bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regional peculiarities of hospitalizations and outpatient medical treatment among the adult population with established type 2 diabetes mellitus
Authors: Shepel R. N. , Levchenko E. I. , Lusnikov V. P. , Kontsevaya A. V. , Drapkina O. M. 
Published: October 2023

Purpose. To analyze the indicators of hospitalization and outpatient visits of patients aged 18 years and older with type 2 diabetes mellitus (DM) in federal districts (FD) and regions of the Russian Federation from the perspective of the World Health Organization concept of ambulatory care sensitive conditions. Materials and methods. The analysis included data from the annual forms of federal statistics (forms No. 12 and No. 14), on the number of hospitalizations and the outpatient visits of patients aged 18 years and older diagnosed of type 2 diabetes (ICD10: E11) in 2022. Results. We analyzed the data of the federal statistics (forms No. 12 and No. 14) of the Federal District and the regions of the Russian Federation in 2022. It was found that in the North Caucasus Federal District, an increased level of adult hospitalization is associated with an increased ratio of the number of hospitalizations to the number of outpatient visits to the primary health care (PHC) facilities. At the same time, in FDs with adult outpatient visits is higher than the Russian average and adult hospitalization is higher than the Russian average (Ural, Central and Volga FDs). And vice versa, in FDs with adult outpatient visits is lower than the Russian average and adult hospitalization is lower than the Russian average (Southern, Far Eastern, Siberian and North-Western FDs). When analyzing the ratio of the number of hospitalizations to the number of outpatient visits to PHC facilities among the adult population, the highest indicator was recorded in the North Caucasus FD, while the heterogeneity of the indicator within the FD was one of the highest among the other FDs. The lowest indicator of the number of hospitalizations to the number of cases of treatment in PHC facilities among the adult population with type 2 DM was recorded in the Northwestern FD, while the heterogeneity of the indicator within the FD was the lowest among the other FGs. There was a high variability of the ratio both for all subjects of the Russian Federation and FDs. The ratio values ranged from 2,55 in the Novgorod Region to 31,39 in the Chechen Republic. Conclusion. Accounting for diseases that can be treated on an outpatient basis can become one of the tools for assessing the quality of medical care to the adult population in PHC facilities. However, before including this indicator as a criterion for assessing the quality of medical services, a deeper understanding of the reasons influencing its change is required.
Distribution of local curvature values as a structural feature for off-line handwritten signature verification
Authors: Starovoitov V. V. , Akhundjanov U. 
Published: October 2023

In the paper, a new feature for describing a digital image of a handwritten signature based on the frequency distribution of the values of the local curvature of the signature contours, is proposed. The calculation of this feature on the binary image of a signature is described in detail. A normalized histogram of distributions of local curvature values for 40 bins is formed. The frequency values recorded as a 40-dimensional vector are called the local curvature code of the signature.During verification, the proximity of signature pairs is determined by correlation between curvature codes and LBP codes described by the authors in [23]. To perform the signature verification procedure, a two-dimensional feature space is constructed containing images of the proximity of signature pairs. When verifying a signature with N authentic signatures of the same person, N(N-1)/2 patterns of the proximity of pairs of genuine signatures and N images of pairs of proximity of the analyzed signature with genuine signatures are presented in the feature space. The Support Vector Machine (SVM) is used as a classifier.Experimental studies were carried out on digitized images of genuine and fake signatures from two databases. The accuracy of automatic verification of signatures on the publicly available CEDAR database was 99,77 % and on TUIT was 88,62 %.
Case Report - Hypotension in Acromegaly: a clinical conundrum
Authors: Nahid Eram , Mittal Madhukar , Shukla Ravindra , Shouan Anish 
Published: October 2023

