bluuebunny/crossref_metadata_2025_split huggingface dataset:
A retrospective cohort study of gastrografin in the management of adhesive small bowel obstruction during pregnancy
Authors: Li Qiu , Lou Huihua , Peng Rong , Zheng Xiaosong , Wang Chenwei , He Xiaojun 
Published: October 2024

Abstract

Adhesive small bowel obstruction (ASBO) during pregnancy is extremely dangerous and has not been well researched. The aim of this study was to resolve the difficulties faced in the management of ASBO during pregnancy through the dual role of the diagnosis and treatment of gastrografin. All patients with ASBO during pregnancy whose medical records were retrospectively analyzed between September 2018 and September 2023 were categorized into two groups based on the type of treatment they received: conventional and gastrografin. The two groups did not differ statistically significantly in terms of demographic information, fundamental patient features, or side effects. On the other hand, the gastrografin group outperformed the convention group in terms of improving the rate of success for conservative treatment, lowering the need for surgical procedures, reducing hospital stays, lowering medical costs, and aiding in diagnosis. Gastrografin can be safely used in the pregnant population, where its efficient therapeutic efficacy and accurate diagnostic role are key to resolving the difficulties of ASBO during pregnancy.
Integrated gene expression and alternative splicing analysis in human and mouse models of Rett Syndrome
Authors: Gioiosa Silvia , Gasparini Silvia , Presutti Carlo , Rinaldi Arianna , Castrignanò Tiziana , Mannironi Cecilia 
Published: October 2024

Abstract

Background
Mutations of the MeCP2 gene lead to Rett syndrome (RTT), a rareX-linked developmental disease causing severe intellectual and physical disability. How the loss or defective function of MeCP2 mediates RTT is still poorly understood. MeCP2 is a global gene expression regulator, acting at transcriptional and post-transcriptional levels. Although several transcriptomic studies have been performed in human RTT biosamples and Mecp2mutant mouse models, few genes or pathways have been consistently associated with MeCP2 mutations. Despite the known regulatory role of MeCP2 in splicing mechanisms, the contribution of alternative splicing dysregulation to RTT pathophysiology has received little attention. To gain insight into common molecular pathways that might be dysregulated in RTT, we explore and integrate publicly available RNA sequencing (RNA-seq) data from human RTT patients and Mecp2-mutant mouse models, processing data for gene expression and alternative splicing.
Methods
We downloaded from the Sequence Read Archive 100 samples (SRA-experiments) from 5 independent BioProjects on human Rett Syndrome patients, and 130 samples from 9 independent BioProjects on MeCP2 mutant mouse models. We performed a massive bioinformatics re-analysis of raw data, applying single, standardized pipelines for differential gene expression and alternative splicing analysis.
Results
Our comparative study across datasets indicates common differentially expressed genes (DEGs) and differentially alternatively spliced (DAS) genes shared by human or mouse datasets. We observed that genes dysregulated either in their expression or splicing are involved in two main functional categories: cell-extracellular matrix adhesion regulation and synaptic functions, the first category more significantly enriched in human datasets. A low overlap between human and mouse DEGs and DAS genes was observed.
Limitations
The main limitation of our analysis is the inclusion in the study of highly heterogeneous RNA-seq datasets, deriving from various RTT tissues and cells, and carrying different MeCP2 mutations.
Conclusions
Our massive bioinformatics study indicates for the first time a significant dysregulation of alternative splicing in human RTT datasets, suggesting the crucial contribution of altered RNA processing to the pathophysiology of Rett syndrome. Additionally, we observed that human and mouse DEGs and DAS genes converge into common functional categories related to cell-extracellular matrix adhesion and synaptic signaling.
Influenza A virus continues to circulate among children in Linyi, northern China, after the relaxation of COVID-19 control measures
Authors: Lv Tiegang , Chen Jie , Li Huafeng , Chen Xiaoyan , Zhang Na , Ma Chunling , Zhang Yanli , You Pengfei 
Published: October 2024

