bluuebunny/crossref_metadata_2025_split huggingface dataset:
Um dispositivo clínico para a formação continuada de professores
Authors: Revah Daniel , Pedreira Maria Gabriela Guidugli 
Published: September 2024

Cet article discute certains aspects du dispositif clinique mis en œuvre dans la formation des enseignants impliqués dans l'inclusion des enfants présentant des obstacles dans leur structure psychique. Pour réaliser cette formation, quatre groupes d'enseignants ont été constitués qui travaillaient dans la salle dite de ressources ou étaient en charge d'un groupe-classe en éducation de la petite enfance ou dans les premières années de l'enseignement élémentaire. Dans ce processus formatif, les impasses signalées par les enseignants dans la scolarisation de ces enfants ont été prises comme point de départ des discussions tenues. Au-delà du dispositif, la manière dont ils s'impliquent dans les situations étudiées et certains effets résultant de ce travail formatif fait l´objet de discussion, en prenant comme référence la perspective de psychanalyse qui a guidé les interventions.
Artificial Intelligence–Enhanced Risk Stratification of Cancer Therapeutics–Related Cardiac Dysfunction Using Electrocardiographic Images
Authors: Oikonomou Evangelos K. , Sangha Veer , Dhingra Lovedeep S. , Aminorroaya Arya , Coppi Andreas , Krumholz Harlan M. , Baldassarre Lauren A. , Khera Rohan 
Published: September 2024

BACKGROUND:
Risk stratification strategies for cancer therapeutics–related cardiac dysfunction (CTRCD) rely on serial monitoring by specialized imaging, limiting their scalability. We aimed to examine an application of artificial intelligence (AI) to ECG images as a surrogate for imaging risk biomarkers and its association with early CTRCD.

METHODS:
Across a US-based health system (2013–2023), we identified 1550 patients (aged, 60 [interquartile range, 51–69] years, 1223 [78.9%] women) without cardiomyopathy who received anthracyclines or trastuzumab for breast cancer or non-Hodgkin lymphoma and had ECG performed ≤12 months before treatment. We deployed a validated AI model of left ventricular systolic dysfunction to baseline ECG images and defined low-, intermediate-, and high-risk groups based on AI-ECG left ventricular systolic dysfunction probabilities of <0.01, 0.01 to 0.1, and ≥0.1 (positive screen), respectively. We explored the association with early CTRCD (new cardiomyopathy, heart failure, or left ventricular ejection fraction <50%), or left ventricular ejection fraction <40%, up to 12 months after treatment. In a mechanistic analysis, we assessed the association between global longitudinal strain and AI-ECG left ventricular systolic dysfunction probabilities in studies performed within 15 days of each other.

RESULTS:

Among 1550 patients without known cardiomyopathy (median follow-up, 14.1 [interquartile range, 13.4–17.1] months), 83 (5.4%), 562 (36.3%), and 905 (58.4%) were classified as high, intermediate, and low risk, respectively, by baseline AI-ECG. A high-risk versus low-risk AI-ECG screen (≥0.1 versus <0.01) was associated with a 3.4-fold and 13.5-fold higher incidence of CTRCD (adjusted hazard ratio, 3.35 [95% CI, 2.25–4.99]) and left ventricular ejection fraction <40% (adjusted hazard ratio, 13.52 [95% CI, 5.06–36.10]), respectively. Post hoc analyses supported longitudinal increases in AI-ECG probabilities within 6 to 12 months of a CTRCD event. Among 1428 temporally linked echocardiograms and ECGs, AI-ECG left ventricular systolic dysfunction probabilities were associated with worse global longitudinal strain (global longitudinal strain, −19% [interquartile range, −21% to −17%] for probabilities <0.1, to −15% [interquartile range, −15% to −9%] for ≥0.5 [
P
<0.001]).

