bluuebunny/crossref_metadata_2025 huggingface dataset:
Microbial characteristics of bile in gallstone patients: a comprehensive analysis of 9,939 cases
Authors: Zheng Xin , Yan Yunjun , Li Xin , Liu Mimin , Zhao Xiaoyue , He Jing , Zhuang Xuewei
Published: December 2024

Introduction

The exact triggers of gallstone formation remain incompletely understood, but research indicates that microbial infection is a significant factor and can interfere with treatment. There is no consensus on the bile microbial culture profiles in previous studies, and determining the microbial profile could aid in targeted prevention and treatment. The primary aim of this study is to investigate the differences in microbial communities cultured from bile specimens of patients with gallstones.

Methods

We collected the clinical characteristics and bile microbial status of 9,939 gallstone patients. Statistical analysis was employed to assess the relationship between microbes and clinical features, and a random forest model was utilized to predict recurrence.

Results

Results showed a higher proportion of females among patients, with the age group of 60-74 years being the most prevalent. The most common type of gallstone was solitary gallbladder stones. A total of 76 microbes were cultured from 5,153 patients, with Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis being the most frequently identified. Significant differences in microbial diversity and positive detection rates were observed across different age groups, types of gallstones, and recurrence status. Positive frequencies of E. coli, Enterococcus faecium, and K. pneumoniae varied significantly by age group and gallstone type. The microbial diversity in the recurrence group was significantly lower compared to the non-recurrence group. The recurrence rate was significantly higher in the group with single microbial species compared to those with no microbes or multiple microbes. For the recurrence group, there were significant differences in the frequencies of seven microbes (Aeromonas hydrophila, Enterococcus casseliflavus, Enterococcus faecium, E. coli, K. pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa) before and after recurrence, with these microbes appearing in a higher number of patients after recurrence. Regression analysis identified patient age, stone size, diabetes, venous thrombosis, liver cirrhosis, malignancy, coronary heart disease, and the number of microbial species as important predictors of recurrence. A random forest model constructed using these variables demonstrated good performance and high predictive ability (ROC-AUC = 0.862).

Discussion

These findings highlight the significant role of microbial communities in gallstone formation and recurrence. Furthermore, the identified predictors of recurrence, including clinical factors and microbial diversity, may help develop personalized prevention and recurrence strategies for gallstone patients.
How does young adults’ dietary and health-related quality of life vary by food security and household income?
Authors: Kim Eun-kyung , Kwon Yong-Seok , Kim Sena , Lee Jin-Young , Park Young Hee
Published: December 2024

Objectives

The objective of this study was to compare the dietary and health-related quality of life of young adults according to their household income and food security status.

Methods

To conduct this study, 10,224 young adults aged 19–34 years who participated in the 2008–2018 Korea National Health and Nutrition Examination Survey (KNHANES) were selected. Subjects were categorized into four groups based on household income and food security: ‘food secure and high income,’ ‘food insecure and high income,’ ‘food secure and low income,’ and ‘food insecure and low income’. General characteristics, daily diet, and dietary quality were compared among the four groups.

Results

The proportion of participants consuming a daily diet below the estimated average requirements for protein, vitamins A, B1, and B2, niacin, vitamin C, calcium, phosphorus, and iron increased in the ‘food insecure and low income’ group. Among the most commonly consumed foods, instant noodles and Sprite ranked relatively high in the ‘food insecure and low income’ group, while apples and beef ranked relatively high in the ‘food secure and high income’ group. The food insecure and low income group exhibited significantly increased rates of mobility problems [OR = 1.55(95% CI = 1.05–2.29)] and anxiety/depression [OR = 1.33(95% CI = 1.07–1.64)] in comparison with the food secure and high income group.

Conclusion

Food insecurity was positively associated with poor diet quality and was associated with health-related quality of life, mobility, and anxiety/depression, especially among young adults.
Exploring adolescents’ experiences navigating the intersection of their gender, sport, and dietary identities: an interpretative phenomenological study
Authors: Deslippe Alysha L. , Middleton Georgia , Wu Olivia Y. , Bergeron Coralie , Cohen Tamara R.
Published: December 2024

