bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mid-term outcomes of patients with subclinical hypothyroidism after coronary bypass surgery
Authors: Zhao Dong , Zhao Wei , Wang Chuangshi , Xu Fei , Zhao Wei , Tiemuerniyazi Xieraili , Ma Hao , Feng Wei 
Published: July 2023

Abstract

OBJECTIVES
Subclinical hypothyroidism (SCH) is characterized by an elevated thyroid-stimulating hormone and normal free thyroxine. This study aimed to evaluate the influence of SCH on mid-term outcomes of patients after coronary artery bypass grafting (CABG).

METHODS
From January 2015 to December 2018, 548 SCH patients and 6718 euthyroid patients who underwent CABG were identified. Propensity score matching was used to create 2 cohorts with similar baseline characteristics (n = 544 in each group). The mid-term follow-up outcomes were compared. Adjusted hazard ratios (HRs) were calculated using Cox proportional hazards models.

RESULTS
The mean follow-up for all patients was 39.7 ± 17.3 months. The unadjusted Kaplan–Meier estimate for mortality at 5-year follow-up was higher in patients with SCH compared with euthyroid patients (5.3% vs 1.6%, log-rank P = 0.03). After adjusting for covariates, the risk of mortality was higher in patients with SCH compared with euthyroid patients [HR, 2.40; 95% confidence interval (CI), 1.03–5.58; P = 0.04]. The adjusted risk of major adverse cardiovascular and cerebral event (HR, 2.16; 95% CI, 1.51–3.08; P &lt; 0.001) and angina (HR, 2.44; 95% CI, 1.41–4.24; P = 0.001) was higher in patients with SCH compared with euthyroid patients.

CONCLUSIONS
SCH is associated with an increased risk of mortality, major adverse cardiovascular and cerebral event and angina compared with euthyroidism in patients undergoing CABG.
A BIM-based framework for automatic numerical modelling and geotechnical analysis of a large-scale deep excavation for transportation infrastructures
Authors: Shi Chao , Jin Yunfei , Lu Hu , Shi Jiangwei 
Published: July 2023

Abstract
Employing emerging information and communication technologies such as building information modelling (BIM) to streamline engineering design and analysis has been mainstream over the past several years. Although BIM models are well established for aboveground infrastructures, underground BIM is still in its infancy. On one hand, valuable subsurface ground models are missing in current BIM applications as site-specific geotechnical data are often sparse and limited. On the other hand, BIM has been mainly used as a visualization tool for concise representation of design and construction data, and it has not been integrated and utilized to assess geotechnical risks associated with underground infrastructures. This paper proposes a BIM-based approach for automatic numerical modelling and geotechnical analysis. Structural information (e.g. geometries) of different project BIMs are grouped, exported, and saved, which provides a unified interface for automatic information extraction using computer codes (e.g. Python). Subsequently, subsurface ground models generated from sparse data are integrated with extracted basic geometric properties for automatic geotechnical model setup and finite element analysis. The performance of the proposed framework is illustrated using a real deep excavation project. It is revealed that BIM, as a data repository, enables timely and accurate information exchange between structural and geotechnical models in an automatic manner, which emphasizes the need of a BIM-based approach for assessing and managing geotechnical risks associated with deep excavations for underground transportation infrastructures, especially in the urban context.
Long-term alliance for pathology equipment and technology acquisition: a paradigm shift for improved quality and efficiency
Authors: Singh Gurmukh , Vinson Kellie A , Jones Kari , Gunsolus Brandy , Keever Jeremy , Keel Brooks A 
Published: July 2023

Abstract

Objective
Personnel costs are the largest single budget item in the clinical laboratory, other major expenses being equipment, analyzers, blood and blood components, and cost of day-to-day consumables. This report describes our experience with developing a long-term relationship with a single major vendor as a paradigm shift from the traditional multiple vendors, multiple contracts, and recurrent extended negotiations. Our objective was to develop a long-term approach for replacement of effete equipment and upgrades to operations in a pathology and laboratory medicine department in collaboration with vendors providing equipment and services.

