bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex differences in readmission rate after cardiac surgery
Authors: Koechlin Luca , Miazza Jules , Gahl Brigitta , Santer David , Vöhringer Luise , Berdajs Denis , Eckstein Friedrich S. , Reuthebuch Oliver 
Published: October 2023

IntroductionThe impact of sex on hospital readmission rate after cardiac surgery is unclear. Therefore, we aimed to analyse sex-specific differences and underlying factors in 30-day readmission rate after cardiac surgery.MethodsWe conducted a single center study including all patients after major cardiac surgery (excluding aortic dissection and left ventricular assist device implantation) from January 2012 to September 2020. Reasons for readmission were adjudicated according to all available medical records. We calculated incidence rate ratios (IRR) with 95% confidence intervals (CI) for female sex with re-admission crude and adjusted for plausible confounding factors using negative binomial regression.Results4,868 patients were included in the analysis. The median [Interquartile range] age was 68 [60 to 74] years and 24% (n = 1,149) of the patients were female. Female patients were significantly older (median [IQR] age 70 (63 to 76) vs. 67 (59 to 74), p &lt; 0.001) and had lower body mass index and fewer cardiovascular risk factors compared to men. Isolated valve surgery was more frequent in female while coronary artery bypass grafting was more often in men. 30-day readmission was comparable between both sexes (7.0% [n = 81] in female vs. 8.7% [n = 322] in men; p = 0.078). Cardiac related readmissions and infections were the most common reasons for readmission in both groups. The overall incidence rate ratios of female sex with readmission (0.80, 95% CI 0.63 to 1.03, p = 0.078) remained robust after adjustment for EuroSCORE 2 (0.78, CI 0.61 to 1.0, p = 0.051).ConclusionReadmission rate and reasons for 30-day readmission after major cardiac surgery were similar between men and women.
Covering digital health applications in the public insurance system: how to foster innovation in patient care while mitigating financial risks—evidence from Germany
Authors: Groene Nicole , Schneck Luca 
Published: October 2023

ContextDigital health applications that support patients in managing their condition can have a positive impact on patients' health and improve the overall care process. In late 2019, as the first country worldwide, Germany included digital health applications in the benefit basket of the statutory health insurance (SHI) system to enable fast, broad-scale patient access and encourage innovation in the digital health industry. While the policy is widely recognized as a pioneering step toward improving patient care through digital technologies, there are concerns regarding the mechanics of the policy and the resulting financial risks for the SHI system.GoalsThe primary objective of this article is to provide a comprehensive and balanced overview of the German policy by evaluating its success in achieving its goals and by reviewing challenges that have emerged. The secondary objective is to delineate prospective policy options and areas warranting future research.ApproachThe article analyzes publicly available data of the Federal Institute for Drugs and Medical Devices collected between February 1st and July 17th, 2023, and complements it with empirical findings published by academic institutions and sickness funds. It discusses policy options and related areas of future research to overcome the identified challenges without jeopardizing the purpose of the legislation to encourage innovation in the digital health industry to improve patient care.ConclusionIn line with the goals of the reimbursement policy, the inclusion of digital health applications in the SHI benefit basked has entailed new digital treatment options for patients across multiple disease areas. However, from a health policy perspective, the policy has several shortcomings, including low prescription rates, the temporary reimbursement of digital health applications that lack proven benefit, and a pricing framework that does not take into account the efficacy and efficiency of a treatment and may lead to a suboptimal allocation of public resources. Rather than the public system covering digital health applications without proven benefit, the authors suggest giving SHI organizations more budget authority to directly incentivize research and development activities and to introduce value-based pricing. More research is needed to determine the details of these mechanisms.
Dimensions of bilingual education program implementation in schools serving linguistically minoritized students in the Czech-Polish border region
Authors: Hopkins Megan , Nowak-Żółty Edyta , Kurowska-Pysz Joanna , Szyszka Michał 
Published: October 2023

