bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of changes in intra-compartmental bioimpedance measurements with early intra-dialytic hypotension during haemodialysis
Authors: Haroon Sabrina , Davenport Andrew 
Published: August 2024

Introduction: Intra-dialytic hypotension (IDH) remains the commonest problem associated with routine haemodialysis treatments. Fluid shifts from intracellular(ICW) and extracellular(ECW) compartments to refill plasma volume during haemodialysis with ultrafiltration. Methods: We studied the effect of relative changes in ICW and ECW indifferent body segments using multifrequency segmental bioimpedance during haemodialysis and IDH episodes. Results: Of 42 haemodialysis patients,16 patients (38.1%) developed IDH within the first hour of dialysis. Patients with and without early IDH were well-matched for demographics and starting bioimpedance measurements. However, after 60 min, the relative change in in ECW/ICW ratio between the non-fistula arm and leg was significantly different for the early IDH group median −1.07 (−3.33 to 0.8) versus 0.61 (−0.78 to 1.8), p < 0.05, whereas there no differences in ultrafiltration rate, relative blood volume monitoring or on-line clearance. Conclusion: Monitoring serial changes in fluid status in different body compartments with bioimpedance may potentially prevent IDH in the future.
Risk factors and a model for prognosis prediction after intravenous thrombolysis with alteplase in acute ischemic stroke based on propensity score matching
Authors: Huang Pan , Yi XingYang 
Published: August 2024

Background: Alteplase intravenous thrombolysis is effective for treating acute ischemic stroke (AIS) within 4.5 h. Nevertheless, the prognosis remains poor for some patients. Objective: To investigate the risk factors for poor prognosis in patients undergoing intravenous thrombolysis with alteplase following AIS based on propensity score matching and to develop a predictive model. Result: Multivariate logistic regression analysis showed that baseline blood glucose (OR = 1.20, 95%CI, 1.03-1.39), baseline NIH Stroke Scale score (OR = 1.23, 95%CI, 1.12-1.35), and hyperlipidemia (OR = 6.60, 95%CI 1.74-25.00) were risk factors for poor prognosis in patients with AIS undergoing alteplase intravenous thrombolysis. Using these factors, a nomogram model was constructed for predicting patient prognosis at 3 months. The areas under the receiver operating characteristic curve (AUCs) of the training and validation groups were 0.792 (95CI% 0.715-0.870) and 0.885 (95CI% 0.798-0.972), respectively, showing good differentiation. The Hosmer Lemeshow goodness-of-fit test showed that the model had good fit. The calibration curve fitted well with the ideal curve, and the decision curve analysis curve showed that the model had good clinical applicability when the threshold probability was between 10%-80%. Conclusion: The established nomogram could successfully predict the 3-month prognosis of patients with AIS after undergoing alteplase intravenous thrombolysis. The model thus has clinical application value.
Vitamin E-poly(2-oxazolin)-ciprofloxacin conjugates that enter bacterial cells via their efflux pumps
Authors: Romanovska Alina , Tophoven Jonas , Brandt Volker , Breisch Marina , Tiller Joerg C. 
Published: August 2024

Rendering established antibiotics by derivatization or formulation is a promising way to quickly obtain higher active antibiotics and to address antibiotic resistant bacterial strains. The antibiotic ciprofloxacin (CIP) conjugated with amphiphilic blockcopoly(2-oxazoline)s (POx) shows greatly enhanced antimicrobial activity, reduces resistance formation, and is active against CIP-resistant bacterial cells with overexpressed efflux pumps. In order to design CIP conjugates with comparable performance, but higher biocompatibility, the hydrophobic POx-block was substituted by a modified α-Tocopherol (VitE), which is predominantly referred to as vitamin E. Modification of VitE with 4-bromomethylbenzoyl bromide leads to a highly active initiator for POx synthesis. Using this initiator for the living cationic polymerization of 2-methyl-2-oxazoline leads to fully end-group functionalized PMOx. Conjugation of these polymers with CIP results in non-cytotoxic conjugates with improved CIP activity. These VitE-PMOx-EDA-xCIP conjugates enter E. coli cells via their efflux pumps. In case of E. coli with overexpressed efflux pumps (typical for resistant bacteria), the molar activity of the novel CIP conjugates is up to 100 times higher than free CIP, indicating potential of polymer conjugation with antibiotics to overcome bacterial resistances. [Formula: see text]
Community recommendations for promoting HIV testing to Black young men who have sex with men in the southern United States
Authors: Budhwani Henna , Outlaw Angulique Y , Oster Robert A , Mugavero Michael J , Johnson Mallory O , Hightow-Weidman Lisa B , Naar Sylvie , Nash Princess , Turan Janet M 
Published: August 2024

