bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Supplemental Oxygen on Physiological Responses to Exercise in Fibrotic Interstitial Lung Disease
Authors: BAIDATS YAEL , KADOSH SHIR , JONES ANDREW M. , WILKERSON DARYL , VELNER ARIELA , REUVENY RONEN , SEGEL MICHAEL J. 
Published: July 2024

ABSTRACT

Purpose
We studied the effect of O2 supplementation on physiological response to exercise in patients with moderate to severe interstitial lung disease (ILD).

Methods
Thirteen patients (age 66 ± 10 yr, 7 males) with ILD (total lung capacity, 71% ± 22% predicted; carbon monoxide diffusion capacity, 44% ± 16% predicted) and 13 healthy individuals (age 50 ± 17 yr, 7 males) were tested. ILD patients performed symptom-limited cardiopulmonary exercise tests and constant work rate (WR) tests at 80% of the WR at the gas exchange threshold. Tests breathing room air (RA; 21% O2) were compared with tests performed breathing 30% O2. Oxygen uptake (V̇O2) kinetics were calculated from the constant WR test results.

Results
In the ILD group, peak WR, peak V̇O2, and V̇O2 at the gas exchange threshold improved significantly when breathing 30% O2 compared with RA (mean ± SD, 75 ± 26 vs 66 ± 23 W, 17 ± 4 vs 15 ± 2 mL·kg−1·min−1, and 932 ± 245 vs 854 ± 232 mL·min−1; P = 0.004, P = 0.001, and P = 0.01, respectively). O2 saturation (SpO2%) at peak exercise was higher with 30% O2 (97% ± 4% vs 88% ± 9%, P = 0.002). The time constant (tau) of V̇O2 kinetics was faster in ILD patients while breathing 30% O2 (41 ± 10 s) compared with RA (52 ± 14 s, P = 0.003). There was a negative linear relation between tau and SpO2% with RA (r = −0.76, P = 0.006) and while breathing 30% O2 (r = −0.68, P = 0.02).

Conclusions
Using a clinically applicable level of O2 supplementation (30%) improved maximal, aerobic exercise capacity and V̇O2 kinetics in ILD patients, likely due to increased blood O2 content subsequently increasing the O2 delivery to the working muscles.
The Physiological and Performance Development of Two Multiple Olympic Champion Rowers: A 20-Year Follow-Up Study
Authors: MIKULIC PAVLE , GULIN JERE 
Published: July 2024

ABSTRACT

Purpose
This study reports the results of a 20-yr (2005 to 2024) follow-up study of two 2-time Olympic and 6-time world champion rowing athletes. To provide a comprehensive picture of adaptations in physiological and performance characteristics to long-term training, we monitored the athletes’ physiological and performance data annually through five 4-yr developmental phases.

Methods
Maximal oxygen uptake (V̇O2max), maximal minute power (MMP), and power output corresponding to anaerobic threshold (PAT) were derived from a rampwise exercise test on a rowing ergometer. In addition, average power output sustained during all-out tests over 2000 and 6000 m on a rowing ergometer was also obtained.

Results
V̇O2max peaked at age 22 for athlete A and at age 25 for athlete B (at ~7 L·min−1) before stabilizing and then gradually declining to a range of 6.2 to 6.5 L·min−1 for both athletes. MMP stabilized in both rowers at values between 550 and 575 W and displayed minimal fluctuations over the final two phases of the study. In addition, MMP closely resembled the corresponding average power output sustained during the 2000-m all-out tests on a rowing ergometer. Average power output during 2000 and 6000-m all-out tests showed steady improvements over the monitored phases of the study, with the highest power output crew averages for both 2000-m (532 W; 5 min 48 s) and 6000-m (463 W; 18 min 4 s) tests recorded during the last 4-yr phase of the assessment.

