bluuebunny/crossref_metadata_2025_split huggingface dataset:
The teaching of Pediatric Palliative Care in medical residencies
Authors: Peripolli Marcelle , Okamoto Cristina Terumy , Coelho Izabel Cristina Meister Martins , Melo Fernanda Pegoraro de Godoi , Kojo Maria Vitoria Mesquita , de Almeida Marcio José 
Published: May 2024

Abstract

Objective: The aim of this study was to understand the perceptions of newly graduated pediatricians in medical residency programs regarding palliative care education, seeking potential gaps in training and comprehending whether professionals feel equipped to manage these patients.
Method: This is an exploratory and descriptive study with a qualitative approach. Semistructured interviews were conducted in a virtual environment with 15 pediatricians who graduated from three pediatric medical residency programs in a capital city. The information was processed according to the content analysis method proposed by Bardin with the support of ATLAS.ti software.
Results: Respondents reported a lack of theoretical and practical preparation regarding palliative care education and did not feel qualified to manage these patients. They also highlight the importance of the palliative care physician, not only for the appropriate treatment of patients but also as a facilitator of teaching during medical residency. Participants noted the need for greater knowledge about the bioethical and legal aspects of pediatric palliative care and for adequate time to address the subject with the patient and their families.
Conclusions: Despite the relevance of this topic, there are still gaps in the teaching-learning process of pediatric palliative care, from undergraduate to postgraduate education. It is necessary to invest in more research to develop a suitable curriculum that favors education through specific and mandatory spaces for palliative care within residency programs.
A Novel Approach to Engineering Three-dimensional Bladder Tumor Models for Drug Testing.
Authors: Monjaras-Avila Cesar Ulises , Luque-Badillo Ana Cecilia , Bacon Jack , Wyatt Alexander , So Alan , Chavez-Munoz Claudia 
Published: May 2024

Abstract

Bladder cancer (BCa) poses a significant health challenge, particularly affecting men with higher incidence and mortality rates. Addressing the need for improved predictive models in BCa treatment, this study introduces an innovative 3D in vitro patient-derived bladder cancer tumor model, utilizing decellularized pig bladders as scaffolds. Traditional 2D cell cultures, insufficient in replicating tumor microenvironments, have driven the development of sophisticated 3D models. In the development of the in vitro bladder cancer model, muscle invasive bladder cancer patients' cells were cultured within decellularized pig bladders, yielding a three-dimensional cancer model. To demonstrate the 3D cancer model's effectiveness as a drug screening platform, the 3D models were treated with Cisplatin (Cis), Gemcitabine (Gem), and a combination of both drugs. Comprehensive cell viability assays and histological analyses illustrated changes in cell survival and proliferation. The model exhibited promising correlations with clinical outcomes, boasting an 83.3% reliability rate in predicting treatment responses. Comparison with traditional 2D cultures and spheroids underscored the 3D model's superiority in reliability, with an 83.3% predictive capacity compared to 50% for spheroids and 33.3% for 2D culture. Acknowledging limitations, such as the absence of immune and stromal components, the study suggests avenues for future improvements. In conclusion, this 3D bladder cancer model, combining decellularization and patient-derived samples, marks a significant advancement in preclinical drug testing. Its potential for predicting treatment outcomes and capturing patient-specific responses opens new avenues for personalized medicine in bladder cancer therapeutics. Future refinements and validations with larger patient cohorts hold promise for revolutionizing BCa research and treatment strategies.
CHAMP1 premature termination codon mutations found in individuals with intellectual disability cause a homologous recombination defect through haploinsufficiency
Authors: Yoshizaki Yujiro , Ouchi Yunosuke , Kurniawan Dicky , Yumoto Eisuke , Yoneyama Yuki , Rizqullah Faiza Ramadhani , Sato Hiyori , Sarholz Mirjam Hanako , Natsume Toyoaki , Kanemaki Masato T. , Ikeda Masanori , Ui Ayako , Iemura Kenji , Tanaka Kozo 
Published: May 2024

