bluuebunny/crossref_metadata_2025_split huggingface dataset:
Monocyte-to-High-Density Lipoprotein Cholesterol Ratio Together With the Lymphocyte-to-Monocyte Ratio in Predicting the Malignancy of the Thyroid Nodule in Patients Complicated With Type 2 Diabetes
Authors: Hu Yingying , Shen Yanyan , Xia Erjie , Hirachan Suzita , Bhandari Adheesh , Jin Zao 
Published: September 2023

Background: Thyroid nodules, although mostly benign and symptomless, have a small chance of being cancerous, necessitating accurate diagnosis. This study aims to develop and validate a nomogram for differentiating malignant and non-malignant thyroid nodules in individuals with type 2 diabetes. Methods: The study included 484 patients with both thyroid nodules and type 2 diabetes who underwent thyroid gland lobectomy at Wenzhou Medical University Hospital. Optimal cutoff values for continuous variables were determined using ROC curve analysis. Significant factors identified in univariable analysis were used to construct the nomogram. The monocyte-to-high-density lipoprotein cholesterol ratio (MHR) was visualized through a histogram and scatter diagram. Discriminatory power was assessed using ROC analysis, and calibration curves ensured consistency. Decision curve analysis (DCA) evaluated clinical benefits. Results: The cohort was divided into a training group (70%) and an internal validation group (30%). The scatter diagram revealed a correlation between MHR levels and the proportion of goiter cases, with higher MHR levels associated with increased goiter incidence. The histogram showed higher average MHR levels in goiter patients compared to those with papillary thyroid carcinoma (PTC) in both groups. Multivariate logistic regression identified age, total cholesterol (TC), triglyceride (TG), fasting blood sugar (FSG), fibrinogen, lymphocyte-to-monocyte ratio (LMR), and MHR as independent predictive factors for malignancy in thyroid nodules with type 2 diabetes. The nomogram achieved high discrimination, with C-index values of 0.901 (training data set) and 0.760 (internal validation data set). Calibration curves displayed good agreement, and DCA demonstrated significant net clinical benefits. Conclusions: MHR is associated with sex, serum cholesterol levels, and peripheral blood cell counts, making it a potential novel biomarker for differentiating between PTC and goiter in type 2 diabetes patients.
Breastfeeding Practices and Associated Factors among Immigrant Muslim Arab Women Living in a Metropolitan Area of the Southwest of United States
Authors: Khasawneh Wafa F , Ahmed Azza H , Petrov Megan E , Reifsnider Elizabeth , Komnenich Pauline 
Published: September 2023

Background: Muslim Arab immigrants are a fast-growing, under-studied, and underserved minority population in the United States. Little is known about breastfeeding practices in this population. objectives: The objective of this study was to describe infant feeding practices and factors associated with these practices among immigrant Muslim Arab women. design: A nonexperimental-one group, cross-sectional, descriptive, prospective design was used to identify infant feeding practices among immigrant Muslim Arab women. methods: A convenience sample of one hundred sixteen immigrant Muslim Arab women with at least one child five years or younger was recruited from a large metropolitan area in the Southwestern region. Participants completed the social ecological model of health promotion self-reported questionnaire. Descriptive statistics were performed to identify infant feeding practices and logistic regression was used to identify factors associated with these practices. results: Immigrant Muslim Arab mothers demonstrate high breastfeeding initiation rates (99.2%) and lengthy breastfeeding duration ( M = 11.86, SD  = 8.04), but low rates of exclusive breastfeeding at six months (21.6%). The most frequent reasons for early termination of breastfeeding were perceived insufficient milk (44.4%), child was still hungry after breastfeeding (37.5%), and the belief that the child was old enough to stop breastfeeding (32.9%). conclusion: Development of educational interventions are needed to improve breastfeeding exclusivity and raise women’s awareness of the importance of exclusive breastfeeding. Healthcare providers should help women gain confidence in their ability to produce enough milk to successfully continue breastfeeding.
Reducing abnormal expenses in national health insurance based on a control chart and decision tree-driven define, measure, analyze, improve and control process
Authors: Chen Yen-Chang , Chen Shui-Chuan , Liu Ying-Sing 
Published: September 2023

