bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bibliometric and visual analyses of trends in the field of T cell exhaustion research: Findings from 2000 to 2022
Authors: Liu Ziling , Wan Huan , Tan Yao , Li Deshuang , Huang Jianguo , Zhang Chuanhe , Liu Fangyuan , Qin Bo 
Published: November 2023

Background T cell exhaustion refers to a state wherein T cells become less functional as a result of their prolonged exposure to cognate antigens. A wealth of T cell exhaustion-focused research has been conducted in recent decades, transforming the current understanding of this biologically relevant process. However, there have not been any comprehensive bibliometric analyses to date focused on clarifying the T cell exhaustion-related research landscape. Here, a bibliometric analysis was thus conducted with the goal of better elucidating the current state of knowledge and emerging research hotspots in this field. Methods The Web of Science Core Collection was searched for articles and reviews related to T cell exhaustion, with the CiteSpace and VOSviewer programs then being employed to analyze the countries, institutions, authors, references, and keywords associated with studies in this research space. Results In total, 2676 studies were incorporated in this analysis, highlighting progressive annual increases in the number of T cell exhaustion-focused publications over the study period. These publications were affiliated with 3117 institutions in 85 countries, with the USA and China being the largest contributors to the field. Of the 18,032 authors associated with these publications, E. John Wherry exhibited the highest publication count and the greatest citation frequency. Keyword analyses indicated that immunotherapy, T cell exhaustion, and PD-1 are the dominant foci for T cell exhaustion-related research. Conclusion These findings highlight the importance of collaborations among institutions and nations in order to further propel novel studies of T cell exhaustion. Efforts to unravel the signal transduction and transcriptional mechanisms underlying the onset of T cell exhaustion were also identified as an emerging hotspot in this field. Ultimately, these results support the pivotal status of T cell exhaustion research as a key direction for immunotherapeutic research and development efforts in the coming years.
Steroid initiation timing and outcome of coronavirus disease 2019 patients: A multicenter, retrospective, observational study
Authors: Sugimoto Ryu , Kenzaka Tsuneaki , Mikami Ayako , Matsunaga Nobuaki , Akiyama Takayuki , Ohmagari Norio , Nishisaki Hogara 
Published: November 2023

Objectives: Dexamethasone’s (DEXA) beneficial effect on survival when administered to critically ill patients with coronavirus disease 2019 (COVID-19) has been documented in randomized trials and meta-analyses. Here, we conducted this study to clarify the association between time from COVID-19 onset to steroid initiation and mortality and to examine the factors underlying these results. Methods: This was a multicenter, retrospective, observational study of patients enrolled in the Japanese COVID-19 Registry from January 1, 2020, to April 30, 2021. Demographic and clinical factors were extracted from patient records. Patients diagnosed with COVID-19 using polymerase chain reaction, loop-mediated isothermal amplification, or antigen tests were included. Patients aged <18 years, pregnant, with a history of chronic obstructive pulmonary disease or steroid or immunosuppressive drug use, transferred to another hospital, or with an unknown symptom onset were excluded. Results and Conclusion: The analysis included 3692 patients (men, 64.1%; median age, 68 years). Unadjusted comparisons of mortality groups showed significant differences in demographic and clinical characteristics; patients with early dexamethasone initiation had more risk factors for severe disease and significantly higher mortality than did patients with delayed initiation (13.3% vs 7.9%, p < .001). No significant differences were found in intubation rates or duration, length of hospitalization, or time from intubation to death. Multivariate analyses showed significant differences from symptom onset to steroid administration, with an adjusted odds ratio of 0.7 ( p = .05) for patients who received steroids for ≥8 days. Early steroid administration to COVID-19 patients was associated with increased mortality, suggesting a subset with early severe disease and high mortality and/or adverse effects of early steroid administration.
Redefining superior escape of the humeral head: A radiographic and magnetic resonance imaging study
Authors: Boyle Alex B , MacLean Simon BM 
Published: November 2023

