bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomass and energy potential of Erianthus arundinaceus and Saccharum spontaneum-derived novel sugarcane hybrids in rainfed environments
Authors: Meena Mintu Ram , Govindaraj Perumal , Kumar Raja Arun , Elayaraja Kandasamy , Appunu Chinnaswamy , Kumar Ravinder , Chhabra Manohar Lal , Kulshreshtha Neeraj , Hemaprabha Govind 
Published: March 2024

Abstract
Background
Energy canes are viable feedstocks for biomass industries due to their high biomass production potential, lower susceptibility to insects and diseases, better ability to adapt to extreme conditions and clean bioenergy. Interspecific hybrids (ISH) and intergeneric hybrids (IGH) have great potential to meet the growing demand of biomass, biomass-derived energy and feedstock.

Results
In this study, two types of energy canes, Type I and Type II, derived from S. spontaneum and E. arundinaceous background were evaluated for high biomass, fiber and bioenergy potential under subtropical climate along with the check varieties Co 0238 and CoS 767. Out of 18 energy canes studied, six energy canes, viz., SBIEC11008 (204.15 t/ha), SBIEC11005 (192.93 t/ha), SBIEC13008 (201.26 t/ha), SBIEC13009 (196.58 t/ha), SBIEC13002 (170.15 t/ha), and SBIEC13007 (173.76 t/ha), consistently outperformed the check varieties under Type-I, whereas in type-II, SBIEC11004 (225.78 t/ha), SBIEC11006 (184.89 t/ha), and SBIEC14006 (184.73 t/ha) energy canes produced significantly higher biomass than commercial checks, indicating their superior potential for cogeneration. Estimated energy output from the energy canes (700–1300 GJ/ha/year) exceeded the range of co-varieties (400–500 GJ/ha/year) and energy utilization efficiency in plants and ratoon crops for energy canes viz., SBIEC11008 (3%, 1.97%), SBIEC14006 (1.93%, 2.4%), SBIEC11005 (1.7%, 1.9%), and SBIEC11001 (1.01%, 1.03%), was higher than best checks Co 0238 (0.77, 0.9%). Additionally, energy canes SBIEC 13001 (22.35%), SBIEC 11008 (22.50%), SBIEC 14006 (28.54%), SBIEC 11004 (30.17%) and SBIEC 11001 (27.03%) had higher fiber contents than the co-varieties (12.45%).

Conclusion
The study gives insight about the potential energy canes for higher biomass and energy value. These energy cane presents a vital option to meet the future demand of bioenergy, fiber and fodder for biomass due to their versatile capacity to grow easily under marginal lands without competing with cultivated land worldwide.
Red blood cell transfusion in neurocritical patients: a systematic review and meta-analysis
Authors: Yu Yun , Fu Yuxuan , Li Wenying , Sun Tiantian , Cheng Chan , Chong Yingzi , Han Ruquan , Cui Weihua 
Published: March 2024

Abstract
Background
Anemia can lead to secondary brain damage by reducing arterial oxygen content and brain oxygen supply. Patients with acute brain injury have impaired self-regulation. Brain hypoxia may also occur even in mild anemia. Red blood cell (RBC) transfusion is associated with increased postoperative complications, poor neurological recovery, and mortality in critically ill neurologic patients. Balancing the risks of anemia and red blood cell transfusion-associated adverse effects is challenging in neurocritical settings.

Methods
We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and MEDLINE (PubMed) from inception to January 31, 2024. We included all randomized controlled trials (RCTs) assessing liberal versus restrictive RBC transfusion strategies in neurocritical patients. We included all relevant studies published in English. The primary outcome was mortality at intensive care unit (ICU), discharge, and six months.

Results
Of 5195 records retrieved, 84 full-text articles were reviewed, and five eligible studies were included. There was no significant difference between the restrictive and liberal transfusion groups in ICU mortality (RR: 2.53, 95% CI: 0.53 to 12.13), in-hospital mortality (RR: 2.34, 95% CI: 0.50 to 11.00), mortality at six months (RR: 1.42, 95% CI: 0.42 to 4.78) and long-term mortality (RR: 1.22, 95% CI: 0.64 to 2.33). The occurrence of neurological adverse events and most major non-neurological complications was similar in the two groups. The incidence of deep venous thrombosis was lower in the restrictive strategy group (RR: 0.41, 95% CI: 0.18 to 0.91).

