bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship of triglyceride-glucose index with cardiometabolic multi-morbidity in China: evidence from a national survey
Authors: Zhang Zenglei , Zhao Lin , Lu Yiting , Meng Xu , Zhou Xianliang 
Published: November 2023

Abstract
Background
Cardiometabolic multi-morbidity (CMM) is emerging as a global healthcare challenge and a pressing public health concern worldwide. Previous studies have principally focused on identifying risk factors for individual cardiometabolic diseases, but reliable predictors of CMM have not been identified. In the present study, we aimed to characterize the relationship of triglyceride-glucose (TyG) index with the incidence of CMM.

Methods
We enrolled 7,970 participants from the China Health and Retirement Longitudinal Study (CHARLS) and placed them into groups according to quartile of TyG index. The endpoint of interest was CMM, defined as the presence of at least two of the following: stroke, heart disease, and diabetes mellitus. Cox regression models and multivariable-adjusted restricted cubic spline (RCS) curves were used to evaluate the relationship between TyG index and CMM.

Results
In total, 638 (8.01%) incident cases of CMM were recorded among the participants who did not have CMM at baseline (2011) during a median follow-up of 84 months (interquartile range, 20‒87 months). The incidences of CMM for the participants in quartiles (Q) 1–4 of TyG index were 4.22%, 6.12%, 8.78%, and 12.60%, respectively. A fully adjusted Cox model showed that TyG index was closely associated with the incidence of CMM: the hazard ratio (HR) [95% confidence interval (CI)] for each 1.0-unit increment in TyG index for CMM was 1.54 (1.29–1.84); and the HRs (95% CIs) for Q3 and Q4 (Q1 as reference) of the TyG index for CMM were 1.41 (1.05–1.90) and 1.61 (1.18–2.20), respectively. The association of TyG index with the incidence of CMM was present in almost all the subgroups, and persisted in the sensitivity analyses and additional analyses. Multivariable-adjusted RCS analysis revealed a significant dose-response relationship of TyG index with the risk of CMM (overall P < 0.001; non-linear P = 0.129).

Conclusions
We found that a high TyG index is associated with a higher risk of incident CMM. This finding may have significance for clinical practice and facilitate the creation of a personalized prevention strategy that involves monitoring the TyG index.

Graphical Abstract
Epidemiological manifestations and impact of healthcare-associated infections in Libyan national hospitals
Authors: Daw Mohamed Ali , Mahamat Mahamat Hassabarassoul , Wareg Said Emhamed , El-Bouzedi Abdallah H , Ahmed Mohamed Omar 
Published: November 2023

Abstract
Background
Healthcare-associated infection is a serious global problem, particularly in developing countries. In North African countries, comprehensive research on the incidence and effects of such infections is rare. This study evaluated the epidemiology and determined the impact of healthcare-associated infections in Libyan national teaching hospitals.

Methods
A prospective longitudinal study was carried out in Libya’s four largest teaching and referral hospitals (Tripoli Medical Center, Tripoli-Central Hospital, Benghazi Medical Center, and Sabha Medical Center) from November 1, 2021, to October 31, 2022. The epidemiological events and the parameters incorporated in this study were based on the data published by the Libyan Centers for Disease Control. The surveillance was carried out on all patients admitted to the wards of medicine, surgery, intensive care, gynecology & obstetrics, and pediatrics in all four hospitals. Trained staff reviewed the medical records and compared the percentages of patients with healthcare-associated infections. Bio-statistical and multivariable logistic regression analyses were carried out to test the variables associated with healthcare-associated infections and the resulting deaths.

Results
A total of 22,170 hospitalized patients in four hospitals were included in the study. Hospital-acquired infection was reported in 3037 patients (13.7%; 95% CI: 12.9–14.4%). The highest incidence was in Benghazi Medical Center (17.9%; 95% CI: 16.9–18.7%), followed by Sabha Medical Center (14.8%; 95% CI:14.9-16.51%). Surgical site infection was the most prevalent (31.3%), followed by ventilator-associated pneumonia (29.3%), urinary tract infection (26.8%), and bloodstream infection (12.6%). Patients with healthcare-associated infections experienced severe morbidity requiring intervention. New antimicrobial regimens were needed for 1836 patients (93%), and 752 patients (34%) required admission to intensive care. Surgical intervention, respiratory support, and inotropes were also needed as a consequence of HAI events.

