bluuebunny/crossref_metadata_2025_split huggingface dataset:
Selective classification with machine learning uncertainty estimates improves ACS prediction: A retrospective study in the prehospital setting.
Authors: Garcia Juan Jose , Kitzmiller Rebecca , Krishnamurthy Ashok , Zègre-Hemsey Jessica K. 
Published: June 2024

Abstract

Accurate identification of acute coronary syndrome (ACS) in the prehospital setting is important for timely treatments that reduce damage to the compromised myocardium. Current machine learning approaches lack sufficient performance to safely rule-in or rule-out ACS. Our goal is to identify a method that bridges this gap. To do so, we retrospectively evaluate two promising approaches, an ensemble of gradient boosted decision trees (GBDT) and selective classification (SC) on consecutive patients transported by ambulance to the ED with chest pain and/or anginal equivalents. On the task of ACS classification with 23 prehospital covariates, we found the fusion of the two (GBDT+SC) improves the best reported sensitivity and specificity by 8% and 23% respectively. Accordingly, GBDT+SC is safer than current machine learning approaches to rule-in and rule-out of ACS in the prehospital setting.
A Clinicopathologic Study of Glomerular Disease: A Single-Center, Ten-year Retrospective Study from Northwest India
Authors: Vagh Tanmay , Jani Nidhi , Godara Suraj 
Published: June 2024

Abstract

Studies published from centers across India have reported different and contradicting patterns of glomerular disease. In this retrospective study, we report our experience from a Tertiary Care Center in Northwest India. A total of 1186 renal biopsies performed between 2014 and 2023 were reviewed of which 632 were excluded from the study because the biopsies were taken from an allograft. The study included 332 males (59.92%) and 222 females (40.07%) with an age range of 08–82 years (mean 40.34 ± 5.04 years). Majority of the biopsies (99.07%) showed some form of glomerulonephritis (GN), either primary (68.88%) or secondary glomerular disease (SGD) (31.12%). Membranous nephropathy was the most common type of primary GN (24.73% of primary GN), followed by focal and segmental glomerulosclerosis (FSGS); 20.96% of primary GN) and minimal change disease (MCD; 17.47% of primary GN).Amyloidosis was the most frequent SGD (44.64% of secondary GN). Lupus nephritis(LN) was found in 32.14% and TMA(Thrombotic microangiopathy) in 17.85%.
Title: Development and Content Validation of the Pediatric Dizziness Index (PDI)
Authors: Tiwari Devashish , Allen Mariah , Schulz Rebecca , Gotts Brittany , Stewart Catherine , Kaur Maninderjit 
Published: June 2024

Abstract

Background
Approximately, 3 million children are impacted by dizziness nationally, and as a result are at a greater risk of intellectual and learning disability. Given the wide variations between children and adults in brain morphology, maturity, and perceptions of injury impact, valid, age-specific patient reported outcome measures are crucial to capture the breadth of disability from dizziness. The purpose of this study was to develop and examine content validity of the PDI to evaluate activity limitation and participation restriction due to dizziness.
Methods
This was a cross sectional, observational study conducted primarily at an academic institute. Eight pediatric clinical and research content experts participated in the Modified Delphi Process. PDI was developed in four steps: 1) item development, 2) item evaluation, 3) content validity ratio and index calculation, and 4) cognitive interviews to ensure face validity, and comprehension of the items. A comprehensive literature search and review of the International Classification of Functioning, Disability and Health- Children and Youth model was conducted to identify potential items. Content validation process followed the COnsensus based Standards for the selection of health status Measurement Instruments (COSMIN) guidelines. Six children (8–16 years) participated in the cognitive interviewing. Content validity ratio (CVR) was calculated using Lawshe’s formula CVR = (ne – N/2)/N/2 (ne = number of experts identified an item as essential; N = total number of experts). Finally, content validity index (CVI) was calculated (CVI > 0.8 indicated good content validity).
Results
After two rounds of modified Delphi process, the initial item bank of 33 items was condensed to 10 items in final version of PDI. Three items on the PDI were revised post cognitive testing. The final version of PDI demonstrated good content validity (CVI = 0.87).
Conclusion
PDI is the first comprehensive patient reported measure specific to dizziness and provides evidence of strong content validity. Further research to establish factor structure and construct validity is recommended.
Surgical site infections after sarcoma resections in the peripelvic region: Do we need perioperative antibiotic prophylaxis?
Authors: Klein Alexander , Chudamani Chataut , Wieser Andreas , Goller Sophia Samira , Berclaz Luc M. , Gioia Dorit Di , Holzapfel Boris M. , Dürr Hans Roland 
Published: June 2024

