bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fatal outcomes following onasemnogene abeparvovec in advanced-stage spinal muscular atrophy
Authors: sanmaneechai oranee , Pongsakornkullachart Peerada , Kulsirichawaroj Pimchanok , Kongkasuwan Ratcharin , Tovichien Prakarn , Jitwongwai Settapong , Kanjanauthai Supaluck , Preeprem Nutnicha , Limpaninlachart Sivaporn , Sermpon Nisasri 
Published: August 2024

Abstract

Objective
Supported by encouraging trial outcomes, onasemnogene abeparvovec (OA) was authorized for treating spinal muscular atrophy (SMA) in children under 2 years of age. Nevertheless, the efficacy of OA in advanced SMA patients remains underexplored. This investigation assessed the clinical effectiveness and adverse effects of OA in a patient cohort including those with advanced SMA, and compared these outcomes to historical survival data for SMA type 1 patients in Thailand.
Methods
We conducted an observational cohort study at Siriraj Hospital, Thailand, from May 2019 to April 2022. The study enrolled eight SMA patients receiving OA therapy. We monitored safety through laboratory tests and clinical evaluations. Patient outcomes, such as motor scores, motor milestones, and survival status, were analyzed.
Results
The cohort comprised five SMA type 1 patients treated at median age of 16.7 months (6.5–24.9 months) and three SMA type 2 patients treated at median age of 20.3 months (19–31.5 months). Before receiving OA, all type 1 patients needed invasive ventilation and nutritional support by feeding tubes. Posttreatment, these patients did not achieve new motor milestones, their survival rates remained static, and each patient experienced severe adverse events, including fatalities. Conversely, type 2 patients exhibited improved motor scores without experiencing serious adverse events.
Interpretation:
This real-world evaluation revealed that OA did not significantly improve outcomes or survival rates among advanced SMA type 1 patients, with all such cases resulting in mortality. These findings suggest the need for additional caution and revised guidelines when administering OA to this subgroup.
Randomized control trial on the effects of a home-based computer- adaptive cognitive training for patients with vascular cognitive impairment
Authors: Soni Amit Kumar , Kumar Mohit , Kothari Saroj 
Published: August 2024

Abstract

Vascular cognitive impairment (VCI) encompasses a range of cognitive deficits attributed to cerebrovascular disease, varying from minor cognitive disruptions to dementia. Innovative technological approaches, such as computerized cognitive retraining, offer promising strategies for mitigating the cognitive challenges faced by individuals with VCI. Despite their potential, the impact of these interventions on neuropsychological function and daily living capabilities has poor outcomes. In this randomized controlled trial (RCT), the effectiveness of a 4-week, remotely-delivered, multi-domain, computer-adaptive cognitive retraining (CACT) was assessed in a cohort of 62 VCI patients. Employing an active control research design, participants were randomly allocated to either an Experimental group, which underwent the CACT program tailored to individual performance levels, or a control group that received standard care. The evaluation focused on neuropsychological functions such as attention, memory, and executive processes, alongside daily living skills. Results indicated that participants in the CACT group exhibited notable improvements in several cognitive areas, including processing speed, category fluency, and visual confrontation naming, when compared to the control group. Nonetheless, enhancements in functional abilities, encompassing basic and instrumental activities of daily living (ADL), were minimal, with no significant changes reported post-intervention. This study proposes that extended periods of adaptive cognitive training might lead to more substantial improvements following CACT.
Second peak of myocardial markers predicts in-hospital adverse outcomes after primary PCI for ST-segment elevation myocardial infarction
Authors: Niu Xiaodou , Ma Yuanji , Cui Xiaotong , Gao Wei , Xia Yan , Wu Shujing , Zhang Meng , Chen Yaolin , Guan Lihua , Wu Hongyi 
Published: August 2024

