bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis and Treatment for Pityriasis Rosea
Authors: Prayogo Keyko Putri 
Published: October 2024

Pitiriasis rosea (PR) merupakan kelainan kulit akut papuloskuamosa yang swasirna. Kejadian PR di seluruh dunia dilaporkan sebanyak 0,3-1,2%. Infeksi human herpes virus (HHV) 6, 7, dan beberapa obat mencetuskan kejadian PR. Gejala klinis diawali dengan lesi primer berupa herald patch, diikuti lesi sekunder berukuran lebih kecil yang tersebar pada garis langer batang tubuh, dapat meluas ke lengan dan paha atas. Klasifikasi PR terbagi menjadi tipikal dan atipikal berdasarkan keberadaan herald patch, lokasi lesi, morfologi lesi, dan perjalan penyakit. Terdapat tiga kriteria untuk mendiagnosis PR, yaitu kriteria esensial, opsional, dan eksklusi. Derajat keparahan PR ditentukan dengan Pityriasis Rosea Severity Score (PRSS). Pemeriksaan dermoskopi dan histopatologi dapat membantu diagnosis. Gambaran dermoskopi berupa background yellow-orange, dull red, dan bright red; warna skuama yellow-white, white, dan white-brown; susunan skuama patchy, peripheral, collarette, diffuse dan central; pola pembuluh darah patchy globular dilatation, punctate dilation of vessels, dotted vessles, dan patchy vessels. Pemeriksaan histopatologi merupakan baku emas. Gambaran yang ditemukan yaitu hiperkeratosis, akantosis iregular, parakeratosis fokal maupun konfluens, spongiosis, ekstravasasi sel darah merah di epidermis, sebukan sel radang limfohistiosit di perivaskular dan dermis superfisial, dilatasi pembuluh darah kapiler papila dermis yang tidak seragam. Berbagai terapi PR adalah antihistamin, kortikosteroid, asiklovir, makrolida, dan narrowband UVB (NB UVB) phototerapy. Pemberian asiklovir 5x800mg/hari selama 7 hari aman dan efektif dalam mengobati PR fase awal dengan cara meredakan eritema pada lesi lama dan mengurangi jumlah lesi baru.
A fundus vessel segmentation method based on double skip connections combined with deep supervision
Authors: Liu Qingyou , Zhou Fen , Shen Jianxin , Xu Jianguo , Wan Cheng , Xu Xiangzhong , Yan Zhipeng , Yao Jin 
Published: October 2024

BackgroundFundus vessel segmentation is vital for diagnosing ophthalmic diseases like central serous chorioretinopathy (CSC), diabetic retinopathy, and glaucoma. Accurate segmentation provides crucial vessel morphology details, aiding the early detection and intervention of ophthalmic diseases. However, current algorithms struggle with fine vessel segmentation and maintaining sensitivity in complex regions. Challenges also stem from imaging variability and poor generalization across multimodal datasets, highlighting the need for more advanced algorithms in clinical practice.MethodsThis paper aims to explore a new vessel segmentation method to alleviate the above problems. We propose a fundus vessel segmentation model based on a combination of double skip connections, deep supervision, and TransUNet, namely DS2TUNet. Initially, the original fundus images are improved through grayscale conversion, normalization, histogram equalization, gamma correction, and other preprocessing techniques. Subsequently, by utilizing the U-Net architecture, the preprocessed fundus images are segmented to obtain the final vessel information. Specifically, the encoder firstly incorporates the ResNetV1 downsampling, dilated convolution downsampling, and Transformer to capture both local and global features, which upgrades its vessel feature extraction ability. Then, the decoder introduces the double skip connections to facilitate upsampling and refine segmentation outcomes. Finally, the deep supervision module introduces multiple upsampling vessel features from the decoder into the loss function, so that the model can learn vessel feature representations more effectively and alleviate gradient vanishing during the training phase.ResultsExtensive experiments on publicly available multimodal fundus datasets such as DRIVE, CHASE_DB1, and ROSE-1 demonstrate that the DS2TUNet model attains F1-scores of 0.8195, 0.8362, and 0.8425, with Accuracy of 0.9664, 0.9741, and 0.9557, Sensitivity of 0.8071, 0.8101, and 0.8586, and Specificity of 0.9823, 0.9869, and 0.9713, respectively. Additionally, the model also exhibits excellent test performance on the clinical fundus dataset CSC, with F1-score of 0.7757, Accuracy of 0.9688, Sensitivity of 0.8141, and Specificity of 0.9801 based on the weight trained on the CHASE_DB1 dataset. These results comprehensively validate that the proposed method obtains good performance in fundus vessel segmentation, thereby aiding clinicians in the further diagnosis and treatment of fundus diseases in terms of effectiveness and feasibility.
Predictive value of geriatric nutritional risk index in cardiac and cerebrovascular events after endovascular aortic aneurysm repair
Authors: Zou YuPei , Wang Jiarong , Zhao Jichun , Ma Yukui , Huang Bin , Yuan Ding , Liu Yang , Han Maonan , Gan Huatian , Yang Yi 
Published: October 2024

