bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of different machine learning algorithms for predicting the length of stay in the emergency departments: a single-centre study
Authors: Ricciardi Carlo , Marino Marta Rosaria , Trunfio Teresa Angela , Majolo Massimo , Romano Maria , Amato Francesco , Improta Giovanni 
Published: January 2024

BackgroundRecently, crowding in emergency departments (EDs) has become a recognised critical factor impacting global public healthcare, resulting from both the rising supply/demand mismatch in medical services and the paucity of hospital beds available in inpatients units and EDs. The length of stay in the ED (ED-LOS) has been found to be a significant indicator of ED bottlenecks. The time a patient spends in the ED is quantified by measuring the ED-LOS, which can be influenced by inefficient care processes and results in increased mortality and health expenditure. Therefore, it is critical to understand the major factors influencing the ED-LOS through forecasting tools enabling early improvements.MethodsThe purpose of this work is to use a limited set of features impacting ED-LOS, both related to patient characteristics and to ED workflow, to predict it. Different factors were chosen (age, gender, triage level, time of admission, arrival mode) and analysed. Then, machine learning (ML) algorithms were employed to foresee ED-LOS. ML procedures were implemented taking into consideration a dataset of patients obtained from the ED database of the “San Giovanni di Dio e Ruggi d’Aragona” University Hospital (Salerno, Italy) from the period 2014–2019.ResultsFor the years considered, 496,172 admissions were evaluated and 143,641 of them (28.9%) revealed a prolonged ED-LOS. Considering the complete data (48.1% female vs. 51.9% male), 51.7% patients with prolonged ED-LOS were male and 47.3% were female. Regarding the age groups, the patients that were most affected by prolonged ED-LOS were over 64 years. The evaluation metrics of Random Forest algorithm proved to be the best; indeed, it achieved the highest accuracy (74.8%), precision (72.8%), and recall (74.8%) in predicting ED-LOS.ConclusionsDifferent variables, referring to patients’ personal and clinical attributes and to the ED process, have a direct impact on the value of ED-LOS. The suggested prediction model has encouraging results; thus, it may be applied to anticipate and manage ED-LOS, preventing crowding and optimising effectiveness and efficiency of the ED.
Late Triassic E-W striking shear zone and its implication on gold mineralization in the Xiaoqinling area, eastern China
Authors: Chen Hong , Zhu Gui-Fan , Bai He , Cui Guo-Shuai , Zhang Huan-Huan , Mu Pei-Ji , Jin Yong-Jie 
Published: January 2024

The Xiaoqinling area is located in the eastern part of the Qinling Orogen and experiences early and late Mesozoic gold mineralization controlled by structural deformation. The relationship between the two stages of mineralization and the orogenic process of the Qinling Orogen is unclear. We investigated the deformation and alteration of E-W striking veins in the Xiaoqinling area. The geometric features revealed that all the veins developed within the E–W-striking Guanyintang brittle–ductile shear zone. The vein was subparallel to the shear zone, dipped at 30°–60°, and had a wave-like appearance. The Guanyintang shear zone underwent three deformation stages: sinistral shearing (D1), dextral thrusting (D2), and sinistral normal faulting (D3). The development of ore-bearing quartz veins was controlled by deformation during D2, and the auriferous pyrite and minor chalcopyrite developed along the shear foliations. Re-Os dating of the molybdenite revealed a well-constrained isochron age of 230.2 ± 2.6 Ma, indicating the E-W striking shear zone developed in Late Triassic. This early Mesozoic shearing deformation in Xiaoqinling represents the early Mesozoic metallogenesis is correlated with the collisional orogeny of the Qinling orogen.
Family quality of life and family-school collaboration during the COVID-19 pandemic: perceptions of Swedish parents of adolescents with special educational needs
Authors: Zakirova-Engstrand Rano , Wilder Jenny 
Published: January 2024

