bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic findings and predictors of outcome among patients with non-variceal upper gastrointestinal bleeding attending Benjamin Mkapa Hospital in Dodoma, Tanzania
Authors: Mziray Samwel , Alphonce Baraka , Sindato Emmanuel 
Published: October 2024

Abstract

Background
Non-variceal upper gastrointestinal bleeding (NVUGIB) is a medical emergency and is associated with poor outcomes. In our setting, there are increased trends of upper gastrointestinal diseases including liver cirrhosis with challenges in management; however, the published data are limited. This study aimed to assess the endoscopic findings and predictors of outcomes of patients with NVUGIB attending Benjamin Mkapa Hospital in Dodoma, Tanzania.
Methods
This prospective longitudinal study was conducted between October 2023 and April 2024. All eligible patients with NVUGIB attending Benjamin Mkapa Hospital were recruited. Consented participants who underwent endoscopic procedures aged 18 years or older were included. Baseline sociodemographic and clinical characteristics and endoscopic procedures were performed during inception. Patients with NVUGIB were followed up for 60 days to assess the outcomes. Data were summarized by descriptive analysis then, presented as a median and interquartile range (IQR) for continuous variables, and categorical variables were analyzed by Fisher exact and Mann-Whitney U tests and reported as numbers and proportions. Binary regression analysis used to assess the predictors of rebleeding within 60 days and reported using odds ratio. A two-tailed p-value of less than 0.05 was considered statistically significant.
Results
Among 124 patients, approximately 57.3% were male with a median age of 44 (IQR 27–61) years. Approximately, 70.2% had H. pylori infections and 42.7% were alcoholic. Median Haemoglobin level was 10.6 (IQR 6.1–15.9); median platelet count accounting for 67 (IQR 43–480) while median SBP was 94 (IQR 79–141 mmHg and median DBP of 64 (48–82) mmHg. Prevalence of NVUGIB was 24.2%. Among NVUGIB patients, 42% had Gastritis and 1.8% had esophageal tumors. Rebleeding was prevalent in 21.8%, whereas, 2.4% required an ICU admission and death was observed in 4%. Predictors of rebleeding included low Haemoglobin (AOR 2.24; 95% CI, 1.39–2.98, p = 0.002); Forest class 1 (AOR 2.51; 95% CI, 1.34–4.02, p = 0.031); Forest class 2 (AOR 1.81; 95% CI, 1.18–2.82, p = 0.044) and thrombocytopenia (AOR 1.43; 95% CI, 1.15–2.71, p = 0.011).
Conclusion
Rebleeding is a common outcome among patients with NVUGIB. Therefore, intensive management is crucial to improve patient outcomes. However, future research is warranted.
Effects of Green tea supplementation on the CRP, ESR, and CBC in the patients with COVID-19, a double-blind placebo-controlled clinical trial
Authors: Yousefi Mojtaba , Hosseinzade Zahra , Mahmoodi Sara , Mahmoodabadi Ali , Pourmahmoudi Azizollah , Saeedinejad Zaker , Hosseinikia Mahak , Naghmachi Mohsen , Malekzadeh Jan Mohamad , Panahande Seyed Bahman 
Published: October 2024

Abstract

Background
This study investigated the effects of green tea extract on biomarkers and signs of COVID-19 patients who were hospitalized.
Methods
This study was a double-blind clinical trial that involved 74 patients who were under hospital care. These individuals were randomly divided into two groups. One group received a 900mg/d dosage of green tea supplement along with standard patient care, while the other group received a placebo alongside standard patient care. This administration lasted for 14 days. Blood factors and anthropometric factors were measured before and after the intervention. Additionally, dietary intake was assessed during the study.
Results
After the intervention, there was a significant decrease in C-reactive protein (CRP) [Mean Differences (MD)18.34 and 95%CI (8.05 to 28.62)] and Erythrocyte Sedimentation Rate (ESR) [MD 16.68 and 95%CI (7.41 to 25.94)] levels in the green tea group compared to the placebo group. There were also significant changes in neutrophils, lymphocytes, red blood cells (RBC), and blood oxygen saturation in the green tea group(p < 0.05). However, there were no significant differences in other blood indices between the two groups.
Conclusions
The results suggest that green tea extract supplementation may positively affect inflammation and blood markers in COVID-19 patients and potentially improve blood oxygen saturation levels.
Trial registration
IRCT20150711023153N3 (https//irct.behdasht.gov.ir/trial/55948), Registration date 20210604
Therapeutic effects of probiotics on symptoms of depression in children and adolescents: a systematic review and meta-analysis
Authors: Chen Chia-Min , Liang Shun-Chin , Sun Cheuk-Kwan , Cheng Yu-Shian , Tang Yen-Hsiang , Liu Cheng , Hung Kuo-Chuan 
Published: October 2024

