bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Characteristics and Healthcare Use for High-cost Patients with Musculoskeletal Disorders in Norway: A Cohort Study
Authors: Amundsen Olav , Moger Tron Anders , Holte Jon Helgheim , Haavaag Silje Bjørnsen , Bragstad Line Kildal , Hellesø Ragnhild , Tjerbo Trond , Vøllestad Nina Køpke 
Published: March 2024

Abstract

Background:
A high proportion of healthcare costs can be attributed to musculoskeletal disorders (MSDs). A small proportion of patients account for most of the costs, and there is increasing focus on addressing service overuse and high costs. We aimed to describe healthcare use contributing to high costs over a five-year period at the individual level and to examine differences between high-cost patients who use healthcare in accordance with guidelines and those who do not. These findings can contribute to the understanding of healthcare use for high-cost patients and help in planning future MSD-care.
Methods:
This study combines Norwegian registries on healthcare use, diagnoses, demographic, and socioeconomic factors. Patients (≥ 18 years) were included by their first MSD-contact in 2013–2015. We analysed healthcare use during the subsequent five years. Descriptive statistics are used to compare high-cost (≥95th percentile) and non-high-cost patients, and to describe the most expensive specialist healthcare contact and healthcare care use prior to this contact. Logistic regression was used to assess factors associated with having seen healthcare personnel delivering conservative treatment prior to the most expensive specialist care contact.
Results:
High-cost patients were responsible for 60% of costs, with 90% related to hospital treatment. Seventy-seven percent of high-cost patients had one specialist healthcare contact responsible for more than half of their total costs, predominantly related to surgical treatment. Fractures/injuries were the most common diagnosis for these contacts, while osteoarthritis and spinal, shoulder and knee disorders accounted for 42%. Less than half had seen a healthcare service delivering conservative treatment, other than GPs, the year before this contact. Being male, from a small municipality, lower education and higher comorbidity were associated with lower odds of having been to healthcare services focused on conservative treatment prior to the most expensive specialist care contact.
Conclusion:
Most health care costs are concentrated among a small proportion of patients. In contrast to recommendations, less than half had been to a healthcare service focused on conservative management prior to specialist care treatment. This could indicate that there is room for improvement, and that ensuring sufficient capacity for conservative care can be beneficial for reducing overall costs.
Diagnosis and risk factor mining for valvular heart disease with atrial fibrillation via ensemble machine learning
Authors: Wang Zhengjie , Lei Nuoyangfan , Zhang Yiweng , Tong Qi , Sun Yiren , Cai Jie , Xu Qiyue , Mahamoud Oumar , Liu Xuemei , Zhao Qijun , Qian Yongjun 
Published: March 2024

Abstract

Diagnosis and risk assessment of atrial fibrillation (AF) remain challenging. As the gold standard, a 12-lead electrocardiogram (ECG) has the limitations of missing diagnosis and high cost of 24-hour Holter ECG. Existing risk scores for AF are also limited by low accuracy. Although electronic health records (EHR) have rich information of patients and machine learning (ML) has been proven useful in medical applications, it is still an open issue how to utilize ML and EHR to analyze AF in patients with valvular heart disease. We collected the EHR of 2077 patients with valvular heart disease (707 cases of AF), and investigated logistic regression (LR), standard ML, and ensemble ML models combined with Smotenn and Shapley algorithms. In addition, we explored the factors related to the occurrence of AF from two aspects: population-individual level feature analysis and cut-off value estimation. The sensitivity of Stacking and Blending ensemble ML models is 0.851 (0.842-0.860) and 0.876 (0.868-0.883), respectively, significantly higher than that of other models (P value <0.001). According to the Shapley algorithm, the occurrence of AF was strongly correlated with the left atrial diameter (LAD), peak mitral e-wave velocity (Emv), stroke volume (SV), and right atrial diameter (RAD). Finally, three continuous features (LAD=43mm, Emv=1.2m/s, SV=44mL) were identified as potential AF risk cut-off values. The ensemble ML models show high potential to build knowledge-based AF diagnosis systems that can assist doctors in making a precise diagnosis of AF and give early warning to patients.
Effect of Geopolymer Treatment on the Ultimate Bearing Capacity of Sabkha Soil under Axial Loading
Authors: Hamid Wagdi , Alnuaim Ahmed 
Published: March 2024

