bluuebunny/crossref_metadata_2025_split huggingface dataset:
The time course of hypoxia effects using an aviation survival trainer
Authors: Borden Cammi K. , McHail Daniel G. , Blacker Kara J. 
Published: April 2024

IntroductionReduced environmental oxygen levels at high altitudes can result in hypoxic hypoxia, which remains a primary threat in tactical aviation. Hypoxia broadly impairs cognition and can degrade a pilot's ability to safely operate the aircraft. Current hypoxia countermeasures include aircraft life support systems that deliver supplemental oxygen and using controlled hypoxia exposures to train aviators to recognize symptoms. To maximize the effectiveness of these countermeasures, it is critical to understand how hypoxia impacts performance and associated neurocognitive outcomes. We previously showed that a neural marker that indexes sensory processing integrity is sensitive to hypoxia impairment.MethodsHere, we extend this line of research closer to the training environment by using hypoxia simulation equipment currently standard in aviation survival training. In a single-blind, repeated-measures, counterbalanced design, we exposed 34 healthy participants to either normoxic air (ground level) or normobaric hypoxia (altitude equivalent gradually increasing from 10 to 25k') for 20 min after a 10 min baseline at ground level. During the exposure, participants completed a cognitive assessment battery while passively elicited neural responses to auditory tones were recorded using electroencephalography (EEG). Participants reported their hypoxia symptoms throughout and upon completion of their exposures.ResultsWe found that the hypoxia exposure rapidly elicited the predicted physiological responses in peripheral oxygen saturation (decrease) and heart rate (increase) within 2–3 minutes of exposure onset. On average, participants reported hypoxia symptoms in a delayed manner, ~8 min following the exposure onset. Performance on the cognitive tasks was relatively unaffected by hypoxia for basic tasks including Stroop, fine motor tracking, color vision and arithmetic, but was significantly degraded by hypoxia for more advanced tasks that combined a visual search component with Stroop and a working memory task. EEG activity associated with pre-attentive auditory processing was impaired on average shortly after the first symptom report, ~10 min from exposure start.DiscussionTogether, these results move hypoxia research closer to conditions encountered in aviation survival training and support the use of training devices for future hypoxia research.
What bycatch tells us about the diet of harbor and gray seals and overlap with commercial fishermen
Authors: Lyssikatos Marjorie C. , Wenzel Frederick W. 
Published: April 2024

Northwest Atlantic harbor (Phoca vitulina vitulina) and gray (Halichoerus grypus atlantica) seal populations are recovering from early to mid-20th century exploitation, increasing their biological interactions and bycatch in Northeastern US commercial fisheries. We evaluated the seals’ diet composition and compared their prey to commercial catches to assess trophic overlap and potential competition with commercial fisherman target catches. We obtained 148 harbor and 178 gray seal stomach samples from bycatch events that occurred between 2004 and 2018. We learned from the hard part remains that the majority of seals bycaught are young-of-the-year (≤12 months old) that consume a wide breadth of prey across three trophic groups. There was a general dichotomy in extrinsic factors associated with seal diet in which 45% trophic niche separation was explained by non-overlapping harbor and gray seal phenology and pup haul-out locations that are adjacent to active fishing areas. Prey size estimated from fish otoliths and squid beaks recovered from stomach contents showed that gray seals consumed larger prey than harbor seals and prey sizes from both seals showed limited overlap with prey sizes caught by commercial gillnet fishermen. The most important prey to both seals included large (&gt;20 cm) and small (≤20 cm) silver hake (Merluccius bilinearis), (≤40 cm) red hake (Urophycis chuss), gulf stream flounder (Citharichthys arctifrons), medium (21–40 cm) white hake (Urophycis tenuis), and (&lt;50 cm) Atlantic cod (Gadus morhua). Important prey to harbor seals that did not overlap with gray seals were Acadian redfish (Sebastes fasciatus), Atlantic herring (Clupea harengus), longfin (Doryteuthis pealeii), and shortfin squid (Illex illecebrosus). They contrasted with prey important to gray seals that did not overlap with harbor seals: yellowtail flounder (Limanda ferruginea), sand lance (Ammodytes spp.), Urophycis spp., and fourspot flounder (Hippoglossina oblonga). Despite the potential bias associated with opportunistic bycatch sampling, this study demonstrates the importance and value of utilizing carcasses retained from bycatch events, is complimentary to newer methodologies (i.e., DNA meta-barcoding), and fills data gaps in our understanding of the role recovering harbor and gray seal populations have on Northeastern US regional food webs.
Thematic analysis of stakeholder perceptions for co-creative healthcare XR resource design and development; traversing a minefield of opportunities
Authors: Antoniou Panagiotis Evaggelos , Varella Annita , Pickering James D. , Chatzimallis Charalambos , Moumtzi Vassiliki , Bamidis Panagiotis D. 
Published: April 2024