Abstract

Background
This meta-analysis aimed at investigating the therapeutic effects of probiotics against the symptoms of depression in children and adolescents as well as to identify the potential confounders.
Methods
Following PRISMA guidelines, major databases were searched for randomized controlled trials focusing on effects of probiotics against the symptoms of depression in children and adolescents to analyze the effect size (ES) for primary outcomes (i.e., improvement in depressive symptoms) expressed as standardized mean difference (SMD) and odds ratios (ORs) for continuous and categorical variables, respectively, with 95% confidence interval (CI).
Results
Meta-analysis of five studies (692 participants, mean age = 7.33 years, treatment duration 8–104 weeks) demonstrated no significant improvement in depressive symptoms in subjects receiving probiotics (SMD = 0.04, 95% CI: -0.33 to 0.41, p = 0.84, five studies, 692 participants). Subgroup analysis also showed no significant improvement associated with probiotic use relative to controls in the subgroup of studies focusing on individuals diagnosed with neurodevelopmental disorders (SMD= -0.11, 95% CI: -0.73 to 0.51, p = 0.72, three studies, 452 participants) and that recruiting the general population (SMD = 0.24, 95% CI: -0.43 to 0.91, p = 0.48, two studies, 240 participants). However, high levels of heterogeneity were found in both our primary results (I2 = 77%, p = 0.001) and subgroup analyses for those with neurodevelopmental disorders (I2 = 84%, p = 0.002) and the general population (I2 = 79%, p = 0.03).
Conclusions
The results did not support the use of probiotics for relieving depressive symptoms compared with controls in children and adolescents diagnosed with neurodevelopmental disorders or in the general population. Nevertheless, given the high level of heterogeneity across the included trials and a lack of studies focusing on those with diagnoses of anxiety or depression in the current meta-analysis, further large-scale clinical investigations are required to elucidate the therapeutic potential of probiotics against depressive symptoms in these populations, especially in those diagnosed with neurodevelopmental disorders or depression.
Improving the Accuracy and Precision of Disease Identification When Utilizing Ehr Data for Research: the Case for Hepatocellular Carcinoma
Authors: Wong Carrie R. , Flores Yvonne N. , Avila Analissa , Tieu Lina , Crespi Catherine M. , May Folasade P. , Bell Douglas , Glenn Beth , Bastani Roshan 
Published: October 2024

Abstract

Objective
We assessed the performance of ICD codes to identify patients with hepatocellular carcinoma (HCC) in a large academic health system and determined whether employing an algorithm using a combination of ICD codes could deliver higher accuracy and precision than single ICD codes in identifying HCC cases using electronic health record (EHR) data.
Results
The use of a single ICD code entry for HCC (ICD-9-CM 155.0 or ICD-10-CM C22.0) in our cohort of 1,007 established ambulatory care patients with potential HCC yielded 58% false positives (not true HCC cases) based on chart reviews. We developed an ICD code-based algorithm that prioritized positive predictive value (PPV), F-score, and accuracy to minimize false positives and negatives. The highest performing algorithm required at least 10 ICD code entries for HCC and the sum of ICD code entries for HCC to exceed the sum of ICD code entries for non-HCC malignancies. The algorithm demonstrated high performance (PPV 97.4%, F-score 0.92, accuracy 94%), which was internally validated (PPV 92.3%, F-score 0.90, accuracy 91%) using a separate sample of potential HCC cases. Our findings support the need to assess the accuracy and precision of ICD codes before using EHR data to study HCC more broadly.
Urethral instrumentation in men with artificial urinary sphincter: a national survey among Brazilian urologists
Authors: Pinto Vicktor Bruno Pereira , de Bessa Jose , Prezotti José Antonio Penedo , Anzolch Karin Marise Jaeger , Fernandes Jose Ailton , Gomes Cristiano Mendes 
Published: October 2024

