bluuebunny/crossref_metadata_2025_split huggingface dataset:
WITHDRAWN: Combination of ultrasound-guided pectoral nerve block I (PECS I) and serratus anterior plane block (SAP) for attenuation of surgical stress response during modified radical mastectomy: a prospective interventional randomized controlled trial
Authors: Pramanik Monotosh , Chaudhuri Shalini , Banerjee Sandipan , Chattopadhyay Uddalak , Hussain Syed Sadaqat , Singh Nikhil Kumar , Kirtania Jyotirmay 
Published: August 2024

Abstract

Background and Aims
General anesthesia with multimodal analgesia is the standard anesthetic management during modified radical mastectomy. In this study, a combined ultrasound-guided pectoral nerve block (PECS I) and serratus anterior plane block (SAP) were used for surgical stress response attenuation and postoperative analgesia.
Methods
Thirty-six consenting patients were randomized into two groups. After induction of general anesthesia, Group B patients received ultrasound-guided PECS I and SAP block whereas Group C patients received intravenous analgesics only. Intraoperative fentanyl dosage to keep the systolic blood pressure (SBP) and heart rate (HR) within 20% of baseline was the primary outcome variable. Secondary outcome variables were intraoperative vitals, postoperative pain score, analgesic requirement, and nausea and vomiting. Wilcoxon rank-sum test (non-parametric data), Student's t-test (parametric data), and Chi-square test (categorical data) were used for comparison. P value <0.05 was considered statistically significant.
Results
Surgical stress response attenuation was achieved with a lower dosage of fentanyl in Group B compared to Group C [intraoperative fentanyl (mean±SD), 116.11±25.70 µg vs. 134.44±20.07 µg, P = 0.023]. Compared to Group C, intraoperative reduction in SBP and HR was higher in Group B [SBP reduction (mean±SD), 24.03±12.5 mm of Hg vs. 15.2±13.05 mm of Hg, P = 0.045 and HR reduction (mean±SD), 18.61±6.6 beats/min vs. 10.73±10.03 beats/min, P = 0.009 respectively]. The apparently higher pain scores in the control group were statistically insignificant.
Conclusion
A combined PECS I and SAP block attenuates intraoperative autonomic stress response due to the surgical stimulus with significantly less opioid requirement.
Trial Registration: CTRI/2023/03/050487. This trial is registered with the Clinical Trial Registry of India ON 09/03/2023. https://ctri.nic.in/Clinicaltrials/login.php
Factors associated with the implementation of Dialectical Behavior Therapy by Spanish speaking mental health professionals who treat suicide risk
Authors: Navarro-Haro María V. , Abanades Alba , Peris-Baquero Óscar , Gagliesi Pablo , Rodante Demián , García-Palacios Azucena , Osma Jorge 
Published: August 2024

Abstract

Background
The lack of training for professionals on how to manage suicide risk is an important barrier to effective intervention. Dialectical Behavior Therapy Intensive Training™ (DBT-IT) includes specific training for suicide and has shown promising results to enhance implementation of DBT. To our knowledge, no published studies have evaluated the effect of DBT-IT on therapists’ attitudes towards treating suicide risk and among Spanish-speaking mental health professionals. The main aim of this study was to evaluate the effect of DBT-IT on therapists’ attitudes regarding treating suicide risk and its relationship with the implementation of DBT before and after receiving DBT-IT.
Methods
A total of 242 mental health workers (76.4% women, mean age 35.38, SD = 9.17; 77.7% from Latin America; 22.3% from Spain) who had received a DBT-IT participated in the study. Self-efficacy (Efficacy in Assessing and Managing Suicide Risk Scale) and concerns (Concerns about Treating Suicidal Clients Scale) in treating suicide, perceived burnout (Copenhagen Burnout Inventory), confidence to apply DBT (Behavioral Anticipation and Confidence Questionnaire), barriers to implementation (Barriers to Implementation Inventory), implementation of DBT and reach were measured via online survey at parts 1 (beginning) and 2 (after 9 months of implementation) of the DBT-IT.
Results
Differences between part 1 and part 2 (n = 61) indicated statistically significant improvements in self-efficacy, concerns about the lack of training and competence in treating suicide, and confidence to apply DBT. Statistically significant increases in the rates of DBT treatment modes implementation (except for individual therapy) and mindfulness practice, as well as the number of team members and consultation team hours, were also found. Findings also indicated statistically significant positive correlations between burnout and concerns about treating suicidal clients, as well as with structural and administrative implementation barriers, and between self-efficacy in managing suicide, confidence to apply DBT and implementation of DBT treatment modes. Participants with more implementation barriers reported lower rates of consultation team and phone coaching implementation.
Conclusions
DBT-IT could be an adequate training model to increase self-efficacy and confidence in treating suicide risk as well as to facilitate implementation of DBT treatment modes by Spanish-speaking mental health professionals.
Risk of Dementia in Nepal: A Cross-Sectional Survey in Mountainous, Hilly, and Lowland Regions
Authors: Simkhada Bibha , Magar Sanju Thapa , Simkhada Padam , Tamang Pasang , Stephenson John 
Published: August 2024

