bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Clinical Utility of Antroduodenal Manometry in the Evaluation of Children with Upper Gastrointestinal Symptoms
Authors: Arbizu Ricardo A. , Trauernicht Sean , Pinillos Sergio , Nurko Samuel , Rodriguez Leonel 
Published: September 2023

Objectives:Antroduodenal manometry (ADM) measures antral and small bowel motility and is clinically used to evaluate upper gastrointestinal (UGI) symptoms. We aimed to evaluate its utility in guiding treatment, predicting response, and association with clinical findings.Methods:Retrospective review of 200 children undergoing ADM. ADM interpretation and parameters were compared to outcomes (response to first therapy after ADM and overall response), predominant symptom (group A, abdominal distention and/or vomiting and group B, abdominal pain and/or nausea), etiology (idiopathic or with known comorbidity), and ADM indication [suspected chronic intestinal pseudo-obstruction (CIPO) or unexplained UGI symptoms].Results:We found an association between a normal intestinal phase III of the migrating motor complex (MMC) and idiopathic etiology, group B symptoms and unexplained UGI symptoms. No variable was associated with initial successful response. However, normal small bowel phase III of the MMC and idiopathic etiology were associated with overall successful response to treatment (including feeding tolerance and weaning of parenteral nutrition). No antral ADM parameter was associated with outcomes or other comparisons. The time to overall successful treatment response was significantly shorter in patients with a normal ADM and presence of a normal phase III of the MMC.Conclusions:The presence of the phase III of the MMC was the single ADM parameter predictive of overall treatment response, also associated to group B symptoms and idiopathic etiology. Our findings suggest that small bowel ADM parameters are more useful to predict outcomes and ADM should be performed primarily in patients presenting with abdominal distention and/or vomiting and those being evaluated for CIPO.
Bladder stone formation due to neglected double J stent: a case report
Authors: Jawad Ali , Hamdar Hussein , Nahle Ali Alakbar , Taher Hussein , Ahmad Ali Faisal , Ahmed Adnan 
Published: September 2023

Introduction and importance:
Double J (DJ) stents are commonly used in genitourinary procedures, but they can lead to complications including infection, hematuria, encrustation, and stone formation. The longer the duration of encrustation, the greater the risk of complications and renal dysfunction. Forgotten stents pose challenges for patients and can require endourological or open surgical procedures.

Case presentation:
A 40-year-old man with hypertension and coronary artery disease had a forgotten DJ stent for 3 years, causing suprapubic pain and dysuria. Kidney, ureter, and bladder (KUB) revealed a coiled DJ stent with a large bladder stone and encrustation, and an open cystolithotomy was successfully performed. Recovery was uneventful, and the patient was discharged without complication.

Clinical discussion:
Ureteral stents, including the DJ stent, are commonly used for urological conditions but can cause complications if retained beyond the intended timeframe. Optimal timing for stent removal is crucial, and patients’ healthcare knowledge and adherence are critical to preventing retention. KUB X-ray can evaluate stent encrustation and bladder stones. Cystoscopy is the typical approach for stent removal, but supplementary interventions may be necessary. Open surgery was recommended for removing a large bladder stone and encrusted stent in this case.

Conclusion:
Timely removal of DJ stents is crucial to avoid complications. Extended retention can cause problems such as encrustation and stone formation. Patient education and adherence are essential to prevent retention and forgetfulness. This case report highlights the importance of careful management of patients with DJ stents for optimal outcomes and prevention of complications.
Nonfluent Variant Primary Progressive Aphasia on FDG, 11C-PIB, and 18F-APN-1607 PET Imaging
Authors: Li Lingchao , Ji Bin , Zhao Min , Bai Lin , Chen Bin 
Published: September 2023

Abstract
A 61-year-old right-handed man presented with decreased cognitive function, short-term memory, fluent speech disorders, and grammatical errors for 1 year. The patient underwent PET imaging with 11C-PIB, 18F-FDG, and 18F-APN-1607. The 11C-PIB PET showed no amyloid accumulation; the 18F-FDG PET showed hypometabolism in the bilateral frontal lobe, temporal lobe, and midbrain; and the 18F-APN-1607 PET showed tau accumulation in the brainstem, basal ganglia, and left inferior frontal gyrus. These findings suggested a diagnosis of nonfluent variant primary progressive aphasia. This case emphasizes the value of combined imaging of glucose metabolism, Aβ, and tau PET in the diagnosis of nonfluent variant primary progressive aphasia.
Fault logic and data-driven model for operation reliability analysis of the flap deflection angle
Authors: Liu Wan-Yi , Feng Yun-Wen , Teng Da , Lu Cheng , Chen Jun-Yu 
Published: September 2023