Abstract

Background
A second peak of high-sensitivity cardiac troponin T (hs-cTnT) after reperfusion therapy in acute myocardial infarction (AMI) patients was reported, while the causes and clinical meanings remain controversial.
Methods
In this retrospective study, we enrolled patients diagnosed with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PPCI). The association between second peak of myocardial markers, including creatine kinase-MB (CK-MB) and hs-cTnT and clinical outcomes, D-dimer (D-D), cardiac structure and function were analyzed. The main study outcome was in-hospital major adverse cardiovascular events (MACE), including cardiac death, non-fatal AMI, revascularization and stroke.
Results
A total of 264 patients were included in the study, with an average age of 63 ± 12 years. Of these, 220 were male. Second peak of cardiac markers including hs-cTnT and CK-MB of STEMI patients after PPCI was universal: The proportion of STEMI patients with secondary elevation of cardiac troponin T (cTnT) was 62.8%, while CK-MB 28.8%. Maximum D-D during hospitalization independently predicted second myocardial markers elevation. STEMI patients with second cardiac markers elevation after PPCI had a worse in-hospital composite endpoint.
Conclusions
D-D was an independent predictor of secondary cardiac markers elevation in STEMI patients after PPCI. Patients with second peak of cardiac markers had a worse outcome.
The Effects of Perturbation Intensities on Backward Slip-Falls Induced by a Split-belt Treadmill
Authors: Lee Chihyeong , Ahn Jooeun , Lee Beom-Chan 
Published: August 2024

Abstract

Fall-inducing systems have two critical applications. One is to obtain the biomechanical features of falling, and the other is to systematically train individuals and reduce the risk of falling. While the former application necessitates the actual occurrence of falls, the latter does not require fall-inducing perturbations to be excessively intense. This study investigated the effects of perturbation intensities (a combination of speeds and durations) on the number of falls, fall rates, and maximum loading forces resulting from backward slips induced by a split-belt treadmill. Twenty-four healthy young adults (12 males and 12 females), naïve to the purpose of the study, completed 16 randomized trials, including 12 perturbation trials and 4 false trials. The forces between a safety harness and a rail were used to identify falls and non-falls and to assess the maximum loading force during falls. Although the number of falls, fall rates, and maximum loading force significantly increase as the slipping speed increases for both durations, the relative risk analysis shows that fall risk significantly increases as the slipping speed increases regardless of the duration. These findings can contribute to establishing design criteria for controlled perturbations in studies on the biomechanics of falls and fall prevention training.
Prediction and classification the risk of stroke patients using data mining techniques
Authors: alizadeh-dizaj ghasem , khoshsirat shiva 
Published: August 2024

Abstract

Background
Stroke is one of the most common causes of death and neurological disabilities in all societies. The use of data mining techniques to create predictive models is very helpful in identifying people at risk to reduce the complications of the disease. The purpose of this study was to investigate the performance of data mining algorithms and predict the risk of stroke in suspected stroke patients using decision tree based on the risk factors that affect it.
Methods
The study analyzed medical records of 1184 stroke-suspected patients presenting at an Emergency Department using data mining algorithms. Attributes such as age, primary diagnoses, gender, blood pressure, smoking, diabetes, and other relevant factors were considered. The dataset was preprocessed to handle missing and incompatible data. Algorithms like Naïve Bayes, Neural Network, kNN, SVM, and Classification Tree were applied, with a training-test data split of 70 − 30 using K-fold Cross Validation.
Results
Among the data mining algorithms used, kNN demonstrated the highest accuracy (97.30%), sensitivity (98.75%), specificity (98.72%), and F1 criteria (98.66%) in predicting stroke severity. Physical inactivity, high cholesterol, cardiovascular disease, history of transient ischemic attack, and high blood pressure emerged as the most influential risk factors for stroke severity. Decision Tree analysis provided valuable insights into the relationship between risk factors and stroke severity.
Conclusion
Data mining techniques proved effective in identifying risk factors and predicting stroke severity, showing promise in enhancing stroke management strategies. The study highlighted the importance of physical inactivity and other key risk factors in stroke prediction. Consistency in risk factor importance across studies suggests common underlying factors, while acknowledging variations based on geographic and lifestyle factors.
Echocardiographic Hemodynamics Correlate with Differences in DOAC-specific Bleeding and Stroke Rates in Non-Valvular Atrial Fibrillation
Authors: O’Shea Michael P , Yusuf Ali , Habib Eiad , Ravi Srekar , Karikalan Suganya Arunachalam , Chao Chieh Ju , Ashraf Hasan , Agasthi Pradyumna , Newton Sam , Scott Robert L , Barry Timothy , Ayoub Chadi , Arsanjani Reza , Masry Hicham El 
Published: August 2024

