bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of time constraints on resident performance in pediatric mock scenarios
Authors: Collins Candace , Parr Madeline F.E. , Lozy Tara , Chirico Amy 
Published: July 2024

Abstract

Background Hospital-based rapid response teams (RRTs) and code teams are expected to respond to acutely decompensating patients within a defined time. However, there is limited data regarding the effect of this defined response time on the performance of the activating team. Residents are commonly the first responders to acutely decompensating patients in the hospital setting and their ability to recognize the need for an RRT or code activation along with their skills in patient management until the responding team arrives appear to be important for patient safety. We sought to evaluate the effect of time constraints on the performance of pediatric residents during simulated clinical scenarios that require activation of the pediatric RRT or pediatric code team.Methods We performed a single-center, prospective cohort study to analyze pediatric resident performance during low-fidelity simulated clinical scenarios involving acutely decompensating patients requiring pediatric RRT or pediatric code team activation. Simulated clinical scenarios were performed by residents without a time constraint (pre) and again with a time constraint (post) and residents were blinded to whether a time constraint had been applied. Statistical analysis was performed using a two-sided t-test to compare the number of interventions performed and time to activation of the pediatric RRT or code team for pre- vs. post-time constraint groups. Effect size was measured using Cohen’s d.Results Implementing a time constraint did have a medium to large effect (Cohen’s d = 0.60) on pediatric resident performance and resulted in 6.2% increase in interventions performed in simulated clinical scenarios. Differences did exist based on the level of resident experience, with senior residents activating the pediatric RRT or pediatric code team faster than junior residents.Conclusion Implementation of a time constraint did have a moderate to large effect on the performance of pediatric residents during simulated clinical scenarios involving hospitalized acutely decompensating patients.
SMC2 as a potential prognostic biomarker in lung adenocarcinoma and its correlation with immune microenvironment
Authors: Zheng Fu-Qiang , Li Yu , Chen Hui-Guo , Peng You , Tian Xiao-Cai 
Published: July 2024

Abstract

Structural maintenance of chromosome 2 (SMC2) has been recognized to play an important role in a variety of cancers, but its function in lung adenocarcinoma (LUAD) remains poorly understood.First, we explored the expression level of SMC2 and its relationship with clinical pathological features using the LUAD dataset from the TCGA database. The expression of SMC2 in LUAD cell lines and tissues was verified using quantitative polymerase chain reaction (qPCR). Secondly, Kaplan-Meier analysis, COX regression analysis and Nomogram construction were employed to assess the prognostic potential of SMC2 in LUAD. In addition, the biological behavior and possible signaling pathways of SMC2 were forecasted by protein-protein interaction (PPI) networks, single-gene correlation analysis, genetic ontology (GO) and genome enrichment analysis (GSEA), together with Kyoto Encyclopedia of Genes and Genomes (KEGG). At last, a systematic analysis of crosstalk and mutations between SMC2 and immune features in the tumor microenvironment (TME) was conducted using a single-sample GSEA algorithm, the Tumor Immune Dysfunction and Rejection (TIDE) algorithm, the TIMER 2.0 and TISIDB databases, as well as the cBioportal database.SMC2 was markedly up-regulated in LUAD cell lines and tissues and was strongly correlated with adverse clinicopathological features and prognosis. ROC curves showed a good diagnostic effect (AUC value: 0.787). The enrichment analysis suggested that SMC2 might be involved in the regulation of LUAD cell cycle. The TIMER algorithm and ssGSEA algorithm showed that SMC2 was associated with suppressive immune cells (e.g., B cells) in LUAD. In addition, SMC2 may interact with the expression of molecules such as NDC80, KIFC1, SKA1, NCAPH, ESPL1, MELK, KIF11, SGO1, TOP2A, KNL1, KIF4A, TPX2, TICRR, TTK, KIF14, NCAPG and others to promote LUAD progression. Evidence from the TISIDB database shows that SMC2 is positively associated with immunosuppressive genes such as CD274, PDCD1LG2, TGFBR1 and LAG3. However, it is inversely associated with chemokines and receptors such as CCL14, CCL17, CXCL16, CX3CL1, CX3CR1, CCR6, CCR7 and CXCR5. Also, as predicted by the TIDE algorithm, patients with high SMC2 expression responded poorly to immunotherapy.Our analysis shows that the high expression status of SMC2 in LUAD is associated with poor patient outcomes and describes some potential reasons for this poor prognosis. These findings suggest that SMC2 is associated with the malignant progression of LUAD and therefore may be a potential target for improving outcomes in LUAD in the foreseeable future.
The role of gut-brain tryptophan metabolism and fatty acid peroxidation in the effect of sleep deprivation on anxiety and depression in PCOS mice
Authors: Han Ting , Liu Shangjing , Liu Hao , Wang Xin , Yang Xiaojia , Chan ShanAn , Tumanov Sergey , Cannon Richard D. , Yang Yang , Han Ting-Li 
Published: July 2024