CONCLUSIONS:
AI applied to baseline ECG images can stratify the risk of early CTRCD associated with anthracycline or trastuzumab exposure in the setting of breast cancer and non-Hodgkin lymphoma therapy.
Rare Genetic Variants in
LDLR
,
APOB
, and
PCSK9
Are Associated With Aortic Stenosis
Authors: Rämö Joel T. , Jurgens Sean J. , Kany Shinwan , Choi Seung Hoan , Wang Xin , Smirnov Andrey N. , Friedman Samuel F. , Maddah Mahnaz , Khurshid Shaan , Ellinor Patrick T. , Pirruccello James P. 
Published: September 2024

BACKGROUND:

Despite a proposed causal role for LDL-C (low-density lipoprotein cholesterol) in aortic stenosis (AS), randomized controlled trials of lipid-lowering therapy failed to prevent severe AS. We aimed to assess the impact on AS and peak velocity across the aortic valve conferred by lifelong alterations in LDL-C levels mediated by protein-disrupting variants in 3 clinically significant genes for LDL (low-density lipoprotein) metabolism (
LDLR
,
APOB
, and
PCSK9
).

METHODS:
We used sequencing data and electronic health records from UK Biobank (UKB) and All of Us and magnetic resonance imaging data from UKB. We identified predicted protein-disrupting variants with the Loss Of Function Transcript Effect Estimator (LOFTEE) and AlphaMissense algorithms and evaluated their associations with LDL-C and peak velocity across the aortic valve (UK Biobank), as well as diagnosed AS and aortic valve replacement (UK Biobank and All of Us).

RESULTS:

We included 421 049 unrelated participants (5621 with AS) in UKB and 195 519 unrelated participants (1087 with AS) in All of Us. Carriers of protein-disrupting variants in
LDLR
had higher mean LDL-C (UKB: +42.6 mg/dL;
P
=4.4e-237) and greater risk of AS (meta-analysis: odds ratio, 3.52 [95% CI, 2.39–5.20];
P
=2.3e-10) and aortic valve replacement (meta-analysis: odds ratio, 3.78 [95% CI, 2.26–6.32];
P
=4.0e-7). Carriers of protein-disrupting variants in
APOB
or
PCSK9
had lower mean LDL-C (UKB: –32.3 mg/dL;
P
<5e-324) and lower risk of AS (meta-analysis: odds ratio, 0.49 [95% CI, 0.31–0.75];
P
=0.001) and aortic valve replacement (meta-analysis: odds ratio, 0.54 [95% CI, 0.30–0.97];
P
=0.04). Among 57 371 UKB imaging substudy participants, peak velocities across the aortic valve were greater in carriers of protein-disrupting variants in
LDLR
(+12.2 cm/s;
P
=1.6e-5) and lower in carriers of protein-disrupting variants in
PCSK9
(–6.9 cm/s;
P
=0.022).

CONCLUSIONS:
Rare genetic variants that confer lifelong higher or lower LDL-C levels are associated with substantially increased and decreased risk of AS, respectively. Early and sustained lipid-lowering therapy may slow or prevent AS development.
Molecular studies of Allographa effusosoredica sp. nov. (Graphidaceae) along with its Trentepohlia photobiont and a comprehensive checklist for Indian Allographa
Authors: ANSIL PARAYELIL A. , RAJESHKUMAR KUNHIRAMAN C. , LÜCKING ROBERT , O. PARAPARATH SRUTHI , SHARMA BHARATI 
Published: September 2024

The current study describes a new species, Allographa effusosoredica, from the Western Ghats, India, along with its Trentepohlia photobiont. This study is based on morphological, chemical and molecular analyses using mtSSU, LSU and RPB2 sequence data for Allographa effusosoredica mycobiont and ITS sequence data for Trentepohlia photobiont. Allographa effusosoredica is characterized by a thin effuse thallus with diffuse soredia, 8-spored asci, transversely 7–11 septate ascospores, and norstictic acid chemistry. It is surprisingly similar to the widespread Graphis glaucescens, which differs in the absence of soredia and norstictic acid, but clusters phylogenetically within Allographa, allied to Allographa xanthospora, making the limits between Allographa and the distantly related genus Graphis more diffuse and raising doubts about the correct placement of G. glaucescens. The photobiont of the novel species is allied to Trentepohlia cf. arborum HZ-2017 isolate YN1047. This is the first species of Allographa sequenced from India.
Infant Mortality, Education and Financial Development: Evidence from World Level Data Using Heterogeneous Panel Granger Causality Analysis
Authors: Tiwari Aviral Kumar , Adewuyi Adeolu O. , Effiong Ekpeno L. , Shylajan C. S. 
Published: September 2024

