bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dynamic contrast-enhanced magnetic resonance imaging of the lung reveals important pathobiology in idiopathic pulmonary fibrosis
Authors: Montesi Sydney B. , Zhou Iris Y. , Liang Lloyd L. , Digumarthy Subba R. , Mercaldo Sarah , Mercaldo Nathaniel , Seethamraju Ravi T. , Rosen Bruce R. , Caravan Peter 
Published: September 2021

IntroductionEvidence suggests that abnormalities occur in the lung microvasculature in idiopathic pulmonary fibrosis (IPF). We hypothesised that dynamic contrast-enhanced (DCE)-magnetic resonance imaging (MRI) could detect alterations in permeability, perfusion and extracellular extravascular volume in IPF, thus providingin vivoregional functional information not otherwise available.MethodsHealthy controls and IPF subjects underwent DCE-MRI of the thorax using a dynamic volumetric radial sampling sequence and administration of gadoterate meglumine at a dose of 0.1 mmol·kg−1at 2 mL·s−1. Model-free analysis of signal intensityversustime curves in regions of interest from a lower, middle and upper axial plane, a posterior coronal plane and the whole lung yielded parameters reflective of perfusion and permeability (peak enhancement and rate of contrast arrival (kwashin)) and the extracellular extravascular space (rate of contrast clearance (kwashout)). These imaging parameters were compared between IPF and healthy control subjects, and between fast/slow IPF progressors.ResultsIPF subjects (n=16, 56% male, age (range) 67.5 (60–79) years) had significantly reduced peak enhancement and slower kwashinin all measured lung regions compared to the healthy volunteers (n=17, 65% male, age (range) 58 (51–63) years) on unadjusted analyses consistent with microvascular alterations. kwashout, as a measure of the extravascular extracellular space, was significantly slower in the lower lung and posterior coronal regions in the IPF subjects consistent with an increased extravascular extracellular space. All estimates were attenuated after adjusting for age. Similar trends were observed, but only the associations with kwashinin certain lung regions remained statistically significant. Among IPF subjects, kwashoutrates nearly perfectly discriminated between those with rapidly progressive diseaseversusthose with stable/slowly progressive disease.ConclusionsDCE-MRI detects changes in the microvasculature and extravascular extracellular space in IPF, thus providingin vivoregional functional information.
Magnitude and associated factors of caesarean section deliveries among women who gave birth in Southwest Ethiopia: institutional-based cross-sectional study
Authors: Mose Ayenew , Abebe Haimanot 
Published: September 2021

Abstract
Background
Caesarean section is a life-saving comprehensive obstetric procedure of women and newborn performed during childbirth-related complications and should be universally accessible for all pregnant mothers globally. Appropriate use of caesarean section can reduce maternal and perinatal mortality. However, inappropriate use of caesarean section can negatively affect infant health, women health, and future pregnancies. The magnitude and factors associated with caesarean section delivery were not consistent and will vary between different hospitals of Ethiopia. Hence, this study aimed at assessing the magnitude and factors associated with caesarean section deliveries in Southwest Ethiopia.

Methods and Materials
An institutional-based cross-sectional study was conducted from January 1 to February 29, 2020. A systematic random sampling technique was used to select 551 study participants. A pretested, structured, and face-to-face interview was used to collect data. Data were entered into Epi-data version 4.2.0 and exported to SPSS version 23 for analysis. Bivariate and multivariate analyses were used to identify factors associated with caesarean section deliveries. P values < 0.05 result were considered as a statistically significant association.

Results
The magnitude of caesarean section deliveries was found to be 32.5 % (95 % CI; 28.6%-36.7 %). Mothers resided in an urban area [AOR = 2.58, (95% CI; 1.66–4.01)], multiple pregnancies [AOR = 3.15, (95% CI; 1.89–5.23), malpresentation [AOR = 3.05, (95% CI; 1.77–5.24)], and previous history of caesarean section [AOR = 3.55, (95% CI; 2.23–5.64) were factors associated with caesarean section deliveries.