IntroductionCompared to other countries, Sweden did not introduce sudden lockdowns and school closures during the COVID-19 pandemic. Instead, the country chose a less restrictive approach to managing the pandemic, such as staying at home with any symptoms of cold or COVID-19, washing hands, and maintaining social distancing. Preschools and compulsory schools remained open. In this context, limited evidence exists about how Swedish families of students with special educational needs and disabilities (SEND) experienced collaboration with school professionals to support their children during the COVID-19, and how the pandemic affected parents’ perceptions of quality of their family life. The present study investigated parental perceptions of satisfaction with family-school collaboration and with family quality of life during the COVID-19 pandemic.MethodsTwenty-six parents of students with SEND who attended general lower secondary schools (grades 7-9) completed a survey using three measures: the demographic questionnaire, the Beach Center Family Quality of Life scale (FQOL), and the Family-School Collaboration scale – the adapted version of the original Beach Center Family-Professional Partnership Scale. Descriptive statistics, Pearson correlations were used to analyse data.ResultsParents felt less satisfied with family-school collaboration related to child-oriented aspects; they were least satisfied with their emotional well-being aspect of family quality of life. Strong, significant and positive associations were found between family-school collaboration and disability-related support aspect of FQOL.DiscussionThe findings point to the importance of family-school partnerships in promoting students’ positive school achievements, and in enhancing FQOL. The findings have practical implications for professional development of pre- and in-service teachers within the existing curricula of teacher preparation programs. Implications for further research are discussed given the study’s small sample size and challenges in recruitment of participants.
Patient factors associated with survival after critical care interhospital transfer
Authors: Reimer Andrew P. , Dai Wei , Schiltz Nicholas K. , Sun Jiayang , Koroukian Siran M. 
Published: January 2024

ObjectiveTo identify the factors that predict mortality post-transfer and develop a comprehensive mortality prediction model capable of supporting pre-transfer decision making.Materials and methodsElectronic health record data from the Medical Transport Data Repository of a large health system hospital in Northeast Ohio that consists of a main campus and 11 affiliated medical centers. We retrospectively analyzed patient data from the referring hospital encounter prior to interhospital transfer. All patient data including diagnoses, laboratory results, medication, and medical and social history were analyzed to predict in-hospital mortality post-transfer. We employed a multi-method approach including logistic regression, gradient boosting, and multiple correspondence analysis to identify significant predictors of mortality as well as variables that are clinically useful to inform clinical decision support development. We identified all patients aged 21 and older that underwent critical care transfer in the health system between 2010 and 2017.ResultsWe found that age, laboratory results (albumin, INR, platelets, BUN, leukocyte, hemoglobin, glucose), vital signs (temperature, respirations, pulse, systolic blood pressure, pulse oximetry), and ventilator usage are the most predictive variables of post-interhospital transfer mortality. Using structured data from the EHR we achieved the same performance as APACHE IV within our health system (0.85 vs. 0.85). Lastly, mode of transport alone was not a significant predictor for the general population in any of the outcome models.ConclusionsOur findings provide a foundation for the development of decision support tools to guide transport referrals and identified the need for further inquiry to discern the role of mode of transport to enable future inclusion in decision support approaches. Further inquiry is needed to identify factors that differentiate patients not triaged as time-sensitive transfers but still require helicopter intervention to maintain or improve post-interhospital transfer morbidity and mortality.
Safety and effectiveness of carbon nanoparticles suspension-guided lymph node dissection during thyroidectomy in patients with thyroid papillary cancer: a prospective, multicenter, randomized, blank-controlled trial
Authors: Zhao Jingzhu , Wang Junyi , Cheng Ruochuan , Qin Jianwu , Ai Zhilong , Sun Hui , Guo Zhuming , Zhang Xiaohua , Zheng Xiangqian , Gao Ming 
Published: January 2024

