bluuebunny/crossref_metadata_2025 huggingface dataset:
Do low-risk patients really need follow-up after a pulmonary embolism?
Authors: Alexander Lesley , Burnie Susan , Rossiter Catherine , Isles Chris
Published: January 2025

Background:

The British Thoracic Society recommend that pulmonary embolism (PE) patients with low-risk Pulmonary Embolism Severity Index (PESI) scores are considered for outpatient (OP) management, in settings where robust pathways for follow-up and monitoring exist.

Methods:

Retrospective cohort study. We reviewed the electronic records of 109 consecutive PE patients considered appropriate for OP management. Primary outcomes were the incidence of recurrent venous thromboembolism, major bleeding, mortality at 1 year and evidence of chronic thromboembolic pulmonary hypertension (CTEPH).

Results:

Low-risk PESI scores (I–II) were recorded in 78 (72%) patients, with higher scores a consequence of age and comorbidity rather than haemodynamic instability. There was a low rate of adverse outcomes despite a lack of formal follow up for most patients. There was no evidence of CTEPH in 34 patients who underwent echocardiography.

Conclusion:

Our analysis challenges the need for robust follow-up pathways for all patients with pulmonary embolism.
A review of green synthesized magnesium oxide nanoparticles coated textiles
Authors: Rashid Saba , Islam Saharin , Qamer Shafqat , Ali Majid , Fatima Mahvish , Javaid Laiba , Ali Azam , Sarwar Aqsa , Farooq Ayesha Shuja
Published: January 2025

The textile industry is striving versatile range of coatings, which imparts multifunctional properties to them. There are many fields where coated textiles perform effectively, where standalone nanoparticles or finishes fail to perform adequately. However, the chemicals, finishes, and synthetically produced nanomaterials currently in use have negative ecological impacts. Hence the review focused on current developments in ecologically friendly biosynthesis techniques for the magnesium oxide nanoparticles, their coating over the textile structures and outlining the potential and novel applications of textiles coated with MgO-NPs in different areas. Due to the rising need for green chemistry and the perspective of nanoparticles in a variety of uses, magnesium oxide nanoparticle production using sustainable and environmentally clean processes has gained popularity. Current advancements in the ecologically pleasant creation of MgO-NPs are those mediated by plants, microbes, and other natural processes. The objective of the current work was to gather all potential methods for the environmentally friendly synthesis of MgO-NPs. Secondly, elaborates on all possible novel applications that green synthetic MgO-NPs coated textiles could have in several industries. The various MgO-NP attributes including size, shape, surface area and their functional characteristics like flammability and antipathogenicity, biocompatibility and redox potential are discussed. The numerous uses of the MgO-NPs coated textiles are also highlighted, including their use as wastewater treatment agents, energy systems, drug delivery, catalysts, and biomedical fields. There is also discussion of these particles in some possible applications in other fields, like nanomedicine and food packaging. The current challenges and future directions in the environmentally friendly MgO-NP production along with applications are also addressed.
Exploring Non-invasive Brain Stimulation Effects on Physical Outcomes in People With Parkinson’s Disease: An Umbrella Evidence Mapping Review With Meta-analyses
Authors: Harris Dale M. , Latella Christopher , Tripodi Nicholas , O’Bryan Steven J.
Published: January 2025

Background. Non-invasive brain stimulation (NIBS) is sometimes used alongside medication to alleviate motor symptoms in people with Parkinson’s disease (PD). However, the evidence supporting NIBS’s effectiveness for improving motor function in PD patients is uncertain. Objective. This umbrella review aims to synthesize recent systematic reviews and meta-analyses that have evaluated the effectiveness of NIBS in improving motor function in people with PD, with a key focus being to examine the quality of the evidence presented. Methods. The review protocol was registered in PROSPERO (CRD42022380544) and conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search strategy was guided by the Population, Intervention, Comparison, and Outcome framework, focusing on individuals with idiopathic PD (Hoehn and Yahr stages 1-4). The review included studies comparing various NIBS techniques (eg, repetitive transcranial magnetic stimulation and transcranial direct current stimulation) to sham or alternative treatments, targeting motor and cognitive regions. Six databases were searched up to June 2024. Methodological quality was assessed using Assessment of Multiple Systematic Reviews 2 (AMSTAR2), and random-effects meta-analyses were performed to pool standardized mean differences (SMDs). Results. The final analysis included 31 meta-analyses and 10 systematic reviews. Overall, the reviews were rated as moderate quality (54% average for AMSTAR2). NIBS showed a small-to-moderate effect on motor function (Unified Parkinson’s Disease Rating Scale-Section III scores; SMD = −0.80), functional mobility (gait speed and timed-up-and-go; SMD = −0.39), and freezing of gait (SMD = −0.58), but no significant effect on balance. Conclusion. NIBS offers small-to-moderate benefits for motor symptoms and functional movement in PD, though it does not significantly impact balance. Practitioners should consider the variety of techniques and treatment parameters before application.
A novel thermoregulated phase-separable Pt nanocatalyst for selective hydrogenation of quinoline and its derivatives
Authors: Liu Mingyang , Wang Yanhua
Published: January 2025