Background The underlying shoulder pathology in radiographic superior escape of the humeral head and association between acromiohumeral interval (AHI) on radiographs and magnetic resonance imaging (MRI) are poorly understood. Methods A retrospective review of shoulder radiographs and MRI scans was undertaken. AHI was measured using both modalities. Deltoid bulk, long head of biceps brachii subluxation/tear, and rotator cuff disease (tendon involvement, severity, fatty infiltration) were noted using MRI. Results A total of 167 patients were included. MRI measurements of AHI were significantly smaller than radiographic measurements ( p = 0.010). AHI was significantly smaller in patients with at least one partial or full thickness rotator cuff tear ( p < 0.0001) and in patients with increased fatty infiltration based on Goutallier grade ( p = 0.004). In the presence of two or more tendon tears, long head of biceps brachii rupture was associated with superior escape ( p < 0.001). In patients with superior escape (AHI <6 mm), the number of rotator cuff tendon tears ranged from 0 to 3 and Goutallier grades from 0 to 4 representing a wide disease spectrum. Discussion Radiographic superior escape of the humeral head is correlated with full thickness rotator cuff tears, fatty infiltration, and long head of biceps brachii rupture. However, superior escape can occur with a single or no tendon injury with minimal fatty infiltration. Level of evidence Level III; Retrospective Case-Control Design; Prognosis Study.
Asymmetry in Hedges, Safe Havens, Flights and Contagion: Unconditional Quantile Regression Approach
Authors: Chang Meng-Shiuh , Chen Meng-Wei , Ju Peijie 
Published: November 2023

We examine the hedging/safe-haven ability of gold, the US dollar, bonds, crude oil, and Bitcoin against stocks using the unconditional quantile regression (UQR). We reveal that hedging (safe-haven) effect generally decreases (increases) with the quantiles of asset returns and find an asymmetric flight from stocks to the US dollar as well as asymmetric stock-gold, stock-bond, and stock-oil contagion. Finally, we find a connection between the asymmetric safe haven and asymmetric cross-asset flights/contagion. Therefore, investors seeking hedging and safe-haven assets and investigating flights or contagion should consider the feature of extremes of assets returns. JEL: C13; G11; G14
Augmentation of ACL Autograft Reconstruction With an Amnion Collagen Matrix Wrap and Bone Marrow Aspirate Concentrate: A Pilot Randomized Controlled Trial With 2-Year Follow-up
Authors: Anz Adam W. , Jordan Steve E. , Ostrander Roger V. , Branch Eric A. , Denney Thomas S. , Cohen Achraf , Andrews James R. 
Published: November 2023

Background: It is theorized that the lack of a synovial lining after anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR) contributes to slow ligamentization and possible graft failure. Whether graft maturation and incorporation can be improved with the use of a scaffold requires investigation. Purpose: To evaluate the safety and efficacy of wrapping an ACL autograft with an amnion collagen matrix and injecting bone marrow aspirate concentrate (BMAC), quantify the cellular content of the BMAC samples, and assess 2-year postoperative patient-reported outcomes. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 40 patients aged 18 to 35 years who were scheduled to undergo ACLR were enrolled in a prospective single-blinded randomized controlled trial with 2 arms based on graft type: bone–patellar tendon–bone (BTB; n = 20) or hamstring (HS; n = 20). Participants in each arm were randomized into a control group who underwent standard ACLR or an intervention group who had their grafts wrapped with an amnion collagen matrix during graft preparation, after which BMAC was injected under the wrap layers after implantation. Postoperative magnetic resonance imaging (MRI) mapping/processing yielded mean T2* relaxation time and graft volume values at 3, 6, 9, and 12 months. Participants completed the Single Assessment Numeric Evaluation Score, Knee injury and Osteoarthritis Outcome Score, and pain visual analog scale. Statistical linear mixed-effects models were used to quantify the effects over time and the differences between the control and intervention groups. Adverse events were also recorded. Results: No significant differences were found at any time point between the intervention and control groups for BTB T2* (95% CI, –1.89 to 0.63; P = .31), BTB graft volume (95% CI, –606 to 876.1; P = .71), HS T2* (95% CI, –2.17 to 0.39; P = .162), or HS graft volume (95% CI, –11,141.1 to 351.5; P = .28). No significant differences were observed between the intervention and control groups of either graft type on any patient-reported outcome measure. No adverse events were reported after a 2-year follow-up. Conclusion: In this pilot study, wrapping a graft with an amnion collagen matrix and injecting BMAC appeared safe. MRI T2* values and graft volume of the augmented ACL graft were not significantly different from that of controls, suggesting that the intervention did not result in improved graft maturation. Registration: NCT03294759 (ClinicalTrials.gov identifier).
The Prognostic Impact of Log Odds of Positive Lymph Nodes on Survival of Patients With Early-stage Non-small Cell Lung Cancer: A Population Study Based on the Seer Database and a Chinese Cohort
Authors: Xi Kexing , Yu Hui , Huang Zewei 
Published: November 2023