Conclusions
Caesarean section deliveries were found high in the study area. Mothers resided in an urban area, multiple pregnancies, malpresentation, and previous history of caesarean section were factors associated with caesarean section deliveries. Therefore, counselling of mothers on the risk of giving birth through elective caesarean section without absolute and relative medical indications and giving enough time for the trial of vaginal birth after caesarean section are recommended.
Development and internal validation of machine learning algorithms to predict patient satisfaction after total hip arthroplasty
Authors: Zhang Siyuan , Chen Jerry Yongqiang , Pang Hee Nee , Lo Ngai Nung , Yeo Seng Jin , Liow Ming Han Lincoln 
Published: September 2021

Abstract
Background
Patient satisfaction is a unique and important measure of success after total hip arthroplasty (THA). Our study aimed to evaluate the use of machine learning (ML) algorithms to predict patient satisfaction after THA.

Methods
Prospectively collected data of 1508 primary THAs performed between 2006 and 2018 were extracted from our joint replacement registry and split into training (80%) and test (20%) sets. Supervised ML algorithms (Random Forest, Extreme Gradient Boosting, Support Vector Machines, Logistic LASSO) were developed with the training set, using patient demographics, comorbidities and preoperative patient reported outcome measures (PROMs) (Short Form-36 [SF-36], physical component summary [PCS] and mental component summary [MCS], Western Ontario and McMaster’s Universities Osteoarthritis Index [WOMAC] and Oxford Hip Score [OHS]) to predict patient satisfaction at 2 years postoperatively. Predictive performance was evaluated using the independent test set.

Results
Preoperative models demonstrated fair discriminative ability in predicting patient satisfaction, with the LASSO model achieving a maximum AUC of 0.76. Permutation importance revealed that the most important predictors of dissatisfaction were (1) patient’s age, (2) preoperative WOMAC, (3) number of comorbidities, (4) preoperative MCS, (5) previous lumbar spine surgery, and (6) low BMI (< 18.5).

Conclusion
Machine learning algorithms demonstrated fair discriminative ability in predicting patient satisfaction after THA. We have identified modifiable and non-modifiable predictors of postoperative satisfaction which could enhance preoperative counselling and improve health optimization prior to THA.
Partial agonists of dopamine receptors: receptor theory and the dopamine hypothesis of psychosis
Authors: Cookson John , Pimm Jonathan 
Published: September 2021

SUMMARYThis article discusses dopamine partial agonism, which is the main mechanism of action of the psychiatric drugs aripiprazole, brexpiprazole and cariprazine. It outlines the principles of receptor theory and the structure of dopamine receptors; characterises agonists, antagonists and partial agonists; and summarises the dopamine hypothesis of psychosis and the role of dopamine and serotonin in depression.
Partial agonists of dopamine receptors: mechanisms and clinical effects of aripiprazole, brexpiprazole and cariprazine
Authors: Cookson John , Pimm Jonathan 
Published: September 2021

SUMMARYAripiprazole, brexpiprazole and cariprazine are partial dopamine (and serotonin) agonists developed as novel antipsychotics. This article discusses their pharmacology, evidence on their licensed and off-licence uses (including psychosis, mania, bipolar depression, Tourette syndrome and autism spectrum disorder) and side-effects. In schizophrenia, they have a low risk of Parkinsonism or hyperprolactinaemia, cause modest increases in body weight and are of moderate efficacy.
Improving Early Identification of Significant Weight Loss Using Clinical Decision Support System in Lung Cancer Radiation Therapy
Authors: Han Peijin , Lee Sang Ho , Noro Kazumasa , Haller John W. , Nakatsugawa Minoru , Sugiyama Shinya , Bowers Michael , Lakshminarayanan Pranav , Hoff Jeffrey , Friedes Cole , Hu Chen , McNutt Todd R. , Voong K. Ranh , Lee Junghoon , Hales Russell K. 
Published: September 2021

