bluuebunny/crossref_metadata_2025_split huggingface dataset:
Satisfação com os cuidados de enfermagem de reabilitação da pessoa submetida a transplante cardíaco
Authors: Loureiro Maria , Duarte João , Azevedo Paulo , Coutinho Gonçalo , Martins Maria Manuela , Novo André 
Published: July 2024

Introdução: A satisfação do cliente é hoje um indicador da qualidade assistencial, influenciada por múltiplos fatores, entre os quais o exercício dos profissionais de saúde. A pessoa transplantada ao coração vivencia um processo complexo de transição em que o enfermeiro de reabilitação é agente ativo e diferenciado de facilitação do mesmo, sendo a satisfação destes cuidados foco importante de mensuração. Assim, pretende-se conhecer o nível de satisfação com os cuidados de enfermagem de reabilitação das pessoas transplantadas ao coração em fase 1 de reabilitação cardíaca.
Metodologia: Estudo descritivo, com amostra não probabilística por conveniência. Aplicado Questionário, QSEnf – 10 e caracterização demográfica, à data de alta da unidade de transplante cardíaco.
Resultados: 21 transplantados ao coração respondentes,71,43% homens e 28,57% mulheres, com idade 50,71(±11,68) anos e 16(±6,53) dias de internamento. A satisfação global média foi de 38,3, correspondendo a níveis de elevada satisfação. Como aspeto de maior nível de satisfação “Relações interpessoais relativamente a si” e o de menor “Tempo que o EEER lhe dedicou”.
Discussão: Os doentes transplantados ao coração em fase 1 de reabilitação cardíaca, demonstram elevados níveis de satisfação com os cuidados de enfermagem de reabilitação, contudo o tempo de intervenção é um aspeto que pode traduzir a necessidade de reajuste das dotações de especialistas ou o desenvolvimento de outras modalidades de intervenção que possam melhorar este aspeto. O facto de existir pouca evidência produzida na área dificulta comparações.
Conclusão: A avaliação da satisfação dos cuidados de enfermagem de reabilitação permite uma reflexão e melhoria da qualidade assistencial, devendo ser alargada a diferentes contextos de cuidados.
Importancia de la capacitación en lo toma adecuada del tamizaje metabólico neonatal por parte del personal de enfermería
Authors: Lozano Borja Ana Milena , Gaibor Chávez Juan Alberto 
Published: July 2024

Introducción: la capacitación, entrenamiento y especialización son aspectos inherentes a la profesión de enfermería, considerando los cambios científicos y tecnológicos que se dan de manera vertiginosa en las ciencias de la salud. Objetivo: evaluar el programa de capacitación a los profesionales de enfermería sobre la adecuada toma de la muestra de tamizaje metabólico neonatal. El grupo de estudio fueron 22 profesionales de enfermería de los centros de salud de la zona urbana de Tulcán. Metodología: se aplicó una encuesta validada por expertos de salud, donde se evaluaron 3 criterios, experiencia, actualización y procedimiento. Se creó además una escala de valoración para cada uno de los tres criterios. Resultados: se evidencian la necesidad que tiene el personal de enfermería de actualizar sus conocimientos sobre el programa de Tamizaje Metabólico Neonatal implementado por el Ministerio de Salud Pública. En cuanto a la actualización de conocimientos, se señala que los profesionales parecen recibir y asimilar las actualizaciones de manera más homogénea, lo cual podría ser resultado de programas de educación continua bien implementados o políticas regulares que promueven la actualización profesional. Conclusiones: un equilibrio entre la personalización y la estandarización es crucial para optimizar la calidad y la eficiencia de los servicios de salud proporcionados. Área de estudio general: Salud. Área de estudio específica: Enfermería. Tipo de estudio: Artículo original
Stroke metric changes pre- vs. postroutine anesthesiologist involvement for endovascular treatment of acute ischemic stroke
Authors: Rall Natalie , Orr Walter N. , Nazir Niaman , Giron Grace , Plaza Erin 
Published: July 2024

