bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smart hospital: achieving interoperability and raw data collection from medical devices in clinical routine
Authors: Martens Eimo , Haase Hans-Ulrich , Mastella Giulio , Henkel Andreas , Spinner Christoph , Hahn Franziska , Zou Congyu , Fava Sanches Augusto , Allescher Julia , Heid Daniel , Strauss Elena , Maier Melanie-Maria , Lachmann Mark , Schmidt Georg , Westphal Dominik , Haufe Tobias , Federle David , Rueckert Daniel , Boeker Martin , Becker Matthias , Laugwitz Karl-Ludwig , Steger Alexander , Müller Alexander 
Published: March 2024

IntroductionToday, modern technology is used to diagnose and treat cardiovascular disease. These medical devices provide exact measures and raw data such as imaging data or biosignals. So far, the Broad Integration of These Health Data into Hospital Information Technology Structures—Especially in Germany—is Lacking, and if data integration takes place, only non-Evaluable Findings are Usually Integrated into the Hospital Information Technology Structures. A Comprehensive Integration of raw Data and Structured Medical Information has not yet Been Established. The aim of this project was to design and implement an interoperable database (cardio-vascular-information-system, CVIS) for the automated integration of al medical device data (parameters and raw data) in cardio-vascular medicine.MethodsThe CVIS serves as a data integration and preparation system at the interface between the various devices and the hospital IT infrastructure. In our project, we were able to establish a database with integration of proprietary device interfaces, which could be integrated into the electronic health record (EHR) with various HL7 and web interfaces.ResultsIn the period between 1.7.2020 and 30.6.2022, the data integrated into this database were evaluated. During this time, 114,858 patients were automatically included in the database and medical data of 50,295 of them were entered. For technical examinations, more than 4.5 million readings (an average of 28.5 per examination) and 684,696 image data and raw signals (28,935 ECG files, 655,761 structured reports, 91,113 x-ray objects, 559,648 ultrasound objects in 54 different examination types, 5,000 endoscopy objects) were integrated into the database. Over 10.2 million bidirectional HL7 messages (approximately 14,000/day) were successfully processed. 98,458 documents were transferred to the central document management system, 55,154 materials (average 7.77 per order) were recorded and stored in the database, 21,196 diagnoses and 50,353 services/OPS were recorded and transferred. On average, 3.3 examinations per patient were recorded; in addition, there are an average of 13 laboratory examinations.DiscussionFully automated data integration from medical devices including the raw data is feasible and already creates a comprehensive database for multimodal modern analysis approaches in a short time. This is the basis for national and international projects by extracting research data using FHIR.
Application research on low cost support method for surrounding rock of broken section roadway in phosphate mine area
Authors: Xu Mengchao , Li Xiaoshuang , Wang Jiawen , Cao Mengzhen , Wang Menglai , Li Shujian 
Published: March 2024

Introduction: Taking a phosphate mine in Yunnan as the engineering research background, the fractured rock mass of the No. 1 belt roadway is selected as the research object.Methods: To reduce the cost of tunnel surrounding rock support and optimize construction technology, a combination of numerical simulation software Midas and on-site experiments was used to compare and analyze the distribution characteristics of the plastic zone of tunnel surrounding rock, deformation characteristics of tunnel surrounding rock, and stress characteristics of tunnel support anchor bolts under two support methods: double-layer spray anchor mesh and single-layer spray anchor mesh with steel bar.Results: Research findings indicate that adopting the single-layer spray anchor mesh with steel bar support method results in a more uniform distribution of the plastic zone at the top of the tunnel surrounding rock, with a smaller range. The settlement of the roof and bulging of the bottom plate in the roadway’s surrounding rock, supported by a single-layer spray anchor mesh and steel bars, measure at 75.033 mm and 82.165 mm, respectively. Additionally, the internal bulging on both sides of the roadway’s surrounding rock is recorded as 37.835 mm and 37.470 mm, respectively. On the other hand, when utilizing a double-layer spray anchor mesh for support, the settlement of the roof and bulging of the bottom plate in the roadway’s surrounding rock are measured at 84.199 mm and 85.255 mm, respectively. Correspondingly, the internal bulging on both sides of the roadway’s surrounding rock records measurements of 41.670 mm and 41.756 mm, respectively. Furthermore, adopting the single-layer spray anchor mesh with steel bar support method ensures a more even transfer of axial forces to the steel bars, thereby increasing the overall load-bearing capacity. In contrast, the anchor bolts in the double-layer spray anchor mesh support method experience higher axial forces, leading to more pronounced stress concentration.Discussion: By comparing the field monitoring data, it is evident that the single-layer spray anchor mesh with steel bar support method exhibits significantly better control over the tunnel surrounding rock than the double-layer spray anchor mesh support method. Therefore, replacing the double-layer spray anchor net support with a single-layer spray anchor net with steel bar support method is entirely feasible and can meet on-site practical production requirements. The research results hold significant value in providing guidance and reference for selecting cost-effective support schemes for tunnel surrounding rock.
Development and application of the overseas exchange willingness and demand survey questionnaire for medical students
Authors: Wang Jingna , Ni Haojie , Ma Huan , Wang Minyan , Shi Yun , Ji Conghua 
Published: March 2024