Abstract

Background: Surgical site infections (SSI) are one of the most common complications after extensive sarcoma resections and represent a daily challenge. SSI occur in up to 50% of cases particularly in the peripelvic area. One possible approach to reduce infection rate is perioperative antibiotic prophylaxis. The aim of this study therefore was to investigate the influence of perioperative antibiotic prophylaxis on the infection rate and the possible influence of location-specific antibiotic prophylaxis with ampicillin/sulbactam.
Methods and patients: This monocentric retrospective study included 366 patients who underwent sarcoma resections in the groin, proximal thigh, or gluteal region. All patients were operated on by 2 surgeons after neoadjuvant pretreatment if necessary.
3 groups of patients were defined. Group 1: In 60.4% of all cases, antibiotic prophylaxis was administered with cephalosporins (also clindamycin in case of penicillin allergy). Group2: In 9.8% of cases, ampicillin/sulbactam was used. Group 3: 29.8% of patients did not receive any antibiotic prophylaxis. In 31.1% of treated cases, antibiotic therapy was prolonged due to extented tumor resections.
Results: Postoperative infections occurred in 23.2% (85 cases), in 77 cases within the first 90 days (on average after 20 days). The median operating time, blood loss, and tumor size were significantly higher in cases of infections, compared to patients without infection. In group 1 and 2 with perioperative single-shot prophylaxis, infection occurred in 24.1% of cases, compared to 13.5% of cases without prophylaxis (group 3) (p= 0.032). In the patients with prolonged antibiotic therapy, infection occurred in 31.6% of cases, compared to 16.3% of cases without prolongation (p< 0.001). In the ampicillin/sulbactam group, infection occurred in 19.4% of cases compared to 24.9% of cases in the cephalosporin group (p= 0.479). In univariate risk analysis, increased blood loss with erythrocyte substitution and neoadjuvant radiotherapy were proven to be risk factors for the occurrence of infections; in the multivariate analysis, neoadjuvant chemotherapy also proved to be a risk factor.
Conclusions: Perioperative antibiotic prophylaxis may reduce the risk of infection after extended sarcoma resection in the peripelvic area. However, the particular bacterial spectrum of this anatomic region should be taken into account when deciding which antibiotics to use.
Stress Responses in Siamese Fighting Fish (Betta splendens) Subjected to Commercial Confinement Rearing Practices: An Assessment in Welfare
Authors: Sintuprom Chanoknan , Nuchchanart Wirawan , Dokkaew Sahabhop , Aranyakanont Chak , Ploypan Raveewan , Shinn Andrew P. , Wongwaradechkul Ratchakorn , Dinh-Hung Nguyen , Dong Ha Thanh , Chatchaiphan Satid 
Published: June 2024

Abstract

Siamese fighting fish, which are subject to unique culture practices, are reared individually in confined spaces. This study aims to examine their stress responses, including blood chemistry, stress hormones, and stress-related gene expression under these commercial confinement rearing practices. The fish (mean body weight 0.12 ± 0.04 g; n = 30) were individually housed in 250 mL glass bottles containing 150 mL water for 14 days, with groups designed as control and treatment, the latter receiving 0.5% NaCl. Baseline parameters were measured before confinement, with assessments at 1, 3, 7, and 14 days. Results showed no significant differences in plasma cortisol, glucose, or hematological values between baseline and confinement (controls), except for increased plasma glucose with 0.5% NaCl (treatments) after 7 days. However, significant upregulation of stress-related genes (GR, MR, and HIF-1α) and downregulation of genes HSP70 and HSP90 were observed in confined fish. While certain genes (HSP70, GR, MR, and HIF-1α) showed significant differences after three days, these returned to baseline levels by the end of 14-day period. The addition of 0.5% NaCl significantly reduced plasma cortisol levels and the expression of certain stress-related genes, including HSP70, HSP90, GR, and MR compared to the control groups (p < 0.05). The findings suggest that current confinement methods do not cause significant stress and do not contradict established animal welfare principles. In addition, adding 0.5% NaCl to the water could be a practical and cost-effective method to reduce stress indicators during confinement, offering a viable solution for betta fish husbandry.
Fragmentation of Care in Breast Cancer: Greater than the Sum of its Parts
Authors: Freeman Hadley D. , Burke Linnea C. , Humphrey Ja’Neil G. , Wilbers Ashley J. , Vora Halley , Khorfan Rhami , Solomon Naveenraj L. , Namm Jukes P. , Ji Liang , Lum Sharon S. 
Published: June 2024