Abstract

Purpose
Urethral instrumentation (UI) in patients with an artificial urinary sphincter (AUS) demands technical considerations and poses a risk of urethral erosion, leading to serious clinical and legal consequences. We conducted a national survey to evaluate the knowledge and experience of Brazilian urologists with UI in these patients.
Methods
This study used an electronic survey distributed to members of the Brazilian Society of Urology. The survey included 19 multiple-choice questions assessing sociodemographic characteristics, practice patterns, AUS training, knowledge of AUS components and functionality, experience with UI in AUS patients, and interest in further training. Urologists were classified as 'competent' in AUS manipulation if they had prior experience and confidence in performing UI.
Results
Among 536 participants (median age 47 years [39–55]), 72.8% reported involvement in urological emergencies, with 89.9% indicating inadequate AUS training during residency. Only 29.7% had occasional or regular involvement with AUS surgeries. Of the participants, 53.4% had performed UI in men with an AUS. Prior UI had been attempted by healthcare staff in 36.2% of cases. Only 46.8% reported knowledge of AUS components and 45.1% felt competent in deactivating it. Regarding urethral catheterization, 47.2% knew the safe catheter diameter, and 20.9% identified safe catheterization duration. Overall, 45.1% self-declared competence in UI, yet many gave incorrect answers on catheter size and duration. Competence strongly correlated with knowledge of AUS components, regular implant involvement, and prior experience. Most (89.3%) expressed interest in additional training for UI.
Conclusion
This study highlights significant gaps in training and knowledge among Brazilian urologists regarding UI in AUS patients. These deficiencies underscore the potential for enhanced education to improve patient outcomes and reduce AUS-associated complications in Brazil and possibly broader international contexts.
Influence of SARS-CoV-2 variants on COVID-19 epidemiological and clinical profiles: a comparative analysis of two waves of cases
Authors: Santos Pérola Rodrigues dos , Santos Uener Ribeiro dos , de Santana Íris Terezinha Santos , Fehlberg Hllytchaikra Ferraz , Ferreira Fabrício Barbosa , Albuquerque George Rego , Mariano Ana Paula Melo , Silva Murillo Ferreira da , Lemos Leonardo Santos , Piton Karoline Almeida , Silva Mylene de Melo , Fontana Renato , Aguiar Eric Roberto Guimarães Rocha , Marin Lauro Juliano , Gadelha Sandra Rocha 
Published: October 2024

Abstract

Background
The COVID-19 pandemic has been the most significant health challenge of the last century. Multiple and successive waves of COVID-19 cases, driven particularly by the emergence of new SARS-CoV-2 variants, have kept the world in a constant state of alert.
Methods
We present an observational, descriptive, cross-sectional study aimed at identifying SARS-CoV-2 variants circulating during two local waves of COVID-19 cases in southern Bahia, Brazil (late 2021 and late 2022), and analyzing the association between the detected variants and the epidemiological and clinical characteristics of the disease. For this purpose, data and nasopharyngeal samples from individuals in southern Bahia, Brazil, with suspected COVID-19 were included. Viral detection was performed by RT-qPCR, and SARS-CoV-2 variants were identified by next-generation viral sequencing.
Results
A total of 368 nasopharyngeal samples were tested. Approximately 23% of the samples from late 2021 tested positive for SARS-CoV-2, while in 2022, the positivity rate was about 56%. All sequenced samples from 2021 were identified as the Delta variant, while in 2022, all samples were classified as the Omicron variant. Overall, individuals who tested positive for SARS-CoV-2 in 2022 were younger than those who tested positive in 2021. Moreover, we observed significant differences in the clinical spectrum of SARS-CoV-2 infection when comparing the two periods. Individuals who presented with anosmia/ageusia were more likely to test positive for SARS-CoV-2 infection in 2021 but not in 2022. Additionally, fever, dry cough, pharyngalgia, headache, and rhinorrhea were more frequent among individuals infected with the Omicron variant than among those infected with the Delta variant.
Conclusions
The profile of COVID-19 in southern Bahia differed when analyzing two distinct waves of the pandemic in the region. These differences are likely related to the variants, which may differ in transmissibility and virulence, thereby altering the dynamics of the pandemic. This underscores the importance of genomic surveillance in better understanding the behavior of viral infections.
Gender Differences in Stress and Upper Respiratory Tract Infections: A Closer Look
Authors: Rüthrich Maria Madeleine , Ascone Leonie , Hammersen Jakob , Hilgendorf Inken , Kalkreuth Jana , Kurze Stephanie , Peters Eva Maria , Rachow Tobias , Rosendahl Jenny , von Lilienfeld-Toal Marie 
Published: October 2024

