bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autonomic neuropathy in dialysis patients – investigations with a new symptom score (COMPASS 31)
Authors: Schramm Catharina Verena , Schramm Michael Christoph , Trautner Markus , Hinz Michael , Mitzner Steffen 
Published: August 2024

Abstract
Background
Symptoms of autonomic neuropathy (AN) are common in patients with diabetes and advanced renal disease. As yet different domains of autonomic neuropathy cannot be detected by a singular laboratory or invasive test. COMPASS 31, a new self-assessment test, has shown reliable results not only in cardiac autonomic neuropathy but also in different sub-domains when judging manifestation of AN by scores.

Methods
One hundred eighty-three patients with or without diabetes were enrolled, one hundred nineteen of them were treated with permanent dialysis therapy (HD), sixty-four patients served as controls (eGFR > 60 ml/min.) Using COMPASS 31 different symptoms of AN were assessed (orthostatic intolerance, vasomotor, secretomotor, gastrointestinal, bladder, pupillomotor changes) and transferred into AN-scores.

Results
AN was more pronounced in dialysis patients compared with controls (AN-score 27,5 vs. 10,0; p < 0,01). These differences were present also in every sub-domain of AN (orthostatic intolerance, vasomotor, secretomotor, gastrointestinal, bladder, pupillomotor changes; p < 0,05 for all sub-domains). In diabetic patients there was a strong correlation between symptoms of AN and diabetes duration (correlation coefficient r = 0,45, p < 0,001). Current glycemic control (HbA1c), body mass index (BMI), sex, and height had no influence on AN when comparing dialysis patients and controls. C-reactive protein (CRP) showed a positive linear correlation with AN-scores (correlation coefficient r = 0,21; p < 0,05).

Conclusion
Symptoms of AN are more pronounced in dialysis patients not only in total but also in all different domains of neuropathic changes. Longlasting diabetic disease promotes development of AN, as duration of diabetes was positively correlated with AN. Future longitudinal studies might help to identify the high cardiovascular and mortality risk in dialysis patients by the easy-to-use COMPASS 31 without need of invasive and time-spending methods for diagnosing AN.
Psychological capital educational program and its effect on nurse interns’ innovative behavior
Authors: Kotb Ahmed Hussien Ahmed , Shazly Mona Mostafa , Mostafa Hemat Abdel-Azeem 
Published: August 2024

Abstract
Background
Nurse interns’ capacity for innovative behavior is a key component of healthcare settings because of increasing demands and complexities. Thus, it is important to find strategies that promote their innovative behavior. The development of psychological capital (PsyCap) improves positive behaviors and attitudes, such as engagement, motivation, and satisfaction, in the work environment. Therefore, this study aimed to assess the effect of a PsyCap educational program on nurse interns’ innovative behavior.

Methods
A quasi-experimental design was used in this study. This study was executed at Fayoum University hospitals. The study participants comprised all the available nurse interns (n = 223) registered in the internship year (2022–2023) in the aforementioned settings. The data were gathered using three instruments, namely, the PsyCap Knowledge Questionnaire, the PsyCap Questionnaire, and the Innovative Behavior Inventory.

Results
The nurse interns’ mean scores regarding total knowledge about PsyCap, total perception of PsyCap, and total perception of innovative behavior significantly improved through the posttest phase (41.27 ± 9.31, 92.22 ± 6.26, 91.31 ± 9.06, respectively) and the follow-up phase (37.83 ± 8.83, 89.96 ± 6.31, 88.89 ± 8.33) in comparison with the pretest phase (14.39 ± 5.83, 69.04 ± 8.13, 60.55 ± 7.15).

Conclusion
The PsyCap educational program was effective and beneficial for improving the nurse interns’ perceptions of innovative behavior. Therefore, PsyCap interventions should be implemented in hospitals through professional development programs and orientation programs.
Construct validity and reliability of Amharic version of DASS-21 scale among Ethiopian Defense University College of Health Science students
Authors: Tsegaye Bitew Sintayehu , Asemu Meseret Molla , Hailu Habtamu Belay 
Published: August 2024

Abstract
Background
DASS-21 is the common and widely used tool for assessing depression, anxiety and stress. However, its validity and Reliability in Ethiopian Amharic language is not assessed.