Abstract

INTRODUCTION: Fragmentation of care (FC, the receipt of care at > 1 institution) has been shown to negatively impact cancer outcomes. Given the multimodal nature of breast cancer treatment, we sought to identify factors associated with FC and its effects on survival of breast cancer patients. METHODS: A retrospective analysis was performed of surgically treated, stage I-III breast cancer patients in the 2004–2020 National Cancer Database, excluding neoadjuvant therapy recipients. Patients were stratified into two groups: FC or non-FC care. Treatment delay was defined as definitive surgery > 60 days after diagnosis. Multivariable logistic regression was performed to identify factors predictive of FC, and survival was compared using Kaplan-Meier and multivariable Cox proportional hazards methods. RESULTS: Of the 531,644 patients identified, 340,297 (64.0%) received FC. After adjustment, FC (OR 1.27, 95% CI 1.25–1.29) was independently associated with treatment delay. Factors predictive of FC included Hispanic ethnicity (OR 1.04, 95% CI: 1.01–1.07), treatment at comprehensive community cancer programs (OR 1.06, 95% CI: 1.03–1.08) and integrated network cancer programs (OR 1.55, 95% CI: 1.51–1.59), AJCC stage II (OR 1.06, 95% CI 1.05–1.07) and stage III tumors (OR 1.06, 95% CI: 1.02–1.10), and HR+/HER2 + tumors (OR 1.05, 95% CI: 1.02–1.07). Treatment delay was independently associated with increased risk of mortality (HR 1.23, 95% CI 1.20–1.26), whereas FC (HR 0.87, 95% CI 0.86–0.88) showed survival benefit. CONCLUSIONS: While treatment delay negatively impacts survival in breast cancer patients, our findings suggest FC could be a marker for multispecialty care that may mitigate some of these effects.
Burden of meningitis and encephalitis in Iran from 1990 to 2019: Findings from the Global Burden of Disease Study
Authors: Rasoulian Pegah , Kazemi Emadoddin , Taherkhani Tina , Niavarani Hoda , Targhi Nikaein Zabeti , Farrokhi Zahra , sajedi Aida , Memari Amirhossein , Danandeh Khashayar 
Published: June 2024

Abstract

Background: Meningitis and encephalitis are significant contributors to morbidity and mortality worldwide. This study aimed to provide a comprehensive overview of the trends and epidemiology of these diseases in Iran from 1990 to 2019.
Methods: Data from the Global Burden of Disease (GBD) study were utilized to assess the epidemiology and burden of meningitis and encephalitis in Iran. This study compared these findings with those of global and Middle East and North Africa (MENA) countries. Age-standardized rates for incidence, prevalence, and years lived with disability (YLD) were calculated, and trends over time were analyzed.
Results: This study revealed a substantial reduction in the burden of meningitis over the observed period, with a 79.24% decrease in age-standardized DALY rates from 1990 to 2019. Encephalitis rates also decreased, though to a lesser extent. Significant disparities in disease burden were observed across different sexes and age groups, with higher rates among males and in the <5 years and ≥90 years’ age groups. Provincial disparities were also noted, with the highest age-standardized DALY rates for meningitis in provinces such as Sistan and Baluchistan, Kohgiluyeh and Boyer-Ahmad, and Hamadan.
Conclusion: This study highlights the progress made in reducing the burden of meningitis and encephalitis in Iran over the past three decades. However, the observed disparities across sexes, age groups, and provinces emphasize the need for continued efforts in surveillance, prevention, and treatment to further alleviate the impact of these diseases.
An affordable and simple method for DNA extraction from agarose suitable for downstream applications
Authors: Sánchez-Flores Jesús Enrique , Sandoval-Cabrera Antonio , Alarcón-Valdés Patricia , Santillán-Benítez Jonnathan Guadalupe 
Published: June 2024

