bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of the Capital Structure on the Financial Default / an Analytical Research in Sample of Companies of the Ministry of Industry and Minerals
Authors: Saad Sabri Zahraa , Ismail Abdul Latif Walaa 
Published: July 2024

The objective of this research is to study the effect of capital structure on financial default. As it is the first research of its kind that deals with this sample of companies affiliated to the Ministry of Industry and Minerals and these companies were chosen especially because they suffer from financial deficit problems. The importance of this research lies in determining the importance of the components of the capital structure and knowing their impact on financial default in the research sample companies. The research sample represented a number of companies of the Ministry of Industry and Minerals located in Baghdad Governorate. The statistical methods represented in used financial ratios in the analysis to evaluate the research variables, which are both capital structure ratios (Long-term debt ratio to equity and long-term debt to total asset) and liquidity ratios (Current ratio, Quick ratio, Cash ratio) and used the programs (SPSS v26) and (Excel 2010) and the moment structure analysis program (AMOS) was adopted in order to calculate each of the standard deviation, correlation coefficient and specificity to find the relationship between the research variables and test its hypotheses. The results showed that the capital structure had no effect on the cases of financial defaults in the companies.
Korelasi hs-CRP dan Keberadaan Staphylococcus aureus pada Luka Gangren Diabetes Mellitus Tipe II
Authors: Wahyuni Sri , Hasanah Fathul Hidayatul , Mu’arofah Binti , Jeferson Verdyan Taufan Rizky 
Published: July 2024

Diabetes mellitus (DM) is a metabolic disorder that is accompanied by an increased glucose in the blood or called hyperglycemia. Diabetes can be caused by problems with the pancreas not being able to produce insulin, insufficient insulin secretion, imperfect insulin action, or both. When blood glucose is left elevated for a long time, it can cause complications such as gangrene. Diabetic gangrene is one of the complications caused by tissue damage. Gangrene occurs due to neuropathy and vascular disorders, usually in the peripheral areas of the body. Bacteria found in diabetic wounds are bacteria that produce biofilms such as Staphylococcus aureus. Staphylococcus aureus can release exotoxins such as leukocidin. Leucosidine lyses PMNs and releases ROS which will then induce a cytokine response such as interleukin-6 which will increase CRP levels. hs-CRP is a high precision CRP measurement even at low concentrations.This study aims to determine the correlation between hs-CRP levels and the presence of Staphylococcus aureus in type II diabetes mellitus gangrene wounds. The research design used is observational analytical using a cross sectional approach and accidental sampling. There were 16 research respondents with increased hs-CRP levels in 15 respondents and 9 respondents with Staphylococcus aureus bacteria. Correlation test with a value of p = <0.05 (p=0.032) means that there is a correlation between hs-CRP and the presence of Staphylococcus aureus in type II diabetes mellitus gangrene wounds.
Outcomes of pulmonary endarterectomy for patients with pulmonary artery sarcoma
Authors: Zhang Zhaohua , Zhen Yanan , Liu Jingwen , Liu Xiaopeng , Yang Liang , Xu Mingyuan , Wen Jianyan , Liu Peng 
Published: July 2024

