bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systemic immune-inflammation index (SII) and the risk of all-cause, cardiovascular, and cardio-cerebrovascular mortality in the general population
Authors: Wang Huan , Nie Huiyong , Bu Gang , Tong Xiaoning , Bai Xiaofang 
Published: December 2023

Abstract
Background
An elevated systemic immune-inflammation index (SII) is associated with higher mortality in patients with coronary artery disease and other diseases. However, the potential of SII for predicting mortality in the general population has been underexplored. Therefore, this study aimed to analyze the relationship between the SII and all-cause, cardiovascular disease, and cardiocerebrovascular disease mortality in the general population.

Methods
This study involved 26,855 participants (≥ 18 years) from the National Health and Nutrition Examination Survey 1999–2014 who were grouped according to the SII tertiles. Survival differences between the groups were analyzed using log-rank tests and Kaplan–Meier plots. Furthermore, multivariate Cox regression and restricted cubic spline analyses were used to examine the relationship between the SII and all-cause, cardiovascular, and cardio-cerebrovascular mortality.

Results
Overall, 1947 (7.425%) participants died following an average follow-up of 87.99 ± 54.04 months. Among these, 325 (1.210%) deaths were related to cardiovascular diseases and 392 (1.459%) to cardio-cerebrovascular mortality. Kaplan–Meier analysis revealed statistically significant differences in all-cause, cardiovascular, and cerebrovascular mortality between the SII tertiles (log-rank test: all P < 0.001). Multi-adjusted models showed that participants in the highest tertile of SII had a higher risk of death from all-cause (hazard ratio [HR] = 1.48, 95% confidence interval [CI] 1.48–1.48) and cardiovascular mortality (HR = 1.60, 95% CI 1.60–1.61) compared with those in the lowest tertile. In addition, the restricted cubic spline curve indicated a nonlinear association between SII and all-cause mortality (P < 0.001), with threshold value of SII at 18.284. There was a 15% decrease in the risk of all-cause mortality for each twofold change in SII on the left flank (HR = 0.85, 95% CI 0.69–1.05) and a 42% increase (HR = 1.42, 95% CI 1.23–1.64) on the right flank of the inflection point. In addition, the risk of cardiovascular mortality increased nonlinearly by 39% per twofold change in SII (HR = 1.39, 95% CI 1.07–1.81). There was also a nonlinear increase in the risk of cardio-cerebrovascular mortality per twofold change in SII (HR = 1.29, 95% CI 1.00–1.66).

Conclusions
In the general population, the SII was significantly associated with all-cause, cardiovascular, and cardio-cerebrovascular mortality, regardless of the established risk factors.
Differentiation between cerebral alveolar echinococcosis and brain metastases with radiomics combined machine learning approach
Authors: Yimit Yasen , Yasin Parhat , Tuersun Abuduresuli , Abulizi Abudoukeyoumujiang , Jia Wenxiao , Wang Yunling , Nijiati Mayidili 
Published: December 2023

Abstract
Background
Cerebral alveolar echinococcosis (CAE) and brain metastases (BM) share similar in locations and imaging appearance. However, they require distinct treatment approaches, with CAE typically treated with chemotherapy and surgery, while BM is managed with radiotherapy and targeted therapy for the primary malignancy. Accurate diagnosis is crucial due to the divergent treatment strategies.

Purpose
This study aims to evaluate the effectiveness of radiomics and machine learning techniques based on magnetic resonance imaging (MRI) to differentiate between CAE and BM.

Methods
We retrospectively analyzed MRI images of 130 patients (30 CAE and 100 BM) from Xinjiang Medical University First Affiliated Hospital and The First People's Hospital of Kashi Prefecture, between January 2014 and December 2022. The dataset was divided into training (91 cases) and testing (39 cases) sets. Three dimensional tumors were segmented by radiologists from contrast-enhanced T1WI images on open resources software 3D Slicer. Features were extracted on Pyradiomics, further feature reduction was carried out using univariate analysis, correlation analysis, and least absolute shrinkage and selection operator (LASSO). Finally, we built five machine learning models, support vector machine, logistic regression, linear discrimination analysis, k-nearest neighbors classifier, and Gaussian naïve bias and evaluated their performance via several metrics including sensitivity (recall), specificity, positive predictive value (precision), negative predictive value, accuracy and the area under the curve (AUC).

