bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving the Accuracy of Emergency Department Clinicians in Detecting SARS-COV-2 on Chest X-Rays Using a Bespoke Virtual Training Platform
Authors: Bahra Jasdeep , Acharya Anita , Ather Sarim , Benamore Rachel , Moreland Julie-Ann , Gulati Divyansh , How Lee , Rose Anne , Huwae Miranthi , Wilson Sarah , Banerji Abhishek , Manso Katerina , Keating Liza , Barrett Amy , Gleeson Fergus , Novak Alex 
Published: June 2023

Abstract
Background
During and after the COVID pandemic, online learning became a key component in most undergraduate and post-graduate training. The non-specific symptoms of COVID-19 and limitations of available diagnostic tests can make it difficult to detect and diagnose in acute care settings. Accurate identification of SARS-CoV-2 related changes on chest x-ray (CXR) by frontline clinicians involved in direct patient care in the Emergency Department (ED) is an important skill. We set out to measure the accuracy of ED clinicians in detecting SARS-CoV-2 changes on CXRs and assess whether this could be improved using an online learning platform.
Methods
Baseline reporting performance of a multi-centre cohort of ED clinicians with varying experience was assessed via the Report and Image Quality Control (RAIQC) online platform. Emergency Medicine clinicians working in EDs across five hospitals in the Thames Valley Emergency medicine Research Network (TaVERN) region were recruited over a six-month period. An image bank was created containing both SARS-CoV-2 and non- SARS-CoV-2 pathological findings. Radiological ground truth diagnosis was established by thoracic radiologists. Participants then undertook an online training module with performance re-assessed. Diagnostic accuracy and speed of X-ray reporting was assessed before and after training in 3 subgroups: Consultants, Junior Doctors and Nurses.
Results
90 clinicians undertook pre-training assessment with an overall reporting accuracy of 43.8 (±9.89)% across all cases. 56 participants completed the post-training assessment and reporting accuracy improved to 57.4 (±9.39)% (p<0.001). The sensitivity for recognition of SARS-CoV-2 improved from 64.7% to 76.8%.
Conclusion
ED clinicians show moderate baseline accuracy in the identification of SARS-CoV-2 related changes on CXR. Accuracy and speed can be improved by online training.
Emerging highly porous activated carbon by pyrolysis-KOH chemical simultaneous-CO2 physical activation of waste tires for Cr(VI) and Cd(II) removal
Authors: Ahi Zeinab , Roshanravan Bita , Younesi Habibollah , Bahramifar Nader 
Published: June 2023

Abstract
In this work, waste tires (WTs) were carbonized under an N2 atmosphere, and then KOH/WTs-char with KOH assisted-CO2 activation was used to prepare activated carbon (AC) as an emerging highly porous carbon to remove Cr(VI) and Cd(II) from a water media. Several techniques, including elemental analysis, Fourier-transform infrared spectroscopy, scanning electron microscopy, and N2 adsorption/desorption techniques, were operated to explore the physical and chemical features of the as-prepared carbons. The WTs-char activated with KOH under CO2 displayed a microstructure with a high BET surface area and pore volume of 1841 m2/g and 0.869 cm3/g, respectively, that exhibited excellent adsorbent performance. Adsorption kinetics was well-matched with the pseudo-second-order equation, and all equilibria were well-matched with the Redlich-Peterson isotherm equation. The positive values of ∆Go confirmed that the uptake process of both ions was nonspontaneous and that feasibility increased with increasing temperatures. The negative values of ΔH° and ΔS° were attained for both ions on carbon, revealing the exothermic nature of the adsorption and disorder decrease. However, the small activation energy revealed that the adsorption was kinetically favored. This study demonstrated the preparation of emerging carbon by effectively high pore structures and the adsorption performance of the carbons on Cr(VI) and Cd(II) ions.
Hierarchical decision-making mechanism of perioperative restricted red blood cell infusion based on cerebral regional oxygen saturation
Authors: Cao Yin , Yang Wanmei , Yang Xiaodong , Chen Yijun , Huang Changshun 
Published: June 2023

