bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of once-daily versus multiple-daily dosing of gentamicin on the incidence of acute kidney injury in patients treated with synergistic combinations of antibiotics
Authors: Sugiyama Kyohei , Hirai Keita , Suyama Yukako , Tsutsumi Masato 
Published: July 2024

Abstract
Background
Gentamicin is a commonly used antibiotic with synergistic effects that is administered once or multiple times daily. However, the influence of the daily administration frequency on renal function has not yet been identified. This study aimed to investigate the effect of the daily dosing frequency on worsening renal function in patients receiving gentamicin.

Methods
This study included 35 patients undergoing gentamicin treatment who had at least one serum trough level measured and underwent therapeutic drug monitoring (TDM). We evaluated the influence of daily dosing frequency on gentamicin trough concentration and the risk of acute kidney injury (AKI).

Results
Compared to patients who received gentamicin once-daily dosing (n = 22), patients who received multiple-daily dosing (n = 13) had significantly higher initial and minimum trough concentrations after TDM. The proportion of patients with trough concentrations lower than 1.0 µg/mL was significantly higher in the once-daily dosing group at the initial trough concentration, whereas there was no significant difference at the minimum trough concentration after TDM. AKI developed in nine patients; however, there was no significant difference in the incidence of AKI according to the frequency of daily gentamicin dosing. In contrast, a higher minimum trough concentration after TDM was found to be a risk factor for AKI development with an odds ratio of 9.2 (95% confidence intervals; 1.3–65.5).

Conclusion
A higher trough concentration of gentamicin correlated with a higher incidence of AKI. The risk of developing AKI may be reduced by choosing a once-daily dosing regimen or implementing TDM.
A multidisciplinary group-based survivorship intervention for those living with multiple myeloma: a feasibility study
Authors: Eilert Nora , Murphy Norma-Jean , Cummins Hannah , Houlihan Emma , Krawczyk Janusz 
Published: July 2024

Abstract
Background
While multiple myeloma continues to be an incurable cancer, advances in its understanding and management have led to significantly improved survival rates. Survivorship interventions for those living with multiple myeloma remain scarce, despite mounting evidence for multiple unmet support needs among multiple myeloma survivors. The current study aimed to evaluate the feasibility and preliminary effectiveness of a novel multidisciplinary group-based multiple myeloma survivorship intervention.

Methods
A mixed-method, repeated measures feasibility study was conducted within a routine cancer support service. Seven participants, aged over 18, who had a multiple myeloma diagnosis and were clinically assessed as suitable for the intervention by their haemato-oncologist, attended online for six weekly group sessions of physical exercise and self-management input, completing qualitative, physical and self-report measures at baseline, post-intervention and follow-up.

Results
The intervention was deemed overall feasible, with relatively high uptake, participants describing it as largely acceptable and appropriate and providing recommendations for feasibility-enhancing intervention refinements. Findings regarding the preliminary effectiveness of the intervention were mixed. While qualitative analyses stressed the benefits of the intervention (e.g. peer support, connectedness, improved well-being) and large effect sizes were observed for most physical outcomes, no improvements in self-reported outcomes (i.e. quality of life, fatigue) were reported.

Conclusions
This study represents the first investigation of a promising novel survivorship intervention for those living with multiple myeloma, highlighting the importance of peer support in particular, on which future clinical trials, aiming to establish the intervention’s effectiveness for routine care, will be able to build.
Scanning electron microscopy and morphometric analysis of the hair in dromedaries with SEM-EDX in relation to age
Authors: Alsafy Mohamed A.M. , El-Gendy Samir A.A. , Derbalah Amira , Rashwan Ahmed M. , Haddad Seham S. 
Published: July 2024

Abstract
Background
Hair characterization is critical for determining animal individuality throughout life. This study aimed to assess the morphological features of dromedary camel hair in relation to age.

Materials and methods
Hair samples were obtained from the camel humps of 30 dromedary camels separated into three groups: G1 (n:10) aged one-year, G2 (n:10) aged 3–5 years, and G3 (n:10) at the age of 8–10 years. The hair was examined using light microscopy, SEM, and SEM-EDX.

