bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physiological function of gut microbiota and metabolome on successful pregnancy and lactation in the captive Yangtze finless porpoise (Neophocaena asiaeorientalis asiaeorientalis)
Authors: Shah Syed Ata Ur Rahman , Tang Bin , He Dekui , Hao Yujiang , Nabi Ghulam , Wang Chaoqun , Kou Zhangbing , Wang Kexiong 
Published: August 2024

Abstract
Gestation period in captive Yangtze finless porpoise (YFP) is a well-coordinated and dynamic process, involving both systemic and local alterations. The gut microbiota and its connection to fecal metabolites are crucial in supporting fetal development and ensuring maternal health during reproductive stages. This study evaluates changes in the gut microbiota and their correlation with fecal metabolites in captive YFPs during different reproductive stages. The results reveal that microbial community structure changed significantly during reproductive stages, while gut microbial diversity remained stable. The genus unclassified Peptostrptococcaceae, Corynebacterium, and norank KD4–96 were significantly greater in non-pregnancy (NP), Terrisporobacter was significantly greater in lactating (LL), and Clostridium was significantly higher in early-pregnancy (EP) compared to the other groups. The host fecal metabolome exhibited significant alterations during the reproductive stages. Indoxyl sulfate, octadecatrienoic acid, and methionyl-methionine were significantly higher in the NP; galactosylglycerol, chondroitin 6-sulfate, and lumichrome were significantly higher in the EP and mid-pregnancy (MP); and valylleucine and butyryl-l-carnitine were significantly higher in the LL. The altered metabolites were mostly concentrated in pathways associated with arachidonic acid metabolism (significantly altered in NP), leucine, valine, and isoleucine biosynthesis (significantly altered in EP and MP), and glycerophospholipid metabolism (significantly altered in LL compared to others stages). Additionally, we found a strong link between variations in the host metabolism and alterations in the fecal bacteria of captive YFP. In conclusion, this study provides detailed insights into host metabolic and fecal bacterial changes in captive YFP during reproduction stages, providing important knowledge for improving the reproductive management in the captive YFP.
The multivariate Bernoulli detector: change point estimation in discrete survival analysis
Authors: van den Boom Willem , De Iorio Maria , Qian Fang , Guglielmi Alessandra 
Published: August 2024

Abstract
Time-to-event data are often recorded on a discrete scale with multiple, competing risks as potential causes for the event. In this context, application of continuous survival analysis methods with a single risk suffers from biased estimation. Therefore, we propose the multivariate Bernoulli detector for competing risks with discrete times involving a multivariate change point model on the cause-specific baseline hazards. Through the prior on the number of change points and their location, we impose dependence between change points across risks, as well as allowing for data-driven learning of their number. Then, conditionally on these change points, a multivariate Bernoulli prior is used to infer which risks are involved. Focus of posterior inference is cause-specific hazard rates and dependence across risks. Such dependence is often present due to subject-specific changes across time that affect all risks. Full posterior inference is performed through a tailored local-global Markov chain Monte Carlo (MCMC) algorithm, which exploits a data augmentation trick and MCMC updates from nonconjugate Bayesian nonparametric methods. We illustrate our model in simulations and on ICU data, comparing its performance with existing approaches.
Reduced-rank clustered coefficient regression for addressing multicollinearity in heterogeneous coefficient estimation
Authors: Zhong Yan , He Kejun , Li Gefei 
Published: August 2024

Abstract
Clustered coefficient regression (CCR) extends the classical regression model by allowing regression coefficients varying across observations and forming clusters of observations. It has become an increasingly useful tool for modeling the heterogeneous relationship between the predictor and response variables. A typical issue of existing CCR methods is that the estimation and clustering results can be unstable in the presence of multicollinearity. To address the instability issue, this paper introduces a low-rank structure of the CCR coefficient matrix and proposes a penalized non-convex optimization problem with an adaptive group fusion-type penalty tailor-made for this structure. An iterative algorithm is developed to solve this non-convex optimization problem with guaranteed convergence. An upper bound for the coefficient estimation error is also obtained to show the statistical property of the estimator. Empirical studies on both simulated datasets and a COVID-19 mortality rate dataset demonstrate the superiority of the proposed method to existing methods.
Value of transperineal three-dimensional ultrasonography in diagnosis of pelvic floor dysfunction
Authors: Zhuang Yingbin , Yao Liping , Liu Yanjie 
Published: August 2024