Methods
Major vendors were invited to visit the department to analyze the workload and workflow and suggest integrated solutions to meet the goals of the department. Multiple iterations of the proposals were evaluated, and a recommendation made to the medical center leadership. The vendor, the medical center, and the department jointly developed a 15-year partnership plan to improve the operations of pathology services. The agreement encompasses a range of management and performance criteria for both sides. The salient items discussed were laboratory staffing, turnaround time, workload change, test insourcing, reference laboratory costs, and scholarly productivity and teaching.

Results
The agreement reduced laboratory staffing by 21%, eliminated stat tests by reducing the turnaround time for routine tests to less than 45 minutes for 90% of tests, with an increase of 9.1% in the number of tests, Cost avoidance in salary and reference laboratory costs was $3,424,136/year against an expected target of $2 million in total savings, despite not including cost avoidance from promoting appropriate use of laboratory testing for inpatients and increase in revenue from increase in ambulatory testing. Vizient score in laboratory utilization improved from the 94th to 76th percentile. Scholarly output increased by more than 100%.

Conclusion
This model of a long-term alliance with a chosen vendor led to improvements in quality and efficiency.
The ubiquity of carbon dredge-up in hydrogen-deficient white dwarfs as revealed by GALEX
Authors: Blouin Simon , Kilic Mukremin , Bédard Antoine , Tremblay Pier-Emmanuel 
Published: July 2023

ABSTRACT
The convective dredge-up of carbon from the interiors of hydrogen-deficient white dwarfs has long been invoked to explain the presence of carbon absorption features in the spectra of cool DQ stars ($T_{\rm eff} \lt 10\,000\,$K). It has been hypothesized that this transport process is not limited to DQ white dwarfs and also operates, albeit less efficiently, in non-DQ hydrogen-deficient white dwarfs within the same temperature range. This non-DQ population is predominantly composed of DC white dwarfs, which exhibit featureless optical spectra. However, no direct observational evidence of ubiquitous carbon pollution in DC stars has thus far been uncovered. In this Letter, we analyse data from the Galaxy Evolution Explorer to reveal the photometric signature of ultraviolet carbon lines in most DC white dwarfs in the $8500\, {\rm K} \le T_{\rm eff} \le 10\,500\,$K temperature range. Our results show that the vast majority of hydrogen-deficient white dwarfs experience carbon dredge-up at some point in their evolution.
Real-world efficacy of belimumab in achieving remission or low-disease activity in systemic lupus erythematosus: A retrospective study
Authors: Hasegawa Yasuhiro , Arinuma Yoshiyuki , Asakura Hirotomo , Shindo Risa , Ino Kazuma , Kanayama Yoshiro , Tanaka Tomoki , Matsueda Yu , Wada Tatsuhiko , Oku Kenji , Yamaoka Kunihiro 
Published: July 2023

ABSTRACT

Objectives
We investigated the effect of belimumab (BEL) on achieving low disease activity (LDA) and remission as an additive molecular-targeting agent to standard of care (SoC) in patients with systemic lupus erythematosus (SLE).

Methods
Clinical information was retrospectively collected from patients with SLE who received BEL additive to SoC (BEL + SoC), and from patients treated with SoC alone as a control arm. Disease activity was measured by SLE-disease activity score (SLE-DAS). The proportion of patients in LDA and remission at 12 months was compared after propensity score matching. The factors contributing to LDA and remission achievement were identified by Cox proportional hazard model.

Results
BEL + SoC significantly reduced SLE-DAS at 6 months, with a significantly higher proportion of patients achieving LDA and remission at 12 months compared to SoC alone. The presence of arthritis at baseline was significantly associated with achieving LDA and remission. Additionally, both treatment groups experienced a significant reduction in daily glucocorticoid dose.