Abstract

CHAMP1 (chromosome alignment-maintaining phosphoprotein 1) plays a role in the repair of DNA double-strand breaks (DSBs) by homologous recombination (HR). The CHAMP1 gene is one of the genes mutated in individuals with intellectual disability. The majority of the mutations are premature termination codon (PTC) mutations, while missense mutations have also been reported. How these mutations affect the functions of CHAMP1 has not been clarified yet. Here we investigated the effects of the CHAMP1 mutations on HR. In B lymphocytes and fibroblasts derived from individuals with CHAMP1 PTC mutations, truncated CHAMP1 proteins of the expected sizes were detected. When DSBs were induced in fibroblasts with PTC mutations, a defect in HR was detected. U2OS cells expressing the CHAMP1 mutants did not show an HR defect in the presence of endogenous wild-type (WT) CHAMP1, whereas they were unable to restore HR activity when WT CHAMP1 was depleted, suggesting that the PTC mutations are loss-of-function mutations. On the other hand, the CHAMP1 mutants with missense mutations restored HR activity when WT CHAMP1 was depleted. In DLD-1 cells, heterozygous depletion of CHAMP1 resulted in an HR defect, indicating haploinsufficiency. These results suggest that CHAMP1 PTC mutations cause an HR defect through a haploinsufficient mechanism, while CHAMP1 missense mutations do not affect the HR function of CHAMP1.
Physical pressure resistance of gastrointestinal anastomotic site via polyglycolic acid promoting fibrosis
Authors: Tanda Hideki , Shibutani Masatsune , Natsuki Seiji , Kasashima Hiroaki , Fukuoka Tatsunari , Maeda Kiyoshi 
Published: May 2024

Abstract

Anastomotic-leakage incidence has been reported to be reduced on using polyglycolic acid (PGA) sheets as reinforcing materials; however, there is insufficient evidence regarding the reinforcement mechanism. Therefore, we investigated effects of PGA sheets on gastrointestinal anastomoses in rats. In the first approach, five rats underwent laparotomy; the PGA sheet was pasted onto the normal cecal wall. After five days, the cecum was removed and histologically evaluated. In the second approach, ten rats were randomly divided into two groups of five animals each. The rats underwent laparotomy; the cecal wall was sutured after a full-thickness incision. In the PGA group, a PGA sheet was used to cover the suture area. After 5 days, the cecum was removed, and the physical pressure resistance was evaluated. We confirmed the growth of a fibrous capsule measuring 855 (648–1048) µm outside the cecal serosa in the first approach. The median pressure resistance in the second approach was 57 (45.0–90.0) and 90 (82.5–94.5) mmHg in Control and PGA groups, respectively. The pressure resistance was significantly higher in the PGA group (p = 0.046). In summary, the PGA sheet may form a barrier of fibrosis on the intestinal wall and provide reinforcement to prevent anastomotic leakage.
Research on sorting reinforcement and repair order of ancient timber buildings based on an ordered fractile weight method
Authors: Gao Zhongwei , Du Yue , Zhang Jinfang , Zhang Yingda , Zhao Shiyu , Yang Xiaobing 
Published: May 2024

Abstract

Ancient timber buildings have existed for a long time. However, due to wood’s natural characteristics, it is prone to damage such as insect infestation, decay, and cracking, resulting in structural unsafety. Therefore, partial and intermittent reinforcement and repair are essential for maintaining ancient timber buildings. Due to limited financial and material resources, it is critical to determine and sort the priority order of reinforcing and repairing ancient timber buildings. In this study, an ordered fractile weighted method was adopted to establish a sorting method that reviews the incentive preferences of decision-makers during the information aggregation process and measures the development levels of the evaluated objects on various indicators. A case study was also used to trial the sorting method. By using the weighted sum with weights not equal to 1 in the information aggregation process, the aggregation values were reduced, thereby further highlighting the differences between the evaluated objects. The method was concluded to be flexible in application and could address the rational sorting of reinforcement and repair order for ancient timber buildings. Thus, it provides a basis for decision-making for the protection and management of ancient buildings.
Cytomegalovirus Results in Poor Graft Function via Bone Marrow-Derived Endothelial Progenitor Cells
Authors: Lv Weiran , Zhou Ya , Zhao Ke , Li Xuan , Huang Fen , Fan Zhiping , Chang Yuan , Yi Zhengshan , Jin Hua , Liang Yang , Liu Qifa 
Published: May 2024

