bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors affecting need and utilization of palliative care services among Ethiopian women in an oncology department: A hospital-based cross-sectional study
Authors: Fetene Deriba , Taylor Lesley , Ferrell Betty , Deribe Bedilu , Abdella Jabir , Aynalem Amdehiwot 
Published: May 2024

Background: Palliative care, which aims to alleviate physical and emotional distress from cancer, is underutilized in many African healthcare systems. Therefore, there is a lack of data on the need and utilization of palliative care services among women with breast cancer in Ethiopia. Objectives: The goal of this study was to identify the level of need and utilization of palliative care services and identify associated factors among women in an oncology department of Hawassa comprehensive and specialized hospitals. Design: Hospital-based cross-sectional study. Methods: A total of 121 women age ⩾18 years old with breast cancer participated from 1 August to 30 October 2021. A hospital-based consecutive sampling technique was used. Data regarding the need and utilization of palliative care services were collected via questionnaire and interview, entered using EpiData 4.6.0.6, and analyzed by SPSS version 25. Variables with p < 0.25 were considered for multivariate analysis, and those with p < 0.05 indicate an association with palliative care utilization. Result: Seventy-two (59.5%) had worse utilization of palliative care services, with higher odds in rural areas (adjusted odds ratio = 11.82). Conclusion: The study findings indicated that more than half of the study participants had worse utilization of palliative care services, with rural living being a contributing factor.
Relationship between serum apolipoprotein B and risk of all-cause and cardiovascular disease mortality in individuals with hypertension: a prospective cohort study
Authors: Huang Ying , Chen Siwei , Pan Huachun , Yang Shumin , Cheng Wenke 
Published: May 2024

Abstract
Background
Dyslipidemia frequently coexists with hypertension in the population. Apolipoprotein B (ApoB) is increasingly considered a more potent predictor of cardiovascular disease (CVD). Abnormal levels of serum ApoB can potentially impact the mortality risk.

Methods
The prospective cohort study employed data from the National Health and Nutrition Examination Survey (NHANES), which was performed between 2005 and 2016, with follow-ups extended until December 2019. Serum ApoB concentrations were quantified using nephelometry. In line with the NHANES descriptions and recommendations, the reference ranges for ApoB concentrations are 55–140 and 55–125 mg/dL for men and women, respectively. Participants were categorized into low, normal, and high ApoB levels. The low and high groups were combined into the abnormal group. In this study, all-cause mortality (ACM) and CVD mortality (CVM) were the endpoints. Survey-weighted cox hazards models were used for evaluating the correlation between serum ApoB levels and ACM and CVM. A generalized additive model (GAM) was employed to examine the dose-dependent relationship between ApoB levels and mortality risk.

Results
After a median of 95 (interquartile range: 62–135) months of follow-up, 986 all-cause and 286 CVD deaths were recorded. The abnormal ApoB group exhibited a trend toward an elevated risk of ACM in relative to the normal group (HR 1.22, 95% CI: 0.96–1.53). The risk of CVM was elevated by 76% in the ApoB abnormal group (HR 1.76, 95% CI: 1.28–2.42). According to the GAM, there existed a nonlinear association between serum ApoB levels and ACM (P = 0.005) and CVM (P = 0.009).

Conclusions
In the US hypertensive population, serum Apo B levels were U-shaped and correlated with ACM and CVM risk, with the lowest risk at 100 mg/dL. Importantly, abnormal Apo B levels were related to an elevated risk of ACM and CVM. These risks were especially high at lower Apo B levels. The obtained findings emphasize the importance of maintaining appropriate Apo B levels to prevent adverse outcomes in hypertensive individuals.
Regional structural abnormalities in thalamus in idiopathic cervical dystonia
Authors: Luo Yuhan , Liu Huiming , Zhong Linchang , Weng Ai , Yang Zhengkun , Zhang Yue , Zhang Jiana , He Xiuye , Ou Zilin , Yan Zhicong , Cheng Qinxiu , Fan Xinxin , Zhang Xiaodong , Zhang Weixi , Hu Qingmao , Peng Kangqiang , Liu Gang , Xu Jinping 
Published: May 2024

Abstract
Background
The thalamus has a central role in the pathophysiology of idiopathic cervical dystonia (iCD); however, the nature of alterations occurring within this structure remain largely elusive. Using a structural magnetic resonance imaging (MRI) approach, we examined whether abnormalities differ across thalamic subregions/nuclei in patients with iCD.