A novel thermoregulated phase-separable Pt nanocatalyst stabilized by ionic liquid [CH3(OCH2CH2)22N+Et3][PF6−] (ILPEG1000-PF6) was prepared and first explored for the selective hydrogenation of quinoline. The conversion of quinoline and selectivity of 1,2,3,4-tetrahydroquinoline were both >99% at 130 °C under 3 MPa for 1.5 h, and the ILPEG1000-PF6 stabilized Pt nanocatalyst can be reused four times efficiently. In addition, the ILPEG1000-PF6 stabilized Pt nanocatalyst was also extended to the selective hydrogenation of 3-methylquinoline, 6-methylquinoline, 8-methylquinoline, and 6-chloroquinoline with >99% conversion and selectivity, respectively.
Design and synthesis of ferulic acid-based aldose reductase inhibitors as hypoglycemic agents
Authors: Zhu Yulan , Ding Yuhang
Published: January 2025

Twelve ferulic acid–based derivatives containing urea groups were synthesized and characterized by elementary analytical,1H and 13C nuclear magnetic resonance and electrospray ionization mass spectrometry spectra. Their hypoglycemic and aldose reductase inhibitory activities were evaluated, several of which showed hypoglycemic activities in vivo comparable with the positive drug glibenclamide. Furthermore, of the tested compounds, 7a and 7b displayed the most potent aldose reductase inhibitory activity in vitro, with an IC50 of 0.55 and 3.88 μM, respectively. Docking simulation indicated compound 7a mainly interact with aldose reductase 2 via three hydrogen bonds with ARG268, SER263, SER210, and one π–π stacking interaction with TYR209.
Protection of the occupational health and safety of teleworkers
Authors: Erikson Merle , Rosin Annika
Published: January 2025

As a rule, labour law protection, including protection of the employee occupational safety and health (OSH), extends to telework. While it is usually the employer's responsibility to ensure OSH, fulfilling this obligation can be complicated in the case of telework. The unconventional workplace, combined with the employees’ constitutional rights, can restrict the employer's possibilities to guarantee the protection of the OSH. Thus, the question of whether the employer OSH obligations should be reduced and the employee responsibilities for their own OSH increased arises. This article examines what the OSH obligations of the employer and employee should be in the case of telework. The article is based on an analysis of European Union (EU), Finnish, and Estonian regulations. While the EU regulation on OSH does not allow for any differential treatment of teleworkers in terms of their OSH protection, in practice, the employer cannot fulfil these duties in the same way as it can in traditional work. Hence, it is reasonable to allow some exceptions. Finnish and Estonian regulations enable the employer to refrain from fulfilling certain OSH obligations, increasing employee responsibility for OSH. In both countries, the employer remains primarily responsible for the protection of OSH, and only the duties that cannot be fulfilled because of the special features of telework are limited. These exceptions must be interpreted restrictively to avoid unnecessarily increasing the employee obligations. In addition, supplementary employee OSH duties must be dependent on and accompanied by significant obligations on the employer ' information and training concerning potential risks and their prevention. The revision of the current EU regulation on OSH also needs to be considered to guarantee that OSH duties are fulfilled as much as possible and to avoid the infringement of the regulation because of objective, practical constraints. Since the employee is more autonomous than usual when organising telework, compliance with OSH rules also requires a relationship of trust rather than control between the parties to the employment contract. If the employer suspects that the employee cannot ensure OSH, the employee must be employed on the employer's premises. However, when placing greater responsibility on the employee, care must also be taken to ensure employers do not force employees to telework.
Polysaccharide-based ionic hydrogels: Comprehensive evaluation of conductivity, mechanical properties, and anti-freezing and anti-drying properties
Authors: Gokul G. K. , Parathakkatt Sudheesh
Published: January 2025

The use of conductive hydrogels in flexible electronics has gained significant attention in recent years. However, the performance of traditional hydrogels is often hindered by dehydration at elevated temperatures and structural rigidity when frozen at low temperatures. In this study, we developed a double-network hydrogel consisting of ionically crosslinked pectin and covalently crosslinked polyacrylamide (PAAm) networks. Scanning Electron Microscopy (SEM) analysis revealed a highly interconnected and porous microstructure, which contributes to the enhanced mechanical strength and flexibility of the hydrogel. Through a solvent exchange process, the PAAm-pectin hydrogel was transformed into an organo-gel by immersing it in a binary solvent system of ethylene glycol and water. The incorporation of ethylene glycol significantly improved the hydrogel’s temperature tolerance, imparting superior anti-freezing and anti-drying properties. The resulting organogel exhibited remarkable transparency, excellent flexibility, and sustained ionic conductivity even at temperatures as low as −40°C. These attributes highlight the PAAm-pectin organogel as a promising candidate for next-generation flexible electronic devices, where performance stability under extreme conditions is essential.
The Reconfiguration of Human Education in an Uncertain World
Authors: Fan (范国睿) Guorui
Published: January 2025

Purpose

In response to contemporary global challenges in politics, economics, and technology, coupled with escalating uncertainties, there arises an imperative to reconstruct an innovative and dynamic education system centered around the advancement of human well-being and sustainable development.