PURPOSE Early identification of patients who may be at high risk of significant weight loss (SWL) is important for timely clinical intervention in lung cancer radiotherapy (RT). A clinical decision support system (CDSS) for SWL prediction was implemented within the routine clinical workflow and assessed on a prospective cohort of patients. MATERIALS AND METHODS CDSS incorporated a machine learning prediction model on the basis of radiomics and dosiomics image features and was connected to a web-based dashboard for streamlined patient enrollment, feature extraction, SWL prediction, and physicians' evaluation processes. Patients with lung cancer (N = 37) treated with definitive RT without prior RT were prospectively enrolled in the study. Radiomics and dosiomics features were extracted from CT and 3D dose volume, and SWL probability (≥ 0.5 considered as SWL) was predicted. Two physicians predicted whether the patient would have SWL before and after reviewing the CDSS prediction. The physician's prediction performance without and with CDSS and prediction changes before and after using CDSS were compared. RESULTS CDSS showed significantly better prediction accuracy than physicians (0.73 v 0.54) with higher specificity (0.81 v 0.50) but with lower sensitivity (0.55 v 0.64). Physicians changed their original prediction after reviewing CDSS prediction for four cases (three correctly and one incorrectly), for all of which CDSS prediction was correct. Physicians' prediction was improved with CDSS in accuracy (0.54-0.59), sensitivity (0.64-0.73), specificity (0.50-0.54), positive predictive value (0.35-0.40), and negative predictive value (0.76-0.82). CONCLUSION Machine learning–based CDSS showed the potential to improve SWL prediction in lung cancer RT. More investigation on a larger patient cohort is needed to properly interpret CDSS prediction performance and its benefit in clinical decision making.
Diagnosis of Male Central Hypogonadism During Childhood
Authors: Grinspon Romina P , Castro Sebastián , Brunello Franco G , Sansó Gabriela , Ropelato María Gabriela , Rey Rodolfo A 
Published: September 2021

Abstract
The diagnosis of male central (or hypogonadotropic) hypogonadism, typically based on low luteinizing hormone (LH) and testosterone levels, is challenging during childhood since both hormones are physiologically low from the sixth month until the onset of puberty. Conversely, follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH), which show higher circulating levels during infancy and childhood, are not used as biomarkers for the condition. We report the case of a 7-year-old boy with a history of bilateral cryptorchidism who showed repeatedly low FSH and AMH serum levels during prepuberty. Unfortunately, the diagnosis could not be ascertained until he presented with delayed puberty at the age of 14 years. A gonadotropin-releasing hormone (GnRH) test showed impaired LH and FSH response. By then, his growth and bone mineralization were partially impaired. Gene panel sequencing identified a variant in exon 15 of FGFR1, affecting the tyrosine kinase domain of the receptor, involved in GnRH neuron migration and olfactory bulb morphogenesis. Testosterone replacement was started, which resulted in the development of secondary sexual characteristics and partial improvement of bone mineral density. This case illustrates the difficulty in making the diagnosis of central hypogonadism in boys during childhood based on classical criteria, and how serum FSH and AMH assessment may be helpful if it is suspected before the age of puberty, and confirm it using next-generation sequencing. The possibility of making an early diagnosis of central hypogonadism may be useful for a timely start of hormone replacement therapy, and to avoid delays that could affect growth and bone health as well as psychosocial adjustment.
Kpna6 deficiency causes infertility in male mice by disrupting spermatogenesis
Authors: Liu Na , Qadri Fatimunnisa , Busch Hauke , Huegel Stefanie , Sihn Gabin , Chuykin Ilya , Hartmann Enno , Bader Michael , Rother Franziska 
Published: September 2021

ABSTRACT
Spermatogenesis is driven by an ordered series of events, which rely on trafficking of specific proteins between nucleus and cytoplasm. The karyopherin α family of proteins mediates movement of specific cargo proteins when bound to karyopherin β. Karyopherin α genes have distinct expression patterns in mouse testis, implying they may have unique roles during mammalian spermatogenesis. Here, we use a loss-of-function approach to determine specifically the role of Kpna6 in spermatogenesis and male fertility. We show that ablation of Kpna6 in male mice leads to infertility and has multiple cumulative effects on both germ cells and Sertoli cells. Kpna6-deficient mice exhibit impaired Sertoli cell function, including loss of Sertoli cells and a compromised nuclear localization of the androgen receptor. Furthermore, our data demonstrate devastating defects on spermiogenesis, including incomplete sperm maturation and a massive reduction in sperm number, accompanied by disturbed histone-protamine exchange, differential localization of the transcriptional regulator BRWD1 and altered expression of RFX2 target genes. Our work uncovers an essential role of Kpna6 in spermatogenesis and, hence, in male fertility.
Y705 and S727 are required for the mitochondrial import and transcriptional activities of STAT3, and for regulation of stem cell proliferation
Authors: Peron Margherita , Dinarello Alberto , Meneghetti Giacomo , Martorano Laura , Betto Riccardo M. , Facchinello Nicola , Tesoriere Annachiara , Tiso Natascia , Martello Graziano , Argenton Francesco 
Published: September 2021