Objective The purpose of this study was to investigate the prognostic value of log odds of positive lymph nodes (LODDS) in patients with early-stage non-small cell lung cancer (NSCLC). Methods Four hundred and eighty-seven NSCLC patients with pT2N0M0 who underwent radical resection from June 1999 to September 2009 at Sun Yat-Sen University Cancer Center and 8,702 patients from the Surveillance, Epidemiology, and End Results (SEER) were reviewed. According to the X-tile analysis, the patients were classified into two groups based on their log odds ratio [≤ –1.40 (group LODDS1) and > –1.40 (group LODDS2)]. Cox univariate and multivariate analyses were used to identify the prognostic factors for survival. Result Patients were divided into two groups according to the value of LODDS: ≤ – 1.40 (group LODDS1) and > – 1.40 (group LODDS2). For the development cohort, the 5-year CSS rate for patients was 79.6% and 69.3% in the group LODDS1 and LODDS2, respectively ( P = .009). For the validation cohort, the 5-year CSS rate was 85.4% for patients in group LODDS1, compared with 82.5% for those in group LODDS2 ( P = .006). In multivariate analysis, LODDS was associated with CSS significantly [hazard ratio (HR), 1.487; 95% confidence intervals (CI), 1.126–1.963] in the development cohort. The HR value of LODDS for CSS was 1.260 (95% CI,1.107–1.434) in the validation cohort. Conclusion LODDS was a strong independent prognostic factor for early-stage NSCLC.
Travel Burden to Cancer Screening and Treatment Facilities Among Washington Women: Data From an Integrated Healthcare Delivery System
Authors: Amiri Solmaz , Robison Jeanne , Pflugeisen Chaya , Monsivais Pablo , Amram Ofer 
Published: November 2023

Purpose To characterize distance traveled for breast cancer screening and to sites of service for breast cancer treatment, among rural and urban women served by a Washington State healthcare network. Methods Data for this study came from one of the largest not-for-profit integrated healthcare delivery systems in Washington State. Generalized linear mixed models with gamma log link function were used to examine the associations between travel distance and sociodemographic and contextual characteristics of patients. Results Median travel distance for breast cancer screening facilities, hematologist/oncologists, radiation oncologists, or surgeons was 11, 19, 23, or 11 miles, respectively. Travel distance to breast cancer screening or referral facilities was longer in non-core metropolitan ZIP codes compared to metropolitan ZIP codes. AI/AN and Hispanic women travelled longer distances to reach referral facilities compared to other racial and ethnic groups. Conclusion Disparities exist in travel distance to breast cancer screening and treatment. Further research is needed to describe sociodemographic and system level characteristics that contribute to such disparities and to discover novel approaches to alleviate this burden.
A 5M Synchronization Mechanism for Digital Twin Shop-Floor
Authors: Liu Weiran , Cheng Jiangfeng , Wen Zhiwen , Zou Xiaofu , Wang Zhaozong , Liu Hongting , Tao Fei 
Published: November 2023

AbstractIn recent years, as a promising way to realize digital transformation, digital twin shop-floor (DTS) plays an important role in smart manufacturing. The core feature of DTS is the synchronization. How to implement and maintain the synchronization is critical for DTS. However, there is still a lack of a common definition for synchronization in DTS. Besides, a systematic synchronization mechanism for DTS is strongly needed. This paper first summarizes the definition and requirements of synchronization in DTS, to clarify the understanding of synchronization in DTS. Then, a 5M synchronization mechanism for DTS is proposed, where 5M refers to multi-system data, multi-fidelity model, multi-resource state, multi-level state, and multi-stage operation. As a bottom-up synchronization mechanism, 5M synchronization mechanism for DTS has the potential to support DTS to achieve and maintain physical-virtual state synchronization, and to realize operation synchronization of DTS. The implementation methods of 5M synchronization mechanism for DTS are also introduced. Finally, the proposed synchronization mechanism is validated in a digital twin satellite assembly shop-floor, which proves the effectiveness and feasibility of the mechanism.
Associations of long-term exposure to PM2.5 constituents with serum uric acid and hyperuricemia in Chinese adults
Authors: Chen Kejun , Yin Jianzhong , Dai Yucen , Tang Xuewei , Xu Huan , Jiang Ye , Lin Hualiang , Li Jingzhong , Yang Tingting , Yu Jianhong , Lv Xiaoyan , Deji Quzong , Zhang Juying , Xie Linshen , Guo Bing , Zhao Xing ,   the China Multi-Ethnic Cohort (CMEC) Collaborative Group
Published: November 2023

