bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ambulatory blood pressure monitoring in Egyptian children with nephrotic syndrome: single center experience
Authors: Alazem Eman Abobakr Abd , El-Saiedi Sonia Ali , Chitrakar Shradha , Othman Shorouk A. 
Published: October 2024

Abstract
Background
Hypertension (HTN), especially masked hypertension, is one of the cardiovascular consequences of nephrotic syndrome. Masked hypertension cannot be identified during routine follow-up visits and adversely effects the patients’ cardiac function. The purpose of this study was to use ambulatory blood pressure monitoring (ABPM) to evaluate the blood pressure status of children with nephrotic syndrome.

Methods
Ninety children with nephrotic syndrome (NS) participated in this cross-sectional study, which was carried out at Cairo University Children Hospital’s nephrology clinic (CUCH). A sphygmomanometer was used in the clinic to measure blood pressure, and a Meditech monitor was used for 24-hour ambulatory blood pressure monitoring (ABPM). Interventricular septum (IVS) was measured, and heart functions were evaluated, using echocardiography.

Results
Two groups comprised the included patients: Group1 (n = 70): HTN group included masked and ambulatory hypertension, and Group 2 (n = 20): non-HTN group included normal blood pressure, white coat HTN and well controlled HTN, 35% of the studied cohort (n = 32/90) had masked HTN.The serum urea was significantly higher in HTN group than non-HTN group with p-value: 0.047, while the serum albumin was significantly lower in HTN group than non-HTN group with p-value: 0.017. The cut-off point of 9.9, the sensitivity and specificity of serum urea to predict the occurrence of hypertension in NS patients was 92.9% and 35% respectively, with p-value : 0.024 and 95% CI (0.534–0.798). The z score of IVS is significantly higher in group 1 (2.5 ± 1.2) when compared to group 2 (1.7 ± 2.1) with p-value: 0.025 and Among group 1, it was noticed that 74% (n = 52/70) of them were systolic non-dipper, also it was observed that the mean serum potassium and cholesterol were significantly higher among systolic non-dipper when compared with systolic dipper patients with p-values: 0.045 and 0.005 respectively.

Conclusion
Children with nephrotic syndrome are particularly vulnerable to experience ambulatory hypertension and masked hypertension, which may adversely impact their cardiac condition because they are not detectable by standard blood pressure readings at the clinic.
Dysfunction of γδ T cells in pediatric chronic active Epstein-Barr virus infection
Authors: Ai Junhong , Xiao Haijuan , Zhang Linlin , Ma Honghao , Wang Dong , Dilmurat Dilara , Wang Ran , Xie Zhengde 
Published: October 2024

AbstractChronic active Epstein-Barr virus infection (CAEBV) is a progressive and life-threatening disease characterized by persistent or recurrent EBV activation. It has been reported that, γδ T cells, a type of cytotoxic lymphocyte, play a critical role in restricting EBV. However, the functional status of γδ T cells in pediatric CAEBV patients has not yet been described. In this study, flow cytometry analysis was conducted to explore the cytokine production capacity of γδ T cells in CAEBV patients. A diminished frequency of γδ T cells and decreased expression of cytolytic molecule granzyme B were found in CAEBV patients, suggesting a dysfunction in the immune regulatory function of γδ T cells in this disease.
Health dialogue intervention versus opportunistic screening in primary care for type 2 diabetes and cardiovascular disease prevention in settings with low socioeconomic status (DETECT): study protocol for a pragmatic cluster-randomized trial
Authors: Ballin Marcel , Backman Enelius Moa , Dini Samira , Galanti Maria Rosaria , Hagströmer Maria , Heintz Emelie , Lager Anton , de Leon Antonio Ponce , Lundh Lena , Nystrand Camilla , Walldin Christina , Augustsson Hanna 
Published: October 2024

Abstract
Background
Meta-analyses of randomized trials suggest that health checks and health promotion interventions targeting behavior change in primary care do not prevent cardiovascular morbidity and mortality in the general population. However, whether such interventions are more effective in high-risk populations, such as people living in low socioeconomic settings, remains unclear, as they have been poorly represented in previous trials. Therefore, we aim to evaluate the effectiveness, cost-effectiveness, and implementation of systematic screening followed by an individually oriented, lifestyle-focused, health dialogue intervention for prevention of type 2 diabetes and cardiovascular disease, as compared to opportunistic screening, in primary care in socioeconomically disadvantaged areas.

