bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social determinants of youth with mild intellectual disability in outpatient care for mental health problems: a case-control study
Authors: Storm M. M.C. , Giltay E. J. , Eldik W. M. , Palstra E. C. , Duin E. D.A. , Berg D. , Vermeiren R. R.J.M. 
Published: October 2024

Abstract

This study examined the unique role of diverse social determinants of mental health (SDOMH) associated with mental health problems (MHP) for children with mild intellectual disability (MID), compared to peers with and without MHP. This population-based case-control study included four groups aged 0–17 years (Mage = 10.6, 35.6% female). Two groups of children receiving outpatient mental health care for MHP with MID (n = 505) and without MID (n = 2,767), each with a matched control group from the general population (n = 2,525 and n = 13,835, respectively), were studied. Through multivariate logistic regression analyses, both MHP groups were compared to their control group and each other to examine the likelihood of a SDOMH associated with receiving mental health care for MHP in children with and without MID. Children with MID receiving mental health care showed significant differences in multiple domains compared to their control group and to children receiving mental health care without MID. They were less likely to have European-born mothers, more likely to have parents with moderate or low education levels, and tended to live in smaller, single-parent, lower-income households. Similar, though less deviant, patterns were observed for children without MID receiving mental health care compared to the general population, except for parental education. Our study highlights that diverse SDOMH are associated with the likelihood of receiving care for MHP in children. Moreover, children with MID face disproportionate disadvantages, particularly regarding low parental education and household income. Thus, interventions should not only target the child but also their family and environmental context.
Molecular characterization and prognostic relevance of m6A regulators in pancreatic adenocarcinoma
Authors: Liu Mei , Chen Chuwen , Zhang Xiao , Shen Junyi , Peng Wei , Zhang Xiaoyun , Wen Tianfu , Li Chuan 
Published: October 2024

Abstract

Background
RNA N6-methyladenine (m6A) modification played an essential role in the occurrence and development of malignant tumors. m6A modification patterns in immune response and tumor microenvironment (TME) remains an enigma.
Methods
25 m6A regulators were collected, the molecular alterations and clinical relevance of which were explored. The mutation landscape of the pancreatic adenocarcinoma (PAAD) patients was explored by using TCGA data. The expression difference of the m6A regulators was identified by TCGA and HPA data. The prognosis value of the m6A regulators was measured by TCGA and ICGC data. Consensus clustering analysis was used for different m6A modification patterns identification. CIBERSORT and ESTIMATE algorithms were used to explore the landscape of TME cell infiltration. DEG analysis was used for m6A-related gene identification. m6A-score signature was established by using univariate Cox regression analysis and PCA.
Results
CNV amplification of m6A regulators led to up-regulated of them in tumor tissues in comparison with normal tissues. 13 of the 25 regulators showed oncogenic features. Two distinct m6A modification patterns were defined. PAAD patients in m6Acluster A occupied better survival compared to m6Acluster B. The relationships between the two m6A patterns and different types of immune infiltrating cells were further identified. A consolidated scoring system to quantify the m6A modification pattern of individual patients was established. Patients in low m6A-score group had better OS compared with these in high m6A-score group. Subsequent analysis proved that m6A methylation modification patterns was associated with response to anti-PD-L1 immunotherapy.
Conclusions
The molecular alterations and prognostic implications of m6A regulators were analyzed. The distinct m6A modification patterns are crucial for understanding the heterogeneity and complexity of individual tumor microenvironments (TMEs). A comprehensive assessment of m6A modification in tumors enhances our understanding of TME infiltration characteristics and facilitates more effective immunotherapy strategies.
Exploring the Potentials and Pitfalls of Work Experience and Widening Participation through Narrative Interviews
Authors: Green Alice , Jackson Dawn , Ward Derek 
Published: October 2024