Conclusions
The high incidence of healthcare-associated infections in Libyan hospitals should be considered a major problem and a serious burden. This should alert healthcare authorities at the national and hospital levels to the urgent need for preventive and control strategies to combat hospital-acquired infections.
Dengue virus serotype did not contribute to clinical severity or mortality in Taiwan’s largest dengue outbreak in 2015
Authors: Tsai Jih-Jin , Chang Ko , Chen Chun-Hong , Liao Ching-Len , Chen Liang-Jen , Tsai Yan-Yi , Tsai Ching-Yi , Lin Ping-Chang , Hsu Miao-Chen , Liu Li-Teh 
Published: November 2023

Abstract
Background
Dengue virus serotype 2 (DENV-2) was the major serotype in the 2015 dengue outbreak in Taiwan, while DENV-1 and DENV-3 were dominant between 2005 and 2014. We aimed to investigate whether DENV-2 contributed to disease severity and mortality in the outbreak in Kaohsiung city, Taiwan.

Methods
We collected serum samples from dengue patients to detect the presence of DENV and determine the serotypes by using quantitative reverse transcription-polymerase chain reaction. Our cohorts comprised 105 DENV-1-infected cases and 1,550 DENV-2-infected cases. Demographic data, DENV serotype, and comorbidities were covariates for univariate and multivariate analyses to explore the association with severity and mortality.

Results
The results suggested that DENV-1 persisted and circulated, while DENV-2 was dominant during the dengue outbreak that occurred between September and December 2015. However, DENV-2 did not directly contribute to either severity or mortality. Aged patients and patients with diabetes mellitus (DM) or moderate to severe chronic kidney disease (CKD) had a higher risk of developing severe dengue. The mortality of dengue patients was related to a higher Charlson comorbidity index score and severe dengue. Among DENV-2-infected patients and older patients, preexisting anti-dengue IgG, DM, and moderate to severe CKD were associated with severe dengue. Moreover, female sex and severe dengue were associated with a significantly higher risk of death.

Conclusions
Our findings highlight the importance of timely serological testing in elderly patients to identify potential secondary infections and focus on the meticulous management of elderly patients with DM or moderate to severe CKD to reduce dengue-related death.
Blood manganese and non-alcoholic fatty liver disease in a high manganese exposure area in China
Authors: Wu Liping , Lan Yanqi , Yu Ze , Wang Yanhong , Liao Wei , Zhang Guoqiang , Wang Li 
Published: November 2023

Abstract
Background and aims
Manganese (Mn) deficiency and intoxication may affect nonalcoholic fatty liver disease (NAFLD) risk differently. We aimed to explore the association between blood Mn and NAFLD in an area with high Mn exposure in drinking water.

Methods
We conducted a case–control study among 1407 patients with NAFLD and 1774 sex- and age-matched healthy controls in a physical examination population in Zhoushan hospital, Zhejiang province in China. We used the restricted cubic splines method to investigate the dose–response relationship. Logistic regression models were applied to determine the risk of NAFLD, and severity of NAFLD.

Results
The blood Mn concentration was higher in the NAFLD group than in the control group in women (16.1 ± 6.2 μg/L vs. 14.7 ± 6.4 μg/L, P = 0.022) and men (14.5 ± 6.3 μg/L vs. 13.6 ± 6.8 μg/L, P < 0.001). We found an inverted L shape relationship between blood Mn and NAFLD in both women and men. Compared to the lowest quartile, the adjusted odds ratio (OR) and 95% confidence interval (CI) of NAFLD for the highest quartile group was 1.646(1.222,2.217), 1.494(1.082,2.061), and 3.146(1.285,7.701) for the total population, men, and women. The positive relationship was only observed in those with fibrosis-4 score < 1.30 and normal alanine transaminase. Stratified analysis showed an interaction between smoking (P = 0.073), alcohol drinking (P = 0.013), and Mn, with a more prominent effect on the NAFLD in the never-smokers (OR = 2.153, 95% CI 1.408–3.290) and drinkers (OR = 2.596, 95% CI 1.608–4.191).

