bluuebunny/crossref_metadata_2025_split huggingface dataset:
Revisiting Rorschach test and Minnesota Multiphasic Personality Inventory-II patterns in Kraepelinian vs. DSM-wise Schizophrenia: How They Differ and What It Means for Diagnosis
Authors: Jo Young Tak , Lee Myung Joo , Lee Ji Soo , Joo Yeon Ho 
Published: July 2024

Objective This retrospective chart review study aimed to investigate the differences in the Rorschach test and Minnesota Multiphasic Personality Inventory (MMPI)-II profiles among patients with Kraepelinian schizophrenia, those with DSM-wise schizophrenia, and controls. Kraepelinian schizophrenia is characterised by a chronic, deteriorative disease course and a predominance of negative symptoms. Methods Patients with Kraepelinian schizophrenia were selected based on medical record reviews. We then compared their Rorschach test and MMPI-II results with those of the DSM-wise schizophrenia group and the control group. Results The Rorschach test revealed a significant increase in DV2 score and a decrease in D score in patients with Kraepelinian schizophrenia compared to those with DSM-wise schizophrenia. In the MMPI-II profiles, patients with Kraepelinian schizophrenia exhibited an elevated L relative to those with DSM-wise schizophrenia. Conclusion Our results suggested the value of revisiting psychological tests in clinically delineated subgroups, such as Kraepelinian schizophrenia. Although patients fall under the same diagnostic category of schizophrenia, considering different phenotypes is important when interpreting psychological test outcomes. Additionally, our study indicated that both schizophrenia groups did not show as many abnormalities as expected compared to controls. This highlights the potential value of revisiting established profiles of certain psychological tests and calls for further research on other psychological tests.
Association between major depressive disorder and gut microbiota dysbiosis
Authors: Rafie Sedaghat Farzaneh , Ghotaslou Pardis , Ghotaslou Reza 
Published: July 2024

Objective Major depressive disorder (MDD) affects 300 million people globally. Because dysbiosis may alter the central nervous system, it plays a potential role in this disorder. Dysbiosis is characterized by a decrease in microbial diversity and an increase in proinflammatory species. The human gut microbiota refers to the trillions of microbes, such as bacteria, that live in the human gut. The purpose of this study was to compare the gut microbiota of patients with MDD with that of healthy controls. Methods This case-control study involved 35 MDD cases and 35 healthy age- and sex-matched controls. Stool samples were collected and subjected to quantitative real-time PCR. Four intestinal bacterial phyla (firmicutes, bacteroidetes, actinobacteria, and proteobacteria) were investigated by 16SrRNA analysis. Results The findings indicated a relative abundance of bacteroidetes to firmicutes in the control and case groups was 0.66 vs. 1.33, respectively ( p < .05). There were no significant differences in actinobacteria or proteobacteria among those in the MDD group compared to the healthy control group. Conclusions Gut microbiota dysbiosis may contribute to the onset of depression, underscoring the importance of understanding the relationship between MDD and gut microbiota. Firmicutes, which produce short-chain fatty acids, are crucial for intestinal health. However, dysbiosis can disrupt the gut microbiota, impacting the central nervous system and contributing to the onset of depression.
Severe neutropenia unrelated to clozapine in patients receiving clozapine
Authors: Taylor David , Vallianatou Kalliopi , Gandhi Shreyans , Casetta Cecilia , Howes Oliver , MacCabe James 
Published: July 2024