Abstract

Poor graft function (PGF), characterized by myelosuppression, represents a significant challenge following allogeneic hematopoietic stem cell transplantation (allo-HSCT) with human cytomegalovirus (HCMV) being established as a risk factor for PGF. However, the underlying mechanism remains unclear. Bone marrow endothelial progenitor cells (BM-EPCs) can support hematopoiesis. We aim to explore the effects of CMV on BM-EPCs and its underlying mechanism. We investigated the compromised functionality of EPCs derived from individuals diagnosed with HCMV viremia (HCMV-emia) accompanied by PGF as well as after infected by HCMV AD 169 strain in vitro. We found dysfunction of HCMV-infected EPCs was characterized by decreased cell proliferation, tube formation, migration and hematopoietic support, and increased apoptosis and secretion of TGF-β1. We demonstrated that HCMV-induced TGF-β1 secretion by BM-EPCs played a dominant role in hematopoiesis suppression in vitro experiment. Moreover, HCMV up-regulates the p38 MAPK and its downstream transcription factor AP-1 to induce myelosuppression through promoting TGF-β1 secretion. In conclusion, HCMV could infect BM-EPCs and lead to their dysfunction. Enhanced secretion of TGF-β1 by BM-PECs is induced by HCMV through the up-regulation of p38 MAPK and its downstream transcription factor AP-1, resulting in myelosuppression, which might make a substantial contribution to the pathogenesis of PGF after allo-HSCT.
EYA-1 is required for genomic integrity independent of H2AX signalling in Caenorhabditis elegans
Authors: Tatnell Hannah , Novakovic Stevan , Boag Peter , Davis Gregory 
Published: May 2024

Abstract

Resolving genomic insults is essential for the survival of any species. In the case of eukaryotes, several pathways comprise the DNA damage repair network, and many components have high evolutionary conservation. These pathways ensure that single and double stranded DNA breaks are resolved which prevents potential disease associated mutations from occurring in a de novo manner. In this study, we investigated the role of the Eyes Absent (EYA) homologue in Caenorhabditis elegans and its role in dsDNA break repair. Current understanding of mammalian EYA associated dsDNA break repair is that EYA1 is recruited in response to H2AX signalling. C. elegans do not possess a H2AX homologue, although they do possess homologues of the core DNA damage repair proteins. Due to this, we aimed to determine if eya-1 contributed to dsDNA break repair independent of H2AX. At a protein level, the active site of C. elegans EYA-1 is conserved in humans and homology modelling shows structural similarity to human EYA1. Absence of eya-1 results in abnormal chromosome morphology in anaphase embryos, including chromosomal bridges, missegregated chromosomes, and embryos with abnormal nuclei. eya-1 mutants are highly sensitive to induction of dsDNA breaks yet show little change to ssDNA break inducement. Additionally, eya-1 mutants display a mortal germline phenotype suggesting a generational inheritance of accumulative mutations. Collectively, this study suggests that the EYA family of proteins may have a greater involvement in maintaining genomic integrity than previously thought and unveils novel roles of EYA associated DNA damage repair.
Comparison of SS-EPI DWI and one-minute TGSE-BLADE DWI for diagnosis of acute infarction
Authors: Okuchi Sachi , Fushimi Yasutaka , Sakata Akihiko , Otani Sayo , Nakajima Satoshi , Maki Takakuni , Tanji Masahiro , Sano Noritaka , Ikeda Satoshi , Ito Shuichi , Urushibata Yuta , Zhou Kun , Arakawa Yoshiki , Nakamoto Yuji 
Published: May 2024