Methods
Structural MRI data were collected from 37 patients with iCD and 37 healthy controls (HCs). Automatic parcellation of 25 thalamic nuclei in each hemisphere was performed based on the FreeSurfer program. Differences in thalamic nuclei volumes between groups and their relationships with clinical information were analysed in patients with iCD.

Results
Compared to HCs, a significant reduction in thalamic nuclei volume primarily in central medial, centromedian, lateral geniculate, medial geniculate, medial ventral, paracentral, parafascicular, paratenial, and ventromedial nuclei was found in patients with iCD (P < 0.05, false discovery rate corrected). However, no statistically significant correlations were observed between altered thalamic nuclei volumes and clinical characteristics in iCD group.

Conclusion
This study highlights the neurobiological mechanisms of iCD related to thalamic volume changes.
Impact of homocysteine on acute ischemic stroke severity: possible role of aminothiols redox status
Authors: Dong Wei-Chong , Guo Jia-Liang , Xu Lei , Jiang Xin-Hui , Chang Cheng-Hao , Jiang Ye , Zhang Ying-Ze 
Published: May 2024

Abstract
Background
Acute ischemic stroke (AIS) is one of the most common cerebrovascular diseases which accompanied by a disruption of aminothiols homeostasis. To explore the relationship of aminothiols with neurologic impairment severity, we investigated four aminothiols, homocysteine (Hcy), cysteine (Cys), cysteinylglycine (CG) and glutathione (GSH) in plasma and its influence on ischemic stroke severity in AIS patients.

Methods
A total of 150 clinical samples from AIS patients were selected for our study. The concentrations of free reduced Hcy (Hcy), own oxidized Hcy (HHcy), free reduced Cys (Cys), own oxidized Cys (cysteine, Cyss), free reduced CG (CG) and free reduced GSH (GSH) were measured by our previously developed hollow fiber centrifugal ultrafiltration (HFCF-UF) method coupled with high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The concentration ratio of Hcy to HHcy (Hcy/HHcy), Cys to Cyss (Cys/Cyss) were also calculated. The neurologic impairment severity of AIS was evaluated using National Institutes of Health Stroke Scale (NIHSS). The Spearman correlation coefficient and logistic regression analysis was used to estimate and perform the correlation between Hcy, HHcy, Cys, Cyss, CG, GSH, Hcy/HHcy, Cys/Cyss and total Hcy with NIHSS score.

Results
The reduced Hcy and Hcy/HHcy was both negatively correlated with NIHSS score in AIS patients with P = 0.008, r=-0.215 and P = 0.002, r=-0.249, respectively. There was no significant correlation of Cys, CG, GSH, HHcy, Cyss, Cys/Cyss and total Hcy with NIHSS score in AIS patients with P value > 0.05.

Conclusions
The reduced Hcy and Hcy/HHcy, not total Hcy concentration should be used to evaluate neurologic impairment severity of AIS patient.
Long non-coding RNA LINC00930 targeting miR-6792-3p/ZBTB16 regulates the proliferation and EMT of pancreatic cancer
Authors: Mao Yingqing , Su Xian , Guo Qingsong , Yao Xihao , Zhao Qun , Guo Yibing , Wang Yao , Li Xiaohong , Lu Yuhua 
Published: May 2024

AbstractEmerging evidence suggests the dysregulation of long non-coding RNAs (lncRNAs) involved in pancreatic cancer (PC). However, the function of LINC00930 in PC has not been elaborated. In this study, we found that LINC00930 was significantly down-regulated in PC cell lines and tissues, and associated with tumor size, lymphatic metastasis, TNM stage and poor prognosis. According to the bioinformatics database, the downregulation of LINC00930 was a common event in PC associated with prognosis and EMT. Overexpression of LINC00930 inhibited the aggressive cancer phenotypes including proliferation, metastasis and epithelial-mesenchymal transition (EMT) of PC in vitro and in vivo. Bioinformatics and dual-luciferase reporter assay indicated that miR-6792-3p could directly bind to LINC00930. Additionally, the Zinc finger and BTB domain containing 16 (ZBTB16) was significantly declined in PC, which was predicted to be the downstream gene of miR-6792-3p. MiR-6792-3p mimic rescued the decreased proliferation, metastasis and EMT caused by ZBTB16 in PC cells. The LINC00930/miR-6792-3p/ZBTB16 axis was associated with the malignant progression and process of PC. The relative expression of LINC00930 was negatively correlated with the expression of miR-6792-3p and was closely linked with ZBTB16 levels in PC. LINC00930 might serve as a potential prognostic biomarker and therapeutic target for PC.
A case-control study of the risk factors for fistula-in-ano in infants and toddlers
Authors: Sun Yanting , Liang Hongtao , Hao Shuang , Yin Lu , Pan Yibin , Wang Chen , Lu Jingen 
Published: May 2024

