bluuebunny/crossref_metadata_2025_split huggingface dataset:
A machine learning–based clinical predictive tool to identify patients with a high risk of medication error
Authors: Abdo Ammar , Gallay Lyse , VALLECILLO Thibault , CLARENNE Justine , Quillet Pauline , VUIBLET Vincent , MERIEUX Rudy 
Published: October 2024

Abstract

A medication error is an inadvertent failure in the drug therapy process that can cause serious harm to patients by increasing morbidity and mortality and are associated with significant economic costs to the healthcare system. Medication reconciliation is the most cost-effective intervention and can result in a 66% reduction in medication errors. To improve patient safety, we developed a machine learning-based tool that prioritizes patients at risk of medication errors upon admission to the hospital to ensure that they undergo medication reconciliation by clinical pharmacists. The data were collected from the electronic health records of patients admitted to Reims University Hospital who underwent medication reconciliation between 2017 and 2023. The data from 12,604 patients were used to train four machine learning-based models based on 52 variables in the development dataset. These models were used to prioritize admitted patients according to their likelihood of being exposed to a medication error. Our models, particularly the voting classifier model, demonstrated good performance (a recall of 0.75, precision of 0.65, F1 score of 0.70 and AUROC of 0.74). In a retrospective evaluation simulating real-life use, the voting classifier model successfully identified 45% of the total patients selected who were found to have at least one unintended discrepancy compared to 21% when using the existing tool. The positive experimental results of this tool showed a superior improvement of 113% over the existing tool by targeting patients at risk of medication errors upon admission to Reims University Hospital.
The impact of prostate volume on Retzius-sparing robot-assisted laparoscopic radical prostatectomy with retrograde release of the neurovascular bundle
Authors: Liu Yang , Liu Zihao , Wang Zhun , Shao Yuan , Yang Zhen , Huang Hua , Wang Zeyuan , Fu Zhinan , Wen Simeng , Niu Yuanjie , Wang Yong 
Published: October 2024

Abstract

Objective: Robot-assisted radical prostatectomy (RARP) has emerged as a primary treatment modality for localized prostate cancer. In this context, we report a novel surgical technique termed Retzius-sparing robot-assisted laparoscopic radical prostatectomy with retrograde release of the neurovascular bundle (RNRS-RARP). This study aims to assess the perioperative, oncologic, and functional outcomes of RNRS-RARP across varying prostate volumes.
Methods: A retrospective analysis was conducted on clinical data retrieved from 298 patients who underwent RNRS-RARP from October 2021 to September 2023. Patients were stratified into three groups based on pathological prostate weight: ≤30g, 30-50g, and ≥50g. Comparative analyses were performed on perioperative and postoperative tumor and functional outcomes among the three groups to discern variations. Relevant analyses were conducted separately for patients who received neoadjuvant therapy and those who did not. Additionally, independent predictors influencing immediate continence following RNRS-RARP were investigated.
Results: Firstly, an association was observed between larger prostate volume and advanced patient age, elevated prostate-specific antigen levels, and higher body mass index. Secondly, patients with larger prostate volume exhibited prolonged console time and increased estimated blood loss, but it will not increase the duration of catheterization and the length of hospital stay and postoperative complications. Finally, immediate continence worsened with increasing prostate volume, and the areas under the curve of the predictive model based on prostate volume, age, and preoperative T stage was 0.751.
Conclusion: RNRS-RARP is an improvement on the posterior approach for RARP. It leads to better continence outcomes and can be done with any volume of prostate. However, larger prostate volume was associated with prolonged console time and inferior immediate continence, with prostate volume identified as an independent predictor of immediate continence following RNRS-RARP.
Clinical trial registration: The clinical trial registration number is ChiCTR2200066350 (December1, 2022).
Effect of Neutrophil Elastase Inhibitor (Sivelestat Sodium) on Oxygenation in Patients with Sepsis Induced Acute Respiratory Distress Syndrome
Authors: Wu Tiejun , Wang Tao , Jiang Jinjiao , Tang Yue , Zhang Lina , Jiang Zhiming , Liu Fen , Kong Guiqing , Zhou Tingfa , Liu Ruijin , Guo Haipeng , Xiao Jie , Sun Wenqing , Li Yuye , Zhu Yingying , Liu Quan , Xie Weifeng , Qu Yan , Wang Xiaozhi 
Published: October 2024

