bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating the Effectiveness of Combining High-Frequency Chest Wall Oscillation with Intermittent Positive Pressure Breathing in Pneumonia Patients: A Retrospective Cohort Study Running head: Effectiveness of Combination of HFCWO and IPPB in Pneumonia
Authors: Chao Ta-Wei , Kao Ya-Chen , Liu Hui-Ling , Lin Sheng-Hsiang , Kuo Chin-Wei 
Published: September 2024

Abstract

Background:
Pneumonia represents a significant global health burden with high morbidity and mortality rates, despite advances in therapeutic and preventive strategies. Airway clearance techniques (ACT), including High-Frequency Chest Wall Oscillation (HFCWO) and Intermittent Positive Pressure Breathing (IPPB), are critical in managing respiratory conditions. However, the combined effectiveness of IPPB and HFCWO in treating adult pneumonia remains underexplored.
Methods:
A retrospective cohort study was conducted at a college hospital in southern Taiwan, enrolling patients aged ≥ 18 years, admitted for pneumonia from January 2020 to December 2022, who received HFCWO therapy for ≥ 5 days in the ordinary ward. Exclusion criteria included prior mechanical ventilation before HFCWO initiation. Univariate and multivariable logistic regression models were used to assess the effectiveness of the combined use of IPPB and HFCWO.
Results:
A total of 271 patients received HFCWO and were enrolled for analysis, including 163 patients who received both IPPB and HFCWO. Patients receiving both IPPB and HFCWO were associated with shortened total hospital stays (OR: 0.49, 95% CI: 0.28–0.83, P = 0.008), decreased frequency of sputum suction (OR: 2.91, 95% CI: 1.46–5.78, P = 0.002), and reduced oxygen need post-HFCWO (OR: 0.55, 95% CI: 0.33–0.91, P = 0.021). However, there was no difference in hospital stay post-HFCWO use, respiratory failure, ICU admission, or hospital death between the groups. Additionally, there was no difference in these outcomes for patients who received HFCWO twice daily compared to those who received it once daily.
Conclusions:
Combining IPPB and HFCWO reduces the need for sputum suction and improves oxygen demand for patients but does not change hospital days, respiratory failure, or mortality. Further large prospective cohort studies are necessary to confirm the efficacy of this management approach.
Unveiling the Psychosocial Impact of Elexacaftor/Tezacaftor/Ivacaftor Therapy in Cystic Fibrosis Patients
Authors: García Marta Solís , Peláez Adrián , Punter Rosa Mar Gómez , López María Criado , Carbajal Claudia Madrid , Ancochea Julio , Bachiller Jose María Eiros , Hernández Ana Sofía Martín , Rodrigo-García María , Clemente Marta García , Moreno Rosa Mª Girón 
Published: September 2024

Abstract

Background. This study aimed to assess how Elexacaftor/Tezacaftor/Ivacaftor (ETI) influences lung function, BMI, sweet test and mental health of Cystic Fibrosis (CF) patients, emphasizing on depression and anxiety.
Methods. We conducted an observational, prospective, multicentre study including 108 patients over 18 years old who initiated ETI therapy between December 2019 and December 2023. Patients underwent regular evaluations, including clinical, functional, and microbiological assessments, alongside completion of quality of life, anxiety, and depression questionnaires. We evaluated whether there was a difference in anxiety and depression levels over time.
Results. After 12 months of treatment, significant improvements were noted in body mass index (BMI), lung function (FEV1 %), sweat test (ST) and various aspects of quality of life (CFQ-R). However, anxiety and depression levels did not differ significantly during the follow-up. When we stratified our sample by key groups, we observed that younger patients (under 28 years) and those with homozygous Phe508del mutations experienced significant higher anxiety with no differences on depression. Furthermore, anxiety and depression demonstrated a moderate correlation, strengthening over time.
Conclusions. Treatment with ETI establishes significant improvements in lung function, BMI, sweat test and quality of life in patients with CF. However, despite these positive outcomes, there were no significant changes observed in levels of anxiety and depression, except for individuals with homozygous mutation type and those younger than 28 years old, who exhibited significant higher levels of anxiety.
A Randomized Controlled Trial Comparing the Tolerability and Efficacy of Maribavir vs. Valganciclovir for CMV Prophylaxis in High-Risk Kidney Transplant Recipients: Study Protocol (Maribavir IIR)
Authors: Culpepper Hannah , Overstreet Morgan , Soliman Karim , Casey Michael , Rice Teresa “Tracy” , Lively Kaylie , Scalea Joseph , McGillicuddy John , Patel Neha , Taber David J. 
Published: September 2024

