bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence, Predictors, and Implications of Secondary Aortic Intervention Following Thoracic Endovascular Aortic Repair for Type B Dissection
Authors: Wang Jizhong , Hu Xiaolu , Liu Jie , Liu Jitao , Li Ting , Huang Jing , Yang Yi , Fan Ruixin , Yang Fan , Luo Songyuan , Li Jie , Chen Zhengbo , Luo Jianfang 
Published: May 2024

Background: Secondary aortic intervention (SAI) following thoracic endovascular aortic repair (TEVAR) is not uncommon. However, a satisfactory management system has not been established for these patients. We aimed to report our single-center experience with SAI after prior TEVAR for type B aortic dissection (TBAD). Methods: From January 2010 to May 2017, 860 eligible patients with TBAD underwent TEVAR. One hundred seven (12.4%) patients required SAI, either endovascularly (n=76) or surgically (n=31). The main indications for SAI were entry flow (n=58 [54.2%]), aneurysm expansion of the proximal or remote aorta (n=26 [24.3%]), retrograde type A aortic dissection (n=11 [10.3%]), distal stent-graft–induced new entry tear (n=6 [5.6%]), and stent migration (n=4 [3.7%]). The Kaplan-Meier curves were generated to determine the degree of freedom from SAI and the prognosis. Cox proportional hazards were used to screen for risk factors for SAI and poor prognosis. Results: The overall 30-day mortality rate after SAI was 4.7% (n=5): endovascular (n=2 [2.6%]) vs open surgery (n=3 [9.7%]; p=0.145). The cumulative survival rates with or without SAI were 86.3%±3.6% vs 95.7%±0.8% at 3 years and 82.0%±4.2% vs 92.2%±1.1% at 5 years, respectively (log-rank p<0.001). Although no significant difference in survival was observed, the incidence of SAI was significantly greater in patients who underwent TEVAR during the chronic phase (acute [11.6%] vs subacute [9.6%] vs chronic [27.8]; p<0.001). Multivariate regression analysis revealed that prior TEVAR in the chronic phase (hazard ratio [HR]=1.73, 95% confidence interval [CI]=1.03-2.90; p=0.039), maximum aortic diameter (HR=1.05, 95% CI=1.04-1.07; p<0.001), and arch involvement (HR=1.48, 95% CI=1.01-2.18; p=0.048) were predictors of the incidence of SAI. In addition, the maximum aortic diameter was demonstrated to be the only risk factor for prognosis after adjusting for confounding factors. Conclusions: Thoracic endovascular aortic repair for chronic TBAD patients should be reconsidered. Open surgery is preferable for those with proximal progression, whereas endovascular treatment is more suitable for distal lesions. Close surveillance and timely reintervention after TEVAR, whether via endovascular techniques or open surgery, are necessary to prevent devastating complications. Clinical Impact The management of patients with type B aortic dissection (TBAD) after thoracic endovascular aortic repair (TEVAR) is challenging. We summarized our single-center experience regarding secondary aortic intervention after TEVAR for TBAD. We found that TEVAR for chronic TBAD patients should be carefully evaulated, and open surgery is recommended for those with proximal progession, while endovascular treatment is more preferable for distal lesions.
Device-Related Skin Reactions Increase Emotional Burden in Youths With Type 1 Diabetes and Their Parents
Authors: Passanisi Stefano , Galletta Francesca , Bombaci Bruno , Cherubini Valentino , Tiberi Valentina , Minuto Nicola , Bassi Marta , Iafusco Dario , Piscopo Alessia , Mozzillo Enza , Di Candia Francesca , Rabbone Ivana , Pozzi Erica , Franceschi Roberto , Cauvin Vittoria , Maffeis Claudio , Piona Claudia Anita , Salzano Giuseppina 
Published: May 2024