Abstract
Saline sabkha soils pose a major challenge for geotechnical engineering because of their low bearing capacity and high settlement potential. The purpose of this research was to evaluate the behavior of stabilized sabkha soil under axial stress after geopolymer treatment utilizing the mix and compact method. A comprehensive numerical analysis, validated by experimental results, was conducted to study the load–displacement behavior of sabkha soil in its natural and treated states. A parametric study using the finite element method was performed to examine the effects of the thickness and diameter of the geopolymer-treated soil layer on the ultimate bearing capacity (UBC). Response surface methodology and ANOVA were employed to develop and evaluate a predictive model for UBC as a function of the dimensionless ratios \(\frac{{H}_{m}}{{D}_{f}}\) and \(\frac{{D}_{m}}{{D}_{f}}\). The results revealed that the geopolymer treatment significantly enhanced the load-bearing capacity of sabkha soil by increasing the thickness and diameter of the treated soil layer. However, a higher ratio of \(\frac{{D}_{m}}{{D}_{f}}\) than 2 adversely affected soil performance when the \(\frac{{H}_{m}}{{D}_{f}}\) ratio was less than 0.6. The study also demonstrated that geopolymer is a novel and environmentally friendly technique for stabilizing sabkha soils, as it utilizes waste materials (fly ash and mine tailings).
Validating Large Language Models for Identifying Pathologic Complete Responses After Neoadjuvant Chemotherapy for Breast Cancer Using a Population-Based Pathologic Report Data
Authors: Cheligeer Cheligeer , Wu Guosong , Laws Alison , Quan May Lynn , Li Andrea , Brisson Anne-Marie , Xie Jason , Xu Yuan 
Published: March 2024

Abstract

In the context of breast cancer management, the accurate determination of pathologic complete response (pCR) from large narrative pathology reports is pivotal for cancer outcome and survivorship studies. Leveraging the Large Language Models (LLMs) in digital pathology, our study developed and validated methods for identifying pCR from pathology reports of 351 breast cancer patients who underwent neoadjuvant chemotherapy. The optimum method demonstrated a sensitivity of 100.0% (95%CI: 100.0-100.0%), positive predictive value of 84.0% (95%CI: 70.0-96.8%), and F1 score of 91.3% (95%CI: 81.5–98.1%). These algorithms, integrating diverse LLMs, exhibited superior performance compared to traditional machine learning models. Our findings suggest LLMs hold significant potential utility in clinical pathology for extracting critical information from textual data.
IFT20 and WWTR1 govern bone homeostasis via synchronously regulating the expression and stability of TβRII in osteoblast lineage cells
Authors: Yang Shuying , Li Yang , Yang Shuting 
Published: March 2024

Abstract

Balance of bone and marrow fat formation is critical for bone homeostasis. The imbalance of bone homeostasis will cause various bone diseases, such as osteoporosis. However, the precise mechanisms governing osteoporotic bone loss and marrow adipose tissue (MAT) accumulation remain poorly understood. By analysis of publicly available databases from bone samples of osteoporosis patients, we found that the expression of intraflagellar transport 20 (IFT20) and WW domain containing transcription regulator 1 (WWTR1) were significantly downregulated in osteoblast lineage cells. Additionally, we found that double deletions of IFT20 and WWTR1 in osteoblasts resulted in a significant accumulation of MAT and bone loss. Moreover, IFT20 and WWTR1 deficiency in osteoblasts exacerbated bone-fat imbalance in ovariectomy (OVX)- and high-fat-diet (HFD)-induced osteoporosis mouse models. Mechanistically, we found that deletions of IFT20 and WWTR1 in osteoblasts synergistically inhibited osteogenesis and promoted adipogenesis and osteoclastogenesis. We also found that IFT20 interacted with TGF-β receptor type II (TβRII) to enhance TβRII stability by blocking c-Cbl-mediated ubiquitination and degradation of TβRII. WWTR1 transcriptionally upregulated TβRII expression by directly binding its promoter. These findings indicate that targeting IFT20/WWTR1 may be a potential therapeutic strategy for the treatment of osteoporosis.
Lung protective effect of Apigenin against X-ray radiation: an experimental study
Authors: Rajabinasab Fatemeh , Hajimirzaei Pooya , Ramezani Fatemeh , Moayer Fariborz , Gorjipour Fazel , Nikoofar Alireza , Hasanzadeh Leila , Hamblin Michael R , janzadeh Atousa , Paydar Reza 
Published: March 2024

