bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Hepatic Glycogen on Nocturnal Gluconeogenesis in Type 2 Diabetes Mellitus
Authors: Unni Uma S , Bril Fernando , Mugler John P , Carter Rickey E , Basu Ananda , Basu Rita 
Published: February 2025

Abstract

Context
Higher gluconeogenesis (GNG) contributes to higher nocturnal endogenous glucose production (EGP) in type 2 diabetes (T2D). Studies using 13C magnetic resonance spectroscopy (MRS) have confirmed lower hepatic glycogen content in subjects with T2D than in subjects with no diabetes (ND).

Objective
We determined the role of glycogen loading (GL) vs nonglycogen loading (NGL) on the contribution of GNG to nocturnal EGP in T2D.

Methods
In total, 14 subjects with T2D and 15 matched subjects with ND were studied on 2 occasions, with GL (60% carbohydrate) vs NGL (40% carbohydrate) isocaloric meals for 3 days, in random order in the overnight state. [6,6-2H2] glucose was infused to measure EGP, deuterium labelled water was used to measure GNG, and 13C MRS scans were performed in fed and fasted states to measure hepatic glycogen content.

Results
Hepatic glycogen content and nocturnal EGP were higher (P &lt; .05) in GL vs NGL in both cohorts. The % GNG to EGP averaged ∼50% in subjects with ND throughout the night after both meals. In contrast, % GNG to nocturnal EGP in T2D was lower with GL vs NGL and matched the pattern observed in subjects with ND with GL lowering overnight rates of GNG in subjects with T2D.

Conclusion
Selective targeting of GNG at night with appropriate medications could reduce nocturnal and early morning fasting hyperglycemia and hepatic insulin resistance in people with T2D.
Diagnostic Challenges in a Case of Refractory Severe Hypercalcemia Due to Splenic Sarcoidosis
Authors: Knott Jeremy A , Horvath Andrea R , Htet Thaw D 
Published: February 2025

Abstract
Hypercalcemia is frequently encountered in clinical practice; however, sarcoidosis-induced hypercalcemia is relatively uncommon and requires careful evaluation, particularly when initial investigations are inconclusive or the hypercalcemia is refractory to standard treatment. We present a complex case of a 60-year-old female with chronic stage IV diabetic nephropathy who presented with acute severe asymptomatic hypercalcemia resulting from splenic sarcoidosis confirmed on splenic biopsy. Despite commencement of prednisone therapy, her hypercalcemia persisted. IV fluid therapy was complicated by fluid overload from chronic renal disease. Ketoconazole was trialed as second-line therapy with no initial improvement. Our case illustrates the diagnostic and therapeutic challenges associated with asymptomatic hypercalcemia attributed to systemic sarcoidosis on a background of chronic renal impairment. It underscores the importance of considering systemic sarcoidosis as a potential etiology in cases of acute PTH-independent hypercalcemia resistant to initial therapy.
Smoke's Enduring Legacy: Bridging Early-Life Smoking Exposures and Later-Life Epigenetic Age Acceleration
Authors: Ramirez Daniel , Povedano Elena , García Aitor , Lund Michael 
Published: February 2025

Abstract
Current literature states that early-life exposure to smoking produces adverse health outcomes in later life, primarily as a result of subsequent engagements with firsthand smoking. The implications of prior research are that smoking cessation can reduce health risk in later life to levels comparable to the risk of those who have never smoked. However, recent evidence suggests that smoking exposure during childhood can have independent and permanent negative effects on health—in particular, on epigenetic aging. This investigation examines whether the effect of early-life firsthand smoking on epigenetic aging is more consistent with (1) a sensitive periods model, which is characterized by independent effects due to early firsthand exposures; or (2) a cumulative risks model, which is typified by persistent smoking. The findings support both models. Smoking during childhood can have long-lasting effects on epigenetic aging, regardless of subsequent engagements. Our evidence suggests that adult cessation can be effective but that the epigenetic age acceleration in later life is largely due to early firsthand smoking itself.
Government Restrictions During the COVID-19 Pandemic and Depressive Symptoms Following Widowhood
Authors: Van Winkle Zachary , Konechni Bartholomew 
Published: February 2025