Not all adolescents have positive sport experiences. Research has repeatedly identified ties between unfavorable eating patterns and food beliefs (i.e., a dietary identity) that hinder an athletes’ health and performance. Gender norms and pressures over idealized bodies (e.g., boys are muscular whereas girls are thin) play a critical role in the manifestation of unfavorable eating habits. However, most research has focused on the experiences of athlete girls in elite sport spaces (e.g., high performance), leaving gaps in our understanding of how diverse youth in high school spaces are impacted. To address this gap, we aimed to explore the intersections between adolescents’ sport, dietary and gender identities in high school. We conducted 33 interviews with high school athletes (n = 9 girls and n = 9 boys) and non-athletes (n = 4 non-binary, n = 6 boys and n = 5 girls) using methods informed by an interpretative phenomenological approach. We generated three themes capturing adolescents’ experiences: (1) De-gendering protein and muscles; (2) Food displays what I value; and (3) Being [too] masculine is bad. Athletes recognized ties between masculinity and sport, but spoke about traditionally masculine eating habits (e.g., valuing protein) and body ideals (e.g., being muscular) as part of their athletic identity, not gender. Regardless of sport involvement, adolescents altered their outward expression of their dietary habits to demonstrate pieces of their identities, like being an athlete (e.g., eating protein) or feminine (e.g., smaller bites). Adolescents also spoke about using food to pursue idealized bodies that show deviation from traditional gender norms. Finally, adolescents held conflicting views about masculinity as being both toxic and useful for competition. By understanding identity intersections, coaches, trainers, parents, and sport decisions-makers can make more informed decisions about sport policy, programs, and practice that involve dietary advice to support this population.
Palinopsia associated with the CDK4/6 inhibitor ribociclib during the first-line treatment of metastatic breast cancer: two case reports
Authors: Martos Tamara , Saint-Gerons Marta , Masfarre Laura , Castro-Henriques Maria , Martinez-Garcia Maria , Servitja Sonia , Albanell Joan
Published: December 2024

The most frequently used standard treatment for hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer patients consists of a CDK4/6 inhibitor (abemaciclib, ribociclib, or palbociclib) combined with endocrine therapy. Despite CDK4/6 inhibitors being part of routine care in the last few years, new adverse events continue to be reported. Here, we report two cases of palinopsia, a rare neurological visual disturbance that refers to the persistence or recurrence of a visual image after the removal of visual stimuli in patients treated with ribociclib and letrozole. Neuro-ophthalmological assessments and brain MRIs did not find any organic cause. However, palinopsia was related in a time- and dose-dependent manner to the intake of ribociclib. Following a one-level dose reduction of ribociclib, palinopsia was mild and well tolerated. Both patients continued the treatment with ribociclib, with one of them for almost 2 years. Based on the identification of two cases in our hospital in a short period of time, it is tempting to suggest that ribociclib-related palinopsias may not be uncommon. We propose that physicians should be aware of this ribociclib-associated adverse event. Patients presenting this symptom should undergo a routine workup (neuro-ophthalmological assessment and brain MRI) and, if negative, be reassured of its relation with ribociclib as well as the safety of continuing on this drug.
The multidisciplinary management of HER2-positive breast cancer brain metastases: from new biological insights to future therapeutic options
Authors: von Arx Claudia , Calderaio Claudia , Calabrese Alessandra , Marciano Benedetta , Martinelli Claudia , Di Lauro Vincenzo , Cerillo Ivana , Cianniello Daniela , De Laurentiis Michelino
Published: December 2024

The advent and success of new drugs for treating HER2-positive metastatic breast cancer has led to a constant improvement in disease and progression-free survival as well as overall survival. Despite these advantages, the overall survival and quality of life of patients with HER2-positive breast cancer brain metastases are significantly worse than the ones of patients with HER2-positive breast cancer metastases outside the brain. For this reason, prevention and treatment of brain metastasis remain a major clinical challenge and the keys to further improving the clinical and survival outcomes of HER2-positive breast cancer patients. This review discusses the etiopathogenesis of brain metastasis, the currently available treatments, and the future perspective on new treatment strategies and diagnostic tools.
Intrathecal methotrexate injection combined treatment of gastric cancer with leptomeningeal metastasis: case report
Authors: Xie Wenting , Kang Xun , Huang Sijie , Li Wenbin
Published: December 2024

Background

Leptomeningeal metastasis of gastric adenocarcinoma (LM-GC) is a rare and severe complication with a poor prognosis, its prognosis is significantly poorer than liver, lung, and peritoneal metastases. Studies on LM-GC have been limited to clinical case reports. Despite advances in systemic therapies, there is a lack of standardized treatment protocols for LM-GC due to its rarity and the challenges it presents.

Methods

This case series reports on six patients diagnosed with LM-GC who received intrathecal methotrexate (MTX) injection from June 2018 to November 2023. Treatment efficacy, safety, and prognostic factors were analyzed by comparing symptoms and laboratory test results before and after treatment.

Results

The average OS for the cohort was 7.5 months, exceeding previous reports for LM-GC patients, which has a median survival time of 4-6 weeks. No significant changes were observed in cerebrospinal fluid glucose and chloride levels post-MTX treatment. However, a statistically significant decrease in cerebrospinal fluid protein levels was noted after treatment (P < 0.05). Adverse reactions were mild, with the most common being bone marrow suppression and oral mucosal ulcers.