This study examined the cost of medical insurance for “sepsis” treatment in Taiwan. We applied statistical tests, cost control charts, and C5.0 decision trees using the define, measure, analyze, improve and control (DMAIC) process to mine data on Diagnosis-Related Groups (DRGs) and clinics that reported expense anomalies and disposal costs. Analyzing 353 valid samples (application fees) from four DRGs, 70 clinics, and 15 input variables, abnormalities in application fees for adults (age ≧18 years old) with comorbidities or complications was significant (95% confidence interval) in one DRG and nine clinics. Four input variables (ward charge, treatment fee, laboratory fee, and pharmaceutical service charge) had a significant impact. Improvements or controls should be prioritized for three clinics (Nos. 49, 44, and 14) and two input variables (treatment and laboratory fees). This model can be replicated to ascertain excess medical expenditures and improve the efficiency of medical resource use.
Social work and social inclusion in sports-based programs: A qualitative study
Authors: Corvino Chiara , D’Angelo Chiara , Gozzoli Caterina 
Published: September 2023

Summary Although the literature is rich in contributions analyzing the role of social workers in sports, there remains a lack of empirical research with respect to how these workers can be determinant in the development of inclusion outcomes in sports-driven interventions targeting socially vulnerable youth. The investigation analyzes the case of a sports-based program run by an Italian non-profit organization (NGO) from an ecological system perspective. Data from interviews and focus groups with youth involved in the program (21), parents (15), sport coaches (9), and the social workers of the NGO (15) were triangulated with the aim of exploring how social workers promoted inclusion through sport. Data were analyzed in a top–down thematic analysis. Findings Social workers promoted many social inclusion outcomes: (1) they linked sport clubs with the youth excluded from the sport system, thus sustaining access to sport; (2) they emotionally supported youth and their families in the program, fostering the relational dimension of social inclusion; (3) they formed alliances between the diverse systems of youth life, enhancing youth capacity to overcome their personal challenges in sports; and (4) they encouraged the integration of people coming from different socio-economic backgrounds within the sport context. Applications The case informs the practice of social workers in sport-driven interventions providing insights around the tasks they should achieve to promote social inclusion, including (1) recruitment of youth excluded from the sport system and linkage with sport clubs, (2) sport bureaucracy support, and (3) dialogue with diverse youth life systems.
Urgent Juxtarenal Aortic Aneurysm Repair With Modified Off-the-shelf Endograft to Preserve Intercostal Arteries and Branch Incorporation by Transfemoral Access
Authors: Ferreira Marcelo , Mannarino Matheus , Cunha Rodrigo , Ferreira Diego , Capotorto Luis Fernando 
Published: September 2023

Purpose: To demonstrate the feasibility of the modification to preserve intercostal arteries of the t-Branch Endograft (Cook Medical, Bloomington, IN) in an urgent setting, associated with a less invasive approach for branch incorporation from percutaneous femoral access with steerable sheaths. Technique: A 73-year-old female patient presented at our institution with intense abdominal pain. Angiotomography showed a 50-mm juxtarenal aortic aneurysm, with no signs of rupture. Urgent endovascular repair was indicated due to abdominal symptom with an off-the-shelf multi-branched endograft. To limit descending thoracic aortic coverage, we performed t-Branch modification to preserve intercostal arteries and minimize the risk of spinal cord injury, associated with a percutaneous transfemoral approach and branch incorporation with steerable sheaths to avoid the risks associated with a superior axillary or brachial access. Control angiotomography showed adequate aneurysm sac exclusion with patency of all four visceral vessels. Conclusion: t-Branch-modified endograft to limit aortic coverage is an alternative option in urgent cases to diminish the risk of spinal cord injury, and association of steerable sheaths with branch incorporation is leading complex aortic repairs to an even less invasive procedure. Clinical Impact This paper highlights the possibility of performing complex endovascular aortic repair in an urgent setting with modification of an off-the-shelf multi branched endograft limiting intercostal arteries coverage, thereby diminishing the risk of spinal cord ischemia. This technical innovation provides an alternative for clinicians when treating large, rapidly expanding, or symptomatic juxtarenal, pararenal, paravisceral or type 4 thoracoabdominal aortic aneurysms that could not wait for a custom-made device and do not need extensive thoracic aortic coverage that an off-the-shelf device provides. In summary, expand the possibilities of an endovascular repair of complex aortic aneurysms.
Neointimal characteristic changes following drug-coated balloons in lesions with repeated revascularization
Authors: Takei Yosuke , Mori Hiroyoshi , Tezuka Takahiro , Omura Ayumi , Wada Daisuke , Sone Hiromoto , Tashiro Kazuma , Sasai Masahiro , Sato Tokutada , Suzuki Hiroshi 
Published: September 2023

