bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, attitude, and practice of medication use among pregnant women in Riyadh City: a cross-sectional study
Authors: Almuhareb Alanoud , Al Sharif Abdullah , Cahusac Peter 
Published: July 2024

IntroductionMedication use during pregnancy is limited by the scarcity of safety data for many drugs. The use of certain drugs during pregnancy can be teratogenic. Overestimating teratogenic medication risk could have serious consequences from drug non-adherence. Assessing and understanding the knowledge, attitude, and practice of medication use among pregnant women is crucial to optimizing the health of pregnant women and their fetuses.MethodologyAn observational cross-sectional study used convenience and snowball sampling with a self-administered online questionnaire in 562 pregnant women from Riyadh City. The questionnaire used was adapted from previously published surveys. The survey included sections on sociodemographic background, awareness of medication risks, medication use during pregnancy, sources of drug information, and statements from the Beliefs about Medicines Questionnaire (BMQ), both general and pregnancy-specific.ResultsMedication use during pregnancy was reported by 44.7%. The primary source for medication information for the majority was the physician. Over 58% indicated inadequate or inconsistent information about medication from physicians. Additionally, 65.7% confirmed not receiving sufficient or inconsistent information from pharmacists during medication dispensing. The responses to the questionnaire reveal a commendable level of knowledge and positive attitude and practice. However, variations could be found in these responses. Overall, no evident relationships were observed between predictors and responses, except in specific statements that indicated a positive association between beliefs and higher levels of education and youth.ConclusionThe results suggest a positive knowledge, attitude, and practice level. However, there was hesitancy and a restrictive attitude towards medication during pregnancy. The study identified inadequate education provided by healthcare professionals, thus presenting an area for improvement to enhance the safety and efficacy of medication use during pregnancy.
Extracellular vesicles derived from stressed beta cells mediate monocyte activation and contribute to islet inflammation
Authors: Dekkers Mette C. , Lambooij Joost M. , Pu Xudong , Fagundes Raphael R. , Enciso-Martinez Agustin , Kats Kim , Giepmans Ben N. G. , Guigas Bruno , Zaldumbide Arnaud 
Published: July 2024

ObjectiveBeta cell destruction in type 1 diabetes (T1D) results from the combined effect of inflammation and recurrent autoimmunity. In recent years, the role played by beta cells in the development of T1D has evolved from passive victims of the immune system to active contributors in their own destruction. We and others have demonstrated that perturbations in the islet microenvironment promote endoplasmic reticulum (ER) stress in beta cells, leading to enhanced immunogenicity. Among the underlying mechanisms, secretion of extracellular vesicles (EVs) by beta cells has been suggested to mediate the crosstalk with the immune cell compartment.MethodsTo study the role of cellular stress in the early events of T1D development, we generated a novel cellular model for constitutive ER stress by modulating the expression of HSPA5, which encodes BiP/GRP78, in EndoC-βH1 cells. To investigate the role of EVs in the interaction between beta cells and the immune system, we characterized the EV miRNA cargo and evaluated their effect on innate immune cells.ResultsAnalysis of the transcriptome showed that HSPA5 knockdown resulted in the upregulation of signaling pathways involved in the unfolded protein response (UPR) and changes the miRNA content of EVs, including reduced levels of miRNAs involved in IL-1β signaling. Treatment of primary human monocytes with EVs from stressed beta cells resulted in increased surface expression of CD11b, HLA-DR, CD40 and CD86 and upregulation of IL-1β and IL-6.ConclusionThese findings indicate that the content of EVs derived from stressed beta cells can be a mediator of islet inflammation.
A novel combined nomogram for predicting severe acute lower respiratory tract infection in children hospitalized for RSV infection during the post-COVID-19 period
Authors: Liu Hai-Feng , Zhang Xue-Zu , Liu Cong-Yun , Li Wang , Li Wen-Hong , Wang Ya-Yu , Li He-Yun , Xiang Mei , Lu Rui , Yuan Ting-Yun , Fu Hong-Min 
Published: July 2024