To effectively perform the reliability analysis of the flap deflection angle, the reliability analysis framework is developed by introducing fault logic and a data-driven model. Herein, the fault logic analysis is used to study the fault mechanism and filter out the characteristic fault parameters that can be used to collect input data for data-driven modelling; the data-driven modelling is employed to establish a reliability analysis model with a small amount of input data. Under this proposed framework, the improved dung beetle optimization algorithm for back propagation (IDBO-BP) method is developed to perform the reliability modelling of the flap deflection angle. To validate the effectiveness of the proposed framework, we study the fault logic of flap symmetry and establish a surrogate model of flap deflection based on the fault parameters and the IDBO-BP algorithm. According to the predicted results of the flap deflection angle, the reliability model based on the fault mechanism can reflect the actual flap motion. At the same time, the proposed IDBO-BP algorithm has excellent modelling and simulation property by comparing with other optimization algorithms. Thus, the efforts of this study provide a new solution to the problem of reliable analysis with uncertain fault parameters.
This article is part of the theme issue 'Physics-informed machine learning and its structural integrity applications (Part 1)'.
A time variant uncertainty propagation method for high-dimensional dynamic structural system via K–L expansion and Bayesian deep neural network
Authors: Liu Jingfei , Jiang Chao , Liu Haibo , Li Guijie 
Published: September 2023

In this paper, a time variant uncertainty propagation (TUP) method for dynamic structural system with high-dimensional input variables is proposed. Firstly, an arbitrary stochastic process simulation (ASPS) method based on Karhunen–Loève (K–L) expansion and numerical integration is developed, expressing the stochastic process as the combination of its marginal distributions and eigen functions at several discrete time points. Secondly, the iterative sorting method is implemented to the statistic samples of marginal distributions for matching the constraints of covariance function. Since marginal distributions are directly used to express the stochastic process, the proposed ASPS is suitable for stationary or non-stationary stochastic processes with arbitrary marginal distributions. Thirdly, the high-dimensional TUP problem is converted into several high-dimensional static uncertainty propagation (UP) problems after implementing ASPS. Then, the Bayesian deep neural network based UP method is used to compute the marginal distributions as well as the eigen functions of dynamic system response, the high-dimensional TUP problem can thus be solved. Finally, several numerical examples are used to validate the effectiveness of the proposed method.
This article is part of the theme issue 'Physics-informed machine learning and its structural integrity applications (Part 1)'.
Assessment of Potential Adverse Events Following the 2022–2023 Seasonal Influenza Vaccines Among U.S. Adults Aged 65 Years and Older
Authors: Shi Xiangyu (Chianti) , Gruber Joann F. , Ondari Michelle , Lloyd Patricia C. , Duenas Pablo Freyria , Clarke Tainya C. , Nadimpalli Gita , Cho Sylvia , Feinberg Laurie , Hu Mao , Chillarige Yoganand , Kelman Jeffrey A. , Forshee Richard A. , Anderson Steven A. , Shoaibi Azadeh 
Published: September 2023

