bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thiamylal serum concentration for refractory convulsive status epilepticus while associated decreased concentrations of concomitant antiepileptics: a case report
Authors: Oda Kazutaka , Katanoda Tomomi , Arakaki Hitomi , Katsume Taiki , Matsuyama Kaho , Jono Hirofumi , Saito Hideyuki 
Published: July 2024

Abstract
Background
Treating refractory status epilepticus (RSE) remains a challenge. Thiamylal can be used as a second- or third-line treatment; however, its potential to induce cytochrome P450 (CYP) activity may reduce the concentration of antiepileptic drugs (AEDs) administered prior to thiamylal. This report details a case of RSE patient treated with thiamylal, with monitored concentrations of thiamylal and other AEDs.

Case presentation
A 72-year-old healthy man developed RSE. Despite the administration of various AEDs, his seizures were not resolved. Thiamylal was then administered at an initial bolus dose of 2.1 mg/kg, followed by a continuous infusion of 4.2–5.2 mg/kg/h. The initial thiamylal concentration was observed at 7.8 μg/mL, increasing to 35.2 μg/mL before decreasing after dose reduction and cessation. Concurrently, the concentration of concomitant carbamazepine decreased from 5.59 μg/mL to 2.1 μg/mL and recovered as thiamylal concentration decreased. Lesser impacts were noted for other AEDs.

Conclusions
This case report underscored the efficacy of thiamylal in treating RSE. However, it also highlighted the need for clinicians to closely monitor the concentrations of concurrent AEDs, especially carbamazepine, during thiamylal therapy.
Resilience and quality of life in patients who underwent mechanical ventilation due to COVID-19, one year after discharge: a cross-sectional study
Authors: Rodriguez Lima David Rene , Rubio Ramos Cristhian , Diaz Quiroz Mateo Andrés , Rodríguez Aparicio Edith Elianna , Gómez Cortes Leonardo Andrés , Otálora González Laura , Hernández-Herrera Gilma , Pinzón Rondón Ángela María , Ruiz Sternberg Ángela María 
Published: July 2024

Abstract
Background
Patients with COVID-19 often experience severe long-term sequelae. This study aimed to assess resilience and Quality of Life (QoL) of patients who underwent mechanical ventilation due to COVID-19, one year after discharge.

Methods
This cross-sectional study enrolled patients who received mechanical ventilation for severe COVID-19 and were assessed one-year post-discharge. Participants completed a structured questionnaire via telephone comprising the Connor-Davidson Resilience Scale (CD-RISC) and the Post-COVID-19 Functional Status scale (PCFS). To establish the association between QoL and resilience, Spearman correlations were calculated between the PCFS and the CD-RISC. Linear regression models were adjusted to evaluate which factors were associated with QoL, with the total score of PCFS as the dependent variable.

Results
A total of 225 patients were included in the analysis. The CD-RISC had a median score of 83 (IQR 74–91). The PCFS results showed that 61.3% (n = 138) of the patients were able to resume their daily activities without limitations. Among them, 37.3% (n = 84) were classified as Grade 0 and 24% (n = 54) as Grade 1. Mild and moderate functional limitations were found in 33.7% of the patients, with 24.8% (n = 56) classified as Grade 2 and 8.8% (n = 20) as Grade 3. Severe functional limitations (Grade 4) were observed in 4.8% (n = 11) of the patients. High CD-RISC scores were associated with lower levels of PCFS score (p < 0.001).

Conclusions
In this cohort of critically ill patients who underwent mechanical ventilation due to COVID-19, 38% of patients experienced a significant decline in their QoL one year after hospital discharge. Finally, a high level of resilience was strongly associated with better QoL one year after discharge.
The association between malnutrition risk and revised Edmonton Symptom Assessment System (ESAS-r) scores in an adult outpatient oncology population: a cross-sectional study
Authors: McLay Katherine , Stonewall Nicole , Forbes Laura , Peters Christine 
Published: July 2024

Abstract
Background
Cancer-associated malnutrition is associated with worse symptom severity, functional status, quality of life, and overall survival. Malnutrition in cancer patients is often under-recognized and undertreated, emphasizing the need for standardized pathways for nutritional management in this population. The objectives of this study were to (1) investigate the relationship between malnutrition risk and self-reported symptom severity scores in an adult oncology outpatient population and (2) to identify whether a secondary screening tool for malnutrition risk (abPG-SGA) should be recommended for patients with a specific ESAS-r cut-off score or group of ESAS-r cut-off scores.