ObjectivePulmonary artery sarcoma (PAS) is an exceedingly rare and insufficiently investigated disease, leading to uncertain in its optimal management. This study aims to present our institutional experience and the outcomes of pulmonary endarterectomy for PAS.MethodsWe gathered clinical characteristics, intraoperative data, postoperative outcomes, and prognosis information from PAS patients who underwent surgical treatment at our institution between December 2016 and September 2023.ResultsA total of 20 patients with PAS underwent pulmonary endarterectomy. The median age of the patients was 52 (IQR 45, 57) years, with 12 patients (60%) being female. Intimal sarcoma was confirmed in 19 patients, while the remaining one was diagnosed with large cell neuroendocrine carcinoma. The perioperative mortality rate was three cases (15%). Follow-up was conducted for a median duration of 14 months (range: 1–61). During the follow-up period, 11 patients experienced recurrence or metastasis, and 5 patients succumbed to the disease. The estimated cumulative survival rates at 1 and 2 years for all 20 patients were 66.4% and 55.3%, respectively.ConclusionPulmonary endarterectomy emerges as a palliative but effective approach for managing PAS, particularly when complemented with postoperative therapies such as chemotherapy and targeted therapy, which collectively contribute to achieving favorable long-term survival outcomes.
AngioJet thrombectomy with extracorporeal membrane oxygenation support for an acute large-scale pulmonary embolism with bilateral atrial thrombosis: a case report of catastrophic antiphospholipid syndrome
Authors: Ji Jianyu , Jiang Lei , Wang Wei , Chi Xinyu , Dong Jinda , Lu Liqiu , Huang Minyan , Wei Xiutian , Pang Guangbao , Pang Jing , Xiong Bin , Xiang Shulin 
Published: July 2024

BackgroundCatastrophic Antiphospholipid Syndrome (CAPS), a severe systemic autoimmune disorder, predominantly causes life-threatening multi-organ failure, with a high mortality rate. It primarily affects small vessels, seldom impacting large vessels. Notably, acute massive pulmonary embolism (PE) with bilateral atrial thrombosis is an exceptional occurrence in CAPS. Acute pulmonary embolism (PE) is a common cardiovascular disease that progresses rapidly and has a high mortality rate. Acute massive PE combined with bilateral atrial thrombosis has an even higher mortality rate. PE treatments primarily include pharmaceuticals, catheter interventions, and surgical measures, with integrated treatment strategies demonstrating promising outcomes in clinical practice. Extracorporeal membrane oxygenation (ECMO) can provide cardiopulmonary support for the treatment of high-risk PE patients and is a proven therapeutic measure.MethodsThis report presents the case of a 52-year-old male admitted due to fever and sudden onset of impaired consciousness, with cardiac ultrasound and pulmonary artery CT angiography revealing an acute large-scale pulmonary embolism accompanied by bilateral atrial thrombosis, with the condition rapidly worsening and manifesting severe respiratory and circulatory failure. With ECMO support, the patient underwent a thrombectomy using an AngioJet intervention. The diagnosis of CAPS was confirmed through clinical presentation and laboratory examination, and treatment was adjusted accordingly.ResultsThe patient made a successful recovery and was subsequently discharged from the hospital.ConclusionIn CAPS patients, the rare instance of acute massive PE accompanied by bilateral atrial thrombosis significantly risks severe respiratory and circulatory failure, adversely affecting prognosis. Early initiation of ECMO therapy is crucial, offering a vital opportunity to address the root cause. In this case report the patient was successfully treated with an AngioJet thrombectomy supported by ECMO.
Improving the diagnostic performance of inexperienced readers for thyroid nodules through digital self-learning and artificial intelligence assistance
Authors: Lee Si Eun , Kim Hye Jung , Jung Hae Kyoung , Jung Jin Hyang , Jeon Jae-Han , Lee Jin Hee , Hong Hanpyo , Lee Eun Jung , Kim Daham , Kwak Jin Young 
Published: July 2024

