bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Smartphone Medical Applications as a Self-Directed Learning Tool for Medical Students and Compulsory Rotatory Residential Internship—A KAP Survey
Authors: Shanmuga Vadivoo Natarajan , Sudha Krishnan , Usha Balasundaram 
Published: May 2024

OBJECTIVES Smartphones have become a powerful instrument in academic life for medical professions worldwide. Global lockdown due to COVID-19 pandemic culminated in the closure of educational institutions and resulted in shifting to online teaching. In our newly implemented competency-based medical education curriculum (CBME) for medical graduates, self-directed learning (SDL) is one of the teachings—learning methods. Smartphones are an essential tool for SDL in medical school. This main objective of the study is to determine the usage of health apps in a tertiary care teaching hospital to encourage the medical students and compulsory rotatory residential internship (CRRI) to continue SDL process. METHODS This cross-sectional questionnaire-based study was conducted for the period of 30 days for medical students and CRRI's at a tertiary care teaching hospital. The population was selected using convenient sampling method. This anonymous questionnaire was validated by the experts and the questions encompassing knowledge, attitude and perception (KAP Survey) of the students toward smartphone medical apps was utilized for this survey. RESULTS Out of 582 participants, only 250 students (43%) have participated in the survey. Our study shows that 95% of students were handling android smartphones, and 84% of them were using various medical applications on them and it leads to SDL. CONCLUSION The impact of the lockdown has increased SDL. Majority of the students (51.8-69.8%) have agreed that medical apps enhanced their SDL and helped them to study independently.
Race-Based Differences in the Response to a Mindfulness Based Integrative Medical Group Visit Intervention for Chronic Pain
Authors: Incollingo Rodriguez Angela C. , Nephew Benjamin C. , Polcari Justin J. , Melican Veronica , King Jean A. , Gardiner Paula 
Published: May 2024

Background Chronic pain is one of the most common drivers of healthcare utilization and a marked domain for health disparities, as African American/Black populations experience high rates of chronic pain. Integrative Medical Group Visits (IMGV) combine mindfulness techniques, evidence-based integrative medicine, and medical group visits. In a parent randomized controlled trial, this approach was tested as an adjunct treatment in a diverse, medically underserved population with chronic pain and depression. Objective To determine race-based heterogeneity in the effects of a mindfulness based treatment for chronic pain. Methods This secondary analysis of the parent trial assessed heterogeneity of treatment effects along racialized identity in terms of primary patient-reported pain outcomes in a racially diverse sample suffering from chronic pain and depression. The analytic approach examined comorbidities and sociodemographics between racialized groups. RMANOVAs examined trajectories in pain outcomes (average pain, pain severity, and pain interference) over three timepoints (baseline, 9, and 21 weeks) between participants identifying as African American/Black (n = 90) vs White (n = 29) across both intervention and control conditions. Results At baseline, African American/Black participants had higher pain severity and had significantly different age, work status, and comorbidity profiles. RMANOVA models also identified significant race-based differences in the response to the parent IMGV intervention. There was reduced pain severity in African American/Black subjects in the IMGV condition from baseline to 9 weeks. This change was not observed in White participants over this time period. However, there was a reduction in pain severity in White participants over the subsequent interval from 9 to 21 week where IMGV had no significant effect in African American/Black subjects during this latter time period. Conclusion Interactions between pain and racialization require further investigation to understand how race-based heterogeneity in the response to integrative medicine treatments for chronic pain contribute to the broader landscape of health inequity.
A worldwide look into long COVID-19 management: an END-COVID survey
Authors: Nigro Mattia , Valenzuela Claudia , Arancibia Francisco , Cohen Mark , Lam David C.L. , Maves Ryan C. , Rath Barbara , Simpson Steven Q. , Song Yuanlin , Tsiodras Sotirios , Chalmers James D. , Aliberti Stefano 
Published: May 2024