ObjectiveTo evaluate the effect of malnutrition assessed by the Geriatric Nutritional Risk Index (GNRI) on major adverse cardiac and cerebrovascular events (MACCE) in the elderly patients after endovascular aortic aneurysm repair (EVAR).Materials and methodsThis was a retrospective cohort study of elderly patients who underwent EVAR in a tertiary hospital. Malnutrition status was assessed by the GNRI. The primary outcome was MACCE. The predictive ability of the GNRI was compared with both the Revised Cardiac Risk Index (RCRI) and the modified Frailty Index (mFI) using Receiver operating characteristic (ROC) curve.ResultA total of 453 patients underwent EVAR November 2015 and January 2020 was retrospectively analyzed, equally divided into three (low/medium/high) groups according to GNRI values which ranked from low to high. Five (1.10%) patients were lost in follow-up after surgery, and the median length of follow-up was 28.00 (15.00–47.00) months. The high GNRI values reduced length of hospital stay following EVAR in comparison to patients in low GNRI values group (β 9.67, 95% CI 4.01–23.32, p = 0.0113; adjusted β −1.96, 95% CI −3.88, −0.05, p = 0.0454). GNRI status was associated with a significantly increased risk of long-term mortality after EVAR (Medium GNRI, unadjusted HR 0.40, 95%CI 0.23–0.70, p = 0.0014; adjusted HR 0.47, 95%CI 0.26–0.84, p = 0.0107; high GNRI, 0.27 95%CI 0.14–0.55; p = 0.0003; adjusted HR 0.32 95%CI 0.15–0.68, p = 0.0029). Both medium and high GNRI values were linked to significantly reduced risks of MACCE compared to low GNRI score patients (Medium GNRI, unadjusted HR 0.34, 95%CI 0.13–0.88, p = 0.00265; adjusted HR 0.37, 95%CI 0.14–0.96, p = 0.0408; High GNRI, 0.26 95%CI 0.09–0.78; p = 0.0168; adjusted HR 0.21 95%CI 0.06–0.73, p = 0.0029). Compared with the RCRI and mFI, the GNRI had better discrimination in predicting long-term MACCE. An area under the curve (AUC) for GNRI mFI, and RCRI is 0.707, 0.614 and 0.588, respectively. (Z statistic, GNRI vs. mFI, p = 0.0475; GNRI vs. RCRI, p = 0.0017).ConclusionMalnutrition assessed by the GNRI may serve as a useful predictor of long-term MACCE in elderly patients after EVAR, with preferable discrimination abilities compared with both RCRI and mFI.
Dairy consumption and its association with anthropometric measurements, blood glucose status, insulin levels, and testosterone levels in women with polycystic ovary syndrome: a comprehensive systematic review and meta-analysis
Authors: Rastad Hadith , Shahrestanaki Ehsan , Heydarian Hamid Reza , Maarefvand Mina 
Published: October 2024