BackgroundTiming of endovascular treatment (EVT) for acute ischemic stroke (AIS) is important for achieving improved patient outcomes. Studies have evaluated how the type of anesthesia administered may impact the timing of EVT for AIS and patient outcomes, but there is limited data regarding how the presence of an anesthesia team can influence these metrics. Against this background, this study aims to compare time metrics and patient outcomes pre- vs. postroutine involvement of a dedicated anesthesia team dealing with EVT cases.MethodsAll patients at our institution who were between 18 and 100 years of age and evaluated for stroke and determined to be candidates for EVT during the period between November 2018 and November 2020 were considered for this study. Time metrics associated with EVT, which are commonly tracked by stroke centers, were compared pre- vs. postroutine involvement of a dedicated anesthesia team dealing with EVT cases. Secondary outcomes were a modified Rankin scale at time of discharge, an NIH Stroke Scale score at time of presentation and discharge, and incidence of intraprocedural hypotension.ResultsA total of 255 patients were included. A comparison of pre- (n = 119) vs. postneuroanesthesia team involvement (n = 136) in EVT for AIS revealed a statistically significant decrease in median time from puncture to TICI score &gt;2b in the in-house group from 49.00 min preinvolvement to 23.00 min postinvolvement (P = 0.02) and puncture to TICI &gt;2b (39.5 vs. 34 min, P = 0.01) for all patient categories when controlling for anesthesia type. The rate of incidence of intraprocedural hypotension (mean arterial pressure &lt; 65 mmHg) also decreased significantly from 79% to 44% (P = 0.04), although it was not significant when controlling for anesthesia type (P = 0.05).ConclusionsRoutine involvement of a dedicated anesthesia team for EVT in patients with AIS could potentially improve stroke metrics and patient outcomes, although more studies are necessary to validate this model of care.
Oleate alters the immune response in non-small cell lung adenocarcinoma through regulation of HMGB1 release
Authors: Cole-Skinner Breanna , Andre Nicole M. , Blankenheim Zachary , Root Kate M. , Jafri Kisa , Simmons Glenn E. 
Published: July 2024

Background: Cancer cell evasion of the immune response is critical to cancer development and metastases. Clinicians' ability to kickstart the immune system to target these rogue cells is an ever-growing area of research and medicine. This study delved into the relationship between lipid metabolism, High Mobility Group Box 1 protein (HMGB1)–a pro-inflammatory damage-associated molecular pattern protein–and immune regulation within non-small cell lung adenocarcinoma (NSCLC).Method: To address this question, we used a combination of proteomics, molecular biology, and bioinformatic techniques to investigate the relationship between fatty acids and immune signals within NSCLC.Results: We found that the expression of stearoyl CoA desaturase 1 (SCD1) was decreased in NSCLC tumors compared to normal tissues. This emphasized the critical role of lipid metabolism in tumor progression. Interestingly, monounsaturated fatty acid (MUFA) availability affected the expression of programmed death ligand-1 (PD-L1), a pivotal immune checkpoint target in lung cancer cells and immune cells, as well as HMGB1, suggesting a novel approach to modulating the immune response. This study uncovered a complex interplay between SCD1, PD-L1, and HMGB1, influencing the immunological sensitivity of tumors.Conclusion: Our work underscores the critical importance of understanding the intricate relationships between lipid metabolism and immune modulation to develop more effective NSCLC treatments and personalized therapies. As we continue to explore these connections, we hope to contribute significantly to the ever-evolving field of cancer research, improving patient outcomes and advancing precision medicine in NSCLC.
Generalising electrocardiogram detection and delineation: training convolutional neural networks with synthetic data augmentation
Authors: Jimenez-Perez Guillermo , Acosta Juan , Alcaine Alejandro , Camara Oscar 
Published: July 2024