Background: Since their emergence, drug-coated balloons (DCBs) have been used widely to treat in-stent lesions with coronary artery disease (CAD). However, despite their superior efficacy to balloon angioplasty, how DCBs affect neointimal characteristics is poorly understood. Objectives: We aimed to assess the neointimal characteristic changes following DCB treatment. Methods: Using optical frequency domain imaging (OFDI), we serially observed the in-stent lesion site just after and 1 year after DCB angioplasty in 12 lesions of 11 patients with repeated revascularization. Neoatherosclerosis was defined as lipid-laden neointima with or without calcification in the stented lesion. Progression or regression of neoatherosclerosis, newly formed neointimal calcification, newly formed uncovered strut and newly formed evagination were assessed. Tiny tissue protrusion was also recorded as mushroom-like protrusion. Results: Underlying stents were first-generation ( n = 5) or newer ( n = 7) drug-eluting stents (DESs) with implantation durations ranging from 1 to 15 years (median 8 years). Surprisingly, two-thirds of the lesions (67%, 8 of 12) showed progression of neoatherosclerosis, while a quarter of lesions (25%, 3 of 12) showed regression of neoatherosclerosis. The maximal lipid arc increased from 122° to 174°. Newly formed neointimal calcification was observed in 2 of 12 lesions (16%). Newly formed uncovered struts (33%; 4 of 12) and newly formed evaginations (33%; 4 of 12) were not rare. Mushroom-like protrusion was found in a quarter of lesions (25%; 3 of 12). Conclusion: Our study demonstrated that a considerable number of lesions showed varied neointimal characteristic changes in a small number of patients. Further studies in a larger population are needed to understand the clinical impact of these findings.
Validation of a New Tool to Detect and Characterize Spinal Cord Injury in the Acute Trauma Patient: The Montreal Acute Classification of Spinal Cord Injury
Authors: Pelletier-Roy Rémi , Dionne Antoine , Richard-Denis Andréane , Briand Marie-Michèle , Bourassa-Moreau Étienne , Mac-Thiong Jean-Marc 
Published: September 2023

Study Design Retrospective validation protocol. Objective The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) is the most comprehensive tool for classifying spinal cord injuries (SCI), but it is not adapted for the evaluation of trauma patients. The objective is to develop and validate a streamlined tool, the Montreal Acute Classification of Spinal Cord Injury (MAC-SCI) that can be integrated in the evaluation of trauma patients to detect and characterize traumatic SCI (tSCI). Methods The completion rate of the ISCNSCI during initial evaluation after tSCI was estimated at a Level-1 trauma center specialized in SCI care. Using a modified Delphi technique, we designed the MAC-SCI, a new tool to detect and characterize the severity grade and level of SCI in the polytrauma patient. A cohort consisting of 35 consecutive tSCI patients with complete ISNCSCI documentation was used to validate the MAC-SCI. The severity grade and neurological level of injury (NLI) were assessed using the MAC-SCI, and compared to those obtained with the ISNCSCI. Results Only 33% of 148 patients admitted after a tSCI had a complete ISNCSCI performed at initial presentation. The MAC-SCI retains 53 of the 134 elements from the ISNCSCI. There was a 100% concordance in severity grade between the MAC-SCI and ISNCSCI. The NLI were within 2 levels between the MAC-SCI and ISNCSI for 100% of patients. Conclusion The MAC-SCI is a streamlined tool that accurately detects and characterizes tSCI in the acute trauma setting. It could be implemented in trauma protocols to guide the management of SCI patients. Level of Evidence Level III Diagnostic criteria.
Functional leg performance 2 years after ACL surgery: a comparison between InternalBrace™-augmented repair versus reconstruction versus healthy controls
Authors: Bühl Linda , Müller Sebastian , Nüesch Corina , Pagenstert Geert , Mündermann Annegret , Egloff Christian 
Published: September 2023