BackgroundWe conducted a systematic review and meta-analysis on dairy consumption and its association with anthropometric measurements, blood glucose status, insulin levels, and testosterone levels in women with Polycystic Ovary Syndrome.MethodsThis study conducted a comprehensive literature search using electronic databases like MEDLINE, Scopus, PubMed, Web of Science, and Google Scholar to identify observational and interventional studies investigating the relationship between dairy product consumption and Polycystic Ovary Syndrome. A meta-analysis was performed on clinical trial studies that examined the effect of a low starch/low dairy diet in Polycystic Ovary Syndrome subjects. Statistical analyses were performed using Stata version 16.0 (Stata Corporation, College Station, Texas, USA), and statistical significance was defined as p-value &lt; 0.05.ResultsOf the 1,313 citations reviewed, our systematic review identified 11 studies that met the inclusion criteria, comprising six case-control studies, four clinical trials, and one cross-sectional study. The case-control studies found limited evidence of an association between dairy consumption and Polycystic Ovary Syndrome. The result of the clinical trial studies in meta-analysis showed that reducing dairy intake along with reducing starch intake led to statistically significant improvements in anthropometric and metabolic measures including mean weight (Standardized mean difference: -8.43 (95% CI: -9.01, -7.86)), Body mass index (-3.14 (95% CI: -3.35, -2.92), waist circumference (-6.63 (95% CI: -10.70, -2.57)) and Waist-to-Height Ratio (-0.04 (95% CI: -0.07, -0.01), insulin fasting (-18.23 (95% CI: -22.11, -14.36)), insulin 120 minutes (-94.05 (95% CI: -157.67, -30.42)), HbA1c (-0.27 (95% CI: -0.37, -0.17)), Ferryman-Gallwey score (-2.07 (95% CI: -2.98, -1.16)) and total testosterone (-9.97 (95% CI: -14.75, -5.19)). No significant reduction was found in fasting glucose, 2 hours glucose, percent of fat mass, and mean free testosterone after intervention.ConclusionsThe findings of this systematic review show limited evidence about the association between dairy consumption and Polycystic Ovary Syndrome. The interventional studies suggest that a low-dairy/low-starch diet may improve some anthropometric and metabolic measures in women with Polycystic Ovary Syndrome.
IVIG response in pediatric acute-onset neuropsychiatric syndrome correlates with reduction in pro-inflammatory monocytes and neuropsychiatric measures
Authors: Melamed Isaac , Rahman Shamma , Pein Heather , Heffron Melinda , Frankovich Jennifer , Kreuwel Huub , Mellins Elizabeth D. 
Published: October 2024

IntroductionPediatric Acute-Onset Neuropsychiatric Syndrome (PANS) is characterized by abrupt onset of obsessive-compulsive disorder or eating restriction along with the abrupt onset of other co-occurring symptoms (tics, behavioral and cognitive regression, etc.). PANS is thought to be a post-infectious immunopsychiatric disorder, although as with most post-infectious disorders, it is challenging to establish a causal relationship with proposed infectious triggers. Intravenous immunoglobulin (IVIG) can modulate inflammation and support the elimination of infection and has been used for treatment of many post-infectious inflammatory disorders and autoimmune conditions. The aim of the study is to explore the pro-inflammatory state in PANS before and after administration of IVIG.MethodsChildren with moderate-to-severe PANS received six infusions of IVIG (Octagam 5%, Octapharma) every 3 weeks with post treatment follow-up. Blood samples and psychiatric measures were obtained at Visits 1 (pre-treatment), 7 and 8 (4 and 11 weeks after last infusion, respectively). Myeloid cell activation was assessed via flow cytometry.ResultsAll ten patients included in the study were male, White, with mean age 12.4 years (range 6–16). Statistically significant improvements following IVIG treatment were demonstrated in all psychometric assessments and parent questionnaires including CY-BOCS (obsessive compulsive scale), YGTSS (tic scale) and a parent PANS rating scale (for all scales p&lt;0.001). The fraction of pro-inflammatory monocytes and dendritic cells decreased from pre-IVIG treatment levels. The proportional reductions were not compensated by increases in total white blood cells; pro-inflammatory monocytes post-IVIG were decreased as a proportion of CD14+ myeloid cells and in absolute number.ConclusionsThe results of this study suggest that active PANS is associated with a pro-inflammatory state. This pro-inflammatory profile and psychometric scores improved following IVIG treatment. Future work will aim to further elucidate the roles of innate and adaptive immune responses in PANS and the regulatory mechanism(s) of IVIG in PANS treatment.
Integrative nursing interventions: knowledge, attitudes and practice in home nursing services in Germany—a quantitative and qualitative online survey
Authors: Stolz Regina , Klocke Carina , Mahler Cornelia , Valentini Jan , Joos Stefanie 
Published: October 2024