IntroductionExtracting beat-by-beat information from electrocardiograms (ECGs) is crucial for various downstream diagnostic tasks that rely on ECG-based measurements. However, these measurements can be expensive and time-consuming to produce, especially for long-term recordings. Traditional ECG detection and delineation methods, relying on classical signal processing algorithms such as those based on wavelet transforms, produce high-quality delineations but struggle to generalise to diverse ECG patterns. Machine learning (ML) techniques based on deep learning algorithms have emerged as promising alternatives, capable of achieving similar performance without handcrafted features or thresholds. However, supervised ML techniques require large annotated datasets for training, and existing datasets for ECG detection/delineation are limited in size and the range of pathological conditions they represent.MethodsThis article addresses this challenge by introducing two key innovations. First, we develop a synthetic data generation scheme that probabilistically constructs unseen ECG traces from “pools” of fundamental segments extracted from existing databases. A set of rules guides the arrangement of these segments into coherent synthetic traces, while expert domain knowledge ensures the realism of the generated traces, increasing the input variability for training the model. Second, we propose two novel segmentation-based loss functions that encourage the accurate prediction of the number of independent ECG structures and promote tighter segmentation boundaries by focusing on a reduced number of samples.ResultsThe proposed approach achieves remarkable performance, with a F1-score of 99.38% and delineation errors of 2.19±17.73 ms and 4.45±18.32 ms for ECG segment onsets and offsets across the P, QRS, and T waves. These results, aggregated from three diverse freely available databases (QT, LU, and Zhejiang), surpass current state-of-the-art detection and delineation approaches.DiscussionNotably, the model demonstrated exceptional performance despite variations in lead configurations, sampling frequencies, and represented pathophysiology mechanisms, underscoring its robust generalisation capabilities. Real-world examples, featuring clinical data with various pathologies, illustrate the potential of our approach to streamline ECG analysis across different medical settings, fostered by releasing the codes as open source.
Association between thyroid autoimmunity and antinuclear antibody prevalence among pregnant women: a cross-sectional study in Qingdao, China
Authors: Wu Mingran , Wan Yanzhen , Zhao Lin , Kang Shan , Hao Guiliang , Guo Mingzhen , Wang Shuai , Dong Jianhong , Song Jinlian 
Published: July 2024

ObjectiveTo identify the relationship between thyroid autoimmunity and antinuclear antibody (ANA) prevalence in Chinese pregnant women.MethodsThe study involved 1923 first-trimester women who were measured for thyroid stimulating hormone (TSH) level, thyroid autoantibodies (thyroperoxidase antibody [TPOAb] and thyroglobulin antibody [TgAb]) and ANA titer. Social demographic data were collected through standardized questionnaires.ResultsIn this study, 23.3% of pregnant women tested positive for TPOAb and 9.9% tested positive for TgAb. Women with a positive ANA were more likely to be TPOAb-positive or TgAb-positive than women with a negative ANA (adjusted odds ratio [AOR] 1.96, 95% confidence interval [CI] 1.47–2.62 for TPOAb [+]; AOR 3.12, 95% CI 2.18–4.48 for TgAb[+]). In addition, ANA titers were closely associated with thyroid autoimmunity. Women with an ANA titer of &gt;1:320 had a significant higher risk of being TPOAb positive or TgAb positive (AOR 4.49, 95% CI 1.48–13.66 for TPOAb [+]; AOR 5.51, 95% CI 1.65–18.49 for TgAb [+]). The higher the ANA titer, the greater the risk of developing thyroid autoimmunity, especially for those with a high ANA titer.ConclusionsANA positivity is strongly correlated with thyroid autoimmunity. Further study is warranted to clarify the causal relationship between thyroid autoimmunity and ANA in pregnant women.This research is essential to evaluate and predict the risk of co-existing autoimmune disorders,leading to improved care for pregnancy and neonatal health.
Remnant cholesterol and all-cause mortality risk: findings from the National Health and Nutrition Examination Survey, 2003-2015
Authors: Bai Muhan , Liao Jiangquan , Wang Yan , Liang Mengqi , Wang Chuan , Zhang Jie , Shao Mingjing 
Published: July 2024

