bluuebunny/crossref_metadata_2025_split huggingface dataset:
Revealing the challenges and efforts of routine immunization coverage in Nigeria
Authors: Ogunniyi Tolulope Joseph 
Published: August 2024

AbstractIntroductionNigeria adopted the expanded program on immunization (EPI) in 1978, which aimed at offering children under 2 years old routine immunization (RI). Early accomplishments with the program resulted in a decrease in childhood mortality. As of 2018, Nigeria accounted for about 4.3 million out of over 13 million unvaccinated children globally. Therefore, this study revealed the challenges and efforts associated with RI program in Nigeria and the way forward.MethodsIn this perspective article, I conducted searches and extracted relevant information from publicly available sources such as Google Scholar, Pubmed, and grey literature. I employed RI, challenges, efforts, and Nigeria as the keywords.ResultsThe 2021 Multiple Indicator Cluster Survey/National Immunization Coverage Survey reports revealed weaknesses in the program, with a national average coverage of 36%. The primary barrier to EPI across various zones is the challenge of reaching marginalized areas that were cut off from vaccination services due to operational and sociocultural issues. Some of the obstacles, such as restricted access to medical facilities, weak cold chain systems, and COVID‐19 containment strategies had a great impact on the RI program. To scale up the RI program, the Nigerian government, through the National Primary Health Care Development Agency (NPHCDA), collaborated with the World Health Organization (WHO) and Gavi, the Vaccine Alliance, to optimize the “Big Catch‐up campaign” and increase immunization coverage nationwide. By 2028, 80% of the projected zero‐dose populace is expected to be covered, reaching these eligible children with life‐saving vaccines.ConclusionNigeria still has a long way to go in making significant progress in the RI program. To further strengthen the immunization coverage, the country needs to maintain data on their achievements, as this will help identify gaps that need to be addressed in the immunization program.
Comparisons of clinical scoring systems among suspected pulmonary embolism patients presenting to emergency department
Authors: Tang Luojia , Hu Yundi , Min Min , Gu Jianyong , Pan Dong , Lin Xiaolei , Tong Chaoyang 
Published: August 2024

AbstractIntroductionPulmonary embolism (PE) is among the most severe cardiovascular disorders worldwide. Timely and appropriate diagnosis of PE remains an important step in reducing PE related mortality and morbidity.MethodsIn this retrospective single‐center cohort study, we comprehensively compared the screening performances of several clinical scoring systems (Wells score [WS], Revised Geneva score [RGS], WS + d‐Dimer [D‐D], RGS + D‐D, WS + PE rule‐out criteria [PERC] and RGS + PERC) among PE suspected patients. Failure rates across different PE severity grades as well as overall sensitivity/specificity were considered in evaluating each screening strategy.ResultsA total of 3437 patients were included in this study and 698 of them were diagnosed with PE. Patients with and without PE were similar in demographics, while significantly different in respiration‐related characteristics. Compared with WS or RGS alone, Integrating PERC or D‐D with WS or RGS significantly decreased the failure rates across all PE severity grades, and increased the overall sensitivity from 88.5% and 87.2% to 96.3% and 94.8% (D‐D) to 99.4% and 99.6% (PERC), respectively. However, compared with other four scoring approaches, using WS or RGS alone increased the specificity from 8.3% and 7.2%, 38.3% and 21.3%, to 63.5% and 34.8%, respectively, and increased the AUC from 0.54 to 0.54, 0.70 and 0.69, to 0.8 and 0.76, respectively. In general, all screening approaches achieved better performances among PE patients with respiratory distress compared to those without respiratory distress.ConclusionCombining PERC or D‐D with WS or RGS, and the presence of respiratory distress provide significantly better PE rule‐out performances.
Perceptions and attitudes of nurse practitioners toward artificial intelligence adoption in health care
Authors: Rony Moustaq Karim Khan , Numan Sharker Md. , Johra Fateha tuj , Akter Khadiza , Akter Fazila , Debnath Mitun , Mondal Sujit , Wahiduzzaman Md. , Das Mousumi , Ullah Mohammad , Rahman Mohammad Habibur , Das Bala Shuvashish , Parvin Mst. Rina 
Published: August 2024