Abstract

Objectives
Neutrophil elastase (NE) plays an important role in the development of acute respiratory distress syndrome (ARDS). As a selective NE inhibitor, Sivelestat may improve the outcomes of patients with sepsis-induced ARDS in previous studies, but there is a lack of solid evidence. This trial aimed to evaluate the effect of sivelestat sodium on oxygenation in patients with sepsis-induced ARDS.
Methods
We conducted a multicenter, double-blind, randomized, placebo-controlled trial enrolling patients diagnosed with sepsis-induced ARDS admitted within 48 hours of the advent of symptoms. Patients were randomized in a 1:1 fashion to sivelestat or placebo. Trial drugs were administrated as a 24-hour continuous intravenous infusion for a minimum duration of 5 days and a maximum duration of 14 days. The primary outcome was the proportion of PaO2/FiO2 ratio improvement on Day5 after randomization, defined by a greater than 50% improvement in PaO2/FiO2 compared with that on ICU admission or PaO2/FiO2 reached over 300 mmHg on Day5.
Results
The study was stopped midway due to a potential between-group difference in mortality observed during the interim analysis. Overall, a total of 70 patients were randomized, of whom 34 were assigned to receive sivelastat sodium and 36 placebo. On day5, 19/34 (55.9%) patients in the sivelastat group had PaO2/FiO2 ratio improvement compared with 7/36 (19.4%) patients in the placebo group (risk difference, 0.36; 95% CI, 0.14 to 0.56, p < 0.001). The Kaplan-Meier curves showed a significantly improved 28-day survival rate in patients receiving sivelestat than those not (hazard ratio, 0.32; 95% CI, 0.11 to 0.95; p = 0.041).
Conclusion
In patients with sepsis-induced ARDS, sivelestat sodium could improve oxygenation within the first five days and may be associated with decreased 28-day mortality.
A 41-Year-Old Male with "Grape-Like" Ureteral Carcinoma: A Case Report and Brief Review
Authors: Li Yue , Liang Ning , Dong Changming , Tao Huiying , Yu Tianxi , Wu Shuang , Xie Hao , Guo Jiahao , Lv Wei , Lin Chunhua 
Published: October 2024

Abstract

Ureteral carcinoma, a rare malignancy, is often characterized by the presence of solitary lesions in the ureter. Early diagnosis and effective management are compounded by nonspecific clinical symptoms and radiographic findings. Here, we present a case of a 41-year-old male with a tumor that nearly spanned the entire length of the right ureter. Multi-regional genomic sequencing of the tumor revealed a pattern of branch evolution in this patient, accompanied by a complex genomic mutational landscape.
Multiscale Gradients of Corticopontine Structural Connectivity
Authors: Rousseau Paul-Noel , Bazin Pierre-Louis , Steele Christopher J. 
Published: October 2024

Abstract

The cerebellum’s involvement in a range of cognitive, emotional, and motor processes has become increasingly evident. Given the uniformity of the cerebellar cortex’s cellular architecture its contributions to varied processes are thought be partially mediated by its patterns of reciprocal connectivity with the rest of the brain. A better understanding of these connections is therefore fundamental to disentangling the cerebellum’s contribution to cognition and behavior. While these connections have been studied extensively in non-human animals using invasive methods, we have limited knowledge of these connections in humans. The current work reconstructed the corticopontine projection, the first segment of downstream connections between the cerebral and cerebellar cortices, with diffusion MRI tractography in human in-vivo whole brain data and an independent higher resolution postmortem brainstem dataset. Dimensionality reduction was used to characterize the pattern of connectivity of cerebral cortical projections to the pons as two overlapping gradients that were consistent across participants and datasets: medial to lateral and core to belt. Our findings align with invasive work done in animals and advance our understanding of this connection in humans – providing valuable context to a growing body of cerebellar research, offering insights into impacts of damage along the pathway, and informing clinical interventions.
Clinical Features and Nursing Strategies of Reexploration for Hematomas after Thyroid Surgery: Insights from a 7-Year Single-Center Study in China
Authors: Zhang Xiuting , Hu Benling , Xiao Jiayu , Zhang Xuesong , Zhang Jingya , Zhu Liqing , Kuang Yanbing , Weng Yujing 
Published: October 2024