AimsCholesterol carried in triglyceride-rich lipoproteins, also called remnant cholesterol, is increasingly acknowledged as an important causal risk factor for atherosclerosis. Elevated remnant cholesterol, marked by elevated plasma triglycerides, is associated causally with an increased risk of atherosclerotic cardiovascular disease. However, the association with all-cause mortality and cause-specific mortality is inconclusive. This study aimed to test the hypothesis that remnant cholesterol levels and plasma triglycerides are associated with increased all-cause mortality and mortality from cardiovascular disease, cancer, and other causes.Methods and resultsUsing a contemporary population-based cohort, 7,962 individuals from the National Health and Nutrition Examination Survey (NHANES) aged over 40 years at baseline in 2003–2015 were included. During up to 109.2 (± 1.44) months of follow-up, 1,323 individuals died: 385 individuals died from cardiovascular disease, 290 from cancer, 80 from cerebrovascular disease, and 568 from other causes. Compared with the middle tertile remnant cholesterol level, multivariable-adjusted mortality hazard ratios were 1.20 (95% confidence interval 1.02–1.40) for all-cause mortality. For the highest tertile remnant cholesterol level, multivariable-adjusted mortality hazard ratios were 1.21 (95% confidence interval 1.05,1.40). Our conclusions remained stable in subgroup analyses. Exploratory analysis of the cause of death subcategories showed corresponding hazard ratios of 1.25 (1.13–1.38) for Non-cardiovascular and Non-cerebrovascular Death for lower remnant cholesterol individuals, 1.47 (1.01–2.15) for cancer death for lower remnant cholesterol (RC) individuals, and 1.80 (1.36–2.38) for cancer death for higher RC individuals.ConclusionRC levels were associated with U-shaped all-cause mortality. RC was associated with mortality from non-cardiovascular, non-cerebrovascular, and cancer, but not from cardiovascular causes. This novel finding should be confirmed in other cohorts.
Balancing productivity and carbon emissions: the potential for carbon reduction in wheat fertilization practices in China
Authors: Qi Li , Li Yanan 
Published: July 2024

The irrational application of chemical fertilizers in wheat cultivation not only threatens the agricultural ecosystem but also significantly contributes to carbon emissions, impeding the achievement of “carbon peaking” and “carbon neutrality” goals. The objective of this research is to assess the efficiency of chemical fertilizer use in wheat production across ten major wheat-producing provinces in China from 2004 to 2020. We employed a stochastic frontier production function to evaluate the technical efficiency of fertilizer use, determining feasible reduction levels. The Gini coefficient, kernel density estimation, and Markov chain analysis were further utilized to dissect the spatio-temporal dynamics of carbon emission reduction potential. Our findings provide a detailed analysis of the carbon emission reduction potential in wheat chemical fertilizer use across China’s ten major wheat-producing provinces from 2004 to 2020. The average carbon emission reduction potential is significant, at 251.1 kg CE/hm2, with considerable variation observed among regions. The western region, in particular, stands out with the highest potential, reaching up to 336.51 kg CE/hm2, which is notably higher compared to the eastern (230.05 kg CE/hm2) and central regions (158.28 kg CE/hm2). The spatial distribution of this potential is uneven, and the disparities are progressively increasing, primarily due to inter-regional differences. Despite a general decline in carbon reduction potential, the spatial distribution remains relatively consistent. To foster sustainable wheat production, it is imperative to prioritize the western region for targeted chemical fertilizer carbon reduction initiatives. Attention must also be given to the issue of regional disparities in low-carbon wheat production. Enhancing the role of soil testing and fertilizer recommendations is essential to increase the effectiveness of carbon reduction efforts. Additionally, a multi-faceted approach that incorporates various alternative measures is necessary to drive further reductions in chemical fertilizer-related carbon emissions.
Expression of a stress-inducible heme oxygenase-1 in NK cells is maintained in the process of human aging
Authors: Kaszubowska Lucyna , Kaczor Jan Jacek , Karnia Mateusz Jakub , Foerster Jerzy , Kmieć Zbigniew 
Published: July 2024