ObjectiveThis study aimed to evaluate the effectiveness and safety of carbon nanoparticles-guided lymph node dissection during thyroidectomy in patients with papillary thyroid cancer(PTC).MethodsClinical trials consisted of two subgroups: unilateral lobectomy (UL; n=283) and total thyroidectomy (TT; n=286). From each subgroup, the patients were randomly assigned to two groups: the carbon nanoparticle group and control group. Primary endpoints included parathyroid hormone (PTH) levels, number of lymph nodes (LNs) detected, number of tiny lymph nodes detected, and recognition and retention of the parathyroid glands. Secondary endpoint was recognition and protection of the recurrent laryngeal nerve.ResultsA total of 569 patients with PTC were recruited. There were no statistically significant differences in demographics between the carbon nanoparticles and control groups (P &gt; 0.05). In the UL subgroup, there were no significant differences in PTH levels between the two groups at preoperative, intraoperative, and postoperative day one, and postoperative month one (P&gt;0.05). There was no significant difference in the serum Ca2+ levels between the two groups preoperatively and at postoperative month one (P&gt;0.05). The number of lymph nodes dissected in the carbon nanoparticles group was significantly higher than that in the control group (P&lt;0.0001). The detection rate of tiny lymph nodes in the carbon nanoparticles group was higher than that in the control group (P=0.0268). In the TT subgroup, there was no significant difference in PTH levels between the two groups at preoperative, intraoperative, and postoperative day one (P&gt;0.05). However, the mean PTH level in the carbon nanoparticles group was significantly higher than that of the control group at postoperative month one (P=0.0368). There was no significant difference in the serum Ca2+ levels between the two groups preoperatively and at postoperative month one (P&gt;0.05). There were no significant differences between the two groups in the number of dissected LNs (P&gt;0.05) or the detection rate of tiny lymph nodes (P&gt;0.05). No drug-related AE and complications due to the injection of carbon nanoparticles were recorded in this study. There were no significant differences between the two groups in terms of parathyroid preserved in situ and recurrent laryngeal nerve injury in the UL and TT subgroups.ConclusionsCarbon nanoparticles demonstrated efficacy and safety in thyroidectomy. The application of carbon nanoparticles could significantly facilitate the identification and clearance of LNs and the optimum preservation of parathyroid function.Clinical trial registrationhttps://www.chictr.org.cn/, identifier ChiCTR2300068502.
Intramuscular injection of human chorionic gonadotropin as luteal phase support in artificial cycle frozen-thawed embryo transfer does not improve clinical outcomes: a parallel, open-label randomized trial
Authors: Li Xiaofang , Huang Yu , Shi Zan , Shi Juanzi , Li Na 
Published: January 2024

BackgroundHuman chorionic gonadotropin (hCG) as one of the first signals secreted by the embryo to the mother may have a direct effect on the endometrium at implantation. The current study was aim to compare the clinical outcomes after frozen-thawed embryo transfer (FET) treated with artificial cycles (AC) between women who were administered intramuscular injection of human chorionic gonadotropin (hCG) as luteal phase support and the routine group.MethodsA randomized controlled trial of 245 women was conducted at the Assisted Reproduction Center, Northwest Women’s and Children’s Hospital, Xi’an, China from January 2019 to January 2020. Women &lt;40 years of age undergoing their first FET treated with AC were included. Patients were randomly allocated into either: (1) the hCG treatment group, who received intramuscular injection of hCG since the third day of progesterone administration, at a dose of 2000 IU once every two days, for a total of four times, (2) the control group, receiving routine protocol without placebo on these four days. Clinical outcomes of the two groups were analyzed.ResultsThe primary outcome ongoing pregnancy rate in the hCG treatment group versus the control group was 73/124 (58.87%) versus 75/121 (61.98%), respectively (odds ratio [OR], 95% confidence interval [CI]:0.88, 0.53-1.47, P = 0.619). Secondary clinical outcomes including biochemical pregnancy, clinical pregnancy, early pregnancy loss, multiple pregnancy, live birth and preterm birth were also comparable between the two groups through the univariate analysis and multivariable regression analysis (P &gt; 0.05).ConclusionIn women undergoing AC-FET, there was no significant difference in the clinical outcomes between the hCG treatment group and the control group. Clinicians should be cautious about adding IM-hCG as luteal phase support to improve the clinical outcome after AC-FET.Clinical trial registrationhttp://www.chictr.org.cn/showprojen.aspx?proj=32511, identifier ChiCTR1800020342.
Association between nonalcoholic fatty liver disease and increased glucose-to-albumin ratio in adults without diabetes
Authors: Wang Shuai , Lin Xiaohong , Zhu Chuchen , Dong Yuqi , Guo Yiwen , Xie Zhonghao , He Xiaoshun , Ju Weiqiang , Chen Maogen 
Published: January 2024