Abstract

Objective
To explore clinical characteristics of postoperative hemorrhage following thyroid or parathyroid surgery, and to discuss the nursing strategies for its prevention.
Methods
A retrospective analysis was conducted on all patients who underwent thyroid or parathyroid surgery from February 2016 to September 2023. The clinical data of patients who experienced postoperative hemorrhage and required reoperation were collected and analyzed.
Results
Among the 5579 patients who underwent surgery, 42 patients experienced postoperative hemorrhage and required reoperation. Hemorrhage occurred within 6 hours in 19 cases (45.2%) and within 24 hours in 35 cases (83.3%). The most common bleeding sites were the anterior cervical muscle group (44.2%) and branches of the superior or inferior thyroid artery (20.9%). Underlying diseases such as hypertension, diabetes, hemophilia, and postoperative activities like neck movements, coughing, vomiting, and drainage tube manipulation were potential risk factors for postoperative hemorrhage. Clinical manifestations of postoperative hemorrhage included neck swelling or tightness, increased drainage fluid with clots, incision bleeding, pain, skin bruising, and worsening dyspnea.
Conclusion
Understanding the potential risk factors and characteristics of postoperative hemorrhage in thyroid surgery is crucial for specialized thyroid nursing care, as it can aid in its prevention and treatment.
GLUT1 and cerebral glucose hypometabolism in human focal cortical dysplasia is associated with hypermethylation of key glucose regulatory genes
Authors: Ghosh Chaitali , Westcott Rosemary , Skvasik David , Khurana Ishant , Khoury Jean , Blumcke Ingmar , El-Osta Assam , Najm Imad M. 
Published: October 2024

Abstract

Focal cortical dysplasia (FCD) is recognized as a significant etiological factor in pharmacoresistant intractable epilepsy, linked with disturbances in neurovascular metabolism. Our study investigated regulation of glucose-transporter1 (GLUT1) and cerebral hypometabolism within FCD subtypes. Surgically excised human brain specimens underwent histopathological categorization. A subset of samples (paired with matching blood) was assessed for DNA methylation changes of glucose metabolism-related genes. We evaluated GLUT1, VEGFα, MCT2, and mTOR expression by western blot analysis, measured glucose-lactate concentrations, and established correlations with patients’ demographic and clinical profiles. Furthermore, we investigated the impact of DNA methylation inhibitor decitabine and hypometabolic condition on the uptake of [3H]-2-deoxyglucose and ATPase in epileptic brain endothelial cells (EPI-EC). We observed hypermethylation of GLUT1 and glucose metabolic genes in FCD brain/blood samples and could distinguish FCDIIa/b from mMCD, MOGHE and non-lesional types in brain. Low GLUT1 and glucose-lactate ratios corresponded to elevated VEGFα and MCT2 in FCDIIa/b vs non-lesional tissues, independent of age, gender, seizure-onset, or duration of epilepsy. Increased mTOR signaling in FCDIIa/b tissues was evident. Decitabine stimulation increased GLUT1, decreased VEGFα expression, restored glucose uptake and ATPase activity in EPI-ECs and reduced mTOR and MCT2 levels in HEK cells. We demonstrated: 1) hypermethylation of glucose regulatory genes distinguish FCDIIa/b from mMCD, MOGHE and non-lesional types, 2) glucose uptake reduction is due to GLUT1 suppression mediated possibly by a GLUT1-mTOR mechanism; and 3) DNA methylation regulates cellular glucose update and metabolism. Together, these studies may lead to GLUT1-mediated biomarkers, glucose metabolism and identify early intervention strategies in FCD.
Breastfeeding Rates in Israel and their Health Policy Implications.
Authors: Zimmerman Deena R. , Brooks Nati , Wasser Janice , Vaknin-Alon Linoy , Dweck Tunie , Alroy-Preis Sharon 
Published: October 2024