Results
The Maghrebi camel had varied medulla patterns and structures across the ages. In the G1 group 75% had continuous medulla patterns and amorphous medulla structures, compared to 70% in G2, and 90% in G3. The medulla index increased with age, rising from 0.3 to 0.77%. The shaft width grew in size from G1 to G2, then fell to approximately one-third of the G2 size at G3. The cortex and cuticle widths were also determined by age, and they increased in the G1 compared to G3 camels. The shape of the cuticle scales in G1 camels was wavy, like mountain tops with irregular edges, within G2 camels the scales were particularly long, oval-shaped scales with smooth, wavy borders. The scales of the older G3 camels were quite long and rectangular. SEM-EDX spectra recognized carbon, oxygen, nitrogen, sulfur, calcium, aluminum, silicon, and potassium at the medulla and cortex. Sulfur levels were highest in the G2 samples but lowest in the G1 samples.

Conclusion
The dromedary camel’s hair structure and mineral content, particularly carbon and nitrogen, differed as camels aged.
Therapeutic modalities for iatrogenic late paresthesia in oral tissues innervated by mandibular branch of trigeminal nerve: a systematic review
Authors: Keykha Elham , Tahmasebi Elahe , Hadilou Mahdi 
Published: July 2024

Abstract

Background
The present systematic review intended to evaluate the current evidence on the modalities used for treating iatrogenic late paresthesia in the oral tissues innervated by the mandibular branch of the trigeminal nerve.

Main text
As a common side effect of dental procedures, paresthesia can exert a profound adverse effect on patients’ quality of life. The inferior alveolar nerve (IAN) and lingual nerve (LN) have the highest chance of injury during several dental procedures, including mandibular orthognathic surgeries, implant placement, extraction of the third molar, anesthetic injections, flap elevation, and endodontic treatments. Moreover, several methods have been proposed for treating iatrogenic late paresthesia, including photobiomodulation (PBM), microsurgery, medication, and close observation until achieving spontaneous recovery of sensation. However, no gold standard treatment for iatrogenic paresthesia has been agreed upon up to now. The present study included a comprehensive search of the databases of PubMed, Embase, Scopus, and Web of Science up to December 04, 2023, resulting in a total of 3122 related studies. Then, the titles, abstracts, and full texts of the studies were evaluated. Ultimately, seven controlled randomized trials (RCTs) were included in the final analysis. Also, the risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. Among all fields, randomization, allocation concealment, and data analysis were found to have the highest chance of bias in the included studies.

Conclusions
In conclusion, PBM, vitamin B12, and corticosteroids could accelerate the recovery of late paresthesia. However, considering the low sample size of the included studies and the high risk of methodological bias, it is recommended to perform further RCTs with robust study designs following Good Clinical Practice (GCP) guidelines to achieve more reliable results.
Cardiovascular events in CML patients treated with Nilotinib: validation of the HFA-ICOS baseline risk score
Authors: Fernando Fiona , Andres Maria Sol , Claudiani Simone , Kermani Nazanin Zounemat , Ceccarelli Giulia , Innes Andrew J. , Khan Afzal , Rosen Stuart D. , Apperley Jane F. , Lyon Alexander R. , Milojkovic Dragana 
Published: July 2024

Abstract
Background
The therapeutic landscape of chronic myeloid leukaemia (CML) has been transformed by tyrosine kinase inhibitors (TKI). Nilotinib, showed higher rates of major molecular response than imatinib, however associated with higher cardiovascular (CV) toxicity. We sought to describe the CV events associated with nilotinib in a real-world population and assess the predictive value of the HFA-ICOS risk score.

Methods
The HFA-ICOS baseline risk was calculated for patients with CML treated with nilotinib beween 2006 and 2021. The primary end point was the incidence of all CV events. The secondary end point was the incidence of ischaemic events. Survival analysis evaluated the risk (hazard ratio [HR]) of events stratified by baseline risk category, whilst on nilotinib therapy.