Conclusion

Intrathecal MTX injection combined treatment offers a potential therapeutic strategy for LM-GC, improving clinical symptoms and extending survival. Further research is warranted to validate these findings and explore the molecular mechanisms of LM-GC for targeted therapies.
Biomarkers for immunotherapy resistance in non-small cell lung cancer
Authors: Rother Catriona , John Tom , Wong Annie
Published: December 2024

Immunotherapy has revolutionised the treatment landscape of non-small cell lung cancer (NSCLC), significantly improving survival outcomes and offering renewed hope to patients with advanced disease. However, the majority of patients experience limited long-term benefits from immune checkpoint inhibition (ICI) due to the development of primary or acquired immunotherapy resistance. Accurate predictive biomarkers for immunotherapy resistance are essential for individualising treatment strategies, improving survival outcomes, and minimising potential treatment-related harm. This review discusses the mechanisms underlying resistance to immunotherapy, addressing both cancer cell-intrinsic and cancer cell-extrinsic resistance processes. We summarise the current utility and limitations of two clinically established biomarkers: programmed death ligand 1 (PD-L1) expression and tumour mutational burden (TMB). Following this, we present a comprehensive review of emerging immunotherapy biomarkers in NSCLC, including tumour neoantigens, epigenetic signatures, markers of the tumour microenvironment (TME), genomic alterations, host–microbiome composition, and circulating biomarkers. The potential clinical applications of these biomarkers, along with novel approaches to their biomarker identification and targeting, are discussed. Additionally, we explore current strategies to overcome immunotherapy resistance and propose incorporating predictive biomarkers into an adaptive clinical trial design, where specific immune signatures guide subsequent treatment selection.
Phosphaturic mesenchymal tumor of the popliteal fossa: a case report and literature review
Authors: Wang Yingjie , Liu Shiwei , Li Caixia , Song Wenjing , Zhang Yimin , Wang Jun
Published: December 2024

Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by hypophosphatemia caused by excessive secretion of fibroblast growth factor-23 (FGF-23) by tumors. This leads to impaired bone mineralization and, ultimately, osteomalacia. The most common underlying cause is a phosphaturic mesenchymal tumor (PMT). Due to its rarity, nonspecific clinical presentation, and limited clinician awareness, TIO is frequently underdiagnosed or misdiagnosed. A 42-year-old man presented with persistent pain in the chest, lower back, knees, and ankles for more than six months, which had worsened in the preceding week. Laboratory tests revealed hypophosphatemia and abnormalities in markers of bone metabolism. Symptomatic treatment provided minimal improvement. The whole-body PET/CT scan subsequently identified a cystic and solid mass in the popliteal fossa of the right knee, with high somatostatin receptor expression. The tumor was surgically removed, and histopathological examination confirmed PMT. The patient’s blood phosphorus concentration returned to normal one week after surgery, and levels of other laboratory indicators gradually returned to normal. Although symptoms persisted during the first postoperative week, significant relief was noted by the second week. This case report highlighted the necessity of improving clinical recognition and management of TIO to ensure timely diagnosis and treatment.
Spinal accessory nerve transfer for shoulder abduction has no benefit over supraclavicular exploration and nerve grafting in brachial plexus birth injury: a systematic review
Authors: Mendiratta Dhruv , Singh Rohan , Abdelmalek George , Pant Krittika , Chu Alice , McGrath Aleksandra
Published: December 2024

Introduction

Brachial plexus birth injury (BPBI) has an incidence of 0.9 per 1,000 live births in the population. Techniques for repair classically include supraclavicular exploration and nerve grafting (SENG) and more recently nerve transfer, namely of the spinal accessory nerve (SAN) to the suprascapular nerve (SSN) to improve functional outcomes such as glenohumeral abduction and external rotation. This systematic review was conducted to evaluate whether spinal accessory nerve transfer produced significantly better outcomes for shoulder abduction in BPBI.

Methods

A search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis Individual Patient Data guidelines. Standardized comparisons were made using the Mallet Score for shoulder abduction.

Results

10 full-text articles with itemized patient outcome measures were selected. 110 patients were identified with 51 patients in the SENG group and 59 patients in the SAN transfer group. The mean shoulder abduction Mallet score in the SENG group was 3.50 ± 0.84, while the mean Mallet score in the SAN transfer group was 3.58 ± 0.77, which displayed no significant differences (p = 0.9012). There was no significant relationship between the age at time of surgery and post-operative Mallet scores for shoulder abduction after SENG (p = 0.3720).

Discussion

Our systematic review found that there was no difference observed in post-operative outcomes of shoulder abduction when comparing SAN transfer and nerve grafting. Continued support for nerve grafting lies in the argument that it incorporates the patient's native neuroanatomy and allows for sensory reinnervation.
Diagnosis of small bowel obstruction due to Shine-Muscat grape ingestion: case report
Authors: Gu Chunhui , Zhang Youcheng , Jiang Guoqing , Hu Xiaoting
Published: December 2024

Introduction

This case report describes a rare instance of small bowel obstruction (SBO) caused by the ingestion of a whole Shine-Muscat grape in a 7-month-old infant. This case adds to the scientific literature by highlighting the potential risk of common fruits, such as grapes, in causing serious gastrointestinal blockages in pediatric patients, which is an uncommon but important consideration for pediatricians and caregivers.

Main symptoms and clinical findings

A 7-month-old female presented with a 3-day history of vomiting, which progressed to bilious vomiting, accompanied by abdominal distension and dehydration. Abdominal CT imaging revealed dilated small bowel loops and a spherical low-density lesion suggestive of an obstructing foreign body.