Abstract

Following the relaxation of control measures for COVID-19 in China in December 2022, there was a resurgence of influenza A among children in Linyi. This research aims to analyze the epidemiology and genetic characteristics of influenza A viruses circulating among children in Linyi from April 2022 to March 2024. Throat swab specimens were collected from children with influenza-like illness (ILI), and the types of influenza were identified. The hemagglutinin (HA) genes of influenza A viruses were amplified using reverse transcription-polymerase chain reaction (RT-PCR) and then sequenced. Subsequently, the gene characteristics and phylogenetics of these sequences were analyzed. A total of 6258 cases of influenza A were tested from 54926 children with ILI over two years, showing three epidemic waves: one in summer 2022 and two in spring and winter 2023. The epidemic waves in summer 2022 and winter 2023 were caused by influenza A(H3N2) viruses. In spring 2023, influenza A(H1N1)pdm09 viruses accounted for 77.1% and A(H3N2) viruses accounted for 22.9%, respectively. The influenza A(H1N1)pdm09 viruses belonged to clade 6B.1A.5a.2a, while the influenza A(H3N2) viruses evolved from clade 3C.2a1b.2a.1a to 3C.2a1b.2a.2a.3a.1. Compared with the vaccine strain of the Northern Hemisphere of the current year, multiple amino acid substitutions and glycosylation sites changes were observed in the HA protein that most likely resulted in antigenic drift. The influenza A viruses have been circulating and evolving persistently in Linyi from 2022 to 2024. Continuous surveillance is essential for comprehending the dynamics of influenza in the post-COVID-19 era.
Implementing national care guidelines in local authorities in England and Wales: A Theory-of-Change
Authors: Bauer Annette , Boaz Annette , Hoomans Ties , Jasim Sarah , Knapp Martin , Mayorga-Camus Joaquin , Malley Juliette , Breuer Erica 
Published: October 2024

Abstract

Background
The delivery of high-quality services in chronically underfunded social or long-term care systems is a major challenge internationally. National guidelines, developed by the National Institute for Health and Care Excellence, set out how local authorities in England and Wales should fund and provide care based on best available evidence. Theoretical and participatory approaches can usefully inform the design and evaluation of implementation strategies for guidelines. The aim of the study is to develop a Theory-of-Change for how the implementation of social care guidelines is expected to lead to impacts from a local authority perspective.
Methods
As part of a comparative case study (The ‘Valuing Care Guidelines’ study; Feb 2022 to April 2024) with three local authority sites in England and Wales, we involved altogether 17 participants in two Theory-of-Change online workshops per site of about 2 hours each. Additional data gathered from the same participants as part of the overall study were used to conceptualise and enrich the information from the workshops.
Results
Participants described the Theory-of-Change map as follows: A wide range of activities (categorised in stages of ‘pre-implementation’, ‘implementation’, ‘sustainment and scaling’) and skills were required to implement guidelines, and achieve long-term organisational sustainability and service delivery outcomes, leading to final impacts for service users and carers. They described a co-creation implementation model, led by Implementation Support Practitioners, who utilised relational skills to achieve motivation, trust, and confidence at different organisational levels, addressing contextual barriers such as inadequate staffing, lack of resources and of organisational support systems. A consistent use of guidelines by frontline staff could only be achieved if the value of guideline implementation was promoted widely, and the role of stakeholders, such as the inspection body, local health care providers, social care users and carer representatives was considered.
Conclusions
Our study is the first to investigate the implementation of national social care guidelines by local authorities in England and Wales. It generated insights that can guide implementation practice as well as inform the evaluation of future implementation strategies.
A qualitative process evaluation: Understanding the “Let’s talk about vaccines” approach’s complementary use of community-based participatory research and human- centered design in under two immunization programming
Authors: Shuro¹ Linda , Lawrence² Emily , de Man¹ Jeroen , Knight³ Lucia , Schneider¹ Helen , Tabana¹ Hanani 
Published: October 2024