Abstract
Spousal loss is associated with an immediate increase in depressive symptoms. However, the consequences of widowhood for symptoms of depression during the COVID-19 pandemic have remained largely unexplored. In this study, we use data from the Survey of Health, Ageing and Retirement in Europe and fixed-effects regression modeling to address three research questions. First, how have depressive symptoms changed over time in 10 European countries for older adults by marital status and spousal death timing? Second, do the surviving spouses of persons who died during the pandemic face greater increases in depressive symptoms compared with adults widowed before the pandemic? Third, to what extent did the strictness of government restrictions moderate the pandemic widowhood penalty for symptoms of depression? We find that depressive symptoms increased dramatically for those widowed during the pandemic compared with widowed adults before the pandemic. In addition, the pandemic widowhood penalty does not apply to all those who lost their partners during the pandemic; it applies only to those who lost their partner when governments were enforcing stay-at-home orders. Our findings support the notion that the COVID-19 pandemic and stringent government restrictions exacerbated risk factors and hindered protective factors that affect older adults’ resilience to spousal death.
Team Makes You Better: Evidence from Online Medical Consultation Platforms
Authors: Zhang Xiaofei , Pu Jingchuan , Lu Yixin , Guo Feng 
Published: February 2025

Practice- and Policy-Oriented Abstract Our study of online medical consultation platforms shows that, when physicians work in virtual teams, they perform better even in their individual patient consultations. This improvement occurs primarily through peer effects: physicians are motivated to work harder when they can observe their teammates’ performance. The findings from our study offer valuable insights for the design and operation of online medical consultation (OMC) platforms. Specifically, whereas the rise of OMC platforms has significantly improved the connectivity among patients and physicians by reducing or even eliminating certain frictions in patient–physician encounters, there remain major challenges as to how to effectively match patients and physicians and facilitate value creation for both sides given the overall supply shortage of physicians. Our analysis indicates that team consultation may complement rather than cannibalize individual consultation. Whereas our research focuses on the healthcare sector, these insights apply broadly to other contexts (e.g., open-source software development and massive open online course platforms) in which professionals can form voluntary teams. The key is to carefully balance individual work with teamwork, providing the right tools and incentives for collaboration.
Would you rather treat? A rare case of Mycobacterium scrofulaceum
Authors: Sheikh Junaid Zafar , Lunjani Nonhlanhla , Gul Hira , Kila Louay , Casserly Brian 
Published: February 2025

Mycobacterium scrofulaceum is a rare cause of non-tuberculous mycobacterial infection in adults, primarily affecting the immunocompromised. Pulmonary involvement has been seen in individuals with pre-existing lung pathology. We report a case of a 63-year-old female who presented with abdominal pain, cough and sputum samples yielding M. scrofulaceum, with a normal clinical examination. Initial investigations were unremarkable, prompting abdomen and pelvis computed tomography (CT), revealing minimal pericardial and ascitic fluid. Thoracic CT exhibited calcified tree-in-bud nodules and a trivial left pleural effusion. Given subdued symptoms and limited disease, discerning colonisation versus clinically relevant infection was uncertain. Due to lack of empirical data for guidance, treatment approaches at this juncture remain unclear. The patient was monitored closely for a period of one year with a plan to treat should there be evidence of active disease.
Pus in the pericardium: a pericardial-oesophageal fistula with cardiac tamponade after ablation for atrial fibrillation
Authors: Mansoor Taha , Massoudi Nahal , Bath Anandbir , Kelly Matthew , Koshy Santhosh , Tanase Armand 
Published: February 2025

Background: Pericardial/atrial oesophageal fistula (PEF/AEF) is the most feared complication of cardiac atrial fibrillation (AF) ablation. Without urgent surgical treatment, most cases of this infrequent complication rapidly prove fatal. Case report: We present an uncommon case of a 60-year-old male who had undergone an AF ablation 2 weeks prior and presented with chest pain. Following diagnosis and treatment of ST-elevation myocardial infarction (STEMI), a small pericardial effusion was noticed on computed tomography (CT) scan. Despite an initially reassuring hospital course, rapid decompensation and expansion of his purulent pericardial effusion led to his death within 24 hours of presentation. A post-mortem review of his CT imaging revealed an inconspicuous PEF. Conclusions: It is essential to maintain a high suspicion of PEF/AEF in patients presenting after AF ablation with suggestive symptoms, such as fever, chest pain/odynophagia, and neurological deficits. CT chest is the most common diagnostic modality and surgical correction is the treatment of choice.
Validation and reliability of the Persian version of the Knee Injury and Osteoarthritis Outcome Score Patellofemoral questionnaire for Iranian patients with patellofemoral pain
Authors: Ghaffari Salman , Razavipour Mehran , Taheri Sadegh , Nazari Fateme , Gharib Masoud 
Published: February 2025