Abstract
Background
While clinical and patient-reported outcomes have been investigated in patients after InternalBrace™-augmented anterior cruciate ligament repair (ACL-IB), less is known regarding restoration of functional performance. We aimed to determine differences in functional performance within and between patients 2 years after ACL-IB, patients 2 years after ACL reconstruction (ACL-R), and healthy controls.

Materials and Methods
A total of 29 ACL-IB, 27 ACL-R (hamstring autograft), and 29 controls performed single-leg hop (maximum forward distance hop, SLH; side hop > 40 cm in 30 s, SH), proprioception (knee joint position sense at 30° and 60° flexion), and dynamic postural balance (Y Balance) tests. Differences were calculated within groups (side-to-side difference) and between the involved leg of patients and the non-dominant leg of controls, and were evaluated to predefined statistical (P < 0.05), clinically relevant, and methodological (smallest detectable change) thresholds. The number of exceeded thresholds represented no (0), small (1), moderate (2), or strong (3) differences. In addition, the relative number of participants achieving leg symmetry (≥ 90%) and normal performance (≥ 90% of the average performance of the non-dominant leg of controls) were compared between groups (chi-squared tests, P < 0.05).

Results
We observed no-to-moderate leg differences within ACL-IB (moderate difference in hops) and within ACL-R (moderate difference in knee proprioception), no leg differences between patient groups, no-to-small leg differences between ACL-IB and controls, and no leg differences between ACL-R and controls in functional performance. However, two patients in ACL-IB and ACL-R, respectively, passed the hop pretest only with their uninvolved leg, and fewer patients after ACL-IB and ACL-R than controls reached a leg symmetry and normal leg performance of controls in SLH (P < 0.001).

Conclusions
Functional performance seems to be comparable 2 years postoperatively between ACL-IB and ACL-R for a specific subgroup of patients (i.e., proximal ACL tears, moderate activity level). However, the presumed advantage of comparable functional outcome with preserved knee structures after augmented ACL repair compared with ACL-R, and the tendency of both patient groups toward leg asymmetry and compromised single-leg hop performance in the involved legs, warrants further investigation.
Level of Evidence Level III, case-control study.
Trial registration clinicaltrials.gov, NCT04429165 (12/09/2020). Prospectively registered, https://clinicaltrials.gov/ct2/show/NCT04429165.
Preparation and anti-triple-negative breast cancer cell effect of a nanoparticle for the codelivery of paclitaxel and gemcitabine
Authors: Yang Fan , Fan Zehui , Zhang Lixia , He Yanjuan , Hu Run , Xiang Jinkun , Fu Shiyang , Wang Guowei , Wang Jianlong , Tao Xiaojun , Zhang Pan 
Published: September 2023

AbstractAmphiphilic polymers (HA-ANI) were prepared by grafting hyaluronic acid (HA) and 6-(2-nitroimidazole)hexylamine (ANI) and then self-assemble in water to form nanoparticles (NPs) that could be loaded with paclitaxel (PTX) and gemcitabine (GEM) by dialysis. Infrared spectroscopy and 1H-NMR indicated the successful synthesis of HA-ANI. Three different ratios of NPs were prepared by adjusting the ratios of hydrophilic and hydrophobic materials, and the particle size decreased as the ratio of hydrophilic materials increased. When HA:ANI = 2.0:1, the nanoparticles had the smallest size distribution, good stability and near spherical shape and had high drug loading and encapsulation rates. In vitro release experiments revealed that NADPH could accelerate the drug release from NPs. Cellular uptake rate reached 86.50% at 6 h. The toxic effect of dual drug-loaded nanoparticles (P/G NPs) on MDA-MB-231 cells at 48 h was stronger than that of the free drug. The AO/EB double-staining assay revealed that a large number of late apoptotic cells appeared in the P/G NPs group, and the degree of cell damage was significantly stronger than that of the free drug group. In the cell migration assay, the 24 h-cell migration rate of the P/G NPs group was 5.99%, which was much lower than that of the free group (13.87% and 17.00%). In conclusion, MDA-MB-231 cells could effectively take up P/G NPs, while the introduction of the nano-codelivery system could significantly enhance the toxicity of the drug to MDA-MB-231 cells as well as the migration inhibition effect.
Comparison between compressed sensing and segmented cine cardiac magnetic resonance: a meta-analysis
Authors: Craft Jason , Li Yulee , Nashta Niloofar Fouladi , Weber Jonathan 
Published: September 2023