Methods
Using an overall pragmatic approach and a cluster-randomized design with two arms, we aim to enroll 3000 participants aged 50–59 years from 30 primary care centers (PCCs) with an above-average level of Care Need Index in Stockholm Region, Sweden. PCCs will be randomized (1:1) either to a health dialogue intervention, which includes inviting enlisted patients to a systematic screening of risk factors followed by an individually oriented lifestyle-focused health dialogue, or to opportunistic screening, which includes screening patients for a smaller set of risk factors during an appointment at their PCC taking place for other reasons. The main outcome will be change in systolic blood pressure during 6- and 12-month follow-ups. Additional short-term outcomes will be changes in other biological risk factors, health-related quality-of-life, and lifestyle habits, as well as process and implementation outcomes, and unintended side effects. The long-term effect on type 2 diabetes and cardiovascular disease incidence and mortality will be examined using regional and nationwide registers. Changes in systolic blood pressure and other health outcomes will be analyzed using mixed-effect generalized linear modeling and mixed-effect Cox regression to capture variability between and within PCCs. A health economic evaluation will assess resource use and costs in the short- and long-term.

Discussion
This trial of lifestyle-focused health dialogues and opportunistic screening in primary care in socioeconomically disadvantaged areas in the largest region of Sweden has the potential to yield valuable insights that could support evidence-based policymaking.

Trial registration
ClinicalTrials.gov (NCT06067178). Prospectively registered September 27, 2023.
Detection of human strongyloidiasis among patients with a high risk of complications attending selected tertiary care hospitals in Colombo, Sri Lanka using molecular and serological diagnostic tools
Authors: Weerasekera Chamarika Jayanetti , Gunathilaka Nayana , Menike Chandrani , Anpahalan Philip , Perera Nilanka , de Silva Nilanthi Renuka , Wickremasinghe Renu 
Published: October 2024

Abstract
Background
Strongyloidiasis a neglected tropical disease is known to cause severe disease among immunosuppressed and has not been studied extensively in Sri Lanka. Parasitological diagnostic approaches based on faecal microscopy and culture often fail to detect low-intensity infections. This study investigates the presence of strongyloidiasis among selected immunocompromised individuals using parasitological, molecular and serological techniques.

Methods
Adult patients with immunocompromising conditions admitted to three tertiary care hospitals in Sri Lanka were recruited. A faecal sample and 2 ml of venous blood were collected. The faecal samples were subjected to direct faecal smear and cultures (agar plate, charcoal and Harada-Mori) and polymerase chain reaction (PCR) using species specific primers designed for Strongyloides stercoralis. The presence of Strongyloides IgG antibodies was tested in the collected serum samples using DRG Strongyloides IgG enzyme-linked immunosorbent assay (ELISA) kits. The PCR products of the positive samples were sequenced using Sanger sequencing method.

Results
A total of 260 patients were recruited to this study, out of which 160 provided faecal samples and 122 provided blood samples. Out of the 160 faecal samples, none were positive for strongyloidiasis by direct smear, charcoal and Harada-Mori cultures. Only one sample (0.6%) was positive by agar plate culture. Out of the 123 samples subjected to PCR, 14 (11.4%), including the culture positive patient, were positive for S. stercoralis. Sequencing results of the PCR products indicated 100% similarity to S. stercoralis. Out of the 122 serum samples subjected to ELISA, 20 (16.4%), including the culture positive patient, were positive for Strongyloides IgG antibodies. However, sociodemographic, exposure factors, clinical features were not significantly associated with the presence of strongyloidiasis infection.

Conclusions
Strongyloidiasis is present among the immunocompromised population in Sri Lanka, even in the absence of a significant relationship with associated factors. It is advisable to screen such patients with highly sensitive tests such as PCR for early diagnosis and treatment.

