bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unleashing the potential of eHealth in outpatient cancer care for patients undergoing immunotherapy—a quantitative study considering patients’ needs and current healthcare challenges
Authors: Holderried Tobias A. W. , Stasik Isabel , Schmitz Marie-Therese , Schmitz Friederike , Meyer Tizian K. , Stauß Leonie , Kirschner Martin , Skowasch Dirk , Landsberg Jennifer , Schmid Matthias , Brossart Peter , Holderried Martin 
Published: October 2024

BackgroundThe use of online information and communication is globally increasing in the healthcare sector. In addition to known benefits in other medical fields, possible specific potentials of eHealth lie in the monitoring of oncological patients undergoing outpatient therapy. Specifically, the treatment with immune checkpoint inhibitors (ICI) requires intensive monitoring due to various possible negative side effects. The present study explores cancer patients’ perspectives on eHealth and demonstrates how eHealth applications, from the patients’ point of view, can contribute to further improving outpatient immunotherapy.Methods and findingsOur multicenter study was executed at the university hospitals in Bonn and Aachen. A structured questionnaire was distributed to patients receiving outpatient immunotherapy. Contents addressed were (1) the patients’ attitude towards eHealth applications, (2) the use of modern information and communications technologies (ICT) in (2a) everyday life and (2b) health-related information search including eHealth literacy, (3) the use of internet-enabled devices as well as (4) socio-demographic data. 164 patients were included in the study, of whom 39.0% were female and 61.0% male and the average age was 62.8 years. Overall, there was a high distribution of internet-enabled devices for everyday use and a great interest in integrating eHealth applications into outpatient immunotherapy. The assessment of eHealth potentials significantly depended on age. The younger participants demonstrated a broader use of modern ICT and a higher affinity for its use in outpatient immunotherapy. In some aspects, level of education and gender were also relevant factors influencing the patients’ view on eHealth.ConclusionThis study demonstrates the potential for further integration of eHealth applications into outpatient immunotherapy from the patients’ perspective. It indicates a dependency on age and educational level for the further integration of eHealth into patient care in oncology. Due to particular patient needs regarding age, level of education, gender and other subgroups, specific education and training as well as target-group specific digital health interventions are necessary to fully utilize the potentials of eHealth for outpatient immunotherapy. Future studies are required to specifically address target-group specific usability of eHealth applications and eHealth literacy, as well as to address information security and data protection.
Genetically mimicked effects of thyroid dysfunction on diabetic retinopathy risk: a 2-sample univariable and multivariable Mendelian randomization study
Authors: Ouyang Junlin , Zhou Ling , Wang Qing , Yan Wei 
Published: October 2024

BackgroundThyroid dysfunction exhibits a heightened prevalence among people with diabetes compared to those without diabetes. Furthermore, TD emerges as a notable correlated risk factor for the onset of diabetic retinopathy.MethodsUsing data from the FinnGen database (R9), we investigated the causal relationship between thyroid dysfunction (TD) and four stages of diabetic retinopathy (DR). A two-sample univariable Mendelian randomization (UVMR) approach was employed to estimate the total causal effect of TD on four stages of DR, while multivariable Mendelian randomization (MVMR) was used to assess the direct causal effect. The meta-analysis was conducted to summarize the collective effect of TD on four stages of DR. The inverse variance weighted (IVW) method was the primary approach for Mendelian randomization analysis, with heterogeneity, horizontal pleiotropy, and leave-one-out sensitivity analyses performed to validate the robustness of the findings.ResultsIn UVMR analysis, thyrotoxicosis (TOS) was significantly associated with an increased risk of diabetic retinopathy across four stages (OR, 1.10–1.19; P&lt;0.025). However, MVMR analysis, after adjusting for Graves’ disease (GD) and/or rheumatoid arthritis (RA), revealed no significant association between TOS and the four stages of diabetic retinopathy. The Meta-analysis demonstrated the collective effect of TOS on diabetic retinopathy across all stages [OR=1.11; 95% CI (1.08–1.15); P&lt;0.01]. In UVMR analysis, the estimates for hypothyroidism (HPT) and GD were similar to those for TOS. In the MVMR analysis, after adjusting for RA, the significant effect of HPT on DR and non-proliferative diabetic retinopathy (NPDR) remained. Additionally, MVMR analysis suggested that the estimates for GD on DR were not affected by TOS, except for GD-proliferative diabetic retinopathy (PDR). However, no significant correlation persisted after adjusting for RA, including for GD-PDR.ConclusionOur study demonstrated a significant association between thyroid dysfunction TD and DR, with the relationship being particularly pronounced in HPT-DR.
Comparison of protective effects of teneligliptin and luseogliflozin on pancreatic β-cell function: randomized, parallel-group, multicenter, open-label study (SECRETE-I study)
Authors: Shimoda Masashi , Katakura Yukino , Mashiko Akiko , Iwamoto Masahiro , Nakanishi Shuhei , Anno Takatoshi , Kawasaki Fumiko , Obata Atsushi , Fushimi Yoshiro , Sanada Junpei , Kohara Kenji , Isobe Hayato , Iwamoto Yuichiro , Hirukawa Hidenori , Tatsumi Fuminori , Kimura Yukiko , Kimura Tomohiko , Mune Tomoatsu , Kaku Kohei , Kaneto Hideaki 
Published: October 2024