Abstract

Introduction
Globally dementia is a growing public health problem, with over 135,000 people in Nepal living with dementia. Nepal lacks national and community-based data on dementia prevalence. This study aims to determine the dementia risk in Nepal and assess the effects of age, sex, and geographical location on disease prevalence. It also intends to inform policy makers about the burden of dementia, prompting them to plan and prepare appropriate health and social care services for individuals affected by dementia.
Methods
A cross-sectional survey with total 1152 individuals (933 older people, aged 60 and over and 219 carers of 60 years and older people) was conducted to determine the prevalence of dementia risk in three geographical regions of Nepal. The Rowland Universal Dementia Assessment Scale (RUDAS) and Memory First Aid Informant Questionnaire adapted from Community Screening Interview for Dementia (CSI-D) for informant were used to measure cognitive impairment. The study evaluated the overall prevalence of cognitive impairment or risk of dementia and subgroups by region, age group, and sex. Chi-squared tests and multiple logistic regression analyses were conducted to assess the effects.
Results
For the RUDAS test, 53.7% (501) participants had cognitive impairment, with slightly higher rates in women (56.5%) than men (51.7%). For the Memory First Aid Informant Questionnaire/CSI-D for informant, 155 participants had cognitive impairment at a rate of 70.8%, with slightly higher rates in men. Cognitive impairment prevalence increases with age and region, with hilly and mountainous areas and low-lying regions having a greater geographic effect.
Conclusions
There is high risk of dementia in Nepal. The risk is influenced by age and geographical regions, necessitating early diagnosis and tailored interventions for older people and who are residing in higher altitude areas. National-level studies and exploration of factors affecting early dementia diagnosis are needed.
Evaluation of split renal function using MR-derived structure and arterial spin-labeled perfusion features in obstructive nephropathy
Authors: Cai Yu-Qing , Wang Lei , Guan Wen-Hao , Yang Jinzhi , Dong Yang , Li Xiancheng 
Published: August 2024

Abstract

Objectives To explore the value of renal arterial spin-labeled (ASL) and structural MRI in evaluating split renal function (SRF) by renal scintigraphy (RS) in obstructive nephropathy.
Materials and methods Consecutive patients with obstructive hydronephrosis were recruited for a 3.0-T conventional and ASL examination from January 2022 to August 2023 prospectively. The 92 independent kidneys were classified into normal renal function, mild to moderate renal impairment, severe renal impairment, or no function groups. Renal blood flow (RBF), renal parenchymal thickness (RPT), and renal pelvic dilatation (RPD) were assessed based on ASL and T1WI maps. One-way analysis of variance (ANOVA) and Kruskal-Walli’s test were used to analyze the differences. Pearson and Spearman rank correlation analysis approaches were adopted to analyze the correlation between RBF, RPT, RPD, and glomerular filtration rate (GFR) by RS. The ROC curve was used to compare their performance in SRF evaluation.
Results Renal cortical RBF, RPT, and RPD could distinguish SRF pairwise subgroups with different renal function impairments (p<0.001), with correlation coefficients of 0.767, 0.635, and -0.589, respectively (all p<0.001). RBF combined with RPT and RPD achieved the best efficacy in distinguishing between normal and mild, mild and severe, normal and severe renal dysfunction, with AUCs of 0.869 (95% CI, (0.768-0.937)), 0.883 (95% CI, (0.756-0.959)) and 0. 994 (95% CI, (0.931-1.00)).
Conclusions MR structural features and ASL imaging enable quantitative measurements of RPT, RPD, and renal cortical RBF, which were correlated with RS-GFR. MR combination demonstrated clinical potential in noninvasive evaluation of SFR in obstructive nephropathy.
Discovering a specialized programmed-cell death patterns for prognostic model of pancreatic ductal carcinoma via machine learning
Authors: Wu Zhaowei , Huang Kun , Jiang Shiming , Chen Yong 
Published: August 2024