Abstract

Introduction
Full coverage of childhood vaccines is a persistent challenge in low- and middle-income countries and there is an urgent need to catch up on children who have missed out on vaccines. This paper summarizes the findings of a process evaluation of the ‘Let’s talk about vaccines’ approach implemented by VillageReach using community-based participatory research (CBPR) to understand the barriers that caregivers and healthcare workers face to fully vaccinate children, and human-centered design (HCD) to codesign potential interventions in Mozambique and Malawi to improve under two immunization access and uptake.
Methods
A qualitative process evaluation guided by the REAIM framework. Interviews and self-administered surveys were conducted to explore insights and immediate feedback from caregivers, healthcare workers and stakeholders who were involved in the approach. The interviews were held with 77 individuals (46 in Mozambique and 31 in Malawi). Interviews were transcribed verbatim and analysed via a combination of framework and thematic analysis. Immediate feedback on the HCD ideation and prototype workshops was obtained from 81 participants. The survey results were analysed in Excel.
Results
Key elements in the implementation of the approach in both countries demonstrated high fidelity to the CBPR and HCD principles. These included the establishment of collaborative study teams, the involvement of caregiver researchers, a mix of novel and traditional participatory methods, extensive mobilization and iterative processes, and activities aimed at creating an equal platform. Challenges were also noted, including adjusting to new methods and contextual realities. Factors influencing the potential adoption of the approach included locally developed solutions, participant involvement, collaborative initiatives, major advantages over alternatives, the potential ease of use of the co-created interventions, alignment with government objectives, and adaptability for system-wide integration in immunization programming. System-level challenges and funding were also identified as persisting barriers.
Conclusion
The findings from the ‘Let’s talk about vaccines’ approach highlight important elements offering practical strategies for how CBPR and HCD can potentially be replicated in similar contexts. These findings demonstrate that integrating CBPR and HCD into routine immunization programs has the potential to enhance community-responsive programming for vaccinating children under two in LMICs, leading to effective and sustained change.
The Multifocal Pathway: Trial of a multifocal intraocular lens selection pathway for use by trainee surgeons in an Australian Tertiary Referral Public Hospital
Authors: Sartor Lauren , FRANZCO Christopher Go , Kong Cheng F , FRANZCO Season Yeung , FRANZCO Andrew White , FRANZCO Chameen Samarawickrama 
Published: October 2024

Abstract

Purpose
To develop a selection pathway to facilitate the use of multifocal intraocular lenses (mfIOLs) in cataract surgery in a public hospital setting.
Setting:
Westmead Hospital, Sydney, Australia
Design:
A single-surgeon prospective cohort study
Methods
A mfIOL selection pathway was designed and assessed. Outcomes measured included unaided distance (UDVA), intermediate (UIVA) and near visual acuity (UNVA), dysphotopsia, spectacle dependence and satisfaction. Patient-reported outcome measures (PROMs) were assessed using Catquest-9SF (CQ) and Near Visual Acuity Questionnaire (NAVQ). A cost-analysis was performed.
Results
Fifty-four eyes from 27 patients underwent cataract surgery with mfIOL implantation. The monocular UDVA (mean ± standard deviation) was 0.05 ± 0.12 logMAR; UIVA 0.19 ± 0.05 logMAR; UNVA 0.28 ± 0.14 logMAR; 87% and 98% of eyes achieved within 0.5D and 1.0D of target refraction respectively. Spectacle independence was 85% at distance, 81% at intermediate, 59% at near vision. High satisfaction was reported with CQ (> 85%) and NAVQ (100%). The cost difference between bilateral monofocal and mfIOLs is comparable to a pair of spectacles. Projected annual cost to the health system for a 5%-10% eligibility rate is 1.1–2.3 million Australian dollars.
Conclusions
The selection pathway presented overcomes the challenges in patient selection inherent to a public hospital setting and was implemented by a senior trainee with excellent vision and PROMs. The pathway ensures the cost-effectiveness of mfOL implantation. There are several funding models that can be applied to support equitable access and improved visual outcomes with mfIOLs within the government funded health system.
An efficacy study was conducted on stamp skin grafting to promote the healing process of chronic wounds for patients from the Wound Care Clinic
Authors: He Huilin , Zhu Li , Chen Xiaohong , Jiang Qingli , Li Yeping , Jing Ke , He Fang , Yang Yuwei 
Published: October 2024