Abstract
The lung is a radiation-sensitive organ. When cells are damaged due to accidental radiation exposure or treatment, they release molecules that lead to the recruitment of immune cells, resulting in the accumulation of inflammatory cytokines at the site of damage. Apigenin (Api) is a natural flavonoid known for its anti-inflammatory properties. In this study, we investigated the radioprotective properties of Api in the lung. Materials and methods: Thirty-six Wistar rats were randomly assigned to nine groups: control, radiation (Rad), CMC + Rad, Rad + Api 10, and Rad + Api 20. Api was administered with an intraperitoneal injection for 7 days, after which the rats were irradiated with 6 Gy whole-body X-rays. At 6 and 72 hours post-irradiation, the rats were euthanized, and their lung tissue was extracted. Results: Radiation led to increased alveolar wall thickness and the infiltration of macrophages and lymphocytes. Furthermore, the expression levels of inflammatory factors such as nuclear factor of kappa light polypeptide gene enhancer in B-cells (NF-ĸB), Glycogen synthase kinase-3 beta (GSK-3β), transforming growth factor-beta1 (TGF-β1), and epigenetic factors including DNA methyltransferase 3a (DNMT3a) and Histone deacetylase 2 (HDAC2) were elevated in the lung tissue following radiation. Meanwhile, the expression level of IκBα decreased. However, administration of Api (at both 10 and 20 doses) reversed the adverse effects induced by radiation. ​Conclusion: In conclusion, Api administration mitigated radiation-induced lung damage by reversing inflammatory and epigenetic changes.
Nitrogen transfer mechanism of mycorrhizal network between Pinus massoniana Lamb. seedlings
Authors: Wang Yi , Ren Youzhi , Tu Guiying , Meng Chao , Zhang Zhiyuan 
Published: March 2024

Abstract

The common mycorrhizal network is to facilitate the underground interchange of materials and information between plants. What the common mycorrhizal network does for plants and the environment yet unknown. The mixed strains (Sm) of Pisolithus orientalis (Po), Scleroderma citrinum (Sc), Suillus luteus (Sl) and non-inoculation (CK) were taken. Varying nitrogen concentrations by used 15N isotope labeling to investigate the impact of mycorrhizal network of Pinus massoniana Lamb. The recipient seedlings could contract mycelia from the donor, the higher of infection rate, the greater of growth and ability to absorb nutrients. P. massoniana seedlings could benefit from both inoculation and nitrogen treatment for growth and nutrient uptake. Under the same nitrogen treatment, donor/recipient seedlings of Sm exhibited a greater uptake of nitrogen compared to those of CK. Under Sm treatment, the 15N absorption by donor/recipient seedlings was the highest at N6 and N4, the 15N utilization and transfer rates were the highest at N4, and the 15N allocation rates were highest in roots at N2 and N6, in leaves at N4 (45.21% and 50.59%, respectively). The 15N transfer rate had a major impact on the biomass of recipient seedlings, 15N absorption, and 15N allocation. Sm-N4 treatment performed well in these areas.
Efficacy of erythropoietin for the late treatment of anemia of prematurity in a level IV neonatal intensive care unit: A retrospective single-center cohort study
Authors: Connolly Jillian , Marasch Jaime , McClary Jacquelyn , Desai Riddhi , Sundaram Anupama , Neudecker Mandy , Nock Mary , Ryan Rita 
Published: March 2024

Abstract

Objective
To determine the average change in hematocrit (Hct) after erythropoietin administration for the treatment of anemia of prematurity and describe the population in which erythropoietin is being utilized.
Study Design
This retrospective chart review study included infants who received erythropoietin for the treatment of anemia of prematurity.
Results
There were 132 infants representing 162 unique treatment courses included in the study. The average change in Hct was 6.2% (SD 3.9%, p<0.001). The average duration of therapy was 9 days (±7) and 6 doses (±2). Rise in Hct was associated with a higher number of EPO doses (P<0.001) and higher postmenstrual age (p<0.001). In our small cohort we did not find an association between the number of rEPO doses and retinopathy of prematurity (ROP) requiring treatment.
Conclusion
Erythropoietin is safe and effective at treating anemia of prematurity as evidenced by a clinically and statistically significant increase in Hct from baseline.
Clinical characteristics and surgical outcomes of acute acquired V-pattern esotropia
Authors: Xu Kai , Zhang Yidan , Fang Wangyi , Liu Qingyu , Hu Zian , Li Wen , Qiao Tong 
Published: March 2024