ABSTRACT
The STAT3 transcription factor, acting both in the nucleus and mitochondria, maintains embryonic stem cell pluripotency and promotes their proliferation. In this work, using zebrafish, we determined in vivo that mitochondrial STAT3 regulates mtDNA transcription in embryonic and larval stem cell niches and that this activity affects their proliferation rates. As a result, we demonstrated that import of STAT3 inside mitochondria requires Y705 phosphorylation by Jak, whereas its mitochondrial transcriptional activity, as well as its effect on proliferation, depends on the MAPK target S727. These data were confirmed using mouse embryonic stem cells: although the Y705-mutated STAT3 cannot enter mitochondria, the S727 mutation does not affect import into the organelle and is responsible for STAT3-dependent mitochondrial transcription. Surprisingly, STAT3-dependent increase of mitochondrial transcription appears to be independent from STAT3 binding to STAT3-responsive elements. Finally, loss-of-function experiments, with chemical inhibition of the JAK/STAT3 pathway or genetic ablation of stat3 gene, demonstrated that STAT3 is also required for cell proliferation in the intestine of zebrafish.
Case Report: Challenges on diagnosis and therapy of malignant adrenal oncocytic neoplasm
Authors: Hamid Agus Rizal Ardy Harlandy , Matondang Sahat , Harahap Agnes Stephanie , Putrantyo Ivan 
Published: September 2021

Background: Adrenal masses are common incidental findings, most of which are benign and non-functional. Malignant adrenal tumors, however, differ from their benign counterpart and confer poor prognosis. In addition, the oncocytic variants of these tumors present challenges to clinicians owing to their unique biologic behavior and rarity. Case presentation: We present a case report of a 61-year-old male with a T2N0M0 adrenocortical oncocytic neoplasm of the right adrenal gland. The patient complained of worsening right upper quadrant abdominal pain and was diagnosed with a right adrenal mass after an abdominal CT-scan examination two weeks before. Subsequently, the patient underwent open adrenalectomy due to a history of abdominal surgery. Due to unique oncocytic biologic behavior, we used the Lin–Weiss–Bisceglia criteria to predict a malignancy instead of the Weiss system. We only found one malignant criterion, which showed a small tumor invasion on the vascular bed on one histopathological section. Thus, we diagnosed it as malignant adrenocortical oncocytic neoplasm. Furthermore, the PET Scan showed no residual mass or pathological metabolic activity on the tumor bed and metastatic sign. Conclusions: The diagnosis of the malignant oncocytic adrenal case is based on the histopathological criteria. Based on this case, we suggest a thorough histopathological examination to determine malignant criteria in adrenal neoplasm cases.
Overuse and underuse of cardiovascular diagnostic and therapeutic procedures for community-dwelling adults: a protocol for a systematic review
Authors: Quinn Dominic , Byrne David , Fahey Tom , Kenny Rose Anne , McGarrigle Christine , Wallace Emma , Boland Fiona 
Published: September 2021

Background: Potentially inappropriate care can result from overuse or underuse of treatments, tests, or procedures. Overuse is defined as the use of health services with no clear benefit to the recipient or where harms outweigh benefits and/or costs of care. Underuse is defined as failure to deliver an effective and cost-effective healthcare intervention. Cardiovascular procedures such as coronary artery bypass grafting, carotid endarterectomy, coronary angiography, and coronary angioplasty (with/without stenting) are potentially both underused and overused. This systematic review aims to identify rates of potential overuse and underuse of these cardiovascular procedures and explore any associated patient or healthcare system factors. Methods: A systematic review and meta-analysis will be conducted in accordance with the PRISMA guidelines. A systematic search of MEDLINE (via Ovid), Embase, Cumulative Index to Nursing and Allied Health Literature and the Cochrane library will be conducted using a predefined search strategy. Eligible studies for inclusion will examine rates of overuse and underuse of cardiovascular procedures, measured against national/international guidelines, for adults aged ≥18 years. Primary observational studies including cross-sectional and cohort studies will be included. Titles, abstracts, and full texts will be screened for inclusion by two reviewers. Data will be extracted using a standardised form. Risk of bias for all included studies will be assessed using a modified version of the Hoy risk of bias tool. Where adequate data exists, and if statistically appropriate, meta-analyses will be conducted. If statistical pooling of the data is not possible, the findings will be narratively summarised focusing on the review’s objectives. Conclusion: This systematic review will examine overuse and underuse of cardiovascular procedures for adults. The results will help inform policy makers, researchers, patients, and clinicians in the appropriate use of these procedures, in line with international guidelines. Registration: This protocol has been submitted for registration on PROSPERO (CRD42021239041).
Tracking aspects of healthcare activity during the first nine months of COVID-19 in Ireland: a secondary analysis of publicly available data
Authors: McGlacken-Byrne Domhnall , Parker Sarah , Burke Sara 
Published: September 2021

