bluuebunny/crossref_metadata_2025_split huggingface dataset:
Informed Consent Practices Among Emergency Staff for Patients Undergoing Emergency Surgery in the Emergency Surgical Units of Two Tertiary Teaching Hospitals in Uganda: A Qualitative Study
Authors: Kituuka Olivia , Munabi Ian , Galukande Moses , Twimukye Adelline , Mwaka Erisa 
Published: June 2024

Abstract

Background
Staff in low resourced emergency units of a low-income country face the challenge of obtaining informed consent for incapacitated patients or their next of kin in a time-constrained situation often in an overcrowded environment. Therefore, we aimed to establish the informed consent practices for emergency surgical care among healthcare professional at two emergency surgical units at two tertiary teaching hospitals in Uganda.
Methods
In October 2022 – February 2023we conducted key informant interviews in Uganda and purposively selected 16 staff in surgical emergency units at two tertiary teaching hospitals and directly observed the informed consent practices. Data was managed and analyzed inductively using NVivo version 12.
Results
Six themes emerged from key informant interviews including knowledge and perspectives no informed consent; processes, procedures, and practices regarding informed consent; communication strategies for informed consent; ethical considerations; benefits of informed consent during surgery; and challenges to emergency informed consent. Staff had adequate knowledge about informed consent but faced several challenges during the consent process due to lack of guiding institutional policies. Overall, the informed consent process was inadequate at both institutions with greeting of patients, disclosure of risks and assessment of understanding poorly done. Consent was conducted in a noisy environment at both institutions and there was no privacy in the public hospital.
Conclusion
Although knowledge about consent practices by emergency staff at both institutions was good, in practice there was inadequate disclosure of risks, inadequate knowledge about the surgical procedure, risks, and benefits. Emergency staff identified the need for procedure specific consent documents which capture the information that is given to the patient and guiding policies on consent for incapacitated patients who have no surrogates.
Mortality Risk Assessment Using the REVEAL 2.0 Score in Pulmonary Hypertension Secondary to Left Heart Disease
Authors: Sharp-Dimitri Demetrio , Pourriahi Mahyar , Zhou Christine , Jandarov Roman , Kay Dana , Jose Arun , Cook Jennifer , Elwing Jean , Gomez-Arroyo Jose 
Published: June 2024

Abstract

Background
Pulmonary hypertension (PH) frequently complicates the course of patients with left heart disease (PH-LHD) and is associated with worse clinical outcomes. Mortality calculators for PH-LHD are lacking, and it is unclear whether any risk prediction tools originally derived from other forms of PH can accurately predict outcomes in patients with PH-LHD.
Methods
We retrospectively analyzed data from 161 patients diagnosed with PH-LHD referred to our pulmonary hypertension center from 2016 to 2022. We calculated the Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL 2.0) risk score and categorized patients as low, intermediate, or high-risk. We assessed survival at 1 and 3 years using Kaplan-Meier and Cox proportional hazards, as well as classification performance using a concordance index.
Results
At the first outpatient visit, 15% of patients were stratified as low-risk, 27% as intermediate, and 57% as high-risk. Cumulative 1-year survival rates were 100%, 94%, and 91% for the low, intermediate, and high-risk strata, respectively. Cumulative 3-year survival rates were 96%, 89%, and 70% for the low, intermediate, and high-risk strata, respectively. We found no difference in outcomes at 1 year between risk groups. High-risk patients had an increased risk of death at 3 years using REVEAL 2.0 (HR 5.32, p < 0.001). However, while REVEAL 2.0 accurately discriminated high-risk patients, the hazard ratio was not statistically different between patients classified as intermediate-risk compared to low-risk.
Conclusion
REVEAL 2.0 accurately predicted 3-year survival in PH-LHD patients with high-risk features. However, the mortality risk between patients classified as intermediate-risk was not different from the low-risk stratum, suggesting inaccurate classification for this group of patients.
The outcomes of patients undergoing in vitro fertilization after fertility-sparing treatment for atypical endometrial hyperplasia and endometrial cancer: 10-year experience
Authors: Tao Tao , Wang Hanbi , Zhen Jingran , Sun Zhengyi , Yu Qi , Wang Xue , Pan Lingya , Cao Dongyan , Zhou Yuanzheng , Deng Chengyan 
Published: June 2024

Abstract

Objective

To summarize the characteristics and outcomes of patients undergoing in vitro fertilization (IVF) after fertility-sparing treatment for atypical endometrial hyperplasia and endometrial cancer (AH/EC), and to analyze the factors influencing reproductive outcomes and disease recurrence.