IntroductionIntegrative nursing interventions (INI) play a significant role in healthcare, particularly in the prevention and treatment of chronic diseases. Integrating evidence-based INI into healthcare aligns with global initiatives such as the WHO’s Decade of Healthy Aging 2020–2030. Many INI are low-threshold practices, empowering patients to independently manage health. However, the extent to which INI are used by home-care nursing-services (HNS) remains largely unknown. This study aims to explore the field of INI in German HNS regarding nurses’ use of INI as well as attitudes, subjective knowledge, and information needs on the subject.MethodsA cross-sectional anonymous online survey with 29 Likert scale items and two open-ended questions was conducted between April 2023 and July 2023. The survey targeted nurse managers of HNS in Baden-Württemberg, Germany. Descriptive analysis was performed for quantitative data, while content analysis according to Kuckartz was applied to analyze open-ended text responses.ResultsIn total, n = 68 out of n = 1,331 HNS took part in the survey yielding a response rate of 5.1%. Their overall attitude toward INI was clearly positive (10-point Likert scale M ± SD: 8.37 ± 2.22). The average self-assessed knowledge level about INI was moderate (M ± SD: 5.39 ± 2.76). Almost half of the participants (45.6%) declared to incorporate INI in patient care. Most participants (84.2%) lacked employees with additional qualifications in INI. The INI used most were medicinal herbal teas (61%), compresses (57%), and aromatherapy (48%). Acupressure showed the greatest disparity between actual use in participating HNS (4.3%) and interest in further education (61%). The most common symptoms for which INI are used are pain, respiratory problems, anxiety, and palliative care. The main challenges reported for the use of INI in HNS are financial aspects, qualification and limited resources (staff and time).DiscussionThis exploratory study provides the first insights into nurses’ attitudes, self-assessed knowledge, and utilization of INI in German HNS. Overall response rate was low (5.1%), therefore, the results should be interpreted with caution. Urgent action is needed to address financial aspects and further education on INI, to promote integration of INI in HNS to the best possible extent.
Exploring the therapeutic mechanisms of Yikang decoction in polycystic ovary syndrome: an integration of GEO datasets, network pharmacology, and molecular dynamics simulations
Authors: Miao Jiang , Gao LiXuan , Liu Xi , Cai Wenpin , Chen Lei , Chen Mojinzi , Sun Yun 
Published: October 2024

ObjectiveThe incidence of Polycystic Ovary Syndrome (PCOS) is increasing annually. This study aims to investigate the therapeutic mechanisms of Yikang Decoction (YKD) in the treatment of PCOS through the integration of GEO datasets, network pharmacology, and dynamic simulation.MethodsActive ingredients of YKD and their targets were collected from the Traditional Chinese Medicine Systems Pharmacology (TCMSP) platform. Disease-relevant targets for PCOS were retrieved from several databases, including GeneCards, OMIM, PharmGKB, DrugBank, and GEO. The underlying pathways associated with the overlapping targets between YKD and PCOS were identified using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. The mechanisms of interaction between the core targets and components were further explored through molecular docking and molecular dynamics simulations (MD).Results139 potential active components and 315 targets of YKD were identified. A topological analysis of the PPI network revealed 10 core targets. These targets primarily participated in the regulation of biological processes, including cell metabolism, apoptosis, and cell proliferation. The pathways associated with treating PCOS encompassed PI3K-Akt signaling pathway, Lipid and atherosclerosis, MAPK signaling pathways, and Endocrine resistance signaling pathways. Moreover, molecular docking and MD have been shown to reveal a good binding capacity between active compounds and screening targets.ConclusionThis study systematically investigates the multi-target mechanisms of YKD in the treatment of PCOS, with preliminary verification provided through molecular docking and MD. The findings offer compelling evidence supporting the efficacy of YKD in treating PCOS.
The relationship between visual health and influencing factors among primary and secondary school students: a survey based in the Ningxia Hui Autonomous Region of China
Authors: Xu Jiyan , Sang Mengjiao , Xu Weiwei , Feng Kaijie 
Published: October 2024