Background: Sláintecare aims to introduce universal healthcare in Ireland. The COVID-19 pandemic poses both challenges and opportunities to this process. This study explored the impact of COVID-19 on aspects of Irish healthcare during the first nine months of the pandemic and considers the implications for Sláintecare implementation. Methods: Secondary analysis was undertaken on publicly available data on three key domains of the Irish healthcare system: primary care, community-based allied healthcare, and hospitals. Descriptive statistics were computed using Microsoft Excel 2016. Results: Up to March 2021, 3.76 million COVID-19 tests were performed by Ireland’s public healthcare system, 2.48 million (66.0%) of which were referred from the community. General practitioners delivered 2.31 million telephone triages of COVID-19 symptoms, peaking in December 2020 when 416,607 consultations occurred. Patient numbers across eight allied healthcare specialties fell by 35.1% versus previous years, with the greatest reductions seen in speech and language therapy (49.0%) and audiology (46.1%). Hospital waiting lists increased from 729,937 to 869,676 (or by 19.1%) from January 2019 to January 2021. In January 2021, 629,919 patients awaited a first outpatient clinic appointment, with 170,983 (27.1%) waiting longer than 18 months. The largest outpatient lists were observed in orthopaedic surgery (n=77,257); ear, nose and throat surgery (n=68,073); and ophthalmology (n=47,075). The proportion of patients waiting more than 12 months for a day-case gastrointestinal endoscopy rose from 6.0% in January 2020 to 19.0% in January 2021. Conclusions: Healthcare activity has been significantly disrupted by COVID-19, leading to increased wait times and greater barriers to healthcare access during the pandemic. Yet, Ireland’s health system responses also revealed strong willingness and ability to adapt and to implement novel solutions for healthcare delivery, rapidly and at scale. This has demonstrated what is achievable under Sláintecare and provides a unique opportunity to ‘build back better’ towards sustainable recovery.
Health literacy education programmes developed for qualified health professionals: a scoping review protocol
Authors: Connell Lauren , Finn Yvonne , Dunne Rosie , Sixsmith Jane 
Published: September 2021

Introduction:Health professional education for health literacy has been identified as having the potential to improve patient outcomes and has been recognized as such in policy developments. Health literacy is an emerging concept encompassing individuals’ skills and how health information is processed in relation to the demands and complexities of the surrounding environment. Focus has been predominantly on the dimension of functional health literacy (reading, writing and numeracy), although increasing emphasis has been placed on interactive and critical domains. Such dimensions can guide the development of health professional education programmes and bridge the gap in the interaction between health professionals and their patients. Currently little is known about qualified health professional’s education for health literacy, its development, implementation or evaluation.Aim:To identify and map current educational interventions to improve health literacy competencies and communication skills of qualified health professionals.Methods:A scoping review will be conducted drawing on methods and guidance from the Joanna Briggs Institute, and will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. This study will retrieve literature on health professional education for health literacy through a comprehensive search strategy in the following databases: CINAHL; Medline (Ovid); the Cochrane Library; EMBASE; ERIC; UpToDate; PsycINFO and Central Register of Controlled Trials (CENTRAL). Grey literature will be searched within the references of identified articles: Lenus; ProQuest E-Thesis Portal; the HSE health research repository and RIAN. A data charting form will be developed with categories agreed by the research team, including: article details, demographics, intervention details, implementation and evaluation methods.Conclusion:Little is known about the extent and nature of the current evidence base therefore in order to identify programmes and consolidate their demographics and characteristics within health literacy competencies and communication skills, a scoping review is warranted.