Abstract
Introduction Hypotension in Acromegaly would commonly nudge a clinician to look for either acute adrenal crises or apoplexy. Both conditions if left untreated may turn fatal. Most cases of apoplexy are associated with pituitary macroadenoma. Due to the large size of tumor at initial detection, clinical or subclinical apoplexy is not uncommon in acromegaly. The classical presentation includes sudden onset headache associated with visual disturbances. The risk factors include hypertension, elderly age, use of anticoagulants and dopamine agonists. Secondary adrenal insufficiency is common in large pituitary tumors and may persist or even develop after surgery.Case Presentation A 55 year female of Acromegaly with pituitary macroadenoma went into sudden unexplained hypotension and shock which led us to sequentially rule out apoplexy, secondary adrenal insufficiency and cardiac causes amongst others. The plausible end culprit for the cause of hypotension was a conundrum which we discuss in this report.Conclusion This case highlights the importance of being aware of first dose hypotension with drugs which in this case was risperidone.
Delirium Screening in the Emergency Department: Evaluation and Intervention
Authors: Meged-Book Tehilah , Frenkel Reut , Nikonov Anna , Zeldetz Vladimir , Kosto Amit , Schwarzfuchs Dan , Freud Tamar , Press Yan 
Published: October 2023

Abstract
Background
Between 8-17% of older adults, and up to 40% of those who arrive from nursing homes present with delirium upon admission to the Emergency Department [ED], yet the condition often goes undiagnosed by ED medical staff [ED staff]. We examined the rate of delirium among patients aged 65 and older who were admitted to the ED and tested the influence of raising awareness via a prospective study.
Methods
The study was divided into three periods: A “pre-intervention period” (T0); an “awareness period” (T1) in which information regarding delirium and its diagnosis was distributed to ED staff; a “screening period” (T2) in which dedicated evaluators screened ED patients aged 65 and older ; and a “post-intervention period” (T3), after the evaluators left the ED. Screening for delirium was performed using the Brief Confusion Assessment Method [bCAM] questionnaire.
Results
We found that during the T0 and T1 periods, the rate of delirium diagnosed by ED staff was lower than 1%. The rate of delirium found by the evaluators during the T2 screening period was 14.9% among the older adults who were surveyed, and 1.6%-1.9% among those not surveyed. In the T3 period, after the evaluators left the ED, the rate of delirium dropped to 0.89%.
Conclusions
The study provides further evidence that most cases of older adult delirium go undiagnosed by ED staff. Even after raising staff awareness, the diagnosis rate did not improve, and during the presence of dedicated delirium evaluators the rate of diagnosis increased only slightly. After they left, the rate returned to pre-intervention levels. The results highlight the need to implement mandatory delirium screening during ED triage and stay.
Prognostic significance of the controlling nutritional status score in patients with biliary tract cancer
Authors: Liu Rongqiang , Zhang Chenxuan , Wang Jianguo , Kuang Tainrui , Ma Wangbin , Qiu Zhendong , Zhang Lilong , Wang Kunpeng , Zhang Yanbing , Zhao Kailiang , Wang Weixing 
Published: October 2023

Abstract

Background:Numerous studies have demonstrated the significance of assessing nutritional status, commonly referred to as Controlling Nutritional Status (CONUT), in predicting the prognostic outcomes of diverse malignancies. Nevertheless, its prognostic significance in individuals diagnosed with biliary tract cancer (BTC) remains an area yet to be comprehensively explored. The CONUT score was analyzed in this study to determine its prognostic significance in BTC patients.Methods:To obtain relevant literature concerning the prognostic implications for patients with BTC and the utilization of the CONUT score, an exhaustive literature search was systematically carried out across multiple databases, including PubMed, Web of Science, and Embase. The search encompassed articles published up to and including April 23, 2023. To amalgamate the data, a comprehensive pooled analysis utilized hazard ratios (HRs) alongside their respective 95% confidence intervals (95% CIs). All statistical computations were performed using STATA 12.0 software.Results:The meta-analysis encompassed nine articles, which collectively involved 1363 patients. The collective findings demonstrated a significant association between a high CONUT score and adverse outcomes in terms of overall survival (OS) (HR: 1.94, 95% CI: 1.40-2.69) as well as disease-free survival/recurrence-free survival (DFS/RFS) (HR: 2.17, 95% CI: 1.71-2.75). Sensitivity analysis further substantiated the robustness and reliability of the meta-analysis results.Conclusions:In patients diagnosed with BTC, a high CONUT score was found to be strongly associated with an adverse prognosis. Patients with BTC may benefit from CONUT scores as prognostic indicators.
Can on-line gait training improve clinical practice? Study protocol for feasibility of an on-line educational intervention to improve clinician’s gait related decision-making in ambulant children and young people with cerebral palsy.
Authors: Hebda-Boon Anna , Shortland Adam P. , Birn-Jeffery Alexandra , Morrissey Dylan 
Published: October 2023