Design/Approach/Methods

Drawing upon empirical data from reputable international organizations, such as the United Nations, United Nations Educational, Scientific and Cultural Organization (UNESCO), the World Bank, and the Organisation for Economic Co-operation and Development (OECD), this study analyzes the uncertainties confronting world development. Furthermore, it elucidates the challenges and opportunities embedded in educational reform, delving into the complexities of contemporary uncertainties.

Findings

First, the enduring repercussions of the pandemic, including the persistent effects of “long COVID-19,” heightened geopolitical insecurities, repercussions of sluggish global economic growth, and challenges and opportunities posed by smart technology to economic and social development collectively contribute to an increasingly uncertain global landscape. Second, the inherent conservatism of the prevailing educational systems poses challenges in adapting to the evolving needs of social development. The uncertainty in economic and social development weakens societal support for educational reform, and a deteriorating labor market compels the re-evaluation of the education system rooted in industrialism, facing transformative challenges from generative artificial intelligence. Finally, recognizing the urgent need for revolutionary changes in human education, this study advocates for the expeditious reshaping of a new humanistic education paradigm.

Originality/Value

This study envisions a novel educational model capable of addressing the challenges posed by intelligent technology and emphasizes the creation of an open and dynamic education system by proposing a reconstruction of the education system oriented toward promoting human health and sustainable development. This study systematically examines the diverse uncertainties confronting human development, critically reflects on the inadequacies of the modern education system rooted in industrialism, and issues a cautionary call for the transition toward an intelligent education system.
How does nature in the city make us happy? The role of affect and connectedness to nature / ¿Cómo nos hace felices la naturaleza en la ciudad? El papel del afecto y la conexión con la naturaleza
Authors: Hefti Manuel , Fleury-Bahi Ghozlane , Navarro Oscar
Published: January 2025

Climate change is generating harmful consequences, specifically in urban environments. Re/naturalizing urban areas and stimulating the connectedness to nature of a significant number of individuals may be responses to mitigate these effects. The main objective of this study is to investigate the interactions between perceived exposure to nature in the city in terms of quality and frequency, positive and negative affect, and subjective well-being by considering connectedness to nature as a moderator of these interactions. Data were collected by convenience using an online questionnaire. Participants had been living for at least one year in a French city of more than 100,000 inhabitants. The final sample consisted of N = 479 participants. Structural equation modelling showed that perceived exposure to nature in the city improves positive affect that contributes to subjective well-being and that the more connected individuals are to nature, the better. Implications and perspectives are discussed for the mitigation of the deleterious effects of climate change.
Out-of-Catchment Area Antiretroviral Therapy Initiation and its Factors among HIV Positive People on Lifelong Therapy in Western Ethiopia: Implementation of Decentralized ART Services
Authors: Bayisa Lami , Keno Tesfaye Shibiru , Ayana Gurmessa Enkosa , Abera Tesfaye , Akuma Adugna Olani
Published: January 2025

Background: Decentralized human immunodeficiency virus (HIV) is a model adopted to improve access to antiretroviral therapy (ART) within communities and mitigate the burden of HIV treatment and care on health care facility. In Ethiopia, these services help HIV clients fully benefit from ART as they are able to access ART within their catchment areas. However, HIV clients still travel out of their catchment areas to commence the ART. Thus, this study aimed to assess the magnitude of out-of-catchment area ART initiation and its associated factors among people living with HIV (PLWHIV) in Western Ethiopia. Methods: This cross-sectional study was conducted among 423 PLWHIV from November 25 to December 30, 2025, at Nekemte Comprehensive Specialized Hospital. A systematic sampling method was used to recruit the study participants. Epi Data 3.1 and STATA 14.0 were used for data entry and analysis, respectively. Logistic regression analysis was computed to identify factors associated with out-of-catchment ART initiation among PLWHIV. Variables with a P value <.25 from the bivariable analysis were entered into the multivariable analysis. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and P value <.05 were used to determine a significant association. Results: A total of 423 PLHIV were included in the study. The mean age of study participants was 33.43 ± 9.79 years. One-fifth (22%) of the participants-initiated ART out of their catchment area with 95% (CI: 18.28-26.20). Participants who did not disclose their HIV (AOR = 4.39, 95% CI = 2.45-7.87), tested through voluntary counseling and testing (AOR = 3.99, 95% CI = 2.21-7.19), knowledgeable about HIV/AIDS (AOR = 2.15, 95% CI = 1.18-3.93), using traditional healing (AOR = 1.91, 95% CI = 1.03-3.55), being female (AOR = 2.42, 95% CI = 1.36-4.32), and perceived stigma (AOR = 3.41, 95% CI = 1.88-6.18) were significantly associated with out-of-catchment ART initiation. Conclusion and Recommendation: A substantial number of PLWHIV in study area had initiated ART outside their designated catchment areas. To address this, it is crucial to enhance HIV serostatus disclosure, combat discrimination associated with HIV/AIDS, and promote decentralized HIV care and ART services.
Subacute Latissimus Dorsi Tendon Repair via a Single Posterior Incision
Authors: Spears Thomas , Luchini Patrick , Nayfa Robert , Chang Peter , LeClere Lance
Published: January 2025

Background:

This is a rare case of the surgical treatment of a subacute presentation of a latissimus dorsi tendon rupture via a posterior single-incision approach.