Background Considering the need to increase HIV testing among racial minority youth in the southern United States, we conducted an exploratory study in Alabama to elucidate recommendations on improving testing rates among Black young men who have sex with men (BYMSM). Methods We conducted in-depth interviews and focus groups with BYMSM and prevention and outreach workers. Data collection occurred online and in person between 2020–2022. Results Our sample included data from n = 56 BYMSM and n = 12 prevention and outreach workers. BYMSMs’ mean age = 24 years. Among prevention and outreach workers, 58% identified as male with mean age = 39 years; 83% identified as Black. Transcripts were coded thematically; five concurrent themes emerged from both BYMSM and prevention and outreach workers: promoting testing at younger ages, need for visibility and outreach, connecting through shared experiences, value of nonjudgmental approaches, and need to increase HIV knowledge in BYMSM. Conclusions Findings suggest that cultivating trust is salient to promoting HIV testing in BYMSM. To end the epidemic in the southern United States, a region that is heavily rural with high rates of HIV, it may be necessary to begin prevention conversations at younger ages and equip prevention and outreach workers with communication skills that leverage de-stigmatizing approaches.
Beyond paraneoplastic neurological syndromes: Anti-neuronal antibodies in neuropsychiatric systemic lupus erythematosus
Authors: Manikuppam Prathyusha , Prakash John Antony Jude , Yadav Bijesh , Mathew John 
Published: August 2024

Introduction Anti-neuronal antibodies target antigens produced by tumour cells and cells of nervous system. These antibodies are formed as a result of autoimmune response elicited by the underlying malignancy, when proteins restricted to immune privileged neurons are presented by the tumour. Previous studies have shown presence of anti-neuronal antibodies in systemic lupus erythematosus and neuropsychiatric lupus (NPSLE) but information on individual antibodies and their pathogenic role is lacking. Aims/Objective To assess the frequency of anti-neuronal antibodies in our neuropsychiatric lupus cohort and to assess any significant association with specific neurological syndrome and to see if the antibodies were more likely to occur in active rather than inactive neuropsychiatric lupus. Methodology This cross-sectional study was conducted in our center from 2019 to 2022. Neuropsychiatric manifestations were defined according to 1999 American College of Rheumatology (ACR) nomenclature and case definitions for neuropsychiatric lupus. Samples were taken from active or inactive NPSLE patients with their informed consent. Testing was done on an anti-neuronal antigen panel which consisted of [Amphiphysin, CV2, GAD 65, PNMA2 (Ma-2/Ta), Ri, Yo, Hu, recoverin, SOX1, titin, Zic, Tr)] by semi-quantitative Line immune assay. Association between the categorical variables and antibody positivity group was established using chi-square/Fisher’s exact test as appropriate. Results 65 patients were recruited, of which 23 (35%) patients had active NPSLE at the time of sample collection. Anti-neuronal antibodies were positive in 13/65 (20%) patients with anti-Gad 65 antibodies having the highest frequency (6.2%) followed by anti CV 2 (3.1%), anti Sox1 (3.1%), anti Amphiphysin (3.1%) anti recoverin (1.5%), anti Yo (1.5%) and anti Zic (1.5%). The panel of anti-neuronal antibodies did not show any specific association with NPSLE features. However, an interesting finding was that, patients with active disease had higher odds of having anti-neuronal antibodies with an OR = 10 (95% CI:2.38 -42) ( p < 0.001) than inactive disease. Conclusion Anti-neuronal antibodies were more likely to be positive in active neuropsychiatric lupus patients, and these antibodies which are commonly used to diagnose paraneoplastic syndromes may have a potential role in the diagnosis of NPSLE.
Assessment of the Potential of Modern Diagnostic Tools in Differentiation of Minimum Conscious State from the Vegetative State
Authors: Grabarczyk Lukasz 
Published: August 2024

