bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic factors and impact of management strategies for status epilepticus: The STEPPER study in the Emilia‐Romagna region, Italy
Authors: Di Vito Lidia , Matteo Eleonora , Meletti Stefano , Zenesini Corrado , Bernabè Giorgia , Bomprezzi Chiara , Casadio Maria Chiara , Castioni Carlo Alberto , Cesnik Edward , Coniglio Carlo , Currò‐Dossi Marco , De Massis Patrizia , Fallica Elisa , Florindo Irene , Giovannini Giada , Guarino Maria , Marchesi Elena , Marudi Andrea , Merli Elena , Monti Giulia , Orlandi Niccolò , Pasini Elena , Passarelli Daniela , Rinaldi Rita , Rizzi Romana , Romoli Michele , Santangelo Mario , Tontini Valentina , Turchi Giulia , Volpini Mirco , Zini Andrea , Zinno Lucia , Michelucci Roberto , Vignatelli Luca , Tinuper Paolo , Bisulli Francesca ,   the STEPPER study group
Published: December 2024

AbstractObjectiveThe STEPPER (Status Epilepticus in Emilia‐Romagna) study aimed to investigate the clinical characteristics, prognostic factors, and treatment approaches of status epilepticus (SE) in adults of the Emilia‐Romagna region (ERR), Northern Italy.MethodsSTEPPER, an observational, prospective, multicentric cohort study, was conducted across neurology units, emergency departments, and intensive care units of the ERR over 24 months (October 2019–October 2021), encompassing incident cases of SE. Patients were followed up for 30 days.ResultsA total of 578 cases were recruited (56% female, mean age = 70 years, 32% with previous diagnosis of epilepsy, 43% with in‐hospital onset, 35% stuporous/comatose, 46% with nonconvulsive SE). Etiology was known in 87% (acute 43%, remote 24%, progressive 17%, definite epileptic syndrome 3%). The mean pre‐SE Rankin Scale score was 2, the Status Epilepticus Severity Score was ≥4 in 33%, the Epidemiology‐Based Mortality Score in Status Epilepticus score was ≥64 in 61%, and 34% were refractory. The sequence of treatments followed current clinical practice guidelines in 63%. Benzodiazepines (BDZs) were underused as first‐line therapy (71%), especially in in‐hospital onset cases; 15% were treated with continuous intravenous anesthetic drugs. Mortality was 24%; 63% of survivors had functional worsening. At the two‐step multivariable analysis, incorrect versus correct treatment sequence with correct BDZ dose was the strongest predictor of failure to resolve SE in the in‐hospital group (odds ratio [OR] = 4.42, 95% confidence interval [CI] = 1.86–10.5), with a similar trend in the out‐of‐hospital group (OR = 2.22, 95% CI = .98–5.02). In turn, failure to resolve was the strongest predictor of 30‐day mortality (OR = 11.3, 95% CI = 4.16–30.9, out‐of‐hospital SE; OR = 6.42, 95% CI = 2.79–14.8, in‐hospital SE) and functional worsening (OR = 5.83, 95% CI = 2.05–16.6, out‐of‐hospital SE; OR = 9.30, 95% CI 2.22–32.3, in‐hospital SE).SignificanceThe STEPPER study offers insights into real‐world SE management, highlighting its significant morbidity and functional decline implications. Although nonmodifiable clinical factors contribute to SE severity, modifiable factors such as optimized first‐line therapies and adherence to guidelines can potentially influence prognosis.
Rare dysfunctional SCN2A variants are associated with malformation of cortical development
Authors: Clatot Jérôme , Thompson Christopher H. , Sotardi Susan , Jiang Jinan , Trivisano Marina , Balestrini Simona , Ward D. Isum , Ginn Natalie , Guaragni Brunetta , Malerba Laura , Vakrinou Angeliki , Sherer Mia , Helbig Ingo , Somarowthu Ala , Sisodiya Sanjay M. , Ben‐Shalom Roy , Guerrini Renzo , Specchio Nicola , George Alfred L. , Goldberg Ethan M. 
Published: December 2024

