bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Management of Hiatal Hernia Found on Imaging During Lung Cancer Screening
Authors: Rahman Uzma , Till Brian , Thosani Darshak S. , Ruane Brooke , Muse Emily , Barta Julie , Grenda Tyler , Evans Nathaniel R. , Okusanya Olugbenga T. 
Published: January 2023

Background: Lung cancer screening has led to the discovery of many incidental findings including hiatal hernias (HH). However, the clinical significance and work up of these HH varies widely and there is no standardized approach toward follow-up studies or interventions. Therefore, we sought to identify the prevalence, symptoms, and describe our approach toward management of incidentally found HH on lung cancer screening CT scans. Methods: We conducted a retrospective chart review of patients who had HH incidentally found on their lung cancer screening CT scans, at our institution between June 2021 and January 2022. We then analyzed the collected data to determine the prevalence of HH in lung cancer screening patients, presence of symptoms, and management of these HH. Results: About 638 patients underwent lung cancer screening, of which 8.8% (n = 56) were found to have HH. Although 64.3% of patients with HH were symptomatic, 51.8% had not seen a gastroenterologist and 64.3% never had prior esophagogastroduodenoscopy. Of the patients with HH, 25% were evaluated by a thoracic surgeon based on symptoms or type of HH, and 10.7% qualified for surgical intervention. Patients not eligible for surgical intervention were referred to gastroenterology for follow-up. Conclusions: Hiatal hernias are common incidental findings on lung cancer screening CT scans. Many of these patients with HH are symptomatic and some have large HH. Therefore, these patients should be referred to specialists who can monitor their symptoms, initiate appropriate work-up when needed, and offer medical or surgical treatment when indicated.
A phase 2 clinical trial of combined BRAF/MEK inhibition for BRAFV600E-mutated multiple myeloma
Authors: Giesen Nicola , Chatterjee Manik , Scheid Christof , Poos Alexandra M. , Besemer Britta , Miah Kaya , Benner Axel , Becker Nicole , Moehler Thomas , Metzler Ivana , Khandanpour Cyrus , Seidel-Glaetzer Andrea , Trautmann-Grill Karolin , Kortüm K. Martin , Müller-Tidow Carsten , Mechtersheimer Gunhild , Goeppert Benjamin , Stenzinger Albrecht , Weinhold Niels , Goldschmidt Hartmut , Weisel Katja , Raab Marc S. 
Published: January 2023

Abstract
Activating BRAF mutations are found in a small subset of patients with newly diagnosed multiple myeloma, but prevalence increases in late-stage, refractory disease, and the mutations are associated with adverse outcome. This prospective single-arm, open-label, multicenter phase 2 trial assessed the efficacy and safety of combined BRAF/MEK inhibition, using encorafenib and binimetinib, in patients with relapsed/refractory multiple myeloma (RRMM) carrying a BRAFV600E mutation. Patients received 450 mg encorafenib once daily and binimetinib 45 mg twice daily. The primary end point was the overall response rate achieved within the first year after start of treatment according to International Myeloma Working Group criteria. Twelve RRMM patients with a median of 5 prior lines of therapy were enrolled. The overall response rate was 83.3%, with 10 patients achieving at least a partial response. The median progression-free survival was 5.6 months, and overall survival was 55% at 24 months. Emerging resistance to therapy was driven by RAS mutations and structural variants involving the BRAF locus. This is the first prospective clinical trial to demonstrate that combined BRAF/MEK inhibition is highly effective in patients with BRAFV600E-mutated RRMM, and it represents a successful targeted precision medicine approach in this disease. This trial was registered at www.clinicaltrials.gov as #NCT02834364.
Experimental Research on the Surface Quality of Milling Contour Bevel Gears
Authors: Wu Mingyang , Zhang Jianyu , Ma Chunjie , Zhang Yali , Cheng Yaonan 
Published: January 2023

