bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in prevalence and management of chronic kidney disease among T2DM inpatients at the grassroots in Beijing and Taiyuan: a retrospective study
Authors: An Lingwang , Wang Dandan , Shi Xiaorong , He Yali , Lee Yaujiunn , Lu Juming 
Published: July 2023

Abstract
Purpose
Chronic kidney disease (CKD) has been one of the most common complications in type 2 diabetes mellitus (T2DM) patients. This retrospective study aimed to investigate the regional differences in the prevalence and management of CKD in T2DM inpatients from two grassroots hospitals in Beijing and Taiyuan.

Methods
The sociodemographic status, health history, lifestyle information, biochemical parameters and drug choices of the patients were collected from the Diabetes Care Information System using a retrospective cross-sectional analysis. The presence of CKD was defined as albuminuria (urine albumin-to-creatinine ratio of ≥ 30 mg/g) and/or as a reduced estimated glomerular filtration rate (< 60 ml/min/1.73 m2).

Results
858 patients with T2DM in Beijing and 1,085 patients with T2DM in Taiyuan were included, with a median age of 61.0 and 61.9 years, respectively. The duration of diabetes was 10.5 and 10.3 years, respectively. The prevalence of CKD in Beijing (39.2%) was significantly higher than in Taiyuan (22.4%). The overall ABC control (A = haemoglobin A1c; B = blood pressure; C = cholesterol) in both the Beijing and Taiyuan groups were not ideal. Patients with CKD tended to use insulin, renin–angiotensin–aldosterone system (RAAS) inhibitors, sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and dyslipidaemia therapy in Taiyuan than in Beijing. The actual proportion of carbohydrate, fat and protein in calories was 49.6%:35.4%:14.4% in Beijing and 61.5%:27.8%:10.8% in Taiyuan.

Conclusions
The higher prescription rates of RAAS inhibitors, SGLT-2i and dyslipidaemia therapy may underlie the fluctuations in the prevalence of CKD in Beijing or Taiyuan. Intensive insulin therapy and personal nutritional guidance, along with the extensive use of RAAS inhibitors, SGLT-2i and dyslipidaemia therapy during follow-up, can all play a positive role in the management of CKD in patients with T2DM in both Beijing and Taiyuan.
Development and content validity assessment of the Dry Eye Disease Questionnaire in patients with dry eye disease, meibomian gland dysfunction, and Sjögren’s syndrome dry eye disease
Authors: Sloesen Brigitte , Young Alyson , Forde Katie , Hodson Nicola , Bentley Sarah , Walsh Oonagh , Naujoks Christel , O’Brien Paul , Sharma Garima 
Published: July 2023

Abstract
Background
Dry eye disease (DED), Meibomian gland dysfunction (MGD), and Sjögren’s syndrome dry eye disease (SS-DED) are eye dryness conditions that show significant overlap in various symptoms of ocular discomfort. The aim of this study was to qualitatively explore the patient experience and evaluate content validity of the newly developed Dry Eye Disease Questionnaire (DED-Q).

Methods
Semi-structured interviews were conducted with 61 US adults who reported experiencing ocular symptoms due to their physician-confirmed primary diagnosis of DED (n = 21), MGD (n = 20), or SS-DED (n = 20). The open-ended concept-elicitation phase was followed by cognitive debriefing (CD) of the DED-Q to evaluate participants’ understanding and relevance of the instructions, items, response options, and recall periods. Interviews were also conducted with eight specialist healthcare professionals to assess clinical relevance of the concepts included. Verbatim interview transcripts were analyzed using thematic analysis in ATLAS.ti v8 software.

Results
A total of 29 symptoms and 14 impacts on quality of life were reported across participant interviews. Primary ocular symptoms reported included eye dryness (n = 61/61; 100%), eye irritation (n = 55/61; 90%), eye itch (n = 54/61; 89%), burning sensation (n = 52/61; 85%), and foreign body sensation (n = 51/61; 84%). The most impacted aspects of daily life were using digital screens (n = 46/61; 75%), driving (n = 45/61; 74%), working (n = 39/61; 64%), and reading (n = 37/61; 61%). CD findings showed most participants had good understanding of DED-Q items and confirmed most concepts were relevant to the lived experience of their condition. Aside from few minor changes to the items and examples to facilitate more accurate interpretation, the proposed instruction wording was modified for various symptom and impact modules to encourage participants to focus only on dry eye vision problems.