Conclusions
Adding BEL to SoC was beneficial for patients with arthritis, leading to higher proportion of achieving LDA and remission, while also reducing their glucocorticoid dose. Our results indicate the utility of BEL in a treat-to-target approach for SLE patients in a real-world setting.
Finite-range effect in the two-dimensional density-induced BCS–BEC crossover
Authors: Sakakibara Hikaru , Tajima Hiroyuki , Liang Haozhao 
Published: July 2023

Abstract
We theoretically investigate the Bardeen–Cooper–Schrieffer (BCS) to Bose–Einstein condensation (BEC) crossover in a two-dimensional Fermi gas with the finite-range interaction by using the Hartree–Fock–Bogoliubov theory. Expanding the scattering phase shift in terms of the scattering length and effective range, we discuss the effect of the finite-range interaction on the pairing and thermodynamic properties. By solving the gap equation and the number equation self-consistently, we numerically calculate the effective-range dependence of the pairing gap, chemical potential, and pair size throughout the BCS–BEC crossover. Our results would be useful for further understanding of low-dimensional many-body problems.
A multimodal celestial object classification network based on 2D spectrum and photometric image
Authors: Zhang Mingru , Gao Junping , Luo A-Li , Jiang Xia , Zhang Liwen , Wu Kuang , Qiu Bo 
Published: July 2023

ABSTRACT
In astronomy, classifying celestial objects based on the spectral data observed by astronomical telescopes is a basic task. So far, most of the work of spectral classification is based on 1D spectral data. However, 2D spectral data, which is the predecessor of 1D spectral data, is rarely used for research. This paper proposes a multimodal celestial classification network (MAC-Net) based on 2D spectra and photometric images that introduces an attention mechanism. In this work, all 2D spectral data and photometric data were obtained from LAMOST (the Large Sky Area Multi-Object Fiber Spectroscopic Telescope) DR6 and SDSS (Sloan Digital Sky Survey), respectively. The model extracts the features of the blue arm, red arm, and photometric images through three input branches, merges the features at the feature level and sends them to its classifiers for classification. The 2D spectral data set used in this experiment includes 1223 galaxy spectra, 466 quasar spectra, and 1202 star spectra. The same number of photometric images constitute the photometric image data set. Experimental results show that MAC-Net can classify galaxies, quasars, and stars with a classification precision of 99.2 per cent, 100 per cent, and 97.6 per cent, respectively. And the accuracy reached 98.6 per cent, it means that the similarity between this result and the results obtained by the LAMOST template matching method is 98.6 per cent. The results exceed the performance of the 1D spectrum classification network. At the same time, it also proves the feasibility and effectiveness of directly using 2D spectra to classify celestial bodies by using MAC-Net.
When the brain turns on with sexual desire: fMRI findings, issues, and future directions
Authors: Bittoni Celeste , Kiesner Jeff 
Published: July 2023

Abstract

Introduction
More than 2 decades of neuroimaging research has sought to uncover the neurologic basis of sexual desire. However, the lack of a clear conceptual distinction between sexual desire and sexual arousal or even a broadly accepted definition of sexual desire has led to confusion in the literature regarding brain areas uniquely associated with sexual desire.

Objectives
(1) To critically review the neuroimaging literature that seeks to identify brain areas and networks involved in sexual desire; (2) to identify and discuss those brain areas and potential networks that are most promising for providing insights to sexual desire; and (3) to offer recommendations for future studies.

Methods
Existing meta-analyses were used as a starting point to identify relevant neuroimaging studies on sexual desire, arousal, and love. This base was then expanded via Google Scholar and forward citation tracking of already identified studies.

Results
Brain areas that are commonly associated with sexual desire and arousal include the amygdala, hypothalamus, dorsal and ventral striatum, anterior cingulate, insula, and prefrontal and orbitofrontal cortex. However, because the same basic paradigm has been used to study sexual desire and arousal, unambiguous conclusions regarding areas uniquely involved in sexual desire cannot be drawn. Moreover, the lack of connectivity analyses and a failure to acknowledge negative BOLD (blood-oxygen level dependent) significantly limit conclusions on the neural basis of sexual desire.