Conclusions
Improvements in rowing ergometer performance over 2000 and 6000 m appear to be largely independent of the multiyear changes in V̇O2max. Long-term rowing training resulted in continuous improvements in MMP and PAT throughout the monitored phases, which more closely mimicked improvements in rowing ergometer performance.
How useful is the tuberculin skin test for tuberculosis detection: Assessing diagnostic accuracy metrics through a large Tunisian case-control study
Authors: Nouira Mariem , Ben Rayana Hazem , Ennigrou Samir 
Published: July 2024

Background and aim During the past decade, the frequency of extrapulmonary forms of tuberculosis (TB) has increased. These forms are often miss-diagnosed. This statement of the TB epidemiological profile modification, conduct us to reflect about the utility of the Tuberculin Skin Test (TST) in active TB detection. This study aimed to evaluate the diagnostic accuracy performance of the TST for active tuberculosis detection. Methods This was a case-control, multicenter study conducted in 11 anti-TB centers in Tunisia (June-November2014). The cases were adults aged between 18 and 55 years with newly diagnosed and confirmed tuberculosis. Controls were free from tuberculosis. A data collection sheet was filled out and a TST was performed for each participant. Diagnostic accuracy measures of TST were estimated using Receiver Operating Curve (ROC) curve and Area Under Curve (AUC) to estimate sensitivity and specificity of a determined cut-off point. Results Overall, 1050 patients were enrolled, composed of 336 cases and 714 controls. The mean age was 38.3±11.8 years for cases and 33.6±11 years for controls. The mean diameter of the TST induration was significantly higher among cases than controls (13.7mm vs.6.2mm; p=10-6). AUC was 0.789 [95% CI: 0.758-0.819; p=0.01], corresponding to a moderate discriminating performance for this test. The most discriminative cut-off value of the TST, which was associated with the best sensitivity (73.7%) and specificity (76.6%) couple was ≥ 11 mm with a Youden index of 0.503. Positive and Negative predictive values were 3.11% and 99.52%, respectively. Conclusions TST could be a useful tool used for active tuberculosis detection, with a moderate global performance and accepted sensitivity and specificity at the cut-off point of 11 mm. However, it cannot be considered as a gold standard test due to its multiple disadvantages.
El virus SARS-CoV-2 es el agente etiológico de la enfermedad por coronavirus de 2019 que provocó la pandemia de Covid-19. Este virus ha logrado una transmisión sostenida entre poblaciones humanas; sin embargo, desde 2020 se han documentado eventos de contagio zoonótico inverso, es decir, la transmisión del virus de humanos a animales domésticos y salvajes. Este estudio tiene como objetivo determinar la infección natural por el coronavirus SARS-CoV-2 en murciélagos capturados en Oaxaca, México. Entre octubre de 2021 y febrero de 2022, se recolectaron muestras de hígado de 6 especies de murciélagos para detectar el ARN del SARS-CoV-2 mediante el ensayo cuantitativo de Reacción en Cadena de la Polimerasa en tiempo real. No se detectó infección natural en ninguna de las muestras analizadas y no se encontró evidencia de infección por SARS-CoV-2 en los murciélagos examinados. Es necesario analizar otros órganos (e.g., tráquea, ganglios linfáticos, pulmón, corazón y riñón), muestras biológicas (e.g., saliva, orina y secreciones nasales) y un mayor número de muestras para aclarar si los murciélagos en Oaxaca son susceptibles a la infección por el coronavirus SARS-CoV-2
Authors: Hernández-Aguilar Itandehui , Ramírez-Palacios Luis Román , Lorenzo Consuelo , Santos-Moreno Antonio 
Published: July 2024

El virus SARS-CoV-2 es el agente etiológico de la enfermedad por coronavirus de 2019 que provocó la pandemia de Covid-19. Este virus ha logrado una transmisión sostenida entre poblaciones humanas; sin embargo, desde 2020 se han documentado eventos de contagio zoonótico inverso, es decir, la transmisión del virus de humanos a animales domésticos y salvajes. Este estudio tiene como objetivo determinar la infección natural por el coronavirus SARS-CoV-2 en murciélagos capturados en Oaxaca, México. Entre octubre de 2021 y febrero de 2022, se recolectaron muestras de hígado de 6 especies de murciélagos para detectar el ARN del SARS-CoV-2 mediante el ensayo cuantitativo de Reacción en Cadena de la Polimerasa en tiempo real. No se detectó infección natural en ninguna de las muestras analizadas y no se encontró evidencia de infección por SARS-CoV-2 en los murciélagos examinados. Es necesario analizar otros órganos (e.g., tráquea, ganglios linfáticos, pulmón, corazón y riñón), muestras biológicas (e.g., saliva, orina y secreciones nasales) y un mayor número de muestras para aclarar si los murciélagos en Oaxaca son susceptibles a la infección por el coronavirus SARS-CoV-2.
BRSET: A Brazilian Multilabel Ophthalmological Dataset of Retina Fundus Photos
Authors: Nakayama Luis Filipe , Restrepo David , Matos João , Ribeiro Lucas Zago , Malerbi Fernando Korn , Celi Leo Anthony , Regatieri Caio Saito 
Published: July 2024

Introduction
The Brazilian Multilabel Ophthalmological Dataset (BRSET) addresses the scarcity of publicly available ophthalmological datasets in Latin America. BRSET comprises 16,266 color fundus retinal photos from 8,524 Brazilian patients, aiming to enhance data representativeness, serving as a research and teaching tool. It contains sociodemographic information, enabling investigations into differential model performance across demographic groups.