Abstract

Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder in women of childbearing age. Numerous studies have indicated a significantly elevated incidence of depression and anxiety in women affected by PCOS, often attributed to dysbiosis of gut microbiota resulting from poor sleep quality. However, the intricate relationship between sleep disorders, gut microbiota, and depression/anxiety in PCOS remains unclear. In this study, we aimed to elucidate the effects of sleep deprivation on the anxiety and depression of PCOS mice through an investigation of the gut-brain axis in order to understand the potential microbial-host interactions contributing to the occurrence of these psychological disorders. We found that sleep deprivation induced symptoms of depression and anxiety in PCOS mice and exacerbated PCOS-like pathology. Moreover, sleep deprivation altered the gut microbiota composition by suppressing beneficial bacteria such as Lactobacillus, and Ruminococcus species. Additionally, sleep deprivation upregulated intestinal tryptophan-kynurenine metabolism, increased intestinal wall permeability, promoted systemic inflammation, and compromised blood-brain barrier integrity. Furthermore, the hippocampal metabolomic analysis indicated that sleep deprivation affected the metabolism of fatty acid and oxylipins, upregulated the tryptophan-kynurenine metabolic pathway and exhibited a significant correlation with anxiety and depressive behaviours. Overall, this study suggests that sleep deprivation plays a pivotal role in the pathological mechanism of depression and anxiety in PCOS mice by modulating tryptophan and lipid metabolism through the gut-brain axis.
SIX1 Expression and its Clinicopathological Significance: Difference between Classic and Follicular Variant Papillary Thyroid Carcinoma
Authors: Khalil Elzahraa Ibrahim , Issa Ahmed S. , Kamal Rehab M. 
Published: July 2024

Abstract

Background
Papillary thyroid carcinoma (PTC) is the most common type of thyroid carcinoma, representing the majority of thyroid cancer cases. Most patients with PTC have an excellent prognosis following treatment, yet approximately 10% face mortality within ten years, primarily due to lymph node metastasis (LNM) or local recurrence. The SIX1 gene, a member of the SIX gene superfamily, encodes a transcription factor integral to the development of certain tissues during embryogenesis. The impact of SIX1 in different subtypes of PTC has not been studied previously.
Objective
The purpose of this study was to investigate the expression of SIX1 protein in PTC and to explore its relationship with clinical behavior in two subtypes of PTC: classic PTC (C-PTC) and follicular variant PTC (FV-PTC).
Material and Methods
Using immunohistochemistry, the study analyzed 125 primary PTC cases, including 85 cases of C-PTC and 40 cases of FV-PTC.
Results
The study found significant positive associations between high SIX1 expression and several adverse clinical features across the PTC samples. High SIX1 expression was linked with increased tumor size, multifocal tumors, LNM, high-grade tumor features, advanced tumor stage, lymphovascular invasion, perineural invasion, and extrathyroidal extension (ETE). Within the classic PTC subgroup, high SIX1 expression showed significant positive correlations with Tumor size (P = 0.04), Multifocality (P = 0.02) and High-grade features (P = 0.03). In the follicular variant subgroup, high SIX1 expression was significantly associated with Lymph node metastasis (LNM) (P = 0.001), Lymphovascular invasion (P = 0.03), ETE (P = 0.003) and Tumor stage (P = 0.007).
Conclusions
The findings of this study indicate that SIX1 expression is a marker of poor prognosis in PTC, suggesting that its high expression is linked with more aggressive tumor characteristics and advanced disease stages. Importantly, the impact of SIX1 expression varies between C-PTC and FV-PTC, predicting distinct prognostic factors in each subtype. This suggests that SIX1 could be utilized not only as a prognostic biomarker but also in developing subtype-specific therapeutic strategies for PTC patients.
Blood-pool SUV analysis of 99mTc-galactosyl human serum albumin (99mTc-GSA) normalized by blood volume for prediction of short-term survival in severe liver failure: preliminary report
Authors: Yama Naoya , Tatsumi Hiroomi , Akatsuka Masayuki , Hatakenaka Masamitsu 
Published: July 2024

