bluuebunny/crossref_metadata_2025_split huggingface dataset:
Digital Inclusive Finance, Consumption Structure Upgrading and Carbon Emissions
Authors: Ye Jian , xu wenhua , Hu Lujing 
Published: August 2023

Abstract
The "14th Five-Year Plan" is not only an important stage for enhancing the inclusiveness of finance in China but also a critical window for the "peak carbon emissions" action. Against the backdrop of rapid development in the digital economy, China urgently needs to explore a high-quality development model that integrates digital finance with low-carbon and green initiatives. This paper employs panel data from 30 provinces in China spanning from 2014 to 2021 to investigate, for the first time, the mechanism and spatial spillover effects of digital inclusive finance on carbon emissions from the perspective of consumption structure upgrading. The research findings indicate that digital inclusive finance significantly curbs carbon emissions, and the upgrading of consumption structure serves as the mechanism through which digital inclusive finance reduces carbon emissions. Heterogeneity analysis reveals that the inhibitory effect of digital inclusive finance on carbon emissions is more pronounced in the central and western regions compared to the eastern region, and the mediating effect of consumption structure upgrading varies across different regions. Furthermore, a positive spatial spillover effect is observed between digital inclusive finance and carbon emissions. This research provides new insights into promoting the carbon emission reduction effects of digital finance from the perspective of consumption structure upgrading, strengthening the synergy between digital finance and consumption structure from a spatial correlation perspective, and ultimately achieving low-carbon and high-quality development.
Two sample Mendelian randomization analysis of the causal relationship between hypertension and vertigo
Authors: Lv Yuan , Shen Yiming , Zhang Junjun , Wu Linrong , Ye Dong , Shen Zhishen 
Published: August 2023

Abstract
Background
Vertigo is not a specific disease, but a symptom, and abnormalities in vestibular function in vertigo may be caused by different pathologies rather than the same etiology, which also leads to different affected groups. At present, there have been many studies that surface a link between hypertension and vertigo, but there are still few studies that analyze genes from a genetic perspective.Therefore, in order to investigate the causal link between hypertension and vertigo, we apply Mendelian randomization in this work.
Methods
The genetically anticipated causal connection between hypertension and vertigo was evaluated using a two-sample MR method. In addition to analysing the link between total vertigo and hypertension, we also analysed 3 major types of vertigo, including central vertigo, benign paroxysmal positional vertigo, and other peripheral vertigo. Data on hypertension and vertigo were taken from genome-wide association study (GWAS), including 162837 controls and 55917 cases. Central vertigo, benign paroxysmal positional vertigo, and other peripheral vertigo, with 186,3834,1293 cases and 209582 controls, respectively. To fully deduce the potential causative association between hypertension and vertigo, the inverse variance weighting approach (IVW) and other efficient methods, such as MR-Egger, weighted median, and simple mode, were used.
Results
Finally, 53 genome-wide significant SNPs associated with hypertension were identified as instrumental variables for subsequent Mendelian randomization analysis. The MR results showed that hypertension and vertigo risk were significantly positively correlated with vertigo (OR: 1.16, 95% CI: 1.08–1.25, p < 0.05 ), benign paroxysmal positional vertigo (OR: 1.12, CI: 1.01–1.24, and p = 0.03), and other peripheral vertigo (OR: 1.19, 95% CI: 1.00-1.41, p = 0.046),except central vertigo (OR: 1.15, 95% CI: 0.74–1.80, p = 0.53).
Conclusion
The genetic confirmation of a causal link between hypertension and vertigo came from this MR analysis. In order to avoid potentially negative vertigo consequences, our findings emphasize the significance of more intensive care and early intervention for patients with hypertension. Additionally, our work offers hints for determining risk factors and early vertigo prediction.
Catalytic pyrolysis of cellulose using acidic ionic liquids at low temperatures and explanation of the catalytic mechanism and product evolution model
Authors: Li zhishuncheng , Yuan Yongheng , Qu GuangFei , Cui Qingyuan , He Yanhua , Ning Ping , Xie Ruosong , Li Weijie , Xu Yibi 
Published: August 2023