ObjectiveThere has been a significant increase in international student exchange in recent years, with medical students comprising a large proportion of international students. This study aimed to develop and validate a questionnaire, the Medical Student Overseas Exchange Willingness and Demand Survey Questionnaire (MS-OEWDSQ), to assess medical students’ intentions to study abroad and explore the potential influencing factors.MethodsThis study was conducted in three stages: item generation and scale development; pilot study; and examination of scale reliability and validity. The item pool for the questionnaire was compiled from a literature review, an assessment of other relevant questionnaires, and interviews with medical students. Descriptive statistics were generated, and correlation analysis was performed to analyze the questionnaire data. The reliability of the measure was examined according to its internal consistency and split-half reliability. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to determine the factor structure and test the construct validity.ResultsThe final version of the MS-OEWDSQ comprised three factors with a total of 14 items. The total Cronbach’s α coefficient of the questionnaire was 0.844, and the total split-half reliability coefficient was 0.639. This study also identified several factors that may affect medical students’ willingness to go abroad for exchange. Specifically, education (p &lt; 0.05) and foreign language level (p &lt; 0.05) were associated with the MS-OEWDSQ score, providing directions for future related research.ConclusionThis study developed and validated a questionnaire to measure medical students’ willingness and demand for overseas exchange. This measure provides a powerful tool for evaluating whether medical students are willing to participate in overseas exchange. The questionnaire can be employed to help medical students self-test their intention to study abroad and to help medical colleges provide more accurate support and assistance to students who intend to study abroad.
Quantitative susceptibility mapping for iron monitoring of multiple subcortical nuclei in type 2 diabetes mellitus: a systematic review and meta-analysis
Authors: Mohammadi Sana , Ghaderi Sadegh , Sayehmiri Fatemeh , Fathi Mobina 
Published: March 2024

IntroductionIron accumulation in the brain has been linked to diabetes, but its role in subcortical structures involved in motor and cognitive functions remains unclear. Quantitative susceptibility mapping (QSM) allows the non-invasive quantification of iron deposition in the brain. This systematic review and meta-analysis examined magnetic susceptibility measured by QSM in the subcortical nuclei of patients with type 2 diabetes mellitus (T2DM) compared with controls.MethodsPubMed, Scopus, and Web of Science databases were systematically searched [following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines] for studies reporting QSM values in the deep gray matter (DGM) regions of patients with T2DM and controls. Pooled standardized mean differences (SMDs) for susceptibility were calculated using fixed-effects meta-analysis models, and heterogeneity was assessed using I2. Sensitivity analyses were conducted, and publication bias was evaluated using Begg’s and Egger’s tests.ResultsSix studies including 192 patients with T2DM and 245 controls were included. This study found a significant increase in iron deposition in the subcortical nuclei of patients with T2DM compared to the control group. The study found moderate increases in the putamen (SMD = 0.53, 95% CI 0.33 to 0.72, p = 0.00) and dentate nucleus (SMD = 0.56, 95% CI 0.27 to 0.85, p = 0.00) but weak associations between increased iron levels in the caudate nucleus (SMD = 0.32, 95% CI 0.13 to 0.52, p = 0.00) and red nucleus (SMD = 0.22, 95% CI 0.00 0.44, p = 0.05). No statistical significance was found for iron deposition alterations in the globus pallidus (SMD = 0.19; 95% CI −0.01 to 0.38; p = 0.06) and substantia nigra (SMD = 0.12, 95% CI −0.10, 0.34, p = 0.29). Sensitivity analysis showed that the findings remained unaffected by individual studies, and consistent increases were observed in multiple subcortical areas.DiscussionQSM revealed an increase in iron in the DGM/subcortical nuclei in T2DM patients versus controls, particularly in the motor and cognitive nuclei, including the putamen, dentate nucleus, caudate nucleus, and red nucleus. Thus, QSM may serve as a potential biomarker for iron accumulation in T2DM patients. However, further research is needed to validate these findings.
Spatiotemporal distribution patterns of soil ciliate communities in the middle reaches of the Yarlung Zangbo River
Authors: Huang Qian , Li Mingyan , Li Tianshun , Zhu Shiying , Wang Zhuangzhuang , Pu Bu 
Published: March 2024