Results
Two hundred and twenty-nine eligible patients were included. The incidence of CV events was 20.9% (95% CI: 15.7–26.2%) following a median duration of treatment of 34.4 months. The secondary end point occurred in 12.7% (95% CI: 8.4–16.9%) of the population. Patients with higher HFA-ICOS baseline score had higher rates of CV events (low: 11.2%, medium: 28.2% [HR: 2.51, 95% CI: 1.17–5.66], high/very high: 32.4% [HR: 3.57, 95% CI: 1.77–7.20]) and ischaemic events (low: 5.20%, medium: 17.9% [HR: 2.19, 95% CI: 0.97–4.96], high/very high: 21.6% [HR: 3.9, 95% CI: 1.91–7.89]). In patients who did not have a CV event, the median total dose at last follow up or cessation of nilotinib therapy was lower when compared to the total daily median dose of nilotinib in patients who had a CV event (450 mg vs. 600 mg, p = 0.0074).

Conclusions
The HFA-ICOS risk stratification tool is an efficient discriminator at low, medium and high/very high risk of developing cardiovascular events, with an overall positive trend towards increasing cardiotoxicity rates with rising risk catergories. This study provides evidence to support the use of this predictive tool in nilotinib treated patients.
Adaptation and validation for use in Brazil of the Confusion, Hubbub, and Order Scale (CHAOS)
Authors: de Espindola Marilia Ignácio , Pires Maria Laura Nogueira , Rafihi-Ferreira Renatha El , Noto Ana Regina , Pompéia Sabine 
Published: July 2024

Abstract
Background
The Confusion, Hubbub, and Order Scale (CHAOS in English Version) was originally developed in the USA by Matheny et al (Bringing order out of chaos: psychometric characteristics of the confusion, hubbub, and order scale. Journal of Applied Developmental Psychology 16(3):429–444, 1995) to measure chaos in the family environment, characterized by confusion, lack of routine, and organization.

Objective
To present evidence of content validity, internal structure validity, and validity based on relationships with external measures of an adapted version of the CHAOS into Brasilian Portuguese with adolescents sample in São Paulo - Brasil.

Method
Study 1 involved the translation/back-translation and adaptation of the scale into Brazilian Portuguese [here named “Escala de Confusão, Alvoroço e Ordem no Sistema familiar” (CAOS)], assessed by 5 judges. In Study 2, we conducted an exploratory factor analyses (EFA) to determine the scale’s factor structure (N = 180 adults). In Study 3, we carried out confirmatory factor analyses (CFA) to confirm the internal validity of the scale, along with complete structural equation modeling to explore convergent validity in another sample (N = 239 adolescents).

Results
The CAOS scale displayed content validity, and the EFA and CFA showed a unifactorial structure (with some scale adjustments) with an acceptable fit. The family chaos latent factor was associated with externalizing symptoms and perceived stress in adolescents.

Conclusion
Overall, the Brazilian version of the scale presented evidence of construct, internal, and concurrent validity that indicate its usefulness in Brazil.
Improving hypertension control in Nigeria: early policy implications from the Hypertension Treatment in Nigeria program
Authors: Ogungbe Oluwabunmi , Abasilim Chibuzor , Huffman Mark D. , Ojji Dike ,   Hypertension Treatment in Nigeria Program Team
Published: July 2024

AbstractHypertension poses a significant health burden globally. In Nigeria, hypertension prevalence is on the rise, with low rates of awareness, treatment, and control. This policy brief explores the critical gaps addressed by the Hypertension Treatment in Nigeria (HTN) Program, highlighting its strengths, initial outcomes, and scalability in primary care settings. The HTN Program employs an integrated, multilevel care model based on the World Health Organization’s HEARTS technical package, including patient registration and empanelment, team-based care, training and supervision, a standardized treatment protocol, a health information management system, and a drug revolving fund to improve medication accessibility. By December 2023, hypertension treatment and control rates reached surpassing 90% and 50%, respectively, thus underscoring the program’s impact. The HTN Program serves as a model for delivering integrated hypertension care in primary care. Results should be leveraged for political commitment and financing to evaluate and manage non-communicable diseases such as hypertension in primary care through federal and state primary health development agencies. Furthermore, incorporating metrics related to hypertension control and treatment into the Integrated Supportive Management Information System can enhance routine monitoring and evaluation.
Protocol for the development and validation of a Polypharmacy Assessment Score
Authors: Tsang Jung Yin , Sperrin Matthew , Blakeman Thomas , Payne Rupert A. , Ashcroft Darren M. 
Published: July 2024