Results
The area under curve (AUC) of support vector classifier (SVC), linear discrimination analysis (LDA), k-nearest neighbors (KNN), and gaussian naïve bias (NB) algorithms in training (testing) sets are 0.99 (0.94), 1.00 (0.87), 0.98 (0.92), 0.97 (0.97), and 0.98 (0.93), respectively. Nested cross-validation demonstrated the robustness and generalizability of the models. Additionally, the calibration plot and decision curve analysis demonstrated the practical usefulness of these models in clinical practice, with lower bias toward different subgroups during decision-making.

Conclusion
The combination of radiomics and machine learning approach based on contrast enhanced T1WI images could well distinguish CAE and BM. This approach holds promise in assisting doctors with accurate diagnosis and clinical decision-making.
Amino acid and mineral digestibility, bone ash, and plasma inositol is increased by including microbial phytase in diets for growing pigs
Authors: Lagos Liz Vanessa , Bedford Mike Richard , Stein Hans Henrik 
Published: December 2023

Abstract
Background
The effect of microbial phytase on amino acid and energy digestibility is not consistent in pigs, which may be related to the phytase dosage or the adaptation length to the diet. Therefore, an experiment was conducted to test the hypotheses that increasing dietary phytase after an 18-day adaptation period: 1) increases nutrient and energy digestibility; 2) increases plasma P, plasma inositol, and bone ash of young pigs; and 3) demonstrates that maximum phytate degradation requires more phytase than maximum P digestibility.

Results
Data indicated that increasing inclusion of phytase [0, 250, 500, 1,000, 2,000, and 4,000 phytase units (FTU)/kg feed] in corn-soybean meal-based diets increased apparent ileal digestibility (AID) of Trp (quadratic; P < 0.05), and of Lys and Thr (linear; P < 0.05), and tended to increase AID of Met (linear; P < 0.10). Increasing dietary phytase also increased AID and apparent total tract digestibility (ATTD) of Ca and P (quadratic; P < 0.05) and increased ATTD of K and Na (linear; P < 0.05), but phytase did not influence the ATTD of Mg or gross energy. Concentrations of plasma P and bone ash increased (quadratic; P < 0.05), and plasma inositol also increased (linear; P < 0.05) with increasing inclusion of phytase. Reduced concentrations of inositol phosphate (IP)6 and IP5 (quadratic; P < 0.05), reduced IP4 and IP3 (linear; P < 0.05), but increased inositol concentrations (linear; P < 0.05) were observed in ileal digesta as dietary phytase increased. The ATTD of P was maximized if at least 1,200 FTU/kg were used, whereas more than 4,000 FTU/kg were needed to maximize inositol release.

Conclusions
Increasing dietary levels of phytase after an 18-day adaptation period increased phytate and IP ester degradation and inositol release in the small intestine. Consequently, increasing dietary phytase resulted in improved digestibility of Ca, P, K, Na, and the first 4 limiting amino acids, and in increased concentrations of bone ash and plasma P and inositol. In a corn-soybean meal diet, maximum inositol release requires approximately 3,200 FTU/kg more phytase than that required for maximum P digestibility.
Comparison of the efficacy of anti-diabetic medications as add-on to metformin in type 2 diabetes mellitus from a real-world database
Authors: Ono Ryosuke , Ogami Chika , Hasegawa Chihiro , To Hideto , Matsumoto Yoshiaki , Tsuji Yasuhiro 
Published: December 2023

Abstract
Background
Metformin is recommended as a first-line drug in the guidelines of the treatment for type 2 diabetes mellitus. However, high-quality evidence from clinical trials directly comparing the degree of hypoglycemic effect of combination therapy of metformin and a hypoglycemic agent with a different mechanism of action with that of monotherapy of a hypoglycemic drug is lacking. We aimed to examine whether combination therapy of hypoglycemic agents with metformin showed antagonism, addition, or synergism compared to monotherapy with hypoglycemic agents other than metformin regarding hemoglobin A1c levels.