IntroductionA core challenge for the implementation of bilingual programs is ensuring that linguistically minoritized students have equitable access to instruction that honors and values their linguistic and cultural assets and strengths. To understand how leaders of bilingual programs might address this challenge, this study sought to identify dimensions of program implementation in bilingual schools serving Polish minorities in the Zaolzie region on the Czech Republic side of the Czech-Polish border.MethodsEmploying a sequential explanatory mixed methods design, the research team first collected surveys from 123 teachers and used factor analytical techniques to identify key dimensions of program implementation. Then, interview and observational data were collected and analyzed using deductive coding to develop descriptions of each dimension in this specific border region.ResultsThe analysis revealed four dimensions of program implementation: (a) program structure and alignment; (b) culturally and linguistically responsive instruction; (c) staff quality and professional learning; and (d) family engagement and community support. They also showed how a network of community-based organizations partnered with schools and families in ways that supported each dimension and facilitated integration across dimensions.DiscussionThe findings have several implications for leaders and researchers in bilingual schools including the important role that community organizations and binational cooperation can play in positively contributing to the education of linguistically minoritized populations.
Solution-processed ZnO coated on LiNi0.8Mn0.1Co0.1O2(NMC811) for enhanced performance of Li-ion battery cathode
Authors: Kang Chiwon , Park Yewon , Kim Yongjoon , Kim Soo Min , Ha Seungho , Yoon Hee Gon , Oh Kyu Won , Shin Keun-Young , Kim Byung Hyo 
Published: October 2023

The LiNi0.8Mn0.1Co0.1O2 (NMC811) cathode material, widely used in Li-ion batteries (LIBs) for electric vehicles (EVs), has gained a fair amount of attention in the industry due to its advantages of high energy capacity and low production cost. However, during charge-discharge cycles, NMC811 cathode faces issues such as hydrofluoric acid (HF) attack, leaching of transition metals and unstable formation of the cathode electrolyte interphase (CEI), which leads to undermining cathode performance. To address these issues, extensive research has been conducted on coating materials based on metal oxides. In this study, our research team chose Li-doped ZnO (LZO) material, known for its high Li+ ion conductivity and structural stability. Employing sol-gel synthetic method, we successfully coated LZO material on commercial NMC811 particles, therefore ensuring its coating uniformity through X-ray photoelectron spectroscopy (XPS) and energy-dispersive X-ray spectroscopy energy dispersive spectroscopy analyses. Evaluation of the coated samples (1 wt%, 2 wt%, and 3 wt% LZO on NMC811) revealed their superior electrochemical performance compared to bare NMC811; furthermore, the 2 wt% LZO-coated sample exhibited the highest cycling performance among the coated samples. These findings could be attributed to the lower charge transfer resistance verified by electrochemical impedance spectroscopy (EIS) analysis. Thus, we confirmed the LZO coating layers could provide stability for the NMC811 surface structure, mitigate the leaching of transition metal ions in the NMC811, and promote the formation of an enhanced CEI layer, therefore facilitating Li+ ion diffusion.
Effects of various land utilization types on groundwater at different temporal scales: a case study of Huocheng plain, Xinjiang, China
Authors: Lu Yongxing , Dai Liangliang , Yan Guanxi , Huo Zhitao , Chen Wen , Lan Jingzhou , Zhang Chaoming , Xu Qingyang , Deng Shimin , Chen Jian 
Published: October 2023

Different land utilization types have unignorable impacts on adjacent aquifers, so studying the effects of varying land utilization types on groundwater balance and groundwater table in arid and semi-arid areas is crucial to facilitate the rational development of territorial space and groundwater resource management. This study investigated the relationship between land utilization type variations and groundwater dynamics from spatial and temporal scales in Huocheng plain, Xinjiang, China, via taking advantage of different land utilization maps provided by remote sensing techniques in 1990, 2000, and 2015. Based on the analysis of results, the findings can be summarized as follows. First, the cultivated and construction land has expanded significantly in the past 25 years. The migration of the regional center of cultivated land was insignificant, as it is still located almost in the center of the entire study area. However, the transfer span of the location center of construction land was more prominent, and its moving direction was mainly from south to northeast, directly affecting the groundwater balance state and groundwater table. Second, the total amount of groundwater storage exhibited a remarkable reduction, from a recharge in 1990 to a continuous discharge in 2000–2015, during which the total recharge and discharge had both continuously declined. Meanwhile, recharging and discharging elements were also changed profoundly as less groundwater recharges from ambient aqueous environments and more groundwater extraction. Thus, human activities were the fundamental driving terms causing the changes in groundwater sources. Third, the groundwater table gradually and continuously dropped from south to northeast in the study area over time. The drawdown of spatially averaged groundwater tables was positively correlated with construction and cultivated area extension. In addition, compared to the former literature, this study offers an alternative approach for groundwater protection and optimization of territorial space development and utilization in arid and semi-arid areas.
The accuracy of using vergence formula to screen myopia in children: a cross-sectional study
Authors: Yi Zhen , Hong Chang , Haikuo Huang , Xinxin Wang 
Published: October 2023