Abstract
Background
An increasing number of people are using multiple medications each day, named polypharmacy. This is driven by an ageing population, increasing multimorbidity, and single disease-focussed guidelines. Medications carry obvious benefits, yet polypharmacy is also linked to adverse consequences including adverse drug events, drug-drug and drug-disease interactions, poor patient experience and wasted resources. Problematic polypharmacy is ‘the prescribing of multiple medicines inappropriately, or where the intended benefits are not realised’. Identifying people with problematic polypharmacy is complex, as multiple medicines can be suitable for people with several chronic conditions requiring more treatment. Hence, polypharmacy is often potentially problematic, rather than always inappropriate, dependent on clinical context and individual benefit vs risk. There is a need to improve how we identify and evaluate these patients by extending beyond simple counts of medicines to include individual factors and long-term conditions.

Aim
To produce a Polypharmacy Assessment Score to identify a population with unusual levels of prescribing who may be at risk of potentially problematic polypharmacy.

Methods
Analyses will be performed in three parts:
1. A prediction model will be constructed using observed medications count as the dependent variable, with age, gender and long-term conditions as independent variables. A ‘Polypharmacy Assessment Score’ will then be constructed through calculating the differences between the observed and expected count of prescribed medications, thereby highlighting people that have unexpected levels of prescribing.
Parts 2 and 3 will examine different aspects of validity of the Polypharmacy Assessment Score:
2. To assess ‘construct validity’, cross-sectional analyses will evaluate high-risk prescribing within populations defined by a range of Polypharmacy Assessment Scores, using both explicit (STOPP/START criteria) and implicit (Medication Appropriateness Index) measures of inappropriate prescribing.
3. To assess ‘predictive validity’, a retrospective cohort study will explore differences in clinical outcomes (adverse drug reactions, unplanned hospitalisation and all-cause mortality) between differing scores.

Discussion
Developing a cross-cutting measure of polypharmacy may allow healthcare professionals to prioritise and risk stratify patients with polypharmacy using unusual levels of prescribing. This would be an improvement from current approaches of either using simple cutoffs or narrow prescribing criteria.
Capturing patient-reported sleep disturbance in atopic dermatitis clinical trials
Authors: Dias-Barbosa Carla , Silverberg Jonathan I. , Ständer Sonja , Rodriguez Danielle , Fofana Fatoumata , Filipenko Dina , Ulianov Liliana , Piketty Christophe , Puelles Jorge 
Published: July 2024

Abstract
Background
Patient-focused approaches to capturing day-to-day variability in sleep disturbance are needed to properly evaluate the sleep benefits of new treatments. Such approaches rely on patient-reported outcome (PRO) measures validated in the target patient population.

Methods
Using atopic dermatitis (AD) as an example of a disease in which sleep is commonly disturbed, we developed a strategy for measuring sleep disturbance in AD trials. In developing this strategy, we conducted a targeted literature review and held concept elicitation interviews with adolescents and adults with AD. We subsequently identified potentially suitable PRO measures and cognitively debriefed them. Finally, we evaluated their psychometric properties using data from phase 2b (NCT03100344) and phase 3 (NCT03985943 and NCT03989349) clinical trials.

Results
The literature review confirmed that sleep disturbance is a key impact of AD but failed to identify validated PRO measures for assessing fluctuations in sleep disturbance. Subsequent concept elicitation interviews confirmed the multidimensional nature of sleep disturbance in AD and supported use of a single-item measure to assess overall sleep disturbance severity, complemented by a diary to capture individual components of sleep disturbance. The single-item sleep disturbance numerical rating scale (SD NRS) and multi-item Subject Sleep Diary (SSD)—an AD-adapted version of the Consensus Sleep Diary—were identified as potentially suitable PRO measures. Cognitive debriefing of the SD NRS and SSD demonstrated their content validity and their understandability to patients. Psychometric analyses based on AD trial data showed that the SD NRS is a well-defined, reliable, and fit-for-purpose measure of sleep disturbance in adults with AD. Furthermore, the SD NRS correlated with many SSD sleep parameters, suggesting that most concepts from the SSD can be covered using the SD NRS.