BackgroundData-driven digital learning could improve the diagnostic performance of novice students for thyroid nodules.ObjectiveTo evaluate the efficacy of digital self-learning and artificial intelligence-based computer-assisted diagnosis (AI-CAD) for inexperienced readers to diagnose thyroid nodules.MethodsBetween February and August 2023, a total of 26 readers (less than 1 year of experience in thyroid US from various departments) from 6 hospitals participated in this study. Readers completed an online learning session comprising 3,000 thyroid nodules annotated as benign or malignant independently. They were asked to assess a test set consisting of 120 thyroid nodules with known surgical pathology before and after a learning session. Then, they referred to AI-CAD and made their final decisions on the thyroid nodules. Diagnostic performances before and after self-training and with AI-CAD assistance were evaluated and compared between radiology residents and readers from different specialties.ResultsAUC (area under the receiver operating characteristic curve) improved after the self-learning session, and it improved further after radiologists referred to AI-CAD (0.679 vs 0.713 vs 0.758, p&lt;0.05). Although the 18 radiology residents showed improved AUC (0.7 to 0.743, p=0.016) and accuracy (69.9% to 74.2%, p=0.013) after self-learning, the readers from other departments did not. With AI-CAD assistance, sensitivity (radiology 70.3% to 74.9%, others 67.9% to 82.3%, all p&lt;0.05) and accuracy (radiology 74.2% to 77.1%, others 64.4% to 72.8%, all p &lt;0.05) improved in all readers.ConclusionWhile AI-CAD assistance helps improve the diagnostic performance of all inexperienced readers for thyroid nodules, self-learning was only effective for radiology residents with more background knowledge of ultrasonography.Clinical ImpactOnline self-learning, along with AI-CAD assistance, can effectively enhance the diagnostic performance of radiology residents in thyroid cancer.
A thorough investigation into the correlation between migraines and the gut microbiome: an in-depth analysis using Mendelian randomization studies
Authors: Zang Xuege , Du Yongkun , Jiang Mengshu , Zhou Shiyao , Wang Libo , Han Xuemei 
Published: July 2024

ObjectiveA growing body of evidence underscores a significant association between neurological disorders, particularly migraines, and the gut microbiota. However, a research gap persists in understanding the cause-and-effect dynamics between these elements. Therefore, we employed robust methodologies aimed at thoroughly exploring the causal relationship between the gut microbiome and migraines.MethodsEmploying bidirectional Two Sample Mendelian Randomization (TSMR) analysis, we investigated the causal association between the composition of the gut microbiota and migraines. Data summarizing the relationship between gut microbiota and migraines were extracted from one or more genome-wide association studies. The TSMR analysis employed five methods to assess the correlation between the gut microbiota and migraines, with the inverse variance-weighted method serving as the primary approach for analyzing causal links. Sensitivity analyses were applied to address horizontal pleiotropy and heterogeneity. Simultaneously, a meta-analysis was performed to strengthen the robustness of the findings. Additionally, a reverse TSMR was carried out to explore potential occurrences of reverse causal relationships.ResultsThe ongoing TSMR analysis identified a collection of 14 bacterial taxa connected to migraines. Among these, 8 taxa exhibited a protective effect, while 5 taxa had a detrimental impact, and 1 taxon maintained a neutral relationship. The reverse Mendelian randomization analysis highlighted stable outcomes for only one bacterial taxonomic group.ConclusionThe study confirms a causal relationship between the gut microbiota and migraines, offering a new perspective for migraine research. Strategically targeting specific bacterial taxa with dysregulation may be effective in both preventing and treating migraines, thus opening new avenues for therapeutic strategies.
Towards optimized methodological parameters for maximizing the behavioral effects of transcranial direct current stimulation
Authors: Santander Tyler , Leslie Sara , Li Luna J. , Skinner Henri E. , Simonson Jessica M. , Sweeney Patrick , Deen Kaitlyn P. , Miller Michael B. , Brunye Tad T. 
Published: July 2024

