bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study on The Effect of Lean Management in Optimizing Nucleic Acid Testing Process in Outpatient Department
Authors: Huang Weiwei , Peng Xia 
Published: April 2022

Objective — To explore the application effect of lean management in optimizing nucleic acid testing process in outpatient department. Methods — A lean management team was established, and the statistics were observed on the spot. The key problems were identified by drawing fish-bone map through the flow chart of nucleic acid test of patients and the time required for each node. The lean management method was adopted to optimize and continuously improve the process. The length of waiting time of nucleic acid test patients before and after the implementation of lean management was compared, and the satisfaction questionnaire was used to analyze the difference between the reference group and the observation group. Results — After the implementation of lean management, the waiting time for nucleic acid test was reduced from 45.50 minutes to 22.36 minutes, and patient satisfaction was improved from 88.6% to 92%. Conclusions — Lean management can not only shorten the time for patients to see a doctor, improve the speed of nucleic acid testing, and patients can be effectively distributed to minimize the risk of cross-infection, improve patients' medical experience, and improve patient satisfaction.
Vascular Injury in the Zebrafish Tail Modulates Blood Flow and Peak Wall Shear Stress to Restore Embryonic Circular Network
Authors: Baek Kyung In , Chang Shyr-Shea , Chang Chih-Chiang , Roustaei Mehrdad , Ding Yichen , Wang Yixuan , Chen Justin , O'Donnell Ryan , Chen Hong , Ashby Julianne W. , Xu Xiaolei , Mack Julia J. , Cavallero Susana , Roper Marcus , Hsiai Tzung K. 
Published: April 2022

Graphical AbstractThe proposed mechanism of injury-mediated Notch and vascular loop formation.
Submarine Landslides in the West Continental Slope of the South China Sea and Their Tsunamigenic Potential
Authors: Pan Xiaoyi , Li Linlin , Nguyễn Hồng Phương , Wang Dawei , Switzer Adam D. 
Published: April 2022

The 109 meridian fault is located in the west of the South China Sea (SCS) connecting to the offshore Red River Shear Zone. Seismic data from the central Vietnamese shelf indicates that many submarine landslides were developed along the steep continental slope in this offshore region. Here, we analyze the potential for such landslides to trigger damaging tsunamis based on the local geological background and sedimentary environment. We assess their tsunamigenic potential along the coast of Southern Central Vietnam (SCV). We point out that the evolutionary processes of the 109° meridian fault: striking-subsidence of the adjacent basin, combined with the high sediment input from numerous montane rivers of the hinterland generate conditions that likely favor the development of submarine landslides along the well-defined and steep continental slope near SCV. To estimate the impact of tsunami waves on the SCV coastline, we conducted a pilot study using two numerical models: NHWAVE and FUNWAVE-TVD to model 4 representative landslides with volumes ranging between 1.3 and 14 km3 and water depth of 300–1000 m. The submarine landslides were treated as rigid slump and deformable slide corresponding to two different sedimentary environments. Our results show that the tsunami waves generated by rigid slump can reach up to 20 m height in the landslide source area and ∼5 m when arriving at the closest coastline. Tsunami waves could arrive at the central Vietnam coast within 30 min in eight scenarios. Our initial results also suggest that seafloor topography, i.e., waveguide effects of ocean ridges, shelf resonance and the potential bay resonance cause significant variability in potential run-up. We note that ocean ridges located in the deep basin of the SCS focus the tsunami energy propagating towards the northwest coast of Luzon Island, Philippines where tsunami wave heights of ∼2.3 m wave height are modeled. These findings underscore the importance of tsunami hazard assessments that account for both earthquake generated and earthquake triggered tsunamis. Our work also highlights a continued need to examine tsunami sources in the region as mitigation and preparedness for the socio-economically important and heavily populated coastlines of the SCS is reliant on a detailed understanding of the hazard.
Cardiorenal Risk Profiles Among Data-Driven Type 2 Diabetes Sub-Phenotypes: A Post-Hoc Analysis of the China Health and Nutrition Survey
Authors: Gao Hui , Wang Kan , Zhao Wensui , Zhuang Jianlin , Jiang Yu , Zhang Lei , Liu Qingping , Ahmadizar Fariba 
Published: April 2022