Methods

This study retrospectively reviewed the medical records of 125 women who underwent assisted reproductive technology (ART) after fertility-sparing treatment of AH/EC in Peking Union Medical College Hospital from March 2013 to March 2023. Data of clinical features, reproductive outcomes, and recurrence were collected. The primary outcomes were clinical pregnancy and live birth. The secondary outcome was disease recurrence.

Results

A total of 125 patients were involved in the study. The average age to start IVF cycle was 33.66±3.56 years.109 patients underwent at least one embryo transfer. The clinical pregnancy rate and live birth rate per ET were 35.80% and 17.70%, respectively. The cumulative pregnancy rate was 74.31%. The total recurrence rate during IVF was 8%. The younger onset age of AH/EC and controlled ovarian stimulation (COS) with levonorgestrel-releasing intrauterine system (LNG-IUS) were the two factors that were negatively correlated with live birth. COS with LNG-IUS and a history of recurrence before IVF were significantly correlated with the risk of recurrence.

Conclusion

IVF was noted as an effective method to achieve pregnancy in a relatively short period of time, and reproductive outcomes for AH/EC patients were satisfied. Repeated AH/EC treatment was feasible, while recurrence might affect subsequent fertility outcomes. COS with LNG-IUS did not exhibit to have negative effects on obtaining embryos. However, the effects of LNG-IUS on recurrence and endometrial receptivity are still remain unknown, and deserve further assessment.
Diagnostic performance of machine-learning-based screening methods for skin disease
Authors: Zhang Daojun , Jiang Xia , Qian Tian , Song Tingting , Chen Haixing , Yu Fubing , Hao Fei 
Published: June 2024

Abstract

The timely identification of skin diseases is of utmost importance, as it affects around 420 million individuals globally. In order to ensure prompt treatment, it is crucial to make a precise diagnosis. To aid in this process, machine learning (ML) techniques offer dependable screening approaches. Two researchers, operating independently, extensively investigated reputable studies sourced from PubMed, Web of Science, and Scopus databases. Their objective was to assess the efficacy of various ML methods and determine the suitability of a screening system for skin disease diagnosis. The analysis also considered factors such as parameters, dataset characteristics, and settings.
Latent profiles of physical behaviour and their impact on physical fitness and function of Portuguese older adults
Authors: Zymbal Vera , Magalhães João P. , Baptista Fátima , Cruz Eduardo B. , Rosa Gil B. , Sardinha Luís B. 
Published: June 2024

Abstract

Exploring individuals’ patterns of physical activity and sedentary behaviour can reveal profiles that could differently impact health outcomes and benefit targeted interventions. This study aimed to identify latent profiles of physical behaviour in older adults and examine their association with physical fitness and function outcomes. The sample included 1095 participants (765 females) from the Portuguese physical activity and sports monitoring system. Latent profiles of physical behaviour were identified based on the percentage of waking time spent in sedentary behaviour, light physical activity, and moderate-to-vigorous physical activity (MVPA) assessed by accelerometery. Physical fitness was assessed by Senior Fitness Test Battery, and physical function was evaluated through the 12-item Composite Physical Function questionnaire. Associations between the profiles of physical behaviour and physical fitness and function outcomes were examined using generalized linear models adjusted for age. Three profiles of physical behaviour were identified: "active", "intermediate", and "sedentary" for both sexes. Participants with “active" or "intermediate" profiles exhibited the most favourable physical fitness and functional outcomes, while those with a "sedentary" profile showed the poorest results. Our findings suggest that a more balanced behaviour between physical activity and sedentary behaviour throughout the waking day appears to provide physical fitness and functional benefits, even if MVPA are not fully met. This is important for older adults who may struggle to comply fully with MVPA guidelines but could maintain or improve their physical fitness and function with a more active behaviour through the reduction of sedentary behaviour and inclusion of light physical activity.
Correlations of Blood and Brain NMR Metabolomics with Alzheimer’s Disease Mouse Models
Authors: Cheng Leo , Knörnschild Franz , Zhang Ella , Biswas Rajshree Ghosh , Kobus Marta , Chen Jiashang , Zhou Jonathan , Sun Joseph , Wang Xiaoyu , Li Wei , Muti Isabella , Habbel Piet , Nowak Johannes , Xie Zhongcong , Zhang Yiying 
Published: June 2024

