bluuebunny/crossref_metadata_2025_split huggingface dataset:
Projected effects of climate change on marine ecosystems in Southeast Asian seas
Authors: Kay Susan , Avillanosa Arlene L. , Cheung Victoria V. , Dao Hung N. , Gonzales Benjamin Jareta , Palla Herminie P. , Praptiwi Radisti A. , Queirós Ana M. , Sailley Sévrine F. , Sumeldan Joel D. C. , Syazwan Wan Mohd , Then Amy Yee-Hui , Wee Hin Boo 
Published: March 2023

The seas of Southeast Asia are home to some of the world’s most diverse ecosystems and resources that support the livelihoods of millions of people. Climate change will bring temperature changes, acidification and other environmental change, with uncertain consequences for human and natural systems, but there has been little regional-scale climate modelling of the marine ecosystem. We present initial dynamically downscaled projections using a biogeochemical model suitable for coastal and shelf seas. A coupled physical-biogeochemical model with a resolution of 0.1° (approximately 11 km) was used to create projections of future environmental conditions under moderate (RCP4.5) and high (RCP8.5) greenhouse gas scenarios. Changes for different parts of the region are presented, including four sensitive coastal sites of key importance for biodiversity and sustainable development: UNESCO Biosphere Reserves at Cu Lao Cham-Hoi An in Vietnam, Palawan in the Philippines and Taka Bonerate-Kepulauan Selayar in Indonesia, and coastal waters of Sabah, Malaysia, which include several marine parks. The projections show a sea that is warming by 1.1 to 2.9°C through the 21st century, with dissolved oxygen decreasing by 5 to 13 mmol m-3 and changes in many other environmental variables. The changes reach all parts of the water column and many places are projected to experience conditions well outside the range seen at the start of the century. The resulting damage to coral reefs and altered species distribution would have consequences for biodiversity, the livelihoods of small-scale fishers and the food security of coastal communities. Further work using a range of global models and regional models with different biogeochemical components is needed to provide confidence levels, and we suggest some ways forward. Projections of this type serve as a key tool for communities and policymakers as they plan how they will adapt to the challenge of climate change.
Graphene-bioactive glass composites: Structural, Vickers hardness, and gamma-ray attenuation characteristics
Authors: Deliormanli Aylin M. , ALMisned Ghada , Ene Antoaneta , Tekin H.O. 
Published: March 2023

Introduction: Graphene-based materials have gained increasing attention for use in radiation attenuation applications. In this study, pristine graphene nanoplatelet-containing (1, 3, 5, and 10 wt%) borate-based bioactive glass composites were prepared.Methods: Structural properties, Vickers microhardness, and gamma-ray radiation shielding properties of the fabricated composites were examined in detail.Results and Discussion: Results revealed that the inclusion of the graphene in the glass matrix led to a decrease in the bulk density of the glass-based composites from 2.41 to 2.31 g/cm3. Similarly, a decrease in Vickers hardness was obtained as the graphene concentration was increased due to a convoluted effect of the non-uniform distribution of graphene nanoplatelets in the bioactive glass matrix and the higher residual porosity. Vickers hardness of the bare and the 10 wt% graphene-containing bioactive glass discs were measured to be 5.03 ± 0.28 GPa and 1.87 ± 0.56 GPa, respectively. On the other hand, the incorporation of graphene starting from 3 wt% decreased the crack propagation after indentation which may be attributed to an increase in fracture toughness. In the study, fundamental gamma ray absorption properties of graphene-containing bioactive glasses were examined in the 0.015–15 MeV incident photon energy range. For this purpose, the Py-MLBUF code was employed to determine gamma ray absorption parameters. Results showed that linear attenuation coefficients of the glass-based composites decreased due to a decrease in the density of the samples. On the other hand, as graphene was incorporated into the bioactive glass structure, exposure buildup factor and energy absorption buildup factor values increased. The growing graphene ratio in the glass structure contributed negatively to the photon’s tendency to interact with the material.
The association of coital incontinence with clinical factors and single voiding cycle ambulatory urodynamic monitoring findings in women
Authors: Çetinkaya Şerife Esra , Seval Mehmet Murat , Varlı Bulut , Dökmeci Fulya 
Published: March 2023