BackgroundLong COVID is a heterogeneous clinical syndrome characterised by a variety of reported symptoms and signs. Its clinical management is expected to differ significantly worldwide.MethodsA survey-based study investigating long COVID-related standard operating procedures (SOPs) has been conducted by the European Respiratory Society (ERS) END-COVID clinical research collaboration with the support of other international societies (ALAT, APSR, CHEST, ESCMID and PATS). A global analysis of the results is provided here, alongside sub-population analysis based on continents, national income levels, type of involved healthcare professional and inclusion or exclusion of paediatric patients.Findings1015 healthcare professionals from 110 different countries worldwide participated in this study, the majority of them being respiratory physicians (60.6%). A dedicated long COVID programme was present in 55.4% of the investigated institutions, with hospital admission during the acute infection being the main inclusion criteria to access them. Consistent differences in long COVID-related procedures were identified among centres, mainly regarding the multidisciplinary approach, the availability of telemedicine and psychological support, the type of requested exams and the total amount of visits in the centre.InterpretationLong COVID management shows important differences related to geographical areas and national income levels. SOPs were significantly different when centres were managed by a pulmonologist or when paediatric patients were included.
Persistent disabilities 28 months after COVID-19 hospitalization, a prospective cohort study
Authors: Renaud Bertrand , Chocron Richard , Reverdito Guillaume , Blanchard Anne , Hua-Huy Thong , Diehl Jean-Luc , Livrozet Marine , Subileau Marielle , Lemogne Cédric , El-Batti Salma , Auclin Edouard , Jannot Anne-Sophie , Rance Bastien , Mousseaux Elie , Smadja David , Lebeaux David , Hulot Jean-Sébastien , Sanchez Olivier , Günther Sven 
Published: May 2024

BackgroundLimited data are available on long-term respiratory disabilities in patients following acute COVID-19.Patients and MethodsThis prospective, monocentric, observational cohort study included patients admitted to our hospital with acute COVID-19 between March 3 and April 24, 2020. Clinical, functional, and radiological data were collected up to 28 months after hospital discharge.ResultsAmong 715 patients hospitalized for COVID-19, 493 (69.0%) were discharged alive. We could access complete medical records for 268/493 patients (54.4%); 138/268 (51.5%) exhibited persistent respiratory symptoms and agreed with the data collection and follow-up. Patients were predominantly male (64.5%), with a mean (±sd) age of 58.9±15.3 years. At the last follow-up, the leading symptoms were asthenia (31.5%), dyspnoea (29.8%), and neuropsychological symptoms (17.7%). Lung function improved up to the last visit. Mean diffusing capacity of the lung for carbon monoxide (DLCO) was 77.8% of predicted value, total lung capacity (TLC) 83.5%, and O2desaturation during exercise (O2desaturation) −2.3%. While DLCO improved over the entire period, TLC improved in the early phase and O2desaturation in the late phase. Except for those with lung comorbidities, only one patient presented with minor functional and chest radiological alterations at 28-months.ConclusionPatients with acute COVID-19 discharged alive showed improved clinical symptoms, lung function parameters and radiological signs up to 28 months post infection. Persistent symptoms consisted mainly of asthenia and dyspnoea, with lung function returning to normal. One patient without prior respiratory issues exhibited moderate pulmonary fibrosis.
Exploring the concept of disease control in chronic cough
Authors: Park Jin Young , Jun Haesung , Lee Seung-Eun , Won Ha-Kyeong , Kang Sung-Yoon , Kang Noeul , Oh Ji-Yoon , Kim Young-Chan , Park So-Young , An Jin , Yoo Youngsang , Kim Mi-Yeong , Lee Hwa Young , Shim Ji-Su , Kim Min-Hye , Kim Sae-Hoon , Kim Sang-Heon , Chang Yoon-Seok , Kim Sang-Hoon , Lee Byung-Jae , Birring Surinder S. , Song Woo-Jung 
Published: May 2024