Abstract

Alzheimer’s disease (AD) is a complex, progressive neurodegenerative disorder, impacting millions of geriatric patients globally. Unfortunately, AD can only be diagnosed post-mortem, through analysis of autopsied brain tissue in human patients. This renders early detection and countering disease progression difficult. As AD progresses, the metabolomic profile of the brain and other organs can change. These alterations can be detected in peripheral systems (i.e., blood) such that biomarkers of the disease can be identified and monitored with minimal invasion. In this work, High-Resolution Magic Angle Spinning (HRMAS) Nuclear Magnetic Resonance (NMR) spectroscopy is used to correlate biochemical changes in mouse brain tissues, from the cortex and hippocampus to blood plasma. 10 µg of each brain tissue and 10 µL of blood plasma were obtained from 5XFAD Tg AD mice models (n=15, 8 female, 7 male) and female C57/BL6 wild-type mice (n=8). 51 spectral regions-of-interest (ROI) were identified, and 121 potential metabolites were assigned using the Human Metabolome Database and tabulated according to their trends (increase/decrease, false discovery rate significance). This work identified several metabolites that impact glucose oxidation (lactic acid, pyruvate, glucose-6-phosphate), allude to oxidative stress resulting in brain dysfuncton(L-cysteine, galactitol, propionic acid), as well as those interacting with other neural pathways (taurine, dimethylamine). This work also suggests correlated metabolomic changes within blood plasma, proposing an avenue for biomarker detection, ideally leading to improved patient diagnosis and prognosis in the future.
FaceNet-Based CNN Architecture for Enhanced Attendance Monitoring System
Authors: Srinivasa P. , Racha Ganesh , Yavvari Naveen , A Sravanthi P , Kamatam Yedukondalu 
Published: June 2024

Abstract

In the present days, the domain of image classification has seen notable progress, particularly with the rise of Convolutional Neural Networks (CNNs) as a formidable tool in this area. The CNNs excel in detecting intricate patterns and features within images like human eye detection pattern system. The CNN architecture is designed by using convolutional layers, pooling layers, and fully connected layers, enables automatic feature extraction and abstraction, leading to more accurate image classification. By employing machine learning techniques, CNNs continuously improve their ability to classify various images with high precision through training on labelled datasets. In practical scenarios, CNNs find application in image classification for automating attendance tracking of groups. Utilizing facial recognition capabilities, the CNN system accurately identifies and records the attendance of individual persons in real-time, eliminating the necessity of manual tracking. To ensure ease of use, a user-friendly web interface is developed, providing a centralized platform for displaying all attendance records. This integrated solution not only streamlines attendance monitoring but also showcases the seamless integration of advanced image classification techniques and web development, offering an efficient approach to attendance management.
MECOM promotes leukemia progression and inhibits mast cell differentiation through functional competition with GATA2
Authors: Goyama Susumu , Iida Kohei , Nakanishi Mayuko , Nakahara Jakushin , Asada Shuhei , Isobe Tomoya , Yabushita Tomohiro , Ozawa Manabu , Yamada Yasuhiro , Kitamura Toshio , Yamamoto Keita 
Published: June 2024