IntroductionThe expansive curricular volume of healthcare education makes a necessity the incorporation of innovative methods and immersive media in it. The core challenge in such approaches is the timely development of relevant immersive content such as Virtual, Augmented or Mixed Reality (VR/AR/MR) resources for healthcare topics. There is currently significant interest in the use of co-creative methods for streamlining immersive content development.MethodsA core research pursuit in this translational research field is the formulation of evidence-based, optimized workflows that streamline immersive content creation allowing for rapid expansion of innovative educational approaches in healthcare curricula. The purpose of this paper is to aggregate the perceptions of healthcare technologists and educators who participated in a series of co-creation sessions in order to elicit their best practice insights for design and development of XR educational resources using co-creative methods.ResultsAccording to our thematic analysis, findings of the qualitative study demonstrated that a rigorous organizational approach is required to maintain a constructive exchange of information and to keep the design process alive for both content and technical experts. In addition, rapid prototype and display of co-created features can empower their contributions and help them design more efficiently.DiscussionCo-creative content production can benefit from adaption of existing frameworks and lightweight authoring environments that can facilitate generalized XR content development use cases.
Association of glycogen synthase kinase-3β with cognitive impairment in type 2 diabetes patients: a six-year follow-up study
Authors: Wei Wei , Xu Pan , Li Li , Mao Hong , Li Na , Wang Xiao-qing , Wang Li , Xu Zhi-peng , Zhao Shi 
Published: April 2024

BackgroundOur previous multicenter case-control study showed that aging, up-regulation of platelet glycogen synthase kinase-3β (GSK-3β), impaired olfactory function, and ApoE ϵ4 genotype were associated with cognitive decline in type 2 diabetes mellitus (T2DM) patients. However, the causal relationship between these biomarkers and the development of cognitive decline in T2DM patients remains unclear.MethodsTo further investigate this potential relationship, we designed a 6-year follow-up study in 273 T2DM patients with normal cognitive in our previous study. Baseline characteristics of the study population were compared between T2DM patients with and without incident mild cognitive impairment (MCI). We utilized Cox proportional hazard regression models to assess the risk of cognitive impairment associated with various baseline biomarkers. Receiver operating characteristic curves (ROC) were performed to evaluate the diagnostic accuracy of these biomarkers in predicting cognitive impairment.ResultsDuring a median follow-up time of 6 years (with a range of 4 to 9 years), 40 patients (16.13%) with T2DM developed MCI. Participants who developed incident MCI were more likely to be older, have a lower education level, have more diabetic complications, a higher percentage of ApoE ϵ4 allele and a higher level of platelet GSK-3β activity (rGSK-3β) at baseline (P&lt;0.05). In the longitudinal follow-up, individuals with higher levels of rGSK-3β were more likely to develop incident MCI, with an adjusted hazard ratio (HR) of 1.60 (95% confidence interval [CI] 1.05, 2.46), even after controlling for potential confounders. The AUC of the combination of age, rGSK-3β and ApoEϵ4 allele predicted for incident MCI was 0.71.ConclusionPlatelet GSK-3β activity could be a useful biomarker to predict cognitive decline, suggesting the feasibility of identifying vulnerable population and implementing early prevention for dementia.
Investigation into hydraulic fracture propagation behavior during temporary plugging and diverting fracturing in deep coal seam
Authors: Zening Sun , Zhanglong Tan , Junwen Lin , Qi An , Yushi Zou , Shikang Liu , Ziwen Zhao 
Published: April 2024