BackgroundNonalcoholic fatty liver disease (NAFLD) affects approximately 30% of individuals globally. Both serum glucose and albumin were demonstrated to be potential markers for the development of NAFLD. We hypothesized that the risk of NAFLD may be proportional to the glucose-to-albumin ratio (GAR).MethodsBased on information from the National Health and Nutrition Examination Survey (NHANES) 1999–2018, it was determined that GAR was associated with an increased risk of NAFLD and liver fibrosis utilizing weighted multivariable logistic regression. Participants with a fatty liver index (FLI) over 60 were identified with NAFLD, and those with an NAFLD fibrosis score (NFS) &gt;0.676 with evidence of NAFLD were labeled with advanced hepatic fibrosis (AHF). The liver biopsy was utilized to verify the relationship between GAR and FLD in our center cohort. Mendelian randomization analysis investigated the genetic relationship between GAR and NAFLD.ResultsOf 15,534 eligible participants, 36.4% of participants were identified as NAFLD without AHF. GAR was positively correlated with the probability of NAFLD following full adjustment for possible variables (OR = 1.53, 95% CI: 1.39–1.67). It was confirmed that patients with NAFLD and AHF had an inferior prognosis. The relationship between GAR and NFS was favorable (R = 0.46, P&lt; 0.0001), and NAFLD patients with a higher GAR tended to develop poor survival. In our center cohort, the association between GAR and NAFLD was verified.ConclusionAmong participants without diabetes, greater GAR was linked to higher risks of NAFLD. In addition, NAFLD patients with higher GAR tended to develop liver fibrosis and adverse outcomes.
Intact ketogenesis predicted reduced risk of moderate-severe metabolic-associated fatty liver disease assessed by liver transient elastography in newly diagnosed type 2 diabetes
Authors: Lee Sejeong , Bae Jaehyun , Kim Seung Up , Lee Minyoung , Lee Yong-ho , Kang Eun Seok , Cha Bong-Soo , Lee Byung-Wan 
Published: January 2024

AimHepatic ketogenesis is a key metabolic pathway that regulates energy homeostasis. Some related controversies exist regarding the pathogenesis of metabolic-associated fatty liver disease (MAFLD). We aimed to investigate whether intact ketogenic capacity could reduce the risk of MAFLD based on transient electrography (TE) in patients with newly diagnosed type 2 diabetes (T2D).MethodsA total of 361 subjects with newly diagnosed T2D were recruited and classified into two groups based on the median serum β-hydroxybutyrate (βHB) level, referred to as the intact and impaired ketogenesis groups. The glucometabolic relevance of ketogenic capacity and associations of the baseline serum β-HB and MAFLD assessed with TE were investigated.ResultsCompared to the impaired ketogenesis group, the intact ketogenesis group showed better insulin sensitivity, lower serum triglyceride levels, and higher glycated hemoglobin levels. The controlled attenuation parameter (CAP) was lower in the intact ketogenesis group without statistical significance (289.7 ± 52.1 vs. 294.5 ± 43.6; p=0.342) but the prevalence of moderate–severe steatosis defined by CAP ≥260 dB/m was significantly lower in the intact group. Moreover, intact ketogenesis was significantly associated with a lower risk of moderate–severe MAFLD after adjusting for potential confounders (adjusted odds ratio 0.55, 95% confidence interval 0.30–0.98; p=0.044).ConclusionIn drug-naïve, newly diagnosed T2D patients, intact ketogenesis predicted a lower risk of moderate–severe MAFLD assessed by TE.
Characteristics and immune checkpoint status of radioiodine-refractory recurrent papillary thyroid carcinomas from Ukrainian Chornobyl Tissue Bank donors
Authors: Bogdanova Tetiana , Rogounovitch Tatiana I. , Zurnadzhy Liudmyla , Mitsutake Norisato , Tronko Mykola , Ito Masahiro , Bolgov Michael , Chernyshov Serhii , Gulevatyi Serhii , Masiuk Sergii , Yamashita Shunichi , Saenko Vladimir A. 
Published: January 2024