Background: Skin reactions due to technological devices pose a significant concern in the management of type 1 diabetes (T1D). This multicentric, comparative cross-sectional study aimed to assess the psychological impact of device-related skin issues on youths with T1D and their parents. Methods: Participants with skin reactions were matched in a 1:1 ratio with a control group. Diabetes-related emotional distress was evaluated using the Problem Areas in Diabetes–Teen version (PAID-T) for participants aged 11 to 19 years and the Problem Areas in Diabetes–Parent Revised version (PAID-PR) completed by parents. In addition, glucose control was assessed through glycated hemoglobin (HbA1c) values and continuous glucose monitoring (CGM) metrics. Results: A total of 102 children and adolescents were consecutively recruited. Adolescents with skin issues had higher PAID-T scores compared to those without (79.6 ± 21.1 vs 62 ± 16.8; P = .004). Parents of youths with skin reactions also reported higher PAID-PR scores than the control group (34.0 ± 11.0 vs 26.9 ± 12.3; P = .015). No differences were observed in HbA1c levels (6.9 ± 0.8% vs 6.8 ± 0.8%, P = .555) or CGM glucose metrics between the two groups. Remarkably, 25.5% were forced to discontinue insulin pumps and/or glucose sensors (21.5% and 5.9%, respectively). Conclusions: Our study highlighted the increased emotional burden experienced by youths with T1D and their parents due to device-related skin reactions, emphasizing the need for further research and interventions in this crucial aspect of diabetes management.
Severe Insulin Pump-Related Adverse Events: Potential Root Causes and Impact of the COVID-19 Pandemic
Authors: Orbell Staci L. , Codario Ronald A. , Zupa Margaret F. , Estock Jamie L. 
Published: May 2024

Objective: To explore insulin pump-associated severe adverse events (SAEs) involving intensive care unit (ICU) admissions and deaths and examine the impact of the COVID-19 pandemic on these SAEs. Methods: Qualitative template analysis of narrative data in reported insulin pump-associated SAEs occurring between May 1, 2019, and January 31, 2021, involving MiniMed 670G, MiniMed 630G, Omnipod, Omnipod DASH, and t:slim X2 insulin pumps. Results: Over the 21-month measurement period, 460 SAEs involving an ICU admission and 288 SAEs involving a death were reported to the Food and Drug Administration. Problems with the pump or pod reservoir/cartridge were among the most frequently cited potential root causes in SAEs involving ICU admissions and deaths overall. However, problems with the infusion set or site and the pump battery or power emerged in the top three potential root causes of SAEs involving an ICU admission, whereas the patient sleeping at the time of the event and the tasks of changing the pod/infusion set, including reservoir/cartridge and programming the pump emerged in the top three for SAEs involving a death. The median monthly number of reported SAEs involving ICU admissions and deaths decreased during the pandemic, but their potential root causes were unchanged. Conclusions: Although insulin pumps are generally safe, SAEs related to their components and external factors can and do occur. By learning from the potential root causes of insulin pump-associated SAEs, providers and patients can implement corrective actions to prevent future events, thereby reducing harm.
Physical Therapy Intervention Effects on Alteration of Spinal Excitability in Patients With Chronic Ankle Instability: A Systematic Review and Meta-analysis
Authors: Lin Chia-Wei , Jankaew Amornthep , Lin Cheng-Feng 
Published: May 2024

Context: Chronic ankle instability (CAI) is a common injury in athletes. Different forms of physical therapy have been applied to the population with CAI to assess their impact on spinal excitability. Objective: The purpose of this systematic review and meta-analysis was to investigate the effectiveness of various physical therapy interventions on the alteration of spinal excitability in patients with CAI. Data Sources: Four databases (EMBASE, MEDLINE, Cochrane CENTRAL, and Scopus) were searched from inception to November 2022. Study Selection: A total of 253 studies were obtained and screened; 11 studies on the effects of physical therapy intervention on the alteration of spinal excitability in patients with CAI were identified for meta-analysis. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 3a. Data Extraction: A total of 11 studies that included the maximal Hoffmann reflex normalized by the maximal muscle response (H/M ratio) in the peroneus longus and soleus muscles were extracted and summarized. The quality of the studies was assessed using the PEDro scale. Results: The extracted studies had an average PEDro score of 4.7 ± 1.4, indicating that most of them had fair-to-good quality. The physical therapy interventions included cryotherapy, taping, mobilization, proprioceptive training, and dry needling. The overall effects showed that the H/M ratios of the peroneus longus ( P = 0.44, I2 = 0%) and soleus ( P = 0.56, I2 = 22%) muscles were not changed by physical therapy in patients with CAI. Conclusion: The meta-analysis indicated that physical therapy interventions such as cryotherapy, taping, mobilization, proprioceptive training, and dry needling do not alter the spinal excitability in patients with CAI. Given that only 1 study reported ineffective changes in spinal excitability with dry needling, more research is essential to establish and validate its efficacy. PROSPERO Registration: CRD42022372998
SVM-RLF-DNN: A DNN with reliefF and SVM for automatic identification of COVID from chest X-ray and CT images
Authors: Saha Sanjib , Nandi Debashis 
Published: May 2024