Background: Clozapine is known to cause agranulocytosis. Mandatory monitoring schemes are aimed at reducing the risk of agranulocytosis and of the consequences of agranulocytosis. All cases of agranulocytosis occurring in people prescribed clozapine are assumed to be caused by clozapine. Methods: In a previous study, we examined a cohort of patients listed on our hospital database as having had clozapine-induced agranulocytosis and applied specific criteria to identify those with confirmed clozapine-related, life-threatening agranulocytosis. In this study, we examine the cases not meeting these specific criteria. Results: In the original study, 9 of 23 cases met the criteria for clozapine-induced, life-threatening agranulocytosis. Of the 13 remaining cases for whom data were available, 5 were probably caused by clozapine but were not life-threatening. Three cases were the result of concomitant cancer chemotherapy. Three were anomalous results probably related to measurement error. For the remaining two cases, the cause was not identified. Conclusion: Not all cases of agranulocytosis occurring in people taking clozapine are caused by clozapine. The widely used threshold criterion-based diagnosis overestimates the risk of agranulocytosis. True clozapine-related agranulocytosis is best identified by pattern-based criteria: rapid fall in neutrophil counts over around 2 weeks to below 0.5 × 109/L for two consecutive days (unless clozapine is stopped very early or granulocyte colony stimulating factor is given) where other possible causes (benign ethnic neutropenia, cancer chemotherapy) can be ruled out.
Development of a deep learning-based fully automated segmentation of rotator cuff muscles from clinical MR scans
Authors: Kim Sae Hoon , Yoo Hye Jin , Yoon Soon Ho , Kim Yong Tae , Park Sang Joon , Chai Jee Won , Oh Jiseon , Chae Hee Dong 
Published: July 2024

Background The fatty infiltration and atrophy in the muscle after a rotator cuff (RC) tear are important in surgical decision-making and are linked to poor clinical outcomes after rotator cuff repair. An accurate and reliable quantitative method should be developed to assess the entire RC muscles. Purpose To develop a fully automated approach based on a deep neural network to segment RC muscles from clinical magnetic resonance imaging (MRI) scans. Material and Methods In total, 94 shoulder MRI scans (mean age = 62.3 years) were utilized for the training and internal validation datasets, while an additional 20 MRI scans (mean age = 62.6 years) were collected from another institution for external validation. An orthopedic surgeon and a radiologist manually segmented muscles and bones as reference masks. Segmentation performance was evaluated using the Dice score, sensitivities, precision, and percent difference in muscle volume (%). In addition, the segmentation performance was assessed based on sex, age, and the presence of a RC tendon tear. Results The average Dice score, sensitivities, precision, and percentage difference in muscle volume of the developed algorithm were 0.920, 0.933, 0.912, and 4.58%, respectively, in external validation. There was no difference in the prediction of shoulder muscles, with the exception of teres minor, where significant prediction errors were observed (0.831, 0.854, 0.835, and 10.88%, respectively). The segmentation performance of the algorithm was generally unaffected by age, sex, and the presence of RC tears. Conclusion We developed a fully automated deep neural network for RC muscle and bone segmentation with excellent performance from clinical MRI scans.
Sex differences in CGRP-induced vasodilation of human middle meningeal arteries but not human coronary arteries: implications for migraine
Authors: de Vries Tessa , Boucherie Deirdre M. , Chan Kayi Y. , Rubio-Beltrán Eloísa , Labastida-Ramírez Alejandro , Labruijere Sieneke , Gupta Saurabh , van den Bogaerdt Antoon , Vincent Arnaud , Dammers Ruben , Danser A. H. Jan , MaassenVanDenBrink Antoinette 
Published: July 2024

Background Migraine prevalence and levels of calcitonin gene-related peptide (CGRP), a peptide involved in migraine pathophysiology, differ between men and women, and appear to be affected by changes in sex hormones. The present study investigated the sex-specific responses to CGRP in human isolated arteries. Methods CGRP-induced relaxation of 62 (28 men and 34 women) human isolated middle meningeal arteries (HMMA) and 139 (69 men and 70 women) human isolated coronary arteries (HCA) was compared between men and women in groups <50 years and ≥50 years of age as a proxy for pre- and postmenopausal status in women, as well as matched-age groups for men. Results In HCA, no differences were observed between male and female tissue, or between the different age groups. However, in HMMA, the maximum response was significantly smaller and CGRP was less potent in females <50 compared with males <50 years of age. No differences were observed between the older age groups. Conclusions Sex differences were observed for CGRP-induced relaxation of HMMA, but not HCA. These differences could arise from differential receptor expression in the vascular beds combined with the effect of sex hormones on CGRP and subsequent receptor desensitization.
Purified granulocytes in extracorporeal cell therapy: A multifaceted approach to combat sepsis-induced immunoparalysis
Authors: Klinkmann Gerd , Brabandt Sophie , Möller Marlene , Wild Thomas , Heskamp Benjamin , Schewe Jens-Christian , Sauer Martin , Altrichter Jens , Mitzner Steffen 
Published: July 2024