Abstract

The efficacy of 2D turbo gradient- and spin-echo diffusion-weighted imaging with non-Cartesian BLADE trajectory (TGSE-BLADE DWI) has not been well studied for acute stroke due to its long acquisition time.This study was performed to compare distortion, artifacts and image quality between single-shot echo planar imaging (SS-EPI) DWI and TGSE-BLADE DWI with acquisition time reduced to 1 minute by simultaneous multi-slice (SMS) imaging, and to evaluate the diagnostic performance of TGSE-BLADE DWI for acute infarctions. Total 104 patients with a past history of stroke or symptoms suspicious for acute infarction or who had undergone surgery for brain tumor within two days were prospectively enrolled. Ten lesions in 9 patients were diagnosed as acute or subacute infarction and were detectable only in TGSE-BLADE DWI but not in SS-EPI DWI. Scores for geometric distortion, susceptibility artifacts, overall image quality, lesion conspicuity and diagnostic confidence were lower for SS-EPI DWI than TGSE-BLADE DWI (p≤.001). Distortion was significantly worse in SS-EPI DWI than TGSE-BLADE DWI (p<.001). SNR of centrum semiovale was significantly higher in SS-EPI DWI than TGSE-BLADE DWI (p<0.001). One-minute TGSE-BLADE DWI showed better image quality than SS-EPI DWI in terms of distortion and artifacts, and higher diagnostic performance for acute infarctions.
“They expect you to give teeth like God, which is very hard”: Dental Clinicians’ and Technologists’ Experiences and Perspectives on Removable Complete Denture Fabrication Services in Makerere University Dental Hospital, Uganda.
Authors: Nono David , Akugizibwe Mathias , Bagenda Godfrey , Okullo Isaac , Rwenyonyi Charles Mugisha 
Published: May 2024

Abstract

Background: Globally, there is growing concern regarding mouth sores, occlusion, cost, ridge resorption, and retention, in the delivery of removable complete dentures (RCDs) fabrication services brought about by the aging of the population and poor oral healthcare. However, there is limited literature about the experiences of dental clinicians and technologists in handling removable complete denture fabrication. The available literature mainly focuses on the process of removable complete denture fabrication in general with less emphasis on the experiences of technologists and clinicians in removable complete denture fabrication. This study aimed to explore dental clinicians’ and technologists’ experiences and perspectives on removable complete denture fabrication.
Methods:The study employed a qualitative design, 25 in-depth interviews were conducted with dental clinicians and technologists in Makerere University Dental Hospital. Both practicing dental technologists and clinicians were purposively selected after providing written informed consent. Interviews’ audios were transcribed verbatim, coded in Nvivo 14 and data were analyzed thematically.
Results: Findings revealed that dental practitioners mainly referred to or followed international guidelines during removable complete denture fabrication. Clinical and socio-demographic assessments like age, oral hygiene, ridge level, underlying health conditions, and mental stability of the patient were done by dental clinicians before removable complete denture fabrication. Dental technologists and clinicians mentioned patients having a lot of expectations like looking the way they used to be before losing their teeth and hoping to get their natural teeth back, being able to eat well/everything, improving physical appearance, and having permanent teeth. However, the patients also had fears and concerns about discomfort, and some worried that they would be given teeth for the dead whites or swallowing the dentures while asleep, eating, or kissing.
Conclusion: The study revealed knowledge gaps about removable complete denture fabrication and a lack of local contextualized guidelines in low and middle-income countries due to reliance on international guidelines.
Hemoglobin status in children attending paediatric clinics in Lomé, 2022.
Authors: Konu Yao Rodion , Lack Fiali Ayawa , Adama Oumarou I.Wone , Kouanfack Harold Régis , Gounon Kokou Herbert , Sogbo François , Womey Kodzovi Mawulé Corcellar , Takassi Elom Ounoo , Kolou Maléwé , Ekouevi Didier Koumavi 
Published: May 2024

Abstract

Aim: to estimate the prevalence of sickle cell disease among children and adolescents in the pediatric department of the Sylvanus Olympio University Hospital in 2022.
Methods: in this cross-sectional study, all children and adolescents attending the study site were proposed to participate and included if: i) aged between 18 months and 19 years, ii) present in pediatric consultations or hospitalizations and iii) provided assent or parental informed consent. A 4-5 ml blood sample was collected for hemoglobin electrophoresis on a cellulose acetate plate at alkaline pH. Sickle cell disease was defined as having either SS, SC, SF or Sß hemoglobin phenotype.
Results: A total of 317 children and adolescents aged 8 years (IQR: 4-12) in median were enrolled. Only in 7.3% of cases did both parents know their hemoglobin status. 68 children/adolescents had hemoglobin S (21.5%), 19 had sickle cell disease (6.0%). Approximately 15.6% of children and adolescents had sickle cell trait AS.
Conclusion: This study revealed a high SCD prevalence in an a priori naïve children/adolescents’ population. We stress that policy makers should consider continued sensitization, genetic counseling and neonatal screening as prevention strategies in Togo.
Feasibility and effects of the Mimba Yangu (My Pregnancy) project in improving routine prenatal ultrasound by nurses-midwives in rural Kenya: A before-after study
Authors: Nyaga Lucy , Hanson Claudia , Leekha Nidhi , Mantel Michaela , Kedenge Sarah , Gitonga Caroline W. , Naanyu Violet , Shah Jasmit , Temmerman Marleen 
Published: May 2024

