bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Non-Invasive Fetal QRS Complex Detection Method Based on a Multi-Feature Fusion Neural Network
Authors: Huang Zhuya , Yu Junsheng , Shan Ying , Wang Xiangqing 
Published: April 2024

Abstract

Fetal heart monitoring, as a crucial part of fetal monitoring, can timely and accurately reflect the fetus's health status. To address the issues of high computational cost, inability to observe fetal heart morphology, and insufficient accuracy associated with the traditional method of calculating fetal heart rate using a four-channel maternal electrocardiogram (ECG), a method for extracting fetal QRS complexes from a single-channel non-invasive fetal ECG based on a multi-feature fusion neural network is proposed. Firstly, a signal entropy data quality detection algorithm based on the blind source separation method is designed to select maternal ECG signals that meet the quality requirements from all channel ECG data, followed by data preprocessing operations such as denoising and normalization on the signals. After being segmented by the sliding window method, the maternal ECG signals are calculated as data in four modes: time domain, frequency domain, time-frequency domain, and data eigenvalues. Finally, the deep neural network using three multi-feature fusion strategies—feature-level fusion, decision-level fusion, and model-level fusion—achieves the effect of quickly identifying fetal QRS complexes. Among the proposed networks, the one with the best performance has an accuracy of 95.85%, sensitivity of 97%, specificity of 95%, and PPV (Positive Predictive Value) of 95%. This method, employing the sliding window technique and lightweight deep neural networks, can quickly and accurately identify fetal QRS complexes from single-channel maternal ECG signals, laying the foundation for home-based fetal QRS shape recognition and fetal risk prediction.
Severe HSV1 pneumonia and EBV enteritidis in a patient with Felty syndrome and ulcerative colitis
Authors: He Jianjun , Liu Da , Jiang ShaLi , Wang Sai , Zhu Yongfeng , Yin Yafei , Yao Jingjiang 
Published: April 2024

Abstract

Background: Felty syndrome (FS), as a rare syndrome, primarily presents as splenomegaly and neutropenia in the context of rheumatoid arthritis (RA).although Inflammatory bowel disease and rheumatoid arthritis are both autoimmune diseases, they only appear together in rare cases.Herpesviruses can be activated in this pathological process, thereby precipitating associated infections, including severe herpes simplex virus type 1(HSV1) pneumonia, and Epstein-Barr virus (EBV) enteritidis in our case.
Case presentation: Here, we report a case illustrating the rapid deterioration of FS following the discontinuation of prednisone andmethotrexate. During the course, this patient exhibited fever, diarrhea, cold sores, and finally be dignosed severe HSV1 pneumonia, cheilitis, EBV enteritidis and ulcerative colitis.
Conclusions: In patients with rheumatoid arthritis, sudden cessation of anti rheumatic drugs may induce Felty syndrome, which in turn can induce the activation of herpesvirus in the body, leading to a series of herpesvirus related infections, such as ,cheilitis, pneumonia and enteritis. Early intravenous use of sufficient antiviral drugs and timely initiation of antirheumatic drugs may be a more appropriate solution.
The application of hip arthroscopy for the management of septic arthritis in adults
Authors: Chen Shu , Liu Zi-ye , Han Ya-guang , Zhou Yi-qin , Shao Jia-hua , Ding Zhe-ru , Zhang Lei , Cao Jia , peng Jinghui 
Published: April 2024