AbstractObjectiveSCN2A encodes the voltage‐gated sodium (Na+) channel α subunit NaV1.2, which is important for the generation and forward and back propagation of action potentials in neurons. Genetic variants in SCN2A are associated with a spectrum of neurodevelopmental disorders. However, the mechanisms whereby variation in SCN2A leads to disease remains incompletely understood, and the full spectrum of SCN2A‐related disorders may not be fully delineated.MethodsHere, we identified seven de novo heterozygous variants in SCN2A in eight individuals with developmental and epileptic encephalopathy (DEE) accompanied by prominent malformation of cortical development (MCD). We characterized the electrophysiological properties of Na + currents in human embryonic kidney (HEK) cells transfected with the adult (A) or neonatal (N) isoform of wild‐type (WT) and variant NaV1.2 using manual and automated whole‐cell voltage clamp recording.ResultsThe neonatal isoforms of all SCN2A variants studied exhibit gain of function (GoF) with a large depolarized shift in steady‐state inactivation, creating a markedly enhanced window current common across all four variants tested. Computational modeling demonstrated that expression of the NaV1.2‐p.Met1770Leu‐N variant in a developing neocortical pyramidal neuron results in hyperexcitability.SignificanceThese results support expansion of the clinical spectrum of SCN2A‐related disorders and the association of genetic variation in SCN2A with MCD, which suggests previously undescribed roles for SCN2A in fetal brain development.
Temporal ecological processes have different seasonal influences on multiple dimensions of riverine insect diversity in China
Authors: Lin Xiaowei , Zhang Xiaoguang , Tan Lu , Tian Zhen , Li Jingting , Luo Qingyi , Resh Vincent H. , Cai Qinghua , Chiu Ming‐Chih 
Published: December 2024

Abstract
An understanding of the relative importance of ecological processes affecting biological communities can assist in interpretations of biodiversity patterns. However, the mechanism behind temporal beta diversity, which refers to the dissimilarity between community structures at different times, remains unclear for aquatic insect communities.
Therefore, we collected monthly samples of aquatic insects at five sites in streams from July 2011 to June 2012 in Central China. The five sample sites were located in river sections with perennially flowing water, which were subject to little human disturbance. We examined taxonomic‐ and trait‐based temporal beta diversity patterns of riverine insects across seasons in sites.
Taxonomic‐ and trait‐based temporal beta diversity demonstrated a decline with species richness but an increase with the time between sampling dates. Taxonomic‐based temporal beta diversity was significantly higher than trait‐based temporal beta diversity. Turnover (i.e. species replacement) was the main driver of taxonomic‐based temporal beta diversity whereas nestedness (i.e. species gain or loss) contributed more to trait‐based temporal beta‐diversity values. In addition, the correlation between taxonomic‐ and trait‐based temporal beta diversity was weak.
Deterministic processes (i.e. operating through physico‐chemical factors and climate) and stochastic processes (i.e. operating through temporal variables) are distinct, but they can act together in influencing the temporal beta diversity of riverine insects. Taxonomic‐based temporal beta diversity was more sensitive to environmental changes than trait‐based temporal beta diversity, and taxonomic shift do not necessarily result in trait changes. The main driver of taxonomic‐based temporal beta diversity changed with the location and components analysed. In contrast, stochastic processes were the most dominant influence on trait‐based temporal beta diversity.
Results suggest that taxonomic‐ and trait‐based conservation measures should consider both turnover and nestedness patterns in the protection of riverine insects in China and elsewhere. Additionally, the development of integrated monitoring and management protocols that apply across seasons and life stages should be considered.
Evidence‐Based Leadership in Nursing: An Evolutionary Concept Analysis
Authors: Hu Shuang , Liu Siying , Li Xianfeng , Chen Wenjun , Li Jialin , Jiale Hu , Välimäki Maritta Anneli , Li Xianhong 
Published: December 2024

