bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving the introduction of telemedicine in pre-hospital emergency medicine: Understanding users and how Acceptability, Usability and Effectiveness influence this process
Authors: O'Sullivan Seán F. , Krautwald Jennifer , Schneider Henning 
Published: April 2024

Abstract

Introduction: Increasing numbers of ambulance calls, vacant positions and growing workloads in Emergency Medicine (EM) are increasing the pressure to find adequate solutions. With telemedicine providing health-care services by bridging large distances, connecting remote providers and even patients while using modern communication technologies, such a technology seems beneficial. As the process of developing an optimal solution is challenging, a need to quantify involved processes could improve implementation. Existing models are based on qualitative studies although standardised questionnaires for factors such as Usability, Acceptability and Effectiveness exist.
Methods: A survey was provided to participants within a German county. It was based on telemedical-surveys, the System Usabilty Scale (SUS) and earlier works describing Usability, Acceptability and Effectiveness. Meanwhile the investigated county introduced a telemedical system. A comparison between user-groups and an exploratory factor analysis (EFA) was performed.
Results: Of n=91 included participants n=73 (80,2 %) were qualified as emergency medical staff (including paramedics (39,56 %), EMTs (30,77 %), call handlers (9,89 %)) and n=18 (19,8%) as emergency physicians. Most participants approved that telemedicine positively impacts EM and improved treatment options with an overall Usabilty Score of 68,68.
EFA provided a 3-factor solution involving Usability,Acceptability and Effectiveness.
Discussion: With our results being comparable to earlier studies but telemedicine only having being sparsely introduced, a positive attitude could still be attested.
While our model could only describe 51,28% of the underlying factors of implementation, more research is needed to identify these.
We showed that Usability is correlated with Acceptability (strong effect), Usability and Effectiveness with a medium effect, likewise Acceptability and Effectiveness.
Therefore we see a need to improve available systems. Our approach can provide as a guide for decision makers and developers, that a focus during implementation should be on improving usability and on a quantifiable data driven implementation process.
Safety Assessment of Symptomatic Intracranial Atherosclerotic Stenosis: A Comparison between Sole Balloon Angioplasty and Medical Treatment
Authors: Cao Wen-feng , Wen An , Cao Xian-min , Wu Ling-feng , Zhou Yong-liang , Xiang Zheng-bing , Rao Wei , Chu Quan-hong , Hang Wang-Wong , Liu Shi-min 
Published: April 2024

Abstract

Patients with symptomatic intracranial arterial stenosis (sICAS) will likely face perioperative risks with stent placement and recurrence with medication. Simple balloon angioplasty (SBA), as a less invasive and safer alternative to stent placement, may offer an effective treatment option for sICAS. This study aimed to assess the perioperative safety of SBA compared to medication for sICAS. A retrospective analysis was conducted on sICAS patients admitted to the Department of Neurology, Jiangxi Provincial People's Hospital, between January 2020 and December 2021, within 60 days of onset. Patients with severe stenosis (70% to 99% rate), confirmed by cerebral angiography, were divided into medication and SBA groups. Demographic data, medical history, NIH Stroke Scale (NIHSS) scores at onset, responsible vessels, degree of vascular stenosis, postoperative residual stenosis rate, and any stroke or death within 30 days postoperatively were assessed. The study included 91 patients, with 51 in the medication group (38 males, mean age 58.06±1.58 years) and 40 in the SBA group (24 males, mean age 60.95±1.37 years). There were no significant differences in demographics, medical history, NIHSS scores, or degree of vascular stenosis (all P > 0.05). All SBA patients underwent successful balloon angioplasty, with 8 cases (20%) requiring a stent placement due to significant post-dilation stenosis regression or dissection affecting blood flow. Within 30 days postoperatively, 2 patients (3.9%) in the medication group experienced progressive stroke, while 3 patients (7.5%) in the SBA group experienced endpoint events, including 2 cases of new-onset infarction and 1 case of subarachnoid hemorrhage. There was no statistically significant difference in endpoint event occurrence between the groups (P > 0.05), and no deaths occurred. In conclusion, SAB in sICAS patients did not significantly increase the risk of stroke within 30 days postoperatively compared to medication treatment. Long-term efficacy warrants further investigation.
Developing archetypes for key roles in a pragmatic trial: implementing human-centered design to promote advance care planning in primary care
Authors: Saylor Martha Abshire , Scerpella Danny , Chapin Margo , Jajodia Anushka , Kadali Amrutha , Colburn Jessica , Cotter Valerie , Wolff Jennifer 
Published: April 2024