AbstractBackgroundWith the ever‐increasing integration of artificial intelligence (AI) into health care, it becomes imperative to gain an in‐depth understanding of how health care professionals, specifically nurse practitioners, perceive and approach this transformative technology.ObjectivesThis study aimed to gain insights into nurse practitioners' perceptions and attitudes toward AI adoption in health care.MethodsThis qualitative research employed a descriptive and phenomenological approach using in‐depth interviews. Data were collected through a semi‐structured questionnaire with 37 nurse practitioners selected through purposive sampling, specifically Maximum Variation Sampling and Expert Sampling techniques, to ensure diversity in characteristics. Trustworthiness of the research was maintained through member checking and peer debriefing. Thematic analysis was employed to uncover recurring themes and patterns in the data.ResultsThe thematic analysis revealed nine main themes that encapsulated nurse practitioners' perceptions and attitudes toward AI adoption in health care. These included nurse practitioners' perceptions of AI implementation, attitudes toward AI adoption, patient‐centered care and AI, quality of health care delivery and AI, ethical and regulatory aspects of AI, education and training needs, collaboration and interdisciplinary relationships, obstacles in integrating AI, and AI and health care policy. While this study found that nurse practitioners held a wide range of perspectives, with many viewings AI as a tool to enhance patient care.ConclusionsThis research provides a valuable contribution to the evolving discourse surrounding AI adoption in health care. The findings underscore the necessity for comprehensive education and training in AI, accompanied by clear and robust ethical and regulatory guidelines to ensure the responsible integration of AI in health care practice. Furthermore, fostering collaboration and interdisciplinary relationships is pivotal for the successful incorporation of AI in health care. Policymakers should also address the challenges and opportunities that AI presents in the health care sector. This study enhances the ongoing conversation on AI adoption in health care by shedding light on the perspectives of nurses, thereby shaping future strategies for AI integration.
Good practice with fluid management in operative hysteroscopy
Authors: Vilos George A. , Vilos Angelos G. , Abu‐Rafea Basim , Ternamian Artin , Laberge Philippe , Munro Malcolm G. 
Published: August 2024

AbstractHysteroscopic surgery requires a balance of continuous controlled irrigation and aspiration to distend the endometrial cavity to a degree that provides the clear and stable visual environment necessary for diagnostic and therapeutic procedures. Whereas the preferred distending solution should be isotonic and isonatremic, radiofrequency (RF) electrosurgery with monopolar instrumentation can only be performed with non‐ionic (hyponatremic) solutions. Absorption of as little as 500 mL and certainly more than 1000 mL of non‐ionic solutions can result in fluid overload and/or dilutional hyponatremia with potentially serious adverse effects under certain conditions and patient characteristics. Both hysteroscopic RF electrosurgery with bipolar instrumentation and electro‐mechanical morcellation and aspiration systems use isotonic and isonatremic solutions. Depending on the clinical context, absorption of more than 1500 mL of isonatremic solutions can also result in serious adverse effects. Automated fluid management systems are preferred and recommended, and surgeons should aim to maintain the maximum allowable intravasation of distending media below 1000 and 1500 mL for non‐ionic and ionic fluids, respectively.
A Novel Classification Approach for Retinal Disease Using Improved Gannet Optimization‐Based Capsule DenseNet
Authors: Venkatesan S. , Kempanna M. , Nagaraja J. , Bhuvanesh A. 
Published: August 2024

ABSTRACTAn unusual condition of the eye called diabetic retinopathy affects the human retina and is brought on by the blood's constant rise in insulin levels. Loss of vision is the result. Diabetic retinopathy can be improved by receiving an early diagnosis to prevent further damage. A cost‐effective method of accumulating medical treatments is through appropriate DR screening. In this work, deep learning framework is introduced for the accurate classification of retinal diseases. The proposed method processes retinal fundus images obtained from databases, addressing noise and artifacts through an improved median filter (ImMF). It leverages the UNet++ model for precise segmentation of the disease‐affected regions. UNet++ enhances feature extraction through cross‐stage connections, improving segmentation results. The segmented images are then fed as input to the improved gannet optimization‐based capsule DenseNet (IG‐CDNet) for retinal disease classification. The hybrid capsule DenseNet (CDNet) classifies disease and is optimized using the improved gannet optimization algorithm to boost classification accuracy. Finally, the accuracy and dice score values achieved are 0.9917 and 0.9652 on the APTOS‐2019 dataset.
PLM‐T3SE: Accurate Prediction of Type III Secretion Effectors Using Protein Language Model Embeddings
Authors: Gao Mengru , Song Chen , Liu Taigang 
Published: August 2024

