bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of cardiac rupture among elderly patients with diabetes presenting with first acute myocardial infarction
Authors: Zu Xiaolin , Jin Yanyan , Zeng Yaping , Li Peng , Gao Hai 
Published: September 2023

ObjectiveWe aimed to analyze the risk of cardiac rupture (CR) in aged diabetic patients with acute ST-segment elevated myocardial infarction (STEMI) who were followed up for one month, and analyze its independent risk factors.MethodsA total of 3063 aged patients with first onset STEMI admitted to Beijing Anzhen Hospital from January 2001 to December 2020 were retrospectively included. There were 2020 patients without diabetes mellitus (DM) and 1043 patients with DM. We used propensity scores matching (PSM) method to balance baseline exposure factors between patients with or without DM, and all were divided the DM group (1043 cases) and the non-DM group (1043 cases) after the PSM. The primary outcome was CR (the composite rate of papillary muscle rupture, ventricular septum perforation, free wall rupture), which was diagnosed based on clinical manifestations and/or echocardiographic findings. Kaplan-meier survival analyses and log-rank test was used to evaluate the risk of CR between the two groups, and Cox regression analysis was used to evaluate the independent risk factors for CR.ResultsAfter PSM, the baseline clinical data were similar between the DM and non-DM group (all P&gt;0.05). However, level of glycated hemoglobin was significantly higher in the DM group (P&lt;0.05). During 1 month of follow-up, there were 55 (2.64%) cases of CR, most occurred within 48h after admission (40 cases). Among the 55 cases, 11(0.53%) had papillary muscle rupture, 18(0.86%) had ventricular septum perforation, and 26(1.25%) had free wall rupture. Kaplan-meier survival analyses detected that the DM group was associated with significantly increased risk of CR (3.36% vs. 1.92%, HR=1.532, 95% CI: 1.054-2.346, P=0.030), ventricular septum perforation (1.05% vs. 0.67%, HR=1.464, 95% CI: 1.021-2.099, P=0.038) and free wall rupture (1.63% vs. 0.86%, HR=1.861, 95% CI: 1.074-3.225, P=0.027) than those in the non-DM group. Among the 2031 aged STEMI patients without CR, 144 cases (6.90%, 144/2086) died; and among the 55 patients with CR, 37 cases (1.77%, 37/2086) died due to CR. Therefore, twenty percent (20.44%, 37/181) of death was due to CR. Multivariate Cox regression analysis indicated that DM (HR=1.532, 95%CI: 1.054-2.346), age (HR=1.390, 95%CI: 1.079-1.791), female (HR=1.183, 95%CI: 1.049-1.334), troponin I (HR=1.364, 95%CI: 1.108-1.679), brain natriuretic peptide (HR=1.512, 95%CI: 1.069-2.139), revascularization (HR=0.827, 95%CI: 0.731-0.936) and β-receptor blocker (HR=0.849, 95%CI: 0.760-0.948) were independent risk factors of CR (all P&lt;0.05).ConclusionDM as well as a few other factors, are independent determinants of CR. CR is not a rare event among the aged STEMI patients and twenty percent of deaths are due to CR. However, large sample-sized studies are warranted to confirm these findings.
Co-exposure to multiple vitamins and the risk of all-cause mortality in patients with diabetes
Authors: Zhou Lin , Zhang Jianing , Zhang Dan , Yu Ye , Jiang Mengqi , Liu Huiying , Li Jiatong , Li Minghui , Zhang Zhuo , Guo Lianying 
Published: September 2023