Abstract

Purpose Primary septic arthritis of the hip is a rare differential diagnosis of acute hip pain in adults, but if it is not diagnosed and treated in time, it often leads to irreversible joint damages. However, the diagnostic options of primary septic arthritis of the hip are limited. The accurate aspiration is difficult to achieve, and the traditional open arthrotomy is invasive and associated with high rates of potential complications. We used hip arthroscopy for the diagnosis and intervention of primary septic arthritis of the hip in adults and evaluated their safety and efficacy.
Methods Seven patients (4 female, 3 male), average age 48±17.3 years with unexplained acute pain and limited hip joint were included. Septic arthritis was confirmed by aspirated joint fluid analysis or synovial pathology. Surgical treatment consisted of immediate arthroscopic lavage using only 2 portals for debridement, high-volume irrigation, partial synovectomy, and drainage. Antibiotics were used according to drug susceptibility results or empirically. The symptoms, related primary disease, levels of inflammatory indicators, bacterial culture results, surgical complications, duration of antibiotic use, and follow-up results were all recorded and analyzed.
Results The median duration of symptoms prior to the arthroscopic lavage was 11.6 (4-45) days. All patients had different degrees of leukocytosis and elevated level of erythrocyte sedimentation rate (ESR) and C-reaction protein (CRP). 2 cases got positive results of preoperative bacterial culture results, and 6 cases got positive results of postoperative bacterial culture results, among which Staphylococcus aureus was the most frequently detected pathogen (3 cases). Antibiotics were administered for 4-6 weeks. After an average of 43 days after surgery, CRP returned to physiological levels, ESR returned to normal in 54 days, and after follow-up for 6 months, the average score of Visual Analogue Scale (VAS) decreased from 6.4±1.3 points to 1.3±0.2 points (p<0.05), and the average score of modified harris hip score（mHHS） increased from 53±9.8 points to 85±8.6 points (p < 0.05). None of the patients had significant surgical complications. During the mean follow-up for 24 months (range 18–30 months), no patient showed recurrence of infection, while 1 case underwent subsequent total hip arthroplasty due to serious destruction of articular cartilage and rapidly progressive degeneration.
Conclusion Hip Arthroscopic therapy is a safe and effective method for the diagnosis and intervention of primary septic arthritis of the hip without dissemination, which is reliable, tends to be less invasive and more thorough than the traditional open arthrotomy.
Usefulness of dual-layer detector spectral CT multi-parameter imaging in preoperative prediction of lymphovascular invasion and perineural invasion in patients with colorectal cancer
Authors: Yang Huiyi , Pu Qian , Yang Jianyang , Peng Pengfei , Yue Xun , Ming Yue , Yue Shuting , Zhang Xiaodi , Li Xinghui , Yang Lie , Sun Jiayu 
Published: April 2024

Abstract

Background
We aimed to investigate the usefulness of combining quantitative parameters obtained with dual-layer detector spectral CT (DLSCT) and clinical risk factors for preoperative prediction of lymphovascular invasion (LVI) and perineural invasion (PNI) in patients with colorectal cancer (CRC).
Materials and methods
From June 2022 to August 2023, 122 patients with clinically suspected CRC were prospectively enrolled in the study for spectral CT scanning, 49 patients were confirmed with CRC by histopathology. Using the pathological results, the patients were divided into LVI-positive and LVI-negative groups and PNI-positive and PNI-negative groups, and their clinical and imaging characteristics were determined. The spectral parameters of arterial-phase (AP) and venous-phase (VP) images in the CRC patients analyzed in this study. Intergroup comparisons of parameters were performed using the independent-sample t-test, Mann–Whitney U test, and chi-square test. Independent predictors of LVI group and PNI group were determined by univariate and multifactorial logistic regression analysis, and single parameter and combined parameter models were constructed accordingly. Receiver operating characteristic curve (ROC) analysis was performed to evaluate the prediction effect of different models.
Results
Tumor maximum diameter (Tdia) and normalized iodine density (NID) in the AP (NIDAP) were independent predictors of LVI (P < 0.05), while Tdia, carcinoembryonic antigen 19 − 9 (CA19-9) level, and NID at the VP (NIDVP) were independent predictors of PNI (P < 0.05) in CRC patients. The area under the curve (AUC) values of Tdia and NIDAP for predicting LVI status in CRC patients were 0.795 and 0.776, respectively. Similarly, the AUC values of Tdia, CA19-9 level, and NIDVP for predicting PNI status among CRC patients were 0.804, 0.701, and 0.735, respectively. Models combining these independent predictors yielded AUC values of 0.899 (95% confidence interval [CI]: 0.781–0.966) and 0.871 (95% CI: 0.771–0.971) for predicting LVI and PNI status, respectively. Thus, the combined model was significantly better than any single independent predictor alone.
Conclusion
The combined models, which integrated quantitative DLSCT and clinical parameters, demonstrated good predictive capability for determining the LVI and PNI status among CRC patients, in order to provide imaging references for clinical treatment decision-making.
Utilizing Instagram Stories to Deliver Educational Content to Medical Students in Pediatrics: Curricular Design and Evaluation
Authors: Bellis Raymond , Kim Rachel , Lendway Rebecca , Sniffen Courtney , Smith Nathan , Chitkara Maribeth 
Published: April 2024