Abstract
Background: Instrumented gait analysis (IGA) is an assessment and research tool with proven impacts on clinical decision-making for the management of ambulant children and young people with cerebral palsy (CYPwCP) but is underused and variably understood by relevant clinicians. Clinicians’ difficulties in gaining expertise and confidence in using IGA are multifactorial and related to access for in-role decision-making, limited training opportunities and inability to translate this training into clinical practice.
Methods: The primary aim of this study is to test the feasibility of an educational intervention to advance clinicians’ application of gait analysis in CYPwCP, to inform a definitive trial. The secondary aim is to measure the effect that appropriate IGA training has on physiotherapists’ knowledge, skills, confidence and behaviours. This will be a two-arm feasibility randomised controlled trial with an experimental and control group. The 6-week on-line intervention uses a multicomponent approach grounded in behavioural change techniques. A repeated measures design will be adopted, whereby participants will complete outcome measures at baseline, immediately after the intervention and at 4-months. The primary outcome measures (trial feasibility related outcomes) are recruitment, retention and engagement. The secondary outcome measures (trial research-related outcomes) are knowledge, skills, confidence and practice change. Outcome measures will be collected via online questionnaires and during observed skill assessments. Analysis of data will utilise descriptive statistics, two-way mixed ANOVA model and qualitative content analysis.
Discussion: This study will determine feasibility of the definitive randomised control trial of educational intervention delivered to advance clinicians’ application of gait analysis in CYPwCP.
This study offers the shift in emphasis from regarding IGA as a tool to a focus on clinicians’ requirements for access, training and a well-defined role to optimise utilisation of IGA. The impact of this should be better engagement with IGA and clinical practice change. This study will contribute to a body of educational research into clinical education of healthcare professionals and IGA training offering insight into high levels of evaluation evidence including clinical behaviour change.
Trial registration: Protocol has been registered with the Open Science Framework (osf.io/nweq6) in June 2023
Heterogeneity of influenza infection at precise scale in Yinchuan, Northwest China,2012-2022: evidence from Joinpoint regression and spatiotemporal analysis
Authors: Zhang Lu , Li Yan , Ma Ning , Zhao Yi , Zhao Yu 
Published: October 2023

Abstract
Identifying high-risk regions and turning points of influenza with a precise spatiotemporal scale may provide effective prevention strategies. In this study, epidemiological characteristics and spatiotemporal clustering analysis at the township level were performed. A descriptive study and a Joinpoint regression analysis were used to explore the epidemiological characteristics and the time trend of influenza. Spatiotemporal autocorrelation and clustering analyses were carried out to explore the spatiotemporal distribution characteristics and aggregation. Furthermore, the hotspot regions were analyzed by spatiotemporal scan analysis. A total of 4025 influenza cases were reported in Yinchuan showing an overall increasing trend. The tendency of influenza in Yinchuan consisted of three stages: increased from 2012 to the first peak in 2019 (32.62/100,000) with a slight decrease in 2016; during 2019 and 2020, the trend was downwards; then it increased sharply again and reached another peak in 2022. The Joinpoint regression analysis found that there were 3 turning points from January 2012 to December 2022, namely January 2020, April 2020, and February 2022. The children under 10 displayed an upward trend and were statistically significant. The trend surface analysis indicated that there was a shifting trend from northern to central and southern. A significant positive spatial auto-correlation was observed at the township level and four high-incidence clusters of influenza were detected. These results suggested that children under 10 years old deserve more attention and the spatiotemporal distribution of high-risk regions of influenza in Yinchuan varies every year at the township level. Thus, more monitoring and resource allocation should be prone to the four high-incidence clusters, which may benefit the public health authorities to carry out the vaccination and health promotion timely.
Androgen deprivation induces neuroendocrine phenotypes in prostate cancer cells through CREB1/EZH2-mediated downregulation of REST
Authors: Li Wenliang , Zheng Dayong , Zhang Yan , Yang Sukjin , Su Ning , Bakhoum Michael , Zhang Guoliang , Naderinezhad Samira , Mao Zhengmei , Wang Zheng , Zhou Ting 
Published: October 2023