IntroductionOff-season upsurge of respiratory syncytial virus (RSV) infection with changed characteristics and heightened clinical severity during the post-COVID-19 era are raising serious concerns. This study aimed to develop and validate a nomogram for predicting the risk of severe acute lower respiratory tract infection (SALRTI) in children hospitalized for RSV infection during the post-COVID-19 era using machine learning techniques.MethodsA multicenter retrospective study was performed in nine tertiary hospitals in Yunnan, China, enrolling children hospitalized for RSV infection at seven of the nine participating hospitals during January–December 2023 into the development dataset. Thirty-nine variables covering demographic, clinical, and laboratory characteristics were collected. Primary screening and dimension reduction of data were performed using Least Absolute Shrinkage and Selection Operator (LASSO) regression, followed by identification of independent risk factors for RSV-associated SALRTI using Logistic regression, thus finally establishing a predictive nomogram model. Performance of the nomogram was internally evaluated by receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) based on the development dataset. External validation of our model was conducted using same methods based on two independent RSV cohorts comprising pediatric RSV inpatients from another two participating hospitals between January–March 2024.ResultsThe development dataset included 1102 patients, 239 (21.7%) of whom developed SALRTI; while the external validation dataset included 249 patients (142 in Lincang subset and 107 in Dali subset), 58 (23.3%) of whom were diagnosed as SALRTI. Nine variables, including age, preterm birth, underlying condition, seizures, neutrophil-lymphocyte ratio (NLR), interleukin-6 (IL-6), lactate dehydrogenase (LDH), D-dimer, and co-infection, were eventually confirmed as the independent risk factors of RSV-associated SALRTI. A predictive nomogram was established via integrating these nine predictors. In both internal and external validations, ROC curves indicated that the nomogram had satisfactory discrimination ability, calibration curves demonstrated good agreement between the nomogram-predicted and observed probabilities of outcome, and DCA showed that the nomogram possessed favorable clinical application potential.ConclusionA novel nomogram combining several common clinical and inflammatory indicators was successfully developed to predict RSV-associated SALRTI. Good performance and clinical effectiveness of this model were confirmed by internal and external validations.
Parameter fuzzy rectification for sliding mode control of five-phase permanent magnet synchronous motor speed control system
Authors: Feng Jingjing 
Published: July 2024

Introduction: Nowadays, five-phase permanent magnet synchronous motors have been widely used in the industrial and transportation fields, and the existing sliding mode control methods for speed control systems can no longer meet the requirements such as fast response and good stability.Methods: In light of the aforementioned considerations, the study initially employs mathematical modeling to elucidate the five-phase permanent magnet synchronous motor. Secondly, on the basis of proportional-integral-derivative sliding mode control, radial basis function and Takagi-Sugeno-Kang fuzzy model are introduced for parameter identification and optimization and regulation. Finally, a new neural network regulation algorithm and speed control strategy are proposed.Results and Discussion: The experimental results demonstrated that the expected parameter optimization rate of the regulation algorithm can reach 90%, and the overshooting amount under small inertia working condition is only 3%, and the adjustment time is 0.02 s. The new control algorithm can be used to control the motor speed with the lowest speed fluctuation and the fastest recovery time. In addition, when affected by the load torque, the motor speed controlled by the new strategy fluctuated the least, with a speed drop of only 1% and the fastest recovery time of 0.02 s. It exhibited the lowest control error of 3.7% and the lowest overshooting amount of 5.9%.Conclusion: In summary, the suggested approach has the potential to significantly enhance the speed control system’s control performance while maintaining strong resilience and anti-interference capabilities. The method has certain guiding significance for the practical application of five-phase permanent magnet synchronous motor speed control system.
Surrogate-based worst-case analysis of a knee joint model using Genetic Algorithm
Authors: Ciszkiewicz Adam , Dumas Raphael 
Published: July 2024