Background The problem of treatment of patients in coma and persistent disturbances of consciousness is difficult and often neglected. Purpose The study validated the effectiveness of functional magnetic resonance imaging, electroencephalography and isotopic brain perfusion in differentiating vegetative state from minimal conscious state. Methods The study was performed in a group of 61 patients with persistent disturbances of consciousness. All patients underwent CRS-R differentiation of consciousness and functional magnetic resonance imaging, EEG, and SPECT/CT studies according to a uniform diagnostic protocol. Results Analysis has shown that functional magnetic resonance imaging is an effective tool for detecting of consciousness. Analysis of the EEG showed that the occurrence of primary alpha rhythm in patients with impaired consciousness coincides with the state of minimal conscious and may indicate a favourable prognosis. Sector analysis of isotopic cerebral perfusion allowed to put forward the thesis that the key role in the maintenance of consciousness plays a medial part of the left parietal lobe. Conclusion On the basis of these results, diagnostic protocol was developed for patients with disturbances of consciousness.
Efficacy and Safety of TACE Combined with Regorafenib versus TACE Combined with Camrelizumab in Hepatocellular Carcinoma With Untreatable Progression After TACE Combined with Sorafenib Therapy: A Case Control Study
Authors: Ren Yanqiao , Liu Yiming , Song Songlin , Zheng Chuansheng 
Published: August 2024

Purpose To evaluate the efficacy and safety of transarterial chemoembolization (TACE) combined with regorafenib (hereafter, TACE-regorafenib) or camrelizumab (hereafter, TACE-camrelizumab) for treating hepatocellular carcinoma (HCC) with untreatable progression after TACE and sorafenib therapy. Methods The medical records of patients with HCC who received TACE-regorafenib or TACE-camrelizumab between September 2018 and December 2023 were retrospectively evaluated. Therapeutic response, overall survival (OS), progression-free survival (PFS), and adverse events (AEs) were compared between the two groups. Results A total of 76 patients were enrolled in this study, with 41 and 35 patients in the TACE-regorafenib and TACE-camrelizumab groups, respectively. The objective response rates in the TACE-regorafenib and TACE-camrelizumab groups were 9.8% and 8.6%, respectively, with no statistically significant difference between the two groups ( P = 0.859). Similarly, there was no statistically significant difference in disease control rates between the two groups (61.0% vs 68.6%, P = 0.838). The median OS was 11 months in the TACE-regorafenib group and 10 months in the TACE-camrelizumab group, with no significant difference between the two groups ( P = 0.348). The TACE-regorafenib group had a median PFS of 7 months, which was significantly longer than that of the TACE-camrelizumab group (4 months, P = 0.004). There was no significant difference in the incidence of AEs between the two groups ( P = 0.544). Conclusions TACE-regorafenib was safe, well-tolerated, and showed promising efficacy in patients with sorafenib-refractory advanced HCC, whereas TACE–camrelizumab demonstrated similar survival benefits.
Modeling of a six-degree-of-freedom magnetic levitation platform actuated by noncontact Lorentz forces
Authors: Li Jinlin , Zeng Sheng , Guo Qiaoying , Zhong Shuncong , Liang Wei , He Wen 
Published: August 2024

In this study, the modeling of a six-degree-of-freedom (DOF) magnetic levitation platform actuated by noncontact Lorentz forces was analyzed. First, an analytic model of the actuator forces was studied, and the magnetic flux density in the working gap of the actuators was established using the Image Method, Ampere molecular hypothesis, and Biot–Savart law. The dynamics model of the floater actuated by the actuators was then built using the Newton–Euler method. Moreover, the double-pendulum chaotic nonlinear system of the hoisted floater was simplified as a single-DOF system, in which the interaction effects between two DOFs were considered. Furthermore, modeling of the platform control system was performed, which included an acceleration measuring unit with six uniaxial accelerometers, a position measuring unit with three two-dimensional PSDs, and a control unit that decouples the six-DOF control. Finally, an experimental setup was built to perform ground tests on the platform. The results verified the platform modeling; translational and rotational positioning accuracies were approximately 5 μm and 40 μrad at the six DOFs, respectively, and the vibrational suppression efficiencies were greater than 90% for low frequency disturbances. Moreover, Kalman estimators and disturbance observers were introduced into the controller to estimate the movement of the floater and observe the direct disturbance. Simulation testing demonstrated a significant improvement in the vibration-suppression performance of the platform.
Optimizing central venous access devices insertion in thrombocytopenic patients: Balancing efficacy and safety
Authors: Farsavian Hossein , Davoodi Mahdi , Najafi Mohammad Javad , Manouchehri Amoli Mahmoud , Zahmatkesh Ahmad , Nazarpour Mahmoud 
Published: August 2024

