bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal Initial PEEP in Management of Preterm Infant with Respiratory Distress Syndrome: A Prospective Study at Newborn Unit of Moi Teaching and Referral Hospital
Authors: Vulalo Deborah Makasi , Mwangi Ann , Chepkemoi Audrey K. , A. Philippe Poli , Ayaya Samuel O. 
Published: December 2024

Abstract

Background:Respiratory distress syndrome remains an important cause of neonatal mortality and morbidity worldwide. Early initiation of continuous positive airway pressure is a standard of care for preterm infants with respiratory distress syndrome. Positive end-expiratory pressure reduces the need for invasive ventilation and prevents chronic lung disease. However, the optimum positive end expiratory pressure level to effectively treat respiratory distress syndrome in preterm infants remains unknown.
Objective: To determine the optimal initial positive end expiratory pressure level in management of preterm infants with respiratory distress syndrome.
Methods:This prospective descriptive study was conducted from July 2023 to January 2024 in the newborn unit of Moi Teaching and Referral Hospital. A total of 204 preterm infants (28-34 weeks gestational age) with respiratory distress syndrome who required Continuous Positive Airway Pressure treatment were recruited. Data on the maternal and neonatal characteristics, low and high positive end expiratory pressure levels, and outcomes at 72 hours were collected and analysed. Descriptive statistics were used for continuous variables, and frequencies were used for categorical data. A p value less than 0.05 was considered statistically significant at the 95% confidence interval. Receiver operating characteristic curves were used to determine the optimal positive end expiratory pressure level.
Results:A total of 45 and 159 preterm infants were started on low and high positive end expiratory pressure levels, respectively. Among 159 (77.9%) of the preterm infants started on high positive end expiratory pressure levels, majority (135, 66.2%) were initiated at a positive end expiratory pressure level of 6 cmH2O. The Area under the curve for low positive end expiratory pressure levels was 0.5757 and the one for high positive end expiratory pressure levels was 0.5405. DeLong's test for two ROC curves D = 0.82979, df = 120.8, p value = 0.4083. The area under the curve of both low and high positive end expiratory pressure levels were close and not significantly different (p=0.4083).
Conclusion: In this study, low positive end expiratory pressure was associated with low failure rate and complications. However low and high positive end expiratory pressure levels were not significantly different to determine the optimal initial PEEP.
The optimal positive end expiratory pressure level for continuous positive airway pressure initiation in preterm infants with respiratory distress syndrome could not be determined because of the small sample size
Spatial variation of soil characteristics within an urban arboretum. A case study of the Salisbury University Arboretum, Maryland, U.S.A.
Authors: Harris Daniel W. , Folkoff Michael E. , Gelata Samuel B. , Briand Christopher H. 
Published: December 2024

Abstract

The impact of long-term institutional management on soil chemistry within urban greenspaces is important to recognize given the proliferation of these urban planning methods in our ever-increasing urban environments. Most research on urban soils primarily focuses upon heavy metal pollutant accumulation and its relationship to industrial history and current environmental quality. Far less research, especially in the United States, examines the impact of soil and landscape management practices aimed at providing greenspaces for the residents of the ever-expanding urban environments. Moreover, systematic studies detailing resultant soil chemistry changes in managed greenspaces rarely exist given the lack of a non-urban analogs by which to compare. Also, land use histories of urban sites are often ambiguous and through time soil management practices vary as managers seek to create varied “aesthetically pleasing” landscapes in these institutional environments. This study details soil chemistry differences within the varied landscapes of an urban greenspace, a University arboretum, following almost 100 years of institutional soil management as the University expanded into former agriculture soils. Soil series mapped on the University campus prior to arboretum establishment remain agriculturally active in the surrounding community enabling our analysis. Results indicate the widespread addition of lime throughout arboretum environments has elevated soil pH thereby increasing the availability of macro- and micronutrients in vegetative communities including lawns, gardens and woodlands. Of concern, organic matter amounts are also elevated in the arboretum, fundamentally changing its natural inverse relationship with pH. The over enrichment of nutrients in this greenspace likely represents the outcome of anthropogenic management practices across many types of urban greenspaces. These soil chemistry modifications likely result in significant changes in runoff water chemistry thereby impacting local surface and groundwater resources. “Urban soils often become defined by human activities and land use histories at a particular location rather than by the continuum of geologic processes.” – Solano 2013 “Urban plant communities are as much a product of the cultural environment as they are a part of the physical landscape.” – Whitney and Adams 1980
Generative Artificial Intelligence in Medicine: A Mixed Methods Survey of UK General Practitioners
Authors: Blease Charlotte , Kharko Anna , Locher Cosima , Torous John , Roche Anna Sophie , Hägglund Maria , Gaab Jens , McMillan Brian , Sundemo David , Mandl Kenneth D. 
Published: December 2024