Abstract
Background
Limited data are available regarding the risk factors for fistula-in-ano (FIA) in infants and toddlers, potentially affecting their daily lives.

Objectives
The purpose of this study was to identify potential risk factors for FIA in infants and toddlers, in order to implement early preventive interventions, avoid disease progression, and develop therapeutic strategies.

Design and settings
A retrospective case-control study was conducted, comparing 41 infants and toddlers diagnosed with FIA with 41 healthy controls, between August 2020 and December 2021.

Independent variables
(a) maternal characteristics during pregnancy and delivery, (b) perinatal characteristics, dietary behaviors, and defecation-related behaviors in infants and toddlers, (c) family dietary behaviors.

Results
Mothers of infants and toddlers with FIA had given birth more times in the past, while the infants and toddlers themselves had less mealtime, a higher rate of exclusive breastfeeding, frequent loose stools, and a larger proportion of used wipes, experiencing perianal skin anomalies. The logistic regression analysis revealed that there are four significant risk factors associated with the development of FIA in infants and toddlers, including the number of previous deliveries by the mother (OR 6.327), defecation frequency score (OR 5.351), stool consistency score (OR 5.017), and cleaning with wipes after defecation (OR 8.089).

Conclusion
Based on our data, it appeared that FIA in infants and toddlers could be attributed to several factors. These included an increased number of previous deliveries by mothers, frequent loose stools, and repeated wipe use. To prevent the occurrence and worsening of the disease, it is important to improve the frequency and consistency of stooling and provide proper care. Further research is required to verify these findings in other clinical settings.
Computer-based facial recognition as an assisting diagnostic tool to identify children with Noonan syndrome
Authors: Huang Yulu , Sun Haomiao , Chen Qinchang , Shen Junjun , Han Jin , Shan Shiguang , Wang Shushui 
Published: May 2024

AbstractBackgroundNoonan syndrome (NS) is a rare genetic disease, and patients who suffer from it exhibit a facial morphology that is characterized by a high forehead, hypertelorism, ptosis, inner epicanthal folds, down-slanting palpebral fissures, a highly arched palate, a round nasal tip, and posteriorly rotated ears. Facial analysis technology has recently been applied to identify many genetic syndromes (GSs). However, few studies have investigated the identification of NS based on the facial features of the subjects.ObjectivesThis study develops advanced models to enhance the accuracy of diagnosis of NS.MethodsA total of 1,892 people were enrolled in this study, including 233 patients with NS, 863 patients with other GSs, and 796 healthy children. We took one to 10 frontal photos of each subject to build a dataset, and then applied the multi-task convolutional neural network (MTCNN) for data pre-processing to generate standardized outputs with five crucial facial landmarks. The ImageNet dataset was used to pre-train the network so that it could capture generalizable features and minimize data wastage. We subsequently constructed seven models for facial identification based on the VGG16, VGG19, VGG16-BN, VGG19-BN, ResNet50, MobileNet-V2, and squeeze-and-excitation network (SENet) architectures. The identification performance of seven models was evaluated and compared with that of six physicians.ResultsAll models exhibited a high accuracy, precision, and specificity in recognizing NS patients. The VGG19-BN model delivered the best overall performance, with an accuracy of 93.76%, precision of 91.40%, specificity of 98.73%, and F1 score of 78.34%. The VGG16-BN model achieved the highest AUC value of 0.9787, while all models based on VGG architectures were superior to the others on the whole. The highest scores of six physicians in terms of accuracy, precision, specificity, and the F1 score were 74.00%, 75.00%, 88.33%, and 61.76%, respectively. The performance of each model of facial recognition was superior to that of the best physician on all metrics.ConclusionModels of computer-assisted facial recognition can improve the rate of diagnosis of NS. The models based on VGG19-BN and VGG16-BN can play an important role in diagnosing NS in clinical practice.
Development of the entrustable professional activity ‘medication reconciliation’ for clinical pharmacy
Authors: Bozic Ula , Witti Matthias J. , Ralf Schmidmaier , Fischer Martin R. , Zottmann Jan M. , Pudritz Yvonne M. 
Published: May 2024