Abstract

Objectives
To investigate the correlation between 3-dimensional ultrasonography parameters and pelvic floor dysfunction (PFD) and its application value in diagnosis and treatment.

Methods
Ninety-two patients with PFD and 22 without who underwent 3-dimensional ultrasonography were selected. Transperineal 3-dimensional ultrasonography was performed by Voluson E8 colour Doppler ultrasonography to analyse the anteroposterior diameter (LHAD), transverse diameter (LHLD), pelvic diaphragmatic hiatus area (LHA), and bladder neck mobility (BND) of the patients. Diagnostic sensitivity and specificity of ultrasound parameters in PFD were analysed using Receiver Operating Characteristic (ROC) curves. Paired sample t test was used to analyse the improvement of pelvic floor muscle training (PFMT) in patients with PFD.

Results
Patients with PFD had significantly higher levels of △LHAD, △LHLD, △LHA, and BND than controls (all P &lt; .01). Binary logistic regression analysis showed that △LHA or BND levels were independent risk factors for the development of PFD. The ROC results showed that the area under the ROC curve with BND level was the highest (0.917). The diagnostic sensitivity of BND in PFD was 100.0% and the specificity was 70.7%. In urinary incontinence (UI) patients, there was a significant positive correlation between the occurrence of UI and BND levels (all r &gt; 0, P &lt; .05). After PFMT treatment, the levels of △LHAD, △LHLD, △LHA, and BND in patients with PFD were significantly decreased (all P &lt; .001).

Conclusions
The abnormal changes in the level of 3-dimensional ultrasound parameters can be used as a sensitive indicator to evaluate PFD and a guiding parameter for PFMT treatment.

Advances in knowledge
The feasibility of operation and repetition by 3-dimensional pelvic floor ultrasonography could provide a reliable imaging basis for clinical diagnosis and treatment of patients with PFD.
Looking for Signs of Life: A Christian Perspective on Defining and Determining Death
Authors: Omelianchuk Adam 
Published: August 2024

Abstract
Looking to Scripture through the eyes of contemporary medical experience, I analyze the meaning of the criteria used for determining death, specifically in the light of Jesus’ final moments and the resurrection of the Shunammite’s son in 2 Kings, chapter 4. I argue that four theses are consistent with, and informed by, these passages that can help guide Christian belief and decision-making about how death is determined in the clinical context: (1) death is neither permanent nor irreversible; (2) something like the “brain-dead” state is, at best, a confounding state that requires one to “pace and pray” or let go; (3) that the case for determining death by neurologic criteria depends on the “working togetherness” of the body’s parts for the sake of impacting its environment; and (4) that the practice of neurologically based death determination is a response to the problem of disaggregation of the human form into its organ systems that modern critical care medicine makes possible. I end with advice about how Christians might approach the debates over the law and practice, even if they cannot come to a consensus.
Factors Associated With Poor Clinical and Microbiologic Outcomes in Candida auris Bloodstream Infection: A Multicenter Retrospective Cohort Study
Authors: Jimenez Adriana , Rosa Rossana , Ayoub Samantha , Guran Rachel , Arenas Sebastian , Valencia Nickolas , Stabile Janna C , Estepa Adrian T , Parekh Dipen J , Ferreira Tanira , Gershengorn Hayley B , Prabaker Kavitha K , Eckardt Paula A , Zahn Matthew , Abbo Lilian M , Shukla Bhavarth S 
Published: August 2024

Abstract

Background
Candida auris has become a growing concern worldwide because of increases in incidence of colonization and reports of invasive infections. There are limited data on clinical factors associated with poor outcomes in patients with C. auris bloodstream infection (BSI).