ABSTRACTThe Type III secretion effectors (T3SEs) are bacterial proteins synthesized by Gram‐negative pathogens and delivered into host cells via the Type III secretion system (T3SS). These effectors usually play a pivotal role in the interactions between bacteria and hosts. Hence, the precise identification of T3SEs aids researchers in exploring the pathogenic mechanisms of bacterial infections. Since the diversity and complexity of T3SE sequences often make traditional experimental methods time‐consuming, it is imperative to explore more efficient and convenient computational approaches for T3SE prediction. Inspired by the promising potential exhibited by pre‐trained language models in protein recognition tasks, we proposed a method called PLM‐T3SE that utilizes protein language models (PLMs) for effective recognition of T3SEs. First, we utilized PLM embeddings and evolutionary features from the position‐specific scoring matrix (PSSM) profiles to transform protein sequences into fixed‐length vectors for model training. Second, we employed the extreme gradient boosting (XGBoost) algorithm to rank these features based on their importance. Finally, a MLP neural network model was used to predict T3SEs based on the selected optimal feature set. Experimental results from the cross‐validation and independent test demonstrated that our model exhibited superior performance compared to the existing models. Specifically, our model achieved an accuracy of 98.1%, which is 1.8%–42.4% higher than the state‐of‐the‐art predictors based on the same independent data set test. These findings highlight the superiority of the PLM‐T3SE and the remarkable characterization ability of PLM embeddings for T3SE prediction.
Survey on the knowledge and practices in anorexia of aging diagnosis and management in Japan
Authors: Takagi Sahoko , Satake Shosuke , Sugimoto Ken , Kuzuya Masafumi , Akishita Masahiro , Arai Hidenori , Aprahamian Ivan , Coats Andrew J. , Klompenhouwer Tatiana , Anker Stefan D. , Wakabayashi Hidetaka 
Published: August 2024

AbstractBackgroundAnorexia of aging (AA) is a condition in older adults that includes loss of appetite and reduced food intake. There is a lack of detailed analysis of the potential influence of educational initiatives in addressing AA. This study aimed to clarify the current state of knowledge and practice regarding AA and its relationship with the availability of continuing education opportunities among Japanese healthcare professionals involved in treating older patients.MethodsThe Japan Geriatrics Society and the Japanese Association on Sarcopenia and Frailty, in collaboration with the Society on Sarcopenia, Cachexia, and Wasting Disorders, conducted an online questionnaire survey on the knowledge and practices in AA detection and management. Questions were asked in the areas of demographics, screening, definition/diagnosis, treatment, referral, and awareness, with those who ‘participate’ in continuing education and professional development programmes in nutrition for their patients were classified as the ‘education group’ and those who ‘do not participate’ were classified as the ‘non‐education group’. The results for each question were compared.ResultsThe analysis included 870 participants (physicians, 48%; registered dietitians, 16%; rehabilitation therapists, 14%; pharmacists, 12%; nurses, 6%; and other professionals, 5%). The education group (45%) was more likely than the non‐education group (55%) to use the Mini‐Nutritional Assessment Short Form (MNA‐SF) to screen for AA (49% vs. 27%) and less likely not to use a validated tool (33% vs. 47%). More participants used evidence‐based tools and materials for AA care (38% vs. 12%), and fewer used their clinical judgement (23% vs. 35%) or were unaware of the tools and materials (9% vs. 23%). The proportion using a team of professionals experienced in AA care were 47% and 24% of the education and non‐education groups, respectively. By profession, few physicians used specific validated tools and resources for AA screening and treatment. More than half of the dietitians used the MNA‐SF regardless of training opportunity availability. Regarding professional availability and team use, differences in educational opportunities were particularly large among physicians.ConclusionsParticipation in continuing education programmes on nutrition is associated with responsiveness to AA screening and treatment and the availability of a team of professionals, which may influence the quality of AA treatment. Nutrition education may support the confidence of healthcare professionals working with older adults in AA with complex clinical signs and encourage them to conduct evidence‐based practice.
Novel metabolic and lipidomic biomarkers of sarcopenia
Authors: Hsu Wei‐Hsiang , Wang San‐Yuan , Chao Yen‐Ming , Chang Ke‐Vin , Han Der‐Sheng , Lin Yun‐Lian 
Published: August 2024