AbstractContour bevel gears have the advantages of high coincidence, low noise and large bearing capacity, which are widely used in automobile manufacturing, shipbuilding and construction machinery. However, when the surface quality is poor, the effective contact area between the gear mating surfaces decreases, affecting the stability of the fit and thus the transmission accuracy, so it is of great significance to optimize the surface quality of the contour bevel gear. This paper firstly analyzes the formation process of machined surface roughness of contour bevel gears on the basis of generating machining method, and dry milling experiments of contour bevel gears are conducted to analyze the effects of cutting speed and feed rate on the machined surface roughness and surface topography of the workpiece. Then, the surface defects on the machined surface of the workpiece are studied by SEM, and the causes of the surface defects are analyzed by EDS. After that, XRD is used to compare the microscopic grains of the machined surface and the substrate material for diffraction peak analysis, and the effect of cutting parameters on the microhardness of the workpiece machined surface is investigated by work hardening experiment. The research results are of great significance for improving the machining accuracy of contour bevel gears, reducing friction losses and improving transmission efficiency.
Machine learning to analyse omic-data for COVID-19 diagnosis and prognosis
Authors: Liu Xuehan , Hasan Md Rakibul , Ahmed Khandaker Asif , Hossain Md Zakir 
Published: January 2023

AbstractBackgroundWith the global spread of COVID-19, the world has seen many patients, including many severe cases. The rapid development of machine learning (ML) has made significant disease diagnosis and prediction achievements. Current studies have confirmed that omics data at the host level can reflect the development process and prognosis of the disease. Since early diagnosis and effective treatment of severe COVID-19 patients remains challenging, this research aims to use omics data in different ML models for COVID-19 diagnosis and prognosis. We used several ML models on omics data of a large number of individuals to first predict whether patients are COVID-19 positive or negative, followed by the severity of the disease.ResultsOn the COVID-19 diagnosis task, we got the best AUC of 0.99 with our multilayer perceptron model and the highest F1-score of 0.95 with our logistic regression (LR) model. For the severity prediction task, we achieved the highest accuracy of 0.76 with an LR model. Beyond classification and predictive modeling, our study founds ML models performed better on integrated multi-omics data, rather than single omics. By comparing top features from different omics dataset, we also found the robustness of our model, with a wider range of applicability in diverse dataset related to COVID-19. Additionally, we have found that omics-based models performed better than image or physiological feature-based models, proving the importance of the omics-based dataset for future model development.ConclusionsThis study diagnoses COVID-19 positive cases and predicts accurate severity levels. It lowers the dependence on clinical data and professional judgment, by leveraging the utilization of state-of-the-art models. our model showed wider applicability across different omics dataset, which is highly transferable in other respiratory or similar diseases. Hospital and public health care mechanisms can optimize the distribution of medical resources and improve the robustness of the medical system.
Creation of new germplasm resources, development of SSR markers, and screening of monoterpene synthases in thyme
Authors: Sun Meiyu , Zhu Li , Zhang Yanan , Liu Ningning , Zhang Jinzheng , Li Hui , Bai Hongtong , Shi Lei 
Published: January 2023

Abstract
Background

Thyme derived essential oil and its components have numerous applications in pharmaceutical, food, and cosmetic industries, owing to their antibacterial, antifungal, and antiviral properties. To obtain thyme essential oil with different terpene composition, we developed new germplasm resources using the conventional hybridization approach.

Results
Phenotypic characteristics, including essential oil yield and composition, glandular trichome density, plant type, and fertility, of three wild Chinese and seven European thyme species were evaluated. Male-sterile and male-fertile thyme species were crossed in different combinations, and two F1 populations derived from Thymus longicaulis (Tl) × T. vulgaris ‘Fragrantissimus’ (Tvf) and T. vulgaris ‘Elsbeth’ (Tve) × T. quinquecostatus (Tq) crosses were selected, with essential oil yield and terpene content as the main breeding goals. Simultaneously, simple sequence repeat (SSR) primers were developed based on the whole-genome sequence of T. quinquecostatus to authenticate the F1 hybrids. A total of 300 primer pairs were selected, and polymerase chain reaction (PCR) was carried out on the parents of the two hybrid populations (Tl, Tvf, Tve, and Tq). Based on the chemotype of the parents and their F1 progenies, we examined the expression of genes encoding two γ-terpinene synthases, one α-terpineol synthase, and maybe one geraniol synthase in all genotypes by quantitative real-time PCR (qRT-PCR).