Conclusion
Five recommendations are made. First, stimulus types (ie, erotic vs sexually explicit) should be selected by the meaningful theoretical conceptualization of the constructs of interest. Second, participants should be provided with definitions of sexual desire, mental sexual arousal, and perceived genital sexual arousal, so they can choose which terms best describe their experience. Third, event-related designs should be used with caution when investigating sexual desire. Fourth, time series analyses should be used to identify both positive and negative BOLD. Fifth, connectivity analyses should be performed to identify brain networks.
Using Natural Language Processing and Machine Learning to Identify Internal Medicine–Pediatrics Residency Values in Applications
Authors: Drum Benjamin , Shi Jianlin , Peterson Bennet , Lamb Sara , Hurdle John F. , Gradick Casey 
Published: July 2023

Problem
Although holistic review has been used successfully in some residency programs to decrease bias, such review is time-consuming and unsustainable for many programs without initial prescreening. The unstructured qualitative data in residency applications, including notable experiences, letters of recommendation, personal statement, and medical student performance evaluations, require extensive time, resources, and metrics to evaluate; therefore, previous applicant screening relied heavily on quantitative metrics, which can be socioeconomically and racially biased.

Approach
Using residency applications to the University of Utah internal medicine–pediatrics program from 2015 to 2019, the authors extracted relevant snippets of text from the narrative sections of applications. Expert reviewers annotated these snippets into specific values (academic strength; intellectual curiosity; compassion; communication; work ethic; teamwork; leadership; self-awareness; diversity, equity, and inclusion; professionalism; and adaptability) previously identified as associated with resident success. The authors prospectively applied a machine learning model (MLM) to snippets from applications from 2023, and output was compared with a manual holistic review performed without knowledge of MLM results.

Outcomes
Overall, the MLM had a sensitivity of 0.64, specificity of 0.97, positive predictive value of 0.62, negative predictive value of 0.97, and F1 score of 0.63. The mean (SD) total number of annotations per application was significantly correlated with invited for interview status (invited: 208.6 [59.1]; not invited: 145.2 [57.2]; P < .001). In addition, 8 of the 10 individual values were significantly predictive of an applicant’s invited for interview status.

Next Steps
The authors created an MLM that can identify several values important for resident success in internal medicine–pediatrics programs with moderate sensitivity and high specificity. The authors will continue to refine the MLM by increasing the number of annotations, exploring parameter tuning and feature engineering options, and identifying which application sections have the highest correlation with invited for interview status.
Exploring challenges in the management and treatment of inclusion body myositis
Authors: Skolka Michael P. , Naddaf Elie 
Published: July 2023

Purpose of review
This review provides an overview of the management and treatment landscape of inclusion body myositis (IBM), while highlighting the current challenges and future directions.

Recent findings
IBM is a slowly progressive myopathy that predominantly affects patients over the age of 40, leading to increased morbidity and mortality. Unfortunately, a definitive cure for IBM remains elusive. Various clinical trials targeting inflammatory and some of the noninflammatory pathways have failed. The search for effective disease-modifying treatments faces numerous hurdles including variability in presentation, diagnostic challenges, poor understanding of pathogenesis, scarcity of disease models, a lack of validated outcome measures, and challenges related to clinical trial design. Close monitoring of swallowing and respiratory function, adapting an exercise routine, and addressing mobility issues are the mainstay of management at this time.

Summary
Addressing the obstacles encountered by patients with IBM and the medical community presents a multitude of challenges. Effectively surmounting these hurdles requires embracing cutting-edge research strategies aimed at enhancing the management and treatment of IBM, while elevating the quality of life for those affected.
Hemosiderotic Xanthelasmas. A New Clinicopathological Variant of Xanthelasma Palpebrarum or a Localized Variant of Xanthosiderohistiocytosis of the Eyelids?
Authors: Lobato-Berezo Alejandro , March-Rodríguez Álvaro , Pujol Ramon M. , Fernández-Figueras María Teresa 
Published: July 2023

Abstract:
Xanthelasma palpebrarum represent the most common subtype of cutaneous plane xanthomas. Xanthosiderohistiocytosis is considered a rare variant of xanthoma disseminatum, with only 4 cases reported to date. We report the case of a man with progressive pigmented lesions on the 4 eyelids that could correspond to hemosiderotic xanthelasmas or a localized variant of xanthosiderohistiocytosis.
Pain management after cardiac surgery via median sternotomy
Authors: Maeßen Timo , Korir Nelson , Van de Velde Marc , Kennes Jelle , Pogatzki-Zahn Esther , Joshi Girish P. 
Published: July 2023

BACKGROUND
Pain after cardiac surgery via median sternotomy can be difficult to treat, and if inadequately managed can lead to respiratory complications, prolonged hospital stays and chronic pain.