Background and AimEvidence about recently proposed data-driven clusters of type 2 diabetes (T2D) is mainly about its prognostic effects and Western populations. We tested the applicability of this clustering approach among the Chinese population. We further investigated the cardiorenal risk profiles among different T2D sub-phenotypes cross-sectionally and before diabetes diagnosis.MethodsWith the use of data from the China Health and Nutrition Survey (1989–2009), 6,728 participants with available fasting blood samples and completed questionnaires in the 2009 survey were included. Glycemic statuses (normoglycemia, prediabetes, and new-onset T2D) were defined according to the 2020 American Diabetes Association criteria. Data-driven cluster analysis was conducted among new-onset T2D based on five variables: age at onset, body mass index (BMI), hemoglobin A1c, homeostasis model estimates of β-cell function, and insulin resistance. Linear regression models were used to cross-sectionally examine the differences of cardiorenal risk factors (body fat distribution, blood pressure, lipid profiles, and kidney function) between glycemic statuses. Mixed-effects models were used to explore a maximum of 20-year trajectories of cardiovascular risk factors (body fat distribution and blood pressure) before diabetes diagnosis.ResultsAmong 557 (8.3%) new-onset T2D, four sub-phenotypes were found, with 57 (10.2%) assigned to the severe insulin-resistant diabetes (SIRD), 72 (12.9%) to the severe insulin-deficient diabetes (SIDD), 167 (30.0%) to the mild obesity-related diabetes (MOD), and 261 (46.9%) to the mild age-related diabetes (MARD). People clustered within different T2D sub-phenotypes had different cardiorenal risk profiles. Three T2D sub-phenotypes (SIRD, SIDD, and MOD) had worse cardiorenal abnormalities, while the risk burden in the MARD sub-phenotype was similar to that in prediabetes. Compared with people with other T2D sub-phenotypes, people in the MOD sub-phenotype had a faster increment in BMI, waist, upper arm circumference, and triceps skinfold up to 10 years before diagnosis. Blood pressure was less distinct in different T2D sub-phenotypes; however, SIDD and MOD clusters had higher blood pressure levels before diabetes diagnosis.ConclusionsData-driven T2D sub-phenotyping is applicable in the Chinese population. Certain sub-phenotypes such as MARD only have a minor cardiorenal risk burden, and distinct cardiovascular risk development occurs long before diabetes diagnosis. Our findings can help improve early prevention and targeted treatment for diabetes.
Endocrine Regulation on Bone by Thyroid
Authors: Zhu Siyuan , Pang Yidan , Xu Jun , Chen Xiaoyi , Zhang Changqing , Wu Bo , Gao Junjie 
Published: April 2022

BackgroundAs an endocrine organ, the thyroid acts on the entire body by secreting a series of hormones, and bone is one of the main target organs of the thyroid.SummaryThis review highlights the roles of thyroid hormones and thyroid diseases in bone homeostasis.ConclusionThyroid hormones play significant roles in the growth and development of bone, and imbalance of thyroid hormones can impair bone homeostasis.
Analysis on Large-Scale Solar PV Plant Energy Performance–Loss–Degradation in Coastal Climates of India
Authors: Navothna Bhogula , Thotakura Sandhya 
Published: April 2022

This article presents a detailed analysis of the performance, rate of degradation, and power and energy loss of a 1 MWp scale solar photovoltaic (PV) plant in the academic institution GITAM (Deemed to be University), located in the coastal region of Andhra Pradesh, India. The PV plant consists of 3,078 polycrystalline PV modules of 325 Wp rating, installed on the rooftop of the institute buildings. The annual energy generated is 1684.881 MWh. In this study, performance analysis involves the calculation of efficiency, capacity factor, and performance ratio with data simulated using the PVsyst tool. Degradation analysis involves energy light-induced degradation (LID) and degradation rate (DR). The predicted result provides an estimate for optimal functioning of PV plant with an annual capacity factor, performance ratio, and energy loss of 11.3%, 87.9%, and −26%, respectively. Energy loss by light-induced degradation is predicted as −2.7%/year, and the degradation rate of module per year is −0.6% to −5%.
Reinvestigating the Spatiotemporal Differences and Driving Factors of Urban Carbon Emission in China
Authors: Wang Ke-Liang , Xu Ru-Yu , Zhang Fu-Qin , Cheng Yun-He 
Published: April 2022

