bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cavitating Osmotic Demyelination Syndrome Following Correction of Chronic Hyponatremia in Sheehan’s Syndrome: A Novel Case Report
Authors: Shaikh Alamgir , León-Ruiz Moisés , Ghosh Ritwik , Soren Manoj , Mukhopadhyay Bilwatosh , Pal Shyamal Kanti , Benito-León Julián 
Published: September 2024

Introduction Rapid correction of hyponatremia can result in osmotic demyelination syndrome (ODS). Sheehan’s syndrome, a rare pituitary disorder caused by severe postpartum hemorrhage, is a potential cause of chronic hyponatremia. This case report describes a rare progression of extrapontine myelinolysis to central pontine myelinolysis, ultimately leading to ODS, following the correction of chronic hyponatremia associated with Sheehan’s syndrome. Notably, this event occurred a decade after the initial postpartum hemorrhage due to placenta previa. Case Report A 40-year-old woman from rural West Bengal, India, presented in a comatose state after five years of progressively worsening symptoms, including fatigue, gastrointestinal disturbances, cold intolerance, hair loss, and severe apathy, which had been misdiagnosed as psychogenic and treated with selective serotonin reuptake inhibitors. Two days before her admission to our hospital, she was diagnosed with a lower respiratory tract infection, dehydration, and severe hyponatremia (118 mEq/L) at a local private healthcare facility. Despite treatment with 3% sodium chloride and intravenous antibiotics, her condition deteriorated, prompting her transfer. At the time of hospitalization, the patient was diagnosed with chronic hyponatremia and hypopituitarism consistent with Sheehan’s syndrome. This condition was attributed to a severe postpartum hemorrhage that occurred a decade prior, resulting from placenta previa. Initial MRI revealed extrapontine myelinolysis, and the correction of her “compensated” hyponatremia was identified as the cause of her neurological decline. Follow-up MRIs at 7 and 14 weeks confirmed the development of cavitating ODS. Discussion This case highlights several key points: First, even a relatively gradual correction of hyponatremia can precipitate ODS, especially in patients with chronic conditions like Sheehan’s syndrome. Second, it underscores the importance of meticulous management of chronic hyponatremia to prevent severe neurological outcomes. Third, it illustrates the diagnostic challenges of differentiating Sheehan’s syndrome from primary psychiatric disorders, particularly in low-resource settings where the syndrome remains prevalent. The case also emphasizes the need for awareness among healthcare providers about the potential for severe complications arising from even minor corrections in serum sodium levels in such patients.
Assessing the risk of tumor lysis syndrome associated with the use of antineoplastic agents: a real-world pharmacovigilance study based on the FDA Adverse Event Reporting System database
Authors: Li Dongxuan , Qin Chunmeng , Wang Hongli , Du Dan , Wang Yalan , Du Qian , Liu Songqing 
Published: September 2024

Background: The use of antineoplastic agents is one of the important triggers of tumor lysis syndrome (TLS), but there is still a lack of comprehensive understanding of antineoplastic agents that may trigger TLS and the TLS risk differences between different antineoplastic agents. Objectives: This study aims to investigate the TLS risk of different antineoplastic agents and provide reference information for clinical practice. Design: Real-world adverse events data in the FDA Adverse Event Reporting System (FAERS) database were used as the basis for the disproportionality analysis. Methods: We reviewed the TLS reports in the FAERS database from 2004 to 2022 to summarize an antineoplastic agent list that was reported to trigger TLS, based on which we conducted disproportionality analysis to assess the TLS risk of each antineoplastic agent. Results: In all, 164 antineoplastic agents were reported to trigger TLS. On the whole, rituximab was the most reported antineoplastic agent in TLS reports, followed by cyclophosphamide, venetoclax, doxorubicin, and etoposide, while tagraxofusp was the antineoplastic agent with the highest adverse drug reaction (ADR) signal strength in signal detection, followed by floxuridine, pentostatin, tebentafusp, and venetoclax. Integrating ADR signal detection results, 129 of 164 antineoplastic agents showed at least one positive ADR signal, and six antineoplastic agents (bevacizumab, carboplatin, cisplatin, fluorouracil, lenvatinib, and paclitaxel) have the highest total number of positive signals. Further classifying the 164 antineoplastic agents into 46 chemical subgroups to conduct ADR signal detection, nitrogen mustard analogs were the most reported antineoplastic agent subclasses, followed by clusters of differentiation 20 inhibitors, and pyrimidine analogs, while clusters of differentiation 22 inhibitors were the antineoplastic agent subclass with the highest ADR signal strength, followed by podophyllotoxin derivatives and actinomycines. Conclusion: Our study showed the TLS risk characteristics of 164 antineoplastic agents by detecting and integrating ADR signals, which may help to optimize clinical practice.
‘GP services are still heteronormative’: Sexual minority cisgender women’s experiences of UK menopause healthcare – Health equity implications
Authors: Westwood Sue 
Published: September 2024