Aim To develop an advanced determination technology for detecting COVID-19 patterns from chest X-ray and CT-scan films with distinct applications of deep learning and machine learning methods. Methods and Materials The newly enhanced proposed hybrid classification network (SVM-RLF-DNN) comprises of three phases: feature extraction, selection and classification. The in-depth features are extracted from a series of 3×3 convolution, 2×2 max polling operations followed by a flattened and fully connected layer of the deep neural network (DNN). ReLU activation function and Adam optimizer are used in the model. The ReliefF is an improved feature selection algorithm of Relief that uses Manhattan distance instead of Euclidean distance. Based on the significance of the feature, the ReliefF assigns weight to each extracted feature received from a fully connected layer. The weight to each feature is the average of k closest hits and misses in each class for a neighbouring instance pair in multiclass problems. The ReliefF eliminates lower-weight features by setting the node value to zero. The higher weights of the features are kept to obtain the feature selection. At the last layer of the neural network, the multiclass Support Vector Machine (SVM) is used to classify the patterns of COVID-19, viral pneumonia and healthy cases. The three classes with three binary SVM classifiers use linear kernel function for each binary SVM following a one-versus-all approach. The hinge loss function and L2-norm regularization are selected for more stable results. The proposed method is assessed on publicly available chest X-ray and CT-scan image databases from Kaggle and GitHub. The performance of the proposed classification model has comparable training, validation, and test accuracy, as well as sensitivity, specificity, and confusion matrix for quantitative evaluation on five-fold cross-validation. Results Our proposed network has achieved test accuracy of 98.48% and 95.34% on 2-class X-rays and CT. More importantly, the proposed model's test accuracy, sensitivity, and specificity are 87.9%, 86.32%, and 90.25% for 3-class classification (COVID-19, Pneumonia, Normal) on chest X-rays. The proposed model provides the test accuracy, sensitivity, and specificity of 95.34%, 94.12%, and 96.15% for 2-class classification (COVID-19, Non-COVID) on chest CT. Conclusion Our proposed classification network experimental results indicate competitiveness with existing neural networks. The proposed neural network assists clinicians in determining and surveilling the disease.
The advantages, disadvantages, threats, and opportunities of electronic patient-reported outcome systems in cancer: A systematic review
Authors: Salmani Hosna , Nasiri Somayeh , Ahmadi Maryam 
Published: May 2024

Objective Electronic patient-reported outcome (ePRO) systems hold promise for revolutionizing communication between cancer patients and healthcare providers across various care settings. This systematic review explores the multifaceted landscape of ePROs in cancer care, encompassing their advantages, disadvantages, potential risks, and opportunities for improvement. Methods In our systematic review, we conducted a rigorous search in Scopus, Web of Science, and PubMed, employing comprehensive medical subject heading terms for ePRO and cancer, with no date limitations up to 2024. Studies were critically appraised and thematically analyzed based on inclusion and exclusion criteria, including considerations of advantages, disadvantages, opportunities, and threats. Findings Analyzing 85 articles revealed 69 themes categorized into four key areas. Advantages ( n = 14) were dominated by themes like “improved quality of life and care.” Disadvantages ( n = 26) included “limited access and technical issues.” Security concerns and lack of technical skills were prominent threats ( n = 10). Opportunities ( n = 19) highlighted advancements in symptom management and potential solutions for technical challenges. Conclusion This review emphasizes the crucial role of continuous exploration, integration, and innovation in ePRO systems for optimizing patient outcomes in cancer care. Beyond traditional clinical settings, ePROs hold promise for applications in survivorship, palliative care, and remote monitoring. By addressing existing limitations and capitalizing on opportunities, ePROs can empower patients, enhance communication, and ultimately improve care delivery across the entire cancer care spectrum.
Long-term efficacy and safety of rituximab in the treatment of neuromyelitis Optica Spectrum disorder
Authors: Hayes Michael T G , Adam Robert J , McCombe Pamela A , Walsh Michael , Blum Stefan 
Published: May 2024