Graphical Abstract
Extracellular vesicles from human cardiac stromal cells up-regulate cardiomyocyte protective responses to hypoxia
Authors: Czosseck Andreas , Chen Max M. , Hsu Chuan-Chih , Shamrin Gleb , Meeson Annette , Oldershaw Rachel , Nguyen Helen , Livkisa Dora , Lundy David J. 
Published: October 2024

Abstract
Background
Cell therapy can protect cardiomyocytes from hypoxia, primarily via paracrine secretions, including extracellular vesicles (EVs). Since EVs fulfil specific biological functions based on their cellular origin, we hypothesised that EVs from human cardiac stromal cells (CMSCLCs) obtained from coronary artery bypass surgery may have cardioprotective properties.

Objectives
This study characterises CMSCLC EVs (C_EVs), miRNA cargo, cardioprotective efficacy and transcriptomic modulation of hypoxic human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs). C_EVs are compared to bone marrow mesenchymal stromal cell EVs (B_EVs) which are a known therapeutic EV type.

Methods
Cells were characterised for surface markers, gene expression and differentiation potential. EVs were compared for yield, phenotype, and ability to protect hiPSC-CMs from hypoxia/reoxygenation injury. EV dose was normalised by both protein concentration and particle count, allowing direct comparison. C_EV and B_EV miRNA cargo was profiled and RNA-seq was performed on EV-treated hypoxic hiPSC-CMs, then data were integrated by multi-omics. Confirmatory experiments were carried out using miRNA mimics.

Results
At the same dose, C_EVs were more effective than B_EVs at protecting CM integrity, reducing apoptotic markers, and cell death during hypoxia. While C_EVs and B_EVs shared 70–77% similarity in miRNA content, C_EVs contained unique miRNAs, including miR-202-5p, miR-451a and miR-142-3p. Delivering miRNA mimics confirmed that miR-1260a and miR-202/451a/142 were cardioprotective, and the latter upregulated protective pathways similar to whole C_EVs.

Conclusions
This study demonstrates the potential of cardiac tissues, routinely discarded following surgery, as a valuable source of EVs for myocardial infarction therapy. We also identify miR-1260a as protective of CM hypoxia.
Teledermatology: an evidence map of systematic reviews
Authors: Chow Aloysius , Smith Helen Elizabeth , Car Lorainne Tudor , Kong Jing Wen , Choo Kay Wee , Aw Angeline Ai Ling , Wong Marie Ann Mae En , Apfelbacher Christian 
Published: October 2024

Abstract
Background
Although the number of teledermatology studies is increasing, not all variables have been researched in equal depth, so there remains a lack of robust evidence for some teledermatology initiatives. This review describes the landscape of teledermatology research and identifies knowledge gaps and research needs. This evidence map can be used to inform clinicians about the current knowledge about teledermatology and guide researchers for future studies.

Methods
Our evidence map was conducted according to the Campbell Collaboration checklist for evidence and gap maps. Eight databases were searched (CINAHL, Embase, PubMed, Scopus, Web of Science, Cochrane Library, JBI Database of Systematic Reviews and Implementation Reports, and OpenGray), and only included systematic reviews of teledermatology involving humans published in English; while excluding non-systematic reviews (i.e., abstracts, conference proceedings, editorials, commentaries, or letters). From 909 records, 14 systematic reviews published between 2004 and 2022 were included. Our analysis focused on the systematic reviews’ characteristics, dermatological conditions studied, rate of overlap and quality assessment of primary studies reviewed, and main findings reported.

Results
Teledermatology was reportedly comparable with clinic dermatology and generally accepted by patients as a mode of care delivery for dermatological conditions. However, there are concerns about privacy, communication, completeness of information transmitted, familiarity with the technology, and technical problems. Healthcare professionals were generally satisfied with teledermatology but found telemedicine consultations longer than face-to-face consultations, and less confident in asynchronous teledermatology than conventional consultations. Teledermatology was reportedly more cost-effective than clinic dermatology; especially considering the distance traveled by patients, referral volume to teledermatology, and clinic dermatology costs. Although patients and providers are satisfied with teledermatology, face-to-face dermatology has higher diagnostic and management accuracy. Teledermatology was also used for training medical professionals. Regarding the validity and reliability of teledermatology outcome measures, no significant discussions were found.

