bluuebunny/crossref_metadata_2025_split huggingface dataset:
The cost-effectiveness of an environmental intervention on Carbapenem-resistant Klebsiella pneumonia healthcare-associated infection control
Authors: CHEN Meilian , MAI Huan , GAO Yan 
Published: March 2024

Abstract

Background
Environmental disinfection is important prevention and control measures for CRE.
Aim
Conducted environmental intervention on CRKP to evaluate the effect and cost.
Methods
During pre-intervention phase, monitored disinfection effect of environment around patients randomly through microbiological tests quarterly and feedback to supervise environment disinfection. During intervention phase, targeted microbiological monitoring disinfection effect of environment around CRKP patients, used multiple monitoring methods including fluorescent labelling, ATP to strengthen monitoring. Compared CRKP HAI rates and surroundings monitoring qualification rates, calculated the increased cost and effect.
Results
44 CRKP positive patients were included from January 2018 to June 2019. CRKP HAI rate decreased from 6.49/1000 admissions in pre-intervention phase to 3.08/1000 in intervention phase, microbiological monitoring qualification rate increased from 79.09% to 90.50%. Total environmental intervention cost was CNY6211.00. CRKP HAI and death cases decreased 3.33, 2.50 respectively. Increased CNY1865.17 environmental intervention cost could prevent one CRKP HAI case, increased CNY2,484.40 cost could reduce one CRKP death case.
Conclusion
CRE infection is persistent threat. Environmental intervention could be cost-effectively measure.
Race/Ethnicity, Age, Gender Disparities among Pancreatic Cancer Patients: A Study based on SEER Database
Authors: qing wang , Xu Jia , Huang Shu , Liao Jingyuan , Yan Qiong , Jiang Jiao , Hu Nan , Zhang Wei , Shi Lei , Deng Mingming , Tang Xiaowei 
Published: March 2024

Abstract
Background: Pancreatic cancer is one of the most common malignancies of the digestive system. This study aimed to explore the disparities in incidence and survival across various races, ages, and genders.
Methods: Data from the SEER 17 Registries Database, encompassing primary malignant pancreatic cancer cases diagnosed from 2016 to 2020, were analyzed. This study compared patients under the age of 50 with the whole population. Chi-square test evaluated the statistical significance of disparities in race/ethnicity, age, gender, cancer stages, and survival times.. Kaplan-Meier survival curve assessed survival differences by race/ethnicity, age, and gender, and using Annual Average Percentage Change to assess incidence trends.
Results:The study included 33,151 patients, comprising 21,309 (64.2%) Whites, 3,817 (11.6%) Blacks, 207 (0.6%) American Indian/Alaska Natives, 2,984 (9.0%) Asians or Pacific Islanders, and 4,780 (14.4%) Hispanics. The findings revealed significant disparities in incidence and mortality rates among different racial and ethnic groups, with Blacks demonstrated notably higher rates. Most diagnosed with pancreatic cancer were elderly,, mainly concentrated in 50-69 years old, patients under 50 had higher survival rate than other age groups. The number of male patients was higher than that of female, with 52.5% of males and 47.4% of females. However, gender-based survival differences in patients under 50 were insignificant.
Conclusion: The study revealed significant differences in incidence and survival rate among patients. These findings are important to further understand the factors that affect pancreatic cancer, and enhance the monitoring of people at high risk.
Gold Mining and Genotoxic Effects on Vicuñas: A Comparative Study of Buccal Cells and Lymphocytes
Authors: Romero Liz , Rodrigo Gloria , Loayza Oscar , Wallace Robert B. 
Published: March 2024