Abstract
In this paper, we investigated the catalytic pyrolysis process of cellulose at temperatures of 140°C, 180°C, 260°C and 300°C with acidic [Bmim]OTf ionic liquids as catalysts. Characterization of the pyrolysis products by SEM, XRD, FTIR and GC-MS showed that the initial pyrolysis temperature of MC was significantly reduced from 315°C to 140°C with a temperature interval of nearly 200°C, and the crystalline structure of cellulose was rapidly destroyed, which might be due to the synergistic catalytic effect of CF3SO3- and [Bmim]+. The molecular potential distributions of cellulose and ionic liquids were analyzed from a microscopic perspective, and a novel mechanism model for the synergistic catalytic pyrolysis of MC by [Bmim]OTf was developed. This study provides a reference for the targeted product's targeted regulation mechanism, and finally achieves the efficient and low consumption utilization of biomass.
Investigating the causal association among 25(OH)D , 25(OH)D3 , C3-epi- 25(OH)D3 and the risk of oropharyngeal cancer using Mendelian randomization
Authors: Yu YaoHui , Zhou Yu 
Published: August 2023

Abstract
Background: Prior research suggested a differential association of 25-hydroxyvitamin D (25(OH)D) metabolites ,25 hydroxyvitamin D and the epimeric form (C3-epi-25(OH)D3) with the health outcomes and cancer1,2, but little is known about the causal direction of the associations in oropharyngeal cancer (OPC). We aimed to evaluate the causal effect of 25-hydroxyvitamin D (25(OH)D) metabolites ,25 hydroxyvitamin D concentration and the epimeric form (C3-epi-25(OH)D3) on the risk of OPC using Mendelian randomization (MR).
Methods: Genetic variants robustly associated with 25(OH)D , 25(OH)D3 and C3-epi-25(OH)D3 were used to perform MR analyses with summary data on 291 OPC cases, obtained from European, North America and South America. We performed two-sample MR analyses using an inverse variance weighted (IVW) as the primary approach, while using 5 additional methods (e.g., MR-Egger, weighted median(WM) and Cochran’s Q) as sensitivity analysis to detect and adjust for pleiotropy.
Results: In MR, we found that evidence for a lower causal effect of 25(OH)D3 on risk of OPC in a European population (Weighted Median(WM) OR = 0.47, 95% CI = 0.24-0.91, P = 0.03).
Although the IVW showed that it was significant, further leave-one-out results indicated that the negative results were unstable, and the results became positive after rs9304669 was excluded (OR = 0.51, 0.28-0.91, P = 0.02). The remaining results were negative. The results of sensitivity analysis were stable, and indicated that it was no heterogeneity and pleiotropy.
Conclusions: Our study found obvious associations of 25(OH)D , 25(OH)D3 and C3-epi-25(OH)D3 with OPC risk.
EGFR Mutation Impacts Recurrence in High-Risk Early-Stage Lung Adenocarcinoma in the IASLC Grading System
Authors: Nomura Kotaro , Aokage Keiju , Kaminuma Yasunori , Nakai Tokiko , Wakabayashi Masashi , Ikeno Takashi , Koike Yutaro , Taki Tetsuro , Miyoshi Tomohiro , Tane Kenta , Samejima Joji , Ishii Genichiro , Tsuboi Masahiro 
Published: August 2023

Abstract
Introduction: The developments of perioperative treatments for patients with high-risk early-stage lung cancer are ongoing, however, real-world data and evidence of clinical significance of genetic aberration is lacking in this population. This study aimed to identify patients with early-stage lung adenocarcinoma at high risk for recurrence based on pathological indicators of poor prognosis, including the International Association for the Study of Lung Cancer (IASLC) grade, and elucidate the prognostic impact of epidermal growth factor receptor mutation (EGFRm) status.
Methods: This retrospective study included 494 consecutive patients who underwent complete resection for pathological stage I lung adenocarcinoma between 2011 and 2016. The patients were evaluated for EGFRm and IASLC grade. Multivariable analysis was used to identify pathological factors for poor prognosis associated with recurrence-free survival (RFS) and overall survival (OS). Patients with any one of these factors were classified into the high-risk group. The prognostic impact of EGFRm was evaluated using RFS, OS, and cumulative recurrence proportion.
Results: Multivariable analysis for RFS and OS revealed that IASLC grade 3, pathological invasion size>2 cm, and presence of lymphovascular invasion were indicators of poor prognosis. EGFRm-positive patients had a higher incidence of all types of recurrence, including central nervous system (CNS) metastasis and distant metastasis in high-risk group, but not in low-risk group.
Conclusions: This study provides evidence that patients with EGFRm-positive stage I lung adenocarcinoma in the high-risk group have an increased risk of recurrence, including CNS metastasis. These findings highlight the need for development of adjuvant treatment in this population.
The investigation on medical diseases comorbidities in geriatric patients with mental disorders
Authors: Song Haining , Zhang Xu , Cao Yuying , Wei Chen , Li Xue , Gao Lingnan , Yang Zhenzhen , Wang Zhonggang 
Published: August 2023