IntroductionCoital incontinence (CI) is a frequent problem in women with urinary incontinence (UI) with significant impact on female sexuality and quality of life. The underlying mechanism is controversial; it has been known that CI is associated with both stress urinary incontinence (SUI) and detrusor overactivity (DO). However, recently it has been reported that CI is mainly related with SUI and urethral incompetence, but not with DO. Ambulatory urodynamic monitoring (AUM) has been shown to be a sensitive tool for the detection of DO. The aim of this study was to investigate the clinical risk factors for CI and the association of CI with urodynamic diagnoses at single voiding cycle AUM.MethodsRecords of sexually active women with urinary incontinence attending the urogynaecology unit of a university hospital, who completed the PISQ-12 were reviewed retrospectively (n = 1,005). Patients were grouped using the 6th question; patients answering “never” to this question were considered as continent during coitus (n = 591) and patients reporting any urinary leakage at coitus were considered to have CI (n = 414). Demographics, clinical examination findings, incontinence severity measured by the Sandvik Incontinence Severity Index, scores of Turkish validated questionnaires (PFDI-20, IIQ-7, OAB-V8, and PISQ-12) and single voiding cycle AUM findings were compared, and univariate and multivariate logistic regression analyses were performed.ResultsAmong all sexually active women with UI, 41.2% had CI; UI was more severe, symptom bother was higher, related quality of life (p &lt; 0.001) and sexual function were worse (≤0.018) in these women. Younger age (OR 0.967, p &lt; 0.001), history of vaginal delivery (OR 2.127, p = 0.019), smoking (OR 1.490, p = 0.041), postural UI (OR 2.012, p = 0.001), positive cough stress test (OR 2.193, p &lt; 0.001), and positive SEST (OR 1.756, p = 0.01) were found as independent clinical factors associated with CI. Urodynamic SUI (OR 2.168, p = 0.001) and MUI (OR 1.874, p = 0.002) were found as significant and independent urodynamic diagnoses associated with CI, whereas no association was found with DO or UUI.ConclusionBoth clinical and AUM findings supported that CI is a more severe form of UI that it is mainly related with SUI and urethral incompetence, but not with UUI or DO.
Dynamic nature and prognostic value of the neutrophil-to-lymphocyte ratio in critically ill patients with acute kidney injury on continuous renal replacement therapy: A multicenter cohort study
Authors: Ko Hyun Lee , Jung Jiyun , Lee Jangwook , Lim Jeong-Hoon , Im Dha Woon , Kim Yong Chul , Paek Jin Hyuk , Park Woo Yeong , Kim Kyeong Min , Lee Soyoung , Lee Sung Woo , Shin Sung Joon , Kim Dong Ki , Han Seung Seok , Baek Chung Hee , Kim Hyosang , Park Jae Yoon , Ban Tae Hyun , Kim Kipyo 
Published: March 2023

IntroductionPatients with acute kidney injury (AKI) receiving renal replacement therapy constitute the subgroup of AKI with the highest risk of mortality. Despite recent promising findings on the neutrophil-to-lymphocyte ratio (NLR) in AKI, studies have not yet addressed the clinical implication of the NLR in this population. Therefore, we aimed to examine the prognostic value of NLR in critically ill patients requiring continuous renal replacement therapy (CRRT), especially focusing on temporal changes in NLR.MethodsWe enrolled 1,494 patients with AKI who received CRRT in five university hospitals in Korea between 2006 and 2021. NLR fold changes were calculated as the NLR on each day divided by the NLR value on the first day. We performed a multivariable Cox proportional hazard analysis to assess the association between the NLR fold change and 30-day mortality.ResultsThe NLR on day 1 did not differ between survivors and non-survivors; however, the NLR fold change on day 5 was significantly different. The highest quartile of NLR fold change during the first 5 days after CRRT initiation showed a significantly increased risk of death (hazard ratio [HR], 1.65; 95% confidence intervals (CI), 1.27–2.15) compared to the lowest quartile. NLR fold change as a continuous variable was an independent predictor of 30-day mortality (HR, 1.14; 95% CI, 1.05–1.23).ConclusionIn this study, we demonstrated an independent association between changes in NLR and mortality during the initial phase of CRRT in AKI patients receiving CRRT. Our findings provide evidence for the predictive role of changes in the NLR in this high-risk subgroup of AKI.
Deep-learning-based survival prediction of patients with cutaneous malignant melanoma
Authors: Yu Hai , Yang Wei , Wu Shi , Xi Shaohui , Xia Xichun , Zhao Qi , Ming Wai-kit , Wu Lifang , Hu Yunfeng , Deng Liehua , Lyu Jun 
Published: March 2023