Objective
To translate the DASS-21 and assess its validity and reliability among Ethiopian Defense University college of health science students in Bishoftu, Ethiopia.

Method
An institutional based cross-sectional study was conducted using a self-administered questionnaire. A total of 435 students from different departments in accordance with their proportional size were participated in this study. As to the sampling technique, the study units were selected from each department and year of study using simple random sampling proportional to size. Confirmatory factor analyses were employed to assess the factor structure and construct validity of Amharic version of the DASS-21. Cronbach alpha coefficient and corrected item total correlation was calculated to assess the internal consistency of Amharic version of DASS-21.

Result
Among 435 undergraduate students who participated in the study, 246(56.6%) were the age of 18–25 year and majority 347(79.8%) were males. Regarding their year of study; 200 (46.0%) were first year students. Confirmatory factor analysis indicates a good model fit of the three correlated factors (Comparative fit index (CFI) = 0.92 with root mean square error of approximation (RMSEA) = 0.059[0.052–0.066] and standardize root mean residual SRMR = 0.045). The internal consistency of overall DASS-21 and each sub scale were in acceptable range (0.91, 0.82, 0.77 and 0.77) respectively.

Conclusion
Amharic version of DASS-21 was found to be a valid and reliable instrument to measure the mental problem especially, Depression, Anxiety and Stress among university students.
Spermatozoon-propelled microcellular submarines combining innate magnetic hyperthermia with derived nanotherapies for thrombolysis and ischemia mitigation
Authors: Weng Pei-Wei , Liu Chia-Hung , Jheng Pei-Ru , Chiang Chia-Che , Chen Yan-Ting , Rethi Lekshmi , Hsieh Yves S. Y. , Chuang Andrew E.-Y. 
Published: August 2024

AbstractThrombotic cardiovascular diseases are a prevalent factor contributing to both physical impairment and mortality. Thrombolysis and ischemic mitigation have emerged as leading contemporary therapeutic approaches for addressing the consequences of ischemic injury and reperfusion damage. Herein, an innovative cellular-cloaked spermatozoon-driven microcellular submarine (SPCS), comprised of multimodal motifs, was designed to integrate nano-assembly thrombolytics with an immunomodulatory ability derived from innate magnetic hyperthermia. Rheotaxis-based navigation was utilized to home to and cross the clot barrier, and finally accumulate in ischemic vascular organs, where the thrombolytic motif was “switched-on” by the action of thrombus magnetic red blood cell-driven magnetic hyperthermia. In a murine model, the SPCS system combining innate magnetic hyperthermia demonstrated the capacity to augment delivery efficacy, produce nanotherapeutic outcomes, exhibit potent thrombolytic activity, and ameliorate ischemic tissue damage. These findings underscore the multifaceted potential of our designed approach, offering both thrombolytic and ischemia-mitigating effects. Given its extended therapeutic effects and thrombus-targeting capability, this biocompatible SPCS system holds promise as an innovative therapeutic agent for enhancing efficacy and preventing risks after managing thrombosis.
Graphical abstract
CAR T cell therapy for refractory pediatric systemic lupus erythematosus: a new era of hope?
Authors: Stojkic Ivana , Harper Lauren , Coss Samantha , Kallash Mahmoud , Driest Kyla , Lamb Margaret , Ardoin Stacy P. , Akoghlanian Shoghik 
Published: August 2024

