstrate the effectiveness of the newly proposed PIS. Finally, an in‐depth investigation is conducted into the reaction mechanism associated with this PIS through molecular orbital calculations and electron spin resonance studies.
Survival and infection rates of microvascular free flaps in pediatric mandibular reconstruction: A systematic review and meta‐analysis
Authors: Huang Ryan S. , Benour Ali , Wong Riff Karen W. Y. 
Published: June 2024

AbstractBackgroundVascularized free tissue transfer has been established as an effective method in the reconstruction of mandibular defects. However, a limited understanding of its efficacy in pediatric patients persists due to its infrequent presentation. The aim of this study is to systematically consolidate the survival and infection rates of free flaps in pediatric mandibular reconstruction.MethodsA systematic literature search was conducted on Ovid Medline, Embase, and Cochrane Library for studies published up to January 2024. We included peer‐reviewed studies reporting on survival and infection outcomes associated with free flap mandibular reconstruction in pediatric patients (<18 years). We performed a random‐effects meta‐analysis with the inverse‐variance weighted approach to estimate survival and infection rates. Heterogeneity was assessed by I2, and publication bias was examined using Egger's test.ResultsA total of 26 studies, reporting on 463 free flaps and 439 pediatric patients with a mean age of 10.7 years, were included in our study. Most free flaps originated from the fibula (n = 392/463, 84.7%) and benign tumors were the most common cause for mandibular reconstruction (n = 179/463, 38.7%). The pooled estimate for survival of flaps was 96% (95% CI: 93–97, I2 = 0%), and recipient‐site infections were estimated to occur in 9% (95% CI: 6–13, I2 = 0%) of cases. The most common reported complications within the study timeframe were early malocclusion (n = 28/123, 21.4%) and bite abnormalities (18/131, 13.7%).ConclusionFree tissue transfer for mandibular reconstruction in pediatric patients is effective and safe. Further research is required to explore functionality following mandibular reconstruction in diverse pediatric populations.
3D‐printed high‐gain beam‐switching dielectric transmitarray fed by an integrated lens antenna
Authors: Kumar Vimal , Srivastava Gunjan , Mohan Akhilesh 
Published: June 2024

AbstractThis article presents a high‐gain linearly polarized three‐dimensionally‐printed dielectric transmitarray with an integrated lens antenna (ILA) as a feed source. The proposed transmitarray contains 1336 unit cells of 16 different types with a gradual phase change of 22.5°. The unit cells have a cross‐section of 5.4 × 5.4 mm, and their height varies from 0 to 24.2 mm for different gradual phase changes. The designed transmitarray shows a maximum gain of 19.5 dBi at 28 GHz with a 3‐dB beamwidth of less than 7° in both the E‐ and H‐planes. Furthermore, a holder with seven distinct feed positions has been designed to alter the location of the feed antenna in the focal plane of the transmitarray. The main beam can be switched by exciting these feeds individually. In addition, it has an impedance bandwidth (|S11 | <−10 dB) from 24.5 GHz to 32.5 GHz for all the feed positions. The proposed antenna system is a good candidate for radar, wireless power transmission, and high‐power military applications.
A scattering‐foil free electron beam to increase dose rate for total skin electron therapy (TSET)
Authors: Ding George X. , Chen Zhe (Jay) , Homann Kenneth 
Published: June 2024

AbstractBackgroundElectron beams are used at extended distances ranging between 300 to 700 cm to uniformly cover the entirety of the patient's skin for total skin electron therapy (TSET). Even with electron beams utilizing the high dose rate total skin electron (HDTSe) mode from the Varian 23iX or TrueBeam accelerators, the dose rate is only 2500 cGy/min at source‐to‐surface distance (SSD) = 100 cm. At extended distances, the decrease in dose rate leads to long beam delivery times that can limit or even prevent the use of the treatment for patients who, in their weakened condition, may be unable to stand on their own for extended periods of time. Previously, to increase dose rate, a customized 6 MeV electron beam was created by removing the x‐ray target, flattening filter, beam monitor chamber, and so forth. from the beam path (Chen, et at IJROBP 59, 2004) for TSET. Using this scattering‐foil free (SFF) electron beam requires the treatment distance be extended to 700 cm to achieve dose uniformity from the single beam. This room size requirement has limited the widespread use of the 6 MeV‐SFF beam.PurposeThis study explores an application of a dual‐field technique with a 6 MeV‐SFF beam to provide broad and uniform electron fields to reduce the treatment distances in order to overcome treatment room size limitations.MethodsThe EGSnrc system was used to generate incident beams. Gantry angles between 6 MeV‐SFF dual‐fields were optimized to achieve the similar patient skin dose distribution resulting from a standard 6 MeV‐HDTSe dual‐field configuration. The patient skin dose comparisons were performed based on the patient treatment setup geometries using dose‐volume‐histograms.ResultsSimilar dose coverage can be achieved between 6 MeV‐SFF and 6 MeV‐HDTSe beams by reducing gantry angles between dual‐field geometries by 8° and 7° at treatment distances of 400 and 500 cm, respectively. To achieve 95% mean dose to the first 5 mm of skin depth in the torso area, the mean dose to depths of 5–10 mm and 10–15 mm below the skin surface was 74% (74%) and 49% (50%) of the prescribed dose when using 6 MeV‐SFF (6 MeV‐HDTSe) beam, respectively.ConclusionsThe 6 MeV‐SFF electron beam is feasible to provide similar TSET skin dose coverage at SSD ≥ 400 cm using a dual‐field technique. The dose rate of the 6 MeV‐SFF beam is about 4 times that of current available 6 MeV‐HDTSe beams at treatment distances of 400–500 cm, which significantly shortens the treatment beam‐on time and makes TSET available to patients in weakened conditions.