Abstract

MECOM is a nuclear transcription factor essential for the proliferation of hematopoietic stem cells (HSCs) and myeloid leukemia cells. MECOM contains N- and C-terminal zinc finger domains (ZFDs) and binding motifs for the corepressor CtBP to regulate gene expression. Recent studies have shown that germline MECOM variants are associated with thrombocytopenia, radioulnar synostosis, and bone marrow failure, collectively termed MECOM-associated syndromes. Although the mutations are clustered in the C-terminal ZFD, how these mutations affect MECOM function has remained unclear. In addition, the individual genes and pathways regulated by MECOM are less well understood. In this study, we showed that the C-terminal ZFD is a major DNA-binding domain of MECOM and that the disease-associated mutations abolish the DNA-binding ability. We also found that MECOM functionally antagonizes GATA2 through the C-terminal ZFD-mediated DNA binding and CtBP interaction, thereby promoting myeloid leukemogenesis while inhibiting mast cell differentiation. Furthermore, we generated mutant MECOM knockin mice harboring a C-terminal ZFD mutation that recapitulate several features of MECOM-associated syndromes, including HSC and B-cell reduction. Our study demonstrates that C-terminal ZFD mutations are loss-of-function mutations with reduced DNA-binding ability, reveals the critical role of MECOM in inhibiting GATA2, and provides a novel mouse model for MECOM-associated syndromes.
Objective Monitoring of Motor Symptom Severity and their Progression in Parkinson’s Disease Using a Digital Gait Device
Authors: Raschka Tamara , To Jackrite , Hähnel Tom , Sapienza Stefano , Ibrahim Alzhraa , Glaab Enrico , Gaßner Heiko , Steidl Ralph , Winkler Jürgen , Corvol Jean-Christophe , Klucken Jochen , Fröhlich Holger 
Published: June 2024

Abstract

Digital technologies for monitoring motor symptoms of Parkinson’s Disease (PD) have underwent a strong evolution during the past years. Although it has been shown for several devices that derived digital gait features can reliably discriminate between healthy controls and people with PD, the specific gait tasks best suited for monitoring motor symptoms and especially their progression, remain unclear. Furthermore, the potential benefit as endpoint in a clinical trial context has not been investigated so far. In this study we employed a digital gait device manufactured by Portabiles HCT, which has been used by 339 patients within the LuxPark cohort (n = 161, Luxembourg) as well as within routine clinical care visits at the University Medical Center Erlangen (n = 178, Erlangen, Germany). Linear (mixed) models were used to assess the association of task-specific digital gait features with disease progression and motor symptom severity measured by several clinical scores. Furthermore, we employed machine learning to evaluate whether digital gait assessments were prognostic for patient-level motor symptom progression. Overall, digital gait features derived from Portabiles digital gait device were found to effectively monitor motor symptoms and their longitudinal progression. At the same time the prognostic performance of digital gait features was limited. However, we could show a strong reduction in required sample size, if digital gait features were employed as surrogates for traditional endpoints in a clinical trial context. Thus, Portabiles digital gait device provides an effective way to objectively monitor motor symptoms and their progression in PD. Furthermore, the digital gait device bears strong potential as an alternative and easily assessable endpoint predictor in a clinical trial context.
The Effect of Zinc Supplementation on Dosage and Sleep in People Suffering from Opioids Dependence Under Methadone-Maintenance Therapy
Authors: Amini Zahra , HeidariFarsani Ebrahim 
Published: June 2024

Abstract

Objectives
Zinc deficiency has been shown to affect the central nervous system, according to animal and human studies. In people under methadone-maintenance therapy (MMT), zinc deficiency is accompanied by various consequences. This study intended to evaluate the impact of zinc supplementation on dosage and sleep in people suffering from opioid dependence under MMT.
Methods
Following a clinical trial design, a total of 68 cases referring to outpatient MMT centers in Isfahan province in 2021 were recruited using the convenience sampling technique. Data were collected using the Pittsburgh Sleep Quality Index, a demographic questionnaire form, and a methadone dose form, which was performed before providing the intervention, and one and three months later. Data analysis was administered using SPSS version 23.
Results
some sleep quality subcomponents, including the score of sleep efficiency (p = 0.001), sleep disturbances (p < 0.001), and use of sleep medication (p < 0.001) were decreased for those in the intervention group, which was statistically significant. However, there was no statistically significant difference in the control group. Regarding components of subjective sleep quality (p = 0.04) and daily functional impairment (p = 0.01), the overall mean difference (before and after the intervention) between the intervention and control groups was statistically significant. However, There was a significant difference between the intervention and control groups concerning total sleep quality (p = 0.002); however, such difference was not found for methadone consumption (p = 0.73).
Conclusion
Zinc supplementation showed a positive effect on some subcomponents of sleep quality in people under MMT. However, it did not affect the dose of methadone.
Safety, Pharmacokinetics, Preliminary Efficacy, Pharmacodynamics, and Immunogenicity of QX002N, an Anti-IL-17A Monoclonal Antibody, after Short-term Treatment of Active Ankylosing Spondylitis
Authors: Wu Min , Li Qianqian , Fang Min , Chen Hong , Zhang Hong , Mai Jiajia , Li Xiaojiao , Ding Yanhua 
Published: June 2024