AbstractSystemic lupus erythematosus (SLE) is a chronic autoimmune condition that can affect multiple organ systems and is heterogenous in its presentation and response to therapy. When diagnosed in childhood, SLE is associated with increased morbidity and mortality compared to adult SLE, often requiring substantial immunosuppression with the risk of significant side effects. There remains a significant unmet need for new therapies that can improve disease control and reduce glucocorticoid and other toxic medication exposure for patients with severe or refractory disease. The pathogenesis of SLE involves B cell dysregulation and autoantibody production, which are a hallmark of the disease. Currently approved B cell directed therapies often result in incomplete B cell depletion and may not target long-lived plasma cells responsible for SLE autoantibodies. It is hypothesized that by persistently eliminating both B cells and plasmablasts, CAR T therapy can halt autoimmunity and prevent organ damage in patient’s refractory to current B cell-depleting treatments. Herein we summarize the current preclinical and clinical data utilizing CAR T cells for SLE and discuss the future of this treatment modality for lupus.
Transcriptional and epigenetic characterization of a new in vitro platform to model the formation of human pharyngeal endoderm
Authors: Cipriano Andrea , Colantoni Alessio , Calicchio Alessandro , Fiorentino Jonathan , Gomes Danielle , Moqri Mahdi , Parker Alexander , Rasouli Sajede , Caldwell Matthew , Briganti Francesca , Roncarolo Maria Grazia , Baldini Antonio , Weinacht Katja G. , Tartaglia Gian Gaetano , Sebastiano Vittorio 
Published: August 2024

Abstract
Background
The Pharyngeal Endoderm (PE) is an extremely relevant developmental tissue, serving as the progenitor for the esophagus, parathyroids, thyroids, lungs, and thymus. While several studies have highlighted the importance of PE cells, a detailed transcriptional and epigenetic characterization of this important developmental stage is still missing, especially in humans, due to technical and ethical constraints pertaining to its early formation.

Results
Here we fill this knowledge gap by developing an in vitro protocol for the derivation of PE-like cells from human Embryonic Stem Cells (hESCs) and by providing an integrated multi-omics characterization. Our PE-like cells robustly express PE markers and are transcriptionally homogenous and similar to in vivo mouse PE cells. In addition, we define their epigenetic landscape and dynamic changes in response to Retinoic Acid by combining ATAC-Seq and ChIP-Seq of histone modifications. The integration of multiple high-throughput datasets leads to the identification of new putative regulatory regions and to the inference of a Retinoic Acid-centered transcription factor network orchestrating the development of PE-like cells.

Conclusions
By combining hESCs differentiation with computational genomics, our work reveals the epigenetic dynamics that occur during human PE differentiation, providing a solid resource and foundation for research focused on the development of PE derivatives and the modeling of their developmental defects in genetic syndromes.
Short-term outcomes and inflammatory stress response following laparoscopy or robotic-assisted transabdominal preperitoneal inguinal hernia repair (TAPP): study protocol for a prospective, randomized trial (ROLAIS)
Authors: Valorenzos Alexandros Valsamidis , Nielsen Kristian Als , Kaiser Karsten , Helligsø Per , Ellebæk Mark Bremholm , Dorfelt Allan , Petersen Sofie Ronja , Pedersen Andreas Kristian , Nielsen Michael Festersen 
Published: August 2024

Abstract
Background
Inguinal hernia repair is a frequently performed surgical procedure, with laparoscopic repair emerging as the preferred approach due to its lower complication rate and faster recovery compared to open repair. Mesh-based tension-free repair is the gold standard for both methods. In recent years, robotic hernia repair has been introduced as an alternative to laparoscopic repair, offering advantages such as decreased postoperative pain and improved ergonomics.
This study aims to compare the short- and long-term outcomes, including the surgical stress response, postoperative complications, quality of life, and sexual function, between robotic-assisted transabdominal preperitoneal (rTAPP) and laparoscopic TAPP inguinal hernia repairs.

Methods
This randomized controlled trial will involve 150 patients from the Surgical Department of the University Hospital of Southern Denmark, randomized to undergo either rTAPP or laparoscopic TAPP. Surgical stress will be quantified by measuring C-reactive protein (CRP) and cytokine levels. Secondary outcomes include complication rates, quality of life, sexual function, and operative times. Data analysis will adhere to the intention-to-treat principle and will be conducted once all patient data are collected, with outcomes assessed at various postoperative intervals.