IntroductionHeme oxygenase-1 (HO-1) is a stress-inducible heat shock protein (HSP32) that exerts cytoprotective effects against oxidative stress and inflammation, and is involved in the maintenance of cellular homeostasis. This study aimed to evaluate the expression of HO-1 in natural killer (NK) cells from individuals of different age groups after stimulation with various factors, and to analyze the relationships between the concentration of this cytoprotective protein and parameters corresponding to oxidative stress and inflammation, that is, NOD-like receptor protein 3 (NLRP3), glutathione (GSH), GSH disulfide (GSSG), and interleukin 6 (IL-6).MethodsThe study population comprised three age groups: young adults (age range, 19–23 years), older adults aged under 85 years (age range, 73–84 years), and older adults aged over 85 years (age range, 85–92 years). NLRP3, GSH, and GSSG concentrations were measured in serum, whereas the HO-1 concentration and IL-6 expression were studied in NK cells cultivated for 48 h and stimulated with IL-2, lipopolysaccharide (LPS), or phorbol 12-myristate 13-acetate (PMA) with ionomycin.ResultsThe analysis of serum NLRP3, GSH, and GSSG concentrations revealed no statistically significant differences among the studied age groups. However, some typical trends of aging were observed, such as a decrease in GSH concentration and an increase in both GSSG level, and GSSG/GSH ratio. The highest basal expression of IL-6 and lowest basal content of HO-1 were found in NK cells of adults over 85 years of age. The NK cells in this age group also showed the highest sensitivity to stimulation with the applied factors. Moreover, statistically significant negative correlations were observed between HO-1 and IL-6 expression levels in the studied NK cells.ConclusionsThese results showed that NK cells can express HO-1 at a basal level, which was significantly increased in activated cells, even in the oldest group of adults. The reciprocal relationship between HO-1 and IL-6 expression suggests a negative feedback loop between these parameters.
PSGL-1, ADAM8, and selectins as potential biomarkers in the diagnostic process of systemic lupus erythematosus and systemic sclerosis: an observational study
Authors: San Antonio Esther , Silván Javier , Sevilla-Montero Javier , González-Sánchez Elena , Muñoz-Callejas Antonio , Sánchez-Abad Inés , Ramos-Manzano Alejandra , Muñoz-Calleja Cecilia , González-Álvaro Isidoro , Tomero Eva G. , García-Pérez Javier , García-Vicuña Rosario , Vicente-Rabaneda Esther F. , Castañeda Santos , Urzainqui Ana 
Published: July 2024

BackgroundEarly diagnosis and treatment of Systemic lupus erythematosus (SLE) and Systemic sclerosis (SSc) present significant challenges for clinicians. Although various studies have observed changes in serum levels of selectins between healthy donors and patients with autoimmune diseases, including SLE and SSc, their potential as biomarkers has not been thoroughly explored. We aimed to investigate serum profiles of PSGL-1 (sPSGL-1), ADAM8 (sADAM8) and P-, E- and L-selectins (sP-, sE- and sL-selectins) in defined SLE and SSc patient cohorts to identify disease-associated molecular patterns.MethodsWe collected blood samples from 64 SLE patients, 58 SSc patients, and 81 healthy donors (HD). Levels of sPSGL-1, sADAM8 and selectins were analyzed by ELISA and leukocyte membrane expression of L-selectin and ADAM8 by flow cytometry.ResultsCompared to HD, SLE and SSc patients exhibited elevated sE-selectin and reduced sL-selectin levels. Additionally, SLE patients exhibited elevated sPSGL-1 and sADAM8 levels. Compared to SSc, SLE patients had decreased sL-selectin and increased sADAM8 levels. Furthermore, L-selectin membrane expression was lower in SLE and SSc leukocytes than in HD leukocytes, and ADAM8 membrane expression was lower in SLE neutrophils compared to SSc neutrophils. These alterations associated with some clinical characteristics of each disease. Using logistic regression analysis, the sL-selectin/sADAM8 ratio in SLE, and a combination of sL-selectin/sE-selectin and sE-selectin/sPSGL-1 ratios in SSc were identified and cross-validated as potential serum markers to discriminate these patients from HD. Compared to available diagnostic biomarkers for each disease, both sL-selectin/sADAM8 ratio for SLE and combined ratios for SSc provided higher sensitivity (98% SLE and and 67% SSc correctly classified patients). Importantly, the sADAM8/% ADAM8(+) neutrophils ratio discriminated between SSc and SLE patients with the same sensitivity and specificity than current disease-specific biomarkers.ConclusionSLE and SSc present specific profiles of sPSGL-1, sE-, sL-selectins, sADAM8 and neutrophil membrane expression which are potentially relevant to their pathogenesis and might aid in their early diagnosis.