Abstract

Objectives
To investigate the safety, pharmacokinetics, preliminary efficacy, pharmacodynamics, and immunogenicity of QX002N, an interleukin-17A monoclonal antibody, in Chinese patients with active ankylosing spondylitis (AS).
Methods
In this phase 1b, double-blind, placebo-controlled, multiple ascending dose study, eligible patients with active AS were randomized into three dose (40, 80, or 160 mg) cohorts, with a 4:1 ratio in each cohort to subcutaneously receive either QX002N or a placebo once every 2 weeks with six doses in total. All patients were followed for 14 weeks (98 days) after the last dose. The primary endpoints were the safety and pharmacokinetics of QX002N, and the secondary endpoints included its preliminary efficacy, pharmacodynamics, and immunogenicity.
Results
Thirty patients (n = 10 in each cohort) were included, with 24 receiving QX002N and 6 receiving a placebo. A total of 85 adverse drug reactions, predominantly Grade 1–2, were identified in 20 out of 24 patients (83.3%) who took QX002N. The exposure to QX002N increased proportionally with the dose escalating from 40 mg to 160 mg. Patients taking 160 mg QX002N achieved higher response rates (ASAS20: 87.6% at Week 8 [Day 56]); ASAS40: 50.0% at Week 12 [Day 78]), than those taking 40-mg or 80-mg QX002N. An increase in interleukin-17A and a decrease in interleukin-6 levels in the serum, with decreases in the erythrocyte sedimentation rate and high-sensitivity C-reactive protein levels, were observed. Anti-drug antibodies were detected in only one of 24 patients taking QX002N.
Conclusions
Subcutaneous administration of QX002N demonstrates a favorable safety profile, with linear PK characteristics. Promising clinical responses in pharmacodynamics and preliminary efficacy have been observed. Immunogenicity does not appear to be a concern.
Trial Registration
This study was registered with Chinadrugtrials.org.cn (CTR20201277)
Association between Metabolic Syndrome and the Risk of Nephrolithiasis: A Cohort Study
Authors: Sun Xiaoping , Wang Minzhen , Wang Zhiping 
Published: June 2024

Abstract

Objectives: Kidney stones are a common urological disease with increasing incidence in numerous countries every year, and its risk factors and prevention are significant public health issues. This study examined the association of metabolic syndrome with incident kidney stones.
Methods: This study included 36 811 adults from the health checkup population (2018–2023). The Cox proportional hazards model was used to elucidate the relationship between metabolic syndrome, the number of metabolic components, metabolic syndrome components, and the risk of nephrolithiasis. This essay used stratified analyses to identify participants with higher incidence risk.
Results: During 93 965.97 person-years of follow-up, 573 participants developed nephrolithiasis. Participants with metabolic syndrome had a higher risk of nephrolithiasis than those without metabolic syndrome. Increasing odds of nephrolithiasis with increasing number of metabolic syndrometraits. Obesity and hypertension were significantly associated with the risk of nephrolithiasis. However, we did not find that it was nonlinearly associated with higher risks of nephrolithiasis among participants with obesity, hypertension, hyperglycemia, and dyslipidemia. Compared with participants without metabolic syndrome, those with metabolic syndrome had a 60.5% higher risk of nephrolithiasis (hazard ratio 1.605, 95% confidence interval 1.275,2.021). Metabolic syndrome, number of metabolic components, and metabolic syndrome composition were independent risk factors for kidney stones in males, whereas these variables were not associated with kidney stones in females.
Conclusions: Metabolic syndrome, the number of metabolic components, obesity, and hypertension were positively associated with increased risk for nephrolithiasis, which were only observed among men.