Introduction: Recently, the rising incidence of trauma, cancer, and critical illnesses has led to a growing necessity for Central Venous Access Devices (CVADs). Inserting CVADs in thrombocytopenic patients is still challenging. This study tries to shed light on the safety and associated risks of CVADs insertion in this high-risk group, with the ultimate goal of informing clinical practice and aiding in decision-making processes. Methods: This study was conducted as prospective cohort study from September 2020 to September 2023 in Mazandaran University of Medical Sciences, Iran. Individuals aged 18–80 years with a platelet count of less than 50,000/dL included and those designated for subcutaneous port procedures or on anticoagulant and antiplatelet therapy, excluded. Ultrasound-guided CVAD insertion using the Seldinger technique and SIC/FIC strategies performed for participants. Incidence of hemorrhagic complications post-CVAD insertion, requirement for blood product transfusions to amend platelet counts, frequency of non-bleeding complications, and complications related to blood product transfusions monitored. Results: The study comprised 137 participants, 54% of whom were men, with an average age of 46.90 ± 15.70 years. No significant correlation was found between the site of CVAD placement (jugular vs femoral) and the incidence of major or minor bleeding. Femoral catheters were associated with a higher rate of infection. No complications related to transfusion of blood products or mortality seen, indicating that CVAD implantation can be safely performed in patients with thrombocytopenia or coagulation disorders. Conclusion: CVAD insertion in thrombocytopenic patients, even with platelet counts below 10 × 109/L, is safe and associated with minimal complications when performed under ultrasound guidance by experienced surgeons. This finding supports the use of a lower platelet count threshold for CVAD insertion than currently recommended in guidelines, potentially reducing the need for platelet transfusions prior to CVAD placement.
A randomised trial of real-time video counselling for smoking cessation among rural and remote residents
Authors: Tzelepis Flora , Wiggers John , Paul Christine L , Mitchell Aimee , Byrnes Emma , Byaruhanga Judith , Wilson Louise , Lecathelinais Christophe , Bowman Jennifer , Campbell Elizabeth , Gillham Karen 
Published: August 2024

Introduction Despite its reach, very limited evidence exists on the effectiveness of real-time video counselling for smoking cessation (e.g. via Skype). This study compared the effectiveness of real-time video counselling for smoking cessation to (a) telephone counselling; and (b) a control among rural and remote residents. Methods Between 25 May 2017 and 3 March 2020, a three-arm, parallel group, randomised trial, randomised 1244 rural and remote residents from New South Wales, Australia who smoked tobacco to: video counselling (4–6 video sessions); telephone counselling (4–6 telephone calls); or a control (printed materials). The primary outcome was 7-day point prevalence abstinence at 13 months post-baseline. Secondary outcomes were point prevalence abstinence at 4 months and 7-months post-baseline, prolonged abstinence, quit attempts, anxiety and depression. Results For the primary outcome of 7-day point prevalence abstinence at 13 months post-baseline, there was no significant difference between video counselling and telephone counselling (14.6% vs 13.3%; (OR = 1.11, 95% CI (0.75–1.64), P = 0.61) or video counselling and control (14.6% vs 13.9%; (OR = 1.06, 95% CI (0.71–1.57), P = 0.77). For secondary outcomes at 4 months post-baseline, the video counselling group had significantly higher odds than the control of 7-day point prevalence abstinence (14.3% vs 8.2%; OR = 1.88, 95% CI (1.20–2.95), P = 0.006) and 3-month prolonged abstinence (4.9% vs 2.2%; OR = 2.28, 95% CI (1.03–5.07), P = 0.04). There were no significant differences for other secondary outcomes. Discussion Video counselling increased smoking cessation in the short-term compared to a control although strategies to improve its long-term effectiveness are needed. Trial registration Australian New Zealand Clinical Trials Registry, https://www.anzctr.org.au ACTRN12617000514303.
Smaller Hospital Size is Associated With Higher Mortality in Stanford Type A Aortic Dissection
Authors: Li Renxi , Luo Qianyun , Green Derrick , Huddleston Stephen 
Published: August 2024