Abstract
Objective
Little is known about the magnitude of the relation of ambient fine particulate matter (PM2.5) constituents with hyperuricemia and serum uric acid (SUA) levels. Therefore, we aimed to assess the associations and to identify the most hazardous constituent.

Methods
This study included 72,840 participants from the China Multi-Ethnic Cohort. Annual average concentrations of PM2.5 mass and its major 7 constituents were matched to individuals by residential address. SUA levels exceeding 7.0 mg/dL (417 μmol/L) for men and 6.0 mg/dL (357 μmol/L) for women were considered to be hyperuricemia. Multiple logistic and linear regressions were performed on the association of single exposure to PM2.5 constituents with hyperuricemia and SUA, separately. The weighted quantile sum method was applied to examine the joint effect of PM2.5 constituents on hyperuricemia/SUA.

Results
Significant positive associations were discovered between PM2.5 constituents and SUA/hyperuricemia. For example, the odds ratio (95% confidence interval) of hyperuricemia for per standard deviation increase of PM2.5 mass, black carbon, organic matter, ammonium, and nitrate concentrations were 1.22 (1.12–1.32), 1.17 (1.08–1.27), 1.20 (1.10–1.31), 1.21 (1.11–1.31), and 1.28 (1.18–1.40), respectively. The joint exposure to PM2.5 constituents was significantly positively correlated with hyperuricemia (1.09, 1.05–1.14) and SUA (1.05, 1.03–1.06). And the weight of nitrate was the largest (0.668 for hyperuricemia, 0.586 for SUA).

Conclusions
Our findings suggest that long-term exposure to PM2.5 constituents is associated with increased SUA levels and a higher risk of hyperuricemia. In particular, nitrate seems to be the main contributor. This study may help prevent hyperuricemia by promoting the introduction of precise preventive measures.

Graphical Abstract
Molecular characteristics of Neisseria meningitidis carriage strains in university students in Lithuania
Authors: Ivaškevičienė Inga , Silickaitė Justina , Mačionienė Asta , Ivaškevičius Rimvydas , Bulavaitė Aistė , Gėgžna Vilmantas , Kiverytė Silvija , Paškevič Božena , Žvirblienė Aurelija , Plečkaitytė Milda 
Published: November 2023

Abstract
Background
Neisseria meningitidis can be carried asymptomatically in the human oropharynx without causing symptoms. Meningococcal carriage is relevant to the epidemiology of invasive meningococcal disease (IMD). No carriage studies have been performed among the general population in Lithuania, whereas the incidence of IMD in Lithuania was among the highest in European countries from 2009 to 2019.

Results
We analyzed a total of 401 oropharyngeal samples collected from university students from December 2021 to February 2023 for N. meningitidis carriage using direct swab PCR assays and culture. The overall carriage prevalence based on both or either swab PCR or culture was 4.99%. PCR-based assays were used to characterize 15 carriage isolates, including detection of genogroup, multilocus sequence typing profile, and typing of antigens PorA and FetA. The most common carriage isolates were capsule null locus (cnl), accounting for 46.7%, followed by genogroups B (26.7%) and Y (13.3%). We also performed a molecular characterization of invasive N. meningitidis isolates collected during the COVID-19 pandemic and post-pandemic period to understand better the meningococcal carriage in the context of prevailing invasive strains. Despite the substantial decrease in the incidence of IMD during the 2020–2022 period, clonal complex 32 (CC32) of serogroup B continued to be the most prevalent IMD-causing CC in Lithuania. However, CC32 was not detected among carriage isolates. The most common CCs were CC269, CC198, and CC1136. The antigen peptide variants found in most carried isolates were classified as ‘insufficient data’ according to the MenDeVAR Index to evaluate the potential coverage by the 4CMenB vaccine. Nearly half of the isolates were potentially covered by the Men-Fhbp vaccine. Resistance to ciprofloxacin was detected only for one cnl isolate. All isolates were susceptible to penicillin and ceftriaxone. Our analysis identified frequent partying (≥ 4 times/month) as a risk factor for meningococcal carriage, whereas smoking, living in a dormitory, and previous COVID-19 illness were not associated with the carriage.