Methods
We assembled a multicenter retrospective cohort of patients with C. auris BSI from 2 geographics areas in US healthcare settings. We collected data on demographic, clinical, and microbiologic characteristics to describe the cohort and constructed multivariate logistic regression models to understand risk factors for 2 clinical outcomes, all-cause mortality during facility admission, and blood culture clearance.

Results
Our cohort consisted of 187 patients with C. auris BSI (56.1% male, 55.6% age &gt;65 years); 54.6% died by facility discharge and 66.9% (of 142 with available data) experienced blood culture clearance. Pitt bacteremia score at infection onset was associated with mortality (odds ratio [95% confidence interval]: 1.19 [1.01–1.40] per 1-point increase). Hemodialysis was associated with a reduced odds of microbiologic clearance (0.15 [0.05–0.43]) and with mortality (3.08 [1.27–7.50]).

Conclusions
The Pitt bacteremia score at the onset of C. auris BSI may be a useful tool in identifying patients at risk for mortality. Targeted infection prevention practices in patients receiving hemodialysis may be useful to limit poor outcomes.
Emerging Patterns of Inflammatory Bowel Disease in Sub-Saharan Africa: 175 Cases From an Inflammatory Bowel Disease Network
Authors: Hodges Phoebe , Adeniyi Oluwafunmilayo , Devani Smita , Nwoko Chinenye , Owoseni Opeyemi , Boateng Kwadwo Gyebi Agyenim , Ocanit Anthony , Muhofa Abdallah , Dankiri Nasiru Altine , Duduyemi Babatunde , Alemayehu Zenahebezu Abay , Musa Yusuf , Micah Eileen , Kabagambe Pissi , Shewaye Abate Bane , Thomas Preetha , Wanjara Samuel , Epstein David , Watermeyer Gillian , Fathi Hani , Alatise Olusegun , Mbelle Mzamo , Kelly Paul , Croft Nicholas M 
Published: August 2024

Abstract
There is a knowledge gap on the epidemiology of inflammatory bowel disease in Africa. To begin to address this issue, we formed a case reporting network of practitioners with an interest in inflammatory bowel disease across sub-Saharan Africa. Here, we report a series of 175 cases from 12 countries over 2 years.
Severe familial dilated cardiomyopathy in a young adult due to a rare LMNA mutation: a case report
Authors: Belcher Adam M , Annie Frank H , Rinehart Sarah , Elashery Ahmad , Amer Muhammad 
Published: August 2024

Abstract

Background
Familial dilated cardiomyopathy prognosis and disease progression vary greatly depending upon the type of genetic mutation. Family history and genetic testing are paramount in developing the best treatment plan for a patient. However, with rare or novel mutations, the significance may be unknown. Regarding this, the following case report highlights the importance of vigilance and suspicion when treating a patient with a variant of unknown significance. Additionally, it shows the importance of thoroughly investigating the family history of cardiovascular disease.

Case summary
A 25-year-old Caucasian male was found to have a right bundle branch block and dilated cardiomyopathy upon presentation to the emergency department. Later testing showed that the dilated cardiomyopathy was due to an incredibly rare lamin A/C (LMNA) gene mutation, R349L. Despite treatment with a maximum-tolerable medication regimen and an automatic implantable cardioverter-defibrillator, the patient continued to decline and required a heart transplant.