Education and financial development are crucial factors in achieving better health, including the reduction of infant mortality. This article investigates the causal relationship between education, financial development and infant mortality rate using annual data for 81 countries for the period 1980–2015 and employing the Emirmahmutoglu and Rose (2011) Granger causality test procedure for heterogeneous mixed panels. The results show that, individually and jointly, education and financial development Granger cause infant mortality in some countries across the major regions of the world. This suggests that improved education and a developed financial system are likely to reduce the infant mortality rate. JEL Codes: C33; E25; I
Is lack of goal-conflict-specific rhythmicity a biomarker for treatment resistance in generalised anxiety but not social anxiety or major depression?
Authors: Shadli Shabah M , Donegan Carina J , Bin Mohd Fahmi Muhammad SS , Russell Bruce R , Glue Paul , McNaughton Neil 
Published: September 2024

Background: Anxiety and depression cause major detriment to the patient, family, and society – particularly in treatment-resistant (TR) cases, which are highly prevalent. TR prevalence may be due to current diagnoses being based not on biological measures but on symptom lists that suffer from clinical subjectivity, variation in symptom presentation, and comorbidity. Aims: Goal-conflict-specific rhythmicity (GCSR) measured using the Stop-Signal Task (SST) may provide the first neural biomarker for an anxiety process and disorder. This GCSR has been validated with selective drugs for anxiety. So, we proposed that GCSR could differ between TR and non-TR individuals and do so differently between those diagnoses normally sensitive to selective anxiolytics and those not. Methods: We recorded electroencephalograms (EEG) from 20 TR participants (4 GAD, 5 SAD and 11 MDD) and 24 non-TR participants (4 GAD, 5 SAD and 15 Comorbid GAD/MDD (GMD)) while they performed the SST. Results: There was significant positive GCSR in all groups except the GAD-TR group. GAD-TR lacked GCSR in the low-frequency range. However, TR had little effect in SAD or MDD/GMD populations with apparent increases not decreases. Conclusions: Overall, these results suggest that GAD may occur in two forms: one resulting from excessive GCSR and so being drug sensitive, and the other resulting from some other mechanism and so being TR. In SAD and MDD groups, heightened GCSR could be a consequence rather than the cause, driven by mechanisms that are normally more sensitive to non-selective panicolytic antidepressants.
Predicting axillary lymph node metastasis in breast cancer based on ultrasound radiofrequency time-series analysis
Authors: Sun Pengfei , Guo Ruifang , Hu Xiangdong , Dekker Andre , Traverso Alberto , Qian Linxue , Wang Zhixiang 
Published: September 2024

Background The status of axillary lymph nodes (ALN) plays a critical role in the management of patients with breast cancer. It is an urgent demand to develop highly accurate, non-invasive methods for predicting ALN status Purpose To evaluate the efficacy of ultrasound radiofrequency (URF) time-series parameters, in combination with clinical data, in predicting ALN metastasis in patients with breast cancer. Material and Methods We prospectively gathered clinicopathologic and ultrasonic data from patients diagnosed with breast cancer. Various machine-learning (ML) models were developed using all available features to determine the most efficient diagnostic model. Subsequently, distinct prediction models were created using the optimal ML model, and their diagnostic performances were evaluated and compared. Results The study encompassed 240 patients, of whom 88 had lymph node metastases. A leave-one-out cross-validation (LOOCV) method was used to split the entire dataset into training and testing subsets. The random forest ML model outperformed the other algorithms, with an area under the curve (AUC) of 0.92. Prediction models based on clinical, ultrasonic, URF parameters, clinical + ultrasonic, clinical + URF, and ultrasonic + URF parameters had AUCs of 0.56, 0.79, 0.78, 0.90, 0.80, and 0.84, respectively, in the testing set. The comprehensive diagnostic model (clinical + ultrasonic + URF parameters) demonstrated strong diagnostic capability, with an AUC of 0.94 in the testing set, exceeding any single prediction model. Conclusion The combined model (clinical + ultrasonic + URF parameters) could be used preoperatively to predict lymph node status, offering valuable input for the design of individualized surgical approaches.
The Utility of Neuromuscular Assessment to Identify ADHD Among Patients with a Complex Symptom Picture
Authors: Udal Anne Beate Helseth , Stray Liv Larsen , Pripp Are Hugo , Stray Torstein , Egeland Jens 
Published: September 2024