Abstract

Background: With the debut of OpenAI’s ChatGPT, there has been growing interest in the use of generative artificial intelligence (AI), including in healthcare. However, there is only limited research into doctors’ adoption of these tools and their opinions about their application in clinical practice.
Objective: This study aimed to explore the opinions of general practitioners (GPs) in the United Kingdom (UK) about the use of generative AI tools (ChatGPT/Bard/Bing AI) in primary care.
Methods: Between February 2nd-24th 2024, using a convenience sample, we administered a web-based mixed methods survey of 1000 GPs in the UK. Participants were recruited from registered GPs currently working in the UK through Doctors.net.uk. Quantitative data were analyzed using descriptive statistics and nonparametric tests. We used thematic content analysis to investigate free-text responses to 2 open-ended questions embedded in the questionnaire.
Results: A total of 1006 GPs responded, with 53% being male and 54% aged 46 years and older. Most GPs (80%) expressed a need for more support and training in understanding these tools. GPs at least somewhat agreed AI would improve documentation (59%), patient information gathering (56%), treatment plans (41%), diagnostic accuracy (40%), and prognostic accuracy (38%). Additionally, 62% believed patients might rely more on AI, 55% felt it could increase inequities, and 54% saw potential for patient harm, but 47% believed it would enhance healthcare efficiency. GPs who used these tools were significantly more optimistic about the scope for generative AI in improving clinical tasks compared with those who did not. 31% of the GPs (307/1006) left comments that were classified into 4 major themes: (1) lack of familiarity and understanding, (2) a role in clinical practice, (3) concerns, and (4) thoughts on future of healthcare.
Conclusions: This study highlights UK GPs' perspectives on generative AI in clinical practice, emphasizing the need for more training. Many GPs reported a lack of knowledge and experience with this technology and a significant proportion used non-medical grade technology for clinical tasks, with the risks that this entails. Medical organizations must urgently invest in educating and guiding physicians on AI use and limitations.
Alzheimer's Disease and Related Dementia among Black Adults Stratified by Nativity
Authors: Sorkpor Setor K , Yang Yijiong , Lane Brittany , Amu Hubert , Tefera Gashaye Melaku , Miao Hongyu , Wang Jing 
Published: December 2024

Abstract

Purpose: To explore ADRD prevalence by nativity, comparing US-born and non-US-born Black individuals to uncover risk factor differences and inform targeted interventions.
Methods: We conducted a retrospective cohort study with 77,069 Black individuals from the All of Us Research Program. We analyzed two cohorts, US-born and non-US-born individuals with ADRD, using 1:1 propensity score matching to balance key factors. Analyses were performed in R and Python with significance set at α = 0. 05.
Results: Of 72,311 US-born and 4,758 non-US-born Black individuals, 1:1 propensity score matching resulted in 4,758 matched participants per group. ADRD prevalence was 3.76% in US-born and 4.12% in non-US-born Blacks, with rates increasing with age and being higher among retirees and the unemployed.
Conclusion: Non-US-born Black individuals have a higher ADRD risk than US-born Blacks due to socioeconomic and demographic factors, supporting the need for targeted interventions and further research to address health inequities.
The Power to Resolve Cultural Transmission and Sibling Interaction Using Polygenic Scores
Authors: Bernardo Josefina Benita , Pahnke Charlotte Katharina Louise , Bergen Elsje van , Dolan Conor Vivian 
Published: December 2024

