bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

IntroductionThis 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 findingsA 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 outcomesThe 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.ConclusionThis 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

BackgroundPosaconazole 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.MethodsWe 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.ResultsOur 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.ConclusionDRT 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 RegistrationPROSPERO, 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

IntroductionThis 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.MethodThe 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).ResultA 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.ConclusionChronic 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

IntroductionIschemic 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.MethodsWithin 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).ResultsThe 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.DiscussionThe 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 Registrationclinicaltrials.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

ObjectivesEmotional 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.MethodsWe 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.ResultsWe 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.ConclusionAddressing 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.
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

BackgroundUp 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.MethodsFor 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.ResultsIn 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.ConclusionThe 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

IntroductionAggression 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.MethodsThis 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.ResultsWhen 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.DiscussionResults 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

IntroductionThe 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.MethodThis 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.ResultsThe 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.DiscussionIn 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

IntroductionPrevious 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.MethodsThis 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.ResultsFifty-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.ConclusionOur 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

PurposeSuccessful 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 methodsWe 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.ResultsWe 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.ConclusionsWe 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

IntroductionExperiencing 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.MethodsThis 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).ResultsWe 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).DiscussionFuture 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.