Indications:

The patient had extensive conservative, nonoperative treatment that failed, and ultimately a surgical intervention was required to return to his activities of daily living.

Technique Description:

The patient is positioned in a lateral decubitus position. A 10-cm incision is created along the posterior axillary fold. Sharp and blunt dissection is utilized to carefully mobilize the chronic tendon rupture. The tendon is captured with 2 suture tapes utilizing a locking Krackow whipstitch. The tendon footprint is identified between the pectoralis major and teres major. The insertion point is prepared with a Cobb to debride the soft tissue and decorticate the bone bed to optimize healing. Two endobuttons are loaded with the suture tapes and then passed through unicortical holes drilled in the tendon bed. Care is taken to ensure the 90° external rotation of the tendon is achieved. A tendon-slide technique is used to reduce the tendon to the humerus. Afterward, a free needle is used to pass 1 limb of the suture through the tendon before tying an additional knot for added fixation.

Results:

The patient was able to resume his activities of daily living without pain at the 4-month mark.

Conclusions:

After the failure of extensive nonoperative management, surgical treatment of a subacute complete rupture of the latissimus dorsi tendon via a single, posterior incision is an effective method of returning a patient to their painless activities of daily living.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Using Non-Immersive Virtual Reality to Teach Life Skills to Students With Disabilities in Rural Schools
Authors: Norwine Laura , Bouck Emily , Reiley Sarah , Long Holly M. , Jakubow Larissa , Nuse James
Published: January 2025

Students with disabilities may find it difficult to learn and gain the life skills needed to live, work, socialize, and attend postsecondary education. In vivo and community-based instruction (CBI) are among the most effective ways to teach life skills, especially with a goal of generalization. Despite the strong relationships that often exist in rural locales between schools and the broader community, students may not be able to access effective instructional practices. Technology-based options, such as virtual reality (VR), offer effective alternatives. Using a multiple probe single-case research design, researchers examined the efficacy of non-immersive VR to provide instruction in targeted life skills to three students with disabilities attending a rural school district. The researchers found two main results: (a) a functional relation between the independent variable—the non-immersive VR—and the dependent variable of student accuracy on the task analysis steps of the targeted life skill, and (b) students maintained high levels of accuracy in completing the task analysis steps post-intervention (i.e., independent variable removed).
Biologics in severe asthma: a state-of-the-art review
Authors: Gyawali Bishal , Georas Steve N. , Khurana Sandhya
Published: January 2025

Asthma is considered severe if it remains uncontrolled despite optimal conventional therapy, characterised by poor symptom control, frequent exacerbations and increased exposure to systemic corticosteroids. This has a significant impact on morbidity, mortality and healthcare resource utilisation. Recent advances in the understanding of asthma heterogeneity and immunopathogenesis have helped delineate precise disease pathways. The discovery of these pivotal pathways has led to the development of highly effective biologic therapies. Currently available asthma biologics target immunoglobulin E, interleukin (IL)-5/IL-5Rα, IL-4Rα and thymic stromal lymphopoietin. Identification of specific asthma phenotypes, utilising easily measurable biomarkers, has paved the way towards personalised and precision asthma management. Biologic therapies play a significant role in reducing exacerbations, hospitalisations and the need for maintenance systemic steroids, while also improving the quality of life in patients with severe asthma. The evidence for their clinical efficacy comes from randomised controlled trials (RCTs), extension studies, metanalyses and real-world data. This review synthesises findings from early, pivotal RCTs and subsequent studies following the approval of biologics for severe asthma. The safety and efficacy data from these studies, completed in a variety of settings, provide practical perspectives on their application and enhance their generalisability.
Influenza vaccine outcomes: a meta-analysis revealing morbidity benefits amid low infection prevention
Authors: Presa Jesus , Arranz-Herrero Javier , Alvarez-Losa Laura , Rius-Rocabert Sergio , Pozuelo Maria Jose , Lalueza Antonio , Ochando Jordi , Eiros Jose María , Sanz-Muñoz Ivan , Nistal-Villan Estanislao
Published: January 2025

Background

The morbidity and mortality associated with influenza viruses are a significant public health challenge. Annual vaccination against circulating influenza strains reduces hospitalisations and increases survival rates but requires a yearly redesign of vaccines against prevalent subtypes. The complex genetics of influenza viruses with high antigenic drift create an ongoing challenge in vaccine development to address dynamic influenza epidemiology. Understanding the evolution of influenza viruses and the vaccine's effectiveness against different types and subtypes is pivotal to designing public health measures against influenza.