Abstract

Background:
Infectious diseases are influenced by both sex and gender, with psychosocial stress potentially playing a critical role, particularly in upper respiratory tract infections (URTIs). Despite existing evidence, a comprehensive analysis of the interplay between sex, gender, stress, and RTIs is lacking.
Methods:
Our monocentric, prospective study included 273 healthy individuals (cohort H) and 194 patients with hematological cancer (cohort P) who had undergone stem cell transplantation, enrolled between 11/2013 and 05/2017. Eligible participants were aged 18 years or older. Data collection encompassed demographics, household composition, smoking behavior, cancer-related characteristics, RTI-symptoms, and perceived stress, measured using the 4-item perceived stress scale (PSS-4). Participants were categorized based on biological sex, without assessing gender identity. For analysis, we assumed that sex and gender were aligned.
Results:
In cohort H, 50% of the participants were female, with most individuals aged ≤ 30 years. Women experienced notably more moderate to severe URTI symptoms than men (57% vs. 36%, p < .001, φ = 0.210). Additionally, women across all age groups also exhibited higher PSS-4 levels than men [t(271) = 2.84, p < .001, d = -0.636] and the PSS-4 was significantly affected by sex [F(1, 261) = 22.22, p < 0.001, η2 0.078]. In cohort P, 40.5% of the patients were female, with the majority aged ≥ 30 years. The occurrence and severity of RTI symptoms were more pronounced in men than women. The PSS-4 was not affected by sex. Unlike in cohort H, a significant correlation between the PSS-4 and RTI symptoms was found for both sexes in cohort P. In both groups, the lowest stress levels were observed in individuals over 60 years old.
Conclusion
Perceived stress was higher in younger women, as was the occurrence and severity of URTIs. However, a significant correlation between stress and URTIs was found only in patients with cancer, suggesting a more complex interaction between sex, gender, stress and URTIs in individuals with compromised health as compared to healthy individuals, which deserves further study.
Trial registration:
Registry: the German Clinical Trials Register
Echocardiographic Predictors and Incidence of Left Ventricular Dysfunction Following Transcatheter Patent Ductus Arteriosus Closure in Extremely Premature Infants
Authors: Adamson Marissa E. , Ligon Ronald Allen , Hamrick Shannon , Mills Marcos , Bhombal Shazia , RN Sarah Hash , Michelfelder Erik 
Published: October 2024

Abstract

Background:
Left ventricular (LV) dysfunction is a known complication after ligation of patent ductus arteriosus (PDA). An increasing number of premature and extremely low birth weight (ELBW) infants undergo transcatheter closure of PDAs. The aim of this study was to evaluate incidence and predictors of LV dysfunction after transcatheter PDA closure in ELBW infants.
Methods:
Subjects undergoing PDA closure from 2020–2022 who were ELBW (< 1 kg) and extremely premature (gestational age < 29 weeks) at birth were included. A single cardiologist reviewed each pre- and post-intervention echocardiogram and calculated LVEF.
Results:
67 subjects were included with a mean gestational age of 24.8 weeks and birth weight of 648.2 g. Mean age and weight at time of procedure were 7.9 weeks and 1722.4 g, respectively. All patients had normal LVEF pre-procedure (mean LVEF 67.0%) with a significant decline post-procedure to 60.3% (p < 0.001). Post-procedure, 81% of subjects maintained normal LVEF (> 53%). 55% of patients did have a decline in EF > 5%. There was no significant difference in post-procedure LV dysfunction in relation to pre-procedural PDA size, left atrial or LV dilation. All subjects recovered function with a median time to observed normal LVEF of 6 days.
Conclusions:
LV dysfunction develops in 19% of ELBW infants undergoing PDA device occlusion, is usually mild in severity, and normalizes in all subjects. The size of PDA, degree of left heart dilation does not predict LV dysfunction in this population.
Detection of Toxoplasma Gondii in the Brain of Pet Birds by Seizures with Loop-Mediated Isothermal Amplification (LAMP)
Authors: Esfahani Mohammad Neshatpour , Gholami-Ahangaran Majid , Sullivan William J 
Published: October 2024