Discussion
This case provides more information on the severity of this specific LMNA mutation that has only been documented once before. Of note, the time from the initial emergency department visit to the heart transplant was approximately 2 years. Given the patient’s young age and rapid disease progression, in addition to a strong family history of sudden cardiac death, the significance of this mutation should not be understated. The additional knowledge gained from this case report can be used to aid in timely interventions and prognosis evaluation.
Plasma 21-deoxycortisone: a sensitive additive tool in 21-hydroxylase deficiency in newborns
Authors: Fiet Jean , Bachelot Guillaume , Sow Coumba , Farabos Dominique , Helin Nicolas , Eguether Thibaut , Dufourg Marie-Noelle , Bellanne-Chantelot Christine , Ribaut Bettina , Bachelot Anne , Young Jacques , Houang Muriel , Lamazière Antonin 
Published: August 2024

Abstract

Objective, Design, and Methods
Although 17-hydroxyprogesterone (17OHP) has historically been the steroid assayed in the diagnosis of congenital adrenal 21-hydroxylase deficiency (CAH-21D), its C11-hydroxylated metabolite, 21-deoxycortisol (21DF), which is strictly of adrenal origin, is assayed in parallel in this pathology. This steroid (21DF) is oxidized by 11beta-hydroxysteroid dehydrogenase type 2 into 21-deoxycortisone (21DE). In the context of CAH-21D confirmation testing, confounding factors (such as intensive care unit admission, stress, prematurity, early sampling, and variations of sex development) can interfere with the interpretation of the gold-standard biomarkers (17OHP and 21DF). Since its tissue concentrations are especially high in the placenta, we hypothesized that 21DE quantification in the neonatal periods could be an interesting biomarker in addition to 17OHP and 21DF. To verify this hypothesis, we developed a new mass spectrometry-based assay for 21DE in serum and applied it to newborns screened for CAH-21D.

Results
In newborns with CAH-21D, the mean serum levels of 21DE reached 17.56 ng/mL (ranging from 8.58 ng/mL to 23.20 ng/mL), and the mean 21DE:21DF ratio was 4.99. In contrast, in newborns without CAH-21D, the 21DE serum levels were low and not statistically different from the analytical 21DE limit of quantification (0.01 ng/mL).

Conclusion
Basal serum 21DE appears to be a novel sensitive and specific biomarker of CAH-21D in newborns.
Preluding on the harp in the late 18th and early 19th centuries
Authors: Marville Jovanka 
Published: August 2024

Abstract
The practice of improvised or apparently improvised preludes has been widely documented over the centuries. Harpists of the late 18th and early 19th centuries were widely expected to introduce pieces of music with improvised preludes. This article shows how harpists drew techniques from thoroughbass treatises and keyboard repertory. Harpists also created their own idiosyncratic features for preludes, using the idiomatic characteristics of their instrument (refined arpeggios, hand-crossings, harmonic sounds) while using the harp’s pedals to expand the harmonic and chromatic palette of the repertory. The article also shows how formulaic figuration and harmonic patterns were used as building blocks for improvised and composed preludes, and as elements in the education of harpists.
Application repetition and electrode–tissue contact result in deeper lesions using a pulsed-field ablation circular variable loop catheter
Authors: Di Biase Luigi , Marazzato Jacopo , Gomez Tara , Byun Eric , Zou Fengwei , Grupposo Vito , Mohanty Sanghamitra , La Fazia Vincenzo Mirco , Ammirati Giuseppe , Lin Aung , Garcia Domingo Ynoa , Della Rocca Domenico , Al Ahamad Amin , Schiavone Marco , Gasperetti Alessio , Freilich Michael , Serna Juan Cedeno , Forleo Giovanni , Liu Xu , Lakkireddy Dhanunjaya , Tondo Claudio , Natale Andrea , Zhang Xiao-Dong 
Published: August 2024

Abstract

Aims
Pulsed-field ablation (PFA) is a novel, myocardial-selective, non-thermal ablation modality used to target cardiac arrhythmias. Although prompt electrogram (EGM) signal disappearance is observed immediately after PFA application in the pulmonary veins, whether this finding results in adequate transmural lesions is unknown. The aim of this study is to check whether application repetition and catheter–tissue contact impact lesion formation during PFA.