Abstract

Aims: Direct oral anticoagulants (DOACs) are widely used for stroke prevention in people with non-valvular atrial fibrillation/flutter (NVAF). Anticoagulants have different bleeding profiles. Apixaban is associated with the lowest bleeding risk. This study evaluates the interaction between DOAC used and right ventricular systolic pressure (RVSP) on echocardiogram and bleeding rates. It was hypothesized that pulmonary hypertension may be associated with excess bleeding based on anticoagulant-specific pharmacologic profiles.
Methods & Results: A retrospective analysis of a database was conducted. Multivariable regression models for bleeding rates were developed using a causative analysis approach among participants who had undergone an echocardiogram, and interaction terms for DOAC choice were incorporated. Stratum specific estimates were calculated using linear computation.
Patients taking Apixaban had lower bleeding rates than those taking Rivaroxaban and Dabigatran. Among those without pulmonary hypertension, there was no difference in bleeding rates. Where RVSP was ≥45mmHg, there was a 90% increase in bleeding rates with use of Dabigatran (HR 1.99, p=0.024) and Rivaroxaban (HR 1.86, p=0.042) compared to Apixaban (Figure 1).
Conclusions: Elevated RVSP is associated with excess bleeding in patients taking Rivaroxaban and Dabigatran, but not Apixaban, after controlling for confounding variables.
Exploring the Interplay Between Phytoplankton Taxonomy, Pigments, and Optical Properties in Ratnagiri Coastal Waters using a Multi-Parameter Approach
Authors: Krishna Aswathy Vijaya , Tirkey Anima , Raman Mini , Ali Syed Moosa , Gupta Anurag , Deb Sanjib Kumar , B Srijith 
Published: August 2024

Abstract

This study presents a comprehensive analysis of phytoplankton diversity and optical properties in the coastal waters of Ratnagiri, India. Ratnagiri, located on the southern coast of Maharashtra, is one of the major centre for fishing activities in India as well as a developing hub for industrial activities. Given its ecological significance and the pressures it faces, the coastal waters of Ratnagiri present a valuable case for studying phytoplankton dynamics and their optical properties. We integrated multiple parameters, including phytoplankton taxonomy, pigment composition, coloured dissolved organic matter (CDOM), and absorption characteristics to provide a holistic view of the phytoplankton community and its optical environment. Phytoplankton samples were collected across various sites in Ratnagiri and analyzed using advanced microscopy and high-performance liquid chromatography for taxonomic identification and pigment profiling. CDOM and absorption properties were measured using spectrophotometric methods. Our findings reveal more or less spatial uniformity in phytoplankton composition, with significant diversity within the phytoplankton community. Pigment analysis identified key marker pigments corresponding to various phytoplankton classes majorly bacillariophytes (diatoms), chlorophytes, cyanophytes, haptophytes and cryptophytes. facilitating a deeper understanding of community structure. CDOM analysis indicated varying levels of dissolved organic matter, influencing light absorption and availability in the water column. The absorption data highlighted the specific wavelengths most affected by phytoplankton presence, notably those contributed by diatoms and cyanophytes, providing insights into the optical properties of Ratnagiri's coastal waters. This integrative approach underscores the importance of considering multiple parameters to accurately assess phytoplankton dynamics and their impact on the aquatic environment. The results contribute to a better understanding of the ecological processes governing coastal waters in Ratnagiri and offer valuable information for future monitoring and management efforts.
Differential analysis of clinical outcomes in cerebral infarction associated with REM-OSA and NREM-OSA
Authors: Xu Liwen , Yu Wenyi , Sun Shutong , Zheng Yixi , Xu Gang , Liu Ruonan , Chu Cheng 
Published: August 2024

Abstract

OBJECTIVE
To investigate the relationships among obstructive sleep apnea (OSA), which is primarily characterized by the rapid eye movement (REM) phase, laboratory tests, cerebral infarction location, respiratory events and cerebral infarction clinical prognosis.
METHODS: At the Department of Neurology at the Affiliated Hospital of Yangzhou University, a retrospective cohort study was performed to gather general data, routine blood, magnetic resonance, objective sleep data from the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and polysomnography (PSG), as well as prognostic indicators from the follow-up of patients with cerebral infarction from February 2022 to September 2023. Additionally, the association between the rapid eye movement apnea hypopnea index (REM-AHI) and clinical data was examined using linear regression, and the relationship between the prognosis of cerebral infarction and REM-OSA was examined using binary logistic regression.
RESULTS: After screening 274 OSA patients with cerebral infarction (N = 229) with an AHI ≥ 5, the patients were divided into two groups: REM-OSA (N = 37, 16.2%) and NREM-OSA (N = 192, 83.8%). Multiple linear regression analysis revealed that leukocyte count, BMI and REM-AHI were linearly related. Binary logistic regression analysis revealed a relationship between the mRS score and REM-OSA, and the results of the t test indicated that the mRS score was lower in the cerebral infarction with REM-OSA group.
CONCLUSION: The prognosis for cerebral infarction patients with REM-OSA is worse than that for patients with NREM-OSA, and the differences between NREM and REM potentially suggest a mechanistic difference.
Tumor-associated chromosomal instability drives progression of colorectal adenoma to adenocarcinoma: evidence from 17-year follow-up after adenoma diagnosis
Authors: LI HUI , YANG FANG , BAI BINGJUN , JIANG ZHINONG , Li Bing , FU GUOXIANG , HU XIAOTONG 
Published: August 2024