Methods
Data from three São Paulo outpatient centers yielded demographic and medical information from electronic records, including nationality, age, sex, clinical history, insulin use, and duration of diabetes diagnosis. A retinal specialist labeled images for anatomical features (optic disc, blood vessels, macula), quality control (focus, illumination, image field, artifacts), and pathologies (e.g., diabetic retinopathy). Diabetic retinopathy was graded using International Clinic Diabetic Retinopathy and Scottish Diabetic Retinopathy Grading. Validation used a ConvNext model trained during 50 epochs using a weighted cross entropy loss to avoid overfitting, with 70% training (20% validation), and 30% testing subsets. Performance metrics included area under the receiver operating curve (AUC) and Macro F1-score. Saliency maps were calculated for interpretability.

Results
BRSET comprises 65.1% Canon CR2 and 34.9% Nikon NF5050 images. 61.8% of the patients are female, and the average age is 57.6 (± 18.26) years. Diabetic retinopathy affected 15.8% of patients, across a spectrum of disease severity. Anatomically, 20.2% showed abnormal optic discs, 4.9% abnormal blood vessels, and 28.8% abnormal macula. A ConvNext V2 model was trained and evaluated BRSET in four prediction tasks: “binary diabetic retinopathy diagnosis (Normal vs Diabetic Retinopathy)” (AUC: 97, F1: 89); “3 class diabetic retinopathy diagnosis (Normal, Proliferative, Non-Proliferative)” (AUC: 97, F1: 82); “diabetes diagnosis” (AUC: 91, F1: 83); “sex classification” (AUC: 87, F1: 70).

Discussion
BRSET is the first multilabel ophthalmological dataset in Brazil and Latin America. It provides an opportunity for investigating model biases by evaluating performance across demographic groups. The model performance of three prediction tasks demonstrates the value of the dataset for external validation and for teaching medical computer vision to learners in Latin America using locally relevant data sources.
The impact of primary health care on AIDS incidence and mortality: A cohort study of 3.4 million Brazilians
Authors: Pinto Priscila F. P. S. , Macinko James , Silva Andréa F. , Lua Iracema , Jesus Gabriela , Magno Laio , Santos Carlos A. S. Teles , Ichihara Maria Yury , Barreto Mauricio L. , Moucheraud Corrina , Souza Luis E. , Dourado Inês , Rasella Davide 
Published: July 2024

Background
Primary Health Care (PHC) is essential for effective, efficient, and more equitable health systems for all people, including those living with HIV/AIDS. This study evaluated the impact of the exposure to one of the largest community-based PHC programs in the world, the Brazilian Family Health Strategy (FHS), on AIDS incidence and mortality.

Methods and findings
A retrospective cohort study carried out in Brazil from January 1, 2007 to December 31, 2015. We conducted an impact evaluation using a cohort of 3,435,068 ≥13 years low-income individuals who were members of the 100 Million Brazilians Cohort, linked to AIDS diagnoses and deaths registries. We evaluated the impact of FHS on AIDS incidence and mortality and compared outcomes between residents of municipalities with low or no FHS coverage (unexposed) with those in municipalities with 100% FHS coverage (exposed). We used multivariable Poisson regressions adjusted for all relevant municipal and individual-level demographic, socioeconomic, and contextual variables, and weighted with inverse probability of treatment weighting (IPTW). We also estimated the FHS impact by sex and age and performed a wide range of sensitivity and triangulation analyses; 100% FHS coverage was associated with lower AIDS incidence (rate ratio [RR]: 0.76, 95% CI: 0.68 to 0.84) and mortality (RR: 0.68, 95%CI: 0.56 to 0.82). FHS impact was similar between men and women, but was larger in people aged ≥35 years old both for incidence (RR: 0.62, 95% CI: 0.53 to 0.72) and mortality (RR: 0.56, 95% CI: 0.43 to 0.72). The absence of important confounding variables (e.g., sexual behavior) is a key limitation of this study.