BackgroundDisease control in chronic diseases is an overarching concept that reflects the degree to which the goals of therapy are met. However, to date, there is no consensus on the definition of disease control in chronic cough. This study aimed to provide a conceptual exploration of patient-reported cough control in chronic cough.MethodsThis research is comprised of two subanalyses. First, patients with chronic cough receiving care at referral clinics were evaluated. Correlation analyses were performed between patient-reported cough control (a 5-point Likert scale), cough-specific patient-reported outcomes (PROs) and generic health PRO scores. Second, a survey was conducted among patients with refractory chronic cough and physicians to identify factors pertinent to cough control.ResultsThe analysis of 341 patients (mean age: 55.5±15.1 years; female: 66.6%) revealed that cough control rating was moderately correlated with cough severity visual analogue scale and Leicester Cough Questionnaire scores, while demonstrating weaker correlations with cough-associated throat symptoms, cough-related complications or general health-related quality of life (QoL). In the survey of patients and physicians, both groups considered certain factors, such as cough frequency, severity and impact on QoL, to be relevant to the concept of cough control. However, patients rated “need for cough rescue drug” notably higher than physicians.ConclusionPatient-reported cough control was associated with cough severity or impact on QoL; however, cough control may not be fully captured by conventional cough PRO measurement tools. Further studies are warranted to define the consensus and tools to measure disease control in chronic cough.
Characteristics and outcomes of gemcitabine-associated pulmonary hypertension
Authors: Mouillot Pierre , Favrolt Nicolas , Khouri Charles , Grandvuillemin Aurélie , Chaumais Marie-Camille , Schenesse Déborah , Seferian Andrei , Jais Xavier , Savale Laurent , Beltramo Guillaume , Sitbon Olivier , Cracowski Jean-Luc , Humbert Marc , Georges Marjolaine , Bonniaud Philippe , Montani David 
Published: May 2024

BackgroundDespite its known cardiac and lung toxicities, the chemotherapy drug gemcitabine has only rarely been associated with pulmonary hypertension (PH), and the underlying mechanism remains unclear. The objective of the present study was to assess the association between gemcitabine and PH.MethodsWe identified incident cases of precapillary PH confirmed by right heart catheterisation in patients treated with gemcitabine from the French PH Registry between January 2007 and December 2022. The aetiology, clinical, functional, radiological and haemodynamic characteristics of PH were reviewed at baseline and during follow-up. A pharmacovigilance disproportionality analysis was conducted using the World Health Organization (WHO) pharmacovigilance database.ResultsWe identified nine cases of pulmonary arterial hypertension, either induced (in eight patients) or exacerbated (in one patient) by gemcitabine. Patients exhibited severe precapillary PH, with a median mean pulmonary arterial pressure of 40 (range 26–47) mmHg, a cardiac index of 2.4 (1.6–3.9) L·min−1·m−2and a pulmonary vascular resistance of 6.3 (3.1–12.6) Wood units. The median time from the initiation of gemcitabine to the onset of PH was 7 (4–50) months, with patients receiving a median of 16 (6–24) gemcitabine injections. Six patients showed clinical improvement upon discontinuation of gemcitabine. In the WHO pharmacovigilance database, we identified a significant signal with 109 cases reporting at least one adverse event related to PH with gemcitabine.ConclusionBoth clinical cases and pharmacovigilance data substantiate a significant association between gemcitabine use and the onset or worsening of precapillary PH. The observed improvement following the discontinuation of treatment underscores the importance of PH screening in gemcitabine-exposed patients experiencing unexplained dyspnoea.
Expression of intramuscular extracellular matrix proteins in vastus lateralis muscle fibres between atrophic and non-atrophic COPD
Authors: Kritikaki Efpraxia , Terzis Gerasimos , Soundararajan Meera , Vogiatzis Ioannis , Simoes Davina C.M. 
Published: May 2024