Main diagnoses, therapeutic interventions, and outcomes

The diagnosis of mechanical small bowel obstruction due to a foreign body was confirmed intraoperatively. The obstructing object was identified as a whole Shine-Muscat grape. Surgical management involved a minimally invasive laparoscopic approach to crush and move the grape into the colon, avoiding bowel incision. The patient recovered well postoperatively and passed the grape fragments naturally, resuming a normal diet within days.

Conclusion

This case underscores the importance of considering fruit ingestion as a potential cause of intestinal obstruction in infants. Pediatric surgeons and emergency clinicians should be aware of this rare but significant risk and employ careful history-taking, appropriate imaging, and minimally invasive techniques to manage such cases effectively.
Factors affecting posaconazole plasma concentrations: a meta-analysis and systematic review
Authors: Qu Ruochen , Liu Yan , Zhao Yan , Wang Ziyi , Yuan Shizhao , Liu Shuai , Yu Jing
Published: December 2024

Background

Posaconazole is a potent antifungal agent widely used to manage invasive fungal infections, especially in immunocompromised individuals. Achieving optimal therapeutic concentrations of posaconazole can be challenging due to interpatient variability, the availability of multiple formulations, and various dosing strategies.

Methods

We conducted a systematic search of PubMed, EMBASE, and the Cochrane Library to identify studies evaluating factors that influence blood concentrations of posaconazole. The primary outcome was the assessment of posaconazole concentrations in relation to various influencing factors, including age, sex, drug interactions, disease state, administered dose, and formulation.

Results

Our analysis included 46 studies involving a total of 8,505 patients. Co-administration of drugs that affect posaconazole metabolism significantly reduced its concentrations. High-fat meals, age, and sex did not have a significant impact on posaconazole oral suspension (POS) concentrations. Diarrhea substantially decreased concentrations of both delayed-release tablets (DRT) and POS. Neither vomiting nor mucositis significantly affected POS concentrations. Acid-suppressing agents, such as H2 receptor antagonists and proton pump inhibitors, notably decreased POS concentrations but had no significant effect on DRT. Comparative studies of different dosage forms revealed significantly higher concentrations with DRT compared to POS.

Conclusion

DRT maintain more stable concentrations than POS and are not affected by acid-suppressing drugs. Given the significant fluctuations in posaconazole concentrations, patients experiencing diarrhea require close monitoring.

Systematic Review Registration

PROSPERO, Identifier CRD42023428822 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023428822).
Progressive iron overload in middle-aged mice impairs olfactory function, triggers lipid oxidation and induces apoptosis
Authors: Deng Lin , Luo Qihui , Liu Yucong , Wang Yao , Xiong Zongliang , Wang Hongping , Zhao Lu , Jia Lanlan , Shi Riyi , Huang Chao , Chen Zhengli
Published: December 2024

Introduction

This study aims to investigate the progressive impact of chronic iron overload on the olfactory bulb, a region significantly affected in early neurodegenerative diseases like Parkinson’s and Alzheimer’s. The focus is on understanding how iron accumulation leads to oxidative stress, mitochondrial dysfunction, and neuronal damage over time in middle-aged mice.

Method

The mice were continuously administered FC for a duration of 16 weeks, and the olfactory behavior of the mice was observed at intervals of 4 weeks. Inductively coupled plasma mass spectrometry (ICP-MS) was employed to detect alterations in iron content within the olfactory bulb of the mice, while levels of lipid peroxidation and antioxidant indexes were assessed using biochemical kits. Additionally, western blotting and qPCR techniques were utilized to analyze transcriptional and expression changes in proteins and genes related to iron metabolism. Furthermore, microstructural modifications as well as mitochondrial observations were conducted through paraffin sectioning and transmission electron microscopy (TEM).

Result

A significant and progressive increase in iron accumulation in the olfactory bulb, starting from week 8 and peaking at week 16. This accumulation coincided with a decline in olfactory function observed at week 12. Key markers of oxidative stress, such as 4-HNE and MDA, were elevated in specific layers, and antioxidant defenses were reduced. Mitochondrial damage became evident from week 8, with caspase-3 activation indicating increased apoptosis, particularly in the granular layer. This study is to demonstrate the link between chronic iron overload and progressive olfactory dysfunction in the context of neurodegenerative diseases. It provides evidence that iron-induced oxidative stress and mitochondrial damage in the olfactory bulb contribute to early sensory deficits, suggesting that the olfactory bulb’s selective vulnerability can serve as an early biomarker for neurodegenerative conditions.