Conclusion
Higher blood Mn is associated with an elevated NAFLD risk in the high Mn exposure areas, especially in nonsmokers and drinkers. Further studies are needed to verify this result in the areas with high Mn exposure.
Have the psychiatric needs of people seeking gender reassignment changed as their numbers increase? A register study in Finland
Authors: Kaltiala Riittakerttu , Holttinen Timo , Tuisku Katinka 
Published: November 2023

Abstract

Background
The number of people seeking gender reassignment (GR) has increased everywhere and these increases particularly concern adolescents and emerging adults with female sex. It is not known whether the psychiatric needs of this population have changed alongside the demographic changes.

Methods
A register-based follow-up study of individuals who contacted the nationally centralized gender identity services (GIS) in Finland in 1996–2019 (gender dysphoria [GD] group, n = 3665), and 8:1 age and sex-matched population controls (n = 29,292). The year of contacting the GIS was categorized to 5-year intervals (index periods). Psychiatric needs were assessed by specialist-level psychiatric treatment contacts in the Finnish Care Register for Hospital Care in 1994–2019.

Results
The GD group had received many times more specialist-level psychiatric treatment both before and after contacting specialized GIS than had their matched controls. A marked increase over time in psychiatric needs was observed. Among the GD group, relative risk for psychiatric needs after contacting GIS increased from 3.3 among those with the first appointment in GIS during 1996–2000 to 4.6 when the first appointment in GIS was in 2016–2019. When index period and psychiatric treatment before contacting GIS were accounted for, GR patients who had and who had not proceeded to medical GR had an equal risk compared to controls of needing subsequent psychiatric treatment.

Conclusion
Contacting specialized GIS is on the increase and occurs at ever younger ages and with more psychiatric needs. Manifold psychiatric needs persist regardless of medical GR.
Large articulations do not increase wear rates of thin second-generation highly cross-linked polyethylene liners at ten years
Authors: Callary Stuart A. , Sharma Deepti K. , D’Apollonio Taisha M. , Campbell David G. 
Published: November 2023

AimsRadiostereometric analysis (RSA) is the most accurate radiological method to measure in vivo wear of highly cross-linked polyethylene (XLPE) acetabular components. We have previously reported very low wear rates for a sequentially irradiated and annealed X3 XLPE liner (Stryker Orthopaedics, USA) when used in conjunction with a 32 mm femoral heads at ten-year follow-up. Only two studies have reported the long-term wear rate of X3 liners used in conjunction with larger heads using plain radiographs which have poor sensitivity. The aim of this study was to measure the ten-year wear of thin X3 XLPE liners against larger 36 or 40 mm articulations with RSA.MethodsWe prospectively reviewed 19 patients who underwent primary cementless THA with the XLPE acetabular liner (X3) and a 36 or 40 mm femoral head with a resultant liner thickness of at least 5.8 mm. RSA radiographs at one week, six months, and one, two, five, and ten years postoperatively and femoral head penetration within the acetabular component were measured with UmRSA software. Of the initial 19 patients, 12 were available at the ten-year time point.ResultsThe median proximal, 2D, and 3D wear rates calculated between one and ten years were all less than 0.005 mm/year, with no patient recording a proximal wear rate of more than 0.021 mm/year. Importantly, there was no increase in the wear rate between five and ten years.ConclusionThe very low wear rate of X3 XLPE liners with larger articulations remains encouraging for the future clinical performance of this material.Cite this article: Bone Jt Open 2023;4(11):839–845.
Women’s lived experience of endometriosis-related fertility issues
Authors: Girard Elodie , Mazloum Anna , Navarria-Forney Isabelle , Pluchino Nicola , Streuli Isabelle , Cedraschi Christine 
Published: November 2023

Objective
The aim of the present study is to conduct a qualitative investigation to provide a deeper understanding of women’s views about endometriosis, fertility and their perception of reproductive options.

Methods
Semi-structured interviews were conducted by two female psychiatrists, specialized in gynecology and obstetrical consultation-liaison psychiatry, trained in qualitative procedures, with experience in qualitative studies and in psychological support of women attending infertility consultations. No prior relationship with respondents was established before data collection. Interviews were tape-recorded and transcribed. Interviews lasted 45–75 minutes. The transcripts were then analysed using thematic content analysis.

Results
Twenty-nine women were contacted. Twelve agreed to an interview at the hospital’s infertility clinic. Eleven women with diverse sociodemographic characteristics were included. The key findings of thematic content analysis can be grouped into four topics: (1) Diagnostic announcement and initial delay; (2) Negative perceptions of initial care: pre-diagnosis phase; (3) Struggle with endometriosis and its treatment; (4) Issues related to health problems, fertility and reproductive options.