Methods

We conducted a systematic review and meta-analysis of 192 705 patients, collecting information on the incidence and severity of the disease. The results of this meta-analysis were further validated using data from 6 594 765 patients from TriNetX. We analysed the prevalence of the most common influenza A virus (IAV) subtypes (H1N1 and H3N2) and influenza B virus (IBV), as well as vaccination effectiveness against them in three age groups, given that age is associated with influenza disease severity.

Results

Our analysis reflects that overall vaccination against H1N1 IAV and IBV is effective in reducing infection and influenza-related complications in children aged <5 years old, individuals between 5 and 65 years old and older adults aged >65 years old. By contrast, while vaccination against H3N2 IAV is effective in protecting against infection in infants <5 years old, it provides reduced protection against infection in older individuals.

Conclusions

Despite higher infection rates, vaccination against H3N2 remains as highly effective as vaccination against H1N1 and IBV in reducing influenza-related morbidity and mortality in all age groups. Detailing vaccine effectiveness in terms of infection protection and disease burden across different age groups is necessary for understanding vaccine impacts in terms of other outcomes,e.g.hospitalisations, mortality and disease severity; for improving vaccine formulations and public awareness; and for enhancing vaccination campaigns to improve coverage and public acceptance.
Machine learning-derived asthma and allergy trajectories in children: a systematic review and meta-analysis
Authors: Lisik Daniil , Özuygur Ermis Saliha Selin , Milani Gregorio Paolo , Spolidoro Giulia Carla Immacolata , Ercan Selin , Salisu Michael , Odetola Faozyat , Ghiglioni Daniele Giovanni , Pylov Danylo , Goksör Emma , Basna Rani , Wennergren Göran , Kankaanranta Hannu , Nwaru Bright I.
Published: January 2025

Introduction

Numerous studies have characterised trajectories of asthma and allergy in children using machine learning, but with different techniques and mixed findings. The present work aimed to summarise the evidence and critically appraise the methodology.

Methods

10 databases were searched. Screening, data extraction and quality assessment were performed in pairs. Trajectory characteristics were tabulated and visualised. Associated risk factor and outcome estimates were pooled using a random-effects meta-analysis.

Results

89 studies were included. Early-onset (infancy) persistent, mid-onset (∼2–5 years) persistent, early-onset early-resolving (within ∼2 years) and early-onset mid-resolving (by ∼3–6 years) wheezing and eczema, respectively, were the most commonly identified disease trajectories. Intermediate/transient trajectories were rare. Male sex was associated with a higher risk of most wheezing trajectories and possibly with early-resolving eczema, while being slightly protective against mid-onset persistent eczema. Parental disease/genetic markers were associated with persistent trajectories of wheezing and eczema, respectively. Prenatal (and less so postnatal) tobacco smoke exposure was associated with most wheezing trajectories, as were lower respiratory tract infections in infancy (particularly with the early-onset resolving patterns). Most studies (69%) were of low methodological quality (particularly in modelling approaches and reporting). Few studies investigated allergic multimorbidity, allergic rhinitis and food allergy.

Conclusions

Childhood asthma/wheezing and eczema can be characterised by a few relatively consistent trajectories, with some actionable risk factors such as pre-/postnatal smoke exposure. Improved computational methodology is warranted to better assess generalisability and elucidate the validity of intermediate/transient trajectories. Likewise, allergic multimorbidity and trajectories of allergic rhinitis and food allergy need to be further elucidated.
Hybrid natural language processing tool for semantic annotation of medical texts in Spanish
Authors: Campillos-Llanos Leonardo , Valverde-Mateos Ana , Capllonch-Carrión Adrián
Published: January 2025

Background

Natural language processing (NLP) enables the extraction of information embedded within unstructured texts, such as clinical case reports and trial eligibility criteria. By identifying relevant medical concepts, NLP facilitates the generation of structured and actionable data, supporting complex tasks like cohort identification and the analysis of clinical records. To accomplish those tasks, we introduce a deep learning-based and lexicon-based named entity recognition (NER) tool for texts in Spanish. It performs medical NER and normalization, medication information extraction and detection of temporal entities, negation and speculation, and temporality or experiencer attributes (Age, Contraindicated, Negated, Speculated, Hypothetical, Future, Family_member, Patient and Other). We built the tool with a dedicated lexicon and rules adapted from NegEx and HeidelTime. Using these resources, we annotated a corpus of 1200 texts, with high inter-annotator agreement (average F1 = 0.841% ± 0.045 for entities, and average F1 = 0.881% ± 0.032 for attributes). We used this corpus to train Transformer-based models (RoBERTa-based models, mBERT and mDeBERTa). We integrated them with the dictionary-based system in a hybrid tool, and distribute the models via the Hugging Face hub. For an internal validation, we used a held-out test set and conducted an error analysis. For an external validation, eight medical professionals evaluated the system by revising the annotation of 200 new texts not used in development.