Abstract

Background Applicant work experience (WE) is a non-academic criteria considered by many medical schools in their admissions processes. Concerns have been raised within the literature that access to some WE opportunities may be more elusive for students from less advantaged socioeconomic backgrounds (LA-SDBs). Few qualitative studies exist which explore applicant experiences of WE, and its contribution to the widening access agenda. Our qualitative research explores the WE of applicants from a variety of socio-demographic backgrounds, and draws on Bourdieu’s concepts of ‘capital’ and ‘habitus’ as tools which enable critical analysis of the role work experience may play in the reproduction of inequality.Methods Narrative telephone interviews were undertaken with 23 applicants to a large United Kingdom medical school in the 2017-18 admissions cycle, purposively sampled backed on school background, age, gender and widening participation experience. Framework analysis was applied to interview data, and themes and subthemes identified.Results WE remains a key step in the preparation process for applicants when applying to medical school. Participants suggested WE has the potential to confirm career choice and deepen understanding about the realities of a career in medicine. At times, applications from LA-SDB’s were provided with application support from healthcare professionals through WE which may have otherwise been inaccessible. Access to WE opportunities depended on access to information networks or school support, typically a barrier for those from LA-SDB’s, and myths and misinformation about WE were more commonly evident in this group.Conclusion Meaningful and equitable engagement in WE requires a consideration of more than just access to WE opportunities. Our results suggest that applicants require timely and transparent information on how best to engage with WE opportunities. Additionally, communication with under-represented schools, directed at dispelling myths and fostering meaningful reflection, may go some way to mitigate the risk of social and cultural disadvantage in applicants from LA-SDBs. .
Effect of Fluorometholone on the Pre-operative Tear Cytokine Profile and Post- trabeculectomy Outcomes of Medicated Asian Glaucoma Patients
Authors: Huang Olivia S. , Sim Jackie Jia Lin , Htoon Hla M. , Chew Annabel C Y , Chong Rachel S , Husain Rahat , Perera Shamira , Wong Tina T. 
Published: October 2024

Abstract

Aim: To determine if a 2-weeks pre-operative course of fluorometholone (FML) eyedrops in chronically medicated glaucoma patients reduces pro-inflammatory cytokines levels pre-operatively and improves early post-operative outcomes after trabeculectomy or phaco-trabeculectomy.
Methods: Asingle-center, unmasked, prospective pilot interventional case series of 36 FML-pretreated glaucoma patients, who received a 2-week pre-operative course of FML eyedrops, and 307 glaucoma patients without FML pre-treatment on chronic IOP-lowering topical medications undergoing trabeculectomy or phaco-trabeculectomy. Multiplex bead assay was used to quantify the presence of pro-inflammatory cytokines in tear samples before and after the use of FML eyedrops, prior to surgery. Clinical outcome measures of post-operative outcomes included IOP and additional post-operative interventions (i.e. needling, glaucoma medications and surgery) required to achieve desired IOP at 6 months.
Results: After excluding patients with a low MCP-1 level (<250pg/ml/mg) at baseline, propensity score matched analysis showed that the mean age for the FML group (n=17) was 71.88 years and the non FML group (n=17) was 73.71 years (p=0.449). The mean duration of glaucoma medications used pre-operatively was 31.29 months (FML group) and 34.79 months (non-FML group) (p=0.763). Patients with FML treatment had a lower odds of requiring any post-operative intervention (including needling, surgery or IOP-lowering medications) (OR 0.22, CI 0.049-0.95, p=0.042) compared to patients who did not have pre-operative FML treatment.
Conclusions: In patients with higher levels of MCP-1 pre-operatively, the use of FML for 2 weeks pre-operatively improved their early post-operative outcomes following trabeculectomy or phaco-trabeculectomy.
Evaluating Effectiveness of sEMG Biofeedback for Posture Training and Scoliosis Management
Authors: Wong Yiu Hong , Cheung Mei-chun , Lei Qiwen Emma , Yip Joanne 
Published: October 2024