Abstract

Background:
Cytomegalovirus (CMV) infection remains a significant problem in kidney transplantation despite advances in screening, monitoring, therapeutics, and management. Although universal prophylaxis with antiviral therapy has significantly reduced the risk of early CMV infection and disease, late-onset CMV is still common and can be difficult to clinically manage in high-risk patients. A recent systematic review showed that with antiviral prophylaxis, early CMV infection occurred in only 6% of kidney recipients and late infection occurred in more than one in six patients. 4
The two antiviral prophylaxis medications this study is comparing, valganciclovir (VGC) and maribavir, are highly effective at preventing CMV infection. In studies using valganciclovir, the reported occurrence of leukopenia is 20 - 40% and neutropenia is 10 - 30%6-12. In studies using maribavir, the reported occurrence of neutropenia was 4 - 5% versus 15 - 18% in valganciclovir patients. With appropriate dosing, maribavir appears to have similar efficacy to valganciclovir in treating current and preventing future CMV infection with a significantly reduced rate of neutropenia.
Methods:
Maribavir IIR is a 12-month, single-center, open-label, randomized controlled trial enrolling 70 patients (35 in each arm) examining the difference in preventing CMV infection while specifically assessing the tolerability of the two antiviral prophylactic medications. The trial is currently in the follow-up phase, with the first patient enrolled in November 2023, and enrollment concluding in June 2024.
Discussion:
The primary objective of this study is to assess the tolerability of maribavir versus valganciclovir (VGC) prophylaxis in adult kidney transplant recipients at high-risk of CMV infection (D+/R- or thymo use if R+). This was done by assessing the incidence of leukopenia in the two arms, the occurrence of CMV infection despite prophylaxis, the impact of these medications on healthcare utilization and costs, and any outcome differences associated with race and sex. In this preliminary report, we describe the study design, methods, aims, and outcome measures that will be utilized in the ongoing Maribavir IIR clinical trial.
Trial Registration:
ClinicalTrials.gov NCT06034925: https://www.clinicaltrials.gov/study/NCT06034925
Introduction: Impact of Early Cleft Lip and Palate Surgery on Maxillary Growth in 5- and 10-Year-Old Patients with Unilateral Cleft Lip and Palate: A Cross-sectional Study
Authors: Novakova Magda , Brysova Alena , Vokurkova Jitka , Marcian Petr , Borak Libor , Koskova Olga 
Published: September 2024

Abstract

Objectives: This study evaluated maxillary growth and dental arch relationships in patients with unilateral cleft lip and palate (UCLP) at 5 and 10 years of age.
Methods: 28 patients with UCLP who underwent cleft lip surgery in neonatal age and cleft palate surgery at average age of 7 months without orthodontic treatment (intervention group) were measured for intercanine and intermolar distances and for dental arch length. These measurements were compared with those of 30 healthy participants in a control group. Dental arch relationships in the intervention group were evaluated by 5-YO index at 5 years and the GOSLON Yardstick score at 10 years of patients’ age.
Results: Patients in the intervention group had significantly shorter mean intercanine distance and arch length than control patients at both 5 and 10 years of age (p&lt;.001 for all). There were no significant differences in intermolar distance at both 5 (p=.945) and 10 years (p=.105) of patients’ age. The average 5YO index increased from 2.46 to an average GOSLON 10-year score of 2.89 in intervention group.
Conclusion: Intercanine distance and dental arch length of patients with UCLP are significantly reduced at 5 and 10 years after early cleft lip and palate surgeries compared to the healthy population. Dental arch relationships at 5 and 10 years of patients with UCLP show comparable outcomes to those reported by other cleft centers.
Clinical significance: This study supports the hypothesis that early cleft lip and palate surgeries do not negatively impact maxillary growth compared to later surgery.
The Impact of the Online Social Support on the Psychological Security: Mediation of Online Social Self-Efficacy
Authors: Guo Wanran , Wang Shizhuang , Li Muchen , Tao Mengxin 
Published: September 2024