Conclusions
This research identified multiple prevalent symptoms and impacts of DED, MGD, and SS-DED, most of which were similar across the conditions. The DED-Q was confirmed to be a content-valid PRO measure suitable for use in clinical studies to assess the patient experience of DED, MGD, and SS-DED. Future work will focus on evaluating the psychometric properties of the DED-Q for use as an efficacy endpoint in clinical trials.
Interval between two-stage exchanges: what is optimal and how do you know?
Authors: Sousa Ricardo , Carvalho André , Soares Daniel , Abreu Miguel Araújo 
Published: July 2023

Abstract
Background
Two-stage exchange arthroplasty remains the most popular option for the treatment of chronic periprosthetic joint infection (PJI). Determining infection eradication and optimal timing of reimplantation can be challenging. Information to allow for a truly informed evidence-based decision is scarce.

Methods
We conducted a critical review of available evidence on the presently available tests to help determine timing of reimplantation.

Results
Serology is traditionally used to follow up patients after the first stage. Despite tradition mandates waiting for normal inflammatory markers, there is actually no evidence that they correlate with persistent infection. The role of synovial fluid investigation between stages is also explored. Cultures lack sensitivity and neither differential leukocyte counts nor alternative biomarkers have proven to be accurate in identifying persistent infection with a spacer in situ. We also examined the evidence regarding the optimal time interval between resection and reimplantation and whether there is evidence to support the implementation of a two week “antibiotic holiday” prior to proceeding with reimplantation. Finally, wound healing and other important factors in this setting will be discussed.

Conclusion
Currently there are no accurate metrics to aid in the decision on the optimal timing for reimplantation. Decision must therefore rely on the resolution of clinical signs and down trending serological and synovial markers.
Advances in mass transfer and fluid flows in non-thermal food processing industry – a review
Authors: Al-Najjar Shahad Z. , Al-Sharify Zainab T. , Onyeaka Helen , Miri Taghi , Obileke KeChrist , Anumudu Christian K. 
Published: July 2023

AbstractAll around the world, food processing techniques make use of various kinds of treatments to improve the shelf-life of foods. The commonly used thermal treatments are likely to result in deteriorating the sensory as well as nutritional qualities of foods. However, consumers are now demanding for safer and cleaner food without needing to compromise on the quality. Owing to the evolving nature of consumer demands, food technologists and others in the agro-food chain have devised processes to meet these changing demands by considering new non-thermal food processing techniques, which achieve microbiological inactivation in food materials without the application of heat directly. This review provides an appraisal on certain non-thermal food processing technologies with a focus on their operational mechanisms and success in the preservation of numerous kinds of food and offers an outline on the developments in non-thermal food processing techniques used in the food industry to enhance mass transfers. Increase in mass transfer is of industrial interest owing to a reduction in operation time. Use of a faster mass transfer velocity in the process produces multiple benefits, such as an increase in productivity, the preservation of physiological and nutritional value of food components, and a reduction in economic costs. The review demonstrates that techniques such as Pulsed Electric Field, Ultrasonication and Supercritical technology are viable treatments for enhancing mass transfer in the food processing industries.
Graphical Abstract
Satisfaction of cardiac surgery trainees with the residency training program in Saudi Arabia: a survey-based study
Authors: Abdulrahman Osama Abdullah , Baaqeel Rahaf Ghassan , Bahakeem Reem Faisal , Alotaibi Naif Fahad , Almarjan Asayil Yousef , Alsulami Marah Meshal , Babgi Mohammad Fawzi , Ahmed Elnazeer Osman 
Published: July 2023

Abstract
Background
There is a direct relationship between the degree of trainees’ satisfaction and their productivity. The Saudi Board of Cardiac Surgery is a new training program established by the Saudi Commission for Health Specialties. As a result, we aimed to provide helpful information and data in order to improve the overall quality of the local cardiac training program. This is the first study to look at how satisfied residents are with the Saudi cardiac surgery training program.