Abstract

DNA serves as the foundation for molecular biology, leading to the development of numerous molecular techniques. Often, these techniques necessitate the separation and visualization of specific DNA regions. Electrophoresis provides a solution for this requirement. However, the purification of DNA from agarose gels presents a significant challenge, both in terms of complexity and cost. Therefore, here we propose a protocol that is both cost-effective and efficient. GFP bands in the PJet vector were visualized and excised for DNA extraction using five treatments. Only the treatment involving TAE buffer failed, while others partially or fully dissolved the gel, aiding DNA recovery. Treatments 2, 4, and 5 showed defined bands without DNA degradation. A nested PCR confirmed the suitability of the recovered DNA for further applications, with only treatments 4 and 5 being amplified. Two additional DNA samples were successfully extracted from a 1% agarose gel using methods 4 and 5, demonstrating their effectiveness.
Exploring the role of the MUC1 mucin in human oral lubrication by tribological in vitro studies
Authors: Ammam Ianis , Pailler-Mattéi Cyril , Ouillon Lucas , Nivet Clément , Vargiolu Roberto , Neiers Fabrice , Canon Francis , Zahouani Hassan 
Published: June 2024

Abstract

In the context of the oral cavity, an organic layer known as the mucosal pellicle (MP) adheres to the surface of the oral epithelium, playing a pivotal role in lubricating and safeguarding oral tissues. The formation of the MP is driven by interactions between a transmembrane mucin known as MUC1, located on the oral epithelium, and salivary secreted mucin, namely MUC5B and MUC7. This study aimed to investigate the function of MUC1 and the influence of its structure on MP lubrication properties. We proposed a novel methodology to study oral lubrication based on four different models of oral epithelium on which we conducted in vitro tribological studies. These models expressed varying forms of MUC1, each possessing on of the distinct domain constituting the mucin. Mechanical parameters were used as indicators of lubrication efficiency and, consequently, of the role played by MUC1 in oral lubrication. The results from the tribological tests revealed that the presence of full MUC1 resulted in enhanced lubrication. Furthermore, the structure of MUC1 protein drive the lubrication. In conclusion, the mechanical tests conducted on our epithelium models demonstrated that MUC1 actively participates in epithelium lubrication by facilitating the formation of the MP.
Effect of Defocusing Variation on Laser Wire Additive Manufacturing Morphology and Plasma Plume Change
Authors: Yan Chenxiao , Han Hongbiao , Zhang Peng , Wang Rui , Hu Jiayang 
Published: June 2024

Abstract

To examine the impact of defocusing amount on the deposition accuracy in the Laser Wire Additive Manufacturing (LWAM) process, a one-factor variable experiment was designed. This experiment analyzed the plasma plume geometry, melting pool spatter, and melting pool length, along with observing bead geometry and porosity. The following conclusions are drawn: Variations in defocusing amount caused changes in energy distribution, which affected the stability of the LWAM process and led to changes in the surface accuracy of the deposited layer and the melt pool morphology. Increasing the defocusing amount enlarged the spot area, diminished laser power density, and effectively reduced spattering during LWAM. Surface roughness increased with defocusing, transforming the hump morphology from an initial smooth fish-scale pattern to a periodic undulating pattern. Larger defocusing decreases the melt pool area and keyhole depth, this reduction aids gas escape from the keyhole, thus mitigating porosity defects in LWAM.
Bus service quality at transfer areas. An assessment procedure based on temporal disutility
Authors: Salicrú Miquel , Mension Josep , Estrada Miquel 
Published: June 2024

Abstract

The design of many transit networks is based on transfer stations. Transfers allow better service connectivity and the avoidance of deploying unaffordable door-to-door services among origin and destination points of low demand. However, these potential improvements in terms of cost and performance are achieved at the expenses of forcing users to incur a temporal disutility at transfer facilities. In this paper, we consider that the quality experienced by users at transfers mainly depends on the temporal disutility. It consists of the walking time between loading areas, the waiting time for bus arrivals at the loading area, and the variability of those times. Hence, a procedure to measure the quality at the transfer areas is proposed, integrating the three relevant components: the physical layout of the transfer area; synchronisation between connected routes; and discrepancies between their actual and scheduled service. A quadratic expression of the previous concepts is justified as a valid approach to measure the total quality of the transfer by transit operators with available data. The calibration of the parameters can be obtained considering the customer perception, the consensus of experts, and the partial consensus of experts with regularity conditions. The proposed model can monitor the transfer performance attributes that depend on service operations and allows attributing the loss of quality to each component involved in the process. The new methodology developed through the paper was applied to Barcelona’s New Bus Network, although it would be generally applicable in other modes of transport.
Impact of Genetic Polymorphisms on the Sulfation of Dehydroepiandrosterone and 17-β estradiol by Human Cytosolic Sulfotransferase SULT2B1a
Authors: Alatwi Eid , Bairam Ahsan 
Published: June 2024