Abstract

Background
Monitoring breastfeeding rates has important health policy implications, as breastfeeding has significant positive impacts on maternal and child health and healthcare costs. This up-to-date, national, population-based breastfeeding rates study in Israel provides important information for health policy development.
Methods
Breastfeeding rates were determined for the years 2016-2022 by retrospective analysis of Machshava Briah electronic medical records used by many Israeli Maternal and Child Health Clinics. This reflects approximately 70% of Israeli children with a nationwide distribution. Comparisons were conducted measuring breastfeeding rates over time and between different sub-groups.
Results
The dataset consists of 945,437 infant records. The percentages of women with any breastfeeding as well as exclusive breastfeeding have shown a gradual decline annually from 2016 to 2022 and are lower than international goals. Sub-group analyses were conducted for 2022. Breastfeeding rates were higher among multipara mothers (versus primapara). Singleton mothers had much higher breastfeeding rates than twin mothers with the difference even more pronounced in exclusive breastfeeding rates. Mothers of preterm infants (<37 weeks) and low birthweight infants breastfed less than mothers of full term infants and normal birthweight and were less likely to exclusively breastfeed. Mothers living in urban areas had the highest rates of breastfeeding and those living in rural areas had the lowest.
A subanalysis performed at two months postpartum for 2022 found the effect of maternal age with the highest rates of breastfeeding among 20-24 year old mothers.Inter-pregnancy interval also had an effect with the highest rates among those whose last pregnancy was 21-33 months ago and the lowest rates among those with an interval of < 1 year.
Conclusions
The population-based data provides an important baseline marker. This study shows a drop in breastfeeding rates, indicating a need to investigate reasons for discontinuing breastfeeding and identifying possible areas for offering support. This data and similar follow-up studies provide the background evidence to warrant that Ministry of Health policies in the hospitals and in the community help accomplish their goals.
The Internal Fixation Selection and Positioning for Proximal Femoral Basicervical Fractures: A Biomechanical Study Through Finite Element Analysis
Authors: Yang Tianhao , Noraddin Faez , Liu Baozhe , Zhang Zegen , Gu Hai-Lun 
Published: October 2024

Abstract

Objectives: This study aims to determine the most suitable implant for proximal femoral basicervical fractures by comparing the biomechanical characteristics of the Dynamic Hip Screw (DHS), Proximal Femoral Nail Anti-Rotation (PFNA), and InterTAN implants through finite element analysis (FEA).
Methods: Thefive fixation styles, namely DHS with a central hip screw in Anteroposterior view , PFNA with a centrally positioned helical blade (PFNA-center), PFNA with an inferiorly positioned helical blade (PFNA-inferior), InterTAN with a centrally positioned hip screw (InterTAN-center), and InterTAN with an inferiorly positioned hip screw (InterTAN-inferior), were simulated. After a three-dimension model of an intact femur was constructed and validated, three distinct basicervical fracture patterns, namely simple, intertrochanteric defect, and lateral wall defect, characterized by increasing displacement and/or bone loss with subsequent instability, were created and incorporated with the aforementioned implants. The models were subjected to FEA, and A load of 700 N was applied to simulate a 70 kg patient standing on one leg. The displacement and stress distributions on implants were analyzed for comparison between implants. Under each basicervical fracture type, we mainly compared DHS, PFNA-center, and InterTAN-center to assess the best implant performance. In addition, we compared PFNA-center and InterTAN-center with PFNA-inferior and InterTAN-inferior to assess the best hip screw position.
Results: In the simple basicervical fracture, DHS, PFNA, and InterTAN exhibited similar and small results in displacement and maximum stress in implants. In the intertrochanteric defect and lateral wall defect basicervical fractures, notable differences were observed within implants. The displacement was greatest with the DHS, followed by the PFNA, then InterTAN(minimal different between PFNA and InterTAN). In contrast, the maximum stress was highest with InterTAN and was higher with PFNA than with DHS, with none of them exceeding the fatigue limit of medical titanium. Regarding the hip screw position with the cephalomedullary nails, the inferior position showed biomechanical parameters advantages compared with the central position.
Conclusion: DHS, PFNA, and InterTAN are all suitable for the management of simple basicervical fractures. In the intertrochanteric defect and lateral wall defect basicervical fracture types, the cephalomedullary nail showed better mechanical stability and is preferred over DHS, with InterTAN showing slightly better stability compared to PFNA. The inferior hip screw position in cephalomedullary nails is preferable over the central hip screw position.
Association of Lymphocyte Subsets Percentage with Prognosis for Recurrent or Metastatic Nasopharyngeal Carcinoma Patients Receiving PD-L1 Inhibitors
Authors: Diao Jianming , Wei Zhigong , Pei Yiyan , Ge Junyou , Qing Yan , Wei Youneng , Peng Xingchen , Chen Ye 
Published: October 2024