Results
The study included 55.3% central region residents (N = 26), 31.9% western region residents (N = 15), and others from other regions, resulting in a total of 47 participants out of 60 with a 78.3% response rate. Only 42.6% of all residents were satisfied with their training in the Saudi Board of Cardiac Surgery program, 23.4% were neutral, and 34.0% were dissatisfied with the program. The most essential area for improvement was operative experience (63.8%), followed by workplace climate (8.5%) and mentorship (6.4%), whereas the area least in need of improvement was research opportunities (2.1%).

Conclusions
Our results indicate a decline in satisfaction level with the training program. In reference to our findings, implementing simulation-based surgical learnings and providing more frequent exposure to Boot Camp experience in cardiac surgery is recommended. Adequate and constant mentoring, and constructive feedback, represent a valuable resource for improvement theoretically and surgically.
Evaluation of surgical approaches to infratemporal and pterygopalatine fossae
Authors: Behairy Essam A. , Barsem Neveen G. , Eldemerdash Ashraf A. 
Published: July 2023

Abstract
Background
Tumors in the pterygopalatine fossa (PPF) and infratemporal fossa (ITF) are still challenging to surgeons because of their deep location and proximity to various arteries and cranial nerves. This study aimed to evaluate the access to infratemporal fossa and pterygopalatine fossa through anterior transmaxillary, modified endoscopic transnasal transmaxillary approaches. The study was a prospective comparative study conducted on 20 patients having a mass in pterygopalatine or infratemporal fossa. History, examination, computed tomography, and magnetic resonance imaging were performed for all patients. Nine patients were operated with anterior transmaxillary approach and eleven patients were operated with endoscopic transnasal transmaxillary approach. The operative duration, intraoperative blood loss, and operative difficulty were assessed. Patients were assessed 1 week postoperatively using a nasal surgical questionnaire for postoperative nasal symptoms. Endoscopic assessment of the nose was done 1 week postoperative to assess the degree of crusting and 4 weeks postoperative to assess nasal adhesions. Postoperative complications were assessed for both groups.

Results
There was a significant difference between the two groups regarding operative duration and blood loss favoring the endoscopic group. There was a non-significant difference between the two groups regarding operative difficulty. There was a significant difference between the two groups regarding nasal obstruction, crustation, bleeding, sneezing, secretion, and nasal pain. There was a significant difference between the two groups regarding the endoscopic assessment for nasal crusting and adhesions. Facial swelling and numbness of the face were significantly more in the open group compared with the endoscopic group.

Conclusion
Endoscopic endonasal transmaxillary approach had less trauma and lower complication rate while anterior transmaxillary was technically feasible and offered excellent surgical access with easy lateral expansion toward the infratemporal fossa. Both approaches had comparable operative difficulty and acceptable postoperative quality of life.
Individual and joint associations of anxiety disorder and depression with cardiovascular disease: A UK Biobank prospective cohort study
Authors: Nakada Shinya , Ho Frederick K. , Celis-Morales Carlos , Jackson Caroline A. , Pell Jill P. 
Published: July 2023

Abstract

Background
Growing evidence suggests that individuals with anxiety disorder have an elevated risk of cardiovascular disease (CVD) but few studies have assessed this association independently of or jointly with depression.

Methods
We conducted a prospective cohort study using UK Biobank. Diagnoses of anxiety disorder, depression, and CVDs were ascertained through linked hospital admission and mortality data. Individual and joint associations between anxiety disorder and depression and CVD overall, as well as each of myocardial infarction, stroke/transient ischemic attack, and heart failure, were analyzed using Cox proportional hazard models and interaction tests.

Results
Among the 431,973 participants, the risk of CVD was higher among those who had been diagnosed with anxiety disorder only (hazard ratio [HR] 1.72; 95% confidence interval [CI] 1.32–2.24), depression only (HR 2.07; 95% CI 1.79–2.40), and both conditions (HR 2.89; 95% CI 2.03–4.11) compared to those without these conditions, respectively. There was very little evidence of multiplicative or additive interaction. Results were similar for myocardial infarction, stroke/transient ischemic attack, and heart failure.