OBJECTIVES
To evaluate available literature and develop recommendations for optimal pain management after cardiac surgery via median sternotomy.

DESIGN
A systematic review using PROcedure-SPECific Pain Management (PROSPECT) methodology.

ELIGIBILITY CRITERIA
Randomised controlled trials and systematic reviews published in the English language until November 2020 assessing postoperative pain after cardiac surgery via median sternotomy using analgesic, anaesthetic or surgical interventions.

DATA SOURCES
PubMed, Embase and Cochrane Databases.

RESULTS
Of 319 eligible studies, 209 randomised controlled trials and three systematic reviews were included in the final analysis. Pre-operative, intra-operative and postoperative interventions that reduced postoperative pain included paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), intravenous magnesium, intravenous dexmedetomidine and parasternal block/infiltration.

CONCLUSIONS
The analgesic regimen for cardiac surgery via sternotomy should include paracetamol and NSAIDs, unless contraindicated, administered intra-operatively and continued postoperatively. Intra-operative magnesium and dexmedetomidine infusions may be considered as adjuncts particularly when basic analgesics are not administered. It is not clear if combining dexmedetomidine and magnesium would provide superior pain relief compared with either drug alone. Parasternal block/surgical site infiltration is also recommended. However, no basic analgesics were used in the studies assessing these interventions. Opioids should be reserved for rescue analgesia. Other interventions, including cyclo-oxygenase-2 specific inhibitors, are not recommended because there was insufficient, inconsistent or no evidence to support their use and/or due to safety concerns.
Treatment of Immune Checkpoint Inhibitor-associated Myocarditis
Authors: Heemelaar Julius C. , Louisa Maria , Neilan Tomas G. 
Published: July 2023

Abstract:
Immune checkpoint inhibitors (ICIs) are a form immunotherapy where the negative regulators of host immunity are targeted, thereby leveraging the own immune system. ICIs have significantly improved cancer survival in several advanced malignancies, and there are currently more than 90 different cancer indications for ICIs. Most patients develop immune-related adverse events during ICI therapy. Most are mild, but a small subset of patients will develop severe and potentially fatal immune-related adverse events. A serious cardiovascular complication of ICI therapy is myocarditis. Although the incidence of myocarditis is low, mortality rates of up to 50% have been reported. The mainstay of ICI-associated myocarditis treatment is high-dose corticosteroids. Unfortunately, half of patients with myocarditis do not show clinical improvement after corticosteroid treatment. Also, high doses of corticosteroids may adversely impact cancer outcomes. There is an evidence gap in the optimal second-line treatment strategy. Currently, there is a paradigm shift in second-line treatment taking place from empirical corticosteroid-only strategies to either intensified initial immunosuppression where corticosteroids are combined with another immunosuppressant or targeted therapies directed at the pathophysiology of ICI myocarditis. However, the available evidence to support these novel strategies is limited to observational studies and case reports. The aim of this review is to summarize the literature, guidelines, and future directions on the pharmacological treatment of ICI myocarditis.
Oral Oncolytics and Cardiovascular Risk Management and Monitoring
Authors: White Raechel T. , Sirek Marie E. , Marrs Joel C. 
Published: July 2023

Abstract:
Oral oncolytic treatment options have expanded over the last decade and have brought to light the need to monitor and manage cardiovascular (CV) disease in patients being treated with these therapies. There is a need to assess CV risk before patients receive oral oncolytic therapy with known potential to cause negative CV sequelae such as left ventricular dysfunction, hypercholesterolemia, hypertension, and arrhythmias. The review highlights the need to evaluate traditional CV risk factors and their association with the development and progression of cancer. In addition, this review suggests approaches to monitor for CV adverse events and manage CV disease during and after treatment with oral oncolytic therapy. Key guideline recommendations are reviewed and highlight specific approaches to minimize CV harm for patients exposed to oral oncolytic therapy. Careful monitoring and patient-centered decision making are key in choosing appropriate therapies. A multidisciplinary approach between oncologists, cardio-oncologists, pharmacists, and other members of the health care team is essential in navigating cardiac toxicities.