BackgroundExtracellular matrix (ECM) proteins are the major constituents of the muscle cell micro-environment, imparting instructive signalling, steering cell behaviour and controlling muscle regeneration. ECM remodelling is among the most affected signalling pathways in COPD and aged muscle. As a fraction of COPD patients present muscle atrophy, we questioned whether ECM composition would be altered in patients with peripheral muscle wasting (atrophic COPD) compared to those without muscle wasting (non-atrophic COPD).MethodsA set of ECM molecules with known impact on myogenesis were quantified in vastus lateralis muscle biopsies from 29 COPD patients (forced expiratory volume in 1 s 55±12% predicted) using ELISA and real-time PCR. COPD patients were grouped to atrophic or non-atrophic based on fat-free mass index (<17 or ≥17 kg·m−2).ResultsAtrophic COPD patients presented a lower average vastus lateralis muscle fibre cross-sectional area (3872±258 μm2) compared to non-atrophic COPD (4509±198 μm2). Gene expression of ECM molecules was found significantly lower in atrophic COPD compared to non-atrophic COPD for collagen type I alpha 1 chain (COL1A1), fibronectin (FN1), tenascin C (TNC) and biglycan (BGN).In terms of protein levels, there were no significant differences between the two COPD cohorts for any of the ECM molecules tested.ConclusionsAlthough atrophic COPD presented decreased contractile muscle tissue, the differences in ECM mRNA expression between atrophic and non-atrophic COPD were not translated at the protein level, potentially indicating an accumulation of long-lived ECM proteins and dysregulated proteostasis, as is typically observed during deconditioning and ageing.
Upregulated dual oxidase 1-induced oxidative stress and caspase-1-dependent pyroptosis reflect the etiologies of heart failure
Authors: Li Yan Song , Xia Jingwen , Chen Chang Yuan , Ren Shu Hong , He Mao Rong 
Published: May 2024

Abstract
Background
Oxidative stress is implicated in the pathogenesis of heart failure. Dual oxidase 1 (DUOX1) might be important in heart failure development through its mediating role in oxidative stress. This study was designed to evaluate the potential role of DUOX1 in heart failure.

Materials and methods
AC16 cells were treated with 2 µmol/L of doxorubicin (DOX) for 12, 24, and 48 h to construct a heart failure model. DUOX1 overexpression and silencing in AC16 cell were established. DUOX1 expression was detected by Quantitative real-time polymerase chain reaction (qRT-PCR) and western blot. Pyroptosis and reactive oxygen species (ROS) production were measured by flow cytometry.

Results
Increased DUOX1 expression levels were observed after DOX treatment for 24 h in AC16 cells. DUOX1 silencing inhibited DOX-induced pyroptosis and ROS production. The release of IL-1β, IL-18, and lactate dehydrogenase (LDH), and expression levels of pyroptosis-related proteins were also decreased. DUOX1 overexpression increased pyroptosis, ROS production, IL-1β, IL-18, and LDH release, and pyroptosis-related protein expression. N-acetyl-cysteine (NAC) significantly reversed DUOX1-induced pyroptosis, ROS, and related factors.

Conclusion
These results suggest that DUOX1-derived genotoxicity could promote heart failure development. In the process, oxidative stress and pyroptosis may be involved in the regulation of DUOX1 in heart failure.
Genetic diversity, phylogeography, and maternal origin of yak (Bos grunniens)
Authors: Wang Xingdong , Pei Jie , Xiong Lin , Bao Pengjia , Chu Min , Ma Xiaoming , La Yongfu , Liang Chunnian , Yan Ping , Guo Xian 
Published: May 2024

Abstract
Background
There is no consensus as to the origin of the domestic yak (Bos grunniens). Previous studies on yak mitochondria mainly focused on mitochondrial displacement loop (D-loop), a region with low phylogenetic resolution. Here, we analyzed the entire mitochondrial genomes of 509 yaks to obtain greater phylogenetic resolution and a comprehensive picture of geographical diversity.

Results
A total of 278 haplotypes were defined in 509 yaks from 21 yak breeds. Among them, 28 haplotypes were shared by different varieties, and 250 haplotypes were unique to specific varieties. The overall haplotype diversity and nucleotide diversity of yak were 0.979 ± 0.0039 and 0.00237 ± 0.00076, respectively. Phylogenetic tree and network analysis showed that yak had three highly differentiated genetic branches with high support rate. The differentiation time of clades I and II were about 0.4328 Ma, and the differentiation time of clades (I and II) and III were 0.5654 Ma. Yushu yak is shared by all haplogroups. Most (94.70%) of the genetic variation occurred within populations, and only 5.30% of the genetic variation occurred between populations. The classification showed that yaks and wild yaks were first clustered together, and yaks were clustered with American bison as a whole. Altitude had the highest impact on the distribution of yaks.