Discussion
This study holds significance in evaluating the potential advantages of robotic-assisted surgery in the context of inguinal hernia repairs.
It is hypothesized that rTAPP will result in a lower surgical stress response and potentially lower the risk of postoperative complications compared to conventional laparoscopic TAPP. The implications of this research could influence future surgical practices and guidelines, with a focus on patient recovery and healthcare costs. The findings of this study will contribute to the ongoing discourse surrounding the utilization of robotic systems in surgery, potentially advocating for their broader implementation if the benefits are substantiated.

Trial registration
ClinicalTrials.gov NCT05839587. Retrospectively registered on 28 February 2023.
Cardiac sarcoidosis presenting as multiple right intra-atrial masses mimicking cardiac tumor
Authors: Gohri Jay , Luthra Harshvardhan , Qureshi Khushboo , Reddy Karnati Prudhveer 
Published: August 2024

Abstract
Background
Cardiac sarcoidosis though in itself, a rare entity, very rarely presents primarily with conduction abnormalities as the primary manifestation in the spectrum of presentations accounted by this chronic granulomatous systemic disease. Sarcoidosis presenting as intra-atrial masses is virtually unheard of.

Case
A middle aged female presented with progressive conduction system disease was found to have right atrial masses of unclear etiologic on relevant imaging. Over the course of 3 months she underwent a dual-chamber ICD implant for her eventual complete heart block and a surgical resection following an inconclusive biopsy of the right atrial free wall mass. She was then diagnosed with cardiac sarcoidosis and started on immunosupressants almost instantaneously as a part of her treatment.

Conclusion
This is an entirely new and unreported presentation of cardiac sarcoidosis as an intra-atrial mass. Through this case we bring light to cardiac sarcoidosis as a potential differential for intra-cardiac masses and how with available data do we go about treating it.
Causative agent for perioperative anaphylaxis in a child with autism successfully identified using the intradermal test under general anesthesia
Authors: Amano Yasuhiro , Mizutani Kumi , Kato Yuki , Fujii Tasuku , Yagami Akiko , Tamura Takahiro 
Published: August 2024

Abstract
Background
The skin-prick and intradermal tests are the main diagnostic methods used to identify the causative agent in patients with suspected perioperative anaphylaxis. Although the intradermal test is more sensitive than the skin-prick test, multiple intradermal injections can be painful for children. Here, we present the case of a child with autism and suspected perioperative anaphylaxis. The causative agent was successfully identified using the intradermal test under general anesthesia.

Case presentation
An 8-year-old boy with autism developed anaphylaxis during general anesthesia for the fourth cleft lip and palate surgery. An allergic workout was performed, but both the skin-prick and basophil activation tests for suspected causative agents yielded negative results. The patient was afraid of multiple injections, and an intradermal test was performed under general anesthesia by anesthesiologists and allergists. Piperacillin was confirmed as the causative agent, and subsequent surgery using the same anesthetic agents without piperacillin was uneventful.

Conclusions
Concerted efforts should be made to identify the causative agent for diagnosing perioperative anaphylaxis.
Beyond content delivery: harnessing emotional intelligence for community building in fully online digital spaces
Authors: Stolba Aneta , Hope Ashley , Branch Jessie , Manoj Prerana , Trinier Jessica , Behboudi Atefeh , vanOostveen Roland , Childs Elizabeth 
Published: August 2024

AbstractThe onset of the pandemic catalyzed a paradigm shift in educational methodologies, bringing various forms, such as hybrid, distance, and fully online models, into focus. The following study explores the affective domain in online learning, focusing on how emotions, facial expressions, and body language influence engagement and support community building in fully online learning environments. This research explores the role of emotional intelligence in Fully Online Learning Communities (FOLC) and examines the impact of positive and negative emotions on interpersonal engagement and participation. Findings indicate positive emotions to be closely linked to increased engagement and active participation. The study also highlights the importance of exploring body language in digital learning environments and addresses challenges posed by technological barriers in fully online learning spaces. Emotional intelligence is pivotal in online learning and community building, emphasizing the need to understand how to create emotionally supportive digital learning environments. Outcomes indicate a need for future research to focus on understanding the role of cultural dimensions in supporting learner agency and community building in the fully online learning context.
The symptoms evolution of long COVID‑19 (SE-LC19): a new patient-reported content valid instrument
Authors: Rofail Diana , Somersan-Karakaya Selin , Mylonakis Eleftherios , Choi Julia Y. , Przydzial Krystian , Marquis Sarah , Zhao Yuming , Hussein Mohamed , Norton Thomas D. , Podolanczuk Anna J. , Geba Gregory P. 
Published: August 2024