Abstract
Background/Objective：
We aimed to establish a hierarchical decision-making mechanism for perioperative restricted red blood cell transfusion based on cerebral regional oxygen saturation (rSO2), and evaluate its role in blood transfusion management in elderly patients undergoing total knee replacement (THR) or total hip replacement (TKA).
Methods:
Eighty elderly patients with perioperative hemoglobin (Hb) in the range of 70 g/L to 100 g/L were divided into study group (improved restrictive transfusion group) and control group ("peri-operative transfusion trigger score (POTTS)" group) by random number table method. The person number of blood transfusion, the average volume of red blood cells transfused, rSO2 and Hb levels of all patients, and the number of patients with postoperative delirium (POD) were recorded.
Results:
The person number of blood transfusion and the average volume of red blood cells transfused in the study group were higher than those in the control group (P<0.05). From the first day to the seventh day after surgery, the Hb level in the study group was significantly higher than that in the control group (P<0.05). On the second and third day after surgery, rSO2 in the study group was significantly higher than that in the control group, and POD incidence was lower than that in the control group (P<0.05). Correlation analysis of rSO2 and Hb levels in all patients throughout the whole process r=0.923, higher rSO2 on the second and third day after surgery was the protective factor of POD (P<0.05).
Conclusion:
The decision-making mechanism of improved restrictive transfusion consumes more blood resources, but it also significantly increases the levels of rSO2 and Hb in elderly patients and reduces the incidence of POD.
Protective effects of Allium macrostemon extract on adipose tissue and liver dysregulation induced by high-fat diet and bisphenol A in C57BL/6 mice
Authors: Kim Juhae , Youn Isoo , Seo Eun Kyoung , Kim Choon Young 
Published: June 2023

Abstract
Exposure of humans to high-fat (HF) diet and bisphenol A (BPA) has increased in recent times, and co-exposure to these causes harmful tissue toxicity. Here, the preventive effect of Allium macrostemon (AM) extract against dysfunction of adipose tissue and the liver under co-exposure to BPA and HF diet was examined. C57BL/6 mice were fed control (CON) diet, HF diet, HF diet with an oral injection of BPA (HF + BP), or HF diet with an oral co-injection of BPA and AM extract (HF + BP + AM). While HF feeding increased body weight gain compared to CON feeding, BP + HF suppressed body weight gain. BP + HF with lower body weight than HF had similar epididymal fat mass and inflammatory stress as HF, but significantly higher serum triglyceride and free fatty acid levels. In the liver, altered endoplasmic reticulum (ER) stress response and decreased autophagy were observed in HF + BP, as shown by increased t-IRE1α, p-JNK, and p62 levels and decreased beclin-1 protein levels, compared to those in HF. HF + BP + AM reduced HF and BPA-induced pro-inflammatory responses in adipose tissue, ER stress in liver, and total cholesterol level in serum. In addition, ecdysterone 25-O-β-D-glucopyranoside and 6-gingerol were firstly identified in AM extract by mass spectrometry and molecular networking analysis. In summary, the AM extract diminished liver and adipose tissue dysregulation, including hepatic ER stress and adipose tissue inflammation while a HF diet and BPA co-exposure induced harmful health outcomes in adipocytes and the liver. Therefore, AM has the potential to alleviate the harmful effects of a HF diet and BPA via anti-ER stress and anti-inflammatory activities.
miR-3606-3p alleviates skin fibrosis by suppressing fibroblast inflammation and migration via inhibiting GAB1 and ITGAV
Authors: Chen Yahui , Gong Yiyi , Shi Mengkun , Tang Yulong , Huang Delin , Wang Wei , Shi Chenyi , Xia Xueyi , Ma Yanyun , Huang Yan , Wang Ziyu , Wang Lei , Tu Wenzhen , Zhao Yinhuan , Lin Jinran , Jin Li , Wu Wenyu , Wang Jiucun , Shi Xiangguang 
Published: June 2023