Conclusions
Due to the small sample size of current studies, the evidence is insufficiently robust to confirm definitive conclusions for neurocritical patients. Therefore, further investigation is encouraged to define appropriate RBC transfusion thresholds in the neurocritical setting.
The association of low serum uric acid with mortality in older people is modified by kidney function: National Health and Nutrition Examination Survey (NHANES) 1999–2018
Authors: Fan Zhongcheng , Li Zhongju , Guo Aixin , Li Yang 
Published: March 2024

Abstract
Background
In older individuals, the role of low serum uric acid (SUA) as risk factor for mortality is debated. We therefore studied whether SUA levels, particularly low SUA concentrations, are associated with all-cause and cardiovascular (CV) mortality in older population, and to clarify potential effect modification of kidney function.

Methods
We identified 14,005 older people in National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2018. SUA was measured only at baseline. The relationship between SUA and mortality was assessed using Cox proportional hazards models and restricted cubic spline Cox regression stratified by the estimated glomerular filtration rate (eGFR).

Results
During mean 8.3 years of follow-up, 4852 all-cause death and 1602 CV death were recorded. A significant U-shaped association was observed between SUA with all-cause mortality, with the lowest risk concentration of 5.5 mg/dL. Comparing to the reference group (5 to 7 mg/dL), the HR of 2 to < 5 mg/dL group was 1.11 (1.03–1.21) and 1.14 (1.00–1.30). This relationship was more pronounced in participants with an eGFR ≥ 60 ml/min/1.73m2 (HR, 1.16; 95%CI, 1.06—1.28). This situation similarly occurred in Urine protein negative group (HR, 1.14; 95%CI, 1.04—1.25).

Conclusions
Low SUA concentrations are associated with an increased risk in all-cause and CV mortality among older participants. Extremely low SUA concentrations are especially undesirable, especially in the older adults with normal kidney function.
Convolutional neural network-based magnetic resonance image differentiation of filum terminale ependymomas from schwannomas
Authors: Gu Zhaowen , Dai Wenli , Chen Jiarui , Jiang Qixuan , Lin Weiwei , Wang Qiangwei , Chen Jingyin , Gu Chi , Li Jia , Ying Guangyu , Zhu Yongjian 
Published: March 2024

Abstract
Purpose
Preoperative diagnosis of filum terminale ependymomas (FTEs) versus schwannomas is difficult but essential for surgical planning and prognostic assessment. With the advancement of deep-learning approaches based on convolutional neural networks (CNNs), the aim of this study was to determine whether CNN-based interpretation of magnetic resonance (MR) images of these two tumours could be achieved.

Methods
Contrast-enhanced MRI data from 50 patients with primary FTE and 50 schwannomas in the lumbosacral spinal canal were retrospectively collected and used as training and internal validation datasets. The diagnostic accuracy of MRI was determined by consistency with postoperative histopathological examination. T1-weighted (T1-WI), T2-weighted (T2-WI) and contrast-enhanced T1-weighted (CE-T1) MR images of the sagittal plane containing the tumour mass were selected for analysis. For each sequence, patient MRI data were randomly allocated to 5 groups that further underwent fivefold cross-validation to evaluate the diagnostic efficacy of the CNN models. An additional 34 pairs of cases were used as an external test dataset to validate the CNN classifiers.

Results
After comparing multiple backbone CNN models, we developed a diagnostic system using Inception-v3. In the external test dataset, the per-examination combined sensitivities were 0.78 (0.71–0.84, 95% CI) based on T1-weighted images, 0.79 (0.72–0.84, 95% CI) for T2-weighted images, 0.88 (0.83–0.92, 95% CI) for CE-T1 images, and 0.88 (0.83–0.92, 95% CI) for all weighted images. The combined specificities were 0.72 based on T1-WI (0.66–0.78, 95% CI), 0.84 (0.78–0.89, 95% CI) based on T2-WI, 0.74 (0.67–0.80, 95% CI) for CE-T1, and 0.81 (0.76–0.86, 95% CI) for all weighted images. After all three MRI modalities were merged, the receiver operating characteristic (ROC) curve was calculated, and the area under the curve (AUC) was 0.93, with an accuracy of 0.87.