Conclusions
COVID-19 spotlighted telemedicine in clinical care, and we must ensure telemedicine continually improves with robust research. Further research is necessary for establishing a standardized outcome set, enhancing accuracy, concordance, cost-effectiveness, and safety, comparing teledermatology with non-dermatologist care, examining its effectiveness in non-Western low and middle-income countries, and incorporating patient involvement for improved study design.

Systematic review registration
https://www.researchregistry.com/ (Unique Identifying Number: reviewregistry878).
Cryopreservation of bovine sperm causes single-strand DNA breaks that are localized in the toroidal regions of chromatin
Authors: Ribas-Maynou Jordi , Muiño Rodrigo , Tamargo Carolina , Yeste Marc 
Published: October 2024

Abstract
Background
Sperm cryopreservation is widely used in the cattle industry, as it allows for disassociating the localization of sires and the collection of semen from the timing of artificial insemination. While freeze-thawing is known to impair sperm DNA integrity, whether the damage induced consists of single- (SSB) or double-strand breaks (DSB) has not been determined. In addition, no previous study has addressed if DNA breaks preferentially reside in specific genome regions such as those forming the toroid linker regions, or are rather spread throughout the regions linked to protamines. The main aim of the present work, therefore, was to elucidate the type and localization of the DNA damage generated by cryopreservation and to evaluate its impact on artificial insemination outcomes in cattle.

Results
The incidence of SSB and DSB was evaluated in 12 ejaculates before and after cryopreservation with the Comet assay, and the localization of the DNA breaks was assessed using pulsed-field gel electrophoresis (PFGE). Before cryopreservation, the incidence of SSB was 10.99% ± 4.62% and involved 20.56% ± 3.04% of sperm cells, whereas these figures significantly (P < 0.0001) increased up to 34.11% ± 3.48% and 53.36% ± 11.00% in frozen-thawed sperm. In contrast, no significant differences in the incidence of DSB were observed (P > 0.990) before and after cryopreservation (before: incidence of 13.91% ± 1.75% of sperm DNA affecting 56.04% ± 12.49% of sperm cells; after: incidence of 13.55% ± 1.55% of sperm DNA involving 53.36% ± 11.00% of sperm cells). Moreover, PFGE revealed that the percentage of sperm DNA fragments whose length was shorter than a toroid (< 31.5 kb) was greater (P < 0.0001) after (27.00% ± 4.26%) than before freeze-thawing (15.57% ± 4.53%). These differences indicated that the DNA breaks induced by cryopreservation affect the regions condensed in protamines, which are structured in toroids. On the other hand, in vivo fertility rates were associated to the incidence of SSB and DSB in frozen-thawed sperm (P = 0.032 and P = 0.005), but not with the size of the DNA fragments resulting from these breaks (P > 0.05).

Conclusion
Cryopreservation of bovine sperm generates single-strand DNA breaks, which are mainly located in protamine-condensed toroidal regions. The incidence of DNA breaks in cryopreserved sperm has an impact on cattle fertility, regardless of the size of generated fragments.
Deep-learning-based attenuation map generation in kidney single photon emission computed tomography
Authors: Kwon Kyounghyoun , Oh Dongkyu , Kim Ji Hye , Yoo Jihyung , Lee Won Woo 
Published: October 2024

Abstract
Background
Accurate attenuation correction (AC) is vital in nuclear medicine, particularly for quantitative single-photon emission computed tomography/computed tomography (SPECT/CT) imaging. This study aimed to establish a CT-free quantification technology in kidney SPECT imaging using deep learning to generate synthetic attenuation maps (μ-maps) from SPECT data, thereby reducing radiation exposure and eliminating the need for CT scans.

Results
A dataset of 1000 Tc-99m DTPA SPECT/CT scans was analyzed for training (n = 800), validation (n = 100), and testing (n = 100) using a modified 3D U-Net for deep learning. The study investigated the use of primary emission and scattering SPECT data, normalization methods, loss function optimization, and up-sampling techniques for optimal μ-map generation. The problem of checkerboard artifacts, unique to μ-map generation from SPECT signals, and the effects of iodine contrast media were evaluated. The addition of scattering SPECT to primary emission SPECT imaging, logarithmic maximum normalization, the combination of absolute difference loss (L1) and three times the absolute gradient difference loss (3 × LGDL), and the nearest-neighbor interpolation significantly enhanced AI performance in μ-map generation (p < 0.00001). Checkerboard artifacts were effectively eliminated using the nearest-neighbor interpolation technique. The developed AI algorithm produced μ-maps neutral to the presence of iodine contrast and showed negligible contrast effects on quantitative SPECT measurement, such as glomerular filtration rate (GFR). The potential reduction in radiation exposure by transitioning to AI-based CT-free SPECT imaging ranges from 45.3 to 78.8%.