Conclusion

Chronic iron overload leads to progressive oxidative damage, mitochondrial dysfunction, and apoptosis in the olfactory bulb, causing sensory deficits. Targeting iron accumulation and oxidative damage may offer new strategies for early intervention in neurodegenerative diseases, highlighting the importance of addressing iron dysregulation.
Cerebrovascular regulation in patients with active tumors and an acute ischemic stroke: a retrospective analysis
Authors: Lakatos Lehel-Barna , Bolognese Manuel , Oesterreich Mareike , Müller Martin , Karwacki Grzegorz Marek
Published: December 2024

Introduction

Ischemic stroke in patients with a systemic tumor disease or cancer not in remission (active tumors) is less well understood. Some aspects of such paraneoplastic strokes remind on a generalized cerebrovascular disorder. We hypothesized that cerebrovascular regulation in active tumor patients with a stroke is different from other patients with stroke who have no active tumor disease.

Methods

Within the first 72 h after the acute ischemic stroke, cerebral blood flow regulation was analyzed by means of transfer function analysis between middle cerebral artery blood flow velocity and blood pressure with estimation of coherence, gain and phase in the very low (0.02–0.07 Hz), low (0.07–0.20 Hz) and high frequencies (0.20–0.5 Hz) in four stroke groups: active tumors, inactive tumors (untreated and in remission), hypertensive lacunar stroke (LS), and non-hypertensive embolic stroke (NHES).

Results

The 4 groups did not differ regarding age, sex distribution, and brain infarct size on magnet resonance imaging Between the four stroke groups, phase was not different in any frequency range in both hemispheres. Gain was highest (either significant or by trend) in the active tumor group in the HF range in comparison to all other stroke subgroups, it was also higher in the LF range in the stroke affected hemisphere when compared to the LS group. The HF gain findings were independent of end-tidal CO2 levels but exhibited some dependency of coherence.

Discussion

The high gain can be interpreted as a generalized high vascular resistance. The cerebrovascular regulation in active tumor patients seems to exhibit some analogy to hypertensive patients with lacunar stroke.

Clinical Trial Registration

clinicaltrials.gov, identifier NCT04611672.
Care providers’ view of the barriers in providing care for adolescents with emotional and behavioral problems
Authors: Paclikova Katerina , Dankulincova Veselska Zuzana , Madarasova Geckova Andrea , Tavel Peter , Jansen Danielle E. M. C. , van Dijk Jitse P. , Reijneveld Sijmen A.
Published: December 2024

Objectives

Emotional and behavioral problems (EBP) during adolescence are a major public health issue due to its high prevalence and long-lasting consequences. The knowledge of the barriers in providing psychosocial care can be a starting point for subsequent efficiency improvement. Therefore, the aim of this study is to assess which barriers do care providers experience while providing psychosocial care for adolescents with EBP.

Methods

We performed a qualitative assessment that was embedded in the Slovak Care4Youth study mapping the system of care provided for adolescents with EBP. We conducted 25 semi-structured individual and group interviews with a total of 49 care providers from 17 institutions that provided preventive counselling, social, and mental healthcare for adolescents with EBP. We focused on the care provider’s perception of barriers in providing care for these adolescents. The interviews were audiotaped and transcribed verbatim. We coded the data using the consensual qualitative research approach in combination with conventional content analysis.

Results

We found that care providers experienced several barriers in providing care for adolescents with EBP which relate to six themes—legislative framework and legislative changes; financing of the care system; coordination of care; workforce development, education, methodical guidance and supervision; personnel and institutional capacities; and administrative burden.

Conclusion

Addressing these barriers within the care system from the “front line” perspective provides clues to efficiently improve the psychosocial care for adolescents with EBP. According to the care providers, the organization and financing of the care system requires adaptation; the burden of the care providers should be reduced; and care providers require quality practical education, training, and methodological guidance.
A group version of the OurRelationship program within residential substance use treatment: preliminary evidence for improving responses to romantic relationship conflict for those dealing with substance misuse
Authors: Karantzas Gery C. , Staiger Petra K. , Romano Daniel A. , Curtis Ashlee , Bruscella Courtney , Miller Peter G. , Gruenert Stefan , Toumbourou John W. , Doss Brian D. , Christensen Andrew
Published: December 2024

The aim of this study was to pilot an adapted version of an online relationships program with residents in treatment for alcohol and other drugs (AOD). The OurRelationship (OR) Program, which is based on Integrative Behavioral Couples Therapy, was piloted in a group-based format to determine whether residents' participation in the program would result in decreases in residents' destructive responses and increases in constructive responses to relationship conflict scenarios as well as reductions in negative affect experienced during these conflict scenarios. Residents (N = 104) across six residential facilities participated in the pilot over 4 weeks. Pre and post program completion, residents read three vignettes in which they were asked to imagine themselves as experiencing each of the three relationship conflicts with a romantic partner. After reading each vignette, residents completed assessments related to their constructive and destructive behavioral responses to each vignette as well as the degree to which they experienced negative affect. Pre-post comparisons across the three vignettes revealed residents reported reductions in destructive behavioral responses and anger (ds −0.31 to −0.58) as well as increases in constructive responses (ds 0.33–0.77). The findings provide preliminary evidence regarding the application of programs to address the relationship difficulties experienced by those in AOD treatment. Future research into control trials of the OR program within the AOD sector can help to establish the effectiveness of relationship programs in helping to address the relationship problems of this vulnerable population.
M.I.N.I.-KID interviews with adolescents: a corpus-based language analysis of adolescents with depressive disorders and the possibilities of continuation using Chat GPT
Authors: Jarvers Irina , Ecker Angelika , Donabauer Pia , Kampa Katharina , Weißenbacher Maximilian , Schleicher Daniel , Kandsperger Stephanie , Brunner Romuald , Ludwig Bernd
Published: December 2024