Objective This article reports on UK sexual minority cisgender women’s experiences of menopause health and healthcare, based on a data subset from a study exploring lesbian, gay, bisexual, and queer (LGBTQ+) menopause. Methods An online survey was conducted with UK LGBTQ + individuals who went through/are going through the menopause. Quantitative data were analysed using simple descriptive statistics. Qualitative data were analysed using thematic analysis. Results Cisgender respondents comprised 51 lesbian, gay, bisexual, pansexual, queer, and ‘other’ women, aged between 17 and 89 years. They reported similar types and levels of menopause symptoms as heterosexual cisgender women in other studies, apart from higher levels of anxiety and depression, especially bisexual women. Dissatisfaction regarding menopause healthcare services related to access, information, and heteronormative/heterosexist provision. Conclusions Healthcare providers must ensure they provide inclusive menopause services to sexual minority cisgender women.
Unlocking biomedical data sharing: A structured approach with digital twins and artificial intelligence (AI) for open health sciences
Authors: Jean-Quartier Claire , Stryeck Sarah , Thien Alexander , Vrella Burim , Kleinschuster Jeremias , Spreitzer Emil , Wali Mojib , Mueller Heimo , Holzinger Andreas , Jeanquartier Fleur 
Published: September 2024

Objective Data sharing promotes the scientific progress. However, not all data can be shared freely due to privacy issues. This work is intended to foster FAIR sharing of sensitive data exemplary in the biomedical domain, via an integrated computational approach for utilizing and enriching individual datasets by scientists without coding experience. Methods We present an in silico pipeline for openly sharing controlled materials by generating synthetic data. Additionally, it addresses the issue of inexperience to computational methods in a non-IT-affine domain by making use of a cyberinfrastructure that runs and enables sharing of computational notebooks without the need of local software installation. The use of a digital twin based on cancer datasets serves as exemplary use case for making biomedical data openly available. Quantitative and qualitative validation of model output as well as a study on user experience are conducted. Results The metadata approach describes generalizable descriptors for computational models, and outlines how to profit from existing data resources for validating computational models. The use of a virtual lab book cooperatively developed using a cloud-based data management and analysis system functions as showcase enabling easy interaction between users. Qualitative testing revealed a necessity for comprehensive guidelines furthering acceptance by various users. Conclusion The introduced framework presents an integrated approach for data generation and interpolating incomplete data, promoting Open Science through reproducibility of results and methods. The system can be expanded from the biomedical to any other domain while future studies integrating an enhanced graphical user interface could increase interdisciplinary applicability.
How to promote telemedicine in underdeveloped cities in central China? Qualitative interviews with medical personnel in tertiary A-level hospital of Xinyang City
Authors: Qingjie Peng , Wanyu Huang , Jingying Yang , Ming Yang , Linlin Wang , Qiyue Mao , Fan Wang , Minghao Pan 
Published: September 2024