Background: Immune cell dysfunction plays a central role in sepsis-induced immunoparalysis. Targeted treatment using healthy donor immune cell transfusions, particularly granulocyte concentrates (GC) potentially induces tissue damage. Initial trials using GC in an extracorporeal immune cell perfusion system provided evidence for beneficial effects with fewer side effects, by separating patient and donor immune cell compartments. A multicenter clinical trial is exploring feasibility and effects of a 6-h treatment (NCT06143137). This ex vivo study examines technical feasibility and cellular effects of an extended treatment interval up to 24 h. Methods: Standard GC were purified to increase the potential storage time and subsequently implemented in the extracorporeal immune cell perfusion system. Parameters assessed included cell viability, phagocytosis activity, oxidative burst, cytokine release, and metabolic parameters of purified. GC during an extended circulation time of up to 24 h. Results: After storage of 72 h granulocytes were viable throughout the study period and exhibited preserved functionality and metabolic activity. The findings highlight a time-dependent nature of cytokine release by neutrophils in the extracorporeal circuit, as cytokine secretion patterns showed IL-8 peaking within 6 h, while MCP-1, IL-6, IL-1β, and TNF-α increased after 24 h of circulation. Conclusion: Purified GC remain functional after 72 h of storage and additional 24 h in the circulating treatment model. Cytokine secretion patterns revealed a significant increase, especially between 10 and 24 h of treatment. Extending treatment time holds promise for enhancing immune response against sepsis-induced immunoparalysis. These findings provide valuable insights for optimizing immune-targeted therapeutic interventions.
COL5A1 overexpression correlates with poor prognosis in human cervical cancer
Authors: Duan Xiaoling , Ye Danjuan , Yuan Jia , Guan Bin , Guan Wencai , Liu Songping , Fang Jingyi , Shi Jimin , Zhu Yan , Li Qinmei , Lu Qi , Xu Guoxiong 
Published: July 2024

Background Cervical cancer is the most prevalent malignant tumor in women. This study aims to detect collagen type V α1 chain (COL5A1) expression and its clinical relevance in the prognosis of patients with cervical cancer. Methods Cervical cancer tissues and their paired adjacent normal tissues were prepared for tissue microarray. The expression of COL5A1 protein and the scores of the expression were evaluated by immunohistochemistry (IHC) staining. The prognostic value of COL5A1 was analyzed by R software version 4.2.1 with “survival, survminer, ggplot2” packages and Gene Expression Profiling Interactive Analysis (GEPIA). The cBioPortal database was utilized for the analysis of COL5A1 gene mutations. Results COL5A1 protein was overexpressed in human cervical cancer tissues compared to their paired adjacent normal tissues detected by IHC ( P < 0.001). High expression of COL5A1 tends to be in elderly patients with cervical cancer. Survival analyses of clinical data of patients with cervical cancer showed that a high level of COL5A1 expression was significantly correlated with shorter overall survival ( P = 0.031) and disease-free survival ( P = 0.042) of patients. Further analyses of The Cancer Genome Atlas-Cervical Squamous Cell Carcinoma and the GEPIA survival datasets confirmed the association of high COL5A1 expression with poor overall survival of patients ( P = 0.040 and P = 0.018, respectively). The analysis of genomic alterations of COL5A1 using the cBioPortal tool revealed that the COL5A1 gene was altered in 4% of cervical cancer patients and COL5A1 corresponding protein alterations with post-translational modifications were hydroxylation. Conclusion COL5A1 is a tissue biomarker correlated with the poor prognosis of patients with cervical cancer, which may lead to a new clinical application.
Midline Catheters as an Alternative for Central Venous Catheters in Venous Oxygen Saturation Monitoring: A Single Center Experience
Authors: Kim Justin S. , Ivanovic Sasa , Davison Danielle , Bheem Rishika , Wu Maria , Sweeney Brendan , Shaykhinurov Eduard , Yamane David 
Published: July 2024