IntroductionThe myopia rate of young people around the world, especially in China, has continued to rise, and the vision health of primary and secondary school students has gradually become a global concern. It was to explore the current characteristics of vision status and their intrinsic links to influencing factors of the Ningxia Hui Autonomous Region primary and secondary school students under regional characteristics.Methods1,670 primary and secondary school students in Ningxia Hui Autonomous Region were surveyed using Vision examination, International Physical Activity Scale, Lifestyle Behavior Scale. The data were analyzed using SPSS 25.0 and AMOS 23.0.ResultsThe prevalence of myopia among primary and secondary school students in the Ningxia Hui Autonomous Region was 27.3%, with rates of 31.5% for girls and 23.4% for boys. There was a significant negative correlation between lifestyle behaviors (r = -0.36, p &lt; 0.01) and physical activity level (r = –0.06, p &lt; 0.05) with vision status. The physical activity level played a significant masking effect between lifestyle behaviors and vision status (a*b = 0.002, c’ = –0.044). Gender moderated the effects of lifestyle behaviors on physical activity level and vision status, as well as the effects of physical activity level on vision status. These factors constituted a mixed model with mediating and moderation. The model fitted well (RMSEA = 0.028, CFI = 0.951, NFI = 0.918).DiscussionThe prevalence of myopia among primary and secondary school students in this region is lower than the national average in China, and it is associated with lifestyle behaviors, physical activity level, and gender. When effectively controlled, the physical activity level significantly will reduce the prevalence of myopia as a masking variable. Gender, as a moderating variable, provides theoretical support for the classification and prevention of myopia. Regional surveys enriched the global database on adolescent myopia research, revealing the characteristics and common factors of visual problems in adolescents. Relevant departments and schools should integrate eye care into the national health security system, implement policies related to myopia prevention and control and safeguard the visual health of primary and secondary school students.
Development and validation of a web-based nomogram for acute kidney injury in acute non-variceal upper gastrointestinal bleeding patients
Authors: Wei Chaolian , Cao Honghua , Huang Lina , Feng Lu-Huai 
Published: October 2024

BackgroundAcute kidney injury (AKI) is a common and serious complication in patients with acute non-variceal upper gastrointestinal bleeding (NVUGIB). Early prediction and intervention are crucial for improving patient outcomes.MethodsData for patients presenting with acute NVUGIB in this retrospective study were sourced from the MIMC-IV database. Patients were randomly allocated into training and validation cohorts for further analysis. Independent predictors for AKI were identified using least absolute shrinkage and selection operator regression and multivariable logistic regression analyses in the training cohort. Based on the logistic regression results, a nomogram was developed to predict early AKI onset in acute NVUGIB patients, and implemented as a web-based calculator for clinical application. The nomogram’s performance was evaluated through discrimination, using the C-index, calibration curves, and decision curve analysis (DCA) to assess its clinical value.ResultsThe study involved 1082 acute NVUGIB patients, with 406 developing AKI. A multivariable logistic regression identified five key AKI predictors: CKD, use of human albumin, chronic liver disease, glucose, and blood urea nitrogen. The nomogram was constructed based on independent predictors. The nomogram exhibited robust accuracy, evidenced by a C-index of 0.73 in the training cohort and 0.72 in the validation cohort. Calibration curves demonstrated satisfactory concordance between predicted and observed AKI occurrences. DCA revealed that the nomogram offered considerable clinical benefit within a threshold probability range of 7% to 54%.ConclusionOur nomogram is a valuable tool for predicting AKI risk in patients with acute NVUGIB, offering potential for early intervention and improved clinical outcomes.
FORTCARE-MCI study protocol: evaluation of Fortasyn Connect in the management of mild cognitive impairment in primary care
Authors: Arrieta Enrique , Baz Pablo , García-Ribas Guillermo 
Published: October 2024

BackgroundNeuropsychiatric symptoms are prevalent in patients with mild cognitive impairment (MCI) and are predictive of the conversion to dementia. Fortasyn Connect, a medical food, has shown efficacy in managing cognitive and behavioral symptoms associated with MCI. Early diagnosis and intervention in primary care are essential for managing MCI. However, real-world prospective studies assessing Fortasyn Connect in MCI are still limited.MethodsThis observational, multicenter, prospective study will enroll 150 patients recently diagnosed with MCI by primary care physicians across several regions in Spain. Participants will be followed-up over a 12-month period, with assessments at baseline, 6 months, and 12 months, as per clinical practice. The study aims to evaluate the impact of Fortasyn Connect on neuropsychiatric symptoms, cognition, and health-related quality of life (HRQoL) using validated neuropsychological tests and machine learning (ML) techniques. The primary outcome measure will be changes in neuropsychiatric symptoms using the Neuropsychiatric Inventory Questionnaire (NPI-Q) at 6 months. Secondary outcome measures include further changes in the NPI-Q at 12 months, and changes in cognition (Fototest, and clock-drawing test) and HRQoL (EQ-5D-5L) at 6 and 12 months. Exploratory outcomes will assess speech using an artificial intelligence (AI)-enhanced ML tool, with a correlation analysis of these findings with traditional neuropsychological test results.ConclusionThis study will provide evidence of the effectiveness of Fortasyn Connect in a real-world setting, exploring its potential to stabilize or improve neuropsychiatric symptoms, cognition, and HRQoL in MCI patients. Results will also contribute to the understanding of AI and ML in identifying early biomarkers of cognitive decline, supporting the timely management of MCI.