bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early changes in cardiac troponin T and NT-proBNP levels in neonates receiving ECMO support: a single-center experience
Authors: Xie Wen-Peng , Liu Yi-Nan , Zeng Ya-Ting , Zheng Yi-Rong , Chen Qiang 
Published: April 2024

AbstractObjectiveThis study aimed to examine the changes in absolute value and decline rate of early serum cardiac troponin T (cTnT) and N-terminal pro b-type natriuretic peptide (NT-proBNP) in neonates who received veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO) support therapy within the first week of life.MethodsWe retrospectively collected clinical data and laboratory test results of 18 neonates who underwent V-A ECMO support within one week of birth, from July 2021 to June 2023, using the electronic medical record system. These patients were categorized into survival and death groups. Comparative analyses of the absolute values and decline rates of cTnT and NT-proBNP were made between the groups at baseline, and at 24, 48, and 72 h post-ECMO initiation.ResultsOut of the 18 neonates, 12 survived (survival rate: 66.7%), while 6 succumbed. The survival group exhibited significantly lower absolute values of cTnT and NT-proBNP than the death group, and their decline rates were significantly higher. Notably, all neonates without an early decline in cTnT and NT-proBNP levels were in the death group.ConclusionThe early changes in the absolute value and decline rate of serum cTnT and NT-proBNP in neonates undergoing V-A ECMO may serve as predictors of their prognosis.
Which training load indicators are greater correlated with maturation and wellness variables in elite U14 soccer players?
Authors: Nobari Hadi , Eken Özgür , Singh Utkarsh , Gorouhi Armin , Bordón José Carlos Ponce , Prieto-González Pablo , Kurtoğlu Ahmet , Calvo Tomás García 
Published: April 2024

Abstract
Background
Monitoring of training load is done to improve physical performance and minimize the incidence of injuries. The study examined the correlation between accumulated training load parameters based on periods with maturity (i.e., maturity offset and peak height velocity -PHV- and wellness variables -e.g., stress and sleep quality-). The second aim was to analyze the multi-linear regression between the above indicators.

Methods
Twenty elite young U14 soccer players (M = 13.26 ± 0.52 years, 95% CI [13.02, 13.51]) were evaluated over 26 weeks (early, mid, and end-season) to obtain stress, sleep quality, and measures of workload in the season (accumulated acute workload [AW], accumulated chronic workload [CW], accumulated acute: chronic workload ratio [ACWLR], accumulated training monotony [TM], accumulated training strain [TS]).

Results
The analysis revealed a moderate, statistically significant negative correlation between sleep quality and training monotony (r = -0.461, p < 0.05). No significant correlations were observed between other variables (p > 0.05). In the multi-linear regression analysis, maturity, PHV, sleep, and stress collectively accounted for variances of 17% in AW, 17.1% in CW, 11% in ACWLR, 21.3% in TM, and 22.6% in TS. However, individual regression coefficients for these predictors were not statistically significant (p > 0.05), indicating limited predictive power.

Conclusion
The study highlights the impact of sleep quality on training monotony, underscoring the importance of managing training load to mitigate the risks of overtraining. The non-significant regression coefficients suggest the complexity of predicting training outcomes based on the assessed variables. These insights emphasize the need for a holistic approach in training load management and athlete wellness monitoring.
The efficacy of real versus sham external Trigeminal Nerve Stimulation (eTNS) in youth with Attention-Deficit/Hyperactivity Disorder (ADHD) over 4 weeks: a protocol for a multi-centre, double-blind, randomized, parallel-group, phase IIb study (ATTENS)
Authors: Rubia Katya , Johansson Lena , Carter Ben , Stringer Dominic , Santosh Paramala , Mehta Mitul A. , Conti Aldo Alberto , Bozhilova Natali , Eraydin Irem Ece , Cortese Samuele 
Published: April 2024

Abstract
Background
Attention Deficit/Hyperactivity Disorder (ADHD), if severe, is usually treated with stimulant or non-stimulant medication. However, users prefer non-drug treatments due to side effects. Alternative non-medication treatments have so far only shown modest effects. External trigeminal nerve stimulation (eTNS) is a minimal risk, non-invasive neuromodulation device, targeting the trigeminal system. It was approved for ADHD in 2019 by the USA Food and Drug administration (FDA) based on a small proof of concept randomised controlled trial (RCT) in 62 children with ADHD showing improvement of ADHD symptoms after 4 weeks of nightly real versus sham eTNS with minimal side effects. We present here the protocol of a larger confirmatory phase IIb study testing efficacy, longer-term persistency of effects and underlying mechanisms of action.