Introduction: Soil ciliates, as protozoa, play a crucial role in biogeochemical cycling and the soil food web, yet they are highly sensitive to environmental fluctuations in soil conditions. The diversity and biogeographic characteristics of soil ciliates in the Tibetan Plateau remain poorly understood. As part of a regional survey focused on soil ciliate diversity, we investigated the composition and spatiotemporal variations of soil ciliate communities along the Yarlung Zangbo River, a representative soil habitat in the Tibetan Plateau.Methods: A total of 290 soil samples were collected from four habitat types of grassland, shrubland, forestland and wetland in the middle reaches of the Yarlung Zangbo River during the wet and dry seasons, and 138 species of ciliates were identified.Results: Soil ciliate diversity exhibited greater variation across habitat types than seasons. Moreover, soil ciliate diversity was higher during the wet season compared to the dry season, with the wetland habitat showing the highest diversity and the grassland habitat displaying the lowest. We observed spatiotemporal heterogeneity in the composition of soil ciliate communities across different seasons and habitat types. Notably, Litostomatea, Karyorelictea, and Prostomatea predominated in ciliate communities during the wet season and in grassland habitat. Phyllopharyngers dominated during dry seasons and in forested regions, while Spirotrichea species were prevalent in wetland and forested areas. The co-occurrence network analysis showed that soil ciliate community was more complex in wet season than in dry season, and the stability of soil ciliate community in wet season was higher than that in dry season. The stability of soil ciliate community in wetland was higher than that in forestland, shrubland and grassland, and the anti-interference ability was stronger. Soil temperature (ST), Total nitrogen (TN), Soil organic matter (SOM) and Soil water content (SWC) are important factors affecting the structure of soil ciliate community. By influencing the metabolic rate and nutrient acquisition of soil ciliates, the distribution pattern of soil ciliate community diversity in the middle reaches of Yarlung Zangbo River is shaped.Discussion: In summary, this study revealed the distribution pattern of soil ciliate community diversity in the Yarlung Zangbo River Basin, and the key factors affecting the spatial and temporal differences and stability of the community, enhancing our understanding of how ciliates adapt to environmental conditions in soil habitats across the Tibetan Plateau.
Coagulation profile in hospitalized children with COVID-19: pediatric age dependency and its impact on long COVID development
Authors: Boyarchuk Oksana , Perestiuk Vita , Kosovska Tetyana , Volianska Liubov 
Published: March 2024