Background Telemedicine has emerged as a novel healthcare service model that plays a vital role in addressing the unequal distribution of medical resources. Telemedicine has recently gained significant traction in economically prosperous cities such as Beijing, Shanghai, and Guangzhou in China. However, Xinyang City in Henan Province is an economically less developed city, and telemedicine is still in its early stages. By exploring the views of medical staff and administrators at Xinyang City's tertiary A-level hospital on telemedicine, this study aims to determine the development status of telemedicine services in Xinyang City. The objective was to identify the challenges in the construction process and formulate corresponding strategies for advancing telemedicine in Xinyang City. Methods Face-to-face personal interviews were conducted with 16 medical staff and administrators from a tertiary A-level hospital in Xinyang City, Henan Province, and the data were collected and analyzed using grounded theory. In the process of data analysis, NVivo12 software was used to encode and organize the data line by line. Results The development of telemedicine in Xinyang City has the potential to benefit residents, hospitals, and healthcare personnel despite several challenges, including the absence of laws and regulations, inadequate policy support, limited hospital cooperation, and low resident awareness, which must be addressed to unlock the full potential of telemedicine. Conclusion The telemedicine system in Xinyang City is currently in a coordinated developmental phase, and several areas require further improvement. The development of standardized telemedicine in Xinyang City requires government support, better training for general practitioners, public awareness campaigns, and improved technology while ensuring reasonable work schedules and motivating medical personnel.
A feasibility study on utilizing machine learning technology to reduce the costs of gastric cancer screening in Taizhou, China
Authors: Yan Si-yan , Fu Xin-yu , Tang Shen-Ping , Qi Rong-bin , Liang Jia-wei , Mao Xin-li , Ye Li-ping , Li Shao-wei 
Published: September 2024

Aim To optimize gastric cancer screening score and reduce screening costs using machine learning models. Methods This study included 228,634 patients from the Taizhou Gastric Cancer Screening Program. We used three machine learning models to optimize Li's gastric cancer screening score: Gradient Boosting Machine (GBM), Distributed Random Forest (DRF), and Deep Learning (DL). The performance of the binary classification models was evaluated using the area under the curve (AUC) and area under the precision–recall curve (AUCPR). Results In the binary classification model used to distinguish low-risk and moderate- to high-risk patients, the AUC in the GBM, DRF, and DL full models were 0.9994, 0.9982, and 0.9974, respectively, and the AUCPR was 0.9982, 0.9949, and 0.9918, respectively. Excluding Helicobacter pylori IgG antibody, pepsinogen I, and pepsinogen II, the AUC in the GBM, DRF, and DL models were 0.9932, 0.9879, and 0.9900, respectively, and the AUCPR was 0.9835, 0.9716, and 0.9752, respectively. Remodel after removing variables IgG, PGI, PGII, and G-17, the AUC in GBM, DRF, and DL was 0.8524, 0.8482, 0.8477, and AUCPR was 0.6068, 0.6008, and 0.5890, respectively. When constructing a tri-classification model, we discovered that none of the three machine learning models could effectively distinguish between patients at intermediate and high risk for gastric cancer (F1 scores in the GBM model for the low, medium and high risk: 0.9750, 0.9193, 0.5334, respectively; F1 scores in the DRF model for low, medium, and high risks: 0.9888, 0.9479, 0.6694, respectively; F1 scores in the DL model for low, medium, and high risks: 0.9812, 0.9216, 0.6394, respectively). Conclusion We concluded that gastric cancer screening indicators could be optimized when distinguishing low-risk and moderate to high-risk populations, and detecting gastrin-17 alone can achieve a good discriminative effect, thus saving huge expenditures.
A method combining LDA and neural networks for antitumor drug efficacy prediction
Authors: Zhu Weiwei , Zhang Lei , Jiang Xiaodong , Zhou Peng , Xie Xinping , Wang Hongqiang 
Published: September 2024