Methods
This retrospective cohort study used a medical information database in Japan. Non-insulin anti-hyperglycemic agents with different mechanisms of action were classified into eight drug classes. A monotherapy cohort and a combination therapy added to the metformin cohort were defined. The change in hemoglobin A1c levels was evaluated to compare the treatment effect between the cohorts.

Results
A total of 13,359 patients with type 2 diabetes mellitus in the monotherapy cohort and 1,064 in the metformin combination therapy cohort were identified. A comparison of the change from baseline HbA1c level by drug class between the two cohorts showed a similar trend. Among those treated with dipeptidyl peptidase-4 inhibitor and sodium-glucose co-transporter-2 inhibitor, no clinically significant difference was observed between the two cohorts (0.00% and -0.07% for unadjusted, 0.15% and -0.03% for propensity score matching-adjusted, and 0.09% and -0.01% for inverse probability treatment weighting-adjusted analysis).

Conclusions
According to the results of this study, the effect of dipeptidyl peptidase-4 inhibitor or sodium-glucose co-transporter-2 inhibitor added to metformin seems to be additive with respect to the reduction in hemoglobin A1c.
Geo-temperature response to reinjection in sandstone geothermal reservoirs
Authors: Li Jialong , Kang Fengxin , Bai Tong , Li Zhenhan , Zhao Qiang , Zhang Pingping , Zheng Tingting , Sui Haibo 
Published: December 2023

AbstractTo study the evolution rules and behaviors of heat transport in a sandstone geothermal reservoir caused by cooled water reinjection, this research focuses on the quantitative relationship among reinjection parameters and the thermal breakthrough time of production wells. The permeation, tracer, and reinjection tests were conducted in a simulation model using a large sand tank in conjunction with the numerical simulation method based on COMSOL Multiphysics. Subsequently, sensitivity analysis and nonlinear fitting were performed to investigate the effects of fluid viscosity and density on the reinjection process, and to analyze the impact of reinjection parameters on the thermal breakthrough time of production wells, along with their underlying mechanisms and law. The results indicate that the migration velocity of reinjection water is greater in coarse sand layer compared to that in medium sand layer, and the thermal breakthrough time t is linearly correlated with reinjection rate (Q) raised to the power of − 0.85, temperature difference (ΔT) raised to the power of − 0.21, and spacing between the production and reinjection wells (R) raised to the power of 1.4. The correlation equation and analysis show that when the temperature difference between production and reinjection ΔT is more than 30 ℃, the influence of ΔT on the thermal breakthrough time of production well becomes weak, because ΔT exerts an effect on the thermal breakthrough time of production well t by influencing the relative position of the 18.5 ℃ isotherm in the temperature transition region. The error in reinjecting high-temperature fluid into low-temperature fluid may be corrected by introducing a viscosity correction coefficient αμ.
Relationship between antihypertensive drug use and number of people with high blood pressure in FY 2018: a descriptive epidemiological study based on the National Database of Health Insurance Claims and Specific Health Checkups of Japan open data
Authors: Mizuno Kanako , Inose Ryo , Yoshimura Yukina , Muraki Yuichi 
Published: December 2023

Abstract
Background
In most countries barring Japan, antihypertensive drug use has been reported using the defined daily doses/1000 inhabitants/day (DID). Although DID has been shown to allow for the assessment of the number of patients treated with a particular drug, the relationship between DID and the number of patients with hypertension has not been clarified. This study aimed to clarify the relationship between antihypertensive drug use and the number of people with high blood pressure based on the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) open data.

Methods
DID was calculated by extracting the use of oral antihypertensive drugs from outpatient prescriptions in the NDB Open Data in FY 2018. The number of people with high blood pressure was calculated using the number of enrollees in each sex–age group for systolic and diastolic blood pressure in the 40–74 years age group. The correlation between the DID of antihypertensive drugs and the number of people with high blood pressure by sex and age class was evaluated using Spearman’s rank correlation coefficient.