Conclusions
Our study revealed a low prevalence of meningococcal carriage among university students in Lithuania. The carriage isolates showed genetic diversity, although almost half of them were identified as having a null capsule locus.
Effect of preoperative sleep disorders on delirium in proximal femoral surgery patients aged 60 or older
Authors: Han Fuyi , Liu Xiaojie , Huang Hui , Chu Haichen , Feng Wei 
Published: November 2023

Abstract
Objective
To examine the effect of preoperative sleep disorders on delirium in patients older than 60 years of age who underwent surgery for proximal femoral fracture.

Methods
This is a prospective observational study. We prospectively selected 143 patients with proximal femoral fracture who underwent surgery between April 2021 and April 2022. The primary outcome was postoperative delirium (PD). Multiple logistic regression analyses were performed and a receiver operating characteristic (ROC) curve was generated. The preoperative sleep quality of all eligible participants was assessed through the Pittsburgh Sleep Quality Index (PSQI). The Confusion Assessment Method (CAM) was used to assess PD from the first to the seventh day postoperatively. Patients were divided into two groups according to the PD diagnosis: (1) the no PD (NPD) group and (2) the PD (PD) group.

Results
Of 143 eligible patients, 43 (30.1%) were diagnosed with PD. Multiple logistic regression analysis demonstrated that postoperative ICU admissions (OR = 2.801, p = 0.049) and preoperative sleep disorders (OR = 1.477 p < 0.001) were independently associated with PD. A receiver operating characteristic (ROC) curve demonstrated that the preoperative PSQI score was predictive of PD (AUC 0.808, 95% CI 0.724 ~ 0.892, p < 0.001).

Conclusion
Preoperative sleeping disorders may be an independent risk factor leading to PD and an independent predictive factor for the development of delirium in proximal femoral surgery patients aged 60 or older.
Implementation strategies for large scale quality improvement initiatives in primary care settings: a qualitative assessment
Authors: Goldberg Debora Goetz , Owens-Jasey Constance , Haghighat Sahar , Kavalloor Sneha 
Published: November 2023

Abstract
Background and objectives
The EvidenceNOW: Advancing Heart Health in Primary Care was designed to assist primary care practices in the US in implementing evidence-based practices in cardiovascular care and building capacity for quality improvement. EvidenceNOW, NCT03054090, was registered with ClinicalTrials.gov on 15/02/2017. The goals of this study were to gain a comprehensive understanding of perspectives from research participants and research team members on the value of implementation strategies and factors that influenced the EvidenceNOW initiative in Virginia.

Methods
In 2018, we conducted 25 focus groups with clinicians and staff at participating practices, including 80 physicians, advanced practice clinicians, practice managers and other practice staff. We also conducted face-to-face and telephone interviews with 22 research team members, including lead investigators, practice facilitators, physician expert consultants, and evaluators. We used the integrated-Promoting Action on Research Implementation in the Health Services (i-PARIHS) framework in our qualitative data analysis and organization of themes.

Results
Implementation strategies valued by both practice representatives and research team members included the kick-off event, on-site practice facilitation, and interaction with physician expert consultants. Remote practice facilitation and web-based tools were used less frequently. Contextual factors that influence quality improvement efforts include leadership support, access to resources, previous quality improvement experience, and practice ownership type (independent compared to health system owned). Many clinicians and staff were overwhelmed by day-to-day activities and experience initiative fatigue, which hindered their ability to fully participate in the EvidenceNOW initiative.

Conclusions
This study provides details on how the practice environment plays an essential role in the implementation of evidence-based practices in primary care. Future efforts to improve quality in primary care practices should consider the context and environment of individual practices, with targeted implementation strategies to meet the needs of independent and health system owned practices. Future efforts to improve quality in primary care practices require strategies to address initiative fatigue among clinicians and practice staff. External support for building capacity for quality improvement could help primary care practices implement and sustain evidence-based practices and improve quality of care.

Trial registration
This project was registered with ClinicalTrials.gov on 15/02/2017 and the identifier is NCT03054090.