AimsThe aim of this study is to directly compare the effects of SGLT2 inhibitors and DPP-4 inhibitors on β-cell function in patients with type 2 diabetes.Materials and methodsWe conducted a 26-week, randomized, open-label, parallel-group study, including a 1-2 week drug washout period, in patients with type 2 diabetes with HbA1c ≥7.0% and &lt;9.0% and BMI ≥20 kg/m2 despite treatment with a drug naïve or other than DPP-4 inhibitors or SGLT2 inhibitors. A total of 103 subjects were randomly assigned to receive once daily oral luseogliflozin (L) or teneligliptin (T). The primary endpoint was the effect of L vs. T on the change in logarithmus naturalis (Ln) disposition index (DI) (DI 0-120min; combining measures of insulin secretion and sensitivity) from baseline to week 25-26 (post intervention), which was calculated by conducting an oral glucose tolerance test.ResultsLn DI 0-120min were improved in both groups: -0.46 ± 0.68 to -0.20 ± 0.59 (p=0.03) in L group and -0.26 ± 0.60 to -0.05 ± 0.62 (p=0.01) in T group. The change in Ln serum proinsulin/C-peptide ratio, a marker of β-cell dysfunction, was reduced in L group (1.63 ± 0.63 to 1.56 ± 0.68, p=0.16), but rather increased in T group (1.70 ± 0.75 to 1.90 ± 0.51, p=0.01), with significant difference between the two groups (-0.27; p=0.004).ConclusionsImprovement of disposition index in subjects with obese type 2 diabetes was comparable between luseogliflozin and teneligliptin. On the other hand, it is likely that alleviation of β-cell dysfunction is more effective with luseogliflozin compared to tenegliptin.Clinical trial registrationhttps://rctportal.niph.go.jp/en, identifier jRCTs061190008.
Knowledge and attitudes of hand, foot, and mouth disease infection among medical students and physicians at the University of Jeddah
Authors: Alshahrani Najim Z. , Bukhari Suzan M. , Bukhari Lujain M. , Alghamdi Lama S. , Aljohani Shouq R. , Ghurab Radwan A. 
Published: October 2024

BackgroundRecent HFMD cases have surged in Saudi Arabia, highlighting a literature gap on healthcare professionals’ understanding and attitudes towards HFMD. This study evaluates and compares knowledge and attitudes among medical students and physicians at the University of Jeddah.MethodsAn analytical cross-sectional study design was employed to survey medical students and physicians at the University of Jeddah from 1 November 2023 to 1 January 2024. Participants were assessed using multiple-item scales to measure their knowledge (max score: 23) and attitudes (max score: 32) towards HFMD. Logistic regression analysis was utilized to explore the association between various independent factors and the outcomes of interest (knowledge and attitude levels).ResultsA total of 317 responses (260 medical students and 57 physicians) were analyzed. Among medical students, the analysis of knowledge scores revealed a mean score of 6.36, with a standard deviation (SD) of 5.68, a median score of 6, and an interquartile range (IQR) of 0-10. About 31.6% of the students demonstrated adequate knowledge of HFMD. Notably, students who had received education on HFMD showed significantly higher levels of knowledge compared to those who had not. For student attitudes towards HFMD, the mean score in the attitude group was 20.1, with a SD of 4.2, a median of 20, and an IQR of 16 to 23. Among physicians, the mean knowledge score for those with adequate knowledge was 14.3, with a SD of 4.3 and a median of 15, and an IQR of 12-18. Furthermore, 54.4% of the physicians showed good knowledge, with being single significantly associated with this higher level of knowledge. In terms of attitudes among physicians, the mean score for the positive attitude group was 19.8, with a SD of 5.92, and a median score of 20, with an IQR of 16 to 25.ConclusionThe study highlights a significant gap in knowledge and attitudes towards HFMD among healthcare professionals in Saudi Arabia.
Development and construction of a cataract risk prediction model based on biochemical indices: the National Health and Nutrition Examination Survey, 2005–2008
Authors: Wang Guoqing , Yi Xiang-Long 
Published: October 2024