Results
The use of antihypertensive drugs increased with age in both men and women. Furthermore, in both sexes, dihydropyridine derivatives, calcium antagonists, and angiotensin II receptor blockers were the main drugs used from the age of 20 years onward. In addition, a very strong positive correlation was found between the number of people with high systolic blood pressure and DID in both sexes (men: r = 1, P < 0.05; women: r = 1, P < 0.05). In contrast, there was no significant correlation between the number of people with high diastolic blood pressure and DID in both sexes (men: r = − 0.214, P > 0.05; women: r = 0.393, P > 0.05).

Conclusions
To our knowledge, this study is the first to investigate the use of oral antihypertensive drugs in outpatient settings in Japan. In addition, the DID of antihypertensive drugs can be used as an alternative indicator of the number of people with high systolic blood pressure.
A Comparison of Neuropathic Pain Experiences Among Paralympic Versus Recreational Athletes with Spinal Cord Injury
Authors: Todd Kendra R. , Olsen Kenedy , Hamamoto Gail , Hirschfield Trevor J. , Kramer John L. K. , Martin Ginis Kathleen A. 
Published: December 2023

Abstract
Background
Individuals with spinal cord injury (SCI) report high levels of neuropathic pain. Current treatment options are primarily pharmaceutical, despite their limited effectiveness. Exercise may reduce neuropathic pain among persons with SCI; however, the optimal dose of exercise required to elicit analgesic effects remains unknown. The purpose of this study was to compare neuropathic pain intensity, pain catastrophizing, use of coping strategies, and positive affect and well-being among Paralympic versus recreational athletes with SCI who experience chronic neuropathic pain. Forty-seven athletes with SCI (25 Paralympic, 27 recreational) completed the International SCI Pain Basic Data Set, Douleur Neuropathique-4, coping strategies questionnaire, pain catastrophizing scale, and SCI-quality of life assessment.

Results
Paralympic athletes reported significantly greater neuropathic pain (p = 0.032) and positive affect and well-being (p = 0.047) than recreational athletes. No other comparisons were significant (ps > 0.09). Significant, medium-sized positive correlations were observed between neuropathic pain and total minutes of moderate-intensity exercise (r = 0.335, p = 0.023) and average minutes per day of moderate-intensity exercise (r = 0.375, p = 0.010) over the past week.

Conclusions
The results suggest that frequent moderate- to high-intensity exercise may exacerbate neuropathic pain sensations for persons with SCI. Research should investigate psychosocial and physiological mechanisms by which exercise may influence neuropathic pain to explain how Paralympic athletes with SCI are able to continue exercising while maintaining positive affect despite neuropathic pain.
The effect of parental diabetes prevention program participation on weight loss in dependent children: a prospective cohort study
Authors: Atluri Namratha , Thariath Joshua , McEwen Laura N. , Ye Wen , Song MinKyoung , Herman William H. 
Published: December 2023

Abstract
Introduction
Obesity has reached epidemic proportions in children and adolescents in the United States. Children’s behaviors are strongly influenced by parental behaviors, and weight loss in parents is positively associated with weight changes in their overweight/obese children. Research is limited on how parents’ National Diabetes Prevention Program (DPP) participation affects the health outcomes of their dependent children. Analyzing the impact of parental DPP participation on weight loss in their dependent children may provide valuable insight into an important secondary benefit of DPP participation.

Methods
In this study, we identified 128 adults with prediabetes who were offered the opportunity to participate in a DPP (n = 54 DPP participants and n = 74 DPP non-participants) and who had at least one child 3 to 17 years of age living with them. Age and BMI percentile for dependent children were collected from insurance claims data for 203 children (n = 90 children of DPP participants and n = 113 children of DPP non-participants). Parental practices related to diet and physical activity were assessed by surveys.

Results
There were no significant changes in BMI percentiles of overweight or obese children (i.e. BMI percentile ≥ 50%) of DPP participants vs DPP non-participants with prediabetes over one-year. Parents who enrolled and did not enroll in the DPP did not report differences in their parenting practices related to diet and physical activity.