Abstract
Background
The field of long COVID research is rapidly evolving, however, tools to assess and monitor symptoms and recovery of the disease are limited. The objective of the present study was to develop a new patient-reported outcomes instrument, the Symptoms Evolution of Long COVID‑19 (SE-LC19), and establish its content validity.

Methods
The 40-item SE-LC19 instrument was developed based on patient-relevant empirical evidence from scientific literature and clinical guidelines that reported symptoms specific to long COVID. A 2-part mixed-method approach was employed. Part 1: Qualitative interviews with a purposive sample of 41 patients with confirmed long COVID were conducted for the content validation of SE-LC19. During cognitive debriefing interviews, patients were asked to describe their understanding of the instrument’s instructions, specific symptoms, response options, and recall period to ensure its relevance and comprehensiveness. Five clinicians of different medical specialties who regularly treated patients with long COVID were also interviewed to obtain their clinical expert opinions on SE-LC19. Part 2: Exploratory Rasch Measurement Theory (RMT) analysis was conducted to evaluate the psychometric properties of the SE-LC19 data collected during the interviews.

Results
Overall, patients reported that the instructions, questions, recall period, and response options for SE-LC19 were comprehensive and relevant. Minor conceptual gaps reported by patients captured nuances in the experience of some symptoms that could be considered in future studies. Some patients suggested a revision of the recall period from 24 h to 7 days to be able to capture more symptoms given the waxing and waning nature of some symptoms. Clinicians found the instrument comprehensive with minimal suggestions regarding its content. Exploratory RMT analyses provided evidence that the SE-LC19 questionnaire performed as intended.

Conclusion
The present mixed-methods study in patients with confirmed long COVID supports the content validity and applicability of the SE-LC19 instrument to evaluate the symptoms of patients with long COVID. Further research is warranted to explore the psychometric properties of the instrument and refine a meaningful and robust patient-relevant endpoint for use in different settings such as clinical trials and clinical practice to track the onset, severity, and recovery of long COVID.
Trends in incidence of self-harm, neurodevelopmental and mental health conditions among university students compared with the general population: nationwide electronic data linkage study in Wales
Authors: John Ann , Rouquette Olivier Y. , Lee Sze Chim , Smith Jo , del Pozo Baños Marcos 
Published: August 2024

BackgroundConcern that self-harm and mental health conditions are increasing in university students may reflect widening access to higher education, existing population trends and/or stressors associated with this setting.AimsTo compare population-level data on self-harm, neurodevelopmental and mental health conditions between university students and non-students with similar characteristics before and during enrolment.MethodThis cohort study linked electronic records from the Higher Education Statistics Agency for 2012–2018 to primary and secondary healthcare records. Students were undergraduates aged 18 to 24 years at university entry. Non-students were pseudo-randomly selected based on an equivalent age distribution. Logistic regressions were used to calculate odds ratios. Poisson regressions were used to calculate incidence rate ratios (IRR).ResultsThe study included 96 760 students and 151 795 non-students. Being male, self-harm and mental health conditions recorded before university entry, and higher deprivation levels, resulted in lower odds of becoming a student and higher odds of drop-out from university. IRRs for self-harm, depression, anxiety, autism spectrum disorder (ASD), drug use and schizophrenia were lower for students. IRRs for self-harm, depression, attention-deficit hyperactivity disorder, ASD, alcohol use and schizophrenia increased more in students than in non-students over time. Older students experienced greater risk of self-harm and mental health conditions, whereas younger students were more at risk of alcohol use than non-student counterparts.ConclusionsMental health conditions in students are common and diverse. While at university, students require person-centred stepped care, integrated with local third-sector and healthcare services to address specific conditions.