Results

In the internal validation, the models yielded F1 values up to 0.915. In the external validation with 100 clinical trials, the tool achieved an average F1 score of 0.858 (± 0.032); and in 100 anonymized clinical cases, it achieved an average F1 score of 0.910 (± 0.019).

Conclusions

The tool is available at https://claramed.csic.es/medspaner . We also release the code (https://github.com/lcampillos/medspaner) and the annotated corpus to train the models.
Effective BCDNet-based breast cancer classification model using hybrid deep learning with VGG16-based optimal feature extraction
Authors: P. Meenakshi Devi , A. Muna , Ali Yasser , V. Sumanth
Published: January 2025

Problem

Breast cancer is a leading cause of death among women, and early detection is crucial for improving survival rates. The manual breast cancer diagnosis utilizes more time and is subjective. Also, the previous CAD models mostly depend on manmade visual details that are complex to generalize across ultrasound images utilizing distinct techniques. Distinct imaging tools have been utilized in previous works such as mammography and MRI. However, these imaging tools are costly and less portable than ultrasound imaging. Also, ultrasound imaging is a non-invasive method commonly used for breast cancer screening. Hence, the paper presents a novel deep learning model, BCDNet, for classifying breast tumors as benign or malignant using ultrasound images.

Aim

The primary aim of the study is to design an effective breast cancer diagnosis model that can accurately classify tumors in their early stages, thus reducing mortality rates. The model aims to optimize the weight and parameters using the RPAOSM-ESO algorithm to enhance accuracy and minimize false negative rates.

Methods

The BCDNet model utilizes transfer learning from a pre-trained VGG16 network for feature extraction and employs an AHDNAM classification approach, which includes ASPP, DTCN, 1DCNN, and an attention mechanism. The RPAOSM-ESO algorithm is used to fine-tune the weights and parameters.

Results

The RPAOSM-ESO-BCDNet-based breast cancer diagnosis model provided 94.5 accuracy rates. This value is relatively higher than the previous models such as DTCN (88.2), 1DCNN (89.6), MobileNet (91.3), and ASPP-DTC-1DCNN-AM (93.8). Hence, it is guaranteed that the designed RPAOSM-ESO-BCDNet produces relatively accurate solutions for the classification than the previous models.

Conclusion

The BCDNet model, with its sophisticated feature extraction and classification techniques optimized by the RPAOSM-ESO algorithm, shows promise in accurately classifying breast tumors using ultrasound images. The study suggests that the model could be a valuable tool in the early detection of breast cancer, potentially saving lives and reducing the burden on healthcare systems.
Changes in the composition of urine over six hours using urine dipstick analysis and automated microscopy
Authors: Parikh Pranav C. , Souza Serena D. , Obeid Wassim
Published: January 2025

Background

Urinalysis is a commonly performed test for the diagnosis and prognosis of kidney disease in hospitalized patients. It involves examining the chemical composition of the urine and microscopy to examine the cells and casts. In clinical settings, urinalysis is frequently delayed by several hours after sample collection and held at room temperature. The purpose of this study is to investigate the changes in urine composition over set time intervals to confirm the reliability of urinalysis when there are delays in performing the tests.

Methods

We obtained 15 mL of urine from the Foley catheters of five patients in the intensive care unit. We utilized the state-of-the-art IDEXX SediVue Dx ® machine to perform urine microscopy and the Siemens CLINITEK Status + Urine Analyzer to perform the dipstick tests. We performed microscopy and dipstick tests at 0, 1, 2, 4, and 6 h. Between the two testing methods, 30 individual components were tested in the urine. We calculated the %CV for each component by taking four repeated measurements at one time period for multiple samples.

Results

After calculating the %CV for each component, we analyzed the trend for each constituent over the 6 h. If the percent change over the six-hour interval was ± twofold than the %CV, we determined time to influence the results. Significant changes were seen in bacteria as the levels increased, red blood cells and pathological casts where the level decreased, and crystal levels were determined inconclusive due to fluctuations in the results. All other components were found to remain unchanged.

Conclusions

Timely urine analysis is necessary for accurate results as delayed analysis can considerably change the makeup of urine, which can affect clinical decisions and patient management.
Exploring the experiences of women and people with diabetes in pregnancy in metropolitan and rural Australia: a national survey
Authors: Payne Ellen , Heaney Susan , Collins Clare , Rollo Megan , Brown Leanne J.
Published: January 2025

Background

Women and people diagnosed with diabetes in pregnancy, are recommended to have frequent monitoring and careful management for optimal pregnancy outcomes. This health care management should be supported by a multidisciplinary healthcare team. For individuals living in rural areas, there are increased barriers to healthcare access, with subsequent worse health outcomes compared to those in metropolitan regions. Despite this, there remains a lack of research into the experiences of healthcare delivery for rural women and people with diabetes in pregnancy.

Methods

Survey invitations were sent via the National Diabetes Services Scheme email list. The survey included multiple choice and open-ended questions. Responses from the open-ended question asking participants the changes they would want made to their care delivery were interpreted using qualitative content analysis. Responses were separated into metropolitan and rural categories using the Modified Monash Model criteria.