AbstractBackgroundWhile safety of influenza vaccines is well-established, some studies have suggested potential associations between influenza vaccines and certain adverse events (AEs). This study examined the safety of the 2022–2023 influenza vaccines among U.S. adults≥65 years.MethodsA self-controlled case series compared incidence rates of anaphylaxis, encephalitis/encephalomyelitis, Guillain Barré-Syndrome (GBS), and transverse myelitis following 2022–2023 seasonal influenza vaccinations (i.e., any, high-dose or adjuvanted) in risk and control intervals among Medicare beneficiaries≥65 years. We used conditional Poisson regression to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) adjusted for event-dependent observation time, seasonality, and outcome misclassification. For AEs with any statistically significant associations, we stratified results by concomitant vaccination status.ResultsAmong 12.7 million vaccine recipients, we observed 76 anaphylaxis, 276 encephalitis/encephalomyelitis, 134 GBS and 75 transverse myelitis cases. Only rates of anaphylaxis were elevated in risk compared to control intervals. With all adjustments, an elevated, but non-statistically significant, anaphylaxis rate was observed following any (IRR: 2.40, 95% CI: 0.96–6.03), high-dose (IRR: 2.31, 95% CI: 0.67–7.91), and adjuvanted (IRR: 3.28, 95% CI: 0.71–15.08) influenza vaccination; anaphylaxis IRRs were 2.54 (95% CI: 0.49–13.05) and 1.64 (95% CI: 0.38–7.05) for those with and without concomitant vaccination, respectively.ConclusionsRates of encephalitis/encephalomyelitis, GBS, or transverse myelitis were not elevated following 2022–2023 seasonal influenza vaccinations among U.S. adults≥65 years. There was an increased rate of anaphylaxis following influenza vaccination that may have been influenced by concomitant vaccination.
Factors associated with delayed umbilical cord clamping in public health facilities in Debremarkos town, northwest Ethiopia
Authors: Workineh Betel Bogale , Cherkose Endeshaw Admasu , Kassie Belayneh Ayanaw 
Published: September 2023

AbstractBackgroundDelayed cord clamping is a proven intervention to improve both maternal and neonatal health and nutrition. World Health Organization recommends not clamping the umbilical cord before 1 minute of delivery. However, little is known about the timing of umbilical cord clamping, and associated factors in Ethiopia.ObjectiveTo assess the timing of umbilical cord clamping and associated factors among women who gave birth at public health institutions in Debremarkos town, 2022/23.MethodsA facility-based cross-sectional study was conducted from December 01, 2022, to January 30, 2023, among women selected using systematic random sampling. Data was collected through observation and review of medical records using a checklist. The data was entered to Epi-data version 4.6.0.4 and analyzed by STATA 14. Descriptive statistics, bivariable and multivariable logistic regression models were fitted.ResultA study of 388(91.73% response rate) women-newborn pairs found that 206(53.09%) newborns received delayed umbilical cord clamping, with mean and median clamping times of 67.87 ± 39.86 SD and 60s, respectively. In the multivariable analysis, giving birth at the hospital (AOR = 2.47, 95% CI: 1.21-5.03), attended by medical interns (AOR = 2.47, 95% CI: 1.29-5.41), receiving uterotonic for AMTSL at or after 60 seconds of giving birth (AOR = 10.36, 95% CI: 6.02-17.84), Rh-negative mothers (AOR = 3.91, 95% CI: 1.40-10.95), and multiparity (AOR = 0.54, 95% CI: 0.32-0.93) were significantly associated with delayed umbilical cord clamp.ConclusionIn this study, half of the newborns had delayed umbilical cord clamping. However, the result is still unsatisfactory, as the recommendations for delayed cord clamping extend to all newborns who do not require intensive care. Therefore, considering the proven benefit of delayed umbilical cord clamping, obstetric care providers should adhere to clinical guidelines for this proven intervention.
Aging measures and cancer: Findings from the Health and Retirement Study
Authors: Wang Shuo , Prizment Anne , Moshele Puleng , Vivek Sithara , Blaes Anne H. , Nelson Heather H. , Thyagarajan Bharat 
Published: September 2023