Abstract

Purpose:This study evaluated the usefulness of SUV analysis of 99mTc-galactosyl human serum albumin (99mTc-GSA) scintigraphy including SUV analysis of the cardiac blood pool normalized by blood volume as a predictor of short-term survival in severe liver failure.
Patients and methods: We enrolled 24 patients with severe liver failure who underwent 99mTc-GSA scintigraphy and were admitted to the intensive care unit. Patients were divided into survival and non-survival groups at 7, 14, and 28 days from performance of 99mTc-GSA scintigraphy. From SPECT images we calculated SUVs of the cardiac blood pool, performing normalization for body weight, lean body weight, Japanese lean body weight, and blood volume and we calculated SUVs of the liver, normalizing by body weight, lean body weight, and Japanese lean body weight. We also calculated the uptake ratio of the heart at 15 minutes to that at 3 minutes (HH15) and the uptake ratio of the liver at 15 minutes to the liver plus the heart at 15 minutes (LHL15) from planar images of 99mTc-GSA scintigraphy.
Results:There were significant differences between the 7-day survival and non-survival groups for all SUVs of the heart and the liver and HH15, for 14-day survival groups in SUVs of the heart normalized by Japanese lean body weight and blood volume, and no significant differences between 28-day survival groups for any SUVs, HH15, or LHL15. Although the difference was not significant, SUV analysis of the heart normalized by blood volume showed the highest value for the area under the receiver-operating-characteristics curve for both 7-day and 14-day survival.
Conclusion: SUV analysis of 99mTc-GSA including SUV analysis of cardiac blood pool normalized by blood volume is of value for prediction of short-term survival in cases with severe liver failure.
Factors Associated With Early Recurrence in Ductal Adenocarcinoma of the Pancreas
Authors: Uad Pedro , Suldrup Federico , Durán María Eugenia , Merlo Ignacio , Mazza Oscar 
Published: July 2024

Abstract

BACKGROUND
Pancreatic ductal adenocarcinoma presents a significant challenge due to its often late-stage diagnosis, with only 15–20% of patients eligible for surgical intervention. Surgical resection, combined with advanced oncological therapies, has shown promise in improving patient survival. Understanding factors influencing early recurrence post-surgery is crucial for prognosis evaluation.
METHODS
This retrospective study, spanning from January 2010 to January 2020, focused on patients undergoing surgery for pancreatic cancer at a single center. Criteria for inclusion involved patients over 18 years with anatomopathological diagnoses of pancreatic adenocarcinoma or undifferentiated carcinoma, devoid of metastasis at the time of surgery, and possessing complete recurrence data during follow-up. Early recurrence, defined as relapse within a year, was assessed alongside overall and disease-free survival, measured from the date of pancreatic tumor resection surgery to death or relapse. Survival analysis utilized the Kaplan-Meier method. Statistical comparisons employed Chi-square, Wilcoxon, or Student tests as appropriate, facilitated by R software.
RESULTS
A total of 176 patients with post-surgical recurrence of pancreatic cancer were included. The group with early recurrences was made up of 79 patients, while the rest were included in the group of late recurrences. No differences were found in age, sex, survival, type of surgical resection, need for venous resection, type of adenocarcinoma (ductal vs undifferentiated), tumor size, number of nodes resected, number of positive nodes, perineural and perivascular infiltration. Significant differences were found in pre- and postoperative CA 19 − 9 values ​​and in adjuvant treatment (complete, incomplete, and null).
CONCLUSIONS
The level of CA 19 − 9 preoperative and postoperative are associated with early recurrence. Complete adjuvant treatment was associated with late recurrence. There were no statistically significant differences in the rest of the variables analyzed.
Reference equations of pulmonary function testing for healthy Chinese children aged 4-18 years
Authors: Wu Jinhong , Zhang Hao , Wu Yufen , Zhang Qiaoling , Li Ming , Dai Fuli , Xu Changfu , Shi Yongsheng , Wang Ning , Jia ChunMei , Liu Sha , Zhang Yuehua , Zhang Zhongping , Liu Aihong , Wang Fei , Liu Li , Chen Qiang , Wang Jinrong , Han Yuling , Song Yuxin , Feng Yong , Sun Yun , Rao Huaping , Zhong Lili , Liu Quanhua , Wan Liya , Long Zhen , Dong Xiaoyan , Zhang Yanli , Jiang Wenhui , Ji Minghong , Huang Jianfeng , Pan Zhiwei , Ma Dongjun , Tang Suping 
Published: July 2024