Abstract

The prevalence of chronic wounds is on the rise, and the healing process is prolonged due to multifactorial etiology. This study aims to investigate the clinical efficacy of stamp skin-grafting in promoting wound healing for patients with chronic wounds from the Wound Care Clinic. This study enrolled 86 patients with chronic wounds from the Wound Care Clinic from November 2022 to December 2023, who were randomly allocated into the control (n = 44) and skin-grafting (n = 42) groups using a preset random number table. The control group received conventional wet dressing care, whereas the skin-grafting group underwent additional stamp skin-grafting care. The skin-grafting group demonstrated significantly reduced wound healing time, improved healing efficacy, decreased dressing change frequency, and lowered dressing change costs compared to the control group (all P < 0.05). During the nursing process, the skin-grafting group exhibited significantly lower pre-treatment NRS scores when the 4th and 5th dressing changes and during-treatment VRS scores when the 3rd to 5th dressing changes compared to the control group (all P < 0.05). After adjusting for confounding factors, wound area served as an independent risk factor for both healing time (rpartial=0.457, P = 0.004) and healing efficacy (Beta=-0.559, P = 0.003) in the skin-grafting group, whereas patient adherence served as an independent risk factor for both healing time (rpartial=0.333, P = 0.038) and healing efficacy (Beta = 1.194, P = 0.002) in the control group, as well as for healing efficacy (Beta = 1.318, P = 0.007) in the skin-grafting group. Stamp skin-grafting effectively promotes the rapid recovery of chronic wounds with reduced medical burden and patient pain. The effectiveness primarily depends on the wound area and patient adherence.
Patients’ Perceptions and Understanding of Pre-operative Informed Consent in a Tertiary Care Setting- Dar-es-salaam
Authors: Michael Steven , Kyejo Willbroad , Ismail Allyzain , Aghan Eric , Mbekenga Columba , Ali Athar 
Published: October 2024

Abstract

Background Informed consent, grounded in the ethical principle of autonomy, represents a patient's agreement to undergo a procedure. Given its critical role in protecting human rights and autonomy, obtaining informed consent before any surgery or procedure is now a mandatory practice. However, many studies question whether informed consent is conducted genuinely, ensuring proper understanding of the information disclosed, or merely serves as a medico-legal formality. This has led to increased malpractice, misunderstanding, anxiety, and overall postoperative dissatisfaction.Methods This descriptive qualitative study was conducted at Aga Khan Hospital using individual in-depth interviews. Fourteen patients who had undergone elective surgery were recruited. Baseline data were presented in tables, and inductive thematic analysis was used to interpret the qualitative data.Results Seven themes emerged from the data: Consent as a legal formality, autonomy and decision-making, insufficient information, time constraints and lack of opportunities for questions, use of medical jargon, patients’ desired information, and overall satisfaction with care. Despite patients’ higher levels of education and the hospital's patient-centered care approach, many felt the information provided was insufficient, superficial, and difficult to understand.Conclusion The study found a significant gap between the information patients desired and what was provided. Insufficient information, coupled with the use of medical jargon and time constraints, adversely affected the informed consent process. Enhancing clarity in communication and allowing adequate time for discussions could improve patient understanding and satisfaction.
Association Between Thyroid Hormone Sensitivity and Dyslipidemia in Elderly Women
Authors: Li Hezhi , Zhou Yiling , Ma Jianxin , Zhu Binghua , Liu Zhipeng , Zhang Jinping 
Published: October 2024