ObjectiveTo evaluate the accuracy of using the vergence formula to screen myopia in children and adolescents.MethodsThis was a cross-sectional study conducted between December 2022 and May 2023 at the ophthalmology clinic of Beijing Tongren Hospital. A total of 336 children aged 6 to 12 years with refractive errors were selected according to the inclusion criteria. Biometric measurements, including axial length, corneal thickness, anterior chamber depth, corneal curvature, and lens thickness, were obtained using a biometer. The Calculated spherical equivalent (SE) was then calculated using the vergence formula. Cycloplegic refraction was performed after paralysis of the ciliary muscle, and the subjective SE was recorded. A diagnosis of myopia was made if the subjective SE was ≤ −0.50 diopters.ResultsThe AL/CR, subjective SE, and calculated SE were not normally distributed (p &lt; 0.05). The AL/CR value was 3.08 (2.81, 3.27), the SE was −1.60 D (−6.00 D, 3.75 D), and the calculated SE was −1.42 D (−6.64 D, 5.73 D). There was no significant difference between the calculated SE and the SE (Z = −2.899, p = 0.004). The AL/CR value was negatively correlated with SE (r = −0.687, p &lt; 0.01), and the calculated SE was positively correlated with SE (r = 0.827, p &lt; 0.01). The area under the ROC curve for predicting myopia using AL/CR and calculated SE was 0.876 and 0.962, respectively, and the difference between the two was significant (p &lt; 0.001). The sensitivity of AL/CR was 84.2%, the specificity was 70.6%, the accuracy was 82.1%, and the Youden index was 0.548. The sensitivity of calculated SE was 83.1%, the specificity was 100%, the accuracy was 85.7%, and the Youden index was 0.831.ConclusionThe vergence formula can be used to evaluate myopia in children and adolescents with relatively high accuracy without cycloplegic refraction.
Widely targeted metabolomics reveals the effect of different raw materials and drying methods on the quality of instant tea
Authors: Jin Jian-Chang , Liang Shuang , Qi Shang-Xiong , Tang Ping , Chen Jian-Xin , Chen Quan-Sheng , Chen Yan-Feng , Yin Jun-Feng , Xu Yong-Quan 
Published: October 2023

IntroductionInstant teas are particularly rich in tea polyphenols and caffeine and have great potential as food ingredients or additives to improve the quality of food and enhance their nutritional and commercial value.MethodsTo determine the relationships between raw material, drying method, and sensory and other quality attributes, instant teas were prepared from three tea varieties, namely black, green and jasmine tea, using two drying methods, namely spray-drying (SD) and freeze-drying (FD).ResultsBoth the raw tea material and drying method influenced the quality of the finished instant teas. Black tea was quality stable under two drying, while green tea taste deteriorated much after SD. Jasmine tea must be produced from FD due to huge aroma deterioration after SD. FD produced instant tea with higher sensory quality, which was attributed to the lower processing temperature. Chemical compositional analysis and widely targeted metabolomics revealed that SD caused greater degradation of tea biochemical components. The flavonoids content changed markedly after drying, and metabolomics, combined with OPLS-DA, was able to differentiate the three varieties of tea. Instant tea preparations via SD often lost a large proportion of the original tea aroma compounds, but FD minimized the loss of floral and fruity aroma compounds. Changes in the tea flavonoids composition, especially during drying, contributed to the flavor development of instant tea.DiscussionThese results will provide an practicle method for high-quality instant tea production through choosing proper raw tea material and lowering down drying temperature with non-thermal technologies like FD.
Radiotherapy-induced dynamic changes in the lymphocyte-to-monocyte ratio in patients with laryngeal cancer indicate poor prognosis
Authors: Cichowska-Cwalińska Natalia , Bieńkowski Michał , Popęda Marta , Dróżka Magdalena , Rutkowski Jacek , Jassem Jacek , Zaucha Renata 
Published: October 2023