Methods
A single-institution retrospective cross-sectional study was conducted. Malnutrition risk was measured using the Abridged Patient-Generated Subjective Global Assessment (abPG-SGA). Cancer symptom severity was measured using the Revised Edmonton Symptom Assessment System (ESAS-r). In accordance with standard institutional practice, patients completed both tools at first consult at the cancer centre. Adult patients who completed the ESAS-r and abPG-SGA on the same day between February 2017 and January 2020 were included. Spearman’s correlation, Mann Whitney U tests, receiver operating characteristic curves, and binary logistic regression models were used for statistical analyses.

Results
2071 oncology outpatients met inclusion criteria (mean age 65.7), of which 33.6% were identified to be at risk for malnutrition. For all ESAS-r parameters (pain, tiredness, drowsiness, nausea, lack of appetite, shortness of breath, depression, anxiety, and wellbeing), patients at risk for malnutrition had significantly higher scores (P < 0.001). All ESAS-r parameters were positively correlated with abPG-SGA score (P < 0.01). The ESAS-r parameters that best predicted malnutrition risk status were total ESAS-r score, lack of appetite, tiredness, and wellbeing (area under the curve = 0.824, 0.812, 0.764, 0.761 respectively). Lack of appetite score ≥ 1 demonstrated a sensitivity of 77.4% and specificity of 77.0%. Combining lack of appetite score ≥ 1 with total ESAS score > 14 yielded a sensitivity of 87.9% and specificity of 62.8%.

Conclusion
Malnutrition risk as measured by the abPG-SGA and symptom severity scores as measured by the ESAS-r are positively and significantly correlated. Given the widespread use of the ESAS-r in cancer care, utilizing specific ESAS-r cut-offs to trigger malnutrition screening could be a viable way to identify cancer patients at risk for malnutrition.
BART, the new robotic assistant: big data, artificial intelligence, robotics, and telemedicine integration for an ICU 4.0
Authors: Bocci Maria Grazia , Barbaro Raffaella , Bellini Valentina , Napoli Christian , Darhour Luigino Jalale , Bignami Elena 
Published: July 2024

AbstractWe are in the era of Health 4.0 when novel technologies are providing tools capable of improving the quality and safety of the services provided. Our project involves the integration of different technologies (AI, big data, robotics, and telemedicine) to create a unique system for patients admitted to intensive care units suffering from infectious diseases capable of both increasing the personalization of care and ensuring a safer environment for caregivers.
Neutralizing Antibody Sample Testing and Report Harmonization
Authors: Jani Darshana , Gunsior Michele , Marsden Robin , Cowan Kyra J. , Irvin Susan C. , Hay Laura Schild , Ward Bethany , Armstrong Luke , Azadeh Mitra , Cao Liching , Carmean Rebecca , DelCarpini Jason , Dholakiya Sanjay L. , Hays Amanda , Hosback Sarah , Hu Zheng , Kulagina Nadia , Kumar Seema , Lai Ching Ha , Lichtfuss Marit , Liu Hsing-Yin , Liu Susana , Mozaffari Reza , Pan Luying , Pennucci Jason , Poupart Marie-Eve , Saini Gurleen , Snoeck Veerle , Storey Kristine , Turner Amy , Vainshtein Inna , Verthelyi Daniela , Wala Iwona , Yang Lili , Yang Lin 
Published: July 2024

AbstractImmunogenicity testing and characterization is an important part of understanding the immune response to administration of a protein therapeutic. Neutralizing antibody (NAb) assays are used to characterize a positive anti-drug antibody (ADA) response. Harmonization of reporting of NAb assay performance and results enables efficient communication and expedient review by industry and health authorities. Herein, a cross-industry group of NAb assay experts have harmonized NAb assay reporting recommendations and provided a bioanalytical report (BAR) submission editable template developed to facilitate agency filings. This document addresses key bioanalytical reporting gaps and provides a report structure for documenting clinical NAb assay performance and results. This publication focuses on the content and presentation of the NAb sample analysis report including essential elements such as the method, critical reagents and equipment, data analysis, study samples, and results. The interpretation of immunogenicity data, including the evaluation of the impact of NAb on safety, exposure, and efficacy, is out of scope of this publication.
Graphical Abstract
Machine Learning–Based Prediction of Large-for-Gestational-Age Infants in Mothers With Gestational Diabetes Mellitus
Authors: Kang Mei , Zhu Chengguang , Lai Mengyu , Weng Jianrong , Zhuang Yan , He Huichen , Qiu Yan , Wu Yixia , Qi Zhangxuan , Zhang Weixia , Xu Xianming , Zhu Yanhong , Wang Yufan , Yang Xiaokang 
Published: July 2024

Abstract

Context
Large-for-gestational-age (LGA), one of the most common complications of gestational diabetes mellitus (GDM), has become a global concern. The predictive performance of common continuous glucose monitoring (CGM) metrics for LGA is limited.