Abstract
Objective:Medical disorders in geriatric patients with mental disorders have attracted more and more attention. So far, there is still a lack of large sample studies on this issue in China. Therefore, we conducted this study to explore the clinical characteristics and effecting factors of the comorbidity of medical disease in geriatric patients with mental disorders.
Method: A total of 2125 geriatric patients with mental disorder hospitalized from January 1,2017 to December 3l,2017 were enrolled in the study. According to whether they had medical diseases, all geriatric patients were divided into the comorbid group and non-comorbid group. The demographic information and disease characteristic information questionnaire was used to collect relevant data for comparative analysis.
Results: The comorbidity rate of medical diseases in geriatric patients with mental disorders was 87.1%, with an average of 2.9 comorbidities per patient. The age, length of stay and hospital expenses of the comorbid group were significantly more than the non-comorbid group (All P <0.05). The comorbidity group’s number of patients who had positive past history, have extrovert disposition were significantly more than the non-comorbidity group (All P <0.05). The top 5 comorbid medical disorders were cerebral infarction (12.3%), hypertension (11.8%), coronary heart disease (11.2%), cerebral atrophy (6.7%) and liver and biliary tract disease (5.5%) in geriatric patients with mental disorder. The spearman analysis showed that age was significantly positively associated with the number of comorbidities (P<0.05), while marriage and residence address were significantly negatively correlated with the number of comorbidities (All P<0.05). The logistic analysis showed that age, disposition and past history were independent risk factors of comorbidities in geriatric patients (All P<0.05).
Conclusion: Geriatric patients with mental disorder have a high rate of comorbidity with medical disorders. Age, marriage, residence address and disposition may all play a role in disease comorbidity.. Medical diseases increase length of stay, the hospital expenses and the burden of geriatric patients. Psychiatrists should take positive measures to treat medical diseases.and mental disorders of geriatric patients.
Intercultural competence in Healthcare Higher Education: Adapting UNESCO Story Circles method in medical education
Authors: Milán Carolina Giménez , Güemes Luciana Acosta 
Published: August 2023

Abstract
The importance for culturally competent healthcare systems that can adapt and meet the needs of changing populations while accommodating cultural, religious, linguistic and gender diversity is becoming increasingly important around the world. Story Circles is a practical intercultural tool designed by UNESCO for developing and practicing intercultural competencies that can be used with different groups of people in a variety of settings. The healthcare training, where patients and healthcare providers are brought together in understanding each other’s perspectives and cultural contexts, is one of the specific contexts in which Story Circles can be used to develop individuals’ intercultural competencies. Story Circles is a tool that gives participants the opportunity to practice intercultural competencies, especially “listening for understanding”; considering that listening is considered a key skill in healthcare. We adapted the UNESCO Story Circles methodology to the specific experiences of undergraduate medical students to include discipline-specific prompts related to healthcare settings. 35 students participated in the activity and completed the final questionnaire. The findings corroborate positive reviews by all participants, and the proposal of Story Circle methodology as a complementary training activity for them to achieve intercultural competencies as well as the practice of “listening for understanding” was highly appreciated by all the participants.
Excess hospitalizations and in-hospital mortality associated with seasonal influenza in Italy: a 11-year retrospective study
Authors: Fattore Giovanni , Pongiglione Benedetta , Vezzosi Luigi 
Published: August 2023