Background Personalized medicine has gained more attention for cancer precision treatment due to patient genetic heterogeneity in recent years. However, predicting the efficacy of antitumor drugs in advance remains a significant challenge to achieve this task. Objective This study aims to predict the efficacy of antitumor drugs in individual cancer patients based on clinical data. Methods This paper proposes to predict personalized antitumor drug efficacy based on clinical data. Specifically, we encode the clinical text of cancer patients as a probability distribution vector in hidden topics space using the Latent Dirichlet Allocation (LDA) model, named LDA representation. Then, a neural network is designed, and the LDA representation is input into the neural network to predict drug response in cancer patients treated with platinum drugs. To evaluate the effectiveness of the proposed method, we gathered and organized clinical records of lung and bowel cancer patients who underwent platinum-based treatment. The prediction performance is assessed using the following metrics: Precision, Recall, F1-score, Accuracy, and Area Under the ROC Curve (AUC). Results The study analyzed a dataset of 958 patients with non-small cell cancer treated with antitumor drugs. The proposed method achieved a stratified 5-fold cross-validation average Precision of 0.81, Recall of 0.89, F1-score of 0.85, Accuracy of 0.77, and AUC of 0.81 for cisplatin efficacy prediction on the data, which most are better than those of previous methods. Of these, the AUC value is at least 4% higher than those of the previous. At the same time, the superior result over the previous method persisted on an independent dataset of 266 bowel cancer patients, showing the generalizability of the proposed method. These results demonstrate the potential value of precise tumor treatment in clinical practice. Conclusions Combining LDA and neural networks can help predict the efficacy of antitumor drugs based on clinical text. Our approach outperforms previous methods in predicting drug clinical efficacy.
Effect of Diffuse Idiopathic Skeletal Hyperostosis on the Occurrence of Thoracolumbar Vertebral Fragility Fractures at Different Ages
Authors: Wu Yinbo , Ye Qin , He Dong , Wei Yuguo , Pan Yaling , Wang Yajie 
Published: September 2024

Study Design Retrospective Case control Study. Objectives To analyze the effect of diffuse idiopathic skeletal hyperostosis (DISH) on the occurrence of new thoracolumbar vertebral fragility fractures (VFFs) at different ages. Methods A retrospective analysis of 564 patients, including 189 patients who presented with new-onset thoracolumbar VFFs and 375 patients without spinal fractures, was performed in 4 age groups (50-59 years, 60-69 years, 70-79 years, and 80+ years). DISH was diagnosed based on computed tomography findings, and the Mata score of each disc space level combined with the maximum number of consecutive ossified segments (MNCOS) for each patient was recorded. Data were compared between the fracture and control groups, and odds ratios (ORs) were calculated for each of the 4 age groups using logistic regression. Results Both the crude ORs and the adjusted ORs of DISH for VFFs decreased with age, with statistical significance shown in the 50-59 years group (crude OR = 4.373, P = 0.017; adjusted OR = 7.111, P = 0.009) and the 80+ years group (crude OR = 0.462, P = 0.018; adjusted OR = 0.495, P = 0.045). The Mata scores and the MNCOS were significant risk factors for VFFs ( P < 0.05) in the 50-59 years group, but they were protective factors in the 80+ years group, which was more significant in the T11/12–L5/S1 subsegment. Conclusions The effect of DISH on the occurrence of thoracolumbar VFFs is complex, and in patients above 50 years, it changes from a risk factor to a protective factor with increasing age.
Outcomes After Extracorporeal Shockwave Therapy for Chronic Noninsertional Achilles Tendinopathy Compared With Chronic Insertional Achilles Tendinopathy: A Retrospective Review
Authors: Butler James J. , DeClouette Brittany , Azam Mohammad T. , Walls Raymond C. , Jejelava George , Zheng Danny , Jia Nathan , Kennedy John G. 
Published: September 2024