Conclusions
Using these findings, we developed an approach for measuring sleep disturbance in AD trials. Subject to further research, the same approach could also be applied to future trials of other skin diseases where itch causes sleep disturbance.
Deep transfer learning for detection of breast arterial calcifications on mammograms: a comparative study
Authors: Mobini Nazanin , Capra Davide , Colarieti Anna , Zanardo Moreno , Baselli Giuseppe , Sardanelli Francesco 
Published: July 2024

Abstract
Introduction
Breast arterial calcifications (BAC) are common incidental findings on routine mammograms, which have been suggested as a sex-specific biomarker of cardiovascular disease (CVD) risk. Previous work showed the efficacy of a pretrained convolutional network (CNN), VCG16, for automatic BAC detection. In this study, we further tested the method by a comparative analysis with other ten CNNs.

Material and methods
Four-view standard mammography exams from 1,493 women were included in this retrospective study and labeled as BAC or non-BAC by experts. The comparative study was conducted using eleven pretrained convolutional networks (CNNs) with varying depths from five architectures including Xception, VGG, ResNetV2, MobileNet, and DenseNet, fine-tuned for the binary BAC classification task. Performance evaluation involved area under the receiver operating characteristics curve (AUC-ROC) analysis, F1-score (harmonic mean of precision and recall), and generalized gradient-weighted class activation mapping (Grad-CAM++) for visual explanations.

Results
The dataset exhibited a BAC prevalence of 194/1,493 women (13.0%) and 581/5,972 images (9.7%). Among the retrained models, VGG, MobileNet, and DenseNet demonstrated the most promising results, achieving AUC-ROCs > 0.70 in both training and independent testing subsets. In terms of testing F1-score, VGG16 ranked first, higher than MobileNet (0.51) and VGG19 (0.46). Qualitative analysis showed that the Grad-CAM++ heatmaps generated by VGG16 consistently outperformed those produced by others, offering a finer-grained and discriminative localization of calcified regions within images.

Conclusion
Deep transfer learning showed promise in automated BAC detection on mammograms, where relatively shallow networks demonstrated superior performances requiring shorter training times and reduced resources.

Relevance statement
Deep transfer learning is a promising approach to enhance reporting BAC on mammograms and facilitate developing efficient tools for cardiovascular risk stratification in women, leveraging large-scale mammographic screening programs.

Key points
• We tested different pretrained convolutional networks (CNNs) for BAC detection on mammograms.
• VGG and MobileNet demonstrated promising performances, outperforming their deeper, more complex counterparts.
• Visual explanations using Grad-CAM++ highlighted VGG16’s superior performance in localizing BAC.

Graphical Abstract
Probiotics in poultry: a comprehensive review
Authors: Halder Neha , Sunder Jai , De Arun Kumar , Bhattacharya Debasis , Joardar Siddhartha Narayan 
Published: July 2024

Abstract
Background
The increase in global population has elevated the food demand which in turn escalated the food animal production systems, especially poultry industries. For a long time, antibiotics are used worldwide to safeguard animals from diseases and for high production performances. Over usage of antibiotics has led to severe side effects such as antibiotic resistance among pathogenic bacteria, harming the beneficial bacteria in the gut, and stacking up of residuals in animal food products. It is the need of the hour to find a competent alternative to antibiotics. Probiotics have gained major attention as safe, feasible, and efficient alternatives to commercial antibiotics.

Main body
Probiotics meaning “prolife” are live, non-pathogenic microorganisms that when given in sufficient amount confer an advantage to the host health and well-being. Probiotics are reported to improve growth, production performance, immunity, and digestibility, safeguard gut microflora, and enhance egg and meat quality traits in poultry. Proper selection of probiotics strains is crucial before their commercialization. This systematic review focuses on the mechanism of action of probiotics and summarizes the potential role of different probiotics supplementation for enhancing the production and shielding the health and immunity of poultry flocks.

Conclusions
Probiotics has got a beneficial impact on the health and immunity of poultry, showing their competence as an alternative to commercial antibiotics. Modern experimental techniques are required to shed more light on the capabilities of probiotics and their usage for animal health.