In this study, we conducted indoor temporary plugging and diverting fracturing (TPDF) experiments on samples of natural deep and shallow coal seams using a small-scale true triaxial fracturing simulation system. By integrating high-precision CT scanning technology and crack reconstruction techniques, and relying on the quantitative characterization of the crack complexity coefficient, we investigated the differences in internal structures between deep and shallow coal seam samples and the variations in the expansion of TPDF cracks. Furthermore, the study primarily focused on exploring the influence of temporary plugging agent (TPA) parameters (quantity and particle size) on the expansion patterns of TPDF cracks in deep coal seam coal-rock samples. The experimental results reveal that in shallow coal samples, artificially induced fractures are notably longer and extend to various surfaces of the samples. Conversely, in deep coal samples, the expansion of artificially induced fractures is influenced by well-developed cleavage and cleats. The crack complexity coefficient of artificial fractures in deep coal samples is 1.54 higher than that in shallow coal samples, with an increased crack width of 98 μm. However, the expansion distance of the fractures is shorter and does not extend to the S3 and S6 surfaces. Increasing the dosage of the TPA is advantageous for inducing frequent redirection of fractures and communication with previously untouched areas. When the dosage of the TPA is increased from 30 g/L to 60 g/L, the expansion distance of artificial fractures significantly increases, extending to various surfaces of the samples. The crack complexity coefficient increases by 1.1, and the crack width enlarges by 84 μm. Appropriate particle sizes of the TPA can effectively form seals. However, small particle sizes (200/400 mesh) struggle to seal initial fractures, while large particle sizes (10/20 mesh) can lead to excessive wellhead blockage, causing rapid shut-in pressure, destructive fracturing in deep coal samples, and the generation of a large amount of coal fines. This study holds significant guidance for the optimal selection of process parameters in the temporary plugging hydraulic fracturing of deep coal rock.
Exploring the roles and potential therapeutic strategies of inflammation and metabolism in the pathogenesis of vitiligo: a mendelian randomization and bioinformatics-based investigation
Authors: He Ming-jie , Ran De-long , Zhang Zhan-yi , Fu De-shuang , He Qing , Zhang Han-Yin , Mao Yu , Zhao Peng-Yuan , Yin Guang-wen , Zhang Jiang-an 
Published: April 2024

Introduction:Vitiligo, a common autoimmune acquired pigmentary skin disorder, poses challenges due to its unclear pathogenesis. Evidence suggests inflammation and metabolism’s pivotal roles in its onset and progression. This study aims to elucidate the causal relationships between vitiligo and inflammatory proteins, immune cells, and metabolites, exploring bidirectional associations and potential drug targets.Methods:Mendelian Randomization (MR) analysis encompassed 4,907 plasma proteins, 91 inflammatory proteins, 731 immune cell features, and 1400 metabolites. Bioinformatics analysis included Protein-Protein Interaction (PPI) network construction, Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. Subnetwork discovery and hub protein identification utilized the Molecular Complex Detection (MCODE) plugin. Colocalization analysis and drug target exploration, including molecular docking validation, were performed.Results:MR analysis identified 49 proteins, 39 immune cell features, and 59 metabolites causally related to vitiligo. Bioinformatics analysis revealed significant involvement in PPI, GO enrichment, and KEGG pathways. Subnetwork analysis identified six central proteins, with Interferon Regulatory Factor 3 (IRF3) exhibiting strong colocalization evidence. Molecular docking validated Piceatannol’s binding to IRF3, indicating a stable interaction.Conclusion:This study comprehensively elucidates inflammation, immune response, and metabolism’s intricate involvement in vitiligo pathogenesis. Identified proteins and pathways offer potential therapeutic targets, with IRF3 emerging as a promising candidate. These findings deepen our understanding of vitiligo’s etiology, informing future research and drug development endeavors.
Health data space nodes for privacy-preserving linkage of medical data to support collaborative secondary analyses
Authors: Baumgartner Martin , Kreiner Karl , Lauschensky Aaron , Jammerbund Bernhard , Donsa Klaus , Hayn Dieter , Wiesmüller Fabian , Demelius Lea , Modre-Osprian Robert , Neururer Sabrina , Slamanig Gerald , Prantl Sarah , Brunelli Luca , Pfeifer Bernhard , Pölzl Gerhard , Schreier Günter 
Published: April 2024