Abstract

Substantial evidence implicates programmed cell death (PCD) in pancreatic ductal adenocarcinoma (PDAC) pathophysiology. Through advanced machine learning paradigms, our study identified 103 PCD-relevant hub genes. Employing a comprehensive panel of 167 algorithmic configurations, spanning 15 unique machine learning approaches, we analyzed the prognostic relevance of these PCD-linked features across diverse cohorts. Our systematic analysis yielded a groundbreaking prognostic indicator, the Cell Death Index (CDI), poised to markedly improve PDAC outcome predictions. Demonstrating notable accuracy in both prognosis and immunotherapy response forecasting, the CDI facilitated the development of an enhanced nomogram. Additionally, we pinpointed targeted therapeutic agents for PDAC patients classified according to specific CDI profiles, advancing personalized medicine strategies. MYOF, identified as a central hub gene, exhibited markedly heightened expression in PDAC tissues versus adjacent non-malignant tissues, as evidenced by quantitative PCR. Further probing revealed MYOF's critical role in mediating proliferation, viability, invasion, and migration in PDAC cells, underscoring its potential significance as a therapeutic target warranting further investigation.
Assessing Risk Factors for Cognitive Decline Using Electronic Health Record Data: A Scoping Review
Authors: Wang Liqin , Yang Richard , Sha Ziqin , Kuraszkiewicz Anna Maria , Leonik Conrad , Zhou Li , Marshall Gad A. 
Published: August 2024

Abstract

Background: The data and information contained within electronic health records (EHR) provide a rich, diverse, longitudinal view of real-world patient histories, offering valuable opportunities to study antecedent risk factors for cognitive decline. However, the extent to which such records’ data have been utilized to elucidate the risk factors of cognitive decline remains unclear.
Methods: A scoping review was conducted following the PRISMA guideline, examining articles published between January 2010 and April 2023, from PubMed, Web of Science, and CINAHL. Inclusion criteria focused on studies using EHR to investigate risk factors for cognitive decline. Each article was screened by at least two reviewers. Data elements were manually extracted based on a predefined schema. The studied risk factors were classified into categories, and a research gap was identified.
Results: From 1,593 articles identified, 80 were selected. The majority (87.5%) were retrospective cohort studies, with 66.3% using datasets of over 10,000 patients, predominantly from the US or UK. Analysis showed that 48.8% of studies addressed medical conditions, 31.3% focused on medical interventions, and 17.5% on lifestyle, socioeconomic status, and environmental factors. Most studies on medical conditions were linked to an increased risk of cognitive decline, whereas medical interventions addressing these conditions often reduced the risk.
Conclusions: EHR data significantly enhanced our understanding of medical conditions, interventions, lifestyle, socioeconomic status, and environmental factors related to the risk of cognitive decline.
Structural and functional changes in the oral microbiome of the patients with craniofacial microsomia
Authors: ZANG TIANYING , TANG XIAOJUN , ZHANG Zhiyong , LIU WEI , YIN LIN , Zhao Shanbaga Zhao , Liu Bingyang , Ma LUNKUN , LI ZHIFENG 
Published: August 2024

Abstract

Background
Craniofacial microsomia (CFM), the second most common congenital craniofacial deformity, has manifold clinical manifestations and treatments that may interact with oral bacteria dysbiosis (OBD). However, studies exploring the relationship between CFM and OBD are scanty.
Methods
Saliva samples of 20 patients with CFM and 24 controls were collected, and oral microflora and gene function annotation were compared using 16S ribosomal RNA and metagenomics. The correlation between clinical phenotypes of CFM and microbiota community structure was also evaluated.
Results
The oral microflora of CFM patients exhibited higher richness and evenness. The dominant genera in CFM were mainly pathogenic and included Actinomyces, Fusobacterium, and Prevotella. The severity of CFM was significantly positively correlated with the abundance of Neisseria and Porphyromonas. The upregulated pathways were primarily enriched in biotin and amino acid metabolism, including Tryptophan metabolism, which positively correlated with the abundance of Neisseria.
Conclusion
This study suggests for the first time that patients with CFM exhibit distinct oral bacterial dysbiosis, characterized by an elevated prevalence of opportunistic pathogens and upregulated pathways associated with oral and systemic health. These findings provide evidence for corresponding preventions and therapeutic interventions of CFM.
Automated Radiographic Total Sharp Score (ARTSS) in Rheumatoid Arthritis: A Solution to Reduce Inter-Intra Reader Variation and Enhancing Clinical Practice
Authors: Moradmand Hajar , Ren Lei 
Published: August 2024