Abstract
Background
To evaluate the clinical characteristics, surgical outcomes and prognosis of acute acquired V-pattern esotropia (AAVE) by comparing with typical V-pattern esotropia (VE).
Methods
15 cases of AAVE and 18 cases of VE were retrospectively reviewed in this study. All patients underwent a comprehensive medical history, ophthalmologic and orthoptic examinations, and stereopsis test. Patients with neurological symptoms were received brain and orbital imaging. Surgical intervention was implemented to correct primary position esotropia and inferior oblique overaction (IOOA).
Results
The mean age at onset of AAVE group and VE group were 8.46 ± 3.60 years and 3.12 ± 1.25 years, respectively (P < 0.0001). One patient of AAVE had a history of febrile convulsion and generalized seizures. The cycloplegic refraction of AAVE was mild to moderate hyperopia or myopia, with a mean diopter (D) of + 0.71 D (spherical equivalent, range, -4.75 to + 3.5 D). The preoperative esodeviation of AAVE was significantly greater, but there was no statistical difference in the severity of IOOA and extent of V pattern between two groups. Overall surgical success rate of AAVE was 73.3%. The stereoacuity of AAVE was obviously improved postoperatively at their last follow-up visit compared with VE group (χ2 = 8.53, P = 0.0362).
Conclusions
AAVE was a sudden onset of esotropia, occurs more common in older children, with mild to moderate hyperopia or myopia. All the AAVE patients had IOOA and V pattern. Some cases may be associated with neurological disorders. Surgical outcomes of AAVE were highly favorable. Trial registration: ChiCTR2000038600 20/09/24 retrospectively registered.
Near-infrared light-driven high-performance photocatalytic cross-coupling of non-active alkyl halides and thiols
Authors: Yuan Shang-Fu , Liu Jia-Xing , Zhang Jing-Ni , Liang Jin-Guan , Ma Hao , Zhou Rui , Li Dongsheng , Chen Wenbin , Li Ming-De , Wu Tao 
Published: March 2024

Abstract

Highly-efficient artificial synthesis of C−S bond-containing compounds has garnered widespread attention due to the crucial role of thioethers in constructing biomolecules, pharmaceuticals, and organic materials. Despite the photocatalytic synthesis of C(sp2)−S bonds from aryl halides using UV-visible light has been well-documented, achieving this with low-energy near-infrared (NIR) light remains challenging as the absence of a suitable NIR-activated photocatalytic system. Additionally, the application of readily available, while inactivated alkyl halides for C(sp3)−S bond construction has not yet been realized. Herein, we employed a designed composite photocatalyst (P2-Au), combining metal chalcogenide semiconductor clusters (P2) and gold nanorods (AuNRs), to achieve highly selective photocatalytic cross-coupling of alkyl halides and thiols under NIR irradiation. This protocol works well with diverse inert alkyl bromides/chlorides, and shows excellent functional group compatibility. Mechanistic studies revealed that hot electrons generated from AuNRs are transferred through P2 to activate halides, leading to the formation of alkyl radicals. Simultaneously, photo-induced holes on AuNRs oxidize thiols to thiol radicals, facilitating a radical-radical cross-coupling process for C–S bond formation. This work not only pushes the boundaries of energy utilization but also expands the substrate applicability toward photocatalytic C−S coupling in valuable organosulfur chemistry.
Development and Pilot Testing of a Comprehensive and Culturally-sensitive Infant Feeding Structured Questionnaire: A Cross-sectional Design
Authors: Yazeedi Basma Al , Yazeedi Salma Al , Omari Omar Al , Alhatali Badriya , Khalaf Atika 
Published: March 2024