Abstract

Background
Colorectal cancer (CRC) is a leading cause of cancer-related deaths globally. Adenomas, precursors to CRC, can be diagnosed early, but the genetic events leading to adenoma–adenocarcinoma conversion remain unclear. This study explored the role of chromosomal instabilities (CINs) in this conversion.
Method
Over a 17-year follow-up period, 119 adenomas were analyzed using low-coverage whole-genome sequencing (LC-WGS) and Ultrasensitive Chromosomal Aneuploidy Detector. Risk factors for adenocarcinoma development were identified through logistic regression analysis, and survival was assessed using Kaplan–Meier curves.
Results
CIN was found in 32% of adenomas, with a higher incidence in high-grade adenomas (P = 0.0359). Common chromosomal changes included loss of 18q, 1p, and 17p and gain of 8q (MYC), 20q, and 7p (EGFR). During the 17-year follow-up, 88 patients experienced tumor recurrence, including 40 cases of adenomas and 48 cases of progression to adenocarcinoma. CIN was identified in 40% of progression cases, 33.6% of adenoma recurrence cases, and 26% of nonrecurrent cases. A strong genetic linkage was observed before and after tumor transformation, with a high match between the tumors and matched prior adenomas. CIN was significantly associated with disease progression (HR: 2.5, 95% CI: 1.4–4.5, P = 0.00162) and was an independent risk factor. Additionally, MFN2 gene copy number deletion was linked to recurrence and/or progression after resection, with reduced expression in tumor tissues.
Conclusions
CIN is a key risk factor for adenoma recurrence and progression, and MFN2 gene copy number deletion is associated with adverse outcomes, providing insights for more accurate clinical prognostication of adenoma-to-adenocarcinoma transformation.
Design and Development of a Training Framework for Specialized Nurses in Central Sterile Supply Department: A Modified Delphi Study
Authors: liu jiawei , qin nian , gui fengliu , chen hui 
Published: August 2024

Abstract

Background Improving the essential competencies of nurses in disinfection supply centers is vital, as these nurses act as a principal defense against infections in hospitals. Therefore, it is necessary to develop a unified training system for the training of nurses at the National Disinfection Supply Center . The aim of this study was to develop a scientific training framework for specialized nurses in disinfection supplies to serve as a benchmark for ongoing training at disinfection supply centers.
Methods: The initialdevelopment of the CSSD nurse training system involved an extensive literature review and discussions among expert groups. From April to June 2024, two rounds of Delphi surveys were conducted, and 25 experts in related fields from 9 provinces in China were consulted to reach a consensus on the index system. Descriptive statistics were used to analyze the data. The consensus threshold is set according to the mean (≥3.5), coefficient of variation (<0.25) and full score ratio (≥70%).
Results: The recovery rates of valid questionnaires in the two rounds of expert consultation were 92.59% and 100%, respectively, and the average authority coefficient of the two rounds was 0.912. In the first round, 13 itemswere modified, 4 items were deleted, 2 items were relocated, and 20 itemswere added. The indicators were not modified in the second round. Finally, the training process index system of specialized nurses in the disinfection supply center (5 first-level indicators, 12 second-level indicators and 50 third-level indicators) and the training content index system (4 first-level indicators, 24 second-level indicators and 107 third-level indicators) were developed. The Kendall's W coefficients for the training process and training content were 0.199 and 0.187 in the first round and 0.227 and 0.218, respectively, in the second round of consultations (p <0.001).
Conclusion: The training index system for specialized nurses in disinfection supply centers is scientific and reliable and can provide a reference for access, curriculum setting and quality management in the training process of specialized nurses in disinfection supply centers.
New definition of borderline resectable colorectal liver metastasis based on prognostic outcomes
Authors: Chiba Naokazu , Iida Shoma , Nakagawa Masashi , Gunji Takahiro , Yokozuka Kei , Kobayashi Toshimichi , Sano Toru , Shigoka Masatoshi , Tabuchi Satoshi , Hidaka Eiji , Kawachi Shigeyuki 
Published: August 2024