Abstract

Dehydroepiandrosterone (DHEA) is considered an endogenous steroid hormone precursor, and 17-ß Estradiol (E2) is one of the estrogen steroid hormones. Of the thirteen known human cytosolic sulfotransferases (SULTs), SULT2B1a has been shown to be expressed in steroid hormone-responsive tissues such as the prostate, ovary, and placenta, as well as the fetal brain. Previous studies have demonstrated that SULT2B1a is capable of sulfating 3β-hydroxysteroids such as DHEA and pregnenolone. The present study aimed to investigate the effects of human SULT2B1SNPs on the enzymatic characteristics of SULT2B1a allozymes in mediating the sulfation of DHEA and E2. To inspect the effects of single nucleotide polymorphisms of the SULT2B1gene on the sulfation of DHEA and E2 by SULT2B1a allozymes, 13 recombinant SULT2B1a allozymes were produced, expressed, and purified using established procedures. 13 SULT 2B1a nonsynonymous missense coding SNPs (cSNPs) were selected among numerous identified human SULT 2B1a SNPs by a comprehensive database search. The corresponding cDNAs, packaged in pGEX-2TK expression vector, and encoding the selected 13 SULT2B1a allozymes, have been generated by performing site-directed mutagenesis. These were then bacterially expressed in BL21 E. coli cells and purified using glutathione-Sepharose affinity chromatography. The purified allozymes were tested for their ability to sulfonate DHEA and E2. In terms of the kinetic parameters, the wild-type SULT2B1a exhibited higher enzyme affinity towards DHEA than with E2. In comparison with the wild-type SULT2B1a, the purified allozymes displayed differential sulfating activities towards DHEA and E2. Accordingly, these findings indicate an apparent effect of SULT2B1 cSNPs on the sulfating activities of SULT2B1a allozymes toward DHEA and E2, and may provide for a better understanding of the pharmacokinetics of DHEA and E2 in individuals with differing SULT2B1 a genotypes.
Comparative effectiveness of Sildenafil Citrate and Estradiol Valerate as adjuvants during Clomiphene Citrate-assisted ovarian stimulation cycles in Patients with unexplained infertility: A double-blind randomized controlled trial in Kisangani, DRC
Authors: Bosenge-Nguma Jean-Didier , O’yandjo Antoine Modia , Djang’eing'a Roland Marini , SKV Juakali , Otuli Noël Labama , Ntokamuda Justin Kadima , Chin Alexis Heng Boon , Bosunga Gedeon Katenga 
Published: June 2024

Abstract

Objective
This study aimed to assess the effect of sildenafil citrate and estradiol valerate as adjuvant therapy during ovarian stimulation cycles with clomiphene citrate in patients with unexplained infertility to update infertility management guidelines in Kisangani.
Method
A double-blind, randomized controlled trial was conducted for two years (from October 1, 2021, to October 31, 2023). The population included 148 patients, 74 of whom were on clomiphene citrate + sildenafil citrate (CCSC) regimens and 74 of whom were on clomiphene citrate + estradiol valerate (CCEV) regimens for three months. The primary indicator was the conception rate, with secondary outcomes encompassing endometrial thickness, appearance and vascularity, the number of mature follicles and ovulation rate.
Results
Perifollicular flow was predominantly high-grade (P = 0.002), and the ovulation rate and clinical pregnancy rate were greater (P = 0.006) in the CCSC group than in the CCEV group. However, biochemical pregnancy rate, endometrial vascularity/thickness, and the number of Graafian follicles were not significantly different. The two groups were comparable in terms of sociodemographic and clinical characteristics. The mean duration of attempting to conceive was 4.39 years versus 4.36 years, and the mean AFC was 11.51 versus 11.46, respectively, in the CCSC versus CCEV groups. Secondary infertility was the most frequent type in each of the two participant assignment groups.
Conclusion
As an adjuvant, sildenafil increases the rate of clinical pregnancy more than does estradiol in patients with unexplained infertility undergoing ovarian stimulation with clomiphene citrate. However, both sildenafil citrate and estradiol valerate can protect the endometrium from the harmful antiestrogenic effects of clomiphene.
Study registration: PACTR 202310849449401 ( Pan African Clinical Trials Registry)