Abstract

Context:
This study investigates the relationship between thyroid hormone sensitivity indices and dyslipidemia in elderly Chinese women. Given the potential impact of thyroid hormones on lipid metabolism, understanding this relationship could improve dyslipidemia management in this population.
Materials and Methods
We conducted a retrospective case-control study involving 1,312 elderly women who underwent health examinations at the Health Examination Center of the 305 Hospital of the Chinese PLA. Thyroid hormone sensitivity indices, including Thyroid Feedback Quantile-based Index (TFQI), Thyroid-stimulating Hormone Index (TSHI), Thyrotroph Thyroxine Resistance Index (TT4RI), and Free Triiodothyronine/Free Thyroxine ratio (FT3/FT4), were assessed alongside dyslipidemia markers. Statistical analyses included logistic regression and restricted cubic spline models to evaluate the associations and dose-response relationships between these indices and dyslipidemia.
Results
The study found a U-shaped dose-response relationship between TFQI, TSHI, and TT4RI levels and dyslipidemia risk, indicating that both very high and very low levels of these indices were associated with increased risk. The FT3/FT4 ratio was positively correlated with dyslipidemia risk but lost significance when adjusting for additional confounders.
Conclusions
Elevated and reduced thyroid hormone sensitivity indices are associated with a higher risk of dyslipidemia in elderly women, while moderate levels may be protective. These findings suggest that a comprehensive approach to thyroid function assessment, incorporating sensitivity indices, could enhance the management of dyslipidemia in older women. Further research is needed to confirm these results and explore the underlying mechanisms.
"Standardized" debridement and antibiotic cement implantation for the treatment of bone infection after intramedullary nailing
Authors: Wang Xiaohua , Wang Shulin , Jia Chao , Hou Chunli , Shen Jie , Xie Zhao , Lin Wei , Wang Guanglin 
Published: October 2024

Abstract

Background
The aim of this study was to investigate the clinical efficacy of "Standardized" debridement and antibiotic cement implantation for the treatment of bone infection after intramedullary nailing.
Methods
Retrospective analysis the patients with lower extremities infection after intramedullary nailing admitted to our hospital between February 2013 and April 2020. In the first stage, "standardized" debridement was performed and the defects(include medullary cavity) were filled with antibiotic loaded cement. In the second stage, the patients were divided into two groups according to whether the bone defects were reconstructed or not. The infection control rate and complications of the two groups were compared.
Results
A total of 69 patients were admitted in this study, there were 37 tibias and 32 femurs. The average follow-up time was 38.82 months. There were 6 patients in reconstructed group and 8 patients in non-reconstructed group recurrence of infection which need debridement again, the infection recurrencerate of reconstructed group was lower than that of non-reconstructed group, P = 0.038. Finally, the overall infection control rate was 97.1%, which was 100% in reconstructed group and 91.30% in non-reconstructed group, P = 0.108. The overall complication rate was 17.39%, and there was no significant difference between the two groups.
Conclusions
The efficacy of "Standardized" debridement and antibiotic cement implantation for the treatment of bone infection after intramedullary nailing with good early results, but repeated debridement may be required to improve the infection control rate. The recurrence rate of infection was higher in patients who had not undergone bone defects reconstructed for a long time.
Challenges in diagnosing and managing massive pulmonary thromboembolism during pregnancy following in vitro fertilization: A case report
Authors: Hwang Ji-won 
Published: October 2024

Abstract

Background : In vitro fertilization (IVF) significantly increases the risk of venous thromboembolism (VTE), particularly pulmonary thromboembolism (PTE), due to elevated estrogen levels during ovarian stimulation. Diagnosing PTE in pregnancy is challenging, making early detection and management essential to prevent severe maternal complications.
Case presentation : This case report describes a 32-year-old woman, 9 weeks pregnant with twins, who presented with sudden dizziness and syncope. She had a history of four IVF procedures. Initial vital signs included tachycardia and normal blood pressure; however, she later developed severe hypotension and shock. Chest computed tomography confirmed the PTE, which was suggested on electrocardiogram and echocardiography. The performance of urgent thrombolysis with tissue plasminogen activator stabilized her condition but resulted in the loss of the twin gestational sacs. The patient was administered rivaroxaban and LMWH after being diagnosed with estrogen-associated PTE and mild anti-phospholipid antibody syndrome and successfully achieved a healthy pregnancy and delivery after further IVF attempts and prophylactic LMWH treatment.
Conclusions : This case highlights the importance of rapid diagnosis and intervention for PTE during pregnancy and the need for tailored anticoagulation strategies to ensure maternal and fetal safety. Despite the tragic loss of the twin gestational sacs, appropriate anticoagulation therapy enabled the patient to achieve a successful pregnancy and healthy delivery in subsequent IVF attempts.