Abstract

The rapid development of the Internet has gradually changed our lives and further affected interpersonal and social relations. Social support and social self-efficacy also gradually affect people's lives and individual psychology through the Internet. This paper studies the relationship among online social support, online social self-efficacy and psychological security. This study took 385 college students as participants to explore the influence of online social support on psychological security under the mediation of online social self-efficacy. We found that college students' online social support, psychological security and online social self-efficacy have significant positive correlation. Through regression and intermediary analysis, it is found that college students' online social support has a positive predictive effect on online social self-efficacy and psychological security, college students' online social self-efficacy has a positive predictive effect on psychological security, and college students' online social self-efficacy plays a complete intermediary role between online social support and psychological security.
A Service Ecosystems perspective to explore Social Prescribing value co-creation for vulnerable young people in NEET situation
Authors: Farina Isabel , Sangiorgi Daniela , Masella Cristina , Simonelli Ilaria , Alves Regina , Marques Maria J. , Dias Sonia , Dantas Carina , Herzog Sabrina , Paternoster Sara , Torri Emanuele , Bertotti Marcello 
Published: September 2024

Abstract

Background
Social prescribing inherently embodies a co-productive nature, particularly within the 'holistic' model, facilitated by the pivotal role of Link Workers. Most of the attention is focused on collecting evidence about the micro-level relationship between Link Workers and their clients. However, little is known about how this co-productive relationship influences or is influenced by value co-creation at different levels, given the involvement of multiple actors in delivering the intervention. To advance research on the operational processes underlying social prescribing, we propose a conceptual framework utilizing the Service Ecosystems perspective investigating the application of Social Prescribing with young people in NEET situation in Italy.
Methods
We conducted a single case study as part of the European C.O.P.E. - Capabilities, Opportunities, Places, and Engagement – initiative, examining the implementation of social prescribing targeting young NEETs (Not in Education, Employment or Training) in Italy. Semi-structured interviews were conducted with a total of 27 participants including 6 members of the C.O.P.E. coordination team, 6 link workers and 15 young people aged 15–34 years old.
Results
Main findings are presented showing the ecosystem dynamic at each phase of the intervention: the referral process; co-production of an individualised action plan; connection and activation of community assets.
Discussion
The research shows how Social Prescribing is not a linear path but rather a complex intervention with multiple interacting elements across ecosystems layers. The dyadic relationship between Link Workers and their clients is not an isolated process and Social Prescribing works along care services to support continuity of care. The service ecosystem perspective is a valuable frame to investigate the dynamic interactions between actors and how their resource integrating process and institutional arrangements foster the emergence of opportunities previously unrecognised to support an invisible and hard to reach target group as the young people in a NEET situation.
vivoBodySeg: Machine learning-based analysis of C. elegans immobilized in vivoChip for automated developmental toxicity testing
Authors: DuPlissis Andrew , Medewar Abhishri , Hegarty Evan , Laing Adam , Shen Amber , Gomez Sebastian , Mondal Sudip , Ben-Yakar Adela 
Published: September 2024

Abstract

Developmental toxicity (DevTox) tests evaluate the adverse effects of chemical exposures on an organism's development. While large animal tests are currently heavily relied on, the development of new approach methodologies (NAMs) is encouraging industries and regulatory agencies to evaluate these novel assays. Several practical advantages have made C. elegans a useful model for rapid toxicity testing and studying developmental biology. Although the potential to study DevTox is promising, current low-resolution and labor-intensive methodologies prohibit the use of C. elegans for sub-lethal DevTox studies at high throughputs. With the recent availability of a large-scale microfluidic device, vivoChip, we can now rapidly collect 3D high-resolution images of ~ 1,000 C. elegans from 24 different populations. In this paper, we demonstrate DevTox studies using a 2.5D U-Net architecture (vivoBodySeg) that can precisely segment C. elegans in images obtained from vivoChip devices, achieving an average Dice score of 97.80. The fully automated platform can analyze 36 GB data from each device to phenotype multiple body parameters within 35 min on a desktop PC at speeds ~ 140× faster than the manual analysis. Highly reproducible DevTox parameters (4–8% CV) and additional autofluorescence-based phenotypes allow us to assess the toxicity of chemicals with high statistical power.
The Impact of Post-Craniotomy Subdural Effusion in Pediatric Brain Tumors
Authors: Nien Ju-En , Lin Tzu-Chin , Wang Yi-Lun , Chang Tsung-Yen , Chen Shih-Hsiang , Wu Chieh-Tsai , Jaing Tang-Her 
Published: September 2024