Abstract
Systemic sclerosis (SSc) and keloid are typical skin fibrotic diseases with unclear epigenetic mechanisms and clinical targets, this study aimed to assess the role of miR-3606-3p in skin fibrosis and the therapeutic potential. MiR-3606-3p was reduced in the skin tissues and fibroblasts from both SSc and keloid patients. RNA-seq analysis and in silico prediction indicated GRB2 associated binding protein 1 (GAB1) and integrin subunit alpha V (ITGAV) were potential targets of miR-3606-3p. We then found that miR-3606-3p downregulated both GAB1 and ITGAV by directly targeting their 3′-UTRs, and further reduced p-AKT and p-ERK activities to inhibit collagen synthesis and fibroblast inflammation. Furthermore, miR-3606-3p inhibited fibroblast migration in primary fibroblasts and keloid-bearing nude mice by wound healing scratch assay and in vivo imaging techniques respectively. In contrast, GAB1 and ITGAV were upregulated in SSc and keloid patients, and siRNA-mediated GAB1 or ITGAV knockdown replicated the phenotypes observed in miR-3606-3p-overexpressing fibroblasts, including inflammation, migration and fibrogenesis. Finally, in vivo experiments showed that miR-3606-3p treatment significantly alleviates skin fibrosis in keloid-bearing mice. Our results indicated miR-3606-3p inhibits ECM deposition, inflammation, and migration of fibroblasts by downregulating GAB1 and ITGAV. miR-3606-3p-enhancing strategies may have beneficial effects on skin fibrosis through lowing p-AKT/p-ERK activity.
Mirror, mirror, on the wall, who is the oldest man in the land? Perhaps the sleepy one!
Authors: Bukhari Shervin , Thompson Mark , Meth Elisa M.S. , Benedict Christian 
Published: June 2023

Abstract
This study aimed to investigate the impact of sleep deprivation on the perceived age appearance of individuals, with a particular focus on subjective sleepiness. The study involved 380 anonymous observers who participated in an online survey. The observers were shown photographs of a Caucasian man, aged 48.2 years, and were asked to estimate his age. The results demonstrated that after 42.6 hours of continuous wakefulness, his estimated age was 2.9 years older than his actual age (p<0.001). Additionally, the study revealed that the sleepier the observers felt during the evaluation, the older they perceived the man to be (p<0.05). These findings suggest that sleep loss may impact how old someone is perceived and that sleepiness may impact how observers estimate others’ age. However, it is important to replicate these findings in diverse populations, including women, individuals from different ethnic backgrounds, and individuals of various age groups who experience sleep loss.
Cervical-Shoulder Syndrome: Shoulder and Cervical Surgeries Are Risk Factors for Each Other
Authors: Liang Chun-Ming , Hung Kuo-Hsien , Tsui Ho , Kao Feng-Chen , Yen Chung-Yo , Tu Yuan-Kun 
Published: June 2023

Abstract
Aim: Converging symptoms of cervical spine and shoulder pathologies can lead to misdiagnosis and unsatisfying outcomes of corresponding surgical interventions, as those seen in published research on hip-spine syndrome. In addition, the intricate biomechanical interdependence between these two sites may be altered after surgery at either site, potentially putting the untreated site at danger of further injury. Thus, this study will examine whether certain surgeries at cervical spine and shoulder joint can be a risk factor for each other.
Method: Reimbursement claims of certain shoulder-related and cervical-related surgery from January 1st 2000 to December 31st 2016 were included according to their diagnosis and treatment codes via Taiwan National Health Insurance Research Database (NHIRD) service. Collected subjects in both groups will be matched with control subjects who did not have that surgery based on age, gender, index date and Charlson Comorbidity Index (CCI). Odds ratio and hazard ratio of having surgeries at the other site between patients with and without surgery at one site will be calculated with logistic regression model.
Result: The odds ratios of having certain cervical spine surgeries between shoulder surgery subjects and matched controls within 3, 6 and 12 months are 1.78(1.27-2.49), 2.19(1.75-2.75) and 2.55(2.17-3.00), respectively. The odds ratios of having certain shoulder surgeries between cervical subjects and matched controls are 2.08(1.48-2.94), 2.88(2.30-3.61) and 3.32(2.82-3.90), respectively. Hazard ratio of having certain surgeries at the other site between subjects and controls is 3.36(2.86-3.96) for cervical group, and 2.54(2.16-2.98) for shoulder group.
Conclusion: Certain cervical surgeries are risk factors of certain shoulder surgeries and vice versa. Detailed physical examinations should be regularly conducted at both sites before arranging surgeries for either one. Preventative measures and early screening for pathologies at the other site should be initiated as soon as allowed to reduce further medical expenses.
Modified paddy husk carbon with linked fibrils of FeHO₂ using aluminium as surface regulator for enhanced As (III) removal in fixed bed system
Authors: Ahmad Samreen , Gautam Shashi Bala , Sawood Ghazi Mohd , Dixit Shobhit , mishra ashutosh 
Published: June 2023