Objective
We aimed to develop and validate an artificial intelligence (AI)-based model to determine the probability of women with GDM giving birth to LGA infants during pregnancy using CGM measurements together with demographic data and metabolic indicators.

Methods
A total of 371 women with GDM from a prospective cohort at a university hospital were included. CGM was performed during 20 to 34 gestational weeks, and glycemic fluctuations were evaluated and visualized in women with GDM who gave birth to LGA and non-LGA infants. A convolutional neural network (CNN)-based fusion model was developed to predict LGA. Comparisons among the novel fusion model and 3 conventional models were made using the area under the receiver operating characteristic curve (AUCROC) and accuracy.

Results
Overall, 76 (20.5%) out of 371 GDM women developed LGA neonates. The visualized 24-hour glucose profiles differed at midmorning. This difference was consistent among subgroups categorized by pregestational body mass index, therapeutic protocol, and CGM administration period. The AI-based fusion prediction model using 24-hour CGM data and 15 clinical variables for LGA prediction (AUCROC 0.852; 95% CI, 0.680-0.966; accuracy 84.4%) showed superior discriminative power compared with the 3 classic models.

Conclusion
We demonstrated better performance in predicting LGA infants among women with GDM using the AI-based fusion model. The characteristics of the CGM profiles allowed us to determine the appropriate window for intervention.
Breast Cancer Is Increased in Women With Primary Ovarian Insufficiency
Authors: Allen-Brady Kristina , Moore Barry , Verrilli Lauren E , Alvord Margaret A , Kern Marina , Camp Nicola , Kelley Kristen , Letourneau Joseph , Cannon-Albright Lisa , Yandell Mark , Johnstone Erica B , Welt Corrine K 
Published: July 2024

Abstract

Context
DNA damage/repair gene variants are associated with both primary ovarian insufficiency (POI) and cancer risk.

Objective
We hypothesized that a subset of women with POI and family members would have increased risk for cancer.

Design
Case-control population-based study using records from 1995 to 2022.

Setting
Two major Utah academic health care systems serving 85% of the state.

Subjects
Women with POI (n = 613) were identified using International Classification of Diseases codes and reviewed for accuracy. Relatives were linked using the Utah Population Database.

Intervention
Cancer diagnoses were identified using the Utah Cancer Registry.

Main Outcome Measures
The relative risk of cancer in women with POI and relatives was estimated by comparison to population rates. Whole genome sequencing was performed on a subset of women.

Results
Breast cancer was increased in women with POI (OR, 2.20; 95% CI, 1.30-3.47; P = .0023) and there was a nominally significant increase in ovarian cancer. Probands with POI were 36.5 ± 4.3 years and 59.5 ± 12.7 years when diagnosed with POI and cancer, respectively. Causal and candidate gene variants for cancer and POI were identified. Among second-degree relatives of these women, there was an increased risk of breast (OR, 1.28; 95% CI, 1.08-1.52; P = .0078) and colon cancer (OR, 1.50; 95% CI, 1.14-1.94; P = .0036). Prostate cancer was increased in first- (OR, 1.64; 95% CI, 1.18-2.23; P = .0026), second- (OR, 1.54; 95% CI, 1.32-1.79; P &lt; .001), and third-degree relatives (OR, 1.33; 95% CI, 1.20-1.48; P &lt; .001).

Conclusion
Data suggest common genetic risk for POI and reproductive cancers. Tools are needed to predict cancer risk in women with POI and potentially to counsel about risks of hormone replacement therapy.
Utility of Salivary Cortisol and Cortisone in the Diagnostics of Adrenal Insufficiency
Authors: Kvam Hellan Kåre , Lyngstad Martin , Methlie Paal , Løvås Kristian , Husebye Eystein Sverre , Ueland Grethe Åstrøm 
Published: July 2024

Abstract

Background
Salivary cortisol (sa-cortisol) and salivary cortisone correlate well with serum cortisol (s-cortisol) but validated reference ranges for healthy individuals are lacking.

Objective
To establish cutoff levels for sa-cortisol and cortisone following cosyntropin testing and assess their diagnostic utility in adrenal insufficiency (AI).