Results

There were 668 survey responses, with 409 responding to the open-ended qualitative survey question/s. 71.6% of respondents were metropolitan and 27.6% lived rurally. A total of 31 codes were established from the open-ended responses, with the five overarching themes of ‘quality of care’, ‘practice & communication’, ‘individual’s experience’, ‘access’ and ‘burden of care’ identified. The most frequently occurring codes irrespective of location included education or information (n = 45), frequency and timeliness of care (n = 42), no changes (n = 42) and improved health professional communication (n = 40). Local care options was the only code with more rural quotes compared to metropolitan.

Conclusions

The most frequently occurring codes had strong representation from metropolitan and rural respondents, indicating that those with previous diabetes in pregnancy had similar priorities for changes in their healthcare delivery regardless of location. Rural respondents identifying local care options as a priority for change is likely indicative of the rural healthcare landscape with limited access to care options. Recommendations from this study supported by previous research include focusing on improving health professional communication both with women and people with diabetes in pregnancy and with other relevant professionals. Recommendations for rural locations should focus on improving local care options whilst considering resource limitation, such as telehealth clinics.
“They were sort of in the room with me”: a qualitative study about callers’ experience of video streaming during medical emergency calls
Authors: Idland Siri , Häikiö Kristin , Kramer-Johansen Jo , Hjortdahl Magnus
Published: January 2025

Background

During the recent years, emergency services in several countries have integrated video streaming into medical emergency calls, and research on the topic has gained increased focus. Video streaming during medical emergency calls may change dispatcher’s perspective of the call and can be a helpful tool for supervising bystanders’ first aid. Little research exists, however, about the caller’s perspective of video streaming during a medical emergency call. With this study, we explore the caller’s experiences with video streaming.

Methods

The study is a qualitative interview study. During a period of five weeks, we recruited respondents from the region of Oslo who had called the medical emergency number 113 and where video streaming had been used by the dispatcher during the call. We conducted 14 semi-structured individual interviews, in-person or digitally on Zoom/Teams, from October to December 2023. The interviews were transcribed verbatim, and we analyzed them drawing on Malterud’s systematic text condensation.

Results

Our material was sorted into three category headings: Increased sense of safety, the unexpected option of video streaming, and emotional discomfort. Most respondents felt comforted knowing that the dispatcher could see and assess the situation visually. Several were also positively surprised that video streaming was an option during the call. Some respondents however felt increased stress during the call due to video streaming. Other respondents reflected on the societal taboo of filming ill or injured persons.

Conclusion

Most respondents experienced video streaming as a positive addition to the medical emergency call and felt comforted knowing that the dispatcher could see the situation. Knowledge of the integration between video streaming and basic communication in a call is nonetheless of great importance, as to not increase stress experienced by the caller. The dispatcher should be sensitive for how the caller will handle video streaming for each call.
Clinical characteristics of hospitalized male adolescents and young adults with avoidant/restrictive food intake disorder (ARFID)
Authors: Nagata Jason M. , Chaphekar Anita V. , Low Patrick , Vargas Ruben , Ganson Kyle T. , Nguyen Anthony , Buckelew Sara M. , Garber Andrea K. , Downey Amanda E.
Published: January 2025

Background

Avoidant/restrictive food intake disorder (ARFID) may result in significant medical sequelae. Compared to youth with eating disorders like anorexia nervosa (AN), youth with ARFID tend to be younger and are more likely to be male. We aim to describe sex differences in clinical characteristics of youth hospitalized for medical complications of ARFID and compare their characteristics with youth hospitalized for anorexia nervosa.

Methods

This is a retrospective review of electronic medical records for youth with ARFID (N = 36; 13 male and 23 female) and AN (N = 355; 40 male and 315 female), including restricting and binge-eating/purging subtypes, aged 9–25 admitted to the inpatient UCSF Eating Disorders Program (2012–2020).

Results

A greater proportion of youth with ARFID were male compared to youth with AN (36.1% vs. 11.2%). Male youth with ARFID (mean age 15.5 ± 2.8) had lower heart rate nadir (49.2 vs. 57.6 beats per minute, p = .019) and lower total cholesterol (129.8 vs. 159.3 mg/dL, p = .008), but higher hemoglobin (13.9 vs. 13.0 g/dL, p = .015) and prescribed calories at discharge (3323 vs. 2817 kcal, p = .001) compared to females with ARFID. Males with AN, who on average had higher admission BMI than males with ARFID (17.3 vs. 15.5 kg/m2, p = .013), required more (3785) kcal on discharge to restore medical stability than males with ARFID (3323 kcal). Compared to all youth with AN, youth with ARFID had lower body mass index (BMI, 15.7 vs. 17.0 kg/m2, p = .001) and lower vitamin D (26.5 vs. 33.0 ng/mL, p = .003).