Abstract

Background:
Utilization of social media has been described in medical education, but Instagram as an educational platform for the pediatric clerkship has not been reported to our knowledge.
Methods:
We piloted an innovative curriculum on Instagram using the Instagram Story functionality to supplement the pediatric clerkship for third-year medical students. Engagement with this curriculum was measured over time and participating study subjects were surveyed at the completion of the clerkship for overall satisfaction.
Results:
A 29-item Instagram Story curriculum was created by study investigators and medical students in their core pediatric clerkship were invited to participate. Over a span of eight clerkship blocks, the average number of views on the first slide in a Story was 24.8 and the average number of views on the last slide of a Story was 13.3. Average retention rate was 54.3%, the average quiz engagement rate was 32.0%, and the average percent correct on quiz was 87.6%. Students positively rated the Instagram Stories project on feasibility (83.6%), clerkship relevance (89.1%), facilitating engagement in the material (65.5%), assisting in NBME pediatric subject exam preparation (61.8%), and recommending the modality to other clinical clerkships (69.1%).
Conclusions:
This study provides evidence that the use of social media within a core clinical clerkship is feasible, engaging, relevant and appreciated by medical students. We conclude that social media can be successfully integrated into medical education endeavors and should be strongly considered as a supplemental tool to aid learners and modernize curricula.
Evaluation of Tranexamic Acid Application without Closed-Suction Drainage versus with Closed Suction Clamping in Patients Undergoing Knee Arthroplasty: A Retrospective Assessment of Blood Loss and Transfusion
Authors: Demirçay Emre , Özgözen Alaaddin Levent 
Published: April 2024

Abstract

Background: The objective of this study was to evaluate the effects of eliminating closed suction drainage (CSD) and utilizing intravenous and intra-articular tranexamic acid on blood loss, blood transfusion, hospital stay, and dressing changes subsequent to total knee arthroplasty (TKA) surgery.
Methods: A retrospective analysis was conducted on 195 knees of 166 patients who underwent TKA surgery performed by a single surgeon between 2012 and 2022. Patients were divided into two groups based on their use of CSD. Group A (N: 78; 9 males, 69 females; mean age: 72.24±7.29 years) underwent CSD omission and received intravenous and intra-articular tranexamic acid, while Group B (N: 88; 4 males, 84 females; mean age: 71.3±6.9 years) had CSD clamped for 120 minutes postoperatively. Total blood volume loss, number of blood transfusions, length of hospital stay, and dressing changes were compared between the groups.
Results: Total blood volume loss was significantly lower in Group A (1155±88 ml) compared to Group B (716ml±78 ml) (p<0.001). Similarly, the mean number of blood transfusions was significantly lower in Group A (1.02±1.08) compared to Group B (0.04±0.194) (p<0.001). The mean hospital stay was 4.09±1.564 days in Group A and 4.7±1.18 days in Group B (p=0.005). The mean number of dressings was 1.18±0.5 in Group A and 3.07±0.85 in Group B (p<0.0001).
Conclusions:Administration of intravenous and intra-articular tranexamic acid without employing CSD substantially reduces total blood loss, blood transfusion requirements, number of dressing changes, and hospital stay following TKA surgery.
Efficacy of 577 nm subthreshold micropulse laser in central serous chorioretinopathy
Authors: Yu Jia , Xu Gezhi , Chang Qing , Liu Wei 
Published: April 2024

Abstract

To evaluate the effects of 577 nm subthreshold micropulse laser (SML) on central serous chorioretinopathy (CSC) and to investigate the possible factors associated with the efficacy of SML in CSC. CSC patients who received SML between July 2021 and March 2022 were included. The rate of complete resolution of subretinal fluid (SRF) at week 6 and week 12 after SML were assessed. The association between baseline factors and the outcome of SML was also investigated. The difference in best corrected visual acuity (BCVA) and the sub foveal choroidal thickness (SFCT) between 12 weeks after SML and those at baseline were assessed. Thirty-five patients(35 eyes)were included. The rate of complete resolution of SRF after SML in CSC patients was 25.7% at week 6 and 40.0% at week 12. Among baseline factors, only longer symptom duration was independently associated with persistent SRF after SML (aOR = 1.431, P = 0.023). The BCVA improved and SFCT decreased significantly at 12 weeks after SML (t = 3.274, P = 0.002, and t = 3.110, P = 0.004, respectively). The 577 nm SML was an effective method to promote resolution of SRF in CSC eyes, especially those with short symptom duration.
Robot-assisted Treatment Contributes to Regaining Upper Limb Motility in Stroke Patients:a Randomized-controlled Trial Based on Functional Near Infrared Spectroscopy
Authors: Xu Jiayue , Cai Guiyuan , Li Wanqi , Lin Tuo , Zhang Cailing , Jiang Junbo , Chen Gengbin , Chen Jialin , Liu Quan , Xu Guangqing , Lan Yue 
Published: April 2024