ABSTRACTAimTo conduct a concept analysis of evidence‐based leadership in a nursing context.MethodsRodgers' evolutionary method was employed to identify attributes, antecedents, consequences, definitions and surrogate and related terms.Data SourceWe systematically searched three databases (PubMed, Cumulative Index to Nursing and Allied Health Literature and Scopus) for relevant publications. The databases were searched from their inception to 4 February 2024.ResultsWe included 12 papers published between 2005 and 2022. The attributes include leadership attributes (personality, developing common goals and visions and influencing others) and evidence‐based attributes (valuing evidence‐based practice, integrating evidence and adapting evidence). The antecedents include individual internal factors (commitment to growth and proficiency in implementation science) and individual external factors (growing need for evidence‐based practice, training support and available resources), while the consequences are personal growth, organisational benefit and disciplinary development. Based on the concept analysis, evidence‐based leadership can be defined as a process whereby individuals, based on their personality and values towards evidence‐based practices, integrate the best evidence into practice, adapt the evidence integration process based on evaluations and influence others towards achieving a common goal and vision.ConclusionsThis concept analysis enhances our understanding of evidence‐based leadership, guiding nurses to integrate evidence into their leadership practices to achieve specific goals and visions within the healthcare context. Future studies could consider developing instruments to evaluate evidence‐based leadership based on this refined concept, ultimately promoting nurses' leadership competencies in real‐world settings.Implication for Nursing PracticeThis concept analysis not only raises awareness of the responsibilities of nurses as healthcare professionals, including the provision of evidence‐based practice, but also facilitates their effective execution of these responsibilities. Empowering nurses to actively incorporate evidence into their leadership practices can further enhance the quality of healthcare delivery.Reporting MethodNot applicable.Patient or Public ContributionNot applicable.
Exploring the Prognostic Value of Tumour‐Associated Genes in Clear Cell Renal Cell Carcinoma Through Single‐Cell RNA Sequencing Insights
Authors: Fu Tongfei , Zhang Xinyi , Liu Yuedong , Wu Junsong , Liu Xuefeng , Lu Bichao , Huang Yi , Yang Liping , Zhan Yongli 
Published: December 2024

ABSTRACTClear cell renal cell carcinoma (ccRCC) characterised by its diversity and a tendency to defy standard therapeutic approaches. Amidst the advent of immunotherapy, it has become imperative to pinpoint prognostic indicators of the tumour microenvironment (TME) influence the efficacy of treatments. Employing single‐cell RNA sequencing (scRNA‐seq), this research delved into the diverse landscape of ccRCC, uncovering its complex underpinnings and pinpointing molecular avenues for therapeutic intervention. We constructed a prognostic model using 101 machine learning algorithms and integrated data from multiple cohorts, including TCGA, ICGC, and microarray datasets. The model's efficacy was assessed using the Concordance Index (C‐index), and further analyses included pseudotime analysis of tumour cells, mutation analysis and correlation analysis between the prognostic model and tumour immunity. The prognostic model, combining Lasso regression and survival Support Vector Machine (SVM), demonstrated robust discrimination with a C‐index of 0.650. Investigation into the TME uncovered pronounced associations between the presence of immune cell infiltrates and patient outcomes, with a notable emphasis on the impact of CCL2‐expressing neoplastic cells. The GO Biological Processes (GOBP) encompass the regulation of endothelial cell maturation, the formation of endothelial layers, the enhancement of gene expression controlled by Notch receptors, and the development of endothelial barriers. The research effectively pinpointed critical prognostic markers and crafted a forecasting model that achieved a C‐index of 0.650, highlighting the significant impact of immune cell infiltration, especially CCL2+ neoplastic cells, on ccRCC patient prognosis.
MSA‐MaxNet: Multi‐Scale Attention Enhanced Multi‐Axis Vision Transformer Network for Medical Image Segmentation
Authors: Wu Wei , Huang Junfeng , Zhang Mingxuan , Li Yichen , Yu Qijia , Zhao Qi 
Published: December 2024