Background

Up to 13% of adolescents suffer from depressive disorders. Despite the high psychological burden, adolescents rarely decide to contact child and adolescent psychiatric services. To provide a low-barrier alternative, our long-term goal is to develop a chatbot for early identification of depressive symptoms. To test feasibility, we followed a two-step procedure, a) collection and linguistic analysis of psychiatric interviews with healthy adolescents and adolescents with depressive disorders and training of classifiers for detection of disorders from their answers in interviews, and b) generation of additional adolescent utterances via Chat GPT to improve the previously created model.

Methods

For step a), we collected standardized interviews with 53 adolescents, n = 40 with and n = 13 without depressive disorders. The transcribed interviews comprised 4,077 question-answer-pairs, with which we predicted the clinical rating (depressive/non-depressive) with use of a feedforward neural network that received BERT (Bidirectional Encoder Representations from Transformers) vectors of interviewer questions and patient answers as input. For step b), we used the answers of all 53 interviews to instruct Chat GPT to generate new similar utterances.

Results

In step a), the classifier based on BERT was able to discriminate answers by adolescents with and without depression with accuracies up to 97% and identified commonly used words and phrases. Evaluating the quality of utterances generated in step b), we found that prompt engineering for this task is difficult as Chat GPT performs poorly with long prompts and abstract descriptions of expectations on appropriate responses. The best approach was to cite original answers from the transcripts in order to optimally mimic the style of language used by patients and to find a practicable compromise between the length of prompts that Chat GPT can handle and the number of examples presented in order to minimize literal repetitions in Chat GPT’s output.

Conclusion

The results indicate that identifying linguistic patterns in adolescents’ transcribed verbal responses is promising and that Chat GPT can be leveraged to generate a large dataset of interviews. The main benefit is that without any loss of validity the synthetic data are significantly easier to obtain than interview transcripts.
Trace amine-associated receptor 1 agonist reduces aggression in brain serotonin-deficient tryptophan hydroxylase 2 knockout rats
Authors: Zhukov Ilya S. , Alnefeesi Yazen , Krotova Natalya A. , Nemets Vsevolod V. , Demin Konstantin A. , Karpenko Marina N. , Budygin Evgeny A. , Kanov Evgeny V. , Kalueff Allan V. , Shabanov Petr D. , Bader Michael , Alenina Natalia , Gainetdinov Raul R.
Published: December 2024

Introduction

Aggression and self-harm disproportionately occur in youths preoccupied with social status tracking. These pathological conditions are linked to a serotonin (5-HT) deficit in the brain. Ablation of 5-HT biosynthesis by tryptophan hydroxylase 2 knockout (TPH2-KO) increases aggression in rodents. Remarkably, deletion of the trace amine-associated receptor 1 (TAAR1) results in the same consequences. Unlike the nuanced dynamics of social status cues in young people, the social ranks of rats mainly advance when they dominate larger opponents in combat.

Methods

This study explored whether the potent TAAR1 agonist RO5263397 reduces aggression caused by 5-HT depletion, and whether social rank advancement motivates this aggression. The resident-intruder paradigm was applied with larger and smaller intruders to evaluate whether social rank advancement motivates aggressive behaviors in TPH2-KO rats.

Results

When a smaller intruder was introduced, 5-HT-deficient rats did not differ from wild type littermates. However, when the intruders were larger, the mutants extended their aggressive efforts, refusing to submit. Importantly, RO5263397 selectively abolished this abnormal form of aggression in TPH2-KO rats.

Discussion

Results supported social rank advancement as the main incentive. These data also suggest that TAAR1 is a promising target for the development of new treatments for aggression; independent data also support this conclusion.
Assessing the impact of tech-driven solutions to manage COVID-19 in Saudi Arabia: insights from health information technology professionals
Authors: Farhah Nesren S.
Published: December 2024

Introduction

The outbreak of the COVID-19 pandemic has disrupted the provision of healthcare services, forcing health systems, governments, and other public health stakeholders to embark on alternative means to deliver care.

Method

This scenario has fueled the adoption of digital health technologies in the healthcare industry to enhance the management of the COVID-19 pandemic. This study aimed to investigate the effect of using health information technologies (HITs) in managing the COVID-19 pandemic in Saudi Arabia from the health information technology professionals' perspectives. In addition, the study aimed to evaluate the usefulness of using HITs interventions to manage COVID-19, assess HITs information exchange capability and quality, and measure practitioners' satisfaction with HITs.