Abstract

Background: Immune checkpoint inhibitors (ICIs), particularly PD-1/PD-L1 inhibitors, have demonstrated significant survival benefits in treating recurrent or metastatic nasopharyngeal carcinoma (R/M-NPC). While baseline peripheral blood lymphocyte subsets have been identified as prognostic biomarkers in various cancers treated with ICIs, their relevance in R/M-NPC has not been extensively studied.
Methods: This post-hoc analysis used data from 153 R/M-NPC patients treated with PD-L1 inhibitor monotherapy in the phase 2 trial KL167-2-05-CTP. The lymphocyte subsets, including total T cells, CD4/CD8 ratio, helper T cells, suppressor cytotoxic T cells, NK cells, and B cells, were tested by flow cytometry. These subsets were grouped using optimal cutoff values identified by the Maximally Selected Log-rank Statistic. Overall survival (OS) and progression-free survival (PFS) were assessed using Kaplan-Meier and Cox regression analysis, and logistic regression analysis evaluated the associations with objective response rate (ORR) and disease control rate (DCR).
Results: Patients with lower NK cell percentages showed significantly longer OS (26.3 vs. 12.1 months, p<0.001) and PFS (5.5 vs. 3.7 months, p<0.001) compared to those with higher NK cell percentages. No significant differences in OS or PFS were observed for other lymphocyte subsets. High NK cell percentages were identified as risk factors for shorter OS (HR, 2.49) and PFS (HR, 1.62). There were no significant differences in ORR and DCR between high and low lymphocyte subsets.
Conclusion: Lower baseline NK cell percentages are associated with improved OS and PFS in R/M-NPC patients undergoing PD-L1 inhibitor therapy.
The 28th February 1969 earthquake and tsunami in the Atlantic Iberian margin
Authors: Baptista Maria Ana , Miranda Jorge Miguel , Omira Rachid 
Published: October 2024

Abstract

On the 28th February1969, a massive earthquake stroke SW Iberia and NE Morocco triggering a tsunami recorded in more than 20 tide stations. The event occurred in the SW Iberian margin, the same seismogenic area of the 1st November 1755 mega event. Several studies were developed in the last 55 years to address its earthquake mechanism and the corresponding tsunami source. In some cases, the study of the 1969 event was also the base for inferences regarding the 1755 earthquake and indirectly to give some light on tsunamigenic processes related with the SW Iberian margin. In this study, we present a comprehensive review of the tsunami data, taking advantage from the great improvement that occurred on the quality of the bathymetric data, particularly on the shallow areas close to the tide stations. We used a larger set of tide-records than previous studies. All records were digitized from the original mareograms and processed them according to modern standards. We address the possible landslide triggered at the NW coast of Morocco as the explanation of the tsunami observation at Casablanca. The new dataset combining both the earthquake and the landslide sources allows a better relocation of the tsunami source, enabling a quantitative comparison of the different source scenarios that have been developed for seismological research. The simulations presented here suggest that a thrust fault of 85 km x 20 km verging to the southeast is the best candidate to be responsible for the 1969 earthquake. The trace of this deep fault follows the one of the “Horseshoe Fault”, a northwest verging structure interpreted from the multichannel seismic data. Moreover, this deep structure may be accountable for both the 1969 event and the later 12th February 2007 M6 earthquake. Even more, the “Deep Horseshoe Fault” is a strong candidate to be the source of the 1st November 1755 event up to now elusive to multiple geological and geophysical studies.