Abstract

BACKGROUND
This study seeks to close this divide by assessing the occurrence of Toxoplasma gondii (T. gondii) in the brain tissues of pet birds displaying neurological symptoms, utilizing Nested Polymerase Chain Reaction (PCR) and Loop-mediated Isothermal Amplification (LAMP) methods. Furthermore, it aims to evaluate and contrast the sensitivity and specificity of different diagnostic procedures. Seventy bird samples, consisting of 50 sick and 20 asymptomatic samples, were assessed using various methods. Brain tissue DNA was isolated and then analyzed using nested PCR and LAMP assays targeting the T. gondii B1 gene and RE gene. Sensitivity and specificity assessments were conducted, and statistical evaluations were made using SPSS software.
RESULTS
No T. gondii cysts were detected in the smear preparations. T. gondii DNA was discovered in 6% of the sick birds using nested PCR, while LAMP identified T. gondii DNA in 8% of these individuals. Both techniques exhibited a high level of specificity; however, LAMP demonstrated higher sensitivity and faster processing times than nested PCR.
CONCLUSION
The study indicates that LAMP is an efficient diagnostic method for quickly and accurately detecting T. gondii in pet birds while also being cost-effective. The results emphasize the significance of molecular diagnostics in promptly identifying and treating toxoplasmosis in birds, which enhances our comprehension and regulation of the disease. To improve the surveillance and preventative strategies against T. gondii infections, it is advisable to do additional studies using more extensive and diversified bird populations.
The role of the BMI ≥40 kg/m² criterium in ASA-PS classification for metabolic surgery
Authors: Ede Elisabeth S. van , Nienhuijs Simon W. , Bouwman R. Arthur , Buise Marc P. 
Published: October 2024

Abstract

Purpose This study explores historical trends in ASA-PS scoring and evaluates whether the ASA-PS III classification based solely on a BMI ≥ 40 kg/m² effectively contributes to peri-operative risk stratification for patients undergoing metabolic surgery.
Methods Adult patients (January 2015-January 2023) were included from the Dutch Audit for the Treatment of Obesity registry. Logistic regression adjusted for confounders compared groups stratified by BMI and presence of systemic disease. Outcome measures: complication prevalence (peri-operative, ≤30days and >30days), Clavien-Dindo score, hospital stay (>2 days), ICU admission, readmission, and mortality rates.
Results A total of 75,871 patients (78.8% women, age 43.5 (SD 11.8) yrs, BMI 42.9 (SD 5.3) kg/m2) were included. The number of patients receiving ASA-PS III increased from 26% to 92% (BMI≥40 kg/m2), and from 20% to 64% (BMI<40 kg/m2), despite generally stable mean age, BMI, and concurrent diseases. From 2018, ASA-PS II was inaccurately assigned in 64%. Patients without severe systemic disease (BMI ≥ 40 kg/m2) were significantly less likely to experience complications, ICU admission, prolonged hospital stay, or readmission compared to patients with severe systemic disease (BMI < 40 kg/m²) (OR: 1.72, 95% CI: 1.43 – 2.08, p < 0.001).
Conclusion A large Dutch national registry on metabolic surgery showed that ASA-PS III patients with BMI ≥ 40 kg/m² only were less likely to experience complications after surgery compared to those with BMI < 40 kg/m² and severe systemic disease. This suggests that adhering to the BMI criterion may undermine the ASA-PS classification's effectiveness in risk stratifying these patients.
Transforming Endometriosis Management: Insights from a Six-Year Application of the 4P Approach
Authors: Lin Shunhe , Qi Wei , Zhang Jinna , Liu Chaobin , Xie Xi , Wang Zhenna , Guo Yuyan 
Published: October 2024

Abstract

Objective To systematically evaluate the effectiveness of the 4P management model (Professionalized management, Personalized care, Pluralistic strategies, and Participatory involvement) in the specialty management of endometriosis, and to explore its impact on disease management effectiveness. Methods A retrospective analysis was conducted using data collected from January 2018 to December 2023, encompassing outpatient and inpatient workload statistics, as well as patient satisfaction surveys. A total of 636 patients who attended the endometriosis specialty clinic between January 2020 and December 2021 were selected as the observation group, while 613 patients from the same period served as the control group. The observation group received standard care integrated with the 4P management approach. In contrast, the control group was treated with traditional standard care alone. Key study indicators included patient follow-up adherence, quality of life assessments, and evaluations of negative emotional status. Results The observation group demonstrated notable enhancements in follow-up adherence, a significant reduction in visual analogue scale/scores (VAS) for pain, and a marked decrease in negative emotional disturbances. Additionally, clinical workload, both outpatient and inpatient, saw considerable growth, with outpatient visits increasing from 574 cases to 2,546 cases and inpatient admissions rising from 432 cases to 997 cases. Patient satisfaction also improved substantially, with outpatient satisfaction rates climbing from 93.2–97.8% and inpatient satisfaction rates growing from 91.8–98.6%. Conclusion The implementation of the 4P management model significantly enhanced patient follow-up adherence, improved quality of life and patient satisfaction, and reduced negative emotional disturbances. This comprehensive approach to managing endometriosis highlights its substantial potential in optimizing specialized care, ensuring consistent and high-quality outcomes. The 4P model offers valuable insights and practical strategies for healthcare institutions seeking to implement innovative and patient-centered management practices in the treatment of endometriosis.