Abstract

Background
Although surgical resection is the curative treatment for colorectal liver metastases (CRLM), the efficacy of neoadjuvant chemotherapy (NAC) has been discussed due to recent remarkable advances in chemotherapy. The definition of borderline resectable (BR) is most important, where neoadjuvant chemotherapy should be administered. This study aimed to examine a new definition of BR CRLM based on the results of the treatment outcomes.
Methods
This study included 127 patients who underwent liver resection for CRLM after exclusion of conversion cases between April 2010 and December 2023. Upfront resection was performed for synchronous and single liver metastasis or metachronous liver metastases. NAC was administered for multiple synchronous liver metastases. In order to find a new definition of BR, we examined the prognostic factors obtained from the treatment outcomes.
Results
CA19-9 level >37.0 was the only prognostic factor in the upfront group [hazard ratio (HR) 2.386, 95% CI, 1.583–4.769; p=0.049]. in the NAC group, a maximum tumor diameter ˃3 cm (HR 2.248, 95% CI 1.038–4,867, p=0.040), CA19-9 level >37.0 (HR 2.239, 95% CI 1.044–4.800, p=0.038), and a right-sided primary tumor in the colon (HR 2.770, 95% CI 1.284-5.988, p=0.009) were identified as significant prognostic factors.
Conclusions
In cases of CRLM, patients with CA19-9 levels >37.0, or CA19-9 level with <37.0 but with a primary tumor in the right colon or a maximum tumor diameter of >3 cm can be defined as BR CRLM and should be treated with NAC.
Post-Pandemic Study on Self-Reported Long Covid and its Determinants in a Rural North Indian Adult Population
Authors: Senjam Suraj Singh , Goel Garima , Manna Souvik , Balhara Yatan Pal Singh , Gupta Yashdeep , Ray Animesh , Lomi Neiwete 
Published: August 2024

Abstract

Background
Most studies on long COVID-19 symptoms (LCSs) have been conducted in urban areas or in hospital-based settings. To date, relevant evidence on LCSs from community-based rural studies is lacking. Therefore, the present study aimed to investigate LCSs and their determinants in a rural adult population of northern India.
Methods
A population-based cross-sectional study was conducted in a rural predominant district, Jhajjar, Haryana, in 2023. A total of forty clusters were covered from one randomly selected subdistrict. The semistructured questionnaire on the SurveyMonkey platform consisted of questions related to sociodemographic profile, health problems, preexisting morbidity, LCSs, and functional difficulties. The data regarding infection with COVID-19 were collected based on self-reported positive RT‒PCR results for SARS-CoV-2.
Results
Out of the 3700 eligible individuals identified, 2954 (79.8%) were surveyed. Based on a self-reported positive test, the rate of past COVID-19 infection was 6.2% (183/2954, 95% CI: 5.3–7.1). Furthermore, approximately 23% (42/183, 95% CI: 17.01–29.7) of the infected patients had LCS, whereas 1.4% (42/2954) of the study population had LCS. The prevalence of LCSs was greater in females than in males (28.7% vs 17.7%). Weakness (14, 33.4%), weight loss (6, 14.3%), memory problems (6, 14.3%) and headache (4, 9.5%) were common reported LCSs. Univariable analysis revealed a significant association between LCSs and age groups of 26–35 years (OR 0.32, 95% CI: 0.10–0.83, p value = 0.019), lower education (OR 4.46, 95% CI: 1.47–13.78, p value = 0.003), preexisting morbidities such as seeing difficulty (OR 2.91, 95% CI: 1.09–7.58, p value = 0.021), difficulty in self-care (OR 3.72, 95% CI: 1.07–12.88, p value = 0.021), and communication difficulties (OR 5.28, 95% CI: (0.76–45.74, p value = 0.046). The multivariable analysis also revealed a similar pattern.
Conclusion
One-fifth of those who were previously infected with COVID-19 had developed LCSs. A greater probability of LCSs was found among older females, participants with less education, and participants with preexisting comorbidities.