Abstract

The vast majority of the global population uses digital devices, in particular, smartphones and tablets. Their use causes the head to tilt forward, and the posture exerts a significant amount of strain onto the neck and shoulders of users. This would normally have adverse effects on a healthy population but poor posture especially exacerbates the spinal deformation of scoliosis patients. As such, this study evaluates the effectiveness of a 30-session surface electromyography (sEMG) biofeedback posture training program for managing the progression of spinal curvature in adolescents with mild scoliosis. The program is designed to reduce imbalanced paraspinal muscle activity and control the progression of the curvature. Prior to the training, significant imbalance is observed in the muscle activity. However, post-training, the muscle activity increases in balance with significant improvements noted in the trapezius and lumbar erector spinae muscles. The study also finds that the training effectively controls the progression of scoliosis. These findings suggest that sEMG biofeedback posture training can be an effective intervention for adolescents with mild scoliosis. Further research is however needed to confirm the findings and explore the long-term effects of the intervention.
Cryoablation in male patients with breast cancer: two first-time case reports
Authors: Sanvido Vanessa Monteiro , Holmes Dennis R. , Bromberg Silvio Eduardo , Waitzberg Angela Flávia Logullo , Gomes Jackeline Oliveira , Barbante Leticia Galvão , Junior Antonio Rahal , Tachibana Bruna Mayumi T , Socolowski Luis Ricardo , Silva Leonard Medeiros , Cavalcanti Alexandre Biasi , Nazário Afonso Celso Pinto 
Published: October 2024

Abstract

Background
The rarity of male breast cancer often relies on data extrapolated from its female counterpart for treatment guidance. Among the promising local treatment modalities for breast cancer, cryoablation stands out.
Case presentation
These meticulous cases confirm the importance of cryoablation and its transformative role in the treatment of early-stage breast cancer, including cases of male breast carcinoma. The main objective of this study was to describe the first two clinical cases involving the interventional protocol, the imaging attributes of the postcryoablation breast, and the feasibility of cryoablation as a specific surgical alternative for male breast cancer patients. To our knowledge, these are the first reported cases of cryoablation in the literature in this setting.
Conclusions
Cryoablation presents an attractive option to treat male patients with breast cancer, providing better therapeutic options.
Impact of maternal hypothyroidism on fetal thyroid gland: a prospective longitudinal cohort study
Authors: Feng Xinyuan , Sun Huijie , Liu Tianci , Li Liang 
Published: October 2024

Abstract

Background
Maternal hypothyroidism has been associated with impaired offspring neurodevelopment but the underlying mechanisms are unclear now. We hypothesize that maternal hypothyroidism influences the development of fetal hypothalamic-pituitary-thyroid axis and thyroid tissue, and thereby indirectly affects postnatal cognitive development.
Methods
This prospective cohort study included singleton pregnancies with hypothyroidism before 14 weeks of gestation. Ultrasound measurements of fetal thyroid size were performed at 21–24 and 28–32 weeks. The primary outcome was fetal thyroid volumes at two time points, and the secondary outcomes were pregnancy and neonatal outcomes, including birthweight, delivery weeks, preterm birth, stillbirth or miscarriage, and neonatal thyroid functions on the third postnatal day.
Results
A total of 136 women participated in this study, comprising 68 with hypothyroidism and 68 with uncomplicated pregnancies. There was no significant difference between the hypothyroidism and control group of fetal thyroid volumes measured at gestation of 21–24 weeks (230.58 ± 63.75mm3 vs 230.15 ± 75.69mm3, P = 0.98 ) and 28–32 weeks (491.55 ± 154.88mm3 vs 450.16 ± 136.13mm3, P = 0.059). Additionally, the incidence of adverse events was also similar between groups. These findings remained unchanged in subgroup analyses.
Conclusions
The results of this study suggest that well-controlled maternal hypothyroidism may not significantly influence the fetal hypothalamic-pituitary-thyroid axis. And further randomized controlled trials and fundamental studies are warranted to confirm the underlying mechanism and long-term clinical consequences of the potential effect.
Comparison of the TEG 6s thrombelastograph with conventional coagulation parameters in infants and toddlers during craniosynostosis surgery - a prospective observational clinical study
Authors: Fideler Frank , Beck Franziska , Feng You-Shan , Drexler Berthold , Magunia Harry , Schuhmann Martin U , Rosenberger Peter , Straub Andreas 
Published: October 2024