Discussion
These results are not consistent with the literature that suggests parent-based interventions may influence their children’s weight trajectories. Limitations include small sample size, short time span of intervention, and limited availability of additional health/biographic data on dependent children. Future studies should collect primary outcome data on children, investigate whether there is a minimum duration of parental involvement and level of parental adherence, and assess the effect of parent–child dynamics on child weight trajectories.
Molecular classification of high-grade, muscle-invasive urothelial carcinomas and the relationship with CTLA-4 and PD-L1 expression
Authors: Pereira Fabiana T. B. , Mattos Tatiana V. A. , Martini Filho Dino , da Silva Maria Antonieta L. G. , Fernandes Roni C. , Montor Wagner R. 
Published: December 2023

Abstract
Purpose
the aim of the current study was to molecularly classify high-grade, muscle-invasive, urothelial carcinoma of basal, luminal, and p53-like subtypes and to assess their relationship with CTLA-4 and PD-L1 expression.

Methods
fifty-seven samples from transurethral resections were tested immunohistochemically for CK5/6, CD44, CK20, p63, p53, and CTLA-4/PD-L1.

Results
about half of the cases presented a basal molecular profile (50.9%), the luminal profile was found in 29.8% and the p53-like profile in 15.8%. Positivity for CTLA-4 occurred in 24 samples (42.1%), with cytoplasmic and membrane expression reported only in neoplastic cells. Of these, 11 were of the luminal subtype, ten were of the basal subtype, and three were of the p53-like subtype. There was an association between CTLA-4 expression and the luminal classification, and an absence of CTLA-4 expression in the basal profile (p = 0.047). PD-L1 expression was found in 12 samples, ten of them classified as the basal subtype (p = 0.036). CTLA-4 and PD-L1 expression were not identified in the same subtypes (p = 0.08), since only one sample was positive for both markers.

Conclusions
A molecular classification into the subtypes was possible in 96.5% of cases of high-grade, muscle-invasive, urothelial carcinoma using immunohistochemistry. Thus, this type of classification is viable in most surgical pathology laboratories, including those in Brazil’s Unified Health System (known as SUS, the acronym for Sistema Único de Saúde). The expression of CTLA-4 is related to the luminal molecular subtype, while the expression of PD-L1 is related to the basal molecular subtype. CTLA-4 and PD-L1 positivity are mutually exclusive.
Reduction in Pappalysin-2 Levels and Lower IGF-I Bioavailability in Female Adolescents With Anorexia Nervosa
Authors: Barrios Vicente , Martín-Rivada Álvaro , Guerra-Cantera Santiago , Campillo-Calatayud Ana , Camarneiro Ricardo A , Graell Montserrat , Chowen Julie A , Argente Jesús 
Published: December 2023

Abstract

Context
Anorexia nervosa (AN) can cause severe undernutrition associated with alterations in the IGF axis. Pappalysins (PAPP-A, PAPP-A2) and stanniocalcins (STC-1, STC-2) modulate IGF binding-protein (IGFBP) cleavage and IGF bioavailability, but their implications in AN are unknown.

Objective
We determined serum levels of PAPP-As and STCs in relationship with classical IGF axis parameters in female adolescents with AN and their association with nutritional status and secondary amenorrhea.

Methods
Parameters of the IGF axis were determined in fasting serum samples of 68 female adolescents with AN at diagnosis and 62 sex- and age-matched controls. Standardized body mass index (BMI) and bone mineral density (BMD) were calculated.

Results
Patients with AN had lower concentrations of total and free IGF-I, total IGFBP-3, acid-labile subunit (ALS), insulin, PAPP-A2, STC-1, and STC-2 and higher levels of IGF-II and IGFBP-2. Their free/total IGF-I ratio was decreased and the intact/total IGFBP-3 and −4 ratios increased. BMI was directly related to total IGF-I and intact IGFBP-3 and inversely with IGFBP-2 and intact IGFBP-4. Weight loss was directly correlated with intact IGFBP-4 and negatively with intact IGFBP-3, ALS, STC-2, and PAPP-A2 concentrations. BMD was directly related to intact IGFBP-3 and inversely with intact IGFBP-4 and PAPP-A2 levels. Patients with amenorrhea had lower levels of total IGF-I and IGFBP-3 than those with menses.

Conclusion
The reduction of PAPP-A2 in patients with AN may be involved in a decline in IGFBP cleavage, which could underlie the decrease in IGF-I bioavailability that is influenced by nutritional status and amenorrhea.