Abstract

Background: Archetypes are representations of a group of people with shared behaviors, attitudes, and characteristics. The design and use of archetypes have potential application to increase partnership and support when embedding and scaling interventions but methodological approaches have not been developed.
Objective: To describe the methodology of designing archetypes for use in a pragmatic trial of advance care planning in the primary care context, SHARING Choices ((NCT04819191). We present resulting archetypes representing three key roles (primary care champion, advance care planning facilitator, and patient) in our pragmatic trial.
Methods: Our process for developing archetypes involved 4 steps: 1) Identify roles for archetype development, 2) Identify Shareholders and Data Sources for Archetype Development, 3) Generate unique archetypes and their distinguishing traits, and 4) Iteratively refine archetypes through exposure, scrutiny, and shareholder input. We also developed a process map to communicate our methodology.
Results: We created 6 distinct archetypes for the primary care champion role, 5 archetypes for the advance care planning facilitator role and 6 archetypes for the patient role. For each archetype we described strengths, challenges, prevailing emotions, and successful approaches to collaboration (e.g., “what works for me”). Unique opportunities for synergy between archetypes (such as with facilitator and champion) and potential challenges between archetypes (such as for facilitator and patient) suggest ways to improve training and support of key roles.
Discussion: Our process for creating archetypes for use in implementation research was iterative and informative in discussion of implementation with shareholders. We expect this methodology to be useful for anticipating and analyzing many aspects of implementation.
Study on the structure of sputum flora in silicosis patients with different stages
Authors: Liu Tao , Zuo Haojiang , Zheng Tianli , Pei Xiaofang , Cheng Lin 
Published: April 2024

Abstract

Silicosis is a serious respiratory disease, which causes great harm to human health. Silicosis patients due to long-term exposure to silica dust particles, may lead to the imbalance of bacterial flora in the respiratory tract, thereby increasing the risk of respiratory infection. In this study, sputum samples from inpatients with silicosis at different stages in a hospital in Chengdu were collected, the genome was extracted, the sputum sample genome was sequenced by high-throughput sequencing technology, and the microflora composition of sputum samples was obtained by using QIIME 1.8.0 for analysis, including OTUs analysis, Alpha diversity analysis, Beta diversity analysis, etc. Then, the structure of respiratory microflora in silicosis patients was analyzed, and the composition, distribution and diversity of microflora in sputum of silicosis patients with different stages were compared. The results showed that the sputum flora of silicosis patients were firmicutes, Proteobacteria, Bacteroidetes, actinobacteria and clostridium, which were consistent with those of healthy people. However, there were differences in the placement of dominant bacteria in silicosis patients with different stages. Therefore, the study of sputum flora structure of silicosis patients with different stages is helpful to further understand the pathophysiological process of silicosis, and provide a more in-depth theoretical basis for the prevention, early diagnosis and treatment of silicosis.
Ultra-deep three-dimensional optical coherence tomography in turbid media
Authors: Ding Zhihua , Yang Lu , Han Tao , Tang Yun , Chen Changyong , Ma Cui , Liu Zhiyi 
Published: April 2024

Abstract

Ultra-deep three-dimensional (3D) optical coherence tomography (OCT) in turbid media is reported. Parallel detection along depth combined with scanning detection across lateral field is exploited in a swept-source OCT system to obtain the depth-resolved reflection matrices. Scanning detection enables the use of a highspeed swept source and a matched detector providing the required depth range for ultra-deep imaging. Disturbances intrinsic to scanning detection are compensated with negligible intra-frame phase variations to ensure satisfactory reconstruction by the inter-frame phase insensitive algorithm. 3D OCT imaging with an ultra-deep imaging depth of 11.5 times the scattering mean-free-path and a triple extension of the imaging depth achieved by a conventional SS-OCT is realized. The measurement time for 3D imaging (125μm×125μm×4mm ) is ~5 min, a significant leap over the time-domain matrix OCT where 6 min is taken for only one specified depth.
Serum soluble CD25 levels were associated with prognosis of children with Langerhans cell histiocytosis
Authors: Zhao Zijing , Lian Hong-Yun , Li Wei-Jing , Zhang Qing , Ma Hong-Hao , Wang Dong , Zhao Yun-Ze , Zhu Ting , Li Hua-Lin , Huang Xiao-Tong , Wang Tian-You , Zhang Rui , Cui Lei , Li Zhi-Gang 
Published: April 2024