Conclusion
Our analysis of the interviews corroborates the distressing impact of the trivialization of pain and the uncertainty of or the long quest for diagnosis. The findings also stress various associated issues, from the diagnostic delay to the low success rates of fertility treatments. This qualitative analysis contributes to better understand the accumulation of negative emotions within the illness trajectory and the poor dyadic adjustment within the couple.
The New Form Agency Problem: Cooperation and Circular Agency
Authors: Chen Chun-Hung , Chen Kuan-Wei , Chen Yu-Fan , Lin Chia-Yin 
Published: November 2023

Abstract
This study explores cooperation in the circular agency problem. In circular agency, an agent has weak power in the face of its principal. This research explores a cooperation mechanism in which three participants simultaneously have the identity of principal and agent, in order to illuminate the power struggle between the board of directors, the external shareholder, and the manager of a company. We use the equilibrium results to explain the phenomenon of cooperation between members of the enterprise in practice. Our results have implications for firm governance.
The crystal structure of 2-(hydroxymethyl)-2-(4H-1,2,4-triazol-4-yl)propane-1,3-diol, C6H11N3O3
Authors: Guo Jing-Jing , Feng Chao , Chen Zi-Jie 
Published: November 2023

Abstract
C6H11N3O3, monoclinic, P21/n (no. 14), a = 6.1802(3) Å, b = 12.6623(5) Å, c = 10.0897(4) Å, β = 93.328(2)°, V = 760.10(6) Å3, Z = 4, R
gt(F) = 0.0341, wR
ref(F
2) = 0.0864, T = 150 K.
Acute Aerobic Exercise at Different Intensities Modulates Motor Learning Performance and Cortical Excitability in Sedentary Individuals
Authors: Kuo Hsiao-I , Hsieh Ming-Hsien , Lin Yi-Ting , Nitsche Michael A. 
Published: November 2023

AbstractConverging evidence indicates the beneficial effects of aerobic exercise on motor learning performance. Underlying mechanisms might be an impact of aerobic exercise on neuroplasticity and cortical excitability. Evidence suggests that motor learning and cortical excitability alterations correlate with the intensity of aerobic exercise and the activity level of participants. Thus, this study aims to investigate the effects of different aerobic exercise intensities on motor learning and cortical excitability in sedentary individuals. The study was conducted in a crossover and double-blind design. Twenty-six healthy sedentary individuals (13 women and 13 men) performed a motor learning task and received a cortical excitability assessment before and after a single session of low-, moderate-, and high-intensity aerobic exercise or a control intervention. The study revealed that motor learning performance and cortical excitability were significantly enhanced in the moderate-intensity aerobic exercise, compared with the other conditions. These findings suggest aerobic exercise intensity-dependent effects on motor learning in sedentary adults. The underlying mechanism might be an exercised-induced alteration of cortical excitability, specifically a reduction of GABA activity.
Analysis of the weighted conical Radon transform
Authors: Duy Nguyen N. 
Published: November 2023

Abstract
In this article, we investigate the weighted conical Radon transform, a novel class of Radon transforms that takes into account the attenuation effect by integrating a function over circular cones. This transform has significant applications in nuclear tomography imaging, the nuclear industry, and homeland security. We propose new inversion formulas for the weighted conical Radon transform, which an explicit formula and a formula based on convolution frames. Furthermore, we provide numerical simulations designed for 2D situation.
Development and validation of a nomogram to predict overall survival in patients with redefined anaplastic thyroid carcinoma based on the SEER database
Authors: zhang chuyue , Li Bin , Yang Yan 
Published: November 2023