Objective: Diagnostic assessment of ADHD is challenging due to comorbid psychopathologies and symptoms overlapping with other psychiatric disorders. In this study, we investigate if a distinct pattern of neuromuscular dysregulation previously reported in ADHD, can help identifying ADHD in psychiatric patients with diverse and complex symptoms. Method: We explored the impact of neuromuscular dysregulation, as measured by The Motor Function Neurologic Assessment (MFNU), on the likelihood of being diagnosed with ADHD, affective disorder, anxiety disorder, or personality disorder among adults ( n = 115) referred to a psychiatric outpatient clinic. Results: Logistic regression revealed that neuromuscular dysregulation was significantly associated with ADHD diagnosis only ( OR 1.15, p < .01), and not with affective-, anxiety-, or personality disorders. Sensitivity and specificity for ADHD at different MFNU scores is provided. Conclusions: A test of neuromuscular dysregulation may promote diagnostic accuracy in differentiating ADHD from other psychiatric disorders in patients with an overlapping symptom picture. This may have important implications for clinical practice. More studies are needed.
Meibomian gland dropout of upper eyelids as a novel biomarker for early diagnosis of primary Sjögren’s syndrome: a pilot study
Authors: Wu Jing , Liang Yongying , Shi Fanjun , Tu Xianghong , Zhang Jingfa , Qiu Qinghua 
Published: September 2024

Background: Early diagnosis of primary Sjögren’s syndrome (pSS) remains difficult due to its insidious onset. Objectives: To identify whether meibomian gland dropout (MGD) is a sensitive and noninvasive predictor of pSS by studying its association with histopathology in labial salivary gland biopsy in patients with clinically suspected pSS. Design: Prospective, randomized, multicenter, comparative effectiveness study. Methods: The study was conducted from July 2022 to July 2023. In all, 56 eligible participants with clinically suspected pSS were recruited from three combined ophthalmology medicine/rheumatology SS clinics. All participants with suspected pSS were evaluated and diagnosed by ophthalmology and rheumatology consultants and underwent infrared imaging of the meibomian glands using Keratograph 5M and histopathological evaluation of labial salivary gland biopsies. The length, width, and tortuosity of the meibomian glands were measured; the dropout rate in the nasal, temporal, and total eyelids was analyzed; and the dropout score was calculated using meibography grading scales. Results: Among the 56 participants, 34 were identified with pSS, and 22 were diagnosed with non-SS dry eye (NSSDE) and served as the control group. We recorded significant differences in the temporal and total MGD rates of the upper eyelids between the pSS and NSSDE groups (all p < 0.01). Improved prediction accuracy was achieved with the temporal and total MGD rates in the upper eyelids, with area under the curve values of 0.94 and 0.91, and optimal cutoff points of 0.78 and 0.75, respectively. Conclusion: MGD in the upper eyelids, especially in the temporal portion, is strongly associated with the histopathological outcome of labial salivary gland biopsy in pSS and is proposed as a highly predictive and noninvasive biomarker for the early diagnosis of pSS. Trial registration: ClinicalTrials.gov identifier: ChiCTR2000038911.
A 38-year-Old Woman With Flaccid Tetraparesis after Presenting With Abdominal Pain
Authors: Rodrigues Dal Bo Carolina , Miranda Menezes Julia , Gabriela Gomes Silva Barbara , dos Santos Sarah Ingrid Farias , Petrucelli Doher Marisa , de Araújo Gleizer René 
Published: September 2024

A 38-year-old woman presented in the emergency department with acute abdominal pain. She underwent laparoscopic cholecystectomy. Postoperatively, she developed worsening abdominal pain, tachycardia, flaccid tetraparesis, urinary retention, constipation and SIADH. She also developed red-colored urine. Porphobilinogen was requested in an isolated urine sample, with the test result showing 256 mg/g of creatinine. This case didactically emphasizes the necessity of considering differential diagnosis in acute abdomen pain associated with neurological disorders.
Preputial urethrostomy in a cat with suspected glandular hypospadias: case report and literature review
Authors: Murcia-Barba Aina , Serra-Aguado Claudio Iván , Serrano-Crehuet Tomás , Fernández-Salesa Núria 
Published: September 2024