Verification, validation, and uncertainty quantification is generally recognized as a standard for assessing the credibility of mechanical models. This is especially evident in biomechanics, with intricate models, such as knee joint models, and highly subjective acquisition of parameters. Propagation of uncertainty is numerically expensive but required to evaluate the model reliability. An alternative to this is to analyze the worst-case models obtained within the specific bounds set on the parameters. The main idea of the paper is to search for two models with the greatest different response in terms of displacement-load curve. Real-Coded Genetic Algorithm is employed to effectively explore the high-dimensional space of uncertain parameters of a 2D dynamic knee model, while Radial Basis Function surrogates reduce the computation by orders of magnitude to near real-time, with negligible impact on the quality. It is expected that the studied knee joint model is very sensitive to uncertainty in the geometrical parameters. The obtained worst-case knee models showcase unrealistic behavior with one of them unable to fully extend, and the other largely overextending. Their relative difference in extension is up to 35% under ±1 mm bound set on the geometry. This unrealistic behavior of knee joint model is confirmed by the large standard deviation obtained from a classical sampling-based sensitivity analysis. The results confirm the viability of the method in assessing the reliability of biomechanical models. The proposed approach is general and could be applied to other mechanical systems as well.
Rationale and design of the multi organ inflammation with serial testing study: a comprehensive assessment of functional and structural abnormalities in patients with recovered COVID-19
Authors: Paterson D. Ian , White James A. , Beaulieu Christian , Sherrington Rachel , Prado Carla M. , Tandon Puneeta , Halloran Kieran , Smith Stephanie , McCombe Jennifer A. , Ritchie Bruce , Pituskin Edith , Haykowsky Mark J. , Coulden Richard , Emery Derek , Tsui Albert K. , Wu Kai Y. , Oudit Gavin Y. , Ezekowitz Justin A. , Thompson Richard B. 
Published: July 2024

IntroductionShort-term clinical outcomes from SARS-CoV-2 infection are generally favorable. However, 15–20% of patients report persistent symptoms of at least 12 weeks duration, often referred to as long COVID. Population studies have also demonstrated an increased risk of incident diabetes and cardiovascular disease at 12 months following infection. While imaging studies have identified multi-organ injury patterns in patients with recovered COVID-19, their respective contributions to the disability and morbidity of long COVID is unclear.MethodsA multicenter, observational study of 215 vaccine-naïve patients with clinically recovered COVID-19, studied at 3–6 months following infection, and 133 healthy volunteers without prior SARS-CoV-2 infection. Patients with recovered COVID-19 were screened for long COVID related symptoms and their impact on daily living. Multi-organ, multi-parametric magnetic resonance imaging (MRI) and circulating biomarkers were acquired to document sub-clinical organ pathology. All participants underwent pulmonary function, aerobic endurance (6 min walk test), cognition testing and olfaction assessment. Clinical outcomes were collected up to 1 year from infection. The primary objective of this study is to identify associations between organ injury and disability in patients with long-COVID symptoms in comparison to controls. As a secondary objective, imaging and circulating biomarkers with the potential to exacerbate cardiovascular health were characterized.DiscussionLong-term sequelae of COVID-19 are common and can result in significant disability and cardiometabolic disease. The overall goal of this project is to identify novel targets for the treatment of long COVID including mitigating the risk of incident cardiovascular disease.Study registrationclinicaltrials.gov (MOIST late cross-sectional study; NCT04525404).
Surgical outcomes of sacrospinous hysteropexy and hysteropreservation for pelvic organ prolapse: a systematic review of randomized controlled trials
Authors: Xiao Xinyu , Yu Xia , Yin Litong , Zhang Ling , Feng Dan , Zhang Lushuang , Gong Zhaolin , Zhang Qiang , Lin Yonghong , He Li 
Published: July 2024