Abstract
The vicuña (Vicugna vicugna) is a wild camelid native from South America, known for its highly valued fiber. In Bolivia, the Apolobamba protected area is a key area for vicuña conservation and Apolobamba’s indigenous communities sustainably harvest the fiber of wild vicuña. The vicuña is an important cultural and economic resource, as well as an indicator of ecosystem health. Over the last decade gold mining activities have increased in Apolobamba potentially causing high levels of mercury contamination, endangering the health of vicuñas, humans, and terrestrial ecosystems. This study used genotoxicity markers: micronuclei (MN) and nuclear abnormalities (NA) in buccal cells and lymphocytes of vicuñas in 13 vicuña management communities in Apolobamba. A mean frequency of 0.48% MN and 14.91% NA was found in buccal cells, and 0.32% MN and 57.13% NA in lymphocytes. A higher frequency of MN in buccal cells was expected as they are the first barrier to inhalation or ingestion of genotoxic agents. However, a higher frequency of NA in lymphocytes suggests a possible prevalence of damage. Furthermore, a gradient of MN frequency was observed consistently with mining activity, but mining may not be the only cause of this damage, as vicuñas are exposed to mixtures of environmental chemicals, including traces of microplastics and persistent organic pollutants that have been detected in the area too. These findings provide a baseline for future vicuña populations monitoring and can be used as bio monitors and sentinels of environmental pollution.
Crizotinib promotes the occurrence of inferior vena cava thrombosis and pulmonary embolism in cold-exposed mice by affecting endothelial cells and macrophages
Authors: Hong Xiaoyu , Shen Li , Gong Wenfeng , He Ruohong , Wu Yao , Zhuo Li , Hu Jun , Li Yingying 
Published: March 2024

Abstract
Background
Despite reports of pulmonary embolism (PE) as a major adverse effect of Crizotinib, the underlying mechanisms remain unclear. This study investigated the pro-thrombotic effects of Crizotinib in mice and its cellular impact.
Methods
Mice underwent inferior vena cava(IVC )ligation or carrageenan-induced tail thrombosis with Crizotinib treatment. Thrombosis incidence and pathology were assessed. In vitro, Crizotinib's effects on human umbilical vein endothelial cell (HUVEC) survival, apoptosis, and permeability, and macrophage polarization and phagocytosis were evaluated.
Results
Crizotinib can cause IVC thrombosis in mice undergoing laparotomy sham surgery. In the Balb/c mouse IVC and tail thrombosis model induced with carrageenan injection, Crizotinib demonstrated an inflammation-independent thrombopromoting effect. In vivo studies in different strains of mice at an ambient temperature of 18°C (but not 25°C) confirmed that Crizotinib has the effect of promoting IVC thrombosis and PE. Mechanistically, Crizotinib induced HUVEC apoptosis and decreased their survival, compromising the endothelial barrier. Additionally, Crizotinib inhibited macrophage polarization and phagocytosis.
Conclusion
Crizotinib significantly increases thrombosis in mice, likely due to its detrimental effects on endothelial barrier integrity and macrophage function, highlighting potential mechanisms for its clinical association with PE.
Impact of cesarean scar defects on the success of assisted human reproduction: The NICHE- ART prospective cohort study protocol
Authors: ASTRUC Audrey , DESEINE Delphine , BOUGUENET Magalie , SPIERS Andrew , MAY-PANLOUP Pascale , BOUET Pierre Emmanuel , LEGENDRE Guillaume 
Published: March 2024

Abstract

Background: The prevalence of caesarean sections worldwide continues to rise, increasing the risk of obstetric complications. Isthmocele, defined as a dehiscence of the hysterotomy following a caesarean section, can lead to intermenstrual bleeding or pelvic pain. Studies have shown that surgical treatment of isthmoceles reduces the incidence of metrorrhagia. In these studies, the authors noted that patients with abnormal bleeding outside the cycle were also more frequently affected by secondary infertility. However, isthmocele surgery can result in intrauterine adhesions and synechiae, which are also recognized as potentially deleterious to fertility. The impact of the presence of an isthmocele on the results of ART must therefore be demonstrated before any attempt at treatment, and this will require larger-scale prospective studies, using a consensus definition of the isthmocele based on sonohysterography (currently considered the "gold standard" examination).
Methods: We designed a multicentric prospective study that will be conducted in 10 French Reproductive Medicine centers. We will include women consulting for infertility with a history of scarred uterus. During sonohysterography and transvaginal ultrasound, a specific measurement is taken to define the presence or absence of an isthmocele, and to classify patients into one of two groups: "isthmocele +" or "isthmocele -". The main objective of the study is to investigate the association between the presence of an isthmocele and the clinical pregnancy rate obtained after in vitro fertilization in patients with a scarred uterus (single or multi-scarred). The primary outcome is clinical pregnancy rate, as defined by the visualization of gestational sac on the transvaginal ultrasound. We will need to include 250 women with a scarred uterus undergoing ART. The duration of the inclusion period is estimated to be 42 months.
Discussion: If our study shows a reduction in the clinical pregnancy rate in the presence of an isthmocele, this could lead to a change in clinical practices for patients undergoing ART. Indeed, surgical management of the isthmocele could be discussed prior to ART by informing the patient of the benefit-risk balance of the operation.
Trial registration: ClinicalTrials.gov, ID:. NCT04869007. Registered on August 16th, 2020.
KLHL14 and E Cadherin Nuclear Co-expression as Predicting Factor of Nonfunctioning Pituitary Adenomas Invasiveness: Preliminary study
Authors: Berardinelli Jacopo , Russo Valentina , Canciello Angelo , Giacinto Oriana , Mauro Annunziata , Bove Ilaria , Solari Domenico , De Caro Marialaura Del Basso , Cavallo Luigi Maria , Barboni Barbara 
Published: March 2024