Abstract
Although effective initially, prolonged androgen deprivation therapy (ADT) promotes neuroendocrine differentiation (NED) and prostate cancer (PCa) progression. It is incompletely understood how ADT transcriptionally induces NE genes in PCa cells. CREB1 and REST are known to positively and negatively regulate neuronal gene expression in the brain, respectively. No direct link between these two master neuronal regulators has been elucidated in the NED of PCa. We show that REST mRNA is downregulated in NEPC cell and mouse models, as well as in patient samples. Phenotypically, REST overexpression increases ADT sensitivity, represses NE genes, inhibits colony formation in culture, and xenograft tumor growth of PCa cells. As expected, ADT downregulates REST in PCa cells in culture and in mouse xenografts. Interestingly, CREB1 signaling represses REST expression. In studying the largely unclear mechanism underlying transcriptional repression of REST by ADT, we found that REST is a direct target of EZH2 epigenetic repression. Finally, genetic rescue experiments demonstrated that ADT induces NED through EZH2’s repression of REST, which is enhanced by ADT-activated CREB signaling. In summary, our study has revealed a key pathway underlying NE gene upregulation by ADT, as well as established novel relationships between CREB1 and REST, and between EZH2 and REST, which may also have implications in other cancer types and in neurobiology.
A Non-Primordial Origin for the Widest Binaries in the Kuiper Belt
Authors: Campbell Hunter , Anderson Kalee , Kaib Nathan 
Published: October 2023

Abstract

Nearly one-third of objects occupying the most circular, coplanar Kuiper belt orbits (the cold classical belt) are binary companions revolving about one another as they orbit the Sun, and several percent of binaries are “ultra-wide” binaries (UWBs): ∼100-km companions spaced by tens of thousands of km. UWBs are dynamically fragile, and their existence is thought to constrain early solar system processes and conditions. However, we demonstrate that UWBs can attain their wide architectures well after the solar system’s earliest epochs when Neptune’s orbital migration implants the modern non-cold, or “kinetic,” Kuiper belt. During implantation, huge numbers of planetesimals cross the in-situ cold classical belt, and cold classical belt binaries suffer close encounters with them. Such encounters efficiently dissociate any existing UWBs and widen a small fraction of tighter binaries into UWB-like arrangements. Thus, today’s UWBs may not be primordial and may constrain the early solar system differently than previously surmised.
Modest geoengineering side effects predicted by an emulator
Authors: Bodai Tamas , Lembo Valerio , Aneesh Sundaresan , Ishuzu Miho , Franz Matthias O. , Chung Eui-Seok 
Published: October 2023

Abstract

It is common to speak about side effects of solar radiation management geoengineering considering that the forcing involved is different in nature from the anthropogenic greenhouse forcing. However, we argue that even if side effects are identified in terms of uncontrolled changes of climatic variables, they should scale with the geoengineering forcing magnitude. This would dictate a definition of side effects that takes a reference scenario where the same target is achieved, e.g. limiting the global mean surface temperature to an agreed maximum, without deploying geoengineering, but, say, by CO2 abatement only. We use a response theory based emulator, derived from new simulation output for the Max Planck Institute’s Earth system model, MPI-ESM, as well as the cGENIE carbon cycle model, in order to evaluate regional side effects regarding annual mean surface temperature and total precipitation in this sense. We find that the respective spatial patterns of the side effects bear the features as those known from the G2-type “cancellation” experiments of the Geo-MIP protocol – more so for temperature than precipitation. The former is governed by the effect of polar amplification, for which we provide now a succinct mathematical model, both for the greenhouse and geoengineering forcing, and explain the G2-type temperature pattern.
Traditional Eye Medicine and self-treatment in Rural Ethiopia
Authors: Sherief Sadik Taju , Sitotaw Munira Sherefedin , Girma Abonesh 
Published: October 2023