PurposeThe aim of this study is to develop and validate a novel multivariable prediction model capable of accurately estimating the probability of cataract development, utilizing parameters such as blood biochemical markers and age.DesignThis population-based cross-sectional study comprised 9,566 participants drawn from the National Health and Nutrition Examination Survey (NHANES) across the 2005–2008 cycles.MethodsDemographic information and laboratory test results from the patients were collected and analyzed using LASSO regression and multivariate logistic regression to accurately capture the influence of biochemical indicators on the outcomes. The SHAP (Shapley Additive Explanations) scale was employed to assess the importance of each clinical feature, excluding age. A multivariate logistic regression model was then developed and visualized as a nomogram. To assess the model’s performance, its discrimination, calibration, and clinical utility were evaluated using receiver operating characteristic (ROC) curves, 10-fold cross-validation, Hosmer-Lemeshow calibration curves, and decision curve analysis (DCA), respectively.ResultsLogistic regression analysis identified age, erythrocyte folate (nmol/L), blood glucose (mmol/L), and blood urea nitrogen (mmol/L) as independent risk factors for cataract, and these variables were incorporated into a multivariate logistic regression-based nomogram for cataract risk prediction. The area under the receiver operating characteristic (ROC) curve (AUC) for cataract risk prediction was 0.917 (95% CI: 0.9067–0.9273) in the training cohort, and 0.9148 (95% CI: 0.8979–0.9316) in the validation cohort. The Hosmer-Lemeshow calibration curve demonstrated a good fit, indicating strong model calibration. Ten-fold cross-validation confirmed the logistic regression model’s robust predictive performance and stability during internal validation. Decision curve analysis (DCA) demonstrated that the nomogram prediction model provided greater clinical benefit for predicting cataract risk when the patient’s threshold probability ranged from 0.10 to 0.90.ConclusionThis study identified blood urea nitrogen (mmol/L), serum glucose (mmol/L), and erythrocyte folate (mmol/L) as significant risk factors for cataract. A risk prediction model was developed, demonstrating strong predictive accuracy and clinical utility, offering clinicians a reliable tool for early and effective diagnosis. Cataract development may be delayed by reducing levels of blood urea nitrogen, serum glucose, and erythrocyte folate through lifestyle improvements and dietary modifications.
A cross-sectional study of evidence-based practice and its determinants among healthcare professionals in Northwest Ethiopia
Authors: Melkamu Yideg , Asemahagn Mulusew Andualem , Walle Ayinengida Adamu , Tsega Yawkal 
Published: October 2024

BackgroundEvidence-based practice (EBP) is the integration of current best evidence with clinical expertise by considering patient preferences and values. Evidence based practice has not been well studied in Ethiopia. Therefore, this study aimed to assess EBP and its determinants among health professionals working at primary public hospitals in the Central Gondar zone, Northwest Ethiopia.MethodsA facility-based cross-sectional study was conducted on 422 health professionals. A simple random sampling technique was used to select the study participants. The data were entered into EpiData version 4.6 and exported to SPSS version 25 for analysis. The descriptive, bivariable, and multivariable logistic regression analysis were conducted. Adjusted Odds Ratio (AOR) with 95% confidence intervals and p-value &lt;0.05 were used to assess association of explanatory variables with EBP and declare statistical significance, respectively.ResultAbout 44.1% (95%CI: 39, 50%) of healthcare professionals had good evidence-based practice. Educational status (AOR: 3.05, CI: 1.07–8.66), spare time (AOR: 1.90, CI: 1.09, 3.31), good knowledge (AOR: 7.95, CI: 4.83, 13.08), good skill (AOR: 2.39: CI: 1.27, 4.53), training (AOR: 2.13, CI: 1.26, 3.58), and internet access (AOR = 2.02: 95% CI: 1.25–3.27) were found to be significant predictors of evidence-based practice.ConclusionThis study revealed that EBP was low compared to national standards. Moreover, having good knowledge and skill about evidence-based practice, being trained, having spare time and internet access and upgrading educational status of health care professionals would enhance good evidence-based practice.
Fecal bile acid dysmetabolism and reduced ursodeoxycholic acid correlate with novel microbial signatures in feline chronic kidney disease
Authors: Rowe John C. , Summers Stacie C. , Quimby Jessica M. , Winston Jenessa A. 
Published: October 2024