Abstract

Background
Langerhans cell histiocytosis (LCH) is a rare myeloid neoplasm with inflammatory characteristics. This study aims to investigate the correlation between sCD25 levels and clinical characteristics and prognosis in pediatric LCH.
Methods
Serum sCD25 levels were measured in 370 LCH patients under 18 years old using ELISA assays. The patients were divided into two cohorts based on different treatment regiments. We further assessed the predictive value for prognosis impact of sCD25 in a test cohort, which was validated in the independent validation cohort.
Results
The median serum sCD25 level at diagnosis was 3908 pg/ml (range: 231 − 44 000). sCD25 level was significantly higher in MS RO + LCH patients compared to SS LCH patients (P < 0.001). Patients with increased sCD25 were more likely have involvement of risk organs, skin, lung, lymph node, or pituitary (all P < 0.05). sCD25 level could predict LCH progression and relapse with an area under the ROC curve of 60.6%. The best cutoff value was determined at 2921 pg/ml. High-sCD25 group had a significantly worse progression-free survival than those in the low-sCD25 group (P < 0.05).
Conclusion
Elevated serum sCD25 levels at initial diagnosis was associated with high-risk clinical features and worse prognosis. sCD25 levels can predict the progression/recurrence of LCH after treatment with first-line chemotherapy.
Deep learning-based carotid plaque ultrasound image detection and classification study
Authors: Zhang Hongzhen , Zhao Feng 
Published: April 2024

Abstract

Objective:To detect and classify carotid plaque ultrasound images based on different deep learning models of convolutional neural networks, and to compare the advantages and disadvantages of each model, with a view to providing a fast and accurate detection method for carotid atherosclerotic plaque ultrasound screening in stroke risk groups using artificial intelligence techniques.
Methods:A total of 5611 carotid ultrasound images of 3683 patients from the ultrasound departments of the Eighth People's Hospital of Shanghai, Fengxian District Central Hospital of Shanghai, the Second People's Hospital of Guangdong Province in Guangdong Province, and the People's Hospital of Huainan City in Anhui Province during the period of 17 September 2020 to 17 December 2022 were selected for the study.All carotid ultrasound image data redundant information was cropped, and two attending physicians with more than ten years of experience in cardiovascular ultrasound labelled and classified all the images for diagnosis. The total dataset was randomly split into a training set (3927 images) and a test set (1684 images) in a ratio of 7:3. Four deep learning models-YOLO V7 (ResNet 50) model, YOLO V7 (Inception V3) model, Faster RCNN (ResNet 50) model, and Faster RCNN (Inception V3) model-were used to detect and analyse the carotid artery plaque ultrasound images and to atherosclerotic plaques to identify and classify whether the carotid arteries are vulnerable plaques or stable plaques.The efficacy of the four deep learning models in classifying carotid atherosclerotic plaques was assessed using Accuracy (ACC), Sensitivity (SEN), Specificity (SPE), F1 scores, and Area under the curve of the working characteristics of the subjects (AUC), with P< 0.05 was taken as statistically significant difference.
Results:In this study, Faster RCNN model and YOLO V7 network base model were constructed using deep learning algorithms and two different feature extraction networks (ResNet 50 and Inception V3) were used to classify ultrasound images of carotid artery plaques.The Faster RCNN (ResNet 50) model in the test set had ACC, SEN, SPE, AUC were 0.88, 0.94, 0.71, and 0.91, respectively, which was the highest prediction efficacy for carotid atherosclerotic plaque classification among the four models. This study demonstrates the feasibility of deep learning for carotid plaque ultrasound image detection and classification, in which the Faster RCNN (ResNet 50) model has high accuracy and reliability.
Conclusion:In the diagnosis of carotid artery vulnerable plaque, the confidence level of the diagnosis using the deep learning Faster RCNN (ResNet 50) model is close to that of intermediate physicians, and the model can improve the diagnosis level of junior ultrasonographers, and also help clinics to formulate a more reasonable ischemic stroke prediction and early warning plan.
Contrasting microbial communities drive iron cycling across global biomes
Authors: Epihov Dimitar , Bryce Casey 
Published: April 2024