Conclusions
CNN based MRI analysis has the potential to accurately differentiate ependymomas from schwannomas in the lumbar segment.
Examining the influence of global smoking prevalence on stroke mortality: insights from 27 countries across income strata
Authors: Abeysekera Isuri , De Silva Roshinie , Silva Disuri , Piumika Lakindu , Jayathilaka Ruwan , Rajamanthri Lochana 
Published: March 2024

Abstract
Background
This study investigates the influence of Global Smoking Prevalence (GSP) on Stroke Death Rates (SDR) across 27 countries categorized into High-Income Countries (HIC), Upper Middle-Income Countries (UMIC), Lower Middle-Income Countries (LMIC), and Low-Income Countries (LIC).

Methods
Analysing data from two distinct periods (1990–1999 and 2010–2019), countries exhibiting an increased SDR were selected. The study uses a polynomial regression model, treating income groups as cross-sectional and years as time series data.

Results
Results from the regression model reveal that 17 countries observed a significant impact of GSP on SDR, with only Turkey, Solomon Islands, and Timor-Leste resulting in negative values. However, the study emphasises that out of all 27 countries, the highest occurrence of the impact of GSP on SDR has been reported in the LMIC stratum for the period under review.

Conclusion
It is evident that GSP affects the risk of incidence of stroke death, specifically in the LMIC stratum. Furthermore, it has been identified that GSP is a major preventable risk factor affecting global mortality. To mitigate the risk of stroke death attributable to smoking prevalence, necessary preventive steps should be adopted to encourage smoking cessation, and essential policies should be implemented to reduce the burden of SDR.
Association between nintedanib adherence trajectory and healthcare use among idiopathic pulmonary fibrosis patients
Authors: Nili Mona , Epstein Andrew J. , Nunag Dominic , Olson Amy , Borah Bijan J 
Published: March 2024

Abstract
Background
Although inverse associations have been found between medication adherence and healthcare use and spending outcomes in many clinical settings, no studies to date have examined these relationships for patients with idiopathic pulmonary fibrosis (IPF) initiating nintedanib. We build on our prior study that used group-based trajectory modeling (GBTM) to compare inpatient hospitalization and medical care spending outcomes between groups of patients with different nintedanib adherence trajectories.

Methods
This analysis used 100% Medicare data and included beneficiaries with IPF who initiated nintedanib during 10/01/2014–12/31/2018. The sample consisted of community-dwelling older adults (≥ 66 years) with continuous coverage in Medicare Parts A (inpatient care), B (outpatient care) and D (prescription drugs) for one year before (baseline) and after (follow-up) initiating nintedanib. Patients were assigned to the GBTM-derived adherence trajectory group closest to their own nintedanib adherence experience. All-cause and IPF-related hospitalization events and total medical spending were measured during the follow-up period. Unadjusted and adjusted regression models were estimated to compare outcomes between patients in different nintedanib adherence trajectories.

Results
Among the 1,798 patients initiating nintedanib, the mean age was 75.4 years, 61.1% were male, and 91.1% were non-Hispanic white. The best-fitting GBTM had five adherence trajectories: high adherence, moderate adherence, high-then-poor adherence, delayed-poor adherence, and early-poor adherence. All-cause hospitalizations and total all-cause medical spending were higher among patients in the high-then-poor, delayed-poor and early-poor adherence trajectories than those in the high adherence trajectory. For example, adjusted total all-cause medical spending was $4,876 (95% CI: $1,470 to $8,282) higher in the high-then-poor adherence trajectory, $3,639 (95% CI: $1,322 to $5,955) higher in the delayed-poor adherence trajectory and $3,907 (95% CI: $1,658 to $6,156) higher in the early-poor adherence trajectory compared with the high adherence trajectory. IPF-related hospitalizations and medical care spending were higher among those in the high-then-poor adherence trajectory compared with those in the high adherence trajectory.

Conclusions
Poor adherence to nintedanib was associated with all-cause hospitalizations and medical costs. Therefore, improved adherence programs, such as support programs, can be implemented to reduce economic burden.
Effect of low-level laser therapy in wound healing of primary molar teeth extraction
Authors: Özer Hazal , İnci Merve Abaklı 
Published: March 2024

Abstract
Introduction
Tooth extraction in children requires attention to wound healing and pain management, which are influenced by patient-related factors and behavioral guidance. Aim of the study: The study aimed to evaluate the effect of LLLT on healing sockets in pediatric patients with bilateral primary molar teeth extraction and determine its impact on pain management.