Background/Aims Patellofemoral pain and osteoarthritis are common among the general population in Iran and have a significant impact on daily activities and quality of life. The aim of this study was to translate and validate the Knee Injury and Osteoarthritis Outcome Score Patellofemoral questionnaire for Iranian patients with patellofemoral pain. Methods This study employed a methodological approach and took place at Imam Khomeini Hospital in Sari, Iran, and clinics affiliated with the hospital. Content and face validity were measured by 10 orthopaedic and rehabilitation specialists using the Delphi method. For the reliability process (internal consistency), the questionnaire was administered to 90 patients with patellofemoral pain. For the reliability process (test–retest), the questionnaire was repeated on 30 patients after 48 hours. Descriptive statistical methods, such as mean and frequency, as well as analytical statistical methods, including Cronbach's alpha and intra-class correlation coefficient, were used to determine validity. Results The study included 90 participants, with a mean age of 58.72 ± 11.95 years, ranging from 30 to 82 years. The highest chosen response for all questions was either 3 or 4. The observed Cronbach's alpha was greater than 0.7, indicating the questionnaire's reliability. The average inter-item correlations ranged between 0.15 and 0.50, signifying good homogeneity among the items. Except for items 3 and 11, the correlation exceeded 0.4, indicating their excellent discriminatory power. The correlation for items 3 and 11 was between 0.2 and 0.39, which is considered good. Conclusions The Iranian version of the Knee Injury and Osteoarthritis Outcome Score Patellofemoral questionnaire demonstrated excellent measurement properties, including reliability, homogeneity among items and responsiveness. Implications for practice The Knee Injury and Osteoarthritis Outcome Score Patellofemoral questionnaire can be used when engaging with Iranian-speaking patients for clinical and research purposes related to patellofemoral pain and osteoarthritis.
Drying Performance and Quality Preservation of Calrose Rice Paddy (Oryza Sativa) Using Convective Zeolite-Based Desiccant Drying
Authors: Ying Tianyu , Dien Alice , Kornbluth Kurt , Spang Edward S. , Simmons Christopher , Donis-Gonzalez Irwin R. 
Published: February 2025

HighlightsPerformance evaluation of a convective Drying Beads® (DB) zeolite-based system.Compared rice paddy drying with DB to 50°C conventional heated-air (HA) drying.Four distinct drying experiments were applied under two ambient conditions.DB significantly enhances the moisture removal rate by 84.3% in humid ambient conditions.DB and HA have a similar total milling yield, but DB has a 10% higher head rice yield in temperate ambient conditions.DB's exothermic reaction increases the drying rate by reducing humidity and rising temperature.Abstract. Desiccant-based drying has the potential to enhance rice quality and reduce energy consumption compared to conventional heated-air drying. This laboratory-scale study evaluated the performance and resultant quality of a convective Drying Beads® (DB) zeolite-based desiccant drying system to dry Calrose rice paddy (Oryza sativa). A rice paddy to DB ratio of 1:2 was compared to conventional 50°C heated-air drying (HA). Four distinct drying experiments, HA and DB, were performed under two controlled ambient temperature and relative humidity (RH) conditions. Conditions were representative of typical paddy drying environments: 22°C at 45% RH (HA1 and DB1) and 27°C at 80% RH (HA2 and DB2) conditions. All drying experiments aimed to achieve a wet basis moisture content (MCwb) below 14%. Compared to their respective HA counterparts, the moisture removal rate (MRR) for DB1 was 9.3% lower, and DB2 was 84.3% higher. The head rice yield (HRY) and total milling yield (TMY), critical determinants of paddy grade and price, showed a 10% increase for DB1 and a 27.5% decrease for DB2. Despite these differences, TMY exceeded 71% for all drying experiments, and rice kernel color remained consistent throughout. This study showed that rice paddy DB drying is promising under temperate drying conditions. However, under humid drying conditions (DB2), improvements are necessary to enhance HRY, and the scalability to larger-scale operations warrants more investigation. Keywords: Dehydration, Food safety, Milling yield, Moisture removal, Paddy drying.
Droplet Size Distributions from PWM-Controlled Hollow-Cone Nozzles Operated at High Modulation Frequencies and Pressures
Authors: Campos Javier , Zhu Heping , Salcedo Ramón , Jeon Hongyoung , Ozkan Erdal , Gil Emilio 
Published: February 2025