AbstractBackgroundEntrustable professional activities (EPAs) are observable process descriptions of clinical work units. EPAs support learners and tutors in assessment within healthcare settings. For use amongst our pharmacy students as well as pre-registration pharmacists we wanted to develop and validate an EPA for use in a clinical pharmacy setting at LMU University Hospital.MethodsThe development of the clinical pharmacy EPA followed a set pathway. A rapid literature review informed the first draft, an interprofessional consensus group consisting of pharmacists, nurses, and medical doctors refined this draft. The refined version was then validated via online survey utilising clinical pharmacists from Germany.ResultsWe designed, refined and validated an EPA regarding medication reconciliation for assessment of pharmacy students and trainees within the pharmacy department at LMU University Hospital in Munich. Along with the EPA description an associated checklist to support the entrustment decision was created. For validation an online survey with 27 clinical pharmacists from all over Germany was conducted. Quality testing with the EQual rubric showed a good EPA quality.ConclusionsWe developed the first clinical pharmacy EPA for use in a German context. Medication reconciliation is a suitable EPA candidate as it describes a clinical activity performed by pharmacists in many clinical settings. The newly developed and validated EPA ‘Medication Reconciliation’ will be used to assess pharmacy students and trainees.
Question banks: credit? Or debit? A qualitative exploration of their use among medical students
Authors: Fisher James , Leahy Declan , Lim Jun Jie , Astles Emily , Salvatore Jacobo , Thomson Richard 
Published: May 2024

Abstract
Background
Online question banks are the most widely used education resource amongst medical students. Despite this there is an absence of literature outlining how and why they are used by students. Drawing on Deci and Ryan’s self-determination theory, our study aimed to explore why and how early-stage medical students use question banks in their learning and revision strategies.

Methods
The study was conducted at Newcastle University Medical School (United Kingdom and Malaysia). Purposive, convenience and snowball sampling of year two students were employed. Ten interviews were conducted. Thematic analysis was undertaken iteratively, enabling exploration of nascent themes. Data collection ceased when no new perspectives were identified.

Results
Students’ motivation to use question banks was predominantly driven by extrinsic motivators, with high-stakes exams and fear of failure being central. Their convenience and perceived efficiency promoted autonomy and thus motivation. Rapid feedback cycles and design features consistent with gamification were deterrents to intrinsic motivation. Potentially detrimental patterns of question bank use were evident: cueing, avoidance and memorising. Scepticism regarding veracity of question bank content was absent.

Conclusions
We call on educators to provide students with guidance about potential pitfalls associated with question banks and to reflect on potential inequity of access to these resources.
The mediating effect of pregnancy adaptation between family support and maternal-fetal bonding: a cross-sectional study
Authors: Wu Wan-Ru , Lee Li-Chun , Hung Chich-Hsiu , Huang Hui-Chuan 
Published: May 2024

Abstract
Background
Establishing a nurturing bond with the unborn child is essential for expectant mothers throughout pregnancy. While the influence of family support and pregnancy adaptation on maternal-fetal bonding is evident, these factors remain unexplored in the early stages of pregnancy. This study aims to elucidate the dynamic interaction between family support, pregnancy adaptation, and maternal-fetal bonding during the first trimester, explicitly investigating the mediating role of pregnancy adaptation.

Method
A cross-sectional design was conducted to recruit expectant mothers between 8 and 12 weeks of gestation without significant complications.

Results
Family support and pregnancy adaptation emerged as significant predictors of maternal-fetal bonding, and pregnancy adaptation mediated the relationship between family support and maternal-fetal bonding in the first trimester.