Abstract

The global iron (Fe) cycle governs important aspects of biosphere function by defining Fe availability thus supporting productivity of terrestrial and ocean ecosystems. However, the link between soil microbiome function to global patterns in terrestrial iron cycling remains poorly investigated. Here, we developed a novel database termed IRon cycle Annotation (IRcyc-A) targeted at discovering and annotating Fe cycle genes within omics data that we validated against known localized patterns of iron cycling. We leveraged this new tool to analyse the Fe cycle of over 220 publicly available soil metagenomes and metatranscriptomes encompassing a wide range of biomes on Earth. We show that the greatest abundance of Fe(III)-reduction and Fe(II)-oxidation genes were attributed to Acidobacteriota and were most abundant in the microbiomes of peatlands and iron sulfide soils, respectively. This is consistent with the high levels of dissolved Fe recorded in rivers draining such areas. In contrast, genes encoding the biosynthesis of siderophores deployed in iron sequestration in response to Fe deficiency peaked in agroecosystems with the majority assigned to Actinomycetota. Siderophore synthesis genes were negatively correlated with Fe(III)-reduction and Fe(II)-oxidation genes, supporting the view of divergent communities under low and high iron availability. Our findings highlight how iron availability shapes terrestrial microbial communities and how microbial processes can in turn contribute to global patterns in terrestrial Fe and C cycling.
Risk Factors and Prevention Strategies for Group B Streptococcus Colonization in Pregnant Women and Infection in Newborns
Authors: su yanlin , Wei Xin , Xu Fang , Liu Pengmin , Zhou Ting , Zhang Xuelian , Rao Lijuan , li minghua 
Published: April 2024

Abstract

Background: Group B Streptococcus (GBS), poses a significant threat to the health of pregnant women and newborns, often leading to life-threatening conditions such as neonatal sepsis, meningitis, pneumonia, and urinary tract infections. Hence, investigating the colonization rate of GBS in pregnant women, along with associated risk factors and their implications on adverse pregnancy and neonatal outcomes, remains imperative.
Objective: This study aims to ascertain the prevalence of GBS colonization in late-term pregnant women and newborns, and to analyze the factors influencing GBS colonization and infection.
Methods: A prospective monitoring was conducted on 7751 pregnant women who underwent GBS screening and delivered between January 2020 and December 2022. GBS diagnosis was conducted via bacterial culture.
Results: The colonization rate of GBS in pregnant women was found to be 6.08% (471/7751), with 44 newborns testing positive for GBS colonization (5.68/1000). Among these cases, 27 newborns required hospitalization due to EOGBS infection (3.48/1000). Multivariate logistic regression analysis revealed that maternal GBS colonization, premature rupture of membranes, and maternal chorioamnionitis were independent risk factors for GBS-positive colonization in newborns (P=2.19e-09,P=8.02e-06,P=0.0354). Cesarean section emerged as an independent protective factor against GBS-positive colonization in newborns (P=0.0277). Moreover, maternal GBS colonization, premature rupture of membranes, and maternal chorioamnionitis were identified as independent risk factors for EOGBS infection in newborns(P=7.41e-07,P=0.00133,P=0.01721).
Conclusion: Timely identification of GBS-positive colonization in newborns and enhancing the prognosis of infants with EOGBS infection can be achieved through GBS screening and intervention for pregnant women and newborns.
Efficacy of vitamin B1 in alleviating chemotherapy-induced nausea and vomiting
Authors: Matsushima Satoru , Sano Hirozumi , Hori Daiki , Yanagi Masato , Suzuki Daisuke , Kobayashi Ryoji 
Published: April 2024