Background Neuromyelitis optica spectrum disorder (NMOSD) is a relapsing, autoimmune, inflammatory astrocytopathy. Rituximab for B-cell suppression is a common treatment for NMOSD; however, large-scale randomised controlled trials are lacking. Objective Evaluate long-term efficacy and safety of rituximab for NMOSD. Methods Retrospective observational study of patients with NMOSD treated with rituximab. Annualised relapse rates (ARRs) before and during rituximab treatment were evaluated; Modified Rankin Scores (mRS) were measured as a marker of disability. Results In total, 37 patients were included: 27 aquaporin-4-IgG-seropositive and 10 seronegative NMOSD. The predominant rituximab dosing regimen was an initial 1000 mg, split over two 500 mg infusions, two weeks apart, followed by single 500 mg doses. Over a median follow-up of 54 months, ARR for the whole cohort was 0.136 (95% CI 0.088–0.201), significantly lower than the pretreatment ARR of 0.366 (95% CI 0.271–0.483, p < 0.001). There was a significant reduction in ARR for the seropositive subgroup, but not seronegative. Significant improvement in mRS was seen post-treatment. Infections were reported in 32% of patients during follow-up; most were mild. Conclusion Rituximab, at doses lower than traditionally used, may be an efficacious therapy for NMOSD, with a favourable safety profile.
Computational approaches and challenges in the analysis of circRNA data
Authors: Digby Barry , Finn Stephen , Ó Broin Pilib 
Published: May 2024

AbstractCircular RNAs (circRNA) are a class of non-coding RNA, forming a single-stranded covalently closed loop structure generated via back-splicing. Advancements in sequencing methods and technologies in conjunction with algorithmic developments of bioinformatics tools have enabled researchers to characterise the origin and function of circRNAs, with practical applications as a biomarker of diseases becoming increasingly relevant. Computational methods developed for circRNA analysis are predicated on detecting the chimeric back-splice junction of circRNAs whilst mitigating false-positive sequencing artefacts. In this review, we discuss in detail the computational strategies developed for circRNA identification, highlighting a selection of tool strengths, weaknesses and assumptions. In addition to circRNA identification tools, we describe methods for characterising the role of circRNAs within the competing endogenous RNA (ceRNA) network, their interactions with RNA-binding proteins, and publicly available databases for rich circRNA annotation.
Application of chitosan nanopriming on plant growth and secondary metabolites of Pancratium maritimum L
Authors: Allam Eman , El-Darier Salama , Ghattass Zekry , Fakhry Amal , Elghobashy Roufaida M. 
Published: May 2024

Abstract
Background
Nanotechnology has demonstrated its vital significance in all aspects of daily life. Our research was conducted to estimate the potential of primed seed with chitosan nanoparticles in seed growth and yield by inducing plant secondary metabolism of Pancratium maritimum L. one of the important medicinal plants. Petri dish and pot experiments were carried out. Seeds of Pancratium maritimum L. were soaked in Nano solution (0.1, 0.5, 1 mg/ ml) for 4, 8, 12 h. Germination parameters (germination percentage, germination velocity, speed of germination, germination energy, germination index, mean germination time, seedling shoot and root length, shoot root ratio, seedling vigor index, plant biomass and water content), alkaloids and antioxidant activity of Pancratium maritimum L. were recorded and compared between coated and uncoated seeds.

Results
Our results exhibited that chitosan nanopriming had a positive effect on some growth parameters, while it fluctuated on others. However, the data showed that most germination parameters were significantly affected in coated seeds compared to uncoated seeds. GC-MS analysis of Pancratium maritimum L. with different nanopriming treatments showed that the quantity of alkaloids decreased, but the amount of pancratistatin, lycorine and antioxidant content increased compared with the control.