BackgroundMicrobial-derived secondary bile acids (SBAs) are reabsorbed and sensed via host receptors modulating cellular inflammation and fibrosis. Feline chronic kidney disease (CKD) occurs with progressive renal inflammation and fibrosis, mirroring the disease pathophysiology of human CKD patients.MethodsProspective cross-sectional study compared healthy cats (n = 6) with CKD (IRIS Stage 2 n = 17, Stage 3 or 4 n = 11). Single timepoint fecal samples from all cats underwent targeted bile acid metabolomics. 16S rRNA gene amplicon sequencing using DADA2 with SILVA taxonomy characterized the fecal microbiota.ResultsCKD cats had significantly reduced fecal concentrations (median 12.8 ng/mg, Mann–Whitney p = 0.0127) of the SBA ursodeoxycholic acid (UDCA) compared to healthy cats (median 39.4 ng/mg). Bile acid dysmetabolism characterized by &lt;50% SBAs was present in 8/28 CKD and 0/6 healthy cats. Beta diversity significantly differed between cats with &lt;50% SBAs and &gt; 50% SBAs (PERMANOVA p &lt; 0.0001). Twenty-six amplicon sequence variants (ASVs) with &gt;97% nucleotide identity to Peptacetobacter hiranonis were identified. P. hiranonis combined relative abundance was significantly reduced (median 2.1%) in CKD cats with &lt;50% SBAs compared to CKD cats with &gt;50% SBAs (median 13.9%, adjusted p = 0.0002) and healthy cats with &gt;50% SBAs (median 15.5%, adjusted p = 0.0112). P. hiranonis combined relative abundance was significantly positively correlated with the SBAs deoxycholic acid (Spearman r = 0.5218, adjusted p = 0.0407) and lithocholic acid (Spearman r = 0.5615, adjusted p = 0.0156). Three Oscillospirales ASVs and a Roseburia ASV were also identified as significantly correlated with fecal SBAs.Clinical and translational importanceThe gut-kidney axis mediated through microbial-derived SBAs appears relevant to the spontaneous animal CKD model of domestic cats. This includes reduced fecal concentrations of the microbial-derived SBA UDCA, known to regulate inflammation and fibrosis and be reno-protective. Microbes correlated with fecal SBAs include bai operon containing P. hiranonis, as well as members of Oscillospirales, which also harbor a functional bai operon. Ultimately, CKD cats represent a translational opportunity to study the role of SBAs in the gut-kidney axis, including the potential to identify novel microbial-directed therapeutics to mitigate CKD pathogenesis in veterinary patients and humans alike.
The clinical course of SARS-CoV-2 infection in patients with glomerular diseases and evaluation of the subsequent risk of relapse
Authors: Lionaki Sophia , Dounousi Evangelia , Marinaki Smaragdi , Kantartzi Konstantia , Papasotiriou Marios , Galitsiou Dimitra , Bellos Ioannis , Sardeli Aggeliki , Kalogeropoulos Petros , Liakopoulos Vassilios , Mpintas Christos , Goumenos Dimitrios , Flouda Sophia , Venetsanopoulou Aliki , Voulgari Paraskevi , Andronikidi Eva , Moustakas Georgios , Panagoutsos Stylianos , Boletis Ioannis 
Published: October 2024