Abstract

Purpose
Over recent decades, survival rates in pediatric brain tumors (PBT) have been significantly improved due to technological advancements in surgical approaches and intensified chemotherapy. Although disease relapse rates have been reduced, these treatments still come with unavoidable complications. Subdural effusion (SDE) is a significant complication that can occur after craniotomy, with its incidence depending on the surgical approach and potentially affecting the prognosis of the disease. The objective of this study is to examine the impact of post-craniotomy SDE on survival outcomes in patients with PBT.
Methods
Our study utilized a retrospective chart review to examine children diagnosed with PBT at Chang Gung Memorial Hospital between January 2013 and December 2023. Survival benefits were assessed using Kaplan-Meier analysis, while differences in continuous variables were examined using Student's t-tests. The statistical analyses were conducted using GraphPad Prism version 9.0 software.
Results
The study included 178 children diagnosed with PBT, and their progress was tracked for a median duration of 3.8 years (IQR 1.6–7.0). The diagnoses consisted of a variety of brain tumors. The incidence of post-craniotomy SDE was 21.3%. The majority of cases (66%) were managed through observation, while surgical intervention was necessary for 34% of cases. The study found that the presence of SDE was associated with slightly lower survival rates (18.4% vs. 15.0%) and slightly higher disease relapse rates (44.7% vs. 35.7%), although these differences did not reach statistical significance.
Conclusion
SDE is still a frequent complication that occurs after craniotomy in PBT patients. The presence of SDE can have a negative impact on both survival rates and the likelihood of disease relapse in PBT.
Significance of additional pulmonary blood flow between second and third stage in Fontan pathway
Authors: Januszewska Katarzyna , Nawrocki Pawel , Bruenen Andreas , Schnabel Alexander , Malec Edward 
Published: September 2024

Abstract

Background
The benefit of additional pulmonary blood flow (APBF) in Fontan pathway remains controversial. The aim of the study was to analyze the systemic arterial saturation, ventricular and atrioventricular (AV) valve function, development of pulmonary arteries and postoperative course after Fontan operation in children with preserved or eliminated APBF between stages 2 and 3 of the Fontan pathway.
Methods
A group of 180 consecutive children (median age: 2.92(1.83–16.83) years) with single ventricle underwent extracardiac conduit Fontan operation. The patients were retrospectively analyzed with respect to the presence of APBF between stages 2 and 3.
Results
Preoperative echocardiography showed no differences in ventricular function (good – 105[95%] vs. 65[98.5%]; reduced – 9[5%] vs 1[1.5%]; p = 0.07) or AV valve function (p = 0.78). There was no difference in oxygen saturation at admission (p = 0.48), in preoperative blood gas analysis (p = 0.62), or at the discharge (p = 0.73). There was no difference in size of the left pulmonary artery (9.5(0-16.2) vs 10.6 (4.9–21.7) mm; p = 0.13), however the right pulmonary artery was significantly larger (11.2(6.5–19.6) vs. 12.8(7.8–2.5) mm; p = 0.048) in APBF group. In this group the mean pressure in the pulmonary artery was significantly higher as well (8[4-17.5] vs 9.5[4-17.33] mmHg; p = 0.03).
Conclusions
APBF does not result in higher oxygen saturation, both before and after Fontan completion. APBF can stimulate the growth of the pulmonary arteries and increase the pulmonary artery pressure. The presence of APBF does not affect the post-operative course after Fontan operation, however it can increase the need of AV valve reconstruction in the longer follow-up.
Safety and Efficacy of Bhutanese Traditional Herbal Drug Formulary for Gastritis-Related Problems (SEDRU): a Nationwide Observational Study
Authors: Gyeltshen Dorji , Dorji Thinley , Pongpirul Krit , Tharpala Tharpala 
Published: September 2024