Conclusions
Applying chitosan nanoparticles in priming seeds might be a simple and effective way to improve the quantity of secondary metabolites of Pancratium maritimum L. valuable medicinal plant.
Winter survival in red clover: experimental evidence for interactions among stresses
Authors: Ergon Åshild , Amdahl Helga 
Published: May 2024

Abstract
Background
There is a lack of knowledge on the combined effects of different stresses on plants, in particular different stresses that occur during winter in temperate climates. Perennial herbaceous plants in temperate regions are exposed to many different stresses during winter, but except for the fact that cold temperatures induce resistance to a number of them, very little is known about their interaction effects. Knowledge about stress interactions is needed in order to predict effects of climate change on both agricultural production and natural ecosystems, and to develop adaptation strategies, e.g., through plant breeding. Here, we conducted a series of experiments under controlled conditions to study the interactions between cold (low positive temperature), clover rot infection (caused by Sclerotinia trifoliorum) and freezing, in red clover (Trifolium pratense) accessions. We also compared our results with winter survival in field experiments and studied associations between stress and shoot growth.

Results
Exposure to low positive temperatures (cold acclimation) induced resistance to clover rot. There was a clear negative interaction effect between freezing stress and clover rot infection, resulting in up to 37% lower survival rate compared to what would have been expected from the additive effect of freezing and infection alone. Freezing tolerance could continue to improve during incubation under artificial snow cover at 3 °C in spite of darkness, and we observed compensatory shoot growth following freezing after prolonged incubation. At the accession level, resistance to clover rot was negatively correlated with growth in the field during the previous year at a Norwegian location. It was also negatively correlated with the shoot regrowth of control plants after incubation. Clover rot resistance tests under controlled conditions showed limited correlation with clover rot resistance observed in the field, suggesting that they may reveal variation in more specific resistance mechanisms.

Conclusions
We here demonstrate, for the first time, a strong negative interaction between freezing and infection with a winter pathogen. We also characterize the effects of cold acclimation and incubation in darkness at different temperatures on winter stress tolerance, and present data that support the notion that annual cycles of growth and stress resistance are associated at the genetic level.
Characteristics that increase the risk for pain on propofol injection
Authors: Leff Phillip J. , Dinner Brett A. , Chuang Keng-Yu , Leff David B. 
Published: May 2024

Abstract
Background
Propofol for anesthesia has become increasingly popular for endoscopic procedures. However, pain on propofol injection (POPI) remains an issue with administration. The primary endpoint of this study was to identify patient characteristics and factors, such as IV site and gauge, that could predict the occurrence of POPI.

Methods
This was a prospective chart review study of 291 patients undergoing endoscopic procedures. The patient’s demographics, intravenous (IV) site, and gauge were extrapolated. POPI was scored 0–3: 0 for no pain, 1 for minimal discomfort or awareness of sensation, 2 for discomfort but manageable/tolerable, and 3 for severe discomfort with writhing.

Results
291 patient charts were reviewed. One patient was excluded for a lower extremity IV site. 225 (77.6%) had no pain, 48 (16.6%) grade 1 pain, 16 (5.5%) grade 2 pain, and 1 (0.3%) grade 3 pain. 137, 13, and 140 patients respectively had antecubital (AC), forearm, and hand IVs. Zero patients with an AC IV experienced a score greater than 1. Compared to AC, forearm IVs with pain of 2–3 had a univariate odds ratio (OR) of 11.3 (0.66,1.92; p-value < 0.001), and hand IVs had a univariate OR of 18.8 (2.46,143.3; p-value < 0.001) with a multivariable OR 15.2 (1.93,118.9; p-value 0.004). Patients with anxiety/depression and pain had a univariate OR 2.31 (1.09, 7.27; p-value 0.031) with a multivariable OR 2.85 (1.06, 7.74; p-value 0.039). SSRI/SNRI use had a univariate OR 1.56 (0.57,4.28; p-value 0.38). Alcohol use had a univariate OR 1.24 (0.39,3.91; p-value 0.71). Narcotic use had a Univariate OR 6.18 (1.49,25.6; p-value 0.012). Diabetic patients had a univariate OR of 1.42 (0.45,4.48; p-value 0.55). Chronic pain had a univariate OR of 3.11 (1.04,9.28; p-value 0.042). Females had a univariate OR 0.98 (0.37,2.63; p-value 0.95).

Conclusion
This study identified potential characteristics for having POPI. The incidence of POPI was statistically significant in patients with hand and forearm IVs compared to AC IV sites, larger IV gauges, history of depression/anxiety, history of chronic narcotic use, fibromyalgia, and chronic pain syndromes. This shows the potential of premedicating with analgesics or using AC sites on these select patients to help reduce the risk of POPI.