Conclusions
AIDS should be an avoidable outcome for most people living with HIV today and our study shows that FHS coverage could significantly reduce AIDS incidence and mortality among low-income populations in Brazil. Universal access to comprehensive healthcare through community-based PHC programs should be promoted to achieve the Sustainable Development Goals of ending AIDS by 2030.
A low molecular weight dextran sulphate, ILB®, for the treatment of amyotrophic lateral sclerosis (ALS): An open-label, single-arm, single-centre, phase II trial
Authors: Srinivasan Venkataramanan , Homer Victoria , Barton Darren , Clutterbuck-James Abigail , Jenkins Siân , Potter Claire , Brock Kristian , Logan Ann , Smith Donna , Bruce Lars , Nagy Zsuzsanna , Bach Simon P. 
Published: July 2024

Background
Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig´s disease, is a rare neurological condition and is the most common motor neurone disease. It is a fatal disease with specific loss of motor neurons in the spinal cord, brain stem, and motor cortex leading to progressive paralysis and usually death within five years of diagnosis. There remains no cure for ALS, and management is focused on a combination of neuroprotective medication, respiratory support, and management by multidisciplinary clinics.

Patients and methods
This prospective, single-arm, open-label phase II clinical trial of sustained weekly administration of 2 mg/kg ILB® (a low-molecular weight dextran sulphate) was conducted in a single UK hospital. Eligible patients were at least 18 years and had a definite diagnosis of ALS according to El Escorial Criteria. The co-primary outcomes were safety, tolerability, and quantity of ILB® administered.
EudraCT number. 2018-000668-28

Findings
Between 18-Apr-2019 and 27-Mar-2020, 11 patients were recruited and treated for up to 38 weeks. There were no treatment terminations or withdrawals. One serious adverse event was reported, which was not related to ILB® and resolved without sequalae. 270 mild/moderate adverse events were reported with no intolerable events occurring during the trial. The total number of ILB® treatments administered per patient ranged from 4 to 38, with a cumulative dose ranging from 745 to 6668 mg. As a result of the COVID-19 pandemic and the high-risk status of study participants, recruitment and treatment was suspended early in Mar-2020. At the long-term follow-up, three patients had died after the trial was halted, between 53 and 62 weeks after their final ILB® injection.

Interpretation
Long-term weekly ILB® injections of 2 mg/kg was well tolerated and had an acceptable safety profile in patients with ALS.

Trial registration
EudraCT: 2018-000668-28. clinicaltrials.gov: NCT03705390. This trial adheres to the principles of GCP in the design, conduct, recording and reporting of clinical trials as listed in part 2, “Conditions and Principles which apply to all Clinical Trials” under the header “Principles based on Articles 2 to 5 of the EU GCP Directive” in the Medicines for Human Use Clinical Trials Regulations (as amended in SI 2006/1928). For clarity, the study did not conform to all aspects of the International Conference on Harmonisation (ICH) E6 R2 Guidelines for GCP (also known as ‘ICH GCP’). Of note, we did not use an external database, perform 100% source data verification, and only primary outcome data were analysed in parallel by a second, independent statistician.
In vivo effects of balanced, low molecular 6% and 10% hydroxyethyl starch compared with crystalloid volume replacement on the coagulation system in major pancreatic surgery—a sub-analysis of a prospective double-blinded, randomized controlled trial
Authors: Eckers Alexander , Hunsicker Oliver , Spies Claudia , Balzer Felix , Rubarth Kerstin , von Heymann Christian 
Published: July 2024

Background
The outcome of patients undergoing major surgery treated with HES for hemodynamic optimization is unclear. This post-hoc analysis of a randomized clinical pilot trial investigated the impact of low-molecular balanced HES solutions on the coagulation system, blood loss and transfusion requirements.

Methods
The Trial was registered: EudraCT 2008-004175-22 and ethical approval was provided by the ethics committee of Berlin. Patients were randomized into three groups receiving either a 10% HES 130/0.42 solution, a 6% HES 130/0.42 solution or a crystalloid following a goal-directed hemodynamic algorithm. Endpoints were parameters of standard and viscoelastic coagulation laboratory, blood loss and transfusion requirements at baseline, at the end of surgery (EOS) and the first postoperative day (POD 1).