IntroductionThis study aimed to describe the clinical course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with glomerular diseases (GDs) and its impact on the probability of relapse.MethodsPatients with biopsy-proven GD and positive PCR test for SARS-CoV-2 from glomerular clinics across Greece were studied retrospectively. Those who received the GD diagnosis after the SARS-CoV-2 vaccination or coronavirus disease 2019 (COVID-19) or ended in ESKD prior to infection were excluded. Demographics, histopathological diagnoses, past medical history, immunosuppression, and GD activity status were recorded.ResultsA total of 219 patients with GDs and documented SARS-CoV-2 infection were included. The mean time from the diagnostic kidney biopsy to SARS-CoV-2 infection was 67.6 ( ± 59.3) months. Among the participants, 82.5% had been vaccinated against SARS-CoV-2 with three doses (range: 2.5–3) without subsequent GD reactivation in 96.2% of them. Twenty-two patients (10%) were hospitalized for COVID-19 and one (0.5%) required mechanical ventilation. Four (1.8%) died due to COVID-19 and one (0.5%) had long COVID-19 symptoms. Among patients in remission prior to SARS-CoV-2 infection, 22 (11.2%) experienced a GD relapse within 2.2 (range: 1.5–3.7) months from the diagnostic test. The relapse-free survival after COVID-19 was significantly shorter for patients with minimal change disease, pauci-immune glomerulonephritis, and focal segmental glomerulosclerosis. No difference was observed in the relapse-free survival post-COVID-19 based on the history of SARS-CoV-2 vaccination.ConclusionsSARS-CoV-2 infection appears to have a symptomatic but uncomplicated sequence in vaccinated patients with GDs, with a significant impact on the clinical course of GD, associated with an increased probability of relapse in certain histopathological types.
Investigating the impact of mental rehearsal on prefrontal and motor cortical haemodynamic responses in surgeons using optical neuroimaging
Authors: Modi Hemel N. , Osborne-Grinter Maia , Patel Ronak , Darzi Ara , Leff Daniel R. , Singh Harsimrat 
Published: October 2024

IntroductionInadequate exposure to real-life operating can impede timely acquisition of technical competence among surgical residents, and is a major challenge faced in the current training climate. Mental rehearsal (MR)—the cognitive rehearsal of a motor task without overt physical movement—has been shown to accelerate surgical skills learning. However, the neuroplastic effect of MR of a complex bimanual surgical task is unknown. The aim of this study is to use functional near-infrared spectroscopy (fNIRS) to assess the impact of MR on prefrontal and motor cortical activation during a laparoscopic knot tying task.MethodsTwelve surgical residents performed a laparoscopic knot tying task before and after either mental rehearsal (MR, intervention group) or textbook reading (TR, control group). In both groups, fNIRS was used to measure changes in oxygenated hemoglobin concentration (HbO2) in the prefrontal (24 channels) and motor cortices (22 channels). Technical performance was measured using leak volume, objective performance score and task progression score.ResultsMR led to a decrease in HbO2 (reduced activation) in the bilateral prefrontal cortex (PFC), and an increase in HbO2 (increased activation) in the left middle frontal gyrus, left precentral gyrus, and left postcentral gyrus. No discernible changes in activation were observed after TR in either the PFC or motor cortex. Moreover, smaller ΔHbO2 responses in the right PFC and greater ΔHbO2 responses in the left motor cortex were observed in the MR group compared with the TR group. Leak volume was significantly less following MR (p = 0.019), but not after TR (p = 0.347). Mean objective performance score was significantly higher following MR compared with TR (p = 0.043).ConclusionMental rehearsal may enhance surgical skill acquisition and technical proficiency by reducing utilization of attentional resources in the prefrontal cortex and improving neural efficiency in motor areas during a laparoscopic surgical task.
Application of Electronic tongue and HPLC in rapid determination of functional triterpenes and origins of Ganoderma lucidum
Authors: Tian Jing , Wei Jinfeng , Liu Yuxin , Li Changqin , Ma Changyang , Kang Wenyi 
Published: October 2024

IntroductionGanoderma lucidum is one well known functional food resource. The triterpenes, such as Ganoderic acid A and Ganoderic acid D, as well as the sensory characteristics could reflect the quality of G. lucidum.MethodsIn order to find rapid methods to evaluate the Ganoderma lucidum from different origins, Electronic tongue and High performance liquid chromatography (HPLC) were used in this paper.ResultsThe Electronic tongue results combined with PCA and LDA analysis showed that the taste of different batches of G. lucidum from the same producing area was similar, but quite different from different producing areas. The overall taste of G. lucidum from Anhui was obviously different from that from Shandong and Sichuan. Meanwhile, the concentrations of two main triterpenes of G. lucidum, Ganoderic acid A and Ganoderic acid D were detected by using HPLC, and the variability of different origins were consistent with that from Electronic tongue. Moreover, the triterpenoid acids content in G. lucidum from Shandong was about 1.04 mg/g, which is the highest of the three origins, followed by Sichuan and Anhui.DiscussionBoth the Electronic tongue and HPLC could efficiently distinguish the different origins of G. lucidum from taste property or content of key triterpenes, and provide new technical support for the quality evaluation of G. lucidum.