Abstract
Purpose
Highly accelerated compressed sensing cine has allowed for quantification of ventricular function in a single breath hold. However, compared to segmented breath hold techniques, there may be underestimation or overestimation of LV volumes. Furthermore, a heterogeneous sample of techniques have been used in volunteers and patients for pre-clinical and clinical use. This can complicate individual comparisons where small, but statistically significant differences exist in left ventricular morphological and/or functional parameters. This meta-analysis aims to provide a comparison of conventional cine versus compressed sensing based reconstruction techniques in patients and volunteers.

Methods
Two investigators performed systematic searches for eligible studies using PubMed/MEDLINE and Web of Science to identify studies published 1/1/2010-3/1/2021. Ultimately, 15 studies were included for comparison between compressed sensing cine and conventional imaging.

Results
Compared to conventional cine, there were small, statistically significant overestimation of LV mass, underestimation of stroke volume and LV end diastolic volume (mean difference 2.65 g [CL 0.57–4.73], 2.52 mL [CL 0.73–4.31], and 2.39 mL [CL 0.07–4.70], respectively). Attenuated differences persisted across studies using prospective gating (underestimated stroke volume) and non-prospective gating (underestimation of stroke volume, overestimation of mass). There were no significant differences in LV volumes or LV mass with high or low acceleration subgroups in reference to conventional cine except slight underestimation of ejection fraction among high acceleration studies. Reduction in breath hold acquisition time ranged from 33 to 64%, while reduction in total scan duration ranged from 43 to 97%.

Conclusion
LV volume and mass assessment using compressed sensing CMR is accurate compared to conventional parallel imaging cine.
Association of cognitive impairment and diabetes on survival in Chinese older people with hypertension: a 10-year prospective study
Authors: Cai Shuang , Cheng Bokai , Li Kailiang , Li Yun , Zhang Anhang , Sun Jin , Su Yongkang , Li Man , Bao Qiligeer , Zhang Yan , Ma Shouyuan , Zhu Ping , Wang Shuxia 
Published: September 2023

Abstract
Background
Older people with hypertension may have more complex multisystem problems and a higher risk of morbidity and mortality. We aimed to examine the association of cognitive impairment (CI) and diabetes mellitus (DM) on all-cause mortality in the aged with hypertension (HTN).

Methods
This is a prospective cohort study with a sample of 1017 older people with hypertension aged 60 years or older who completed baseline examinations in 2009–2010 and followed up for ten years in 2020. The endpoint was death from any cause. Subjects were categorized as HTN only, HTN + DM, HTN + CI, and HTN + DM + CI. Cox regression model was used to determine the association of comorbidities on all-cause mortality.

Results
During the 10-year follow-up period, 196 deaths occurred. After adjusted for covariates, risk of death from any cause was significantly increased in the older people with increased comorbidities (P = 0.003). Compared with the HTN only, with HTN + CI, and HTN + DM + CI, the HRs (95% confidence intervals) for all-cause mortality were 1.61(1.13–2.30) and 1.79(1.07–2.99), respectively. In stratified analyses, the relationship between comorbidities level and the risk of all-cause mortality persisted.

Conclusion
All-cause mortality risks increased with increasing the comorbidities. This study emphasizes the importance of comprehensive management of the older people with HTN in clinical practice and public health policy.