Results

The present study used a primary analysis and cross-sectional design. Data were collected using survey questionnaires and analyzed. A total of 371 participants (n = 371) responded to the questionnaire that was administered online, in March 2022. The study found that HITs significantly influenced the management of the COVID-19 pandemic in various areas, including consulting, screening, and monitoring. However, technical issues, among other challenges, hindered the realization of the desired outcomes.

Discussion

In addition, the study found HITs helpful in managing COVID-19, adding that these technologies improved providers' satisfaction concerning access to and value of information. The study found the need to address the challenges associated with HITs that prevent the effective deployment of HITs to manage COVID-19 and future pandemics.
Depressive and anxiety symptoms in postpartum women after recovery from COVID-19: a questionnaire-based observational study
Authors: Hsieh Chia-Jung , Su Hsiu-Wei , Lee Chen-Yu , Lin Chih-Chien , Chen Wei-Chih
Published: December 2024

Introduction

Previous studies on the association between recovery from Coronavirus Disease 2019 (COVID-19) infection and postpartum depressive and anxiety symptoms had conflicting results. This study aimed to investigate the psychological burdens among postpartum women who had experienced COVID-19 infection during their pregnancies and those who had not.

Methods

This cross-sectional study was conducted at Taichung Veterans General Hospital in Taiwan from April 2022 to January 2023. A total of 113 postpartum women completed self-reported questionnaires, including the Edinburgh Postnatal Depression Scale (EPDS) and General Anxiety Disorder-7 (GAD-7), in the postpartum clinics or wards.

Results

Fifty-four individuals (47%) who experienced COVID-19 infection during their pregnancies and 59 uninfected women completed the questionnaires. The mean EPDS scores were 5.00 ± 4.26 vs. 6.46 ± 4.50 (p = 0.09) and the mean GAD-7 scores were 3.17 ± 2.88 vs. 3.69 ± 2.73 (p = 0.21). Multivariate linear regression analyses revealed that factors associated with lower EPDS scores included experiencing COVID-19 infection during pregnancy, delivery by expected mode, and neonates not requiring admission to the Intensive Care Nursery (ICN) or Neonatal Intensive Care Unit (NICU). Delivery by expected mode was the only variable associated with a lower GAD-7 score in the multivariate model.

Conclusion

Our study demonstrated that COVID-19 infection during pregnancy was associated with fewer postpartum depressive symptoms based on linear regression analysis, with no significant difference in postpartum anxiety symptoms.
DreamOn: a data augmentation strategy to narrow the robustness gap between expert radiologists and deep learning classifiers
Authors: Lerch Luc , Huber Lukas S. , Kamath Amith , Pöllinger Alexander , Pahud de Mortanges Aurélie , Obmann Verena C. , Dammann Florian , Senn Walter , Reyes Mauricio
Published: December 2024

Purpose

Successful performance of deep learning models for medical image analysis is highly dependent on the quality of the images being analysed. Factors like differences in imaging equipment and calibration, as well as patient-specific factors such as movements or biological variability (e.g., tissue density), lead to a large variability in the quality of obtained medical images. Consequently, robustness against the presence of noise is a crucial factor for the application of deep learning models in clinical contexts.

Materials and methods

We evaluate the effect of various data augmentation strategies on the robustness of a ResNet-18 trained to classify breast ultrasound images and benchmark the performance against trained human radiologists. Additionally, we introduce DreamOn, a novel, biologically inspired data augmentation strategy for medical image analysis. DreamOn is based on a conditional generative adversarial network (GAN) to generate REM-dream-inspired interpolations of training images.

Results

We find that while available data augmentation approaches substantially improve robustness compared to models trained without any data augmentation, radiologists outperform models on noisy images. Using DreamOn data augmentation, we obtain a substantial improvement in robustness in the high noise regime.

Conclusions

We show that REM-dream-inspired conditional GAN-based data augmentation is a promising approach to improving deep learning model robustness against noise perturbations in medical imaging. Additionally, we highlight a gap in robustness between deep learning models and human experts, emphasizing the imperative for ongoing developments in AI to match human diagnostic expertise.
PTSD, dysregulation profile and substance use: exploring differences in a sample of adolescents in an outpatient clinic
Authors: Reyentanz Emely , Basedow Lukas A. , Roessner Veit , Golub Yulia
Published: December 2024

Introduction

Experiencing traumatic events (TEs), especially interpersonal TEs, is related to an increased risk of developing post-traumatic stress disorder (PTSD). Both TEs and PTSD are associated with a higher risk of substance use and problems in emotion regulation. Little is known about the associations between specific types of TEs, problems with general self-regulation (including cognitive and behavioral components) and substance use severity in adolescents. Knowledge on these associations could provide important approaches for prevention and therapy for adolescents with a history of trauma.