BackgroundThis study obtained data on patients with cutaneous malignant melanoma (CMM) from the Surveillance, Epidemiology, and End Results (SEER) database, and used a deep learning and neural network (DeepSurv) model to predict the survival rate of patients with CMM and evaluate its effectiveness.MethodsWe collected information on patients with CMM between 2004 and 2015 from the SEER database. We then randomly divided the patients into training and testing cohorts at a 7:3 ratio. The likelihood that patients with CMM will survive was forecasted using the DeepSurv model, and its results were compared with those of the Cox proportional-hazards (CoxPH) model. The calibration curves, time-dependent area under the receiver operating characteristic curve (AUC), and concordance index (C-index) were used to assess the prediction abilities of the model.ResultsThis study comprised 37,758 patients with CMM: 26,430 in the training cohort and 11,329 in the testing cohort. The CoxPH model demonstrated that the survival of patients with CMM was significantly influenced by age, sex, marital status, summary stage, surgery, radiotherapy, chemotherapy, postoperative lymph node dissection, tumor size, and tumor extension. The C-index of the CoxPH model was 0.875. We also constructed the DeepSurv model using the data from the training cohort, and its C-index was 0.910. We examined how well the aforementioned two models predicted outcomes. The 1-, 3-, and 5-year AUCs were 0.928, 0.837, and 0.855, respectively, for the CoxPH model, and 0.971, 0.947, and 0.942 for the DeepSurv model. The DeepSurv model presented a greater predictive effect on patients with CMM, and its reliability was better than that of the CoxPH model according to both the AUC value and the calibration curve.ConclusionThe DeepSurv model, which we developed based on the data of patients with CMM in the SEER database, was found to be more effective than the CoxPH model in predicting the survival time of patients with CMM.
Experiences with and perspectives on advance care planning in young- and late- onset dementia: A focus group study with physicians from various disciplines
Authors: Van Rickstal Romy , De Vleminck Aline , Engelborghs Sebastiaan , Van den Block Lieve 
Published: March 2023

IntroductionDespite the relevance of advance care planning (ACP) for people with dementia, its uptake in this population is particularly low. Several challenges for ACP in dementia have been identified from physicians’ perspectives. However, the literature available mainly includes general practitioners and focuses exclusively on the context of late-onset dementia. This is the first study to inquire physicians from four highly relevant specialisms in dementia care, with a focus toward potential specificities based on patients’ age. The research question of this study is: “What are physicians’ experiences with and perspectives on discussing ACP with people with young- and/or late-onset dementia?”.MethodsFive online focus groups were conducted with 21 physicians (general practitioners, psychiatrists, neurologists and geriatricians) in Flanders, Belgium. Verbatim transcripts were analyzed through the qualitative method of constant comparative analysis.ResultsPhysicians believed that the societal stigma related to dementia influences people’s reaction to their diagnosis, at times characterized by catastrophic expectations for the future. In this regard, they explained that the topic of euthanasia is sometimes addressed by patients very early in the disease trajectory. Respondents paid ample attention to actual end-of-life decisions, including DNR directives, when discussing ACP in dementia. Physicians felt responsible for providing accurate information on both dementia as a condition, and the legal framework of end-of-life decisions. Most participants felt that patients’ and caregivers’ wish for ACP was more driven by who their personality than by their age. Nonetheless, physicians identified specificities for a younger dementia population in terms of ACP: they believed that ACP covered more domains of life than for older persons. A high consistency regarding the viewpoints of physicians from differing specialisms was noted.DiscussionPhysicians acknowledge the added value of ACP for people with dementia and especially their caregivers. However, they face several challenges for engaging in the process. Attending to specific needs in young-onset, in comparison to late-onset dementia, requires ACP to entail more than solely medical domains. However, a medicalized view on ACP still appears to be dominant in practice as opposed to its broader conceptualization in academia.
Effects of post-acute COVID-19 syndrome on the functional brain networks of non-hospitalized individuals
Authors: Churchill Nathan W. , Roudaia Eugenie , Chen J. Jean , Gilboa Asaf , Sekuler Allison , Ji Xiang , Gao Fuqiang , Lin Zhongmin , Jegatheesan Aravinthan , Masellis Mario , Goubran Maged , Rabin Jennifer S. , Lam Benjamin , Cheng Ivy , Fowler Robert , Heyn Chris , Black Sandra E. , MacIntosh Bradley J. , Graham Simon J. , Schweizer Tom A. 
Published: March 2023