Background: Extracorporeal shockwave therapy (ESWT) is a noninvasive treatment modality that is used in the treatment of chronic Achilles tendinopathy (AT). Purposes: To (1) retrospectively assess outcomes after ESWT for both noninsertional AT (NAT) and insertional AT (IAT) at >1-year follow-up and (2) identify potential predictors of outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: Chart review was conducted to identify patients who underwent ESWT for AT with a minimum of 1-year follow-up. Data collected and assessed included patient demographic characteristics, pathological characteristics including the location of AT (NAT or IAT), presence of a Haglund deformity, and severity of tendon degeneration on magnetic resonance imaging (MRI), in addition to treatment characteristics including number of sessions and intensity of ESWT. The Victorian Institute of Sports Assessment–Achilles (VISA-A) and visual analog scale (VAS) pain scores were obtained before ESWT, 6 months after ESWT, and at final follow-up. Failures were also recorded, which were defined as no improvement in VISA-A or VAS scores or need for surgical intervention. Linear regression was performed to identify potential predictors of inferior subjective clinical outcomes and failures. Survival analysis was conducted using Kaplan-Meier curves. Results: The study included 52 patients with IAT and 34 patients with NAT. The mean follow-up in the NAT cohort was 22.3 ± 10.2 months and the mean follow-up in the IAT cohort was 26.8 ± 15.8 months. Improvements in VISA-A and VAS scores were observed in the NAT cohort at 6-month follow-up and at final follow-up ( P < .05). Improvements in VISA-A and VAS scores were recorded in the IAT cohort at 6-month follow-up, which subsequently deteriorated at final follow-up. In the NAT cohort, the failure rate at 6-month follow-up was 11.8%, which increased to 29.4% at final follow-up. In the IAT cohort, the failure rate at 6-month follow-up was 32.7%, which increased to 59.6% at final follow-up. Predictors of inferior subjective clinical outcomes and failures in the NAT cohort included pre-ESWT subjective clinical score, male sex, presence of a cardiovascular risk factor, and more severe MRI grading of tendinopathy. Predictors of inferior subjective clinical outcomes and failures in the IAT cohort included pre-ESWT subjective clinical score and more severe MRI grading of tendinopathy. Conclusion: Superior subjective clinical outcomes together with a lower failure rate were maintained for >1 year in the NAT cohort compared with the IAT cohort, calling into question the long-term benefit of ESWT for patients with IAT.
Evaluating Outcomes of a Co-Produced Theatre-Based Experiential Learning Project in Psychiatry
Authors: Walker Thomas , Jones Tomos , Grant-Peterkin Hugh , Dave Rupal , Röhricht Frank 
Published: September 2024

INTRODUCTION The benefits of theatre and arts-based initiatives for enhancing the health and wellbeing of adults, regardless of mental health status, are well-documented. Theatre methodologies offer a platform for co-produced experiential learning, promoting perspective-taking and effective communication among staff and service users. This project aimed to bring together service users and mental health professionals through workshops conducted by an experiential theatre company, focusing on themes such as relationship dynamics, co-production, empowerment and perspective-taking. Notably, the sessions were conducted online due to the COVID-19 pandemic. METHODS The study sought to explore the experiences, learning outcomes and work-related wellbeing benefits of participating in this innovative project. Methods involved inviting East London Foundation Trust members to eight weekly online workshops, culminating in a co-created filmed performance. Interviews conducted 9 months to a year later with participants and facilitators were thematically analysed. RESULTS Results revealed four key themes: (1) personal and collective growth through storytelling and embodied acting experiences; (2) the importance of workshop structure for experiential learning; (3) challenging traditional role definitions through diminished hierarchy; and (4) sustained impacts on time management at work and in personal lives. CONCLUSIONS In conclusion, participants valued their involvement, indicating that theatre-based co-produced learning enhances communication and interpersonal skills in mental healthcare settings. These findings suggest the potential for integrating such approaches into healthcare education and training programs.