Methods
6–10 years of age, systemically healthy, and with atraumatic extraction indications of bilateral primary molar teeth were included in the study (n = 40). In the first session, randomly selected teeth were extracted under local anesthesia. In the control group, only clot formation in the socket was observed and photographed. The other group extractions were performed 2 weeks later. The low-level laser therapy (LLLT) group was treated with a 980 nm wavelength, in a continuous emission mode, 0.5 W power, 300 J of energy, 400 µm tip, 60 s diode laser and photographed. Nonepithelialized surface measurements were performed using ImageJ. Pain assessment was performed using the Wong-Baker Pain Scale. Statistical analyses were performed using SPSS software.

Results
There was a statistically significant difference between the groups in the Wong-Baker values in 3rd day (p < 0.05). In soft tissue healing on the 3rd and 7th day, the nonepithelialized surface of the laser socket was smaller than that of the control group, and the measurement results were found to be statistically significant (p < 0.05).

Conclusion
Although LLLT was not found to be very effective in reducing postoperative discomfort after extraction of primary molars, it provided better wound healing in extraction sockets.
Deep-learning-based radiomics of intratumoral and peritumoral MRI images to predict the pathological features of adjuvant radiotherapy in early-stage cervical squamous cell carcinoma
Authors: Zhang Xue-Fang , Wu Hong-yuan , Liang Xu-Wei , Chen Jia-Luo , Li Jianpeng , Zhang Shihao , Liu Zhigang 
Published: March 2024

Abstract
Background
Surgery combined with radiotherapy substantially escalates the likelihood of encountering complications in early-stage cervical squamous cell carcinoma(ESCSCC). We aimed to investigate the feasibility of Deep-learning-based radiomics of intratumoral and peritumoral MRI images to predict the pathological features of adjuvant radiotherapy in ESCSCC and minimize the occurrence of adverse events associated with the treatment.

Methods
A dataset comprising MR images was obtained from 289 patients who underwent radical hysterectomy and pelvic lymph node dissection between January 2019 and April 2022. The dataset was randomly divided into two cohorts in a 4:1 ratio.The postoperative radiotherapy options were evaluated according to the Peter/Sedlis standard. We extracted clinical features, as well as intratumoral and peritumoral radiomic features, using the least absolute shrinkage and selection operator (LASSO) regression. We constructed the Clinical Signature (Clinic_Sig), Radiomics Signature (Rad_Sig) and the Deep Transformer Learning Signature (DTL_Sig). Additionally, we fused the Rad_Sig with the DTL_Sig to create the Deep Learning Radiomic Signature (DLR_Sig). We evaluated the prediction performance of the models using the Area Under the Curve (AUC), calibration curve, and Decision Curve Analysis (DCA).

Results
The DLR_Sig showed a high level of accuracy and predictive capability, as demonstrated by the area under the curve (AUC) of 0.98(95% CI: 0.97–0.99) for the training cohort and 0.79(95% CI: 0.67–0.90) for the test cohort. In addition, the Hosmer-Lemeshow test, which provided p-values of 0.87 for the training cohort and 0.15 for the test cohort, respectively, indicated a good fit. DeLong test showed that the predictive effectiveness of DLR_Sig was significantly better than that of the Clinic_Sig(P < 0.05 both the training and test cohorts). The calibration plot of DLR_Sig indicated excellent consistency between the actual and predicted probabilities, while the DCA curve demonstrating greater clinical utility for predicting the pathological features for adjuvant radiotherapy.

Conclusion
DLR_Sig based on intratumoral and peritumoral MRI images has the potential to preoperatively predict the pathological features of adjuvant radiotherapy in early-stage cervical squamous cell carcinoma (ESCSCC).
Interventions, methods and outcome measures used in teaching evidence-based practice to healthcare students: an overview of systematic reviews
Authors: Nielsen Lea D. , Løwe Mette M. , Mansilla Francisco , Jørgensen Rene B. , Ramachandran Asviny , Noe Bodil B. , Egebæk Heidi K. 
Published: March 2024