Conclusion
We used hybridization to create new germplasm resources of thyme, developed SSR markers based on the whole-genome sequence of T. quinquecostatus, and screened the expression of monoterpene synthase genes in thyme. The results of this study provide a strong foundation for the creation of new germplasm resources, construction of the genetic linkage maps, and identification of quantitative trait loci (QTLs), and help gain insight into the mechanism of monoterpenoids biosynthesis in thyme.
Development of a novel tool: a nomogram for predicting in-hospital mortality of patients in intensive care unit after percutaneous coronary intervention
Authors: Yuan Miao , Ren Bin Cheng , Wang Yu , Ren Fuxian , Gao Dengfeng 
Published: January 2023

Abstract
Backgrounds
Increased risk of in-hospital mortality is critical to guide medical decisions and it played a central role in intensive care unit (ICU) with high risk of in-hospital mortality after primary percutaneous coronary intervention (PCI). At present，most predicting tools for in-hospital mortality after PCI were based on the results of coronary angiography, echocardiography, and laboratory results which are difficult to obtain at admission. The difficulty of using these tools limit their clinical application. This study aimed to develop a clinical prognostic nomogram to predict the in-hospital mortality of patients in ICU after PCI.

Methods
We extracted data from a public database named the Medical Information Mart for Intensive Care (MIMIC III). Adult patients with coronary artery stent insertion were included. They were divided into two groups according to the primary outcome (death in hospital or survive). All patients were randomly divided into training set and validation set randomly at a ratio of 6:4. Least absolute shrinkage and selection operator (LASSO) regression was performed in the training set to select optimal variables to predict the in-hospital mortality of patients in ICU after PCI. The multivariate logistical analysis was performed to develop a nomogram. Finally, the predictive efficiency of the nomogram was assessed by area under the receiver operating characteristic curve (AUROC)，integrated discrimination improvement (IDI), and net reclassification improvement (NRI), and clinical net benefit was assessed by Decision curve analysis (DCA).

Results
A total of 2160 patients were recruited in this study. By using LASSO, 17 variables were finally included. We used multivariate logistic regression to construct a prediction model which was presented in the form of a nomogram. The calibration plot of the nomogram revealed good fit in the training set and validation set. Compared with the sequential organ failure assessment (SOFA) and scale for the assessment of positive symptoms II (SAPS II) scores, the nomogram exhibited better AUROC of 0.907 (95% confidence interval [CI] was 0.880-0.933, p <  0.001) and 0.901 (95% CI was 0.865-0.936, P <  0.001) in the training set and validation set, respectively. In addition, DCA of the nomogram showed that it could achieve good net benefit in the clinic.

Conclusions
A new nomogram was constructed, and it presented excellent performance in predicting in-hospital mortality of patients in ICU after PCI.
Analgesic effect of erector spinae plane block in adults undergoing laparoscopic cholecystectomy: a systematic review and meta-analysis of randomized controlled trials
Authors: Yang Xiaoli , Zhang Yu , Chen Yong , Xu Mingxing , Lei Xue , Fu Qiang 
Published: January 2023

Abstract
Background
Laparoscopic cholecystectomy is the gold standard surgical procedure for treating gallstone disease. Despite it being minimally invasive, various medications and methods are used to alleviate postoperative pain, and some patients still experience moderate-to-severe pain. This is a crucial problem that must be solved to avoid chronic pain. As part of postoperative multimodal analgesia, regional block is being increasingly applied in surgery under ultrasound guidance. We aimed to evaluate the analgesic effect of erector spinae plane block in adult patients undergoing laparoscopic cholecystectomy.

Methods
PubMed, Cochrane Library, EMBASE, and Web of Science were searched for randomized controlled trials investigating the efficacy of erector spinae plane block on postoperative pain after laparoscopic cholecystectomy. The primary outcome was the postoperative pain score. The secondary outcomes were the cumulative intraoperative and postoperative opioid consumption at 24 h, incidence of postoperative nausea and vomiting, and shoulder pain after surgery. The results were pooled using the fixed- or random-effects model with Review Manager 5.3.