Background Central venous oxygen saturation (ScvO2) obtained from a central venous catheter (CVC) is often used to approximate oxygen delivery in critically ill patients. Despite their importance in administering medications and monitoring oxygen delivery, the use of CVCs can be associated with significant complications. Midline catheters are inserted via a peripheral vein above the antecubital fossa and provide a safe alternative to CVCs. This study aimed to determine the equivalence of ScvO2 and midline catheter oxygen saturation (SmO2) in critically ill patients. Methods This was a single-center observational study of critically ill adult patients who had concurrently placed CVCs (internal jugular and subclavian) and midline catheters as part of standard ICU care. Venous oxygen saturation and lactate levels were measured from both catheters using the Abbott point-of-care i-STAT analyzer. Demographic and ICU admission data were collected. Continuous variables were compared using the paired t-test. Pearson's correlation was used to evaluate the linear correlation between ScvO2 and SmO2. The systematic error (bias) was calculated using Bland-Altman analysis. Receiver operating characteristic curves were constructed to evaluate the sensitivities and specificities for different values of SmO2 to predict ScvO2. Results Forty-eight patients (n = 48) were enrolled in the study. The mean ScvO2 and SmO2 were 65.5% +/- 11.2% and 62.7% +/- 17.6% respectively (p = 0.1197). In the Bland-Altman analysis, the mean bias between ScvO2 and SmO2 was 2.8% +/- 12.3% with 95% limits of agreement of −21.3% to 26.9%. More than 60% of the ScvO2 and SmO2 values diverged by ≥ 5%. Conclusions The difference between the mean SmO2 and ScvO2 was not statistically significant and the mean bias between SmO2 and ScvO2 is low. Despite this, the substantially large standard deviation and limits of agreement preclude the use of SmO2 as a direct surrogate of ScvO2.
Inula helenium extract and lidocaine-loaded electrospun wound dressings for managing skin wounds pain and their healing: An in vitro and in vivo study
Authors: Wang Huidong , Li Hongyu , Zhao Pin , Zhang Hongbing , Jalili Saman 
Published: July 2024

The skin injuries pose a substantial public health challenge, not only due to their physical trauma but also the accompanying pain and complexities in wound healing. In the current research, Inula helenium extract and lidocaine were loaded into electrospun PVA/calcium alginate nanofibers to promote skin wounds healing and alleviate the resulting pain. Various in vitro experiments were utilized to characterize these dressings. Wound healing potential of these constructs and their analgesic effects were studied in a rat model of skin wounds. Our developed scaffolds released the loaded drugs in a slow manner and showed antioxidative and anti-inflammatory activities. Fiber size measurement showed that drug-loaded and drug-free scaffolds had around 418.025 ± 140.11 nm and 505.51 ± 93.29 nm mean fiber size, respectively. Bacterial penetration assay confirmed that drug-loaded scaffolds reduced bacterial infiltration through the matrices. Wound healing study showed that on day 14th, the dressings loaded with inula helenium extract and lidocaine could close the wounds up to 91.26 ± 5.93%. In addition, these scaffolds significantly reduced the animals pain sensitivity. ELISA assay results implied that these dressings modulated inflammation and reduced tissue’s oxidative stress.
“I Often Just Don’t Know what to Say!”: Variations in Multidisciplinary Palliative Care Clinicians’ Confidence and Needs Related to Spiritual Care
Authors: Miller Megan , Rosa William E. , Buller Haley , McDarby Meghan , Ferrell Betty R. 
Published: July 2024