Abstract
Background. According to the latest classification of thyroid tumors released by the WHO in 2022, primary squamous c ell carcinoma of the thyroid (PSCCTh ) is classified as anaplastic thyroid carcinoma (ATC). The objective of this study was to determine the differences in characteristics between ATC and PSCCTh and develop a nomogram to predict overall survival patients with the redefined anaplastic thyroid carcinoma (rATC).
Methods. Patients diagnosed with ATC and PSCCTh between 2000 and 2018 from the Surveillance, Epidemiology, and End Results (SEER) database were enrolled and randomly divided into a training cohort and a validation cohort with a ratio of 7:3. Overall survival (OS) and cancer specific survival (CSS) was estimated using the Kaplan Meier method and compared using l og r ank tests. The univariate and multivariate Cox proportional hazards regression analyses were used to determine independent prognos tic factors of rATC patients. We then developing and validating nomograms to predict the 3 -, 6 and 12 month OS of rATC and the results were evaluated by C-index, and calibration curves.
Result. After application of the inclusion and exclusion criteria, a total of 1338 ATC and 127 PSCCTh patients, were included in the study. Further OS and CSS of patients with PSCCTh was better than that of patients with ATC. Prognostic factors were not identical for the two cancers. Multivariate Cox model analysis indicated that age, tumor size, Metastasis, surgery, radiotherapy, chemotherapy are independent prognostic factors for CS S in patients with ATC, while for patients with PSCCTh, the corresponding factors are age, and surgery. We selected six survival predictors (age, tumor size, metastasis, surgery, radiation, and, chemotherapy) for nomogram construction. The C indexes in the training and validation cohort were 0.740 and 0.778, respectively, reflecting the good discrimination ability of the model. The calibration curves also showed good consistency in the probability of 3 -, 6 -, and 12 month OS between the actual observation and the nomogram prediction.
Conclusion. We constructed a nomogram to provide a convenient and reliable tool for predicting OS in rATC patients Prognostic factors influencing CSS were not identical in patients with ATC and PSCCTh. These findings indicate th at different clinical treatment and management plans are required for patients with these two types of thyroid cancer.
Influence of N, N'-ethylene bis oleamide (EBO) on the flowability of the Acrylonitrile-butadiene-styrene (ABS) resin and lubrication mechanism
Authors: Sun Xiang , Lu ShuLai , Song Zhenbiao , Kang Ning , Zhao Shicheng 
Published: November 2023

Abstract
With the aim of enhancing the flowability of the ABS resin, the effect of N, N'-ethylene bis oleamide (EBO) as a new lubricant on the melt flow rate (MFR), torque value, and rheological behavior of ABS resin was investigated. The result showed the MFR of the ABS resin with 2.0 wt% EBO was 22.1 g/10 min, which was improved by 49% compared with the pure ABS resin (14.8 g/10 min). The torque value of the ABS resin, including 2.0 wt% EBO (1.69 N·m) was lower than that of the pure ABS resin (2.03 N·m). The rheological study further indicated that EBO can reduce the complex viscosity of the ABS resin. The above results indicated that EBO was an effective lubricant for the ABS resin. A possible lubrication mechanism was proposed based on the consequences of the rotational rheometry, dynamic mechanical analysis (DMA), and molecular dynamics simulation (MD). EBO decreased the entanglement density of the SAN molecular chains and increased the mobility of the SAN molecular chain segments. On the other hand, EBO increased the space for the free migration of the SAN molecular chain fragments due to the free volume effect. This work, we suggest, will provide a fresh avenue to achieve high-flow ABS resin and new insights into the lubrication mechanism of lubricant in the ABS resin.
Quantifying systemic racial accessibility inequality in urban transit network
Authors: Li Yong , Zhang Yunke , Xu Fengli , Gonzalez Marta C. 
Published: November 2023

Abstract

Urban transit networks are crucial for developing sustainable cities, yet uneven transit infrastructure distribution often leads to unequal access to urban resources. Prior studies utilize simple spatial metrics to measure accessibility, overlooking systemic inequality within transit networks and its real-world implications. Utilizing door-to-door travel information within a complex transit network, we probe racial inequality in transit-oriented accessibility to various urban resources and assess its impact on mobility behaviours. Our analysis reveals minority neighbourhoods endure consistently reduced transit-oriented accessibility to urban areas, job opportunities, and essential facilities by 15.2%, 37.3%, and 37.0%, respectively, compared to White-majority neighbourhoods. The uneven accessibility to urban areas exacerbates residential segregation by 32.1% relative to the equitable scenario. Regarding behavioural consequences, low accessibility subjects minority neighborhoods to constrained activity spaces, elevated unemployment risks, and extended travel distances to essential facilities. To inform potential mitigation policies, we conduct simulation experiments and discover that solely enhancing transit-oriented developments in minority-concentrated public housing districts can reduce current racial inequality by 8.8%. Our findings emphasize the imperative of prioritizing equity and inclusiveness in designing future sustainable transit systems.