Conclusion
The study successfully developed and optimized a deep learning algorithm for generating synthetic μ-maps in kidney SPECT images, demonstrating the potential to transition from conventional SPECT/CT to CT-free SPECT imaging for GFR measurement. This advancement represents a significant step towards enhancing patient safety and efficiency in nuclear medicine.
On the cutting edge of sickle cell disease: a snapshot narrative review
Authors: Menshawey Rahma , Menshawey Esraa 
Published: October 2024

Abstract
Background
Sickle cell disease (SCD) is the most common hemoglobinopathy worldwide, characterized by vaso-occlusive crises and ischemia that affects patients on a multi-system level. Despite being a genetically simple disease due to a single base mutation, SCD poses many therapeutic challenges. Additionally, its impact on patients’ life remains significant. This narrative review aims to provide a snapshot of recent highlights of the significant progress in SCD therapy, and the impact of SCD on patients’ life, including the complications, morbidity, and mortality factors of the disease.

Methodology
Google Scholar and PubMed were searched for “sickle cell disease”. Only full-text English language original research articles were included in this review. In total, 600 articles were screened, 300 from each database, which were published from 2020 to 2024-06-01. A total of 139 studies were included in this review, after screening for inclusion.

Conclusions
The increasing global incidence of sickle cell disease underscores the urgency for healthcare interventions to address the health challenges of an aging population living with this chronic condition. While treatment options for sickle cell disease have broadened, their availability is still limited. Among these options, stem cell transplant stands out as the definitive treatment, with ongoing efforts to enhance the donor pool. The disease significantly affects patients' quality of life and overall health, with emerging neurological and psychiatric issues. Additionally, the impact of sickle cell disease on reproductive health in both men and women presents a pressing need for further research to meet reproductive challenges.
Higher FSH Level Is Associated With Increased Risk of Incident Hip Fracture in Older Adults, Independent of Sex Hormones
Authors: Koh Eileen H , Ewing Susan K , Sigurdsson Sigurdur , Gudnason Vilmundur , Hue Trisha F , Vittinghoff Eric , Ohlsson Claes , Tivesten Åsa , Grahnemo Louise , Yuen Tony , Zaidi Mone , Rosen Clifford J , Schwartz Ann V , Schafer Anne L 
Published: October 2024

Abstract

Context
Higher levels of FSH are associated with bone loss among women during the perimenopausal transition and among older men, independent of estradiol and testosterone levels, but whether higher FSH is an independent fracture risk factor is unknown.

Objective
To determine whether baseline FSH level predicts subsequent hip fracture in older adults.

Setting, Design, Participants
Using a case-cohort design, we randomly sampled 295 participants stratified by sex from the Age, Gene/Environment Susceptibility-Reykjavik cohort, including 25 participants with incident hip fracture within 10 years after baseline. We sampled an additional 230 sex-stratified participants with incident hip fracture. Serum FSH and sex hormone levels were measured at baseline. Robust weighted Cox proportional hazards models were used to determine the relationship between FSH and hip fracture risk.

Main Outcome
Incident hip fracture.

Results
As no interaction was identified between FSH and sex for the relationship with fracture, men and women were pooled for analysis. Higher levels of FSH were associated with a significantly increased risk of incident hip fracture in models adjusted for age and sex [hazard ratio (HR) 1.24 (95% CI 1.04-1.48, P = .02)] and after further adjustment for estradiol, testosterone, and SHBG levels [HR 1.20 (95% CI 1.01-1.44, P = .04) per sex-specific SD increase in FSH level].

Conclusion
Higher FSH is associated with an increased risk of subsequent hip fracture. Our findings support a growing body of evidence for the direct pleiotropic effects of FSH on bone and for a role for FSH in aging and disability independent of sex hormone levels.