Abstract

Background Establishing accurate spirometry reference values for Chinese children is essential for diagnosing and managing respiratory conditions. This study aims to develop spirometric reference values for healthy Chinese children. Methods A cross-sectional study involving healthy children aged 4 to 18 years from 33 research centers across 24 regions in China was conducted. Physical growth indices were measured and spirometry tests were conducted. New prediction equations were developed using multiple linear regression models with age, height, and weight as predictors. Comparisons were made with existing Caucasian and Chinese pediatric reference equations, including the Zapletal and GLI-2012/2022 equations. Results Lung function was assessed in 8929 healthy Chinese children aged 4 to 18 years. In our individuals, sex, age, height, and weight were significant predictors of lung function (p < 0.001), and internal validation revealed that sex-specific reference equations based on these three factors were fairly reliable. Negative mean z-scores in the forced vital capacity (FVC), peak expiratory flow (PEF), forced expiratory flow between 25% and 75% of FVC (FEF25-75%), and positive mean z-scores in forced expiratory volume in one second (FEV1) and FEV1/FVC ratio were observed when adopting the Zapletal equations. According to the GLI-2012 and GLI-2022 equations, positive mean z-scores were observed in FEV1 and FVC in both sexes. In contrast, negative mean z-scores were observed in the FEV1/FVC ratio when applying the GLI-2012 equations. Compared with this study, the z-score of previous Chinese studies ranged from − 3.421 to 18.109, which were found to significantly overestimate or underestimate lung function parameters. Conclusion Current reference equations for spirometry in healthy Chinese children have been investigated in this study. These present a chance to improve lung disease diagnosis and treatment for both acute and chronic conditions in this sizable and susceptible population.
Trends in Tranq: Prevalence of Xylazine in Oral Fluid Toxicology in Michigan, Ohio, and Indiana
Authors: Thomas Chris , Mondal Ankita , Levitas Matthew , Widman Corey , Lemberg Bridget 
Published: July 2024

Abstract

Background
Xylazine (which goes by the street name “Tranq”) is a veterinary animal tranquilizer that is commonly and sometimes unknowingly used in combination with illicit fentanyl and has garnered increased media and government attention in recent months. The White House National Response Plan from July 2023 emphasized increased testing for xylazine as a crucial first step to curbing abuse. Forensic Fluids Laboratories (FFL), which specializes in oral fluid drug testing, began surveilling this substance beginning in early 2023. Here, we examined our data from over a year of testing and present our observations and trends we identified from this data. We show that oral fluid is an excellent tool for identifying xylazine use.
Methods
From March 2023 through March 2024, over 55,000 oral fluid specimens were analyzed using Liquid Chromatography-Tandem Mass Spectrometry (LC-MS-MS) following a presumptive positive screen for methamphetamine, cocaine, opiates, fentanyl, and/or xylazine using FDA-approved Enzyme Linked Immunosorbent Assays (ELISA). Results of these analyses as well as associated geospatial metadata were extracted from the sample database and analyzed using Pandas and NumPy libraries in Python. Plots and maps were generated using Matplotlib and GeoPandas libraries in Python.
Results
On average over the entire testing period, xylazine was found in 3.41% of the total 55,691 analyzed samples. Using the three-month xylazine positivity rate, prevalence peaked at 3.76% of analyzed samples in June 2023 and hit its low in September 2023 at 3.14%. Of the xylazine-positive samples, fentanyl was present 96.5% of the time. In addition, 86.2% of xylazine samples indicated some degree of polydrug use where at least two other drug classes were present. Of note, stimulants and fentanyl were present in 61.4% of xylazine positives. Xylazine increased in prevalence among fentanyl-positive samples over time. Using the three-month average, xylazine was found in 21.70% of fentanyl-positive samples in May 2023 and was found in 30.92% in March 2024. Across the states of Michigan, Ohio, and Indiana, xylazine use spread to 45 new counties by the conclusion of our study window. At the county level, general xylazine hotspots were identified, and prevalence trends were variable with certain counties increasing and decreasing in xylazine use.
Conclusions
While the overall xylazine prevalence fluctuated among illicit recreational drug users from March 2023 through March 2024, the individual county-level trends during this time tended to reveal dynamic shifts in xylazine use. Our data highlights the spread of this drug across Michigan, Ohio, and Indiana, and provides support for increased xylazine adulteration of the illicit fentanyl drug supply. With these data trends, we aim to support local and state agencies in promoting continued action and collaboration toward mitigating spread of xylazine.
Textbook outcomes in patients with a cesarean scar pregnancy: A comprehensive analysis from a single Eastern center
Authors: Wu Zhi-Wei , Lin Cheng-Bin , Lin Ying-Ying , Cai Yuan-Jun , Xie Li 
Published: July 2024