AimWe hypothesized that markers of inflammation correlate with response to radiotherapy in patients with non-metastatic laryngeal cancer (LC). Our aim was to assess peripheral and local markers of inflammation including lymphocyte to monocyte ratio (LMR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), infiltrating CD8+ lymphocytes (TILsCD8), and programmed death 1 ligand (PD-L1) expression.MethodsWe performed a retrospective single-center analysis of LC patients administered definitive (R-RT) or postoperative radiotherapy (PORT). The primary endpoint was overall survival (OS) in relation to peripheral and local inflammatory markers and their dynamic changes during RT.ResultsStudy group included 215 patients (R-RT, n=116; PORT, n=99). The baseline (t0) NLR and LMR were significantly correlated with OS in the R-RT group. In patients with high and low NLR at t0, the five-year OS was 33% and 56% (p=0.010) and in high and low LMR at t0, the five-year OS was 56% and 27% (p=0.003), respectively. The LMR increase during R-RT predicted better prognosis: the five-year OS in high and low LMR was 57% and 31% at t2 (after 2 weeks of RT) (p=0.015), 49% and 26% at t4 (p&lt; 0.001), and 50% and 25% at t6 (p=0.013), respectively. Multivariable analysis shows that the worse performance status (p=0.003), the presence of nodal metastases (p=0.0001), and low baseline LMR (p=0.049) in the R-RT group, and the presence of nodal metastases (p=0.035) and completion treatment on time (p=0.042) in PORT group were associated with poor prognosis. The PD-L1 expression had no significant prognostic value in any of the examined patients.ConclusionThe baseline LMR and its dynamic changes during R-RT and baseline NLR are independent prognostic factors in patients with nonmetastatic LC. PD-L1 expression and number of TILsCD8 have no prognostic value in R-RT and PORT group.
Involved-field irradiation or elective-nodal irradiation in neoadjuvant chemo-radiotherapy for locally-advanced esophageal cancer: comprehensive analysis for dosimetry, treatment-related complications, impact on lymphocyte, patterns of failure and survival
Authors: Chen Xianyan , Zhang Yingjie , Zhou Xiaojuan , Wang Min , Na Feifei , Zhou Lin , Xu Yong , Zou Bingwen , Xue Jianxin , Liu Yongmei , Gong Youling 
Published: October 2023

PurposeTo compare the differences between involved-field irradiation (IFI) and elective nodal irradiation (ENI) in selecting the optimal target area for neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced esophageal squamous cell carcinoma (LA-ESCC).Materials and methodsWe retrospectively analyzed 267 patients with LA-ESCC, of whom 165 underwent ENI and 102 underwent IFI. Dosimetry, treatment-related complications, pathological responses, recurrence/metastasis patterns, and survival were compared between the two groups.ResultsThe median follow-up duration was 27.9 months. The R0 resection rates in the IFI and ENI groups were 95.1% and 92.7%, respectively (p=0.441), while the pathological complete response (pCR) rates were 42.2% and 34.5%, respectively (p=0.12). The ENI group received higher radiation doses to the heart (HV30:23.9% vs. 18%, p=0.033) and lungs (LV30:7.7% vs. 4.9%, p&lt;0.001) than the IFI group. Consequently, the ENI group showed a higher incidence of grade 2 or higher radiation pneumonitis (30.3% vs. 17.6%, p=0.004) and pericardial effusion (26.7% vs. 11.8%, p=0.021) than the IFI group. Post-operation fistulas were observed in 3 (2.9%) and 17 cases (10.3%) in the IFI and ENI groups, respectively (p=0.026). In the multivariate analysis, smoking, positive lymph node involvement (pN+), and anastomotic fistula were independent predictors of overall survival (OS). The pN+ patients exhibited a greater propensity for recurrence compared to pN- patients, especially in the first year of follow-up (6.67% vs. 0.56%, p=0.003).ConclusionThe ENI group had a higher incidence of radiation-induced adverse events compared to the IFI group, likely due to the higher radiation doses to normal tissues. Considering the similar disease-free survival (DFS) and OS rates in the two groups, IFI may be suitable for nCRT in patients with LA-ESCC, although further prospective studies are warranted.
An effective approach for plant leaf diseases classification based on a novel DeepPlantNet deep learning model
Authors: Ullah Naeem , Khan Javed Ali , Almakdi Sultan , Alshehri Mohammed S. , Al Qathrady Mimonah , El-Rashidy Nora , El-Sappagh Shaker , Ali Farman 
Published: October 2023