IntroductionPulmonary endotheliopathy and microvascular immunothrombosis play a key role in acute COVID-19. Moreover, persistent endotheliopathy and heightened coagulability frequently occur in individuals recovering from COVID-19, suggesting the intriguing possibility of their role in the development of long COVID. The aim of our study was to investigate the coagulation profile in patients with COVID-19 based on age and their role in the development of long COVID.MethodsWe conducted a prospective single-center cohort study from September 2022 to August 2023. The study involved 190 patients younger than 18 years who were hospitalized at the Ternopil City Children's Hospital, Ukraine due to COVID-19. Patients underwent determination of coagulation profile in addition to the general clinical examination. After discharge from the hospital, patients were monitored for the presence of long COVID symptoms. Among the 157 participants who consented for follow-up, 62 patients (39.5%) had long COVID symptoms according to the WHO definition, while the rest (95 patients) did not have symptoms of long COVID (fully recovered).ResultsThe study revealed the normal count of platelets in the majority of patients (86.8%), whereas abnormalities in the coagulation profile were revealed in 94.5% of children with COVID-19, and these changes were age-dependent. The patients were mostly presented with increased activated partial thromboplastin time (69.1%), prothrombin time (PT) (39.8%) and D-dimer (45.0%). There was no significant difference between the median of platelet levels and coagulation profile indicators between the groups with long COVID and recovered. Among children who developed persistent long COVID symptoms there was a statistically higher percentage of abnormal PT values (53% versus 36.1%, p=0.0432), with no significant differences in other coagulation profile indicators. Abnormal PT along with female gender, comorbidities, especially allergic pathology, nutritional disorder, including obesity, were determined as potential risk factors of the long COVID development (Odds ratio - 2.0611; 95% 1.0179-4.1737, p=0.0445).ConclusionsThe study highlights the need for more extensive research into the coagulation profiles of pediatric populations, considering age-specific factors. This could enhance our understanding of thromboinflammation in COVID-19 and its potential contribution to the development of persistent symptoms.
Development of an explainable AI system using routine clinical parameters for rapid differentiation of inflammatory conditions
Authors: Hoffmann Joerg , Rheude Anne , Neubauer Andreas , Brendel Cornelia , Thrun Michael C. 
Published: March 2024

IntroductionInflammatory conditions in patients have various causes and require different treatments. Bacterial infections are treated with antibiotics, while these medications are ineffective against viral infections. Autoimmune diseases and graft-versus-host disease (GVHD) after allogeneic stem cell transplantation, require immunosuppressive therapies such as glucocorticoids, which may be contraindicated in other inflammatory states. In this study, we employ a combination of straightforward blood tests to devise an explainable artificial intelligence (XAI) for distinguishing between bacterial infections, viral infections, and autoimmune diseases/graft-versus-host disease.Patients and methodsWe analysed peripheral blood from 80 patients with inflammatory conditions and 38 controls. Complete blood count, CRP analysis, and a rapid flow cytometric test for myeloid activation markers CD169, CD64, and HLA-DR were utilized. A two-step XAI distinguished firstly with C5.0 rules pruned by ABC analysis between controls and inflammatory conditions and secondly between the types of inflammatory conditions with a new bivariate decision tree using the Simpson impurity function.ResultsInflammatory conditions were distinguished using an XAI, achieving an overall accuracy of 81.0% (95%CI 72 – 87%). Bacterial infection (N = 30), viral infection (N = 26), and autoimmune diseases/GVHD (N = 24) were differentiated with accuracies of 90.3%, 80.0%, and 79.0%, respectively. The most critical parameter for distinguishing between controls and inflammatory conditions was the expression of CD64 on neutrophils. Monocyte count and expression of CD169 were most crucial for the classification within the inflammatory conditions.ConclusionTreatment decisions for inflammatory conditions can be effectively guided by XAI rules, straightforward to implement and based on promptly acquired blood parameters.
Long-term reduced functional capacity and quality of life in hospitalized COVID-19 patients
Authors: da Silveira Anderson Donelli , Scolari Fernando Luis , Saadi Marina Petersen , Brahmbhatt Darshan H. , Milani Mauricio , Milani Juliana Goulart Prata Oliveira , Junior Gerson Cipriano , Sartor Ivaine Tais Sauthier , Zavaglia Gabriela Oliveira , Tonini Maiko Luis , da Costa Marcela Santos Correa , Scotta Marcelo Comerlato , Stein Renato T. , Rosa Regis Goulart 
Published: March 2024