HighlightsPWM valves were investigated to control nozzles at modulation frequencies up to 40 Hz with pressures up to 2068 kPa.Modulation frequency did not affect droplet size distributions and uniformity of hollow cone nozzles.Duty cycles between 30% and 100% produced stable droplet size distributions from variable flowrate nozzles.Matching PWM valve speeds to detection sensor speeds could further increase precision application efficiency.Abstract.Sprayers equipped with pulse width modulated (PWM) solenoid valves and the most accurate laser-scanning sensors allow real-time variable rate applications of pesticides based on canopy volumes. However, the accuracy of variable-rate applications could be increased by accommodating the flow modulation speed of the PWM valves to match the high speeds of the sensor detecting crop architectures. Based on previous investigations of 12 commercially available high-frequency PWM valves, two PWM valves with the highest modulation capability were selected for further evaluations. These investigations included the influence of modulation frequencies and duty cycles on the droplet size distribution and uniformity of two disc-core hollow-cone nozzles manipulated with the two PWM valves operated at pressures of 1034, 1380, and 2068 kPa. The modulation frequencies ranged from 10 to 40 Hz and duty cycles (DUCs) were between 10% and 100%. Test results showed that droplet size distribution and uniformity remained consistent with varied modulation frequencies. However, DUCs slightly affected droplet size distribution and uniformity, especially when DUCs were 30% and below. Therefore, there would be a potential to integrate these high-frequency PWM valves, properly operated at DUCs in the range between 30% and 100%, into orchard sprayers to further increase the variable-rate application accuracy while maintaining stable droplet size distributions. Keywords: Orchard sprayer, Pesticide, Precision farming, Pulse width modulation, Specialty crops, Variable rate application.
Optimization design method of DOE diffraction efficiency and its application in a zoom lens
Authors: Huo Jiaqi , Hu Yuan , Liu Zilong 
Published: February 2025

Conventional single-layer diffractive optical elements (SLDOEs) frequently overlook the impact of incident angle and environmental temperature, leading to reduced diffraction efficiency, stray light, and compromised imaging quality. This study addresses these limitations by deriving the phase delay increment caused by temperature-induced changes in the refractive index and thermal expansion coefficients of the SLDOE substrate and propagation material. We propose the temperature angle bandwidth integrated average diffraction efficiency (TABIADE) concept and establish its mathematical model. An algorithm targeting the maximum TABIADE value is used to optimize the microstructure height, enabling the design of high-diffraction-efficiency SLDOEs. Our TABIADE-based design demonstrates superior performance in adapting to complex temperature variations compared to conventional designs optimized for maximum angle bandwidth integrated average diffraction efficiency (ABIADE). We designed a cooled infrared continuous zoom system incorporating multiple SLDOEs and analyzed the impact of SLDOEs’ diffraction efficiency on the system modulation transfer function (MTF). Compared with the approximate maximum ABIADE method, the DOE designed by our proposed method causes less degradation in imaging quality when used in optical systems. The final system incorporates three SLDOEs, achieving an MTF>1 at 33 lp/mm across a 3.7–5 µm wavelength range. With an F-number of 4, a zoom range of 40–900 mm, and a total length of 337 mm, an innovative balance between high zoom ratio, long focal length, and lightweight design has been demonstrated. This method addresses the challenge in infrared continuous zoom system design, where ensuring imaging quality typically limits the number of SLDOEs, making it difficult to balance high zoom ratios, long focal lengths, and lightweight structures. Additionally, it provides technical support for the use of SLDOEs in various refractive–diffractive hybrid system designs.
Ultra-wideband MHz to THz plasmonic EO modulator
Authors: Horst Yannik , Moor David , Chelladurai Daniel , Blatter Tobias , Fernandes Sónia , Kulmer Laurenz , Baumann Michael , Ibili Hande , Funck Christian , Keller Killian , Destraz Marcel , Heni Wolfgang , Chérix Loïc , Liu Yuqi , Wang Hua , Koepfli Stefan M. , Leuthold Juerg 
Published: February 2025