Abstract
Purpose: Novel diagnostic and therapeutic approaches are needed to improve the clinical management of nonfunctioning pituitary adenomas (NFPA). Here, the expression of two proteins controlling the epithelial-mesenchymal transition (EMT) – an underlying NFPA pathogenic mechanism – were analyzed as prognostic marker: E-cadherin (E-Cad) and KLHL14.
Methods. Immunohistochemistry characterization of KLHL14 and E-Cad subcellular expression in surgical specimens of 12 NFPA patients, with low and high invasiveness grade (respectively, Ki67+ < and ³ 3%).
Results. The analysis of healthy vs NFPA tissues demonstrated an increased protein expression and nuclear translocation of KLHL14. Moreover, both E-Cad+ and KLHL14+ shifted from a cytoplasmic (C) form in low invasive NFPA to a nuclear (N) localization in high invasive NFPA. Pearson correlation demonstrated the existence of a significant relation between E-Cad/KLHL14 co-localization in cytoplasm (-0,614: p < 0,05) and nucleus (0,729; p < 0,01) and NFPA invasiveness grade.
Conclusions. Nuclear buildup of both E-Cad and KLHL14 detected on high invasive NFPA patients highlights a novel intracellular mechanism governing the tumor propensity to local invasion (Ki67+ >3%). The prolonged progression-free survival trend documented in patients with lower KLHL14 expression further supported such a hypothesis even if a larger cohort of NFPA patients have to be analyzed to definitively recognize for KLHL14 a key prognostic role.
Analysis of Emergency Assembly Points for Post-Earthquake Disaster Management: A Case Study of Erzincan, Türkiye
Authors: Akar Alper , Akar Özlem , Konakoğlu Berkant 
Published: March 2024

Abstract

The selection of emergency assembly points within the urban area holds significant importance for ensuring swift and effective intervention in the aftermath of a potential disaster until temporary shelter areas are prepared. In both historical and instrumental periods, Erzincan (Turkey) has experienced major earthquakes resulting in significant loss of life and property. The likelihood of similar earthquakes occurring in Erzincan in the future remains high. Therefore, it is necessary to identify safe areas where people can assemble after an earthquake, moving away from hazardous zones. The aim of this study is to analyse the capacities and adequacies of emergency assembly points, which constitute a step in disaster management and enhance the earthquake resilience of the city, using Geographic Information Systems (GIS) based on selected criteria (accessibility, spatial distribution, proximity to healthcare facilities, size, capacity adequacy, and proximity to fault avoidance zones), and to propose solutions. The assessment revealed that the available assembly points are not homogeneously distributed throughout the city and are inadequate to meet the available building and population density. Therefore, in addition to the available 38 emergency assembly points, 67 new alternative emergency assembly points have been identified. The proposed emergency assembly areas (in the 75–100% range) increased the number of neighborhoods within the 250m service area by 43.75% and 42.5% for 500m.The findings underscore the necessity for more comprehensive and effective planning for Erzincan in the event of a potential disaster or emergency.
Association between SARC-F scores and risk of adverse outcomes in older patients with cardiovascular disease: a prospective study at a tertiary hospital in Ho Chi Minh City
Authors: Nguyen Tan , Nguyen Tuan Dinh , Dinh Hung Cao , Nguyen Tuan Dinh , Ngo Trinh Thi Kim , Do Dung Viet , Le Thanh Dinh 
Published: March 2024