IntroductionThe potential for secondary use of health data to improve healthcare is currently not fully exploited. Health data is largely kept in isolated data silos and key infrastructure to aggregate these silos into standardized bodies of knowledge is underdeveloped. We describe the development, implementation, and evaluation of a federated infrastructure to facilitate versatile secondary use of health data based on Health Data Space nodes.Materials and methodsOur proposed nodes are self-contained units that digest data through an extract-transform-load framework that pseudonymizes and links data with privacy-preserving record linkage and harmonizes into a common data model (OMOP CDM). To support collaborative analyses a multi-level feature store is also implemented. A feasibility experiment was conducted to test the infrastructures potential for machine learning operations and deployment of other apps (e.g., visualization). Nodes can be operated in a network at different levels of sharing according to the level of trust within the network.ResultsIn a proof-of-concept study, a privacy-preserving registry for heart failure patients has been implemented as a real-world showcase for Health Data Space nodes at the highest trust level, linking multiple data sources including (a) electronical medical records from hospitals, (b) patient data from a telemonitoring system, and (c) data from Austria’s national register of deaths. The registry is deployed at the tirol kliniken, a hospital carrier in the Austrian state of Tyrol, and currently includes 5,004 patients, with over 2.9 million measurements, over 574,000 observations, more than 63,000 clinical free text notes, and in total over 5.2 million data points. Data curation and harmonization processes are executed semi-automatically at each individual node according to data sharing policies to ensure data sovereignty, scalability, and privacy. As a feasibility test, a natural language processing model for classification of clinical notes was deployed and tested.DiscussionThe presented Health Data Space node infrastructure has proven to be practicable in a real-world implementation in a live and productive registry for heart failure. The present work was inspired by the European Health Data Space initiative and its spirit to interconnect health data silos for versatile secondary use of health data.
Significant improvement of physicians’ knowledge and clinical practice: an opportune, effective, and convenient continuing medical education program on functional dyspepsia
Authors: Chen Jie , Bai Tao , Liu Jinsong , Xiong Lishou , Wang Weifeng , Wang Huahong , Wang Rongquan , Hou Xiaohua 
Published: April 2024

AimsThis cohort study aimed to explore the effect of a one-day online continuing medical education (CME) on the improvement of physicians’ knowledge and clinical practice on functional dyspepsia (FD).MethodsPhysicians were invited to participate in this CME via medical education applications. FD training videos made in advance were sent to participants via a weblink. Before and after training, participants were required to finish the FD knowledge test and provide case information of FD patients. McNemar test, Wilcoxon rank-sum test, Freidman test, Chi-square test, quantile regression, and generalized estimating equations (GEE) were used to perform statistical analysis.ResultsThere were 397 of 430 (92.33%) physicians finished this CME program. The total score of the FD knowledge test after training was significantly higher compared with before training [488.3 (468.3–510.0) vs. 391.7 (341.7–450.0), p &lt; 0.001]. Particularly, physicians from primary hospitals show more increase in total scores than physicians from secondary and tertiary hospitals. According to the GEE model, receiving this online training was an independent predictor of physicians’ choice of upper gastrointestinal endoscopy in patients with FD [OR 1.73, 95%CI (1.09–2.73), p = 0.020], especially in PDS. Also, it was an independent predictor of physicians’ choice of acid-suppressive drugs in patients with FD [OR 1.30, 95%CI (1.03–1.63), p = 0.026], especially in EPS and PDS overlapping EPS.ConclusionThis one-day online CME program effectively and conveniently improved physicians’ knowledge and clinical practice, providing new ideas for future CME and facilitating precise clinical management of FD patients with different subtypes especially in primary hospitals.
Effect of thoracic paravertebral nerve block on delirium in patients after video-assisted thoracoscopic surgery: a systematic review and meta-analysis of randomized controlled trials
Authors: Zhou Xuelei , Mao Wei , Zhao Li , Zhu Hongyu , Chen Linlin , Xie Ying , Li Linji 
Published: April 2024