Abstract
The As (III) uptake capacity of Fe impregnated AC greatly depends on availability of active surface sites of Iron Oxide, which is determined by the surface area of the anchoring particles. In this context, utilizing Al as a surface regulator, we proposed a process to attach linked fibrils of FeHO₂ with the objective of developing an adsorbent with enhanced As (III) adsorption capacity. The procedure was based on hydrothermal process using paddy husk based AC, and both Iron and aluminium ions in the test hydrolysis solution. By a dynamic approach that would enable an industrial-scale treatment, fixed column adsorption tests were conducted to enhance the generation of cleaner effluents and further study the primary mechanisms involved in the adsorption process. CCD was employed to evaluate the interactions between various operating process variables and their effects on the breakthrough time for optimization of As (III) adsorption process. The exhaust time was observed to rise with increasing dose, falling flow rate, and influent concentration. The CCD optimization result showed that the FeAlPBC was an efficient and cost effective adsorbent with a maximum response of 1681 min, when the independent parameters were retained at 15.0 g FeAlPBC dose, 500 µg/L influent concentrations, 2.0 mL/min flow rate, and a desirability value of 0.986. To further comprehend the primary adsorption mechanisms, the breakthrough curves were predicted by application of the test data in the Thomas, Adam-Bohart, Yoone-Nelson, and Advection diffusion models. The experimental results and Thomas and Advection diffusion models were in good agreement. 0.1 M NaOH solution was used to regenerate the columns. The FeAlPBC samples can be recycled upto four cycles with little to no reduction in adsorption capacity. Also, the TCLP test demonstrated that the used FeAlPBC were inert and could be put into landfills without risk. In conclusion, FeAlPBC is a strong contender for removing As (III) from potable water and has a wide range of potential future applications.
Association of Maternal Blood Mercury Concentration during the First Trimester of Pregnancy with Birth Outcomes: A Nested Case- Control Study
Authors: Zhu Yibing , Miao Chong , Sun Bin , Wu Zhengqin , Wang Xinrui , Li Haibo , Gao Haiyan , Cao Hua , Li Wei 
Published: June 2023

Abstract
Background Research has shown that mercury exposure in early pregnancy, as one of the toxic metals, may be related to birth outcomes. Fujian Province, as one of the largest seafood-consuming provinces in China, is at risk of mercury exposure.However, literature on mercury exposure and pregnancy outcomes in Chinese pregnant women is limited. Therefore, the aim of our study was to investigate a possible association between maternal mercury (Hg) exposure and spontaneous preterm birth (SPB) and birth weight.
Methods This study was a nested case-control study based on the birth cohort project of Fujian Maternal and Child Health Hospital. The maternal blood mercury concentration of 10-16 weeks of gestation were measured. Paired logistic regression analysis was used to analyze the relationship between blood mercury concentrations and SPB, including the unadjusted model and the model. Estimation of the effect of mercury on birth weight was by smooth spline regression with adjustment for potential confounders. Tests for trend were assessed by modelling the quartiles of mercury concentration as continuous variables using integer values. In addition, the dose-response relationship between mercury concentration and birth outcomes was estimated using restricted cubic spline (RCS) regression.
Results A total of 240 participants were enrolled in this study, including 120 control group and 120 SPB group. Except for gestational age, other characteristics were not significantly different in 4 quartile groups (P>0.05). Adjusted smoothed plots suggest a linear relationship between blood mercury concentration and SPB (OR=1.12, 95% CI=0.97-1.28, P=0.124). Higher blood mercury concentration was associated with a higher risk of SPB (Q3 vs Q1: crude OR=2.50, 95% CI=1.16-5.41; adjusted OR=2.54, 95% CI=1.12-5.74). There was no significant association between blood mercury concentration during the first trimester and birth weight (adjusted coefficient:14.51, 95% CI=-5.36-34.38).
Conclusions We found that maternal blood mercury concentration was positively associated with SPB in a dose-dependent manner. Further research is needed to investigate the association between the main source of mercury exposure and SPB. and mechanism studies were warranted to explore the underlying pathways.
A study of micro space-time theory and time dilation in bound muon decay
Authors: Deng Jian-Bo , Deng Miao-Yi , Ma Shi-Jie , Fan Qi-Qi , He Peng-Zhang , He Yi-Peng , Li Shuo-Wen , Hu Xianru 
Published: June 2023