Abstract

In the classical twin design, the assumption that the additive genetic (A) and shared environment (C) variance components are uncorrelated may not hold. If there is positive AC covariance, the C component is overestimated. Two processes have been studied that lead to AC covariance: Cultural transmission (e.g., genetic nurture), when the parents’ genotype contributes to the effective environment of the child, and sibling interaction, when the genotype of one sibling contributes to the effective environment of another. Several designs use polygenic scores of parents or siblings to detect AC covariance, but these models cannot unambiguously identify the source. A combined model has been proposed, but its power to identify both processes has not been well-studied yet. This study uses simulated data from genotyped twins and their parents to investigate the power to disentangle these processes. Results demonstrated that we can detect AC covariance using either genotyped-sibling or genotyped-parent data, but we cannot resolve its source and risk making wrong inferences. However, these sources of AC covariance can be resolved using genotyped data of both siblings and parents. This emphasizes the need for whole-family genotyping and modeling.
Mechanics of plant epidermal cell wall: Effect of anisotropic alignment of cellulose microfibrils in the junction region
Authors: Lee Jongcheol , Kim Jessica Sohyun , Yu Jingyi , Ryu Jihyeong , Choi Juseok , Cosgrove Daniel J. , Yi Hojae , Kim Seong H. 
Published: December 2024

Abstract

In plants, cellulose microfibrils (CMFs) play a major role in cell wall mechanics. Plant epidermal peels have been widely used as a model system to study the relationship between the CMF arrangement and the mechanical properties of the cell wall. Recently, vibrational sum frequency generation (SFG) spectroscopy imaging has discovered that CMFs in the cell-cell junction regions (i.e., edges of each cell) in the periclinal wall are preferentially aligned (anisotropic) perpendicular to the anticlinal plane, while those in the face regions have the crossed-polylamellate (isotropic) structure possessing all possible orientations. Here, we studied the effect of these regiospecific CMF orientations on the tensile properties of peeled plant epidermal cell walls using finite element analysis (FEA). The FEA simulation showed that the anisotropic fibers in the junction region of the elongated hexagonal cells amplified the anisotropy in the mechanical behavior of the wall under tensile stretching and exhibited a strain-dependent Poisson’s ratio with nonlinear mechanical behavior. The SFG analysis suggested that, in the junction region, there are alterations in cellulose chain conformation within CMFs and/or in CMF-CMF bundling upon tensile stretch.
How can we optimize the surgical management of the axilla in breast cancer since the MonarchE trial ?
Authors: Jankowski Clémentine , Houvenaeghel Gilles , Renaudeau Celine , Leveque Jean , Marchal Frederic , Benbara Amélie , Barranger Emmanuel , Rouzier Roman , Cohen Monique , Classe Jean-Marc , Ladoire Sylvain , Coutant Charles 
Published: December 2024

Abstract

Purpose
Results of MonarchE trial have changed adjuvant therapy for estrogen-receptor-positive(ER+), HER-2-negative breast cancer. Given the importance of the extent of nodal disease in this study, surgical management of the axilla has resurfaced as a question asked at multidisciplinary boards.
Methods
Using data from a cohort of Werkoff (JCO, 2009) in which patients underwent both sentinel lymph nodebiopsy(SLNB) and axillary node dissection(ALND), we assessed the proportion of patients in whom the absence of ALND would have led to a lack of awareness of "high-risk" status. We evaluated the contribution of the Katz nomogram (that predict pN2/N3 stage) to guide possible indications for complementary ALND.
Results
Among the 536 patients, 88 were excluded (ER- and/or isolated cells in SLN). Of patients with 1 or 2 SLN+(n = 352), only 7.9% were pN2/N3. When the ratio (number of SLN+/total number of SLN sampled) was less than 1, only 3.9% were pN2/N3. Patients with 1 or 2 SLN + met the ACOSOG Z0011 criteria so none would benefit from an ALND, but 7.9% of patients at high risk will not receive Abemaciclib. If we use the Katz nomogram (threshold ≤ 5%), this rate decrease at 3.3% but 116 patients will have an ALND with no benefit. With a threshold ≤ 20%, 5% patients at high risk will not receive Abemaciclib but 21 patients will have an ALND with no benefit.
Conclusion
The indications for adjuvant Abemaciclib should not lead to surgical escalation in the management of the axilla.
Using a syringe as tubular retractor and working channel in minimally invasive cranial and spinal neurosurgery
Authors: Feigl Guenther C , Staribacher Daniel , Ruggieri Iván N Camal , Britz Gavin , Kuzmin Dzmitry 
Published: December 2024