ABSTRACTConvolutional neural networks (CNNs) are well established in handling local features in visual tasks; yet, they falter in managing complex spatial relationships and long‐range dependencies that are crucial for medical image segmentation, particularly in identifying pathological changes. While vision transformer (ViT) excels in addressing long‐range dependencies, their ability to leverage local features remains inadequate. Recent ViT variants have merged CNNs to improve feature representation and segmentation outcomes, yet challenges with limited receptive fields and precise feature representation persist. In this work, we propose MSA‐MaxNet. Specifically, our model utilises an encoder–decoder structure, using MaxViT blocks that apply multi‐axis self‐attention (Max‐SA) as the encoder for local and global feature extraction. To restore the feature map's spatial resolution during upsampling operations, a symmetric MaxViT block–based decoder and upsampling layers are employed. To address the feature mismatches in the skip connections of UNet architecture, we introduce convolutional block attention module (CBAM). Furthermore, we design a multi‐scale convolutional block attention module (MCBAM) based on CBAM, which utilises multi‐scale features to enhance feature representation and refine the skip connection. We evaluate the segmentation performance of MSA‐MaxNet on three publicly available medical imaging datasets, including Synapse for multi‐organ segmentation, ACDC for cardiac analysis and Kvasir‐SEG for gastrointestinal polyp detection. Notably, MSA‐MaxNet achieves state‐of‐the‐art (SOTA) Dice scores of 85.59% and 95.26% on Synapse and Kvasir‐SEG datasets, respectively, with 40.28 M parameters. Additionally, we introduce two smaller versions of MSA‐MaxNet to meet the demands of various scenarios. In summary, our work provides a robust framework for diverse medical imaging tasks, offering potential applications in early cancer detection, cardiovascular disease diagnosis and comprehensive organ‐level assessments.
Association between infant feeding and ADHD development in childhood: a birth cohort study in Taiwan
Authors: Chen Chiu‐Ying , Shih Pin‐Yang , Su Chih‐Ting , Cheng Chi‐Fung , Lee Meng‐Chih , Lane Hsien‐Yuan 
Published: December 2024

BackgroundInfant feeding plays a vital role in neurodevelopment, and a lack of breastfeeding and complementary feeding may increase the risk of developing attention‐deficit/hyperactivity disorder (ADHD). However, empirical evidence on this relationship remains uncertain, as most studies are based on cross‐sectional designs. Therefore, this study aimed to examine this temporal relationship using longitudinal data from a birth cohort.MethodsA retrospective cohort study was conducted using data from Wave I (starting at 6 months old, 2005–2006) to Wave IV (up to 5 years old, 2010–2011) of the Taiwan Birth Cohort Study. A total of 19,721 pairs completed the four‐wave interviews and provided information on infant feeding, medical history, ADHD occurrence, and sociodemographic characteristics. An extended Cox model with time‐dependent covariates was used to examine this association.ResultsIn total, 207 infants developed ADHD during the 54‐month observational period, with an estimated cumulative incidence of 5.56 per 1,000 person‐years. The average breastfeeding duration was approximately 2 months. With complementary feeding, rice solid food (HR = 0.73) was found to be a protective factor against developing ADHD. Significantly associated factors for increasing ADHD risk included males, lower family income, low birth weight, maternal weight, advanced maternal age, child gastrointestinal disease, child seizures, maternal heart disease, and paternal diabetes mellitus.ConclusionsComplementary feeding within 6 months is important to protect infants from developing ADHD. The beneficial effect of breastfeeding within 6 months was not observed while controlling for other risk factors. However, owing to the limitation of a smaller number of ADHD cases, further studies should rely on larger observational periods.
Rapid Visual Detection of Red Sea Bream Iridovirus Using a Novel Cross‐Priming Amplification‐Based Lateral Flow Assay
Authors: Kim Guk Hyun , Shin Dong Jun , Choi Ji Yeong , Choi Hyun Deok , Min Joon Gyu , Kim Kwang Il 
Published: December 2024