Results
Fifteen randomized controlled trials involving 947 patients were included in the analysis. Postoperative pain score in the erector spinae plane block group was lower than that in the control group at postoperative 12 h (MD − 0.81, 95% CI − 1.1 to − 0.51, p < 0.00001) and 24 h (MD − 0.41, 95% CI − 0.62 to − 0.19, p = 0.0002). Cumulative opioid consumption was lower in the erector spinae plane block group than in the control group at postoperative 24 h (MD − 7.88, 95% CI − 10.17 to − 5.58, p < 0.00001). The erector spinae plane block group also experienced a lower incidence of postoperative nausea and vomiting than the control group. Opioid consumption and the incidence of postoperative nausea and vomiting were similar between the erector spinae plane block group and other block groups, including the oblique subcostal transversus abdominis plane block and quadratus lumborum block groups.

Conclusions
Ultrasound-guided erector spinae plane block provides effective postoperative analgesia in adults undergoing laparoscopic cholecystectomy.
Management, clinical outcomes, and its predictors among heart failure patients admitted to tertiary care hospitals in Ethiopia: prospective observational study
Authors: Beri Berhanu , Fanta Korinan , Bekele Fekede , Bedada Worku 
Published: January 2023

Abstract
Background
Heart failure is a global pandemic, as it affects approximately 64.34 million people worldwide with a $346.17 billion global economic burden. The prevalence of heart failure has increased from 43.4 to 46.5% in the last 10 years in lower and middle-income countries. Most of the studies conducted in Ethiopia were retrospective cross-sectional, with limited study participants, and conducted in a single setting that commonly addresses the prevalence and pattern of heart failure rather than clinical outcome, associated factors, and specific management in different areas. Hence, this study aimed to assess management, clinical outcomes and their predictors among heart failure patients admitted to tertiary care hospitals in Ethiopia.

Methods
A prospective observational study design was conducted on heart failure patients admitted at two tertiary care hospitals in Ethiopia from September 2020 to May 2021. Using semi-structured questionnaires relevant data were collected from patients’ medical records and face-to-face interviewing. Data were analyzed using SPSS version 23.0. A multivariate Cox regression model was performed to identify independent predictors of 90-day all-cause mortality. Variables with P values < 0.05 were considered statistically significant.

Results
Out of 283 patients enrolled in this study, 52.3% were male and the mean (± SD) age was 52.4 ± 17.9 years. The most common medications prescribed during hospitalization and discharge were diuretics (98.9% vs 95.6%), angiotensin I converting enzyme inhibitors/angiotensin II receptor blockers (48.8% vs 67.3%), and beta-blockers (46.6% vs 64.7%), respectively. In the present study, the 90-day all-cause mortality was 10.2%. Hypertension (HR = 3.7, 95% CI 1.2–11.6), cardiogenic shock (HR = 8.7, 95% CI 3.2–20.8), alcohol drinking (HR = 2.8, 95% CI 1.1–7.8), absence of angiotensin I converting enzyme inhibitors/angiotensin II receptor blockers (HR = 0.02, 95% CI 0.0–0.2), and reduced ejection fraction (HR = 1.5, 95% CI 1.1–3.8) were predictors of 90-day all-cause mortality.

Conclusion
High 90-day all-cause mortality was observed among heart failure patients in the present study. In the current study, the majority of heart failure patients were treated with diuretics. Alcohol drinking, hypertension, cardiogenic shock, reduced ejection fraction, and absence of angiotensin I converting enzyme inhibitors/angiotensin II receptor blockers drugs were predictors of poor treatment outcomes for whom restriction of alcohol consumption, early management of hypertension, reduced ejection fraction, cardiogenic shock, and providing angiotensin I converting enzyme inhibitors/angiotensin II receptor blockers drugs for all heart failure patients would be recommended to improve these poor treatment outcomes.
A systematic review and meta-analysis of the association between sarcopenia and myocardial infarction
Authors: Li Feika , Bai Tingting , Ren Yan , Xue Qiqi , Hu Jiaan , Cao Jiumei 
Published: January 2023

Abstract
Background
Systematic review and meta-analysis of the association between sarcopenia and the development of myocardial infarction.

Methods
PubMed, Cochrane Library, and Embase were searched for studies on the association between sarcopenia and myocardial infarction from their inception until November 26, 2022. The fixed-effects model was used to calculate the combined risk ratio (RR) of sarcopenia in patients with myocardial infarction. Sensitivity analysis was used to test the robust of the combined result, and funnel plot were used to test publication bias.