ObjectiveAlthough the effect of vitamins on the risk of mortality in diabetic patients has been reported, most studies focus on individual vitamins. However, humans are often exposed to multiple vitamins simultaneously in daily life. Therefore, it is worth exploring the effects of co-exposure to multiple vitamins on the risk of mortality in diabetic patients.MethodsThis study included diabetic patients aged ≥20WD years who participated in NHANES from 2003 to 2006. An unsupervised K-means clustering method was used to cluster eight vitamins in serum into several patterns of co-exposure to multiple vitamins, and the Cox proportional hazards model was used to evaluate the impact of different patterns of co-exposure to multiple vitamins on the risk of all-cause mortality in diabetic patients.ResultsThree patterns of co-exposure to multiple vitamins were generated based on K-means clustering, namely, low-level, moderate-level, and high-level. Among the 484 diabetic patients, with a median follow-up of 13.7 years, a total of 211 deaths occurred. After adjusting for covariates, the individual vitamins had varying effects on the risk of all-cause mortality in diabetic patients. Compared to the low-level group of co-exposure to multiple vitamins, the high-level group significantly reduced the risk of all-cause mortality in diabetic patients, with a HR of 0.42 (95% CI: 0.20, 0.87). Subgroup analysis demonstrated that high levels of co-exposure to multiple vitamins significantly reduced the risk of all-cause mortality in males, individuals aged ≥ 60 years, and non-Hispanic White people with diabetes compared to the low-level group, with HR of 0.42 (95% CI: 0.18, 0.98), 0.53 (95% CI: 0.26, 0.98), and 0.26 (95% CI: 0.12, 0.58) respectively.ConclusionWhile individual vitamins had different effects on the risk of all-cause mortality in patients with diabetes, high-level co-exposure to multiple vitamins significantly reduced the risk of all-cause mortality in patients with diabetes, with differences observed among genders, ages, and race. This suggests that when developing vitamin intervention strategies for patients with diabetes, consideration should be given not only to the dosage of individual vitamins but also to the variations between different population groups.
Alien species established in the Bay of Biscay suggest significant contribution of both fouling and dry ship compartments
Authors: Menéndez-Teleña Deva , Soto-López Veronica , Bartolomé Marlene , González Arenales Monica , Montes Horacio J. , Ardura Alba , Garcia-Vazquez Eva 
Published: September 2023

IntroductionThe majority of studies on marine biosecurity focus on aquatic species, but invaders can also use dry ship compartments for dispersal; this pathway has been less explored than fouling or ballast water. Here we analysed the maritime traffic of the international Port of Gijon (south Bay of Biscay, Spain) as a case study.MethodsMain donor countries were identified from traffic data. From the Global Invasive Species Database, we detected a similar proportion of expected global alien invasive species (AIS) from fouling and containers pathways to be actually settled in the recipient region.ResultsThe AIS diversity transported via fouling was higher than that transported by containers. No significant difference between Australia, Brazil, Canada and South Africa in the proportion of global AIS actually transferred to Bay of Biscay supports the vision of port networks as a new ecosystem with multiple demes. Different AIS catalogues in the donor regions may explain a higher proportion of terrestrial AIS introduced via containers from Brazil and South Africa and marine AIS introduced via fouling.DiscussionA more careful surveillance of biota in dry ship compartments, including it in a future revision in the International Convention for Safe Containers, is recommended to reduce the contribution of shipping to biological invasions.
Evaluating the performance of ChatGPT-4 on the United Kingdom Medical Licensing Assessment
Authors: Lai U Hin , Wu Keng Sam , Hsu Ting-Yu , Kan Jessie Kai Ching 
Published: September 2023

IntroductionRecent developments in artificial intelligence large language models (LLMs), such as ChatGPT, have allowed for the understanding and generation of human-like text. Studies have found LLMs abilities to perform well in various examinations including law, business and medicine. This study aims to evaluate the performance of ChatGPT in the United Kingdom Medical Licensing Assessment (UKMLA).MethodsTwo publicly available UKMLA papers consisting of 200 single-best-answer (SBA) questions were screened. Nine SBAs were omitted as they contained images that were not suitable for input. Each question was assigned a specialty based on the UKMLA content map published by the General Medical Council. A total of 191 SBAs were inputted in ChatGPT-4 through three attempts over the course of 3 weeks (once per week).ResultsChatGPT scored 74.9% (143/191), 78.0% (149/191) and 75.6% (145/191) on three attempts, respectively. The average of all three attempts was 76.3% (437/573) with a 95% confidence interval of (74.46% and 78.08%). ChatGPT answered 129 SBAs correctly and 32 SBAs incorrectly on all three attempts. On three attempts, ChatGPT performed well in mental health (8/9 SBAs), cancer (11/14 SBAs) and cardiovascular (10/13 SBAs). On three attempts, ChatGPT did not perform well in clinical haematology (3/7 SBAs), endocrine and metabolic (2/5 SBAs) and gastrointestinal including liver (3/10 SBAs). Regarding to response consistency, ChatGPT provided correct answers consistently in 67.5% (129/191) of SBAs but provided incorrect answers consistently in 12.6% (24/191) and inconsistent response in 19.9% (38/191) of SBAs, respectively.Discussion and conclusionThis study suggests ChatGPT performs well in the UKMLA. There may be a potential correlation between specialty performance. LLMs ability to correctly answer SBAs suggests that it could be utilised as a supplementary learning tool in medical education with appropriate medical educator supervision.
Organic management increases beneficial microorganisms and promotes the stability of microecological networks in tea plantation soil
Authors: Huang Xinhui , Zheng Yuting , Li Panfeng , Cui Jixiao , Sui Peng , Chen Yuanquan , Gao Wangsheng 
Published: September 2023