This study analyzed the spatiotemporal differences and driving factors of carbon emission in China’s prefecture-level cities for the period 2003–2019. In doing so, we investigated the spatiotemporal differences of carbon emission using spatial correlation analysis, standard deviation ellipse, and Dagum Gini coefficient and identified the main drivers using the geographical detector model. The results demonstrated that 1) on the whole, carbon emission between 2003 and 2019 was still high, with an average of 100.97 Mt. Temporally, carbon emission in national China increased by 12% and the western region enjoyed the fastest growth rate (15.50%), followed by the central (14.20%) and eastern region (12.17%), while the northeastern region was the slowest (11.10%). Spatially, the carbon emission was characterized by a spatial distribution of “higher in the east and lower in the midwest,” spreading along the “northeast–southwest” direction. 2) The carbon emission portrayed a strong positive spatial correlation with an imbalance polarization trend of “east-hot and west-cold”. 3) The overall differences of carbon emission appeared in a slow downward trend during the study period, and the interregional difference was the largest contributor. 4) Transportation infrastructure, economic development level, informatization level, population density, and trade openness were the dominant determinants affecting carbon emission, while the impacts significantly varied by region. In addition, interactions between any two factors exerted greater influence on carbon emission than any one alone. The findings from this study provide novel insights into the spatiotemporal differences of carbon emission in urban China, revealing the potential driving factors, and thus differentiated and targeted policies should be formulated to curb climate change.
Characteristics and Outcomes of Paroxysmal Sympathetic Hyperactivity in Anti-NMDAR Encephalitis
Authors: Chen Zhongyun , Zhang Yan , Wu Xiaowen , Huang Huijin , Chen Weibi , Su Yingying 
Published: April 2022

BackgroundTo explore the clinical characteristics and prognosis of autonomic dysfunction and paroxysmal sympathetic hyperactivity (PSH), and evaluate the efficacy of drugs used to suppress PSH episode in anti-NMDAR encephalitis patients.MethodsPatients who met the diagnostic criteria of anti-NMDAR encephalitis were enrolled from January 2012 to August 2018 and followed up for 2 years. PSH was diagnosed according to the PSH-Assessment Measure. The demographics data, clinical features, auxiliary tests results, treatments, and outcomes were prospective collected and analyzed.ResultsA total of 132 anti-NMDAR encephalitis patients were enrolled, of which 27.3% and 9.1% experienced autonomic dysfunction and probable PSH respectively. Cardiac autonomic dysfunction was the most common subtype (77.8%). Patients with a higher incidence of ovarian teratoma, mechanical ventilation, neurological intensive care unit admission, and elevated glucose and NMDAR antibody titer in the CSF were more likely to exhibit autonomic dysfunction or PSH. Episodes of PSH can be suppressed by monotherapy in patients without prior sedative drug use with an efficacy of 90%. No significant difference was observed between the prognosis of patients with or without autonomic dysfunction, or between the PSH versus non-PSH groups after 6 months and even during long-term follow-up. However, patients with cardiac autonomic dysfunction had poor prognosis at 6 months.ConclusionPSH is a common clinical condition in patients with anti-NMDAR encephalitis, especially in severe cases, and can be effectively managed by several drug monotherapies. Despite necessitating longer hospital stay, autonomic dysfunction or PSH do not seem to compromise the neurological recovery of patients.
Interleukin-26 Expression in Inflammatory Bowel Disease and Its Immunoregulatory Effects on Macrophages
Authors: Song Dongjuan , Lai Lijie , Lu Juntao , Tong Jinlu , Ran Zhihua 
Published: April 2022