Conclusions
The study confirms the critical role of family support and pregnancy adaptation in facilitating maternal-fetal bonding during early pregnancy, with pregnancy adaptation fully mediating this relationship. Healthcare providers are encouraged to involve family members in early interventions, focusing on assessing family support and engaging them in education and activities to strengthen the emotional bond between the mother and her unborn child.
Quasi-static mechanical evaluation of canine cementless total hip replacement broaches: effect of tooth design on broach and stem insertion
Authors: Lawson Zachary T. , Hollenbeck Danielle L. , Silveira Catrina J. , Moreno Michael R. , Robbins Andrew B. , Saunders W. Brian 
Published: May 2024

Abstract
Background
Biomedtrix BFX® cementless total hip replacement (THR) requires the use of femoral broaches to prepare a press-fit envelope within the femur for subsequent stem insertion. Current broaches contain teeth that crush and remove cancellous bone; however, they are not particularly well-suited for broaching sclerotic (corticalized) cancellous bone. In this study, three tooth designs [Control, TG1 (additional V-grooves), TG2 (diamond tooth pattern)] were evaluated with a quasi-static testing protocol and polyurethane test blocks simulating normal and sclerotic bone. To mimic clinical broaching, a series of five sequential broach insertions were used to determine cumulative broaching energy (J) and peak loads during broach insertion. To determine the effect of broach tooth design on THR stem insertion, a BFX® stem was inserted into prepared test blocks and insertion and subsidence energy and peak loads were determined.

Results
Broach tooth design led to significant differences in broaching energy and peak broaching loads in test blocks of both densities. In low density test blocks, TG1 required the lowest cumulative broaching energy (10.76 ±0.29 J), followed by Control (12.18 ±1.20 J) and TG2 (16.66 ±0.78 J) broaches. In high density test blocks, TG1 required the lowest cumulative broaching energy (32.60 ±2.54 J) as compared to Control (33.25 ±2.16 J) and TG2 (59.97 ±3.07 J). During stem insertion and subsidence testing, stem insertion energy for high density test blocks prepared with Control broaches was 14.53 ± 0.81 J, which was significantly lower than blocks prepared with TG1 (22.53 ± 1.04 J) or TG2 (19.38 ± 3.00 J) broaches. For stem subsidence testing in high density blocks, TG1 prepared blocks required the highest amount of energy to undergo subsidence (14.49 ± 0.49 J), which was significantly greater than test blocks prepared with Control (11.09 ±0.09 J) or TG2 (12.57 ± 0.81 J) broaches.

Conclusions
The additional V-grooves in TG1 broaches demonstrated improved broaching performance while also generating press-fit envelopes that were more resistant to stem insertion and subsidence. TG1 broaches may prove useful in the clinical setting; however additional studies that more closely simulate clinical broach impaction are necessary prior to making widespread changes to THR broaches.
Gastric emphysema and pneumatosis intestinalis in two common marmosets with duodenal dilation syndrome
Authors: Kawarai Shinpei , Sakai Yasuhiro , Iriki Atsushi , Yamazaki Yumiko 
Published: May 2024

Abstract
Background
Common marmosets (Callithrix jacchus) are widely used as primate experimental models in biomedical research. Duodenal dilation with chronic vomiting in captive common marmosets is a recently described life-threatening syndrome that is problematic for health control. However, the pathogenesis and cause of death are not fully understood.

Case presentation
We report two novel necropsy cases in which captive common marmosets were histopathologically diagnosed with gastric emphysema (GE) and pneumatosis intestinalis (PI). Marmoset duodenal dilation syndrome was confirmed in each case by clinical observation of chronic vomiting and by gross necropsy findings showing a dilated, gas-filled and fluid-filled descending duodenum that adhered to the ascending colon. A diagnosis of GE and PI was made on the basis of the bubble-like morphology of the gastric and intestinal mucosa, with histological examination revealing numerous vacuoles diffused throughout the lamina propria mucosae and submucosa. Immunostaining for prospero homeobox 1 and CD31 distinguished gas cysts from blood and lymph vessels. The presence of hepatic portal venous gas in case 1 and possible secondary bacteremia-related septic shock in case 2 were suggested to be acute life-threatening abdominal processes resulting from gastric emphysema and pneumatosis intestinalis.

Conclusions
In both cases, the gross and histopathological findings of gas cysts in the GI tract walls matched the features of human GE and PI. These findings contribute to clarifying the cause of death in captive marmosets that have died of gastrointestinal diseases.