ABSTRACTBackgroundCompared to cancer-free persons, cancer survivors of the same chronological age (CA) have increased physiological dysfunction, i.e., higher biological age (BA), which may lead to higher morbidity and mortality. We estimated BA using eight aging metrics: BA computed by Klemera Doubal method (KDM-BA), phenotypic age (PhenoAge), five epigenetic clocks (ECs, Horvath, Hannum, Levine, GrimAge, and pace of aging (POA)), and subjective age (SA). We tested if aging constructs were associated with total cancer prevalence and all-cause mortality in cancer survivors and controls, i.e., cancer-free persons, in the Health and Retirement Study (HRS), a large population-based study.MethodsIn 2016, data on BA-KDM, PhenoAge, and SA were available for 946 cancer survivors and 4,555 controls; data for the five ECs were available for 582 cancer survivors and 2,805 controls. Weighted logistic regression was used to estimate the association between each aging construct and cancer prevalence (odds ratio, OR, 95%CI). Weighted Cox proportional hazards regression was used to estimate the associations between each aging construct and cancer incidence as well as all-cause mortality (hazard ratio, HR, 95%CI). To study all BA metrics (except for POA) independent of CA, we estimated age acceleration as residuals of BA regressed on CA.ResultsAge acceleration for each aging construct and POA were higher in cancer survivors than controls. In a multivariable-adjusted model, five aging constructs (age acceleration for Hannum, Horvath, Levine, GrimAge, and SA) were associated with cancer prevalence. Among all cancer survivors, age acceleration for PhenoAge and four ECs (Hannum, Horvath, Levine, and GrimAge), was associated with higher all-cause mortality over 4 years of follow-up. PhenoAge, Hannum, and GrimAge were also associated with all-cause mortality in controls. The highest HR was observed for GrimAge acceleration in cancer survivors: 2.03 (95% CI, 1.58-2.60). In contrast, acceleration for KDM-BA and POA was significantly associated with mortality in controls but not in cancer survivors. When all eight aging constructs were included in the same model, two of them (Levine and GrimAge) were significantly associated with mortality among cancers survivors. None of the aging constructs were associated with cancer incidence.ConclusionVariations in the associations between aging constructs and mortality in cancer survivors and controls suggests that aging constructs may capture different aspects of aging and that cancer survivors may be experiencing age-related physiologic dysfunctions differently than controls. Future work should evaluate how these aging constructs predict mortality for specific cancer types.
PSYCHIATRIC COMORBIDITY & STRUCTURAL BRAIN FEATURES IN THE ADOLESCENT BRAIN AND COGNITIVE DEVELOPMENT STUDY COHORT: A CROSS-SECTIONAL US POPULATION-BASED STUDY
Authors: Luna Alex , Wu Qihang , Zhu Xi , Ryu Hyunnam , Marsh Rachel , Lee Seonjoo 
Published: September 2023

AbstractBackgroundChildren who develop a psychiatric disorder often also develop additional comorbid psychiatric conditions, ultimately impacting prognosis, outcomes, and treatment planning. In this cross-sectional study using the ABCD dataset, the authors set out to identify distinct comorbidity profiles using comorbidity network analysis and any associated clinical correlates of behavior and structural neuroimaging markers.MethodsStructural magnetic resonance imaging and psychometric testing were obtained from 7077 eligible children between the ages of 9-10 in the ABCD dataset. Children were separated into the typically developing group and the psychiatric group based on the presence of a DSM-V diagnosis.ResultsThree comorbidity profiles across gender emerged using comorbidity network analysis. Girls with the ADHD – ODD (AO) comorbidity profile and sparse comorbidity profile had thicker left superior frontal gyri compared to typically developing children. Boys and girls with the ADHD – ODD comorbidity profile had significantly higher externalizing scores compared to typically developing children. The ADHD-OCD-Specific Phobia (AOS) profile among boys had significantly higher internalizing scores, while the AO profile had significantly higher internalizing scores for girls. The AOS profile for boys and the AO profile for girls had significantly higher total problem scores compared to typically developing children.ConclusionComorbidity network analysis successfully identified comorbidity profiles associated with unique neurobiological markers and behavioral correlates and is a feasible technique for the investigation of comorbid psychiatric conditions.
Association between lipoprotein(a),LPAgenetic risk score, aortic valve disease, and subsequent major adverse cardiovascular events
Authors: Moore Matthew K , Jones Gregory T , McCormick Sally , Williams Michael JA , Coffey Sean 
Published: September 2023