Results
Five studies were included finally. There was no significant association between sarcopenia and risk of developing myocardial infarction [RR = 1.01; 95% CI = 0.94, 1.08; P = 0.317]. The sensitivity analysis showed robust of the combined result. The funnel plot showed no significant publication bias.

Conclusion
Limited evidence suggests no definitive association between sarcopenia and risk of myocardial infarction.
Impact of medication therapy management (MTM) service model on multi-morbidity (MMD) patients with hypertension: a pilot RCT
Authors: Li Na , Song Jin-fang , Zhang Ming-zhu , Lv Xiao-min , Hua Hui-lian , Chang Yi-ling 
Published: January 2023

AbstractBackgroundThis study explored the impact of MTM service on MMD patients with hypertension.MethodsA total of 120 MMD inpatients from September to November 2019 were received and randomly divided into intervention group and control group. General services for noninfectious chronic diseases were given to the control group, while a standard MTM service was given to the intervention group. Patients’ blood pressure, EQ-5D utility value, readmission rate, drug-related problems, and average daily medication therapy cost were compared between the two groups and within the groups. This was done at the initial admission phase and in the first, third, sixth, and twelfth months after discharge.ResultsThe intervention group had significantly lower blood pressure and average daily medication therapy cost 12 months after discharge compared to the control group (systolic blood pressure:P = 0.023, diastolic blood pressure:P < 0.001, average daily medication therapy cost:P = 0.049); the number of DRPs decreased in both groups 12 months after discharge; the number of DRPs solved in the intervention group in the third, sixth and twelfth months after discharge were statistically higher compared with that in the control group (P = 0.013,P = 0.012,P = 0.001); there was no significant difference in the EQ-5D utility value and readmission rate between the two groups (P > 0.05).ConclusionsMTM implementation in MMD patients can improve health outcomes and reduce healthcare-related costs among MMD patients.Trial registrationChinese Clinical Trial Register ChiCTR2200065111, date of registration: October 28, 2022.
Unintended impact of COVID-19 pandemic on the rate of catheter related nosocomial infections and incidence of multiple drug resistance pathogens in three intensive care units not allocated to COVID-19 patients in a large teaching hospital
Authors: Zand Farid , Vakili Hedayatollah , Asmarian Naeimehossadat , Masjedi Mansoor , Sabetian Golnar , Nikandish Reza , Shafiee Elham , Tabatabaei Esfehani Azita , Azadi Fatemeh , Sanaei Dashti Anahita 
Published: January 2023

Abstract
Background
The prevalence of resistant hospital infections in the intensive care unit (ICU) increases mortality and antibiotic resistance. COVID-19 pandemic may have unintended impact on nosocomial infections (NI) and the prevalence of resistant microorganism.

Methodology
The present non-interventional study was performed by a pre and a post survey each lasting 8 months before (March–October 2019) and after (March–October 2020) the onset of COVID-19 pandemic in three ICU’s, not allocated to COVID-19 patients, in Nemazee Hospital, Shiraz, Iran. The rates of the following nosocomial infections were compared at pre- and post-pandemic period: ventilator associated pneumonia (VAP), central line associated blood stream infection (CLABSI), catheter-associated urinary tract infections (CAUTI) and incidence of multiple drug resistance (MDR) pathogens.

Results
Pre-pandemic and pandemic incidence of VAP was 23.5 and 17.2 cases per 1000 device-days, respectively; an absolute decrease of 27%. The main reason for the decrease in the rate of VAP during the pandemic was a significant decrease in the rate of VAP caused by Acinetobacter baumannii; from 39 to 17% in total VAP episodes. The rate of VAP associated with other microorganisms remained relatively unchanged from 14.2 cases in pre-pandemic period to 14.3 cases per 1000 MV-days during the pandemic (P = 0.801). Pre-pandemic incidence of CLABSI was 7.3 cases and, in pandemic period, was 6.5 cases per 1000 device-days (IRR = 0.88, 95% CI  0.43–1.73, P = 0.703). Pre-pandemic incidence of CAUTI was 2 and in pandemic period, was 1.4 cases per 1000 device-days (IRR = 0.70, 95% CI  0.22–1.98, P = 0.469).

Conclusion
The results of the present study showed a decrease in the incidence of VAP in critically ill non-COVID-19 patients during the pandemic compared to before the pandemic, especially regarding Acinetobacter baumannii.