IntroductionOrganic agriculture is highly regarded by people for its commitment to health, ecology, care, and fairness. The soil microbial community responds quickly to environmental changes and is a good indicator for evaluating soil microecology. Therefore, from the perspective of soil microbial communities, elucidating the impact of organic management on soil microecology in tea plantations has great significance for improving local tea plantation systems.MethodsThe study collected bulk soil from organic management (OM) and conventional management (CM) tea plantations in Pu'er City, a major tea-producing area in China, and analyzed their species diversity, structural composition, and co-occurrence networks using metagenomics technology.ResultsCompared with CM, the diversity index (Shannon) and evenness index (Heip) of soil fungi increased by 7.38% and 84.2% in OM tea plantations, respectively. The relative abundance of microorganisms related to the nitrogen cycle increased. Specifically, there was a significant increase in Rhodobiales, a 2-fold increase in Nitrospirae, and approximately 1.95 and 2.03 times increases in unclassified genera within Betaproteobacteria and Deltaproteobacteria, respectively. The relative abundance of plant residue degradation species, Gemmatimonadetes, Ascomycota, and Basidiomycota, increased by 2.8, 1, and 1.4 times, respectively. The OM was conducive to the establishment of collaborative relationships among bacterial species and increased the diversity and complexity of species relationships in fungal communities. The network stability of soil ecosystems was promoted. The organic tea plantations' keystone taxa contained mycorrhizal fungi (Pezoloma_ericae, Rhizophagus_irregularis, Rhizophagus_clarus), as well as species involved in soil nitrogen metabolism (Acidobacteria_bacterium, Acidobacteriia_bacterium_AA117, Sphingomonas_sp._URHD0007, Enhydrobacter_aerosaccus), pathogen (Erysiphe_pulchra), and parasites (Paramycosporidium saccamoeba). The partial least squares method (PLS-SEM) indicated that OM affected N-NH4+ negatively, increasing the abundance of fungi, and thereby positively affecting the Shannon index.ConclusionIn brief, reasonable organic management can improve the diversity of soil microorganisms, increase the relative abundance of beneficial bacteria in tea plantation soil, and promote the stability of the soil microbial ecological network.
Heat stress exposure cause alterations in intestinal microbiota, transcriptome, and metabolome of broilers
Authors: Liu Xuan , Ma Zhenhua , Wang Yanfei , Jia Hao , Wang Zheng , Zhang Lihuan 
Published: September 2023

IntroductionHeat stress can affect the production of poultry through complex interactions between genes, metabolites and microorganisms. At present, it is unclear how heat stress affects genetic, metabolic and microbial changes in poultry, as well as the complex interactions between them.MethodsThus, at 28  days of age a total of 200 Arbor Acres broilers with similar body weights were randomly divided into the control (CON) and heat stress treatment (HS). There were 5 replicates in CON and HS, respectively, 20 per replication. From the 28–42  days, the HS was kept at 31 ± 1°C (9:00–17:00, 8 h) and other time was maintained at 21 ± 1°C as in the CON. At the 42nd day experiment, we calculated the growth performance (n = 8) of broilers and collected 3 and 6 cecal tissues for transcriptomic and metabolomic investigation and 4 cecal contents for metagenomic investigation of each treatment.Results and discussionThe results indicate that heat stress significantly reduced the average daily gain and body weight of broilers (value of p &lt; 0.05). Transcriptome KEGG enrichment showed that the differential genes were mainly enriched in the NF-kB signaling pathway. Metabolomics results showed that KEGG enrichment showed that the differential metabolites were mainly enriched in the mTOR signaling pathway. 16S rDNA amplicon sequencing results indicated that heat stress increased the relative abundance of Proteobacteria decreased the relative abundance of Firmicutes. Multi-omics analysis showed that the co-participating pathway of differential genes, metabolites and microorganisms KEGG enrichment was purine metabolism. Pearson correlation analysis found that ornithine was positively correlated with SULT1C3, GSTT1L and g_Lactobacillus, and negatively correlated with CALB1. PE was negatively correlated with CALB1 and CHAC1, and positively with g_Alistipes. In conclusion, heat stress can generate large amounts of reactive oxygen and increase the types of harmful bacteria, reduce intestinal nutrient absorption and antioxidant capacity, and thereby damage intestinal health and immune function, and reduce growth performance indicators. This biological process is manifested in the complex regulation, providing a foundational theoretical basis for solving the problem of heat stress.
Impact of a moulded pureed diet on taste, appearance, recognisability, and overall liking among patients in an acute hospital
Authors: Lam Calvin Jun Yan , Phua Quan Quan , Guo Emily Yiting , Sia Isaac Kwee Mien 
Published: September 2023