ObjectiveIn several randomized controlled trials (RCTs), sacrospinous hysteropexy and other forms of hysteropreservation have been compared. Nevertheless, there is no definitively best treatment. This study summarized RCT evidence for various uterine preservation surgical procedures.MethodsFrom each database inception to August 2023, we searched PubMed, Embase, Cochrane Library, and Web of Science for eligible RCTs. A comparison was made between sacrospinous hysteropexy and other hysteropreservation, including vaginal and abdominal surgery. For categorical and continuous variables, relative risks (RRs) and mean differences (MDs) were calculated using random-effects models.ResultsWe reviewed a total 1,398 studies and ultimately included five RCTs that met all inclusion criteria. These five studies included a total of 1,372 uterine POP cases all of whom received transvaginal surgery and had a follow-up period for assessment of recurrence from 12 months to 5 years. There were no significant differences between sacrospinous hysteropexy and other hysteropreservation for the incidences of recurrence (RR,1.24; 95% CI, 0.58 to 2.63; p = 0.58) or hematoma (RR,0.70; 95% CI, 0.17 to 2.92; p = 0.62). Moreover, neither sacrospinous hysteropexy nor hysteropreservation had any significant effect on the risk of mesh exposure (RR,0.34; 95% CI, 0.03 to 4.31; p = 0.41), dyspareunia (RR,0.45; 95% CI, 0.13 to1.6; p = 0.22), urinary tract infection (RR,0.66; 95% CI, 0.38 to 1.15; p = 0.15), bothersome bulge symptoms (RR,0.03; 95% CI, −0.02 to 0.08; p = 0.24), operative time (MD, −4.53; 95% CI, −12.08 to 3.01; p = 0.24), and blood loss (MD, −25.69; 95% CI, −62.28 to 10.91; p = 0.17). However, sacrospinous hysteropexy was associated with a lower probability of pain (RR,4.8; 95% CI, 0.79 to 29.26; p = 0.09) compared with other hysteropreservation.ConclusionThere was no difference between sacrospinous hysteropexy and hysteropreservation in terms of recurrence, hematoma, mesh exposure, dyspareunia, urinary tract infection, bothersome bulge symptoms, operative time, pain, and blood loss.Systematic Review RegistrationPROSPERO [CRD42023470025].
Is fluorometric sentinel lymph node biopsy in endometrial cancer necessary?
Authors: Huang Liqiong , Cheng Wei , He Chenghui , Li Xin , Huang Lu , Zhang Jiajia , Song Liwen , Zhou Yifan , Wang Chenchen , Gan Xiaoqin , Qiu Jin 
Published: July 2024

ObjectiveIn this study, we collected perioperative and postoperative follow-up data from patients with endometrial cancer (EC) at different stages to evaluate the role of sentinel lymph node biopsy (SLNB) in endometrial cancer surgery.MethodsA total of 186 endometrial cancer patients undergoing radical hysterectomy from January 2018 to April 2022 were retrospectively analyzed. Patients were classified into four groups. Group A comprised patients diagnosed with stage IA grade 1 and 2 endometrioid EC who underwent SLNB. Group B comprised patients with stage IA grade 1 and 2 endometrioid EC who did not undergo SLNB. Group C comprised patients with higher-grade endometrioid EC, wherein systematic lymph node dissection was performed based on SLNB results. Group D comprised patients with higher-grade endometrioid EC who did not undergo SLNB and instead underwent direct systematic lymph node dissection. Clinical, pathological data, and follow-up information for all patients were collected.ResultsIn Group A and B, SLNB was performed on 36 out of 67 patients with IA stage 1 and 2 endometrial cancer, yielding a SLN positivity rate of 5.6%. There were no significant differences observed between the two groups regarding perioperative outcomes and postoperative follow-up. Conversely, among 119 patients with higher-grade endometrial cancer, 52 underwent SLNB, with 20 patients exhibiting SLN positivity, resulting in a SLN positivity rate of 38.4%. However, the decision to undergo SLNB did not yield significant differences in perioperative outcomes and postoperative follow-up among these patients.ConclusionFor stage IA grade 1 and 2 endometrioid EC, the incidence of lymph node positivity is low, omitting SLNB in this subpopulation is a feasible option. In other stages of endometrioid EC, there is no significant difference in perioperative and postoperative follow-up data between patients undergoing routine systematic lymphadenectomy and those undergoing systematic lymphadenectomy based on SLNB results. Therefore, if SLNB is not available, the standard procedure of PLND remains an option to obtain information about lymph node status, despite the surgical complications associated with this procedure.
Association of liver function markers and apolipoprotein E ε4 with pathogenesis and cognitive decline in Alzheimer’s disease
Authors: Han Sang-Won , Lee Sang-Hwa , Kim Jong Ho , Lee Jae-Jun , Park Young Ho , Kim SangYun , Nho Kwangsik , Sohn Jong-Hee 
Published: July 2024