Conclusions
Having anxiety is associated with the same magnitude of increased risk of CVD among people who do not have depression and those who do. Anxiety disorder should be considered for inclusion in CVD risk prediction and stratification, in addition to depression.
Quest for a universal cluster preformation formula: A new paradigm for estimating the cluster formation energy
Authors: Majekodunmi Joshua T. , Kumar Raj , Bhuyan M. 
Published: July 2023

Abstract
This study presents a holistic picture of the preformation of nuclear clusters with credence to the kinematics of their emissions. Besides the fitting of the preformation formula to reproduce the experimental half-lives, we have investigated the interrelationship between the parameters involved in the cluster decay process for medium, heavy and superheavy nuclei. Based on the established conceptual findings, we propose a new cluster preformation probability (P
0) formula that incorporates all influential parameters of the cluster radioactivity and thus has an edge over the existing formulae in the literature. Further, we hypothesize that a fraction of the decay energy is needed for cluster formation within the parent nucleus. The proposed formula opens a new paradigm to separately estimate the energy contributed during the cluster formation from its emission and thus shows that the contribution of the Q-value splits into three major parts accounting for the energy contributed during the cluster preformation, its emission and recoil of the daughter nucleus. Moreover, the expression P
0 is adept at accommodating the theorized concept of heavy particle radioactivity (HPR). The result reveals that, like α-decay, a proper estimation of the P
0- and Q-value in the cluster studies is enriched with qualitative information about the nuclear structure. However, from the analysis, the Geiger-Nuttall law is not the best compromise in the clustering due to the non-linearity between log10 T
1/2 and

, unlike in α-decay. We have demonstrated that with the inclusion of the proposed formula, the half-life predictions from both microscopic R3Y and phenomenological M3Y NN potentials closely agree with the available experimental data and that the slight variation can be traced to their peculiar barrier characteristics.
Hemoglobin Levels Improve Fracture Risk Prediction in Addition to FRAX Clinical Risk Factors and Bone Mineral Density
Authors: Jaiswal Raju , Johansson Helena , Axelsson Kristian F , Magnusson Per , Harvey Nicholas C , Vandenput Liesbeth , McCloskey Eugene , Kanis John A , Litsne Henrik , Johansson Lisa , Lorentzon Mattias 
Published: July 2023

Abstract

Context
Anemia and decreasing levels of hemoglobin (Hb) have previously been linked to increased fracture risk, but the added value to FRAX, the most utilized fracture prediction tool worldwide, is unknown.

Objective
To investigate the association between anemia, Hb levels, bone microstructure, and risk of incident fracture and to evaluate whether Hb levels improve fracture risk prediction in addition to FRAX clinical risk factors (CRFs).

Methods
A total of 2778 community-dwelling women, aged 75-80 years, and part of a prospective population-based cohort study in Sweden were included. At baseline, information on anthropometrics, CRFs, and falls was gathered, blood samples were collected, and skeletal characteristics were investigated using dual-energy x-ray absorptiometry and high-resolution peripheral quantitative computed tomography. At the end of follow-up, incident fractures were retrieved from a regional x-ray archive.

Results
The median follow-up time was 6.4 years. Low Hb was associated with worse total hip and femoral neck bone mineral density (BMD), and lower tibia cortical and total volumetric BMD, and anemia was associated with increased risk of major osteoporotic fracture (MOF; hazard ratio 2.04; 95% CI 1.58-2.64). Similar results were obtained for hip fracture and any fracture, also when adjusting for CRFs. The ratio between 10-year fracture probabilities of MOF assessed in models with Hb levels included and not included ranged from 1.2 to 0.7 at the 10th and 90th percentile of Hb, respectively.