Background Stanford Type A Aortic Dissection (TAAD) is associated with high in-hospital mortality and the need for immediate surgical intervention. Larger hospital size may be associated with better patient care and surgical outcomes. This study aimed to examine the effect of hospital size on TAAD outcomes. Method Patients who underwent TAAD repair were identified in National Inpatient Sample (NIS) from Q4 2015-2020. NIS stratifies hospital size into small, medium, and large based on the number of hospital beds, geographical location, and the teaching status of the hospitals. Patients admitted to small/medium and large hospitals were stratified into two cohorts. Multivariable logistic regressions were performed to compare in-hospital outcomes, adjusted for demographics, comorbidity, primary payer status, and hospital characteristics including procedural volume. Results There were 1106 and 3752 TAAD admitted to small/medium and large hospitals, respectively. Among patients admitted to small/medium hospitals, there was higher mortality (17.27% vs 14.37%, aOR = 1.32, P < 0.01), but shorter length of stay ( P < 0.01) and lower cost ( P = 0.03) compared to larger hospitals. There was no difference in morbidities. Conclusions Marked higher mortality is associated with admission to smaller hospitals among patients with TAAD, which may in turn decrease the average hospital stay and cost. Given that a significant percentage of patients are already being transferred out of the initial hospital and small/medium hospital is associated with higher mortality, centralization of care in centers of excellence may decrease the high mortality associated with TAAD.
The association of vagal atrophy with parameters of autonomic function in multiple system atrophy and progressive supranuclear palsy
Authors: Kleinz Teresa , Scholz Leonard , Huckemann Sophie , Rohmann Rachel , Kühn Eva , Averdunk Paulina , Kools Saskia , Hilker Lovis , Bieber Antonia , Müller Katharina , Motte Jeremias , Fisse Anna-Lena , Schneider-Gold Christiane , Gold Ralf , Kwon Eun Hae , Tönges Lars , Pitarokoili Kalliopi 
Published: August 2024

Background: Vagal atrophy is a hallmark of Parkinson’s disease (PD) and has been found to be associated with autonomic dysfunction, while analyses of the vagus nerve (VN) in atypical Parkinsonian syndromes (APS) have not yet been performed. We here investigate the characteristics of the VN in multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) and, in a second step, its potential as a possible biomarker for orthostatic dysregulation. Objectives: The aim was to compare the VN pathology in MSA and PSP with healthy individuals and patients with PD as a differentiating factor and to further analyse the correlation of the VN with clinical parameters and cardiovascular response. Design: We conducted a monocentric, cross-sectional cohort study in 41 APS patients and compared nerve ultrasound (NUS) parameters with 90 PD patients and 39 healthy controls. Methods: In addition to a detailed neurological history and examination, several clinical severity and motor scores were obtained. Autonomic symptoms were reported in the Scales for Outcomes in Parkinson’s Disease – Autonomic questionnaire. Further scores were used to detect other non-motor symptoms, quality of life and cognition. Additionally, we performed a head up tilt test (HUTT) and NUS of the VN. We conducted correlation analyses of the VN cross-sectional area (CSA) with clinical scores and the heart rate and blood pressure variability parameters of the HUTT. Results: The examination demonstrated a high prevalence of abnormal autonomic response in both MSA (90%) and PSP (80%). The VN CSA correlated with spectral parameters of the HUTT, which are associated with sympatho-vagal imbalance. In addition, the CSA of the VN in patients with PD and PSP were significantly smaller than in healthy controls. In MSA, however, there was no marked vagal atrophy in comparison. Conclusion: The occurrence of autonomic dysfunction was high in MSA and PSP, which underlines its impact on these syndromes. Our findings indicate a connection between vagal pathology and autonomic dysfunction and might contribute to a better comprehension of APS. To further evaluate the clinical relevance and the VN as a possible marker of autonomic dysfunction in APS, prospective longitudinal observations are necessary.