AbstractBackgroundThe pathophysiology of sarcopenia is complex and multifactorial and has not been fully elucidated. The impact of resistance training and nutritional support (RTNS) on metabolomics and lipodomics in older adults with sarcopenia remains uncertain. This study aimed to explore potential biomarkers of sarcopenia and clinical indicators of RTNS in older sarcopenic adults.MethodsOlder individuals diagnosed with sarcopenia through routine health checkups at a community hospital were recruited for a 12‐week randomized controlled trial focusing on RTNS. Plasma metabolomic and lipidomic profiles of 45 patients with sarcopenia and 47 matched controls were analysed using 1H‐nuclear magnetic resonance (1H‐NMR) and liquid chromatography‐mass spectrometer (LC–MS).ResultsAt baseline, the patient and control groups had similar age, sex, and height distribution. The patient group had significantly lower weight, BMI, grip strength, gait speed, skeletal muscle index, lean mass of both the upper and lower limbs, and lower limb bone mass. There was a significant difference in 12 metabolites between the control and patient groups. They are isoleucine (patient/control fold change [FC] = 0.86 ± 0.04, P = 0.0005), carnitine (FC = 1.05 ± 0.01, P = 0.0110), 1‐methylhistamine/3‐methylhistamine (FC = 1.24 ± 0.14, P = 0.0039), creatinine (FC = 0.71 ± 0.04, P < 0.0001), carnosine (FC = 0.71 ± 0.04, P = 0.0007), ureidopropionic acid (FC = 0.61 ± 0.10, P = 0.0107), uric acid (FC = 0.88 ± 0.03, P = 0.0083), PC (18:2/20:0) (FC = 0.69 ± 0.03, P = 0.0010), PC (20:2/18:0) (FC = 0.70 ± 0.06, P = 0.0014), PC (18:1/20:1) (FC = 0.74 ± 0.05, P = 0.0015), PI 32:1 (FC = 4.72 ± 0.17, P = 0.0006), and PI 34:3 (FC = 1.88 ± 0.13, P = 0.0003). Among them, carnitine, 1‐methylhistamine/3‐methylhistamine, creatinine, ureidopropionic acid, uric acid, PI 32:1, and PI 34:3 were first identified. Notably, PI 32:1 had highest diagnostic accuracy (0.938) for sarcopenia. 1‐Methylhistamine/3‐methylhistamine, carnosine, PC (18:2/20:0), PI 32:1, and PI 34:3 levels were not different from the control group after RTNS. These metabolites are involved in amino acid metabolism, lipid metabolism, and the PI3K‐AKT/mTOR signalling pathway through the ingenuity pathway analysis.ConclusionsThese findings provide information on metabolic changes, lipid perturbations, and the role of RTNS in patients with sarcopenia. They reveal new insights into its pathological mechanisms and potential therapies.
Ferrate(VI) green oxidant: electrochemical generation, self‐decomposition, and application for reactive red 195 azo dye treatment
Authors: Nguyen Thi Van Anh , Mai Thi Thanh Thuy , Phan Thi Binh , Tran Huu Quang , Bui Minh Quy 
Published: August 2024

AbstractBACKGROUNDFerrate(VI), an environmentally friendly oxidant, has recently emerged as one of the most promising chemicals for water and wastewater treatment due to its versatile application as an oxidant, coagulant, and disinfectant. In this paper, the factors affecting the electrosynthesis process of ferrate using ductile iron anode were studied. Besides, the obtained ferrate was used to remove reactive red 195 (RR195).RESULTSThe optimal ferrate electrochemical synthesis conditions were determined, including 14 mol L−1 NaOH electrolyte solution, a current density of 40 mA cm−2, and electrolysis time of approximately 5–6 h. Furthermore, the kinetics of the ferrate's self‐decomposition reaction was also studied at different temperatures. The decomposition process of ferrate in a 14 mol L−1 NaOH environment followed second‐order kinetics, with reaction rate constants of 4.70 × 10−9, 7.31 × 10−8, 1.95 × 10−7, and 4.70 × 10−7 (L mol−1 s−1) at temperatures of 4, 10, 20, and 30 °C, respectively. RR195 treatment efficiency by ferrate reached 96.3% in a short time of 3 min at pH 3 with a ferrate/RR195 molar ratio of 30/1.CONCLUSIONThis study identified the optimal conditions for the electrochemical synthesis of ferrate using a ductile iron anode. Ferrate was stable at a low temperature of 4 °C, so unused ferrate needs to be stored at low temperatures to avoid decomposition of ferrate. The ferrate green oxidant demonstrated high efficiency in the treatment of RR195 in a short time. © 2024 Society of Chemical Industry (SCI).
Extracellular vesicles may provide an alternative detoxification pathway during skeletal muscle myoblast ageing
Authors: Fernández‐Rhodes María , Buchan Emma , Gagnon Stephanie D. , Qian Jiani , Gethings Lee , Lees Rebecca , Peacock Ben , Capel Andrew J. , Martin Neil R. W. , Oppenheimer Pola Goldberg , Lewis Mark P. , Davies Owen G. 
Published: August 2024