Conclusions
Yaks have high genetic diversity and yak populations have experienced population expansion and lack obvious phylogeographic structure. During the glacial period, yaks had at least three or more glacial refugia.
Examining dynamic developmental trends: the interrelationship between age-friendly environments and healthy aging in the Chinese population—evidence from China Health and Retirement Longitudinal Study, 2011–2018
Authors: Cheng Yan , Chen Zhi-liang , Wei Yue , Gu Ning , Tang Shao-liang 
Published: May 2024

Abstract
Background
The objective of this research is to investigate the dynamic developmental trends between Age-Friendly Environments (AFE) and healthy aging in the Chinese population.

Methods
This study focused on a sample of 11,770 participants from the CHARLS and utilized the ATHLOS Healthy Aging Index to assess the level of healthy aging among the Chinese population. Linear mixed model (LMM) was used to explore the relationship between AFE and healthy aging. Furthermore, a cross-lagged panel model (CLPM) and a random-intercept cross-lagged panel model (RI-CLPM) were used to examine the dynamic developmental trends of healthy aging, taking into account both Between-Person effects and Within-Person effects.

Results
The results from LMM showed a positive correlation between AFE and healthy aging (β = 0.087, p < 0.001). There was a positive interaction between the geographic distribution and AFE (central region * AFE: β = 0.031, p = 0.038; eastern region * AFE: β = 0.048, p = 0.003). In CLPM and RI-CLPM, the positive effect of healthy aging on AFE is a type of Between-Person effects (β ranges from 0.147 to 0.159, p < 0.001), while the positive effect of AFE on healthy aging is Within-Person effects (β ranges from 0.021 to 0.024, p = 0.004).

Conclusion
Firstly, individuals with high levels of healthy aging are more inclined to actively participate in the development of appropriate AFE compared to those with low levels of healthy aging. Furthermore, by encouraging and guiding individuals to engage in activities that contribute to building appropriate AFE, can elevate their AFE levels beyond the previous average level, thereby improving their future healthy aging levels. Lastly, addressing vulnerable groups by reducing disparities and meeting their health needs effectively is crucial for fostering healthy aging in these populations.
The association between attention deficit hyperactivity disorder and pregnancy, delivery and neonatal outcomes—an evaluation of a population database
Authors: Amikam Uri , Badeghiesh Ahmad , Baghlaf Haitham , Brown Richard , Dahan Michael H. 
Published: May 2024

Abstract
Background
Attention deficit hyperactivity disorder (ADHD) is one of the more common neuropsychiatric disorders in women of reproductive age. Our objective was to compare perinatal outcomes between women with an ADHD diagnosis and those without.

Methods
A retrospective population-based cohort study utilizing the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample (HCUP-NIS) United States database. The study included all women who either delivered or experienced maternal death from 2004 to 2014. Perinatal outcomes were compared between women with an ICD-9 diagnosis of ADHD and those without.

Results
Overall, 9,096,788 women met the inclusion criteria. Amongst them, 10,031 women had a diagnosis of ADHD. Women with ADHD, compared to those without, were more likely to be younger than 25 years of age; white; to smoke tobacco during pregnancy; to use illicit drugs; and to suffer from chronic hypertension, thyroid disorders, and obesity (p < 0.001 for all). Women in the ADHD group, compared to those without, had a higher rate of hypertensive disorders of pregnancy (HDP) (aOR 1.36, 95% CI 1.28–1.45, p < 0.001), cesarean delivery (aOR 1.19, 95% CI 1.13–1.25, p < 0.001), chorioamnionitis (aOR 1.34, 95% CI 1.17–1.52, p < 0.001), and maternal infection (aOR 1.33, 95% CI 1.19–1.5, p < 0.001). Regarding neonatal outcomes, patients with ADHD, compared to those without, had a higher rate of small-for-gestational-age neonate (SGA) (aOR 1.3, 95% CI 1.17–1.43, p < 0.001), and congenital anomalies (aOR 2.77, 95% CI 2.36–3.26, p < 0.001).

Conclusion
Women with a diagnosis of ADHD had a higher incidence of a myriad of maternal and neonatal complications, including cesarean delivery, HDP, and SGA neonates.