Conclusion
Anemia and decreasing levels of Hb are associated with lower cortical BMD and incident fracture in older women. Considering Hb levels may improve the clinical evaluation of patients with osteoporosis and the assessment of fracture risk.
Pheochromocytomas Most Commonly Present As Adrenal Incidentalomas: A Large Tertiary Center Experience
Authors: Aggarwal Sunil , Prete Alessandro , Chortis Vasileios , Asia Miriam , Sutcliffe Robert P , Arlt Wiebke , Ronchi Cristina L , Karavitaki Niki , Ayuk John , Elhassan Yasir S 
Published: July 2023

Abstract

Context
Pheochromocytomas are increasingly diagnosed in incidentally detected adrenal masses. However, the characteristics of incidental pheochromocytomas are unclear.

Objective
We aimed to assess the proportion and clinical, biochemical, radiological, genetic, histopathological, and follow-up characteristics of incidental pheochromocytomas.

Methods
A retrospective review was conducted of patients with pheochromocytoma seen between January 2010 and October 2022 at a large UK tertiary care center. The diagnosis was confirmed histologically or by the combined presence of increased plasma and/or urinary metanephrines (MN), indeterminate adrenal mass on cross-sectional imaging, and metaiodobenzylguanidine avidity.

Results
We identified 167 patients with pheochromocytoma; 144 (86.2%) underwent adrenalectomy, for 23 (13.8%) surgery was either awaited, deemed unsuitable due to frailty or other metastatic malignancy, or declined by the patients. Excluding pheochromocytomas diagnosed via screening genetically predisposed individuals (N = 20), 37 of 132 (28.0%) presented with adrenergic symptoms and/or uncontrolled hypertension, while 91 of 132 (69.0%) patients presented with an incidentally detected adrenal mass. Incidentally detected patients were older (median age 62 years) than those detected due to clinical suspicion (aged 42 years) or after genetic screening (aged 33 years) (all P &lt; .05). Incidentally detected pheochromocytomas were smaller (median 42 mm) than tumors detected due to adrenergic symptoms/uncontrolled hypertension (60 mm), but larger than tumors identified by genetic screening (30 mm) (all P &lt; .05). Increased MN excretion showed a similar pattern (symptomatic/uncontrolled hypertension &gt; incidental &gt; genetic screening) (all P &lt; .05). Hereditary predisposition was detected in 20.4% of patients (incidental, 15.3%; symptomatic/uncontrolled hypertension, 42.9%).

Conclusion
The majority of pheochromocytomas are diagnosed incidentally and have distinct clinical, radiological, biochemical, and genetic features. Their detection at older age but smaller size may point to a different underlying tumor biology.
It’s a Balancing Act! Menopausal Symptoms in Competitive Weightlifters
Authors: Huebner Marianne , Ma Wenjuan 
Published: July 2023

ABSTRACT

Introduction
Athletes may be unprepared for the onset and duration of menopausal symptoms and how they affect training and competition goals. There are inconsistent results about physical activity and menopausal symptoms, and guidance for athletes is lacking.

Purpose
We aimed to study the reciprocal association of performance and weekly hours of weightlifting training with menopausal symptoms.

Methods
Women reported the frequency of weightlifting training and additional physical activities, heaviest weight lifted, and menopausal symptoms using the validated Menopausal Rating Scale. An online survey was distributed by national governing bodies in 30 countries to female master weightlifters (ages 30 to 79 yr) in May 2022. Simultaneous equation models were used to provide reliable estimates in the presence of contemporaneous effects.

Results
Participants included 868 women, 178 postmenopausal. The proportions of moderate or more severe somato-vegetative symptoms and psychological symptoms were 25.7% and 46.5%, respectively. Better performance, defined as weight lifted relative to age and body weight, was associated with a lower score of menopausal symptoms (−0.51, P < 0.001); worse menopausal symptoms were associated with lower performance (−1.22 for somato-vegetative, −2.19 for psychological; P < 0.001). More hours of weightlifting training were associated with worse menopausal symptoms, whereas more hours of other physical activities were associated with worse somato-vegetative but not with psychological symptoms. Instrumental variables in the model were joint pain and protein tracking. The majority tracked their daily protein intake (62.8%) with a median of 1.9 g·kg−1 body mass.

Conclusion
Somato-vegetative symptoms were less prevalent in weightlifters than in the general population. There is simultaneous feedback between sport performance and severity of menopausal symptoms. Athletes must balance training intensity and menopausal symptoms to achieve training goals.