Abstract

Background: Craniosynostosis surgery (CS) is associated with severe diffuse perioperative bleeding which can result in a significant coagulopathy. The Thrombelastograph Coagulation Analyzer TEG 6s is a modern point of care (POC) device for rapid detection of perioperative coagulation disorders and for the guidance of coagulation factor substitution. By now little is known about changes in TEG 6s values in infants and toddlers with perioperative coagulopathies. The aim of this study was to monitor, compare and relate TEG 6s parameters with conventional coagulation parameters (CCP) during pediatric CS.
Methods: In this prospective clinical observational study 29 infants and toddlers (median age 6 months, median weight 8.5 kg) undergoing CS were enrolled. Blood was sampled pre- and perioperatively. Samples were analyzed by TEG 6s and using CCP (prothrombin time, aPTT, INR, fibrinogen, factor XIII, and antithrombin III). The TEG 6s parameters (reaction time “R”, coagulation time “K”, maximum amplitude “MA”) and CCP were related using linear regression analyses.
Results: Regarding the linear relationship of “R”, “MA”, and “K” of the TEG 6s assays CK, CRT, CKH, and CFF with CCP highest R2 values were obtained for the CK-R – aPTT relationship (R2 = 0.448), for the CK-MA – fibrinogen relationship (R2 = 0.47) and for the CK-K - aPTT relationship (R2=0.631).
Conclusions: The relationship between TEG 6s and conventional coagulation assays is rather low in the perioperative setting of CS in infants. This may be explained by the fact that TEG 6s and conventional coagulation assays do not employ identical methods and do not measure the same coagulatory substrates and dynamics. Our results may contribute to the establishment of reference ranges for TEG6s parameters.
Further studies should evaluate which method may be preferred and should establish algorithms and treatment thresholds to guide coagulation management in the pediatric population.
Trial registration: not applicable (observational data only, no trial interventions)
Evaluating Sensitivity, Specificity, and Optimal Cutoff Scores of the Montreal Cognitive Assessment Using U.S. National Alzheimer Coordinating Centre Uniform Data Set: A Retrospective Analysis of 16,309 Participants
Authors: Ismail Youssef A. , Auf Huda A. , Sadik Shahd A. , Ahmed Nada M. 
Published: October 2024

Abstract

Background: Neurodegenerative diseases (NDDs) like Alzheimer's disease and Mild Cognitive Impairment are characterized by progressive cognitive decline, with limited effective treatments available. Several screening tools are available for diagnosing MCI and dementia, including the Rapid Cognitive Screen, the Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), and the Dementia Rating Scale (DRS).
Objective: This study aims to evaluate the sensitivity and specificity of MoCA to determine its suitability as a diagnostic tool in screening programs.
Methods: The study analyzed data from participants aged 55 and older, recruited from U.S. Alzheimer's Disease Research Centers (ADRCs), using a National Alzheimer Coordinating Center Uniformed Data Set (NACC-UDS). Participants had an initial diagnosis and complete records, focusing on MoCA and then was followed by evaluations to classify MCI, dementia, or no impairment. Receiver operating characteristic (ROC) analysis was used to calculate the area under the curve (AUC).
Results: The study utilized an initial dataset of 188,700 participant records from NACC. After applying inclusion criteria, 16,309 participants were included. The participants had complete diagnostic information, clinician-conducted cognitive assessments, and MoCA scores. The participants were categorized into three groups: 7,624 with no cognitive impairment (NoCI), 4,893 with MCI, and 3,792 with dementia. The study focused on MoCA scores, revealing significant differences among diagnostic groups (P< 0.001). ROC analysis demonstrated the MoCA's strong diagnostic capability, with AUC values significantly above 0.5 (P < 0.001). Sensitivity and specificity were calculated at the recommended cutoff scores of 26 and 21, while the "optimal" cutoff scores were identified as (< 24) for detecting MCI and (< 21) for dementia based on the Youden index in reference to individuals with no cognitive impairment. Although PPV was generally low, the high NPV across comparisons underscores the MoCA's effectiveness in ruling out cognitive impairment.
Conclusion: The study confirms MoCA as an effective tool for detecting dementia, showing 83% sensitivity and 82% specificity at a cutoff value of 21. With a high NPV of 94%, MoCA is particularly reliable for ruling out dementia. However, its ability to identify MCI is limited, with a sensitivity of 52.7%. Despite this, MoCA's 87% specificity helps reduce false positives for MCI, supporting its overall validity as a cognitive assessment tool.
Video-based Coaching Improves Trainee Robotic Technical Performance
Authors: Clanahan Julie M. , Gerull William D. , Williamson Andrea J.H. , Ohman Kerri A. , Yee Andrew , Awad Michael M. 
Published: October 2024