Abstract
This paper proposes a space-time theory for describing the physical laws of the micro-world by introducing scalar fields $\mathcal{D}\left(x\right)$ and $\zeta\left(x\right)$. A new field action is constructed, and the Lagrangian for particle motion is rewritten, resulting in a modified space-time relation. The Klein-Gordon equation is theoretically derived using the Hamilton-Jacobi method in four dimensions. To experimentally test the correctness of this theory, we further investigate the time delay between proper time and local coordinate time caused by $\mathcal{D}\left(x\right)$ and discuss the decay rate of bound muons in different elements. The results are consistent with the proposed theory.
Mattering in older adults in service-assisted recovery processes from substance use problems: Conditions, experiences, and implications for action
Authors: Bahl Nina , Nafstad Hilde , Blakar Rolv , Øversveen Emil , Brodahl Morten , Ness Ottar , Prilleltensky Isaac 
Published: June 2023

Abstract
Aim: Mattering is a fundamental human experience promoting crucial components to later-life recovery processes. Today, the largest population of older adult persons with substance use problems, so far, is on a steep rise in many Western countries. To tailor and offer substance use services promoting mattering, more knowledge about later life mattering of older adults recovering with the assistance of substance use services is needed. This study aims to explore conditions for, and experiences of, mattering in older adults in service-assisted recovery from substance use problems.
Methods: A collaborative and deductive reflexive thematic approach was applied in analysing 23 interviews with participants using substance use services in their recovery processes from different substance use problems: alcohol, medication and illegal substances. The participants were recruited from three different Norwegian contexts: two urban and one medium size municipality. The age of the sample ranged from 65-80 years, with approximately equal numbers for those aged 60-69 (12 participants) and 70-80 (11 participants). Seven participants were women and 16 men.
Results: Two main themes were identified in the data: “Conditions for later life mattering” and “Experiences of mattering from community relationships and own actions”. The findings illustrate various conditions for mattering and experiences of mattering and not mattering in later life recovery processes.
Conclusions: Several participants experienced not mattering; promoted by lack of support, disrespect and devaluation and loss of relationships, but also being ignored and not receiving fair treatment and help by service professionals. Overall, the participants’ mattering depended on fair and healthy community relationships; fair distribution of resources such as affordable housing, accessible transportation, and fair organizational structures where participants could feel valued and also have a chance themselves to add value to others. Several practical implications to enhance the therapeutic and preventive potentials of later life mattering in recovery are suggested.
An elderly case of paraneoplastic anti-NMDA receptor limbic encephalitis associated with large cell neuroendocrine carcinoma of the lung
Authors: Naka Masamitsu , Inaba Atsushi , Miyasaka Hana , Suzue Keisuke , Ishigaki Junichi , Shibuya Hideki , Hara Kei , Ohishi Nobuya , Sugiyama Yusuke , Shiio Yasushi , Tajiri Ryosuke , Kishida Yukiko , Ishihara Tasuku , Yugeta Akihiro 
Published: June 2023

Abstract
Background
Recent studies have suggested that N-methyl-D-aspartate (NMDA) receptors are involved in the cell proliferation in several tumors. However, there have been no reports demonstrating the expression of NR1 subunit of the NMDA receptor in large cell neuroendocrine carcinoma (LCNEC).
Case presentation
Here, we report the first elderly case of paraneoplastic anti-NMDA receptor limbic encephalitis associated with LCNEC of the lung with NR1 expression. Of note, NR1 subunit expression in the tumor cells of the present case was confirmed by immunohistochemistry (IHC). Radiation therapy and immunotherapies, such as corticosteroids and intravenous immunoglobulin (IVIG), shrank the tumors and improved neurological symptoms in the present case. Additionally, we also confirmed the expression of NR1 in the tumor cells obtained from three other cases with LCNEC of the lung at our hospital by IHC.
Conclusion
Our IHC results indicate that LCNEC generally expresses NR1 subunit and NMDA receptor may be involved in the tumor development and growth.