Abstract

Background
The management of chemotherapy-induced nausea and vomiting (CINV) is of primary concern for both patients with cancer and medical workers. Refractory or breakthrough CINV is especially difficult to deal with and necessitates a different approach. Vitamin B1 deficiency is likely to occur during cancer chemotherapy, with early symptoms of fatigue, anorexia, nausea and vomiting. The efficacy of vitamin B1 for the treatment of delayed or refractory CINV should be confirmed.
Methods
Serum vitamin B1 level was prospectively measured in patients experiencing persistent nausea and vomiting after chemotherapy. The response to vitamin B1 therapy was evaluated for three consecutive days after vitamin B1 infusion. Moreover, serum level of vitamin B1 at diagnosis of persistent delayed CINV was compared with the level before chemotherapy.
Results
In total, 408 courses of chemotherapy in 86 patients were analyzed. The median age at hospital admission of the enrolled patients was 10.7 years (0.2–25.2). Among these, 44 (10.8%) episodes of persistent delayed CINV were identified in 26 of the enrolled patients. At day 3, the overall response rate was 79.5%; 21 (47.7%) patients achieved a complete response and 14 (31.8%) patients achieved a partial response. The median vitamin B1 level at diagnosis of CINV was significantly lower than the value before chemotherapy (22.8, range 11.9–49.2 vs. 32.7, range 11.2 − 80.1, respectively, P < 0.001).
Conclusion
Patients with a malignant disease who experience persistent nausea and vomiting after chemotherapy often exhibit vitamin B1 deficiency. Vitamin B1 infusion may be beneficial for many of these patients.
Comparison of Efficacy, safety, and cost-effectiveness of pembrolizumab versus chemotherapy for patients with advanced non-small cell lung cancer: a real-world study
Authors: Wan Ning , Yang Chen , Wang Bing , Guo Ya , He ZiJian , Lv YaJuan , Lu LiQing , Yang Ning , Xiao WeiBin , Chen YongBang , Yuan Jin , Yang DanDan , Liu Tao , Fang WenFeng , Chen ZhuoJia , Liang WeiTing 
Published: April 2024

Abstract

Background: While pembrolizumab has demonstrated effectiveness in clinical trials for non-small cell lung cancer (NSCLC), its real-world efficacy and cost-effectiveness, particularly considering its high cost, remain uncertain. This study aimed to compare the clinical efficacy, safety, and cost-effectiveness of pembrolizumab versus chemotherapy in treating patients with advanced NSCLC.
Methods: In this retrospective cohort study, advanced NSCLC patients treated with pembrolizumab (either as monotherapy or combined with chemotherapy) and chemotherapy alone were analyzed from April 2017 to March 2023 at a major 3A Hospital. Primary outcomes included progression-free survival (PFS), overall survival (OS), and the incremental cost-effectiveness ratio (ICER). Secondary outcomes were the objective response rate (ORR), disease control rate (DCR), and adverse events (AE).
Results: The study involved 630 patients, with 169 in the pembrolizumab group and 461 in the chemotherapy group. Post propensity score matching (PSM), the sample size was 450 (149 in pembrolizumab, 301 in chemotherapy). Pembrolizumab showed a significantly higher ORR (48.63% vs. 36.00%, p<0.05) and comparable DCR (95.21% vs. 90.00%, p>0.05) compared to chemotherapy. The median PFS was longer with pembrolizumab (15.5 months vs. 8.8 months, p<0.001), and the median OS was not reached compared to 26.2 months in chemotherapy. In second-line treatments, pembrolizumab showed superior PFS and OS. From the perspective of the Chinese healthcare system, pembrolizumab was not cost-effective compared to chemotherapy at a willingness-to-pay threshold of $36,070.2/QALY but was cost-effective at three times the per capita GDP in Guangzhou.
Conclusion: Pembrolizumab demonstrates superior clinical efficacy over chemotherapy in a real-world setting for advanced NSCLC, with manageable AEs. Its cost-effectiveness varies by regional economic conditions and payment thresholds, suggesting potential economic feasibility in economically developed areas with drug grant policies.
The Role of Environmental Health in the Prevention and Control of Environment-Related Diseases Worldwide
Authors: Ravanipour Masoumeh , Ravanipour Maryam , Hamidi Ali 
Published: April 2024

Abstract

Environmental factors are crucial in the global health landscape and the burden of diseases. Scientometrics is a quantitative method used to better analyze research status and trends in a specific subject area. This study aims to analyse the role of environmental health in preventing and controlling diseases.
A total of 50,274 documents were retrieved. The US and Harvard University were the most prolific and influential countries and organizations. The top three journals were PLOSONE, International Journal of Environmental Research and Public Health, and Environmental Health Perspectives. The highest interest is in burden of disease and air pollution, mainly particulate matter and PM2.5. The main focus are on air pollution, cardiovascular diseases, coronavirus disease, inflammatory bowel disease, multiple sclerosis, cognitive decline, and COVID-19 lockdown.
In the early years, studies predominantly centered on exposures, but investigating the relationship between these factors and medical science and health has become a significant area of interest in recent years. Air pollutants and burden of disease are topics of interest recognized as global environmental challenges.