Methods
Steroids in saliva were assayed using liquid chromatography tandem mass spectrometry before and after administration of a 250-µg cosyntropin test in 128 healthy subjects (16 on oral estrogens) and 59 patients with suspected AI, of whom 26 were diagnosed with AI with conventional serum cortisol criteria. The cutoff level for AI was defined as the 2.5th percentile in healthy subjects not receiving estrogens. Performance was evaluated by calculating diagnostic accuracy and analyzing receiver operating characteristic curves.

Results
The sa-cortisol cutoff 60 minutes after cosyntropin stimulation was 12.6 nmol/L (accuracy 89%, sensitivity 85%, and specificity 90%). Salivary cortisone and the sum of sa-cortisol and cortisone exhibited poorer diagnostic performance than sa-cortisol. The correlation between sa-cortisol and s-cortisol was best described by a model incorporating 2 regression lines (R2 = 0.80). Segmented regression analysis identified a breakpoint at sa-cortisol 9.7 nmol/L and s-cortisol 482 nmol/L, likely corresponding to saturation of cortisol binding globulin. Healthy subjects on oral estrogens demonstrated a linear agreement between s- and sa-cortisol through all measurements. Seventeen healthy subjects repeated the test, with similar outcomes, but reproducibility in terms of intraclass coefficient and correlation was poor.

Conclusion
Sa-cortisol in cosyntropin-test has high diagnostic accuracy in detecting adrenal insufficiency and is particularly useful in women on oral estrogens. An sa-cortisol ≥ 12.6 nmol/L assayed with liquid chromatography tandem mass spectrometry 60 minutes after 250 µg cosyntropin is normal.
Large Independent Sets in Recursive Markov Random Graphs
Authors: Gupte Akshay , Zhu Yiran 
Published: July 2024

Computing the maximum size of an independent set in a graph is a famously hard combinatorial problem that has been well studied for various classes of graphs. When it comes to random graphs, the classic Erdős–Rényi–Gilbert random graph [Formula: see text] has been analyzed and shown to have the largest independent sets of size [Formula: see text] with high probability (w.h.p.) This classic model does not capture any dependency structure between edges that can appear in real-world networks. We define random graphs [Formula: see text] whose existence of edges is determined by a Markov process that is also governed by a decay parameter [Formula: see text]. We prove that w.h.p. [Formula: see text] has independent sets of size [Formula: see text] for arbitrary [Formula: see text]. This is derived using bounds on the terms of a harmonic series, a Turán bound on a stability number, and a concentration analysis for a certain sequence of dependent Bernoulli variables that may also be of independent interest. Because [Formula: see text] collapses to [Formula: see text] when there is no decay, it follows that having even the slightest bit of dependency (any [Formula: see text]) in the random graph construction leads to the presence of large independent sets, and thus, our random model has a phase transition at its boundary value of r = 1. This implies that there are large matchings in the line graph of [Formula: see text], which is a Markov random field. For the maximal independent set output by a greedy algorithm, we deduce that it has a performance ratio of at most [Formula: see text] w.h.p. when the lowest degree vertex is picked at each iteration and also show that, under any other permutation of vertices, the algorithm outputs a set of size [Formula: see text], where [Formula: see text] and, hence, has a performance ratio of [Formula: see text]. Funding: The initial phase of this research was supported by the National Science Foundation [Grant DMS-1913294].
Positron emission tomography/computed tomography (PET/CT) as predictor of sarcoidosis activity: A case series
Authors: Carneiro Lopes Mariana , Ribeiro-Alves Marcelo , Porto Amadeu Thaís , Da Costa Claudia Henrique , Palermo Bruno Leonardo , Jauhar Cardoso Bessa Elizabeth , Rangel Antunes da Silva Bruno , Machado Neto Luiz , Rufino Rogério 
Published: July 2024