Abstract

Background
Gastritis-related symptoms, often manifesting as stomach disorders, are among the top ten diseases diagnosed and treated in traditional medicinal units (TMU) in Bhutan. This study evaluated the safety and potential efficacy of the currently used medications for stomach disorders in Bhutan.
Methods
This prospective observational study was conducted across all 63 TMUs in Bhutan over a six-month period in 2019. Patients presenting with gastritis-related symptoms were enrolled and monitored throughout the study. Adverse reactions were assessed using the Naranjo algorithm. The Severity of Dyspepsia Assessment (SODA) scores, both overall and recipe-specific, were recorded at baseline and at weekly follow-up visits. The changes in SODA scores over time were analyzed using repeated measures ANOVA to assess the efficacy of the herbal treatments.
Results
A total of 152 patients were included in the study, with baseline information available for 109 patients. Follow-up data were collected for 100 patients at one week, 88 patients at two weeks, 72 patients at three weeks, and 51 patients at four weeks. The most common prescribed herbal drugs were Sedru 5, Ruta 6 and Zhijay 6. The baseline SODA score averaged 54.4 (± 8.8), which decreased progressively to 50.0 (± 8.3) at week 1, 46.9 (± 8.0) at week 2, 42.7 (± 12.0) at week 3 and 38.9 (± 13.7) at week 4, with a statistically significant improvements (p < 0.001). Nine adverse drug events were reported, but there were no definite adverse drug reactions. Patient satisfaction with the traditional formulations also showed a significant improvement.
Conclusion
The study found significant improvements in both pain and non-pain symptoms of gastritis, as well as patient satisfaction, with the use of traditional Bhutanese herbal medicines. The absense of definite adverse drug reactions indicates a favorable safety profile for these treatments. This study marks the first time the traditional medicine system in Bhutan has adopted scientific measures to promote evidence-based clinical practice, demonstrating a significant step forward in integrating traditional knowledge with modern research methodologies.
Trial registration
: Thai Clinical Trials Registry TCTR20180430004 dated 30 April 2018.
Outcomes of Odontoid Fractures with Associated Cardiac Arrest: Retrospective Bi-Center Case Series and Systematic Literature Review
Authors: Schaible S. F. , Häckel S. , Rutsch N. , Aregger F. C. , Bigdon S. F. , Schoenborn V. , Broger I. , Albers C. E. , Tinner C. 
Published: September 2024

Abstract

Background:
Odontoid fractures from high-energy trauma are associated with significant morbidity and mortality, including spinal cord injury, neurological damage, and cardiac arrest. The literature on odontoid fractures leading to cardiac arrest is limited to isolated case reports. This study aims to conduct a retrospective bi-center case series and a systematic review of existing literature.
Methods:
We conducted a retrospective bi-center case series on patients with odontoid fractures from high-energy trauma who experienced post-traumatic cardiac arrest with return of spontaneous circulation (ROSC) after CPR from two Level 1 Trauma Centers (2008–2024). The primary outcome was mortality; secondary outcomes included epidemiological, pre-hospital, and in-hospital data, and CT and MRI findings. Additionally, we performed a systematic literature review to summarize existing evidence.
Results:
The study included 25 patients (mean age 71.1 ± 12.3 years, SD; 8 females). The mortality rate was 92% (23 patients). Median downtime before CPR was 5.0 minutes (IQR: 7.0), with CPR lasting 17.0 minutes (IQR: 13.0), primarily initiated by professionals (60%). All patients were quadriplegic. Type II Anderson d'Alonzo fractures were most common (88%), with all patients showing myelopathy on MRI. Only three patients (12%) underwent surgical intervention due to favorable prognosis. Our literature review identified seven case reports, with two patients surviving and one achieving full recovery.
Conclusions:
In this case series, patients experiencing cardiac arrest after odontoid fractures exhibited high mortality rates despite comprehensive management at Level 1 trauma centers. Survivors faced significant and enduring morbidity.