BackgroundPersistent symptoms and exercise intolerance have been reported after COVID-19, even months after the acute disease. Although, the long-term impact on exercise capacity and health-related quality of life (HRQoL) is still unclear.Research questionTo assess the long-term functional capacity and HRQoL in patients hospitalized due to COVID-19.Study design and methodsThis is a prospective cohort study, conducted at two centers in Brazil, that included post-discharge COVID-19 patients and paired controls. The cohort was paired by age, sex, body mass index and comorbidities, using propensity score matching in a 1:3 ratio. Patients were eligible if signs or symptoms suggestive of COVID-19 and pulmonary involvement on chest computed tomography. All patients underwent cardiopulmonary exercise testing (CPET) and a HRQoL questionnaire (SF-36) 6 months after the COVID-19. The main outcome was the percentage of predicted peak oxygen consumption (ppVO2). Secondary outcomes included other CPET measures and HRQoL.ResultsThe study sample comprised 47 post-discharge COVID-19 patients and 141 healthy controls. The mean age of COVID-19 patients was 54 ± 14 years, with 19 (40%) females, and a mean body mass index of 31 kg/m2 (SD, 6). The median follow-up was 7 months (IQR, 6.5–8.0) after hospital discharge. PpVO2 in COVID-19 patients was lower than in controls (83% vs. 95%, p = 0.002) with an effect size of 0.38 ([95%CI], 0.04–0.70). Mean peak VO2 (22 vs. 25 mL/kg/min, p = 0.04) and OUES (2,122 vs. 2,380, p = 0.027) were also reduced in the COVID-19 patients in comparison to controls. Dysfunctional breathing (DB) was present in 51%. HRQoL was significantly reduced in post COVID patients and positively correlated to peak exercise capacity.InterpretationHospitalized COVID-19 patients presented, 7 months after discharge, with a reduction in functional capacity and HRQoL when compared to historical controls. HRQoL were reduced and correlated with the reduced peak VO2 in our population.
Safety, tolerability, and efficacy estimate of evoked gamma oscillation in mild to moderate Alzheimer’s disease
Authors: Hajós Mihály , Boasso Alyssa , Hempel Evan , Shpokayte Monika , Konisky Alex , Seshagiri Chandran V. , Fomenko Vitella , Kwan Kim , Nicodemus-Johnson Jessie , Hendrix Suzanne , Vaughan Brent , Kern Ralph , Megerian Jonathan T. , Malchano Zach 
Published: March 2024

BackgroundAlzheimer’s Disease (AD) is a multifactorial, progressive neurodegenerative disease that disrupts synaptic and neuronal activity and network oscillations. It is characterized by neuronal loss, brain atrophy and a decline in cognitive and functional abilities. Cognito’s Evoked Gamma Therapy System provides an innovative approach for AD by inducing EEG-verified gamma oscillations through sensory stimulation. Prior research has shown promising disease-modifying effects in experimental AD models. The present study (NCT03556280: OVERTURE) evaluated the feasibly, safety and efficacy of evoked gamma oscillation treatment using Cognito’s medical device (CogTx-001) in participants with mild to moderate AD.MethodsThe present study was a randomized, double blind, sham-controlled, 6-months clinical trial in participants with mild to moderate AD. The trial enrolled 76 participants, aged 50 or older, who met the clinical criteria for AD with baseline MMSE scores between 14 and 26. Participants were randomly assigned 2:1 to receive self-administered daily, one-hour, therapy, evoking EEG-verified gamma oscillations or sham treatment. The CogTx-001 device was use at home with the help of a care partner, over 6 months. The primary outcome measures were safety, evaluated by physical and neurological exams and monthly assessments of adverse events (AEs) and MRI, and tolerability, measured by device use. Although the trial was not statistically powered to evaluate potential efficacy outcomes, primary and secondary clinical outcome measures included several cognitive and functional endpoints.ResultsTotal AEs were similar between groups, there were no unexpected serious treatment related AEs, and no serious treatment-emergent AEs that led to study discontinuation. MRI did not show Amyloid-Related Imaging Abnormalities (ARIA) in any study participant. High adherence rates (85–90%) were observed in sham and treatment participants. There was no statistical separation between active and sham arm participants in primary outcome measure of MADCOMS or secondary outcome measure of CDR-SB or ADAS-Cog14. However, some secondary outcome measures including ADCS-ADL, MMSE, and MRI whole brain volume demonstrated reduced progression in active compared to sham treated participants, that achieved nominal significance.ConclusionOur results demonstrate that 1-h daily treatment with Cognito’s Evoked Gamma Therapy System (CogTx-001) was safe and well-tolerated and demonstrated potential clinical benefits in mild to moderate AD.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03556280.