Abstract
Background
Older patients typically face elevated mortality rates and greater medical resource utilization during hospitalizations compared to their younger counterparts. Sarcopenia, serving as a prognostic indicator, is related to disability, diminished quality of life, and increased mortality. The SARC-F questionnaire, known for its cost-effectiveness, offers a valuable means of assessing sarcopenia.
Method
Participants aged 60 and above, admitted to the Cardiovascular Department from November 2021 to June 2022, were recruited in the prospective, single-center study. The prognostic outcomes included all-cause death and the initial occurrence of emergency rehospitalization within six months’ post-discharge. The Kaplan–Meier analysis compared the overall survival rates between different SARC-F score groups.
Results
The study enrolled 285 patients with a median age of 74 (67, 81). During a 6-month follow-up period, there were 14 cases of mortality. A SARC-F score of 4 or higher was significantly associated with an increased risk of all-cause mortality, with HR of 2.02 (95% CI: 1.39 – 2.92, p < 0.001), and higher incidence of re-hospitalization events with RR of 1.66 (95% CI: 1.06 to 2.59, p = 0.026). Kaplan-Meier survival analysis indicated a notably higher mortality rate in the patients with high SARC-F scores (p < 0.001).
Conclusions
In elderly patientswith cardiovascular disease, the SARC-F questionnaire could serve as a simple and cost-effective method for detecting mortality and the risk of rehospitalization.
Constructing an Ovarian Cancer Prognostic Model Based on Shared m6A Modifications and Cellular Senescence-Related Genes with Polycystic Ovary Syndrome
Authors: Liu Yang , Gengxiao Yujie , Wu Yanzhi , Hu Xi , Ma Yingying , Sun Chunyi 
Published: March 2024

Abstract
Background: Polycystic ovary syndrome (PCOS) and ovarian cancer (OV) are significant women's health concerns. This study aims to identify genes related to m6A modification and cellular senescence that are shared by PCOS and OV and to develop a prognostic model for OV outcomes.
Methods: Transcriptomic datasets from GEO and TCGA were collected to identify differentially expressed genes (DEGs) associated with m6A modifications and cellular senescence in both PCOS and OV. We identified hub genes through WGCNA and assessed their prognostic significance. An OV prognostic model was developed and validated using multiple datasets, and correlations between risk scores and tumor immune microenvironment were evaluated. Drug sensitivity was predicted based on risk scores. qRT-PCR was performed to verify model gene alterations in OV cell lines.
Results: We identified 73 DEGs that were common to both PCOS and OV, with eight genes associated with m6A modification and cellular senescence. WGCNA revealed 242 DEhub genes. A 19-gene prognostic model was established, exhibiting impressive efficacy with AUCs exceeding 0.7 for predicting OV patient survival. High-risk scores correlated with increased M0 macrophages and monocytes and decreased M1, CD8+ T cells, and T follicular helper cells. Drug sensitivity varied based on risk scores. Model gene alterations were verified in external OV datasets and OV cell lines. In external datasets, CXCR4 emerged as a key target gene of m6A modification.
Conclusions: The derived 19-gene prognostic model offers potential avenues for risk assessment and personalized therapy in OV patients.
RETRACTED: Congenital heart defects and hypothyroidism in Down syndrome patients with common MTHFR polymorphisms
Authors: Garg Mahak , Patial Ajay , Kapoor Harmanpreet Singh , Attri Savita Verma , Panigrahi Inusha 
Published: March 2024

Abstract

The authors have requested that this preprint be removed from Research Square.
Glycated hemoglobin variability predicts diabetic retinopathy in patients with type 2 diabetes: results from the Brazilian Diabetes Study
Authors: Jesus Daniel Campos , Barreto Joaquim , Chaves Fernando , Gasparini Matheus S. , Fernandes Vicente H. R. , Sposito Andrei C 
Published: March 2024