Background Spiritual care is a core component of high-quality palliative care, yet gaps exist in spiritual care provision. Understanding clinicians’ levels of confidence around spiritual care and their perceptions of necessary knowledge/skills to enhance their ability to provide spiritual care is foundational for improving delivery of spiritual care in practice. Objectives To understand confidence levels with providing spiritual care and perceived needs in relation to the provision of spiritual care among palliative clinicians (nurses, social workers, chaplains). Design N = 260 clinicians participating in interprofessional communication and end-of-life care training programs completed a structured survey. Measurements Clinicians responded to 42 closed-ended questions assessing their confidence in engaging in spiritual care across 6 dimensions, and one open-ended question: “What areas of knowledge or skill would best help to improve your ability to provide spiritual care across diverse populations?” Results Findings reveal varied levels of confidence with spiritual care across dimensions. Chaplains reported the highest levels of confidence compared with nurses and social workers. Key areas of knowledge/skills to improve spiritual care provision were: (1) Training and support for clinicians in spiritual care; (2) Strategies for providing spiritual care to patients from diverse cultural and/or religious backgrounds; (3) Better understanding of specific populations and contexts that may affect spiritual care provision; and (4) Clinicians’ personal growth & practices to improve spiritual care. Conclusions Additional support with spiritual care provision is needed, especially among spiritual care generalists. A focus on culturally attuned care is needed, honoring unique patient contexts and centering patient and family priorities.
Impact of COVID-19 Pandemic on Cleft Lip/Palate Surgery in Brazil: Assessing the Current Landscape
Authors: Candido Marcelo A. , Alonso Nivaldo 
Published: July 2024

ObjectiveThis study aims to evaluate the impact of COVID-19 and the current situation for cleft lip/palate treatment surgeries within Brazil's public health system.DesignOur retrospective study analyzed CL/P corrective surgeries in Brazil's health system using DATASUS TabNet data from March 2020 to December 2022, with historical data from January 2016 to February 2020. We employed ARIMA analysis to estimate pandemic-related surgery cancellations.ResultsIn 2020, 1992 (CI 95%: 989–2995) CL/P surgeries were not conducted due to pandemics, a 44.1% (CI 95%: 28.1–54.2%) decrease compared to expectations for march to December 2020. Between the onset of the pandemic in Brazil and the end of 2022, 10,643 surgeries were performed in the country, representing a 33.8% shortfall compared to the expected number for the period (16,076; 95% CI: 9697–22,456).ConclusionThe study highlights COVID-19's impact on CL/P surgeries in Brazil. Post-pandemic, surgeries increased but regional disparities remain, urging collaborative efforts to improve services and support affected patients.
Immune checkpoint blockade effect on immunologic and virologic profile of five cancer patients living with human immunodeficiency virus (HIV) infection
Authors: Yazji Azzam , Brown Erika Nicole , De La Torre Rodrigo , Umoru Godsfavour Oghenero 
Published: July 2024

Introduction Immune checkpoint inhibitors (ICI) have changed the prognostic outlook for several malignancies. Despite the unprecedented durable responses and improvement in survival outcomes with ICIs, exclusion of oncology patients living with human immunodeficiency virus (HIV) from most ICI-related trials has limited utility of these agents. Clinical outcomes related to concomitant use of antiretroviral therapy and ICI remain unclear. We present a case series based on our institution's experience to address this unmet need of clinical outcomes with ICI in oncology patients living with HIV. Methods Electronic medical records were queried to identify patients living with HIV who were also diagnosed with cancer and treated with ICI from May 2019 to September 2022. Results A total of five patients were on concurrent antiretroviral therapy and immunotherapy. From an efficacy perspective, three patients were observed to have a response (one complete response, one partial response, and one stable disease). There were three patients with known cluster of differentiation (CD4 + ) levels who had an increase in CD4  +  cell count with ICI treatment. The HIV viral load remained undetected in most of the patients on ICI treatment. No confirmed immune-related adverse effects were documented for any patients in this review. Conclusion Immune checkpoint inhibitors may be efficacious and tolerable for treatment of cancer in patients living with HIV. Upward trends in CD4  +  cell counts observed in this case series suggest that immune checkpoint inhibitors may enhance HIV disease control. Further research is needed for this patient population to supply more robust evidence for clinical practice.