Introduction: Sarcoidosis is a multisystemic granulomatous disease that can present different clinical and radiological manifestations, while nospecific exams exist to monitor its activity and spontaneous or drug-induced remission. Objective: This study aimed to evaluate the degree of consistency between patients’ symptoms and Positron emission tomography/computed tomography (PET/CT) results in patients with sarcoidosis. Methods: Patients with sarcoidosis underwent two PET/CT scans, which were performed at the nuclear medicine sector of the National Cancer Institute (INCA) at two different times during a four-year period, to assess disease activity. The SUVmax value was noted and its consistency with the clinical status of the disease was checked. The analysis was performed using the maximum standardized uptake value (SUVmax). Results and Discussion: Twenty-seven patients were recruited, totaling 54 exams. The median SUVmax was 8.1 (range 3.5–16.1). Most examinations that showed hypermetabolism included both lung and extrapulmonary sarcoidosis sites in the same patient. The most affected sites with uptake by PET/CT were the lungs, followed by the intra-abdominal, pelvic, and peripheral lymph nodes. Other organs with glycolytic hypermetabolism included the spleen, subcutaneous tissue, bones, and heart. In 44% of the patients, the PET/CT scans and clinical status were not consistent. This result occurred mainly in: patients with cutaneous manifestations that exhibited no metabolic correspondence on PET/CT; patients with pulmonary fibrosis and dyspnea not attributable to disease activity; extrapulmonary sites such as the spleen, abdominal and peripheral lymph nodes, and bone without symptoms; and patients with pulmonary uptake on PET/CT despite being asymptomatic. Conclusions: The applicability of PET/CT should be discussed ineach case to ensure that the information will assist the patient’s diagnosis and management.
Empatia e Disposição de Adolescentes para o Envolvimento em Ações de Prevenção do Suicídio
Authors: Bezerra Viviane Alves dos Santos , Galvão Lilian Kelly de Sousa 
Published: July 2024

O presente estudo teve como objetivo principal investigar como a empatia influencia a disposição de adolescentes brasileiros para ajudar pessoas em risco de suicídio. Trata-se de um estudo transversal, de natureza quantitativa, do qual participaram 135 adolescentes, do sexo feminino (71,1%) e do sexo masculino (28,9%), com idades variando de 14 a 19 anos (Midade = 17,24; DP = 1,44). Os participantes responderam à Suicide Helpfulness Scale, ao Interpersonal Reactivity Index e a um questionário sociodemográfico. Na análise de dados, empregou-se as análises de correlação e a Regressão Linear Múltipla. Os resultados dessas análises evidenciaram que houve associações positivas e significativas entre as dimensões da empatia e da disposição para ajudar pessoas em risco de suicídio. De forma específica, a consideração empática foi capaz de prever a disposição dos adolescentes para prestar assistência e conversar com pessoas em risco de suicídio, mas não a disposição para informar a terceiros. Os resultados deste estudo evidenciam que a empatia pode ser uma variável importante, mas não suficiente para engajar adolescentes em ações eficazes de prevenção do suicídio, enfatizando a necessidade de que outras variáveis sejam trabalhadas junto ao público adolescente para que este possa atuar como um vetor de prevenção.
Fatores associados aos motivos de escolha por restaurantes populares
Authors: Bento Isabel Cristina , Souza Hugo Marcos Alves Vilhena , Abreu Mery Natali Silva , Pereira Simone Cardoso Lisboa 
Published: July 2024

O objetivo deste estudo foi analisar aspectos socioeconômicos associados aos motivos pelos quais indivíduos frequentam Restaurantes Populares (RPs) Os participantes foram questionados, por meio de entrevista face a face, sobre os motivos que os levaram a realizar refeições nesses estabelecimentos. As respostas foram categorizadas em: preço, refeição saudável, localização, higiene/limpeza e bom atendimento. Ademais, levantou-se informações sobre sexo, faixa etária, ocupação, condição domiciliar de (in) segurança alimentar, escolaridade, classe socioeconômica e principais carências sociais. Foram entrevistados 1.649 frequentadores de RPs de uma metrópole brasileira pioneira na idealização e implementação dessa importante política de acesso de Segurança Alimentar (SA). Amaioria do sexo masculino (71%). O preço foi o motivo mais relatado (72,7%) para a realização das refeições nos RPs, sendo determinado pelo maior número de carências sociais (OR: 1,15; IC 95%: 1,05-1,25); pelo maior nível de escolaridade: ensino médio (OR: 1,41; IC 95%: 1,10-1,80) e superior (OR: 1,56; IC 95%: 1,12-2,18), em relação ao ensino fundamental; e pela condição de IAN (OR: 1,52; IC 95%: 1,15-2,02). O segundo motivo mais relatado foi a oferta de refeições saudáveis (40,4%), seguido pela localização (39,3%). O bom atendimento foi o motivo menos relatado (15,0%). Este estudo apurou que os motivos que influenciaram os indivíduos a frequentarem os RPs estão em sintonia com a proposta dessa relevante política pública: :ampliação da oferta de refeições saudáveis, comercializadas a preços acessíveis em regiões de grande movimentação e fluxo de população de baixa renda.