Abstract
Background
Influenza and flu-like syndromes are difficult to monitor because the symptoms are not specific, laboratory tests are not routinely performed, and diagnosis codes are often lacking or incompletely registered in medical records. This may result in an underestimation of hospital admissions, associated costs, and in-hospital mortality. Therefore, this study aimed to estimate the public health and economic burden of hospitalisations associated with influenza in Italy, at the national and regional levels.
Methods
This 11-year retrospective study included patients admitted to hospitals for influenza or diagnoses attributable to influenza (including respiratory and cardiocirculatory conditions) from 2008/09 to 2018/19. Data on hospitalisations were extracted from the Italian Hospital Discharge Records. Information on weekly influenza-like syndrome incidence and weekly average temperature were used to estimate the burden of influenza in terms of hospital admissions in every Italian region and for different age groups by applying a negative binomial model. The model was also applied to estimate in-hospital mortality and the total costs of influenza and influenza-like hospital admissions.
Results
Over the study period, in addition to 3,970 average seasonal admissions coded as influenza, we estimated an average of 21,500 admissions per season attributable to influenza, which corresponds to 36.4 cases per 100,000. Most of the estimated additional hospitalisations concerned older individuals (> 65 years) and children (0–4 years) with 86 and 125 cases per 100,000, respectively. Large variations were observed across regions. Overall, the total estimated hospital burden attributable to influenza (including respiratory and cardiocirculatory conditions) was approximately €132m per year. While the in-hospital mortality for admissions with a primary diagnosis of influenza was very low (∼150 cases per season), cases increased dramatically for primary diagnoses of influenza and pneumonia (about 9,500 cases per season). The average seasonal estimated in-hospital mortality for admissions attributable to influenza was equal to 2,775 cases.
Conclusions
Our findings suggest a remarkable underestimation of the burden of influenza, mostly in the older population but not neglectable in younger individuals. Our results may aid the management of current and future flu seasons and should be used for policy making (e.g., vaccine strategies) and operation management choices (e.g., planning and staffing beds during influenza peaks). Overall, the present study supports the need for increased testing for influenza in Italy to tackle the current underestimation of influenza burden.
Assessment of Clinical Relevance of Antigen Improves Diagnostic Accuracy of Hypersensitivity Pneumonitis
Authors: Iijima Yuki , Ejima Masaru , Yamana Takashi , Shibata Sho , Shirai Tsuyoshi , Okamoto Tsukasa , Furusawa Haruhiko , Tateishi Tomoya , Adachi Takuya , Mori Mio , Kirimura Susumu , Anzai Tatsuhiko , Takahashi Kunihiko , Miyazaki Yasunari , Sonoda Shiro 
Published: August 2023

Abstract
Background
Exposure assessment is integral to the diagnosis of hypersensitivity pneumonitis (HP). Although the clinical relevance of exposed antigens is essential for the assessment, many of the previous guidelines or reports have only evaluated a simple exposure history or immunological test. To overcome this problem, the Exposure Assessment Form (EAF) was developed as an assessment tool for classifying the exposure grade from G0 to G4. The EAF was modified from the description in the HP guidelines published by the Japanese Respiratory Society.
Methods
One hundred and seventy-two consecutive patients with interstitial lung disease who underwent multidisciplinary discussion (MDD) at our hospital were retrospectively examined. We assessed whether the use of the EAF improved the performance of guidelines in the diagnosis of HP. We also evaluated whether the exposure grade affected the prognosis of HP.
Results
Even when HP diagnosis with a confidence of 70% or higher was made according to the international guideline, almost half of these cases had different final diagnoses with exposure grades of G0, G1, or G2. When the result of the EAF was integrated into the exposure definition of the international guideline, the specificity of the diagnostic performance improved, while sensitivity was maintained. Furthermore, HP patients with an exposure grade of G3 or higher showed tendency for longer time to initiate drug treatment.
Conclusions
This is the first study to evaluate the clinical relevance of possible antigens using the EAF. Assessing the exposure grade prevents overdiagnosis and improves the diagnostic performance of the guideline.
Combined anatomical MRI differentiates pulmonary invasive adenocarcinoma from tuberculoma in noncalcified nodule: a retrospective comparison of CT with MRI
Authors: Yang Shuyi , Shi Yuxin , Liu Tiefu , Zhuo Yaoyao , Wang Qingle , Zhang Zhiyong , Shan Fei 
Published: August 2023