Abstract

Background: Infant feeding tools available in the literature lack comprehensiveness and inclusiveness to infants of different ages. This study aimed to pilot test a newly developed infant feeding structured questionnaire.
Methods: This study utilized a cross-sectional design. The structured questionnaire developed had two main sections; the first section included questions relative to sociodemographic characteristics, birth and clinical history, and infant food history in the first year. The second section incorporated a 22-item design to stipulate a comprehensive description of infant feeding practices (IFP) and Infant Feeding Beliefs (IFB). A convenient sampling technique was used to collect data from six health centers located in Muscat and Al-Sharqia North. The infant feeding practices and beliefs variables were dichotomized to either meeting the recommendations (1) or not meeting the recommendations (0), based on the WHO guidelines
Results: The data analysis encompassed a cohort of 203 participants. Most mothers aged between 26 and 35 years (58.6%). Among the mothers, 67% practiced exclusive breastfeeding in the first six months, 89.2% were breastfeeding in the first year, and 44.9% initiated infant formula feeding at six months of age or later. Moreover, 64% of the mothers introduced solid food (e.g., rice, vegetables, fruits) at six months, while (87.2%) started feeding meat, chicken, or fish at six months. For feeding egg white, fresh milk, and bee honey, 43.4%, 84.7%, and 78.4%, respectively, met the recommendation of waiting until the child ages 12 months. The mean IFP score was 8.09 (SD 1.75), while the mean IFB score was slightly higher (m=8.90, SD= 1.45). The Pearson correlation analysis signified a positive relationship between IFP and IFB (r=0.53, p<0.001). Mothers who received infant feeding counseling had higher IFP scores compared to the mothers who did not. Additionally, mothers with at least a baccalaureate degree and a family income of at least 1000 OMR had better IFB recommendation scores (p < 0.05).
Conclusions: Data generated from the newly developed infant feeding practices and beliefs questionnaire shall assist in determining the risks associated with multiple nutrition-related morbidities in children, thus promising a valid and feasible mean for a comprehensive infant feeding assessment.
The late Early Pleistocene site of Fuente Nueva-3 (Guadix-Baza Depression, SE Spain): A hyena latrine developed on a quicksand trap for megaherbivores?
Authors: Palmqvist Paul , Campaña Isidoro , Granados Alejandro , Martínez-Navarro Bienvenido , Pérez-Ramos Alejandro , Rodríguez-Gómez Guillermo , Guerra-Merchán Antonio , Ros-Montoya Sergio , Rodríguez-Ruiz María Dolores , García-Aguilar José Manuel , Hernández Víctor , Espigares María P. 
Published: March 2024

Abstract

The late Early Pleistocene archaeological site of Fuente Nueva-3 (FN3), which lies in the Guadix-Baza Depression (SE Spain) and is dated to ~ 1.4 Ma, contributes some of the oldest evidence of hominin presence in Western Europe, including a huge tool assemblage of Oldowan tradition, manuports (i.e., unmodified stones used as percussion tools) and abundant fossils of large mammals, some of which preserve anthropogenic marks related to defleshing, butchering and marrow processing. In addition, there are bones with tooth marks produced by scavenging carnivores. The fertile layers of the FN3 section have been grouped in a lower archaeological level (LAL) and an upper archaeological level (UAL). Both levels preserve abundant skeletal remains and lithic tools. However, the LAL shows a high density of manuports, which suggests that hominin activity was more intense at this level, while the UAL preserves many remains of megaherbivores, particularly proboscideans (Mammuthus meridionalis), and almost all coprolites unearthed from the site, which points to a greater involvement of the giant hyenas (Pachycrocuta brevirostris). In this paper, we (i) test for statistical differences in the composition of the faunal assemblages preserved in the UAL and LAL; and (ii) analyze particle size in the fertile layers of both archaeological levels. Our results show that megaherbivores are comparatively overrepresented in the UAL, specially by young elephants, while other medium-to-large and large-sized ungulates, particularly equids, are more abundant in the LAL, showing a predominance of adult individuals. Concerning the sedimentology, layers 2–3 of the LAL show a predominance of silts and clays, with sands representing a minor fraction. In contrast, layer 5 of the UAL is composed of two-thirds of fine and very fine sands, with the remaining third consisting of silts and clays. These data and the paleoenvironmental reconstruction of layer 5 suggest that it may be interpreted as a paleo-quicksand in which megaherbivores were trapped due to the elevated weight per unit area supported by their feet, and their half-sunken carcasses attracted the scavengers, particularly the hyenas, which fed on these carcasses and defecated in their surroundings.