Abstract

Background
Robot-assisted treatment(RAT) has drawn a lot of interest in stroke motor rehabilitation. Theoretically, the best protocol for a patient should be selected based on features of the brain's functional reactions associated with RAT. However, due to a paucity of techniques for dynamic brain functional testing, the cortical reaction response to RAT has yet to be thoroughly understood.
Objective
This study concentrated on the treatment effect and brain functional responses to RAT obtained with functional near infrared spectroscopy (fNIRS) in individuals having experienced a stroke with upper limb mobility impairment to direct the application of clinical therapy.
Methods
Eighteen stroke patients were randomly distributed to the robotics group (RG) to receive RAT and the control group (CG) to receive motor training without robot-assistance. Therapies were administered five days per week, for one month, and the outcome indicators were assessed at baseline and 30 days after treatment onset. The clinical evaluations included administration of the Fugl-Meyer assessment for upper-extremity(FMA-UE), action research arm test(ARAT), together with fNIRS recordings.The relative variations in oxyhemoglobin (OxyHb) concentrations measured by fNIRS were used to determine cortical activity levels.
Results
After four weeks of rehabilitation training, the FMA-UE and ARAT points of both groups considerably increased. The FMA-UE and ARAT points of the RG improved more than those of the CG. In comparison to the CG, fNIRS recordings showed enhanced cortical activation of the primary motor cortex in the ipsilateral hemisphere (i-M1) in the RG. Correlation analysis demonstrated a significant positive correlation between FMA-UE points improvements and therapy-evoked increases in the OxyHb of i-M1 in both the RG(r = 0.88, p < 0.001) and CG (r = 0.71, p = 0.03).It also showed a substantial positive association of the ARAT score changes and therapy-evoked increases in the OxyHb of M1 in the RG (r = 0.92, p < 0.001) and CG(r = 0.87, p < 0.002).
Conclusion
Our findings suggest that RAT performed as well or better than classic therapy methods that could help patients with stroke with upper extremity motor dysfunction and activate M1. This activation may promote reorganization of brain function.
Trial registration
ChiCTR, ChiCTR1800019783. Registered 28 November 2018, https://www.chictr.org.cn/ ChiCTR1800019783
Vascular Hemodynamic Effects of Penille Revascularization Surgery and the Role of Resisti̇ve Index in Follow-up
Authors: Akdemir Fatih , Kayıgil Önder 
Published: April 2024

Abstract

Purpose
The aim of this study is to measure the effects of penile revascularization surgery performed in vascular origin erectile dysfunction on penile vascular hemodynamics and to determine the importance of vascular parameters in postoperative patient follow-up.
Methods
A total of 35 patients who underwent penile revascularization surgery due to vascular erectile dysfunction were included in this study. In the preoperative period and at the 3rd postoperative month, penile color doppler ultrasonography was performed to evaluate cavernosal arteries, dorsal arteries, deep dorsal vein and inferior epigastric artery separately. During this evaluation, peak systolic velocity, end diastolic velocity, and resistive index were measured. The International Index of Erectile Function questionnaire was applied to all patients in the preoperative period and at the 3rd postoperative month. The relationship between changes in International Index of Erectile Function questionnaire score and penile vascular hemodynamic changes in the postoperative period was evaluated.
Results
The average preoperative resistive index values of the operated cases were determined as 0.74 ± 0.07/0.73 ± 0.09 cm/s for the right cavernosal artery and left cavernosal artery, respectively. The same values were found as 0.95 ± 0.09/0.96 ± 0.06 cm/s at the last postoperative control. The average International Index of Erectile Function − 5, 15 scores were determined as 8.52 ± 4.83, 19.4 ± 8.54, respectively, in the preoperative period, and 15.26 ± 4.50, and 35.76 ± 13.65, respectively, at the last postoperative follow-up.
Conclusion
This study showed that the resistive index can be used in the diagnosis of vascular originated erectile dysfunction and in the postoperative follow-up of the patients.
Are Dual-Phase 18F-FDG PET-mpMRI Diagnostic Performances to Distinguish Brain Tumour Radionecrosis/Recurrence after Cranial Radiotherapy usable in routine?
Authors: Cailleteau Axel , Ferrer Ludovic , Geffroy Delphine , Fleury Vincent , Lalire Paul , Doré Mélanie , Rousseau Caroline 
Published: April 2024