Abstract

Background
Quality medical care is crucial in evaluating clinical results. This study assessed the value of medical quality control using the comprehensive indicator "textbook outcome" (TO) in patients with a cesarean scar pregnancy (CSP).
Methods
This study included 140 patients from a CSP cohort from April 2022 to May 2024. TO was characterized by the total removal of the gestational sac, lack of intraoperative complications, absence of severe postoperative complications, freedom from re-interventions, no unplanned admissions to the intensive care unit, postoperative hospital stay of ≤ 7 days, zero postoperative mortalities within 30 days post-surgery, and no readmission within 30 days post-surgery. Logistic regression was used to analyze factors contributing to non-TO.
Results
Overall, 119 (85.0%) achieved a TO. Significant differences were observed between the TO and non-TO groups in terms of the number of days with abdominal pain, number of days with vaginal bleeding, number of days without menstruation, history of cesarean section in a primary healthcare hospital, time from previous cesarean section to CSP, gestational sac size, and CSP classification (all P < 0.05). Most patients in the TO group received high-intensity focused ultrasound (HIFU) combined with hysteroscopy (53.8%), resulting in lower average intraoperative blood loss, length of hospital stay, and hospitalization cost compared to the non-TO group (all P < 0.05). The postoperative pain score in the TO group was lower (P = 0.002), and the time required for β-hCG levels to return to normal in the TO group was shorter than in the non-TO group (P = 0.025). Multivariate logistic analysis revealed that history of cesarean section at a primary hospital, CSP-III classification, and intraoperative blood loss exceeding 30 mL were independent risk factors for a non-TO (all P < 0.05), whereas HIFU combined with hysteroscopy was an independent protective factor against non-TO (P = 0.020).
Conclusion
In clinical practice, it is important to pay attention to patients with history of cesarean section in primary healthcare hospitals, CSP-III classification, and intraoperative blood loss exceeding 30 mL. HIFU combined with hysteroscopy can help patients with a CSP achieve a TO.
Self-stigma in people with bipolar disorder based on their real sense of acceptance from their family
Authors: Shimizu Lyrica , Ando Kumiko , Tobe Yuki , Kocha Hiroki 
Published: July 2024

Abstract

Background: Although efforts have been made to reduce discrimination against people with disabilities, stigma regarding mentally disabled people still exists and significantly impacts treatment success and their way of life.This study aimed to determine how a patient’s sense of acceptance from their family influenced self-stigma, the patient’s treatment, and social life by asking several questions about their demographics and feelings. Based on these results, we discussed effective interventions for self-stigma reduction and social integration in patients with bipolar disorder based on our results.
Results: Of the 131 respondents, 127 were included in the analysis. Multiple logistic analysis revealed that for patients with bipolar disorder, having a sense of acceptance from their families was related to self-stigma intensity, and self-stigma was weakened when the patient felt accepted by the family. Furthermore, in those who felt a sense of acceptance from their families, the odds ratio was 11 times higher for those who disclosed the illness to their partners and 5.7 times higher for those who disclosed the illness to their siblings than for those who did not feel a sense of acceptance from their families. Conclusions: To reduce self-stigma in patients with bipolar disorder, they need to obtain a sense of acceptance from their families. Furthermore, to help their families accept the patient, we should provide family care tailored to their respective positions and ways of interacting with their affective family.