Case summary An 11-year-old neutered male Turkish Angora cat was referred for obstructive feline lower urinary tract disease (FLUTD). On physical examination, the penis was curved at the tip and had a smaller than normal urethral opening proximal to the end, consistent with singular glandular hypospadias with a dorsal penile curvature. Because of its recurrent obstructive FLUTD history and inability to catheterise the urethra, a preputial urethrostomy (PRU) was performed. The PRU resolved the clinical signs with no clinical recurrence and no short- or long-term complications. Relevance and novel information To the authors’ knowledge, this is the first description of singular glandular hypospadias in a cat. In addition, this is the first time feline hypospadias has been reported to occur with obstructive FLUTD and to be treated by preputial urethrostomy.
Recombination fraction in pre-recombinant inbred lines (PRERIL) - revisiting a century old problem in genetics
Authors: Xu Shizhong , Osorio y Fortéa José 
Published: September 2024

Abstract
Background
Traditional recombinant inbred lines (RILs) are generated from repeated self-fertilization or brother-sister mating from the F1 hybrid of two inbred parents. Compared with the F2 population, RILs cumulate more crossovers between loci and thus increase the number of recombinants, resulting in an increased resolution of genetic mapping. Since they are inbred to the isogenic stage, another consequence of the heterozygosity reduction is the increased genetic variance and thus the increased power of QTL detection. Self-fertilization is the primary form of developing RILs in plants. Brother-sister mating is another way to develop RILs but in small laboratory animals. To ensure that the RILs have at least 98% of homozygosity, we need about seven generations of self-fertilization or 20 generations of brother-sister mating. Prior to homozygosity, these lines are called pre-recombinant inbred lines (PRERIL). Phenotypic values of traits in PRERILs are often collected but not used in QTL mapping. To perform QTL mapping in PRERILs, we need the recombination fraction between two markers at generation t for t < 7 (selfing) or t < 20 (brother-sister mating) so that the genotypes of QTL flanked by the markers can be inferred.

Results
In this study, we developed formulas to calculate the recombination fractions of PRERILs at generation t in self-fertilization, brother-sister mating, and random mating. In contrast to existing works in this topic, we used computer code to construct the transition matrix to form the Markov chain of genotype array between consecutive generations, the so-called recurrent equations.

Conclusions
We provide R functions to calculate the recombination fraction using the newly developed recurrent equations of ordered genotype array. With the recurrent equations and the R code, users can perform QTL mapping in PRERILs. Substantial time and effort can be saved compared with QTL mapping in RILs.
Quality and safety in prehospital airway management – retrospective analysis of 18,000 cases from an air rescue database in Germany
Authors: Lorenzen Ulf , Marung Hartwig , Eimer Christine , Köser Andrea , Seewald Stephan , Rudolph Marcus , Reifferscheid Florian 
Published: September 2024

Abstract
Background
Prehospital airway management remains crucial with regard to the quality and safety of emergency medical service (EMS) systems worldwide. In 2007, the benchmark study by Timmermann et al. hit the German EMS community hard by revealing a significant rate of undetected oesophageal intubations leading to an often-fatal outcome. Since then, much attention has been given to guideline development and training. This study evaluated the incidence and special circumstances of tube misplacement as an adverse peri-intubation event from a Helicopter Emergency Medical Services perspective.

Methods
This was a retrospective analysis of a German helicopter-based EMS database from January 1, 2012, to December 31, 2020. All registered patients were included in the primary analysis. The results were analysed using SPSS 27.0.1.0.

Results
Out of 227,459 emergency medical responses overall, a total of 18,087 (8.0%) involved invasive airway management. In 8141 (45.0%) of these patients, airway management devices were used by ground-based EMS staff, with an intubation rate of 96.6% (n = 7861), and alternative airways were used in 3.2% (n = 285). Overall, the rate of endotracheal intubation success was 94.7%, while adverse events in the form of tube misplacement were present in 5.3%, with a 1.2% rate of undetected oesophageal intubation. Overall tube misplacement and undetected oesophageal intubation occurred more often after intubation was carried out by paramedics (10.4% and 3.6%, respectively). In view of special circumstances, those errors occurred more often in the presence of trauma or cardiopulmonary resuscitation, with rates of 5.6% and 6.4%, respectively. Difficult airways with a Cormack 4 status were present in 2.1% (n = 213) of HEMS patients, accompanied by three or more intubation attempts in 5.2% (n = 11).

Conclusions
Prehospital airway management success has improved significantly in recent years. However, adverse peri-intubation events such as undetected oesophageal intubation remain a persistent threat to patient safety.

Trial registration
The study was registered in the German Register for Clinical Studies (number DRKS00028068).