IntroductionThe radioiodine-refractory (RAI-R) recurrent papillary thyroid carcinomas (PTCs) are more frequent in elderly patients and have an unfavorable prognosis. Data on the prevalence and characteristics of RAI-R recurrent PTCs in patients of young and middle age with or without a history of radiation exposure in childhood are poorly described. The aim of the current study was: i) to determine the frequency of RAI-R recurrent PTCs among donors of the Chornobyl Tissue Bank (CTB) and analyze the clinicopathological features of primary tumors (PTs), primary metastases (PMTSs), recurrent metastases (RMTSs) and risk factors for RMTS, and ii) to determine the immune checkpoint status (ICS) of the RAI-R recurrent PTCs and to assess the factors associated with ICS positivity.MethodsSixty RAI-R recurrent PTCs (46 exposed to radiation and 14 non-exposed, 2.5% of all cases registered with the CTB) from the Ukrainian patients aged up to 48 years were identified.ResultsThe clinicopathological characteristics of the PTs moderately to weakly resembled those of the PMTS and RMTS from the same patients while the metastatic tissues were highly similar. The multivariate model of RMTS included the dominant solid-trabecular growth pattern of the PT, cystic changes, N1b metastases, and the probability of a causation (POC) of PTC by radiation as risk factors. Among these factors, the lateral PMTS (N1b) had the strongest effect. The longer period of latency (a POC component) was the second statistically significant characteristic. ICS percent agreement between the PT and RAI-R RMTS was 91.5%; 23.7% of PTs and 28.8% of RMTSs had positive ICS (positive PD-L1 tumor epithelial cells (TECs) and positive PD-L1/PD1 tumor-associated immune cells). ICS positivity of PTs was associated with pronounced oncocytic changes and high density of the p16INK4A-positive TECs in the invasive areas of PTs. In RMTSs, ICS positivity was associated with pronounced oncocytic changes and Ki-67 labeling index ≥ 4.5% of PTs, and the dominant solid-trabecular growth pattern, Ki-67 labeling index ≥ 7.6% and p16INK4A-positivity of RMTS.DiscussionThe findings are of clinical relevance and may be useful for developing individual treatment approaches for patients with RAI-R recurrent PTCs possibly involving immunotherapy.
Unified dispatch of grid-connected and islanded microgrids
Authors: Wodicker Mackenzie Robert , Nelson James , Johnson Nathan Gregory 
Published: January 2024

This work develops microgrid dispatch algorithms with a unified approach to model predictive control (MPC) to (a) operate in grid-connected mode to minimize total operational cost, (b) operate in islanded mode to maximize resilience during a utility outage, and (c) utilize weighting factors in the grid-connected objective function to preserve islanded capability (on-site fuel reserves, battery state of charge) to enhance resilience in the potential event of an unplanned grid outage. Resilience is defined using microgrid survivability (probability to serve 100% of critical load), autonomy (duration of time to serve 100% of critical load), and unserved energy (curtailed critical load) for a target of 7 days during a grid outage. The developed methods are applied to a military microgrid with 2,250 kW of diesel generation, 3,450 kW/13,800 kWh battery storage, and 16,479 kW of solar photovoltaics. Sensitivity analysis is conducted to determine the selection of weighting factors to have the best impact on three developed objectives: grid-connected economics, islanded resilience, and carbon intensity. Optimal weighting factors reduce operating costs by 0.1%, increase survivability by 3.9%, increase autonomy by 16.7%, reduce unserved energy by 94.1%, and increase carbon intensity by 2.5%.
The impacts of digital value chain embeddedness on trade-related carbon emissions intensity
Authors: Lyu Yanfang , Xiang Yun , Wang Dong 
Published: January 2024

Objective: Digitalization supported by digital technology presents a potential solution for improving the efficiency of resource utilization. However, the impacts of digitalization on trade-related carbon emissions intensity have not been studied systematically.Methods: Based on panel data of 41 countries and regions over the period 2000–2014, this study examines how different types of digital value chain embeddedness can affect carbon emissions intensity using a semi-parametric partially linear model.Results: Research findings indicate that there is an inverted U-shaped relationship between digital domestic value chain embeddedness and carbon emissions intensity embodied in domestic trade; only when digitalization reaches a threshold of approximately 0.88, does the effects on carbon emissions intensity become negative. In addition, the impacts of digital global value chain embeddedness on carbon emissions intensity embodied in import trade and export trade are recognized as being non-linear; the thresholds of digitalization are approximately 0.1 and 0.3 for import trade and approximately 0.03 and 0.21 for export trade. Although participating in global value chains is conducive to accelerating digital technology diffusion, the actual environmental effects are constrained by a country’s absorptive capacity and high economic system complexity. Compared with developed countries, developing countries lag behind in entering the downward stage of the inverted U-shaped curve, thereby gaining environmental benefits from digital value chain embeddedness. Moreover, in terms of utilizing digital value chain embeddedness to improve energy efficiency, measures include optimizing trade conditions, adjusting energy structure, and increasing trade scale, which can play an active role.Value: This study sheds light on the exploration of the potential of digitalization and the facilitation of economic development in a more environmentally friendly manner.