IntroductionRecently, plant disease detection and diagnosis procedures have become a primary agricultural concern. Early detection of plant diseases enables farmers to take preventative action, stopping the disease's transmission to other plant sections. Plant diseases are a severe hazard to food safety, but because the essential infrastructure is missing in various places around the globe, quick disease diagnosis is still difficult. The plant may experience a variety of attacks, from minor damage to total devastation, depending on how severe the infections are. Thus, early detection of plant diseases is necessary to optimize output to prevent such destruction. The physical examination of plant diseases produced low accuracy, required a lot of time, and could not accurately anticipate the plant disease. Creating an automated method capable of accurately classifying to deal with these issues is vital. MethodThis research proposes an efficient, novel, and lightweight DeepPlantNet deep learning (DL)-based architecture for predicting and categorizing plant leaf diseases. The proposed DeepPlantNet model comprises 28 learned layers, i.e., 25 convolutional layers (ConV) and three fully connected (FC) layers. The framework employed Leaky RelU (LReLU), batch normalization (BN), fire modules, and a mix of 3×3 and 1×1 filters, making it a novel plant disease classification framework. The Proposed DeepPlantNet model can categorize plant disease images into many classifications.ResultsThe proposed approach categorizes the plant diseases into the following ten groups: Apple_Black_rot (ABR), Cherry_(including_sour)_Powdery_mildew (CPM), Grape_Leaf_blight_(Isariopsis_Leaf_Spot) (GLB), Peach_Bacterial_spot (PBS), Pepper_bell_Bacterial_spot (PBBS), Potato_Early_blight (PEB), Squash_Powdery_mildew (SPM), Strawberry_Leaf_scorch (SLS), bacterial tomato spot (TBS), and maize common rust (MCR). The proposed framework achieved an average accuracy of 98.49 and 99.85in the case of eight-class and three-class classification schemes, respectively.DiscussionThe experimental findings demonstrated the DeepPlantNet model's superiority to the alternatives. The proposed technique can reduce financial and agricultural output losses by quickly and effectively assisting professionals and farmers in identifying plant leaf diseases.
HIV test-and-treat policy improves clinical outcomes in Zambian adults from Southern Province: a multicenter retrospective cohort study
Authors: Hamooya Benson M. , Mutembo Simon , Muyunda Brian , Mweebo Keith , Kancheya Nzali , Sikazwe Lyapa , Sakala Morgan , Mvula Johanzi , Kunda Salazeh , Kabesha Shem , Cheelo Chilala , Fwemba Isaac , Banda Clive , Masenga Sepiso K. 
Published: October 2023

BackgroundGlobally, most countries have implemented a test-and-treat policy to reduce morbidity and mortality associated with HIV infection. However, the impact of this strategy has not been critically appraised in many settings, including Zambia. We evaluated the retention and clinical outcomes of adults enrolled in antiretroviral therapy (ART) and assessed the impact of the test-and-treat policy.MethodsWe conducted a retrospective cohort study among 6,640 individuals who initiated ART between January 1, 2014 and July 31, 2016 [before test-and-treat cohort (BTT), n = 2,991] and between August 1, 2016 and October 1, 2020 [after test-and-treat cohort (ATT), n = 3,649] in 12 districts of the Southern province. To assess factors associated with retention, we used logistic regression (xtlogit model).ResultsThe median age [interquartile range (IQR)] was 34.8 years (28.0, 42.1), and 60.2% (n = 3,995) were women. The overall retention was 83.4% [95% confidence interval (CI) 82.6, 84.4], and it was significantly higher among the ATT cohort, 90.6 vs. 74.8%, p &lt; 0.001. The reasons for attrition were higher in the BTT compared to the ATT cohorts: stopped treatment (0.3 vs. 0.1%), transferred out (9.3 vs. 3.2%), lost to follow-up (13.5 vs. 5.9%), and death (1.4 vs. 0.2%). Retention in care was significantly associated with the ATT cohort, increasing age and baseline body mass index (BMI), rural residence, and WHO stage 2, while non-retention was associated with never being married, divorced, and being in WHO stage 3.ConclusionThe retention rate and attrition factors improved in the ATT compared to the BTT cohorts. Drivers of retention were test-and-treat policy, older age, high BMI, rural residence, marital status, and WHO stage 1. Therefore, there is need for interventions targeting young people, urban residents, non-married people, and those in the symptomatic WHO stages and with low BMI. Our findings highlight improved ART retention after the implementation of the test-and-treat policy.