ABSTRACTRed sea bream iridovirus (RSIV) occurs mainly at high water temperatures and infects more than 30 different species of fish. In Asia, infected fish cause mass mortality every year. Molecular diagnostics is a technology that efficiently detects and identifies a wide range of fish pathogens through rapid and sensitive analysis of their genetic material. Rapid viral detection is essential for effective disease control. In this study, we developed and validated a cross‐priming amplification‐based lateral flow assay (CPA‐LFA) suitable for field diagnosis owing to its short diagnostic time and simple diagnostic process. The CPA‐LFA achieved optimal performance with concentrations of 4 mM MgSO4, 1.2 mM dNTPs and 0.7 M betaine, with the reaction conducted at 60°C for 60 min. The developed CPA‐LFA could specifically identify RSIV without cross‐reactivity with several pathogens commonly reported in various fish cell lines and fish. The 95% limit of detection (LOD95%) of CPA‐LFA was 385.76 copies/μL, which was comparable to that of conventional polymerase chain reaction (PCR). Quantitative PCR (qPCR) was used to identify true‐positive and true‐negative samples from 210 fish samples (160 from cultured fish and 50 from artificially infected fish). Compared with qPCR, CPA‐LFA classified six positive samples as false positives. The viral load of these samples was determined to be less than 195.1 copies/μL. The diagnostic sensitivity and specificity of CPA‐LFA were 94.34% and 100%, respectively. Furthermore, inter‐operator reproducibility testing yielded a kappa value of 1.0, indicating perfect agreement. Therefore, the novel CPA‐LFA is especially well‐suited for field diagnostics owing to its straightforward diagnostic procedure and capability to quickly and accurately detect RSIV.
Transauricular vagal nerve stimulation suppresses inflammatory responses in the gut and brain in an inflammatory bowel disease model
Authors: Atalar Kerem , Alim Ece , Yigman Zeynep , Belen Hayrunnisa Bolay , Erten Fusun , Sahin Kazım , Soylu Ayse , Dizakar Saadet Ozen Akarca , Bahcelioglu Meltem 
Published: December 2024

AbstractInflammatory bowel disease (IBD) encompasses Crohn's disease (CD) and ulcerative colitis (UC), is a major health problem on a global scale and its treatment is unsatisfactory. We aimed to investigate the effects of transauricular vagal nerve stimulation (tVNS) on inflammation in rats with IBD induced by trinitrobenzene sulfonic acid (TNBS). A total of 36 adult female Sprague–Dawley rats were given TNBS, or vehicle, and tVNS, or sham, every other day for 30 min for 10 days. Postmortem macroscopic and microscopic colon morphology were evaluated by histological staining. Additionally, IL‐1β, IL‐6, IL‐10, and TNF‐α cytokine levels in the colon and the brain were evaluated by immunohistochemistry and western blotting analysis. TNBS induced epithelial damage, inflammation, ulceration, and thickened mucosal layer in the colonic tissues. Administration of tVNS significantly ameliorated the severity of TNBS‐induced tissue damage and inflammatory response. TNBS also alters pro‐inflammatory and anti‐inflammatory balance in the brain tissue. TVNS application significantly suppressed the protein levels of pro‐inflammatory cytokines, namely IL‐1β, IL‐6, and TNF‐ α while augmenting the level of anti‐inflammatory cytokine IL‐10 in the colonic and the brain tissue. We have shown that TNBS‐mediated colonic inflammation and tissue damage are associated with neuroinflammatory responses in the brain tissue. Also demonstrated for the first time that neuroinflammatory response in the gut‐brain axis is suppressed by tVNS in the IBD model. Non‐invasive tVNS stands out as a new potential treatment option for types of IBD.
Cap‐to‐bell stage molar tooth morphogenesis occurs through proliferation‐independent sulcus sharpening and condensation‐associated tension in the dental papilla
Authors: Piper Claire , Green Jeremy B. A. 
Published: December 2024

AbstractThe anatomy of molar teeth is important both functionally for chewing food and in evolutionary studies as a well‐preserved species marker in the fossil record. Molar teeth begin to develop their characteristic biting‐surface shape of cusps (peaks) and sulci (valleys) at the bell stage, when corresponding folds in the dental epithelium become apparent. Theories about the developmental mechanisms of cusp and sulcus morphogenesis have hitherto largely focused on the non‐proliferating nature of the secondary enamel knots (EKs) at the cusp tips. EKs have been thought to direct cusp/sulcus formation by stimulating proliferative growth of the surrounding epithelium which, being confined within a capsule of condensed mesenchyme, bends by mechanical buckling. Here we show, using explant inhibition and cut‐and‐recoil experiments, that cap‐to‐bell morphogenesis is largely proliferation‐independent (sulcus sharpening entirely so) and that tension in the mesenchyme of the dental papilla, immediately sub‐adjacent to the cusps, rather than compression by the mesenchyme surrounding the whole structure, is what holds the structure in shape. Fine mapping of the degree of condensation shows that it is highest in the mesenchyme of the dental papilla and becomes progressively more focused to the cusp regions, consistent with a key role in cusp shaping. Together these findings overturn the prevailing models of molar morphogenesis, including both cusp and sulcus formation.