AbstractBackgroundTo fully implement the internationally acknowledged requirements for teaching in evidence-based practice, and support the student’s development of core competencies in evidence-based practice, educators at professional bachelor degree programs in healthcare need a systematic overview of evidence-based teaching and learning interventions. The purpose of this overview of systematic reviews was to summarize and synthesize the current evidence from systematic reviews on educational interventions being used by educators to teach evidence-based practice to professional bachelor-degree healthcare students and to identify the evidence-based practice-related learning outcomes used.MethodsAn overview of systematic reviews. Four databases (PubMed/Medline, CINAHL, ERIC and the Cochrane library) were searched from May 2013 to January 25th, 2024. Additional sources were checked for unpublished or ongoing systematic reviews. Eligibility criteria included systematic reviews of studies among undergraduate nursing, physiotherapist, occupational therapist, midwife, nutrition and health, and biomedical laboratory science students, evaluating educational interventions aimed at teaching evidence-based practice in classroom or clinical practice setting, or a combination. Two authors independently performed initial eligibility screening of title/abstracts. Four authors independently performed full-text screening and assessed the quality of selected systematic reviews using standardized instruments. Data was extracted and synthesized using a narrative approach.ResultsA total of 524 references were retrieved, and 6 systematic reviews (with a total of 39 primary studies) were included. Overlap between the systematic reviews was minimal. All the systematic reviews were of low methodological quality. Synthesis and analysis revealed a variety of teaching modalities and approaches. The outcomes were to some extent assessed in accordance with the Sicily group`s categories; “skills”, “attitude” and “knowledge”. Whereas “behaviors”, “reaction to educational experience”, “self-efficacy” and “benefits for the patient” were rarely used.ConclusionsTeaching evidence-based practice is widely used in undergraduate healthcare students and a variety of interventions are used and recognized. Not all categories of outcomes suggested by the Sicily group are used to evaluate outcomes of evidence-based practice teaching. There is a need for studies measuring the effect on outcomes in all the Sicily group categories, to enhance sustainability and transition of evidence-based practice competencies to the context of healthcare practice.
Unfinished nursing care in healthcare settings during the COVID-19 pandemic: a systematic review
Authors: Bayram Aysun , Chiappinotto Stefania , Palese Alvisa 
Published: March 2024

Abstract
Background
Unfinished nursing care is becoming increasingly more of a concern in worldwide healthcare settings. Given their negative outcomes, it is crucial to continuously assess those nursing interventions that are commonly postponed or missed, as well as the underlying reasons and consequences. The worldwide COVID-19 pandemic has made it difficult for health facilities to maintain their sustainability and continuity of care, which has also influenced the unfinished nursing care phenomenon. However, no summary of the studies conducted during the COVID-19 pandemic was produced up to now. The main aim of this study was to systematically review the occurrence of, reasons for, and consequences of unfinished nursing care among patients in healthcare settings during the COVID-19 pandemic.

Methods
Systematic review registered in PROSPERO (CRD42023422871). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guideline and the Joanna Briggs Institute Critical Appraisal tool for cross-sectional studies were used. MEDLINE-PubMed, the Cumulative Index to Nursing and Allied Health Literature, and Scopus were searched from March 2020 up to May 2023, using keywords established in the field as missed care, unfinished nursing care, or implicit rationing.

Results
Twenty-five studies conducted mainly in European and Asiatic countries were included and assessed as possessing good methodological quality. The following tools were used: the MISSCARE Survey (= 14); the Basel Extent of Rationing of Nursing Care (= 1), also in its revised form (= 2) and regarding nursing homes (= 2); the Perceived Implicit Rationing of Nursing Care (= 4); the Intensive Care Unit-Omitted Nursing Care (= 1); and the Unfinished Nursing Care Survey (= 1). The order of unfinished nursing care interventions that emerged across studies for some countries is substantially in line with pre-pandemic data (e.g., oral care, ambulation). However, some interesting variations emerged at the country and inter-country levels. Conversely, labour resources and reasons close to the emotional state and well-being of nurses were mentioned homogeneously as most affecting unfinished nursing care during the pandemic. None of the studies investigated the consequences of unfinished nursing care.

Conclusions
Two continents led the research in this field during the pandemic: Europe, where this research was already well established, and Asia, where this research is substantially new. While unfinished care occurrence seems to be based on pre-established patterns across Europe (e.g., regarding fundamentals needs), new patterns emerged across Asiatic countries. Among the reasons, homogeneity in the findings emerged all in line with those documented in the pre-pandemic era.