Abstract

Purpose: Radionecrosis is a complex challenge in the post-radiotherapy management of these patients due to the difficulty to distinguish this complication from local tumour recurrence. MRI alone have a variable specificity and sensibility as well as PET-CT imaging. We aimed to investigate the diagnostic performance of dual-phase [18F]-FDG PET-MRI to distinguish cerebral radionecrosis from local tumor recurrence after cranial radiotherapy.
Materials and Methods: A retrospective analysis was conducted on patients who underwent dual-phase [18F]-FDG PET-MRI between May 2021 and September 2022. Inclusion criteria encompassed patients with inconclusive MRI findings post-radiotherapy and history of cerebral radiotherapy for primary or metastatic brain lesions. Lesions are assessed qualitatively and semi-quantitatively, with sensitivity and specificity calculations. The gold standard to assess radionecrosis was histopathology or a composite criteria at three months. The ethics committee approved the study (N° 2023-034 9th march 2023).
Results: The study evaluated 24 lesions in 23 patients. Qualitative analysis yielded 85.7% sensitivity and 75% specificity. Semi-quantitative analysis, based on contralateral background noise, achieved 100% sensitivity and 50% specificity. Moreover, using contralateral frontal lobe background noise resulted higher performances with 92% sensitivity and 63% specificity. Stratification by lesion type demonstrated a 100% sensitivity and specificity rates for metastatic lesions.
Conclusions: This study demonstrated the potential of dual-phase [18F]-FDG PET-MRI to distinguish cerebral radionecrosis from local recurrence. The method showed promising diagnostic performance, particularly in semi-quantitative data for metastatic lesions. This study sheded light on the importance of combined PET and MRI data and presented perspectives for a better post-therapeutic differential diagnosis.
Simulation of γ-Ray Radiation Shielding Utilizing Gd2O3/Bi2O3/Epoxy Resin
Authors: Cao Rongxing , Li Guangyao , Li Hongxia , Xue Yuxiong , Zeng Xianghua 
Published: April 2024

Abstract

In order to meet the requirement of radiation shielding materials for space nuclear reactors, gamma shielding effect of epoxy resin base added with Gd2O3/Bi2O3 particles was studied by Monte Carlo simulation platform Geant4 in this paper. Firstly, the gamma ray shielding effects of functional filler with different ratios and content were simulated. Then, based on the gamma-ray energy range generated by space nuclear reactors, the γ-ray protection performance of epoxy resin composites under different energy ranges was studied. Finally, the effects of the particle size and arrangement of the fillers on the γ-ray shielding properties of the composites were presented, and the results showed that the smaller of the particle size, the better the shielding effect will be; for the same size of the filler, the arrangement of the filler with a larger projection area has a better γ-ray shielding performance. The effect of Gd2O3/Bi2O3 added to epoxy resin base on low-energy gamma rays is obvious, but the effect on high-energy rays is less.
Mendelian Randomization revealed a one-way causal association between increased Isovalerylcarnitine (C5) levels and the risk of idiopathic pulmonary fibrosis
Authors: He Jing , Liao zhengyue , Chen Hongyu , Fu Jiaojiao , Liu sijing , Hua Yanan , Guo Jinlin 
Published: April 2024

Abstract
Background There have been multiple observational studies that have established a link between metabolite levels in the body and idiopathic pulmonary fibrosis (IPF), specifically focusing on metabolites derived from fatty acids. However, a complete understanding of the precise molecular and biological factors, as well as the causality between them, remains elusive.Objective The main objective of our study was to evaluate the potential causal relationship between blood metabolites and IPF by using Mendelian randomisation (MR).Methods To achieve this goal, we utilized the most comprehensive genome-wide association study (GWAS) to date, which identified genetic variants associated with blood metabolites (1,091 blood metabolites and 309 metabolite ratios). Summary statistics of IPF were collected from Finngen R8 (1,812 IPF patients and 338,784 controls), Inverse Variance Weighted method (IVW) is used as the main method in determining causality.Results Isovalerylcarnitine (C5) levels (OR = 1.2435, 95%CI: 1.0494–1.4736, PIVW = 0.0119) was found significantly related to higher risk of IPF. There was no significant heterogeneity in our study (IVW method: Pval = 0.132; MR-Egger method: Pval = 0.105) and horizontal pleiotropy (β=-0.027; se = 0.0337; Pval = 0.4310). The sensitivity analysis did not reveal any potential abnormal drivers (0.1 < All < 0.3).Conclusion Two-sample MR Method demonstrated the causal relationship between blood metabolites and IPF, and further studies found that C5 levels, as a potential biological risk factor for IPF, may provide a new target for the treatment of IPF.