Abstract

The total Sharp-van der Heijde score (TSS) is crucial for assessing the joint damage severity in rheumatoid arthritis (RA). Manual scoring is often time-consuming and subjective, leading to variability. This study introduces an Automated Radiographic Sharp Scoring (ARTSS) framework that leverages deep learning to analyze full-hand X-ray images, aiming to reduce inter- and intra-observer variability. A key innovation is its ability to handle patients with joint disappearance and variable-length image sequenced. The framework involves four stages: image pre-processing with ResNet50, hand segmentation using UNet, joint identification via YOLOv7, and TSS prediction using models like VGG16, VGG19, ResNet50, DenseNet201, EfficientNetB0, and Vision Transformer (ViT). Evaluation metrics included Intersection over Union (IoU), Mean Average Precision (MAP), Mean Absolute Error (MAE), Root Mean Squared Error (RMSE), and Huber loss. Training used 3-fold cross-validation with 970 patients, and external testing included 291 subjects. The joint identification model achieved 99% accuracy, with ViT showing a Huber loss of 0.87 for TSS prediction. The ARTSS addresses the challenge of joint disappearance and variable joint numbers, which lead to its generalizability and applicability to clinical. This approach preserves time, reduces inter- and intra-reader variability, improves radiologist accuracy, and aids rheumatologists in making more personalized treatments.
A meta-analysis of the risk of adverse cardiovascular events in patients with cancer treated with inhibitors of the PI3K/AKT/mTOR signaling pathway
Authors: Liang Xiao , Zhang Chengrong , Tang Yuyao , Li YongXin , Zhu Zijun , Qiu Tianlei , Zhao Jiuda 
Published: August 2024

Abstract

Background: With the increasing of PI3K/AKT/mTOR (PAM) inhibitors in cancer therapy, there is a growing need to understand the incidence of cardiovascular events (CVAEs) associated with PAM inhibitors.
Methods: A systematic search of all randomized clinical trials (RCTs) containing at least one PAM group in electronic databases such as PubMed, ClinicalTrials.gov registry, Embase, Medline, Cochrane Library, and major conferences was performed to extract available CVAEs. The cut-off date was January 31, 2024. Study heterogeneity was assessed using the I2 statistic. The risk of CVAEs associated with PAM inhibitors was calculated using Peto OR.
Main outcomes and measures:
The primary outcome was the incidence (95% CI) of PAM inhibitors cardiovascular adverse events in the total population and subgroups. The secondary outcome was the pooled risk of different CVAEs associated with PAM inhibitor exposure in the RCTs.
Results:
33 unique RCTs (n=12,351) were included. The incidence of PAM inhibitors CVAEs of any grade in the intervention group was 48.2%, yielding a combined OR of 2.52 (95% CI, 1.82 - 3.49). The incidence of severe adverse cardiovascular events (≥ grade 3) in the intervention group was estimated at 7.1%, yielding a combined Peto OR of 1.41 (95% CI,1.04 - 1.93). PAM inhibitors were associated with an increased risk of 5 CVAEs including peripheral edema, lymphoedema, hypercholesterolemia, hypertriglyceridaemia and hyperlipidemia, with higher risks for hypercholesterolemia (Peto OR:3.27,95% CI:2.61-4.11, P<0.01; I2 = 55.5%，P=0.06) and hyperlipidemia (Peto OR:3.53. 95%CI:1.70-7.32, P<0.01; I2 = 19.3%，P=0.29).
Conclusion:
This study identified an overall incidence of PAM inhibitors CVAEs and the increased risks associated with PAM inhibitor for five specific CVAEs, not confined to hypercholesterolemia and peripheral edema.
Diagnostic aspect of ferritin level in acquired heart failure in children: a retrospective study in Covid-19 patients
Authors: Hasabi Amir , Farrokhpour Sajjad , Fallahi Mahsa , Tavanayan Masome , Shahvari Samira Zakeri , Satarzadeh Mohammad 
Published: August 2024