AbstractSkeletal muscle (SM) acts as a secretory organ, capable of releasing myokines and extracellular vesicles (SM‐EVs) that impact myogenesis and homeostasis. While age‐related changes have been previously reported in murine SM‐EVs, no study has comprehensively profiled SM‐EV in human models. To this end, we provide the first comprehensive comparison of SM‐EVs from young and old human primary skeletal muscle cells (HPMCs) to map changes associated with SM ageing. HPMCs, isolated from young (24 ± 1.7 years old) and older (69 ± 2.6 years old) participants, were immunomagnetically sorted based on the presence of the myogenic marker CD56 (N‐CAM) and cultured as pure (100% CD56+) or mixed populations (MP: 90% CD56+). SM‐EVs were isolated using an optimised protocol combining ultrafiltration and size exclusion chromatography (UF + SEC) and their biological content was extensively characterised using Raman spectroscopy (RS) and liquid chromatography mass spectrometry (LC‐MS). Minimal variations in basic EV parameters (particle number, size, protein markers) were observed between young and old populations. However, biochemical fingerprinting by RS highlighted increased protein (amide I), lipid (phospholipids and phosphatidylcholine) and hypoxanthine signatures for older SM‐EVs. Through LC‐MS, we identified 84 shared proteins with functions principally related to cell homeostasis, muscle maintenance and transcriptional regulation. Significantly, SM‐EVs from older participants were comparatively enriched in proteins involved in oxidative stress and DNA/RNA mutagenesis, such as E3 ubiquitin‐protein ligase TTC3 (TTC3), little elongation complex subunit 1 (ICE1) and Acetyl‐CoA carboxylase 1 (ACACA). These data suggest SM‐EVs could provide an alternative pathway for homeostasis and detoxification during SM ageing.
Hospital commitments to address diagnostic errors: An assessment of 95 US hospitals
Authors: Campione Russo Alexandra , Tilly Jean‐Luc , Kaufman Leah , Danforth Melissa , Graber Mark L. , Austin J. Matthew , Singh Hardeep 
Published: August 2024

AbstractBackgroundDiagnostic errors are a leading cause of patient harm. In 2022, the Leapfrog Group published a report containing 29 evidence‐based practices that hospitals can adopt to reduce diagnostic errors.ObjectivesTo understand the extent to which US hospitals have already implemented these practices, we conducted a national pilot survey of Leapfrog‐participating hospitals.MethodsTo reduce respondent burden, we divided the 29 practices across two surveys: one focused on organizational culture and structure (Domain 1), and the second focused on the diagnostic process itself (Domain 2).ResultsA total of 95 hospitals from 23 states responded to one or both surveys. On average, hospitals reported implementing 9 of the 16 practices (56%) in Domain 1 and 8 of the 13 practices (62%) in Domain 2. The rate of practice implementation varied greatly, with some hospitals implementing as few as three practices in their domain. The most commonly implemented practices were ensuring access to medical interpreters, continuous access to radiologists, ensuring staff and patients can report diagnostic errors and concerns, and having a formal process to identify and notify patients when diagnostic errors occur. The least implemented practices included convening a multidisciplinary team focused on diagnostic safety and quality, a CEO commitment to diagnostic excellence, conducting diagnosis‐focused risk assessments, and training clinicians to optimize clinical reasoning in the diagnostic process.ConclusionsThe findings suggest large and important implementation gaps for practices related to diagnostic excellence and can inform new initiatives to promote diagnostic excellence in US hospitals.
Association of HLA‐DRB1 alleles with status of antibodies to hepatitis B surface and e antigen
Authors: Li Xinze , Zhou Qiaomiao , Lu Zhe , Huang Renliang , Lin Dan , Xu Jing , Yu Xinhua , Li Xuexia 
Published: August 2024

AbstractAntigen presentation by HLA class II molecules to CD4+ T cells is an essential step for generating antibodies to hepatitis B antigens. In this study, we investigated the association between the HLA‐DRB1 gene and the status of antibodies to hepatitis B surface and e antigens. Our results revealed a significant association between the status of anti‐HBsAg and HLA‐DRB1*04:03 (OR = 4.11, 95% CI = 1.50–10.84, p = 0.005, Padj. = 0.05) as well as HLA‐DRB1*15:01 (OR = 1.74, 95% CI = 1.20–2.50, p = 0.002, Padj. = 0.045). MHC II binding predictions and in silico docking demonstrated strong binding affinity of HBsAg peptides to these two HLA‐DRB1 molecules. Conversely, the status of anti‐HBeAg was inversely associated with HLA‐DRB1*14:54 (OR = 0.34, 95% CI = 0.18–0.64, p = 0.001, Padj. = 0.011), and in silico analysis revealed weak binding affinity of HBeAg peptides to HLA‐DRB1*14:54. In conclusion, these findings support the involvement of HLA‐DRB1 in humoral immunity against HBV infection.