Methods

This study investigated associations between different types of TEs and PTSD, self-regulation and substance use severity. Moreover, participants were categorized into three groups according to their trauma status: (I) no history of TEs (noTEs), (II) history of TEs but no PTSD diagnosis (TEs), and (III) history of TEs and PTSD diagnosis (PTSD). Differences between the three groups were analyzed in terms of self-regulation and substance use severity. Our sample consisted of N = 89 adolescents aged 12 to 18 years in a child and adolescent psychiatric outpatient clinic in Germany. Substance use severity was only assessed in a smaller subsample (n = 37). Data were obtained from standardized diagnostic procedures and included information on types of TEs and PTSD diagnosis according to ICD-10, problems in self-regulation assessed with the Child Behavior Checklist (CBCL)/ Youth Self Report (YSR) Dysregulation Profile (DP), and substance use severity measured with the Drug Use Disorders Identification Test (DUDIT).

Results

We found that interpersonal TEs were significantly associated with higher rates of PTSD diagnosis compared to non-interpersonal TEs. We found no significant associations between different types of TEs and both problems in self-regulation and substance use severity. Moreover, our findings do not indicate differences in both self-regulation and substance use severity between trauma statuses (noTEs, TEs, PTSD).

Discussion

Future studies should consider other characteristics of TEs such as timing and duration when investigating associations with self-regulation. Longitudinal studies are needed to investigate developmental pathways, as a better understanding of the role of characteristics of TEs and self-regulation in the development of PTSD and substance use problems would provide opportunities for prevention and therapy for trauma-exposed patients.
Evaluating client functioning in a harm reduction program in South Africa: insights from a tool derived from the International Classification of Functioning, Disability and Health
Authors: Janse van Rensburg Michelle N. S. , Casteleijn Daleen , Scheibe Andrew
Published: December 2024

South Africa faces the detrimental effects of problematic substance use. The Community Oriented Substance Use Program (COSUP) is a research-based, community-situated harm-reduction program. The International Classification of Functioning, Disability and Health (ICF) was used as the framework to develop a unique tool to determine the functioning of COSUP clients. The study was a quantitative descriptive, cross-sectional design, with data collected from COSUP sites during January 2023 using the COSUP Client Functioning Tool. Twenty-three Likert-scale structured closed questions about clients’ perceptions of their functioning and context were analyzed using descriptive statistics. Open-ended questions about COSUP services were thematically analyzed. Most COSUP clients are working-age African males, and many are unemployed. Clients seem to be coping well physically but need more mental health support. Pressing concerns for COSUP clients are feeling stressed and anxious, an inability to handle stress, poor use of free time, not getting support from others, and not having enough money to meet daily needs. Lack of energy and boredom are significant concerns, along with feelings of rejection and loneliness. Facilitating opportunities for sustaining livelihoods requires focus. Even so, there are those who have a sense of hope due to the positive impact of the program. Basing the COSUP Client Functioning Tool on the ICF framework provided a useful picture of the functioning of people who use/d drugs in their contexts. The COSUP Tool is helpful to guide interventions that are responsive to clients’ needs.
Chemical and nutritional characterization of loengo (Anisophyllea boehmii) fruits as a source of important bioactive with impact on health
Authors: Lofa Alcides Morais , Mourato Miguel Pedro , Prista Catarina , Sousa Isabel , Ferreira Ricardo Boavida
Published: December 2024

Introduction

Fruits are vital for promoting human health, as well as providing nutrients and other compounds linked to protection against many different diseases. Loengo (Anisophyllea boehmii Engl.) produces an edible stone fruit, plum-shaped (drupe), dark blue and maroon or carmine in the ripening stage, which is generally, consumed fresh in the production areas. Characterization of this fruit will contribute to estimate its nutritional and pharmaceutical potential impact. The present work aimed at the physic-chemical, nutritional and antioxidant activity characterization of loengo fruit.

Methods

Soluble solid contents (SSC) in the pulp were assessed in juice, at room temperature. Total protein was determined using the Dumas method. In what concerns the mineral composition were determined by ICP-OES. Organic acids identification and quantification was accomplished using a high-performance liquid chromatography (HPLC) system. The total polyphenol contents (TPC) were determined in 96-well microplate assays. Antioxidant activity were determined by 2,2-diphenyl-1-picrylhydrazyl (DPPH) and the ferric reducing antioxidant power (FRAP) assay.

Results and discussion

Composition, in terms of fresh matter is as follows: pulp soluble sugar content (refractometer) is 19.5% ± 0.02%, and pulp titratable acidity 1.2% ± 0.1% expressed in citric acid; total protein content is 7.4% ± 0.02%, 8.0% ± 0.1%, 16.9% ± 0.2%, for the peel, pulp and seed, respectively. In what concerns the mineral composition, the results obtained show that it is a good source of minerals, mainly potassium and phosphorus, but also calcium, sulfur, and magnesium, with the pulp richer in potassium, the seed in phosphorus, and the peel in calcium. As expected, the pulp showed the highest total soluble sugar content, whereas the seed had the lowest. The main sugars found in the pulp were glucose and fructose. In the peel citric acid was the main organic acid found, together with malic, oxalic, and ascorbic acids. Most antioxidant activity was found in the seed. The results of this work provide important basic information to recommend the consumption of this fruit for its sweet taste, chemical and nutritional composition, and, most of all, for its richness in total phenolic compounds for it potential to formulate nutraceutical foods.