IntroductionTranscranial direct current stimulation (tDCS) administers low-intensity direct current electrical stimulation to brain regions via electrodes arranged on the surface of the scalp. The core promise of tDCS is its ability to modulate brain activity and affect performance on diverse cognitive functions (affording causal inferences regarding regional brain activity and behavior), but the optimal methodological parameters for maximizing behavioral effects remain to be elucidated. Here we sought to examine the effects of 10 stimulation and experimental design factors across a series of five cognitive domains: motor performance, visual search, working memory, vigilance, and response inhibition. The objective was to identify a set of optimal parameter settings that consistently and reliably maximized the behavioral effects of tDCS within each cognitive domain.MethodsWe surveyed tDCS effects on these various cognitive functions in healthy young adults, ultimately resulting in 721 effects across 106 published reports. Hierarchical Bayesian meta-regression models were fit to characterize how (and to what extent) these design parameters differentially predict the likelihood of positive/negative behavioral outcomes.ResultsConsistent with many previous meta-analyses of tDCS effects, extensive variability was observed across tasks and measured outcomes. Consequently, most design parameters did not confer consistent advantages or disadvantages to behavioral effects—a domain-general model suggested an advantage to using within-subjects designs (versus between-subjects) and the tendency for cathodal stimulation (relative to anodal stimulation) to produce reduced behavioral effects, but these associations were scarcely-evident in domain-specific models.DiscussionThese findings highlight the urgent need for tDCS studies to more systematically probe the effects of these parameters on behavior to fulfill the promise of identifying causal links between brain function and cognition.
Clinical presentation and imaging findings in juvenile-onset back pain: a ten-year hospital-based retrospective analysis in Douala (Cameroon)
Authors: Kemta Lekpa Fernando , Eloundou Paul , Moulion Tapouh Jean Roger , Simeni Njonnou Sylvain Raoul , Fojo Talongong Baudelaire , Same Bebey Francine , Megne Tamo Estelle , Noukeu Diomède , Enyama Dominique , Abouame Palma Haoua , Sime Tchouamo Arielle Annick , Namme Luma Henry , Ngandeu-Singwe Madeleine , Choukem Simeon Pierre 
Published: July 2024

IntroductionStudies exploring the clinical and imaging characteristics of juvenile-onset back pain (JOBP) are scarce. The purpose of this study was to assess the clinical presentation, imaging findings, and factors associated with JOBP.MethodsA retrospective record-based study was conducted among all pediatric cases presenting to the Rheumatology unit of the Douala General Hospital, Cameroon, from January 2014 to December 2023. The study did not include children whose back pain began after 16 years of age.ResultsOf the 216 records of patients under 18 examined, 67 children (31 girls) were diagnosed with JOBP. The median age was 15 [13–16] years. More than two-third of the children included in this study had chronic pain (n = 46; 68.65%). Pain was mild to moderate in intensity in 48 children (71.6%). Radiculopathy was present in 10 children (14.92%). The most common location of back pain was the lumbar region (n = 64; 95.52%). Some children experienced pain in more than one location. The location of the pain was not associated with gender, duration of the pain, radiculopathy, or practice of a competitive sport (p &gt; 0.05). Musculoskeletal abnormalities on imaging were found in 38 children (62.29%). In multivariate analysis, peripheral joint involvement [aOR = 0.253 (0.073–0.878); p = 0.030] and mild pain intensity [aOR = 0.077 (0.014–0.422); p = 0.003], were independently associated with the presence of musculoskeletal abnormalities on imaging.ConclusionJOBP affects a third of children and adolescents of our clinic population. The common musculoskeletal abnormalities found on spine imaging are disc diseases and scoliosis.
Clinical adverse events to dexmedetomidine: a real-world drug safety study based on the FAERS database
Authors: Liu Feng , Zheng Jing-xuan , Wu Xiao-dan 
Published: July 2024

ObjectiveAdverse events associated with dexmedetomidine were analyzed using data from the FDA’s FAERS database, spanning from 2004 to the third quarter of 2023. This analysis serves as a foundation for monitoring dexmedetomidine’s safety in clinical applications.MethodsData on adverse events associated with dexmedetomidine were standardized and analyzed to identify clinical adverse events closely linked to its use. This analysis employed various signal quantification analysis algorithms, including Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-Item Gamma Poisson Shrinker (MGPS).ResultsIn the FAERS database, dexmedetomidine was identified as the primary suspect in 1,910 adverse events. Our analysis encompassed 26 organ system levels, from which we selected 346 relevant Preferred Terms (PTs) for further examination. Notably, adverse drug reactions such as diabetes insipidus, abnormal transcranial electrical motor evoked potential monitoring, acute motor axonal neuropathy, and trigeminal cardiac reflex were identified. These reactions are not explicitly mentioned in the drug’s specification, indicating the emergence of new signals for adverse drug reactions.ConclusionData mining in the FAERS database has elucidated the characteristics of dexmedetomidine-related adverse drug reactions. This analysis enhances our understanding of dexmedetomidine’s drug safety, aids in the clinical management of pharmacovigilance studies, and offers valuable insights for refining drug-use protocols.
Patient preferences for generic substitution policies: a discrete choice experiment in China
Authors: Zhang Lingli , Li Dashuang , Li Xin , Yan Jianzhou 
Published: July 2024