IntroductionThe long-term impact of COVID-19 on brain function remains poorly understood, despite growing concern surrounding post-acute COVID-19 syndrome (PACS). The goal of this cross-sectional, observational study was to determine whether there are significant alterations in resting brain function among non-hospitalized individuals with PACS, compared to symptomatic individuals with non-COVID infection.MethodsData were collected for 51 individuals who tested positive for COVID-19 (mean age 41±12 yrs., 34 female) and 15 controls who had cold and flu-like symptoms but tested negative for COVID-19 (mean age 41±14 yrs., 9 female), with both groups assessed an average of 4-5 months after COVID testing. None of the participants had prior neurologic, psychiatric, or cardiovascular illness. Resting brain function was assessed via functional magnetic resonance imaging (fMRI), and self-reported symptoms were recorded.ResultsIndividuals with COVID-19 had lower temporal and subcortical functional connectivity relative to controls. A greater number of ongoing post-COVID symptoms was also associated with altered functional connectivity between temporal, parietal, occipital and subcortical regions.DiscussionThese results provide preliminary evidence that patterns of functional connectivity distinguish PACS from non-COVID infection and correlate with the severity of clinical outcome, providing novel insights into this highly prevalent disorder.
Rescue thrombolysis for medium vessel occlusion (RESCUE-TNK): Rationale and design of a phase 2 randomized trial
Authors: Hu Hai-Zhou , Qiu Jing , Li Wei , Nguyen Thanh N. , Wang Feng , Li Di , Shi Huai-Zhang , Wang Shou-Chun , Wei Ming , Chen Hui-Sheng 
Published: March 2023

BackgroundThe best reperfusion strategy for medium-sized vessel occlusion (MeVO) is not well established. Given the proven treatment effect of intra-arterial thrombolysis in patients with large vessel occlusion (LVO), we hypothesized that intra-arterial tenecteplase (TNK) could increase the recanalization rate of MeVO and thus improve clinical outcome.AimsTo explore the safety and efficacy of intra-arterial TNK in patients with MeVO.Sample size estimatesA maximum of 80 patients are required to test the superiority hypothesis, using power = 80% and α = 0.025 to conduct the one-sided test.DesignRescue treatment for mEdium veSsel oCclUsion by intra-artErial TNK (RESCUE-TNK) is a pilot, randomized, open-label, blinded end point, and multicenter trial. Eligible patients including primary MeVO as detected by the first DSA examination or secondary MeVO after endovascular treatment (EVT) for LVO will be assigned into the experimental group and control group as a ratio of 1:1. The experimental group will be treated with intra-arterial TNK (0.2–0.3 mg/min, for 20–30 min) via a microcatheter placed proximal to the site of occlusion, and the control group will be treated with routine therapy. Both groups of patients will be given standard stroke care based on the guidelines.OutcomeThe primary efficacy end point is successful recanalization of MeVO, defined as the expanded treatment in cerebral ischemia (eTICI) score 2b67-3 after the procedure, while the primary safety end point is symptomatic intracranial hemorrhage (sICH), defined as National Institutes of Health Stroke Scale score increase ≥4 caused by intracranial hemorrhage within 24 (−6/+24) hours after randomization.ConclusionThe results of RESCUE-TNK will provide evidence for the efficacy and safety of intra-arterial TNK in the recanalization of patients with MeVO.
The postoperative analgesic efficacy of different regional anesthesia techniques in breast cancer surgery: A network meta-analysis
Authors: An Ran , Wang Dan , Liang Xiao-Long , Chen Qi , Pang Qian-Yun , Liu Hong Liang 
Published: March 2023