Results
Fifty-two patients were included in the analysis (HES 10% (n = 15), HES 6% (n = 17) and crystalloid (n = 20)). Fibrinogen decreased in all groups at EOS (HES 10% 338 [298;378] to 192 [163;234] mg dl-1, p<0.01, HES 6% 385 [302;442] to 174 [163;224] mg dl-1, p<0.01, crystalloids 408 [325;458] to 313 [248;370] mg dl-1, p = 0.01). MCF FIBTEM was decreased for both HES groups at EOS (HES 10%: 20.5 [16.0;24.8] to 6.5 [5.0;10.8] mm, p = <0.01; HES 6% 27.0 [18.8;35.2] to 7.0 [5.0;19.0] mm, p = <0.01). These changes did not persist on POD 1 for HES 10% (rise to 16.0 [13.0;24.0] mm, p = 0.88). Blood loss was not different in the groups nor transfusion requirements.

Conclusion
Our data suggest a stronger but transient effect of balanced, low-molecular HES on the coagulation system. Despite the decline of the use of artificial colloids in clinical practice, these results may help to inform clinicians who use HES solutions.
Effects of a passive upper-body exoskeleton on whole-body kinematics, leg muscle activity, and discomfort during a carrying task
Authors: Garcia Gabriela , Arauz Paul Gonzalo , Alvarez Isabel , Encalada Nicolas , Vega Shirley , Baldo Marco , Martin Bernard J. 
Published: July 2024

Objective
To compare whole-body kinematics, leg muscle activity, and discomfort while performing a 10-min carrying task with and without a passive upper-body exoskeleton (CarrySuitⓇ), for both males and females.

Background
Diverse commercial passive exoskeletons have appeared on the market claiming to assist lifting or carrying task. However, evidence of their impact on kinematics, muscle activity, and discomfort while performing these tasks are necessary to determine their benefits and/or limitations.

Method
Sixteen females and fourteen males carried a 15kg load with and without a passive exoskeleton during 10-min over a round trip route, in two non-consecutive days. Whole-body kinematics and leg muscle activity were evaluated for each condition. In addition, leg discomfort ratings were quantified before and immediately after the task.

Results
The gastrocnemius and vastus lateralis muscle activity remained constant over the task with the exoskeleton. Without the exoskeleton a small decrease of gastrocnemius median activation was observed regardless of sex, and a small increase in static vastus lateralis activation was observed only for females. Several differences in sagittal, frontal, and transverse movements’ ranges of motion were found between conditions and over the task. With the exoskeleton, ROM in the sagittal plane increased over time for the right ankle and pelvis for both sexes, and knees for males only. Thorax ROMs in the three planes were higher for females only when using the exoskeleton. Leg discomfort was lower with the exoskeleton than without.

Conclusion
The results revealed a positive impact on range of motion, leg muscle activity, and discomfort of the tested exoskeleton.
Interventions to improve primary healthcare in rural settings: A scoping review
Authors: Aubrey-Basler Kris , Bursey Krystal , Pike Andrea , Penney Carla , Furlong Bradley , Howells Mark , Al-Obaid Harith , Rourke James , Asghari Shabnam , Hall Amanda 
Published: July 2024

Background
Residents of rural areas have poorer health status, less healthy behaviours and higher mortality than urban dwellers, issues which are commonly addressed in primary care. Strengthening primary care may be an important tool to improve the health status of rural populations.

Objective
Synthesize and categorize studies that examine interventions to improve rural primary care.

Eligibility criteria
Experimental or observational studies published between January 1, 1996 and December 2022 that include an historical or concurrent control comparison.

Sources of evidence
Pubmed, CINAHL, Cochrane Library, Embase.

Charting methods
We extracted and charted data by broad category (quality, access and efficiency), study design, country of origin, publication year, aim, health condition and type of intervention studied. We assigned multiple categories to a study where relevant.

Results
372 papers met our inclusion criteria, divided among quality (82%), access (20%) and efficiency (13%) categories. A majority of papers were completed in the USA (40%), Australia (15%), China (7%) or Canada (6%). 35 (9%) papers came from countries in Africa. The most common study design was an uncontrolled before-and-after comparison (32%) and only 24% of studies used randomized designs. The number of publications each year has increased markedly over the study period from 1-2/year in 1997–99 to a peak of 49 papers in 2017.

Conclusions
Despite substantial inequity in health outcomes associated with rural living, very little attention is paid to rural primary care in the scientific literature. Very few studies of rural primary care use randomized designs.