Abstract

Background:
Minimally invasive spinal and cranial neurosurgery often requires tissue retraction. However, excessive tissue retraction is contrary to the principles of minimally invasive neurosurgery. Therefore, any retractor used should be small and atraumatic. Circular plastic retractors made from syringes of various sizes meet these requirements.
Observation(s):
We report a case series of patients with various cranial and spinal pathologies who underwent surgeries using “self-made” retractors made from plastic syringes of various sizes (2 mL, 5 mL, and 10 mL). All surgeries were performed via minimally invasive approaches. In all cases, the goals of surgical treatment were achieved with no neurological deficits.
Lessons:
The use of “self-made” plastic retractors can be helpful in spinal and cranial minimally invasive neurosurgery. Making retractors from plastic syringes and using them is not labor-intensive. This method can extend the possibilities of the neurosurgeon, especially in the field of minimally invasive neurosurgery.
Time-restricted eating to address persistent cancer-related fatigue among cancer survivors: A randomized controlled trial
Authors: Kleckner Amber S. , Clingan Carin L. , Youngblood Shari M. , Kleckner Ian R. , Quick Lauren , Elrod Rebecca D. , Zhu Shijun , Manoogian Emily N. C. , Panda Satchidananda , Badros Ashraf Z. , Emadi Ashkan 
Published: December 2024

Abstract

Purpose: Time-restricted eating (TRE) helps regulate rest-activity rhythms, blood glucose, and other diurnally regulated energetics processes, which may have implications for persistent fatigue. In a randomized controlled trial, we tested the effects of TRE vs. control on fatigue in cancer survivorship.
Methods: Adult cancer survivors were recruited who were 2 months to 2 years post-treatment and reported moderate to severe fatigue. Participants were randomized 1:1, TRE:control and all received individualized nutrition counseling. The TRE group self-selected a 10-hour eating window for 12 weeks. At baseline, week 6, and week 12, participants were asked to log eating instances, complete the Functional Assessment of Chronic Illness Therapy-Fatigue questionnaire (FACIT-F, higher score=less fatigue), and wear an actigraph and continuous glucose monitor.
Results: Thirty participants completed baseline assessments and were randomized (77% female, 53% Black/African American, 43% White, 7% Hispanic; 54.1±14.7 years old; 87% with blood cancer); 25 completed 12-week assessments. TRE led to a meaningful reduction in fatigue at week 12 controlling for baseline levels (change in FACIT-F fatigue subscale=0.0±5.4 for control, 4.1±5.7 for TRE, p=0.11, effect size [ES]=0.70; clinically meaningful threshold=3.0 points). Glucose parameters (e.g., average interstitial glucose, average fasting glucose) tended to be lower and rest-activity rhythms tended to indicate more regularity for those in the TRE vs. control group at weeks 6 and 12, though differences were not statistically significant (p>0.19).
Conclusions: A 12-week, nutritionist-led TRE program led to less fatigue than control. Continued study of TRE patterns are warranted to optimize this eating pattern and address persistent cancer-related fatigue.
Clinicaltrials.gov identifier: NCT05256888, registered 02/2022
Metabolic State Determines Central and Peripheral Mechanisms of Liraglutide-Enhanced Insulin Secretion
Authors: Bonner Caroline , Saponaro Chiara , Imbernon Monica , Louvet Isaline , Deligia Eleonora , Chen Shiqian , Davies Iona , Acosta-Montalvo Ana , Moreno-Lopez Maria , Wemelle Eve , Kothagali Laskshmi , Porteiro Begoña , Auger Florent , Zubiaga Lorea , Delalleau Nathalie , Thevenet Julien , Mühlemann Markus , Pasquetti Gianni , Gmyr Valery , Pfrieger Frank W. , Nogueiras Ruben , Schwaninger Markus , Rorsman Patrik , Staels Bart , Kerr-Conte Julie , Knauf Claude , Jones Ben , Pattou François , Prevot Vincent 
Published: December 2024