Background and AimInterleukin-26 (IL-26) has been implicated in several chronic inflammatory diseases. However, its role in inflammatory bowel disease (IBD) remains to be elucidated. We aimed to investigate IL-26 expression in IBD and its immunoregulatory effects on macrophages.MethodsWe assessed IL-26 expression in the intestinal mucosa and blood samples of IBD patients and healthy controls (HC). The associations between the clinical characteristics of IBD and IL-26 expression levels in serum and peripheral blood mononuclear cells (PBMCs) were investigated. In addition, the transcriptional changes in THP-1 macrophages exposed to IL-26 were determined by RNA sequencing and validated with qRT-PCR, ELISA and western blots.ResultsCompared with HC, in IBD patients, IL-26 expression levels were elevated in the inflamed intestinal mucosa, and reduced in serum and PBMCs. IL-26 mRNA levels in PBMCs, but not serum IL-26 levels, were inversely correlated with disease activity in IBD. Furthermore, IL-26 mRNA levels in PBMCs were significantly lower in patients with complicated Crohn’s disease. A total of 1,303 differentially expressed protein-coding genes were identified between untreated and IL-26-treated macrophages. The up-regulated genes showed enrichment in some inflammatory and immune-related processes and pathways. Additionally, GSEA showed that neutrophil, monocyte, and lymphocyte chemotaxis was significantly enriched in IL-26-treated macrophages. Further validation revealed that IL-26 promotes the secretion of multiple inflammatory cytokines and chemokines and upregulates the expression of adhesion molecules, MMP-8, and MMP-9 while inhibiting MMP-1 in macrophages.ConclusionCompared with HC, in IBD patients, IL-26 levels were elevated in the inflamed intestinal mucosa, and reduced in the peripheral blood. The transcriptional changes in macrophages exposed to IL-26 suggest that IL-26 may amplify the aberrant immune response in IBD by activating macrophages.
A Machine Learning-Based Predictive Model for Predicting Lymph Node Metastasis in Patients With Ewing’s Sarcoma
Authors: Li Wenle , Zhou Qian , Liu Wencai , Xu Chan , Tang Zhi-Ri , Dong Shengtao , Wang Haosheng , Li Wanying , Zhang Kai , Li Rong , Zhang Wenshi , Hu Zhaohui , Shibin Su , Liu Qiang , Kuang Sirui , Yin Chengliang 
Published: April 2022

ObjectiveIn order to provide reference for clinicians and bring convenience to clinical work, we seeked to develop and validate a risk prediction model for lymph node metastasis (LNM) of Ewing’s sarcoma (ES) based on machine learning (ML) algorithms.MethodsClinicopathological data of 923 ES patients from the Surveillance, Epidemiology, and End Results (SEER) database and 51 ES patients from multi-center external validation set were retrospectively collected. We applied ML algorithms to establish a risk prediction model. Model performance was checked using 10-fold cross-validation in the training set and receiver operating characteristic (ROC) curve analysis in external validation set. After determining the best model, a web-based calculator was made to promote the clinical application.ResultsLNM was confirmed or unable to evaluate in 13.86% (135 out of 974) ES patients. In multivariate logistic regression, race, T stage, M stage and lung metastases were independent predictors for LNM in ES. Six prediction models were established using random forest (RF), naive Bayes classifier (NBC), decision tree (DT), xgboost (XGB), gradient boosting machine (GBM), logistic regression (LR). In 10-fold cross-validation, the average area under curve (AUC) ranked from 0.705 to 0.764. In ROC curve analysis, AUC ranged from 0.612 to 0.727. The performance of the RF model ranked best. Accordingly, a web-based calculator was developed (https://share.streamlit.io/liuwencai2/es_lnm/main/es_lnm.py).ConclusionWith the help of clinicopathological data, clinicians can better identify LNM in ES patients. Risk prediction models established in this study performed well, especially the RF model.
Adherence to European Society of Gastrointestinal Endoscopy Quality Performance Measures for Upper and Lower Gastrointestinal Endoscopy: A Nationwide Survey From the Italian Society of Digestive Endoscopy
Authors: Zagari Rocco Maurizio , Frazzoni Leonardo , Fuccio Lorenzo , Bertani Helga , Crinò Stefano Francesco , Magarotto Andrea , Dajti Elton , Tringali Andrea , Da Massa Carrara Paola , Cengia Gianpaolo , Ciliberto Enrico , Conigliaro Rita , Germanà Bastianello , Lamazza Antonietta , Pisani Antonio , Spinzi Giancarlo , Capelli Maurizio , Bazzoli Franco , Pasquale Luigi 
Published: April 2022