BackgroundRegional anesthesia have been successfully performed for pain management in breast cancer surgery, but it is unclear which is the best regional anesthesia technique. The aim of the present network meta-analysis was to assess the analgesic efficacy and disadvantages of regional anesthesia techniques.MethodsMultiple databases were searched for randomized controlled trials (RCTs). The association between regional anesthesia and analgesic efficacy was evaluated by Bayesian network meta-analysis.ResultsWe included 100 RCTs and 6639 patients in this study. The network meta-analysis showed that paravertebral nerve block, pectoral nerve-2 block, serratus anterior plane block, erector spinae plane block, rhomboid intercostal block, and local anesthetic infusion were associated with significantly decreased postoperative pain scores, morphine consumption and incidence of postoperative nausea and vomiting compared with no block. Regarding the incidence of chronic pain, no significance was detected between the different regional anesthesia techniques. In the cumulative ranking curve analysis, the rank of the rhomboid intercostal block was the for postoperative care unit pain scores, postoperative 24-hour morphine consumption, and incidence of postoperative nausea and vomiting.ConclusionRegional anesthesia techniques including, paravertebral nerve block, pectoral nerve-2 block, serratus anterior plane block, erector spinae plane block, rhomboid intercostal block, and local anesthetic infusion, can effectively alleviate postoperative acute analgesia and reduce postoperative morphine consumption, but cannot reduce chronic pain after breast surgery. The rhomboid intercostal block might be the optimal technique for postoperative analgesia in breast cancer surgery, but the strength of the evidence was very low.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/(PROSPERO), identifier CRD 42020220763.
Exploration of the methods of establishing the minimum clinical important difference based on anchors and their applications in the quality of life measurement scale QLICP-BR (V2.0) for breast cancer
Authors: Zhou Xuan , Liu Yuxi , Tan Jianfeng , Hu Liren , Chen Huanwei , Wan Chonghua 
Published: March 2023

ObjectiveThe measurement of the quality of life (QOL) in patients with breast cancer can evaluate the therapeutic effects of medical treatments and help to provide reference for clinical decisions. The minimum clinically important difference (MCID) can be better used in clinical interpretation than the traditional statistical significance. Based on the anchors, a variety of ways including traditional and updated anchor-based methods were used to explore most suitable MCID, so that to find better interpretation on scores of the scale QLICP-BR(V2.0) (Quality of Life Instruments for Cancer Patients-Breast cancer).MethodsAccording to the investigation data of breast cancer patients before and after treatment, the most relevant indicators in various domains of QLICP-BR (V2.0) was found as an anchor to statistically analyze the value of MCID, and three analysis methods of anchors were used: Traditional anchor-based method, ROC curve method, multiple linear regression model analysis. Anchors are divided into four standards according to the degree of change in the treatment effect: one grade difference (Standard A), at least one grade difference (Standard B), one grade better (Standard C), better (Standard D). The final MCID value is selected from different statistical methods and classification standards that are most suitable for clinicians to use.ResultsUsing Q29 of the EORTC QLQ-C30 as an anchor has the highest correlation with each domain of QLICP. The order of magnitude of MCID values among the four standard groups is: standard A&lt; Standard C&lt; Standard B&lt; Standard D. The MCID value obtained by the ROC curve method is the most stable and is least affected by the sample size, and the MCID value obtained by the multiple linear regression model is the least. After comparisons and discussions, Standard C in the multiple linear regression model is used to determine the final MCID, which is the closest to other methods. After integer the MCID values of Physical domain (PHD), Psychological domain (PSD), Social domain (SOD), Common symptoms and side effect domain (SSD), Core/general module (CGD), Specific domain (SPD), Total score(TOT) can be taken as 15,10, 10, 11, 10, 9 and 9, respectively.ConclusionIn the evaluation of the QOL of breast cancer patients, although the results of MCID values produced by different methods are different, the results are relatively close. The anchor-based methods make the results of MCID more clinically interpretable by introducing clinical variables, and clinicians and researchers can choose the appropriate method according to the research purpose.