Electromagnetic fields at terahertz frequencies open a window to multiple applications, such as wireless communication, sensing, and medical imaging. Yet the challenge remains to efficiently generate, receive and process such high frequencies. In this work, we investigate plasmonic modulators to bring THz frequencies to photonic integrated circuits (PICs). We demonstrate a frequency response beyond the 1 THz and develop an equivalent circuit model of the modulator. Our results show that plasmonic modulators are uniquely suited for THz PICs.
Status and associations of transition shock among nursing students during clinical practice: A cross-sectional study
Authors: Tang Yinying , Chen Xiuwen , Liao Yuying , Zheng Tingyu , Xiao Yao , You Yunhui 
Published: February 2025

Aim
This study aimed to investigate the current state and influencing factors of transition shock among nursing students during clinical practice.

Background
Transition shock among nursing students can significantly impact their academic performance and well-being. Understanding the key factors contributing to this shock is crucial for developing effective support strategies and improving overall educational outcomes.

Methods
This cross-sectional study was conducted on October 8–28, 2022 at four tertiary Class A hospitals in Changsha, Hunan Province, located in south-central China. A convenience sample of 620 full-time nursing students was surveyed to collect demographic information and assess their transition shock levels using the transition shock scale. Data analysis included descriptive statistics, nonparametric tests, correlation analysis, and multiple regression. STROBE checklist was used for the methodology in this study.

Results
A total of 564 nursing students were ultimately included in the study. The average overall transition shock score was 46 (41, 52). Attitude toward the nursing profession had an independent influence on nursing students’ transition shock (p < 0.05). Additionally, the number of night shifts, choosing nursing as the first choice, being class leaders, education level, future plans, school scale, and monthly household income contributed to different dimensions of transition shock (p < 0.05).

Conclusion and implications for nursing policy
Nursing students experience moderate transition shock, with attitude towards nursing as a key influencing factor. Clinical managers should implement targeted measures to better support nursing students improve their attitudes.
Evaluation of comorbidity burden on disease progression and mortality in patients with interstitial pneumonia with autoimmune features: A retrospective cohort study
Authors: Joerns Elena K. , Ghebranious Michelle A. , Adams Traci N. , Makris Una E. 
Published: February 2025

Background
Interstitial pneumonia with autoimmune features (IPAF) is a subset of interstitial lung disease that manifests with features of autoimmunity while not meeting classification criteria for a defined rheumatic disease. Comorbidity burden is an important prognostic indicator in various rheumatic and interstitial lung diseases, but few studies have commented on comorbidities in this population. This study was conducted to evaluate the association of individual comorbidities, the Charlson Comorbidity Index (CCI), and the Rheumatic Disease Comorbidity Index (RDCI) with lung disease progression and transplant/mortality outcomes in patients with IPAF.

Methods
In a retrospective study, we evaluated the prevalence and severity of comorbidities in an institutional cohort of patients with IPAF. Using Cox regression, we correlated the association of individual comorbidities and comorbidity indices with time to lung disease progression (relative forced vital capacity decline of 10% or more) and with time to lung transplant/death. We compared the performance of CCI and RDCI in predicting outcomes.

Results
History of cerebrovascular accident (CVA) or cardiovascular disease (CVD), moderate-severe chronic kidney disease, and fracture was associated with a faster onset of lung disease progression, while a history of gastroesophageal reflux was protective. History of CVA/CVD, diabetes mellitus, and lymphoma were associated with a faster onset of lung transplant/death. Both CCI and RDCI were associated with shorter time to lung disease progression and lung transplant/death in unadjusted analyses. However, only CCI was associated with shorter time to lung transplant/death in analyses adjusted for age, sex, pulmonary function, and radiographic pattern of lung lesion.

Conclusions
CCI and RDCI may be useful tools in assessing prognosis in patients with IPAF in terms of both lung disease progression and mortality. Prospective studies are needed to further evaluate the performance of CCI and RDCI and the impact of optimizing comorbid conditions that may mitigate poor outcomes among patients with IPAF.