BackgroundThe quality of gastrointestinal (GI) endoscopy has been recently identified as a major priority being associated with many outcomes and patient's experience.ObjectiveTo assess adherence of endoscopists to the European Society of Gastrointestinal Endoscopy (ESGE) quality performance measures for upper and lower GI endoscopy in Italy.MethodsAll endoscopist members of the Italian Society of Digestive Endoscopy (SIED) were invited from October 2018 to December 2018 to participate to a self-administered questionnaire-based survey. The questionnaire included questions on demographics and professional characteristics, and the recent ESGE quality performance measures for upper and lower GI endoscopy.ResultsA total of 392 endoscopists participated in the study. Only a minority (18.2%) of participants recorded the duration of esophagogastroduodenoscopy (EGD) and 51% provided accurate photo documentation in the minimum standard of 90% of cases. Almost all endoscopists correctly used Prague and Los Angeles classifications (87.8% and 98.2%, respectively), as well as Seattle and Management of precancerous conditions and lesions in the stomach (MAPS) biopsy protocols (86.5% and 91.4%, respectively). However, only 52.8% of participants monitored complications after therapeutic EGD, and 40.8% recorded patients with a diagnosis of Barrett's esophagus (BE). With regard to colonoscopy, almost all endoscopists (93.9%) used the Boston Bowel Preparation Scale for measuring bowel preparation quality and reported a cecal intubation rate ≥90%. However, about a quarter (26.2%) of participants reported an adenoma detection rate of &lt;25%, only 52.8% applied an appropriate polypectomy technique, 48% monitored complications after the procedure, and 12.4% measured patient's experience.ConclusionThe adherence of endoscopists to ESGE performance measures for GI endoscopy is sub-optimal in Italy. There is a need to disseminate and implement performance measures and endorse educational and scientific interventions on the quality of endoscopy.
Clinical Profile and Treatment Outcome in MOGAD: A Single-Center Case-Series Study in Guiyang, China
Authors: Lei Xiaoyang , Guo Shipeng , Cui Shengnan , Pu Yin , Zhang Anni , He Dian 
Published: April 2022

BackgroundThe clinical spectrum of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is expanding over time. However, the long-term management and prognosis of this disorder are still controversial. Therefore, this study aimed to report the clinical profiles and treatment outcomes of MOGAD in our center.MethodsThis was a single-center case-series study. Clinical and para-clinical data, along with treatment outcomes of patients with MOGAD were analyzed.ResultsA total of 27 patients were identified, of which 19 (70%) patients were women, and the median age at disease onset was 40 years (range 20–67). A total of 47 episodes were observed, with optic neuritis (53%) being the most frequent presentation and 60% of them were unilateral. Other presentations included rhombencephalitis (RE) (17%), limbic encephalitis (9%), simultaneous optic neuritis and myelitis (9%), acute disseminated encephalomyelitis (ADEM)-like presentation (6%), myelitis (4%), and ADEM (2%). One patient presenting with RE also met the diagnostic criteria of area postrema syndrome (APS). Another patient with RE presented with imaging characteristics of chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS). A total of 29 lumbar punctures were recorded, among which an elevated protein level was found in 34% of the samples, pleocytosis was found in 14% of the samples, and positive intrathecal oligoclonal bands were found in 19% of the patients. One patient was found to have anti-N-methyl-D-aspartate receptor antibodies both in his serum and cerebrospinal fluid. Intravenous methylprednisolone (IVMP) was administrated for 85% of the attacks while both IVMP and intravenous immunoglobulin were for 6% of the attacks. Moreover, nine patients received maintenance therapy. Among them, six patients were treated with mycophenolate mofetil, three patients were treated with prednisone, rituximab, and teriflunomide, respectively. The median follow-up period was 20 months (range 6–127). At follow-up, twelve (44%) patients experienced a relapsing course, and the median time to the first relapse was 9.5 months (range 2–120). The median Expanded Disability Status Scale score at nadir was 3.5 (range 2–8) and was 0 (range 0–3) at the last follow-up.ConclusionThe clinical spectrum of MOGAD is heterogenous, wherein APS and CLIPPERS-form can occur. The long-term outcome of MOGAD seems benign. Further studies are warranted to determine the risk factors of relapse and identify the optimal steroid-sparing agents.