Abstract
Objective: MRI as a non-ionizing modality can be a complementary tool for nodules assessment. This study is aimed to evaluate the potential of the combined conventional and modified anatomical MRI sequences for differential diagnosis of invasive adenocarcinoma (IAC) and tuberculoma.
Materials and methods:Sixty-seven patients (median 54 years, range 18-82 years) with 82 noncalcified nodules (mean 19.56±6.85 mm, range 7-30 mm) underwent CT and MRI (T1WI-starVIBE, T1WI-VIBE, T2WI-TSE-fBLADE). Two radiologists independently assessed nodule dimensions and morphologic features (margin, morphology, lobulation, spiculation, cavity, air bronchogram, pleural indentation). Comparison of categorical variables was performed using Chi-square test. The inter-method agreement of morphologic features assessment by CT and MRI sequences were compared using Kappa test. Multivariate logistic regression analyses were applied to identify independent predictors to IAC. ROC analysis was performed to investigate the differential diagnosis capability.
Results: Thirty-eight IACs and 44 tuberculomas were identified. Readers 1 and 2 underestimated the nodules mean diameter with T1WI-starVIBE (T1WI-VIBE, T2WI-TSE-fBLADE) by 0.86±1.71 mm (1.19±2.06 mm, 0.15±1.96 mm) and 0.99±1.75 mm (1.27±2.04 mm, 0.19±1.91 mm). The inter-method agreements between MRI and CT were “fair” to “excellent” in the evaluation of morphological features except for spiculation (0.318≦Kappa≦0.895). Compared with the tuberculoma group, the IAC group was significant with unclear margin (T1WI-starVIBE, T1WI-VIBE), irregular morphology (CT, MRI), lobulation (CT, MRI), spiculation (T1WI-starVIBE, T2WI-TSE-fBLADE) and air bronchogram (CT, T1WI-starVIBE and T1WI-VIBE) (P﹤0.05). The AUC values for the logistic model by the combination of CT and MRI were 0.867/0.877 (reader 1/2: sensitivity 73.68%/76.32%, specificity 86.36%/86.36%) and were significantly higher than that by T1WI-starVIBE (P=0.002) and T1WI-TSE-fBLADE (P=0.027) (reader 1), as well as higher than that by CT (P=0.045) and T1WI-starVIBE (P=0.003) (reader 2).
Conclusion: The combined conventional and modified anatomical MRI sequences has diagnostic potential in distinguishing pulmonary IAC from tuberculoma.
A Rare Cause of Extreme Leukocytosis: Primary Plasma Cell Leukemia with High-risk Cytogenetics
Authors: Sonmez Ozge , Elverdi Tugrul , Tekin Tuba Ozkan , Kaya Selin Kucukyurt , Akı Suat Hilal , Salihoglu Ayse 
Published: August 2023

Abstract
Background
Primary plasma cell leukemia (pPCL) is a rare and highly aggressive plasma cell disorder. Extreme leukocytosis is an infrequent finding in pPCL.
Case presentation:
We reported an 82-year-old female patient who presented with marked leukocytosis (61.900/µl) and was diagnosed with pPCL. Plasma cells were found to have t(14;20) and 1q21 amplification. Following partial response after two cycles of bortezomib/dexamethasone combination, central nervous system (CNS) relapse occurred. Due to the advanced age and frailty, no further therapy could be administered. She had a fulminant disease course and died within one month of the CNS involvement.
Conclusion
PCL should be included in the differential diagnosis of leukocytosis.
Effectiveness and Safety of Pharmacopuncture therapy for chronic low back pain: A protocol for an assessor-blinded, pragmatic randomized controlled, pilot trial
Authors: Choi Youn Young , Kim Young Kyung , Won Eun Sol , Ryu Hwa Yeon , Kang Jae Hui , Lee Hyun 
Published: August 2023

Abstract
Background
Low back pain is a common musculoskeletal disorder worldwide with a lifetime prevalence of up to 80%, and Korean medicine treatment is often used for it. Chronic low back pain results in great personal, social, and economic burden. However, its cause is known to be non-specific. We will investigate the effectiveness and safety of pharmacopuncture for chronic low back pain since there is a current lack of research on this topic.
Methods
This will be a pragmatic randomized, and assessor-blinded pilot clinical study. The participants will be randomly allocated to the treatment group (pharmacoupunture therapy with traditional Korean medicine) or to the control group (traditional Korean medicine). The duration of the clinical trial will be 9 weeks. The primary outcome will be measured using the visual analog scale; the secondary outcomes will include the Oswestry Disability Index, Patient Global Impression of Change, no worse than mild pain, and range of motion.
Conclusions
We will evaluate the efficacy and safety of pharmacopuncture for chronic low back pain and will contribute to knowledge on the evidence-based treatment for it.
Abberviations:
LBP: low back pain, IRB: Institutional Review Board, KMD: Korean medical doctor, TKM: Traditional Korean medicine, VAS: Visual Analog Scale, ODI: Oswestry Disability Index, PGIC: Patient Global Impression of Change, ROM: Range of motion, PRCT: pragmatic randomized controlled trial, SAE: serious adverse event
Trial registration:
This study protocol was registered with the Korean National Clinical Research Information Service (CRIS) on July 17, 2023 (CRIS-KCT0008620). The participants will be retrospectively registered. https://cris.nih.go.kr/cris/search/detailSearch.do?seq=25180&search_page=L