Abstract

Background:Diabetic retinopathy (DR) is the leading cause of blindness in working-age patients. Although prior studies revealed hyperglycemia as an imperative marker of diabetic retinopathy risk, whether glycemic variability imposes an increased risk of retinopathy remains unclear. As retinopathy is often diagnosed at later stages, when the potential benefit of intervention is significantly attenuated, assessing glycemic variability as an added source when selecting diabetes patients for earlier referral for ophthalmological evaluation may assist in preventing disability. To evaluate this hypothesis, this study investigated the relationship between glycemic variability parameters and diabetic retinopathy using data from a local cohort of patients with type 2 diabetes.
Basic procedures. This study included cohort members aged 18 years and older who had undergone ophthalmological examinations, including retinography and visual acuity testing, and who had at least two glycemic hemoglobin measurements throughout their participation in the study. The Early Treatment Diabetic Retinopathy Study (ETDRS)criteria were used to classify diabetic retinopathy. Using validated methods, glycemic variability was calculated as the standard deviation and mean amplitude of glycemic excursions.
Main findings: In the studied population, 22% of individuals with T2DM had DR. Each 1% increase in baseline HbA1c was related to a 44% greater risk of diabetic retinopathy (OR 1.44, 95% CI 1.190–1.754, p 0.001). A one-unit increase in the standard deviation of HbA1c was associated with a 74% increased risk of DR (OR 1.74, 95% CI 1.067–2.847; p 0.027).
Principal conclusions: Glycated hemoglobin variability, measured as the standard deviation of repeated measures, was independently related to diabetic retinopathy risk (Clinicaltrials.gov: NCT04949152).
FR-nnUNet: A Novel Medical Segmentation Network Based on the Fuzzy Regions Recognition Scheme and Improved nnU-Net
Authors: Huang Zizhen , Wang Lei , Han Yaolong , Yan Chunyu , Yang Shanliang , Li Bin 
Published: March 2024

Abstract

The performance of the traditional supervised learning based medical image segmentation methods heavily depends on the expensive and scarce data labeling. The semi-supervised based segmentation strategies, such as the mean teacher model, have achieved milestone success in this domain. However, few studies have focused on the problem of target selection. Therefore, a novel medical image segmentation model is proposed based on the fuzzy regions recognition scheme and improved nnU-Net. The novel fuzzy regions recognition strategy is introduced and the improved nnU-Net with the new semi-supervised mean teacher network architecture is constructed, which can efficiently optimize the representation of image features via the intensity and spatial transformations. The class-conditional labeling noise identification method is applied to the image segmentation task and combines the concepts of confusion matrix and thresholding to improve the robustness of the model to class imbalance and overconfidence predictions. Experimental results show that the proposed fuzzy selective mean teacher model can achieve excellent segmentation performance on the Left Atrium and ACDC datasets. Compared with the traditional methods, it can not only improve the objective segmentation evaluation metrics in terms of the Dice coefficient, Jaccard coefficient, and Hausdorff95 distance but also obtain better segmentation results especially when less labeled data is used.
Neuro-Adaptive Path following Control of Autonomous Ground Vehicles with Input Deadzone
Authors: Maaruf Muhammad , Mysorewala Muhammad Faizan 
Published: March 2024

Abstract

This article investigates the path-following control problem of an autonomous ground vehicle (AGV) with unknown external disturbances and input deadzones. Neural networks are used to estimate unknown external disturbances, dead zones, and nonlinear functions. A backstepping control is proposed to facilitate the tracking of the target path. The steady-state path-following error is decreased by adding an integral error term to the backstepping controller. Command filtering is employed to address the explosion of the complexity issue of the conventional backstepping approach, and the filtering error is compensated via an auxiliary signal. Lyapunov stability study indicates that the AGV closed-loop system is bounded by the proposed control with reasonable accuracy. At last, simulations are given to demonstrate the potential of the proposed scheme in path-following control.
Multi Day Ahead Flood Predictionin South Asian Tropical Zone Using Deep Learning
Authors: Madhushanka Tharindu , Jayasinghe Thishan , Rajapakse Ruwan 
Published: March 2024

Abstract
A reliable and accurate flood forecasting procedure is a critical need due to the hazardous nature of the disaster. Researchers are increasingly favoring innovative approaches with enhanced accuracy, such as machine learning models, over traditional methods for this task. However, lack of such studies regarding South Asian tropical region, which has its own climate characteristics, was unidentified as a major issue. This research delves into the viability of employing ANN, LSTM, BLSTM, ConvLSTM2D and Transformer models for multi-day ahead flood simulation. One-day, two-days and three-days were selected as lead times for the task considering the lower reaches of the Mahaweli catchment in Sri Lanka, which is mostly affected by the Northeast Monsoon. The prediction capability of extreme stream flows was also of interest. Observed rainfall data from three nearby rain gauges, along with historical discharges of the target river gauge, serve as input features for the models. The ANN model showed the worst performance, having the mean NSE of 0.67. An improved performance was observed from the Transformer compared to the LSTM based models, especially in multiple day ahead forecasting scenarios. For all the models, the forecasting capability of extreme water levels drops down drastically when the prediction lead time is increased.