Abstract

Purpose
While video-based surgical coaching (VBC) can improve operative performance, it is not widely utilized in surgical training due to limited video access. New robotic platforms enable automated access to operative video and performance metrics. The aim of this study is to evaluate the effect of structured robotic VBC on technical skills of surgical trainees.
Methods
Surgical resident participants were randomized to control or coaching groups over a 1-year intervention period. Both groups obtained operative assessments (RO-SCORE) during rotations, and active control time (ACT) robotic case participation metric was also analyzed. The coaching group received 1-hour VBC with trained robotic faculty coaches between operative assessments. Wilcoxon, paired t-tests, and descriptive statistics were applied.
Results
Fourteen residents completed the study (6 control, 8 coaching). Overall technical performance on RO-SCORES improved for coached residents (median 2.0 v 3.0, p = 0.031) with greatest improvement in procedural efficiency and flow (median 3.0 v 4.0, p = 0.0156). Overall technical performance did not change for the control (median 3.0 v 3.0, p = 0.50). Although mean percent ACT increased for the coaching group (44 ± 9.0 v 49 ± 20, p = 0.42) this was not statistically significant. Mean percent ACT was unchanged for control (49 ± 12 v 48 ± 38, p = 0.92). Most coached residents (88%) found VBC very or extremely valuable and were highly satisfied with coaching feedback.
Conclusions
This study demonstrates that VBC within robotic surgery can accelerate resident technical skill development. Residents who received coaching reported high value and satisfaction compared to traditional teaching. With improved video access, training programs should implement VBC to support competency development in minimally invasive technologies.
Net Albumin Leakage in Patients in the Icu with Suspected Sepsis. A Prospective Analysis Using Mass Balance Calculations
Authors: Selden Dag , Tardif Nicolas , Wernerman Jan , Rooyackers Olav , Norberg Åke 
Published: October 2024

Abstract

Introduction
Albumin kinetics in septic shock have been extensively studied, but clinical recommendations remain weak. An increased transcapillary escape rate (TER) of albumin has been demonstrated, though TER does not account for lymphatic return. Mass balance calculations, considering lymphatic return, have been used to assess net albumin leakage (NAL) in major surgery but not in sepsis.
Objectives
This study aimed to evaluate NAL in ten ICU patients with suspected sepsis, hypothesizing a net positive leakage. Secondary aims included investigating associations between NAL and fluid overload, glycocalyx shedding products, and cytokines, as well as identifying factors associated with NAL.
Methods
This prospective, observational study included ten patients within twelve hours of ICU admission for suspected sepsis at Karolinska University Hospital Huddinge. Albumin, hematocrit, and hemoglobin levels were sampled at 0, 1, 2, 4, 8, and 24 hours. NAL was estimated using mass balance calculations, comparing proportional changes in albumin and hemoglobin concentrations over time, adjusted for albumin and hemoglobin infusions and losses. A proportionally greater decrease or smaller increase in albumin compared to hemoglobin indicated NAL, representing the net leakage from the circulation to the interstitium minus lymphatic return.
Results
Over 24 hours, patients exhibited a net positive albumin leakage to the interstitium of 8 ± 10g (p = 0.029). NAL showed no correlation with glycocalyx shedding products or fluid overload but had a weak correlation with interleukin-6 and interleukin-8 in the first 4 hours. Albumin infusions appeared to increase net leakage.
Conclusion
This study demonstrated a net positive albumin leakage of 8 ± 10g over 24 hours in ICU patients with suspected sepsis, with a weak early correlation to pro-inflammatory cytokines but no significant link to fluid balance or glycocalyx shedding. Notably, albumin infusions were associated with increased net leakage.
Trial Registration
The study protocol was published before patient enrollment at www.anzctr.org.au (UTN: U1111-11-88-1309, Principal investigator: Åke Norberg, registered: October 31, 2016).