Conclusions

ARFID in males is associated with lower heart rate nadirs than in females with ARFID. Clinicians should be aware of unique medical complications in youth with ARFID compared to youth with AN.
Effect of geocell height on behavior of sand under constant compaction energy evaluated by plate load testing in large-scale soil box
Authors: Kim Yeontae , Jafri Turab H. , Do Jinung
Published: January 2025

Geocell is a reinforcing material in civil engineering that creates cell structures with multiple bands filled with fill materials inside the cells, thereby providing a ground reinforcement effect. Due to the easiness of the construction and application, geocell is suitable for rapid and temporary installation on unpaved roads. Geocells have various heights depending on manufacturing conditions. In this study, the behavior of sand reinforced with geocells having various heights was evaluated. The stress-settlement relationships of the test grounds were analyzed with a large-scale soil box system and a series of plate load tests. For additional analysis, the unit weight of the reinforced ground was measured. The performance of the system was quantified using a subgrade reaction modulus (K30). As results, the K30 of sand reinforced with 10 cm height geocell showed higher than that of unreinforced sand. However, for 20 cm and 30 cm height geocells, the measured K30 were similar to or lower than that of unreinforced sand. It was discovered that as the geocell height increases, the compaction efficiency delivered to the fill material within the geocells decreases, causing lowering the engineering performance of the geocell-reinforced zone. At the end of the paper, possible scenarios of using geocells are discussed.
The impact of spray-induced gene silencing on cereal phyllosphere microbiota
Authors: Sundararajan Poorva , Ghosh Samrat , Kelbessa Bekele Gelena , Whisson Stephen C. , Dubey Mukesh , Chawade Aakash , Vetukuri Ramesh Raju
Published: January 2025

Background

Fusarium head blight (FHB) is a major disease affecting cereal crops including wheat, barley, rye, oats and maize. Its predominant causal agent is the ascomycete fungus Fusarium graminearum, which infects the spikes and thereby reduces grain yield and quality. The frequency and severity of FHB epidemics has increased in recent years, threatening global food security. Spray-induced gene silencing (SIGS) is an alternative technique for tackling this devastating disease through foliar spraying with exogenous double-stranded RNA (dsRNA) to silence specific pathogen genes via RNA interference. This has the advantage of avoiding transgenic approaches, but several aspects of the technology require further development to make it a viable field-level management tool. One such existing knowledge gap is how dsRNA spraying affects the microbiota of the host plants.

Results

We found that the diversity, structure and composition of the bacterial microbiota are subject to changes depending on dsRNA targeted and host studied, while the fungal microbiota in the phyllosphere remained relatively unchanged upon spraying with dsRNA. Analyses of fungal co-occurrence patterns also showed that F. graminearum established itself among the fungal communities through negative interactions with neighbouring fungi. Through these analyses, we have also found bacterial and fungal genera ubiquitous in the phyllosphere, irrespective of dsRNA treatment. These results suggest that although rarer and less abundant microbial species change upon dsRNA spray, the ubiquitous bacterial and fungal components of the phyllosphere in wheat and barley remain unchanged.

Conclusion

We show for the first time the effects of exogenous dsRNA spraying on bacterial and fungal communities in the wheat and barley phyllospheres using a high-throughput amplicon sequencing approach. The results obtained further validate the safety and target-specificity of SIGS and emphasize its potential as an environmentally friendly option for managing Fusarium head blight in wheat and barley.
Morbidity in Males With 45,X/46,XY Resembles the Morbidity Pattern in Turner Syndrome: A National Population-Based Study
Authors: Berglund Agnethe , Gravholt Claus Højbjerg , Stochholm Kirstine
Published: January 2025

Context

Few studies have reported on males with 45,X/46,XY mosaicism. Most studies stem from pediatric settings, and knowledge of natural history and long-term health outcomes are therefore lacking.

Objective

To describe long-term health outcomes in males with 45,X/46,XY in comparison to the general population.

Design

A national population-based registry study.

Setting

A public uniform healthcare system.

Patients and Controls

All males in Denmark diagnosed with 45,X/46,XY mosaicism from 1960-2016 (n = 135) and 1:100 age-matched males from the background population.

Main Outcome Measures

Hospital diagnoses, prescribed medication, and surgery codes were analyzed using a Cox proportional hazards regression model yielding hazard ratios (HRs).

Results

45,X/46,XY was associated with an increased overall risk of being referred to the hospital [HR = 1.6, confidence interval (CI): 1.3-1.9], undergoing surgery (HR = 1.8, CI: 1.4-2.2), and being prescribed medication (HR = 1.2, CI: 1.03-1.5). This risk applied to 15/18 diagnostic groups, 6/14 medication groups, and 10/16 surgery groups. Diagnoses with increased HRs included diabetes, thyroid disorders, obesity, hypertension, ischemic heart disease, osteoporosis, and inflammatory bowel disease. Half of all 45,X/46,XY males (69/135) had ≥1 diagnosis related to the genitourinary system, and nearly one-third (39/135) underwent urogenital surgery.

Conclusion

45,X/46,XY mosaicism in males impacts long-term health significantly. The morbidity pattern includes a wide range of diseases, most known to occur at increased frequencies in Turner syndrome. The study underscores the importance of identifying these males and following them with systematic screening as in Turner syndrome.