Abstract

Introduction
Point-of-care ultrasound delivered by nurses and midwives has the potential to improve the quality of antenatal care. The 2016 World Health Organizations Antenatal Care Guidelines recommend one ultrasound below 24 weeks of gestational age for every pregnant woman, however programming is facing difficulties. Here we report on the feasibility, effects and acceptability of the Mimba Yangu implementation research project in Kenya using point-of-care ultrasound supported by digital training and supervision.
Methods
We conducted a quasi-experimental trial including 28 primary care facilities in Kilifi County, Kenya between April 2021 and March 2022. Fourteen facilities received the ultrasound intervention composed of i) a task-shifting approach where ultrasound was delivered by nurses-midwives using portable ultrasound devices (LumifyTM) connected to a tablet and ii) a unique digital platform to facilitate distant support. Hybrid training of 32 nurse-midwives was provided based on a nationally derived and agreed curriculum including theoretical and hands-on components by an academic team of obstetricians and radiologists.
Data collection used i) exit interviews with pregnant women and those who had delivered within the last six months, and ii) data abstraction from the health facility records and Kenyan health management information system, and iii) in-depth interviews with nurse-midwives and health care managers. We descriptively analyzed data and used a difference-in-difference analysis based on a generalized linear model to assess the effect of the intervention on the number of antenatal visits.
Results
The intervention was successfully and consistently implemented during a nine-month period in all 14 health facilities with 2,799 pregnant women. Interviews with trained nurse-midwives indicated that the intervention was relevant, acceptable, and feasible. In intervention facilities, 50.4% of women received at least one ultrasound compared to 19.2% in the comparison facilities, where women were referred to other facilities for their ultrasound. Furthermore, our analysis suggested a non-significant change of 10.5% in ANC 4+ visits in the intervention compared to comparison facilities.
Conclusion
Our analysis provides evidence of the feasibility, acceptance and relevance of providing ultrasound at primary care level delivered by nurse-midwives. Scaling-up will demand policy reforms to allow task-sharing at national and sub-national levels and embedding the approach in basic nursing/midwifery education.
Automatic magnetic resonance imaging series labelling for large repositories
Authors: Maya Armando Gomis , Alberich Leonor Cerda , Canuto Diana Veiga , Faggioni Lorenzo , Ten Amadeo , Ribas Gloria , Mallol Pedro , Vila-Frances Joan , Martí-Bonmatí Luis 
Published: May 2024

Abstract

Large medical image repositories present challenges related to unstructured data. A data enrichment process allows the storage of additional information for fast identification of the content and properties of medical imaging studies. The aim of this study is to develop a metadata enrichment pipeline to facilitate the secondary use of medical images in a high-throughput environment. Our aim was to develop a categorization tool for the MR series to generate standardized tags that identify relevant image characteristics such as patient orientation, sequence type, weighting type, or the presence of fat suppression.
Three models that make use of machine learning (ML) and DICOM tags are proposed. The dataset for their development consists of 4,666 MR series from cancer patients, labeled by expert radiologists and acquired from different manufacturers, clinical centers, and anatomical regions, covering as much variability as possible with the aim of making the models generalizable to other databases. Moreover, the inference performance of the end system has been evaluated on 25,596 MR series as well as the final model outputs with an external evaluation set of 1,286 MR series.
The weighting model achieves very reliable results with a macro f1-score of 0.88 in the validation set. Junk and chemical shift models achieved scores of 0.82 and 0.83respectively. These results open the door to the automatic application of image post-processing and deep learning algorithms after accurate labeling, minimizing human intervention. Furthermore, the proposed solution can infer thousands of DICOM series in less than 1 minute. Thanks to the fast inference times provided by this solution, it fits well in a big data ecosystem, eliminating any performance issues on ingestion in a semi-real-time environment.