Abstract

Background
More important than the issue of Covid is the management of its consequences on other vital organs. Many biomarkers change as a result of this respiratory infection, which depends on the function of vital organs such as the heart. This study aims to investigate the relationship between serum ferritin level and acquired heart diseases in children suffered from covid.
Method
This retrospective study started by examining ferritin levels measured in children with a positive PCR result. Children who underwent echocardiography from March 2019 to one year later were examined. We evaluated the age, gender, echocardiography results and ferritin level of these children.
Results
Out of a total of 116 examined covid patients, 62 (53.45%) were women and 54 (46.55%) were men. The highest level of ferritin based on the age of the examined patients was 6 months to 1 year and then 1 to 3 years, 90% of children were normal in terms of heart diseases, 4.3% MILD TR and 2.6% MILD TR & MR and 2.6 percent were MOD TR + SEVER MR + RV, LV HYPERTROPHY. Ferritin in children and infants with covid disease was lower in females and the statistical analysis of the data showed that there is a significant relationship between ferritin and heart diseases in female covid patients as opposed to males in covid patients in infants and children. Ferritin was significantly higher in covid patients under 6 months who had heart diseases, but this relationship is negligible in other categories.
Conclusion
Serum ferritin level is a predictive factor for acquired cardiovascular disorders, the increase of ferritin level has a high correlation with the severity of heart diseases, so it has a high prognostic potential in children suffered from covid.
A comprehensive treatment algorithm of hip replacement in patient with End-Stage renal disease: A Case Series
Authors: Yan Zhen-lin , Zhu Hong-xia , Xie Yu , Xie Lun-Li 
Published: August 2024

Abstract

Background
Considering the difficulties of femoral neck fractures in patient with end-stage renal disease associated with hemodialysis, it is important to formulate a comprehensive treatment algorithm providing a suitable individual protocol. Thus, the purpose of our study is to introduce a novel comprehensive treatment algorithm for these population.
Case presentation
This article retrospectively analyzed the data of six patients diagnosed with femoral neck fractures or femoral intertrochanteric fracture accompanying with end-stage renal disease associated and accepted regular hemodialysis. The subjects, comprising both males and a female, are of Asian ancestry and exhibit an age range from 66 years to 90 years. All patients accepted hemiarthroplasty of femoral intertrochanteric fracture or femoral neck fracture. Despite lack of large samples, the case series reveals an effective treatment algorithm.
Conclusions
Our study formulate a comprehensive treatment algorithm in patients with femoral neck fractures associated with End-Stage renal disease,and received regular hemodialysis.
Early-onset of Svalbard greening driven by sea ice loss and glacier retreat after the Little Ice Age
Authors: Ingrosso Gianmarco , Ceccarelli Chiara , Giglio Federico , Giordano Patrizia , Hefter Jens , Langone Leonardo , Miserocchi Stefano , Mollenhauer Gesine , Nogarotto Alessio , Sabino Mathia , Tesi Tommaso 
Published: August 2024

Abstract

Climate change is rapidly modifying tundra vegetation productivity and composition in the Arctic. However, empirical long-term evidence of this process is lacking due to field measurement limitations and problematic interpretation of the greening vs. browning from satellite data. Here, we measured plant-derived biomarkers from an Arctic fjord sediment core as proxies to reconstruct past changes in the tundra vegetation during the transition from the Little Ice Age to Modern Warming. Our findings reveal a rapid expansion of the tundra since the beginning of the twentieth century, largely coinciding with the decline of summer sea ice extent and glacier retreat. The greening trend inferred by biomarker analysis peaked significantly in the late 1990s, along with a shift in the tundra community toward a more mature successional stage. Most of this signal was consistent with the biomolecular fingerprint of vascular plant species more adapted to warmer conditions and widely expanding in proglacial areas during recent decades. Our results suggest that vegetation cover in Arctic fjords will drastically increase under the predicted warming scenario and sea ice loss, leading also to a significant change in tundra community structure.