AbstractBackgroundCohort studies have demonstrated associations between calcific aortic valve disease (CAVD) and Lp(a). As Lp(a) is almost entirely genetically determined, with the increasing clinical availability of genetic information, we aimed to determine if Lp(a), when predicted from genetic data, is associated with CAVD and major adverse cardiovascular events (MACE).MethodsPatients undergoing coronary angiography were invited to participate in the study. Of 752 analysable participants, 446 had Lp(a) measured, and 703 had a calculableLPAgenetic risk score (GRS). CAVD was categorized as absent/present and by severity. The primary outcomes were presence of CAVD at baseline, and MACE over seven years follow-up.ResultsThe GRS explained 45% of the variation in Lp(a). After adjustment for cardiac risk factors and coronary artery disease, the odds of CAVD increased with Lp(a) (OR 1.039 per 10 unit increase, 95% C.I. 1.022 – 1.057, p<0.001) and GRS (OR 1.054 per 10-unit increase, 95% C.I. 1.024 – 1.086; p <0.001). Lp(a) and the GRS as continuous variables were not associated with subsequent MACE. Dichotomised GRS (>54) was associated with MACE, but this relationship became non-significant when coronary artery disease classification was added into the model (OR 1.333, 95% C.I. 0.927 – 1.912; p = 0.12).ConclusionAnLPAGRS can explain 45% of the variation in Lp(a) levels, and both Lp(a) and the GRS are associated with CAVD. An elevated GRS is associated with future cardiac events in a secondary risk setting, but, if coronary artery disease status is known, it does not provide additional prognostic information.
Prehospital scale to differentiate intracerebral hemorrhage from large-vessel occlusion patients: A prospective cohort study
Authors: Freixa-Cruz A , Jimenez-Jimenez G , Mauri-Capdevila G , Gallego-Sánchez Y , García-Díaz A , Mitjana Penella R , Paul-Arias M , Pereira-Priego C , Ruiz-Fernández E , Salvany-Montserrat S , Sancho-Saldaña A , San-Pedro-Murillo E , Saureu E , Vázquez-Justes D , Purroy F 
Published: September 2023

ABSTRACTBackground and rationaleEvaluating scales to detect large vessel occlusion (LVO) could aid in considering early referrals to a thrombectomy-capable center in the prehospital stroke code setting. Nevertheless, they entail a significant number of false positives, corresponding to intracranial hemorrhages (ICH), which could result in a delay in medical attention and potential harm. Our study aims to identify easily collectible variables for the development of a scale to differentiate patients with ICH from LVO in a prehospital context.MethodsWe conducted a prospective cohort study of stroke code patients between May 2021 and January 2023. Patients were evaluated with CT/CT-Angiography at arrival. We compared clinical variables and vascular risk factors between ICH and LVO patients to design a prehospital ICH screening scale (PreICH).ResultsOut of 989 stroke code patients, we included 190 (66.7%) LVO cases and 95 (33.3) ICH cases. In the multivariate analysis, headache (odds ratio [OR] 3.56; 1.50-8.43), GCS<8 (OR 8.19; 3.17-21.13), SBP>160mmHg (OR 6.43; 3.37-12.26) and male sex (OR 2.07; 1.13-3.80) were associated with ICH, while previous hypercholesterolemia (HCL) (OR 0.35; 0.19-0.65) with LVO. The scale design was conducted, assigning a score to each significant variable based on its specific weight: +2 points for SBP > 160, +1 points for headache, +1 points for male sex, +2 points for GCS<8, and -1 points for HCL. The area under the curve (AUC) was 0.82 (0.77-0.87). A score ≥4 exhibited a sensitivity of 0.10, a specificity of 0.99, a positive predictive value of 0.21, and a negative predictive value of 0.98.ConclusionWe present the development of a prehospital scale to discriminate between ICH and LVO patients, utilizing easily detectable variables in the prehospital setting.
Unlocking Efficient Hospital Operations: Discrete Event Simulation in R
Authors: Kamal Mohamed , Hassanain Omneya 
Published: September 2023

AbstractIn healthcare systems, optimizing resource allocation without compromising patient care is paramount. This study employs a simulation-based approach to evaluate the efficiency of bed allocation within a hospital setting. Utilizing a patient arrival model with an exponential distribution, we simulated patient trajectories to examine system bottlenecks, particularly focusing on waiting times. Initial simulations painted a scenario of an “unstable” system, where waiting times and queue lengths surged due to the limited number of available beds. Through iterative simulations, we explored the operational research question: “What is the minimum number of beds required to stabilize the system?” Our results, visualized in a series of detailed metrics plots, suggest that the addition of a specific number of beds can significantly reduce patient waiting time and stabilize the system. This research offers insights for hospital management on resource optimization, potentially leading to improved patient care and reduced operational costs.