BackgroundNerve blocks are widely used in various surgeries to alleviate postoperative pain and promote recovery. However, the impact of nerve block on delirium remains contentious. This study aims to systematically evaluate the influence of Thoracic Paravertebral Nerve Block (TPVB) on the incidence of delirium in patients post Video-Assisted Thoracoscopic Surgery (VATS).MethodsWe conducted a systematic search of PubMed, Embase, Web of Science, Cochrane Library, and Scopus databases in June 2023. The search strategy combined free-text and Medical Subject Headings (MeSH) terms, including perioperative cognitive dysfunction, delirium, postoperative cognitive dysfunction, paravertebral nerve block, thoracic surgery, lung surgery, pulmonary surgery, and esophageal/esophagus surgery. We utilized a random effects model for the analysis and synthesis of effect sizes.ResultsWe included a total of 9 RCTs involving 1,123 participants in our study. In VATS, TPVB significantly reduced the incidence of delirium on postoperative day three (log(OR): −0.62, 95% CI [−1.05, −0.18], p = 0.01, I2 = 0.00%) and postoperative day seven (log(OR): −0.94, 95% CI [−1.39, −0.49], p &lt; 0.001, I2 = 0.00%). Additionally, our study indicates the effectiveness of TPVB in postoperative pain relief (g: −0.82, 95% CI [−1.15, −0.49], p &lt; 0.001, I2 = 72.60%).ConclusionThe comprehensive results suggest that in patients undergoing VATS, TPVB significantly reduces the incidence of delirium and notably diminishes pain scores.Systematic review registrationCRD42023435528. https://www.crd.york.ac.uk/PROSPERO.
Risk of secondary immune thrombocytopenia following alemtuzumab treatment for multiple sclerosis: a systematic review and meta-analysis
Authors: Sun Yuying , Liu Zhimei , Yang Jianguo , Jia Qingqing , Sun Jinglong , Wang Lei , Liang Fengjiao , Song Shiyuan , Wang Kaixi , Zhou Xia 
Published: April 2024

ObjectThe purpose of this study was to evaluate the risk of secondary immune thrombocytopenia in multiple sclerosis patients treated with alemtuzumab through a meta-analysis.MethodsWe searched databases including PubMed, Web of Science, OVID and EMBASE for studies reporting changes in platelet levels in MS patients treated with alemtuzumab from their inception until May 2023 and performed a meta-analysis. Information and data were screened and extracted by two researchers. The inclusion and exclusion criteria were established according to the PICOS principle. The obtained data were analyzed using the R software meta package and the quality assessment was conducted using Newcastle-Ottawa Scale (NOS). The causes of heterogeneity were analyzed using subgroup analysis and sensitivity analysis. Publication bias was evaluated using funnel plots and Egger test.ResultsA total of 15 studies were included, encompassing 1,729 multiple sclerosis patients. Meta-analysis of overall secondary ITP in the included studies yielded a pooled rate of 0.0243. The overall incidence of secondary autoimmune events was 0.2589. In addition, subgroup analysis was applied using study regions and study types. The results showed that the incidence rate of secondary ITP in Europe was about 0.0207, while the incidence of autoimmune events (AEs) was 0.2158. The incidence rate of secondary ITP and AEs in North America was significantly higher than in Europe, being 0.0352 and 0.2622. And the analysis showed that the incidence rates of secondary ITP and AEs in prospective studies were 0.0391 and 0.1771. Retrospective studies had an incidence rate of secondary ITP at 2.16, and an incidence rate of AEs at 0.2743.ConclusionThis study found that there was a certain incidence of Immune thrombocytopenia in multiple sclerosis patients after treatment with alemtuzumab. Alemtuzumab may have some interference with platelet levels, and the mechanism may be associated with Treg cells. But due to the absence of a control group in the included literature, we cannot determine the specific impact of Alemtuzumab on platelet levels in patients with MS. Therefore, clinical physicians should perform a comprehensive assessment of the patient’s benefit-to-risk ratio before initiating alemtuzumab.Systematic Review RegistrationInplasy website, DOI number is 10.37766/inplasy2024.3.0007.