Methods and results
A circular loop PFA catheter was used to deliver repeated energy applications with various levels of contact force. A benchtop vegetal potato model and a beating heart ventricular myocardial model were utilized to evaluate the impact of application repetition, contact force, and catheter repositioning on contiguity and lesion depth. Lesion development occurred over 18 h in the vegetal model and over 6 h in the porcine model. Lesion formation was found to be dependent on application repetition and contact. In porcine ventricles, single and multiple stacked applications led to a lesion depth of 3.5 ± 0.7 and 4.4 ± 1.3 mm, respectively (P = 0.002). Furthermore, the greater the catheter–tissue contact, the more contiguous and deeper the lesions in the vegetal model (1.0 ± 0.9 mm with no contact vs. 5.4 ± 1.4 mm with 30 g of force; P = 0.0001).

Conclusion
Pulsed-field ablation delivered via a circular catheter showed that both repetition and catheter contact led independently to deeper lesion formation. These findings indicate that endpoints for effective PFA are related more to PFA biophysics than to mere EGM attenuation.
Measuring Social Frailty: A Scoping Review of Available Scales and Tools
Authors: Montayre Jed , Kuo Kay , Leung Ka Man Carman , Zhao Ivy 
Published: August 2024

Abstract

Background and Objectives
Social frailty is an emerging concept characterized by state of vulnerability due to the lack or absence of social resources that enable health and well-being, particularly among older people. However, there is no consensus on how to accurately measure and assess social frailty, given the broad coverage of social dimensions affecting older individuals. This scoping review aimed to identify the existing tools and scales used to measure social frailty in older people.

Research Design and Methods
A scoping review methodology was employed. Articles published between January 2014 and April 2024 were searched in 6 electronic databases: PubMed, PsycINFO, ProQuest, Scopus, SocIndex, and CINAHL. The scoping review followed a 5-stage process by Arksey and O’Malley and adhered to the guidelines provided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews.

Results
Nine social frailty tools were identified across the 58 papers included in this review. The individual question item commonly used in the scales were classified into main categories based on their conceptual characteristics and intentions. The most common individual questionnaire constructs used to measure social frailty included financial status, social resources, social behaviors and activities, and sense of purpose. The reviewed tools varied in terms of their robustness and the process of scale development.

Discussion and Implications
Our review suggested the development of a standardized, psychometrically tested, and accurate screening tool to screen social frailty status. An accurate social frailty assessment can inform the development of useful interventions, which also has implications in preventing the development of physical frailty.
Beyond the needle: a qualitative exploration of Sierra Leonean healthcare workers’ post COVID-19 vaccination experiences
Authors: David Ifeolu , Tefera Gashaye Melaku , Majee Wilson 
Published: August 2024

Abstract
The global health crisis precipitated by the COVID-19 pandemic underscored the necessity of swift vaccine development and distribution to curb virus transmission. However, discussions on vaccine acceptance and hesitancy have predominantly focused on pre-vaccination attitudes, often overlooking the significance of post-vaccination experiences in shaping individual and communal attitudes toward vaccines. This oversight is particularly critical among healthcare workers in low- and middle-income countries (LMICs), who play a dual role in combating the pandemic and influencing public vaccine sentiment. Using the theory of planned behavior, this study explores the post-vaccination experiences of healthcare workers in Sierra Leone and assesses how these experiences influence their attitudes toward vaccine safety, efficacy and their advocacy for vaccine uptake within their communities. Employing a qualitative design, the study interviewed 24 healthcare workers, 21 of whom were vaccinated against COVID-19. Semi-structured interviews, conducted in English or Krio, were audio recorded, transcribed verbatim and analyzed using thematic analysis to identify key themes. Three themes were identified: positive vaccination experiences exceeding initial expectations, strong belief in the vaccine’s protective benefits and active roles in vaccine advocacy. Despite initial hesitations due to concerns over potential adverse effects, participants reported no significant issues post-vaccination, fostering trust in vaccine safety and effectiveness. Healthcare workers’ positive post-vaccination experiences significantly bolster their vaccine advocacy, influencing their recommendations to patients, friends, families, colleagues and community members. This study highlights the importance of understanding and leveraging healthcare workers’ experiences to enhance public trust and vaccine uptake, crucial for pandemic response efforts in LMICs.