Abstract

Introduction: Traditional medicines are commonly used worldwide, especially in Africa—however, there is limited information on the prevalence and types of traditional eye medicine utilization in Ethiopia. The goal of this study was to determine the type and nature of traditional eye medicine use and practices related to self-medication for ophthalmic diseases in a rural Ethiopian population.Methods: A cross-sectional was conducted in six randomly selected primary health centers in rural Gurage Zone, Southern Ethiopia. Health-seeking behavior, use of self-medication, and traditional eye medicine were assessed in the population using a semi-structured questionnaire. Descriptive statistics and multivariable logistic regression analysis were computed to determine associated factors for using self-medication and traditional eye medicine.Result: Of the 814 participants interviewed, 487 (59.8%) reported using traditional eye medicine, mainly for combinations of symptoms of ocular redness, irritation, and eye discharge (95.5%). Besides, 604 (74.2%) participants reported self-treatment with tetracycline 1% eye ointment. Older age, females, low income, illiterate, and lack of access to media were risks for utilizing traditional eye medicine.Conclusion: The use of traditional eye medicine and self-treatment are common in this population. Regulatory legislation, public awareness, and making eye care are vital activities required to monitor such practices.
Study on the desalination and regeneration performance of PBA/AC electrode enhanced by membrane capacitor deionization
Authors: Wang Xiaobing , He Hao , Jiang Xiaoxue , Jin An , Li Dong , Gu Junfeng , Wang Lu 
Published: October 2023

Abstract
In this study, we investigate the desalination and regeneration performance of oilfield concentrated brine by the membrane capacitive deionization (MCDI) systems through batch experiments. Prussian blue analog (PBA) and active carbon (AC) electrodes is used in the MCDI cell. The influences of capacitive deionization on adsorption-desorption efficiency under optimal desorption conditions are analyzed. The experimental results show that the optimized operational parameters for achieving superior deionization regeneration performance in membrane capacitors comprise a voltage magnitude of -1.6 V, a desorption flow rate of 30 mL/min, and an electrode regeneration duration of 25 minutes. The MCDI system achieves a desorption amount of 45.87 mg/g, a remarkable regeneration rate of 99.23%, and an impressive desorption rate of 1.83 mg/(g·min) under the optimized operating conditions. The MCDI system demonstrates a desorption amount and regeneration rate that are 22.56 mg/g and 17.47% higher, respectively, compared to the Capacitive Deionization (CDI) system.
Pollution characteristics and source apportionment of Polycyclic Aromatic Hydrocarbons in atmospheric PM2.5 in Jinchang City
Authors: Wang Hong liang , Chu Run 
Published: October 2023

Abstract
Polycyclic aromatic hydrocarbons (PAHs) are typical persistent organic pollutants with persistence, long-distance migration, bioaccumulation, and high toxicity. Due to their adverse effects on human health and the environment, they have been listed as a priority to be monitored and controlled. To explore the pollution characteristics and sources of polycyclic aromatic hydrocarbons (PAHs) in atmospheric PM2.5 in Jinchang City, the mass concentrations of PM2.5 and 16 types of priority polycyclic aromatic hydrocarbons (PAHs) were determined by gas chromatography-mass spectrometry (GC-MS). The HYSPLIT model was used to simulate the backward trajectory of the air masses, and the potential source contribution factor (PSCF) and the characteristic ratio methods were used to analyze the pollution characteristics and the source of PAHs respectively. The results indicated that ρ(PAHs) in atmospheric PM2.5 was in the order Winter [(86.40 ± 12.55) ng∙m− 3] > Spring [(71.82 ± 18.60) ng∙m− 3] > Autumn [(61.54 ± 17.48) ng∙m− 3] > Summer [(31.86 ± 7.64) ng∙m− 3]. Correlation analysis showed that the concentration of PAHs was highly significantly negatively correlated with temperature and humidity, but was significantly positively correlated with wind speed and pressure. Characteristic ratio analysis showed that the PAHs in PM2.5 atmosphere were mainly from automobile combustion and exhaust sources. The trajectory clustering and PSCF analysis showed that the airflows in southwestern and southern Inner Mongolia, as well as in the Hexi Corridor have a significant impact on the air quality in Jinchang City. The sources of PAHs in PM2.5 atmosphere in Jinchang are mainly from combustion sources and exhaust from motor vehicles. In winter, they mainly originate from burning of coal and biomass as well as oil combustion. The results of this study reveal that, the pollution characteristics and the sources of PAHs in Jinchang City are widely distributed especially in autumn and winter seasons, which may be related to meteorological conditions.