BackgroundAlzheimer’s disease (AD) is a complex neurodegenerative disorder influenced by various factors, including liver function, which may impact the clearance of amyloid-β (Aβ) in the brain. This study aimed to explore how the apolipoprotein E (APOE) ε4 allele affects the relationship of liver function markers with AD pathology and cognition.MethodsWe analyzed data from two independent cohorts, including 732 participants from the Hallym University Medical Center and 483 from the Alzheimer’s Disease Neuroimaging Initiative, each group consisting of individuals with and without the APOE ε4 allele. Cross-sectional analyses evaluated the associations of liver enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT], alkaline phosphatase, total bilirubin, and albumin) with AD diagnosis, amyloid positron emission tomography (PET) burden, and cerebrospinal fluid biomarkers for AD (Aβ42, total tau, and phosphorylated tau181) at baseline. Longitudinally, we investigated the associations between these liver enzymes and changes in cognitive performance over the course of a year. Logistic and linear regression models were used to analyze these associations and mediation analyses were conducted to assess whether age and amyloid PET burden mediated these associations.ResultsOnly in the APOE ε4 carrier group, a high AST to ALT ratio and low ALT levels were significantly associated with AD diagnosis, increased amyloid PET burden, and faster longitudinal decline in cognitive function in both cohorts. In particular, the AST to ALT ratio was associated with cerebrospinal fluid Aβ42 levels exclusively in the APOE ε4 carrier group in the Alzheimer’s Disease Neuroimaging Initiative cohort but not with phosphorylated tau181 or total tau levels. Moreover, mediation analyses from both cohorts revealed that in the APOE ε4 carriers group, age did not mediate the associations between liver enzymes and AD diagnosis or amyloid PET burden. However, amyloid PET burden partially mediated the association between liver enzymes and AD diagnosis exclusively in the APOE ε4 carriers group.ConclusionThis study provides valuable insights into the significant association of the APOE ε4 allele with liver enzymes and their potential role in Aβ-related pathogenesis and cognition in AD. Further research is required to elucidate the underlying mechanisms and potential therapeutic implications of these findings.
Importance of serum albumin in machine learning-based prediction of cognitive function in the elderly using a basic blood test
Authors: Karako Kenji , Hata Takeo , Inoue Atsushi , Oyama Katsunori , Ueda Eiichiro , Sakatani Kaoru 
Published: July 2024

IntroductionIn this study, we investigated the correlation between serum albumin levels and cognitive function, and examined the impact of including serum albumin values in the input layer on the prediction accuracy when forecasting cognitive function using deep learning and other machine learning models.MethodsWe analyzed the electronic health record data from Osaka Medical and Pharmaceutical University Hospital between 2014 and 2021. The study included patients who underwent cognitive function tests during this period; however, patients from whom blood test data was not obtained up to 30 days before the cognitive function tests and those with values due to measurement error in blood test results were excluded. The Mini-Mental State Examination (MMSE) was used as the cognitive function test, and albumin levels were examined as the explanatory variable. Furthermore, we estimated MMSE scores from blood test data using deep learning models (DLM), linear regression models, support vector machines (SVM), decision trees, random forests, extreme gradient boosting (XGBoost), and light gradient boosting machines (LightGBM).ResultsOut of 5,017 patients who underwent cognitive function tests, 3,663 patients from whom blood test data had not been obtained recently and two patients with values due to measurement error were excluded. The final study population included 1,352 patients, with 114 patients (8.4%) aged below 65 and 1,238 patients (91.6%) aged 65 and above. In patients aged 65 and above, the age and male sex showed significant associations with MMSE scores of less than 24, while albumin and potassium levels showed negative associations with MMSE scores of less than 24. Comparing MMSE estimation performance, in those aged below 65, the mean squared error (MSE) of DLM was improved with the inclusion of albumin. Similarly, the MSE improved when using SVM, random forest and XGBoost. In those aged 65 and above, the MSE improved in all models.DiscussionOur study results indicated a positive correlation between serum albumin levels and cognitive function, suggesting a positive correlation between nutritional status and cognitive function in the elderly. Serum albumin levels were shown to be an important explanatory variable in the estimation of cognitive function for individuals aged 65 and above.