Background: Generic substitution policies have been widely implemented worldwide to enhance the accessibility of medications. Nevertheless, certain patients have voiced discontent with these policies. This study aimed to evaluate the patient preferences for generic substitution policies and explore the potential for optimization to enhance patient acceptance.Methods: A discrete choice experiment (DCE) was conducted to estimate the relative importance (RI) of five attributes, including generic consistency evaluation (GCE), reimbursement rate, medication use control, information disclosure, and post-marketing surveillance. Respondents were recruited among inpatients and outpatients in three cities and surveys were conducted face-to-face. Preference coefficients, RI of attributes, and the uptake rate of various policies were computed using a mixed logit model. The interaction effects were also included to examine preference heterogeneity.Results: A total of 302 patients completed the survey. All five attributes significantly impacted policy acceptance. GCE held the highest RI value at 56.64%, followed by reimbursement rate (RI = 12.62%), information disclosure (RI = 12.41%), post-marketing surveillance (RI = 9.54%), and medication use control (RI = 8.80%). Patient preferences varied depending on their gender and income. The patient uptake rate of China’s current policy was only 68.56%. If all generics were to pass GCE without altering the other attributes, the uptake rate of policies would rise to 82.63%. Similarly, implementing information disclosure without changing other attributes would result in a 78.67% uptake rate, which is comparable to the effect of a 10% increase in reimbursement rate for generics (78.81%). Combining these policies could mitigate the adverse effects of mandatory substitution on patient.Conclusion: Chinese patient preferences for generic substitution policies were mainly influenced by GCE. China’s current generic substitution policy has room for further optimization to enhance patient acceptance.
Very low monomethyl fumarate exposure via human milk: a case report—a contribution from the ConcePTION project
Authors: Van Neste Martje , Nauwelaerts Nina , Ceulemans Michael , Cuppers Benedikte , Annaert Pieter , Smits Anne , Allegaert Karel 
Published: July 2024

IntroductionWhile breastfeeding is recommended, knowledge regarding medicine transfer to human milk and its safety for nursing infants is limited. Only one paper has previously described dimethyl fumarate (DMF) transfer during breastfeeding in two patients at 5 and 6 months postpartum, respectively. The current case report describes maternal pharmacokinetic data of monomethyl fumarate (MMF), the active metabolite of DMF, and infant exposure estimations of MMF at 3 months postpartum.MethodsA 32-year-old Caucasian woman started DMF therapy (120 mg, 2x/day) for multiple sclerosis at 3 months postpartum, after weaning her infant from breastfeeding. On day 99 after birth, the patient collected four milk samples over 24 h after 6 days of treatment at the initial dose. Additionally, a single maternal blood sample was collected to calculate the milk-to-plasma (M/P) ratio. The samples were analyzed using liquid chromatography coupled with the mass spectrometry method.ResultsA wide range of measured steady-state concentrations of MMF (5.5-83.5 ng/mL) was observed in human milk samples. Estimated daily infant dosage values for MMF, calculated with 150 and 200 mL/kg/day human milk intake, were 5.76 and 7.68 μg/kg/day, and the relative infant doses were 0.16 and 0.22%. The observed mean M/P ratio was 0.059, similar to the M/P ratio predicted using the empirical Koshimichi model (0.06).DiscussionCombining this case report with the two previously described cases, the estimated infant exposure is low, albeit with relevant intra- and inter-patient variabilities. Research should further focus on infant exposure and safety.