IntroductionHospital meals potentially influence patients’ nutritional, physical, and emotional well-being during their admission. Patients on pureed diets report poorer meal satisfaction, due to taste, appearance, and recognisability, potentially impacting on their nutritional status. This study compared whether a moulded pureed diet made from modified maize starch led to improved taste, appearance, recognisability, and overall liking, compared to an unmoulded pureed diet made from potato starch in an acute hospital.MethodsPatients on texture-modified diets were recruited and presented with two pureed diets – unmoulded and moulded. Participants were asked to identify meat and vegetable dishes prior to eating. After the meal, participants indicated their diet preference in terms of appearance, taste, and overall liking.Results145 participants were recruited, of which 126 completed data collection. 86% correctly identified moulded meat dishes, 69% correctly identified moulded vegetable dishes, with an overall 77% accuracy in identifying moulded puree side dishes. On unmoulded puree side dishes, participants correctly identified 25% of meat dishes, 4% of vegetable dishes, with an overall accuracy of 14%. In terms of preference, the moulded puree was preferred, with 81% for appearance, 76% for taste and 75% for overall preference. When participants had differing preferences for appearance and taste (e.g., prefers unmoulded puree appearance and moulded puree taste), 95% of them subsequently aligned their overall preference with their taste preference (i.e., overall preferred moulded pureed diet). This suggests that taste has a stronger influence on overall preference compared to appearance.DiscussionFindings indicate that a moulded pureed diet made from modified maize starch led to improved recognisability, taste, appearance, and overall liking compared to an unmoulded pureed diet made from potato starch. Taste had a stronger influence on overall preference compared to appearance. These findings capture patient preferences and may have implications on how hospital pureed diets may be improved, potentially improving patient nutrition and health outcomes.
Automated diagnosis of pancreatic mucinous and serous cystic neoplasms with modality-fusion deep neural network using multi-modality MRIs
Authors: Zhang Gong , Chen Weixiang , Wang Zizheng , Wang Fei , Liu Rong , Feng Jianjiang 
Published: September 2023

BackgroundPancreatic cystic neoplasms are increasingly diagnosed with the development of medical imaging technology and people’s self-care awareness. However, two of their sub-types, serous cystic neoplasms (SCN) and mucinous cystic neoplasms (MCN), are often misclassified from each other. Because SCN is primarily benign and MCN has a high rate of malignant transformation. Distinguishing SCN and MCN is challenging and essential.PurposeMRIs have many different modalities, complete with SCN and MCN diagnosis information. With the help of an artificial intelligence-based algorithm, we aimed to propose a multi-modal hybrid deep learning network that can efficiently diagnose SCN and MCN using multi-modality MRIs.MethodsA cross-modal feature fusion structure was innovatively designed, combining features of seven modalities to realize the classification of SCN and MCN. 69 Patients with multi-modalities of MRIs were included, and experiments showed performances of every modality.ResultsThe proposed method with the optimized settings outperformed all other techniques and human radiologists with high accuracy of 75.07% and an AUC of 82.77%. Besides, the proposed disentanglement method outperformed other fusion methods, and delayed contrast-enhanced T1-weighted MRIs proved most valuable in diagnosing SCN and MCN.ConclusionsThrough the use of a contemporary artificial intelligence algorithm, physicians can attain high performance in the complex challenge of diagnosing SCN and MCN, surpassing human radiologists to a significant degree.
The safety and efficacy of PD-1 inhibitors in patients with advanced cancers and HIV/AIDS in China
Authors: Xiong Yu , Mo Pingzheng , Yan Yajun , Wang Shan , Zhuang Ke , Ma Zhiyong , Chen Xiaoping , Deng Liping , Xiong Yong , Deng Di , Zhang Yongxi 
Published: September 2023