Abstract

While liraglutide effectively treats type 2 diabetes (T2D) and obesity, its mechanism of action across disease progression remains poorly understood. Liraglutide selectively enhances GSIS in islets from glucose-intolerant donors and in islets exposed to prediabetic conditions, but not in normoglycemic or T2D islets. In healthy mice, liraglutide's insulinotropic effect requires tanycyte-mediated central transport, whereas in glucose intolerance it acts directly on islets. Additionally, liraglutide reduces blood glucose in normoglycemic mice through insulin-independent mechanisms involving decreased gluconeogenesis and enhanced peripheral glucose uptake. These findings demonstrate that the therapeutic window for liraglutide's pancreatic effects may be optimal during prediabetes, while its central and insulin-independent actions predominate in other metabolic states.
Nuclear spin hyperpolarization of pyruvate enables longitudinal monitoring of treatment response in intestinal tumor organoids
Authors: Peters Josh , Xiang Hang , Assaf Charbel , Mohamad Farhad Haj , Rosenstiel Philip , Schreiber Stefan , Hövener Jan-Bernd , Aden Konrad , Pravdivtsev Andrey 
Published: December 2024

Abstract

Colorectal cancer, a leading cause of death in the Western world, is increasingly affecting younger populations. The Warburg effect, characterized by enhanced lactate production, is a hallmark of this cancer type. While 18F-FDG PET-CT is commonly used for diagnosis, magnetic resonance imaging (MRI) offers higher spatial and chemical resolution without the drawbacks of radiation. However, MRI's low sensitivity has been a barrier to real-time metabolic imaging, hence implementation into clinical practice. Hyperpolarization has significantly boosted NMR sensitivity, enabling detailed metabolic studies in vivo. This study utilizes hyperpolarized [1-13C]pyruvate with dissolution dynamic nuclear polarization (dDNP) to non-invasively monitor metabolic changes in intestinal organoids from a genetically defined mouse model of spontaneous carcinogenesis (Rnaseh2b/Xbp1ΔIEC) with a previously established targeted therapeutic intervention (mTOR inhibition by rapamycin). Hyperpolarized NMR revealed a significant reduction in lactate production in rapamycin-treated organoids, indicating suppressed metabolic activity. This method also detected alanine and bicarbonate metabolism, highlighting its sensitivity. Unlike traditional methods that destroy cellular integrity, hyperpolarization enables repetitive, non-invasive metabolic assessments, bridging the gap between preclinical and clinical applications and affirming the method's potential for targeted metabolic imaging as a novel diagnostic and treatment control approach in cancer medicine.
Early Expressed Milk Volume and Coming to Volume for Mother’s Own Milk Feeding in Hospitalized Infants
Authors: Gray Keyaria , Chen Nellie , Tanaka David , Athavale Kamlesh , Li Lusia , Cotten Michael 
Published: December 2024

Abstract

Objective
Assess if cumulative pumping volumes during the first 5 postnatal days (CVx5) influence coming to volume (CTV: producing > 500 milliliters breast milk per day by postnatal day 14) for mothers of hospitalized infants, with a secondary aim to develop and compare a new predictive model using CVx5 with our previous model.
Study Design:
A retrospective cohort analysis was conducted at Duke University Hospital for singleton mother-baby dyads of neonatal intensive care infants between January 2020 and December 2023.
Results
Of 887 mother-baby dyads, 325 (37%) achieved CTV and were more likely to have higher CVx5 (1 058 ± 25 ml vs. 231 ± 19 ml; p < 0.0001). In generalized regression models for CTV that included birth weight, 5x5, AMx5, and CVx5, only CVx5 and 5x5 remained significant (p < 0.0001).
Conclusion
CTV is significantly associated with CVx5, and with 5x5, creates a stronger model than that of 5x5 and birth weight.