Purpose-Immunotherapy has revolutionized cancer therapy, becoming the standard of care for various malignancy treatments. Human immunodeficiency virus (HIV) patients, however, are an underserved group with limited access to clinical trials and cancer therapy. This study was to evaluate the safety and efficacy of programmed cell death 1 (PD - 1) inhibitors in patients with advanced cancer and HIV/acquired immunodeficiency syndrome (AIDS). Methods and Materials-We performed a prospective, open-label, nonrandomized, phase 1 single center study. Patients with advanced cancer and HIV/AIDS received the treatment of PD - 1 inhibitors (camrelizumab, 200 mg, administered intravenously every 3 weeks), along with combination antiretroviral therapy (cART) for HIV. Results-Sixteen participants (12 men and 4 women; median age, 46.5 (29 - 78) years) were enrolled; 1 had non - Hodgkin lymphoma (NHL), and 15 had non - AIDS - defining cancers. Safety was observed over 130 cycles of treatment with camrelizumab. Most treatment-emergent adverse events at least possibly attributed to camrelizumab were grade 1 or 2, including reactive cutaneous capillary endothelial proliferation (RCCEP) (9 participants), hearing loss (1 participant), hypophysitis (1 participant). 3 participants experienced hemorrhage due to poor performance status. HIV was controlled in all participants. Best tumor responses included 3 complete response, 5 partial response, 2 stable disease, and 6 progressive disease. The 2 years progression-free survival (PFS) was 67.0% (95% CI: -0.05, 0.00) and overall survival (OS) was 55.3% (95% CI: -0.05, 0.01) for the 16 patients who had received camrelizumab. Conclusions-This study demonstrates that camrelizumab treatment in patients with advanced cancers and HIV/AIDS was feasible and the clinical outcomes were acceptable.
Comparison of perioperative, oncologic, and functional outcomes between 3D and 2D laparoscopic radical prostatectomy: a systemic review and meta-analysis
Authors: Shuai Hui , Duan Xi , Wu Tao 
Published: September 2023

ObjectivesLiterature regarding experience with 3D laparoscopy about prostatectomy has remained scanty, and this could be related to the rise of robotic assisted laparoscopic surgery. This study aimed to perform a systemic review and meta-analysis to evaluate the perioperative, functional, and oncologic outcomes between 3D and 2D laparoscopic radical prostatectomy (LRP).MethodsWe systematically searched the PubMed, Embase, and Cochrane Library databases for studies that compared perioperative, functional, or oncologic outcomes of both 3D and 2D LRP. The Newcastle-Ottawa Scale (NOS) tool and Jadad scale were used to assess the risk of bias in the included studies. Review Manager 5.3 was used for the meta-analysis.ResultsSeven studies with a total of 542 patients were included in the analysis. Among them, two were RCTs. There was no difference between groups in terms of preoperative characteristics. Anastomosis time, hospital day, and overall complication rates were similar in 3D than 2D group. However, operative time [mean difference (MD) -36.96; 95% confidence interval [CI] -59.25 to -14.67; p = 0.001], blood loss (MD -83.5; 95% CI -123.05 to -43.94; p &lt;0.0001), and days of drainage (MD -1.48; 95% CI -2.29 to -0.67; p = 0.0003) were lower in 3D LRP. 2D and 3D LRP showed similarity in the positive surgical margin (PSM) rate and biochemical recurrence (BCR) rate at 3, 6, and 12months postoperatively. Additionally, there was no significant differences in continence and potency recovery rate between two group except higher continence rate of 3D LRP at 3 months.ConclusionCurrent evidence shows that 3D LRP offers favorable outcomes compared with 2D LRP, including operative time, blood loss, days of drainage, and early continence. However, there was no conclusive evidence that 3D LRP was advantaged in terms of oncologic and functional outcomes (except for continence rate at 3 months).Systematic review registrationThe study has been registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023426403).