Methods
A confirmatory, sham-controlled, double-blind, parallel-arm, multi-centre phase IIb RCT of 4 weeks of eTNS in 150 youth with ADHD, recruited in London, Portsmouth, and Southampton, UK. Youth with ADHD will be randomized to either real or sham eTNS, applied nightly for 4 weeks. Primary outcome is the change in the investigator-administered parent rated ADHD rating scale. Secondary outcomes are other clinical and cognitive measures, objective hyperactivity and pupillometry measures, side effects, and maintenance of effects over 6 months. The mechanisms of action will be tested in a subgroup of 56 participants using magnetic resonance imaging (MRI) before and after the 4-week treatment.

Discussion
This multi-centre phase IIb RCT will confirm whether eTNS is effective in a larger age range of children and adolescents with ADHD, whether it improves cognition and other clinical measures, whether efficacy persists at 6 months and it will test underlying brain mechanisms. The results will establish whether eTNS is effective and safe as a novel non-pharmacological treatment for ADHD.
Trial registration: ISRCTN82129325 on 02/08/2021, https://doi.org/10.1186/ISRCTN82129325.
Medication adherence and costs of medical care among patients with Parkinson’s disease: an observational study using electronic medical records
Authors: Yi Zhanmiao , Mao Yudan , He Chenxuan , Zhang Yantao , Zhou Junwen , Feng Xing Lin 
Published: April 2024

Abstract
Background
Adherence to antiparkinsonian drugs (APDs) is critical for patients with Parkinson’s disease (PD), for which medication is the main therapeutic strategy. Previous studies have focused on specific disorders in a single system when assessing clinical factors affecting adherence to PD treatment, and no international comparative data are available on the medical costs for Chinese patients with PD. The present study aimed to evaluate medication adherence and its associated factors among Chinese patients with PD using a systematic approach and to explore the impact of adequate medication adherence on direct medical costs.

Methods
A retrospective analysis was conducted using the electronic medical records of patients with PD from a medical center in China. Patients with a minimum of two APD prescriptions from January 1, 2016 to August 15, 2018 were included. Medication possession ratio (MPR) and proportion of days covered were used to measure APD adherence. Multiple linear regression analysis was used to identify factors affecting APD adherence. Gamma regression analysis was used to explore the impact of APD adherence on direct medical costs.

Results
In total, 1,712 patients were included in the study, and the mean MPR was 0.68 (± 0.25). Increased number of APDs and all medications, and higher daily levodopa-equivalent doses resulted in higher MPR (mean difference [MD] = 0.04 [0.03–0.05]; MD = 0.02 [0.01–0.03]; MD = 0.03 [0.01–0.04], respectively); combined digestive system diseases, epilepsy, or older age resulted in lower MPR (MD = -0.06 [-0.09 to -0.03]; MD = -0.07 [-0.14 to -0.01]; MD = -0.02 [-0.03 to -0.01], respectively). Higher APD adherence resulted in higher direct medical costs, including APD and other outpatient costs. For a 0.3 increase in MPR, the two costs increased by $34.42 ($25.43–$43.41) and $14.63 ($4.86–$24.39) per year, respectively.

Conclusions
APD adherence rate among Chinese patients with PD was moderate and related primarily to age, comorbidities, and healthcare costs. The factors should be considered when prescribing APDs.
Advanced AI-driven approach for enhanced brain tumor detection from MRI images utilizing EfficientNetB2 with equalization and homomorphic filtering
Authors: Zubair Rahman A. M. J. , Gupta Muskan , Aarathi S. , Mahesh T. R. , Vinoth Kumar V. , Yogesh Kumaran S. , Guluwadi Suresh 
Published: April 2024

AbstractBrain tumors pose a significant medical challenge necessitating precise detection and diagnosis, especially in Magnetic resonance imaging(MRI). Current methodologies reliant on traditional image processing and conventional machine learning encounter hurdles in accurately discerning tumor regions within intricate MRI scans, often susceptible to noise and varying image quality. The advent of artificial intelligence (AI) has revolutionized various aspects of healthcare, providing innovative solutions for diagnostics and treatment strategies. This paper introduces a novel AI-driven methodology for brain tumor detection from MRI images, leveraging the EfficientNetB2 deep learning architecture. Our approach incorporates advanced image preprocessing techniques, including image cropping, equalization, and the application of homomorphic filters, to enhance the quality of MRI data for more accurate tumor detection. The proposed model exhibits substantial performance enhancement by demonstrating validation accuracies of 99.83%, 99.75%, and 99.2% on BD-BrainTumor, Brain-tumor-detection, and Brain-MRI-images-for-brain-tumor-detection datasets respectively, this research holds promise for refined clinical diagnostics and patient care, fostering more accurate and reliable brain tumor identification from MRI images. All data is available on Github: https://github.com/muskan258/Brain-Tumor-Detection-from-MRI-Images-Utilizing-EfficientNetB2).
Assessing satisfaction in simulation among nursing students: psychometric properties of the Satisfaction with Simulation Experience - Italian Version scale
Authors: Alberti Sara , Guasconi Massimo , Bolzoni Marina , Donnini Giulia , Volpi Paola , Rovesti Sergio , Monaco Federico , Bonacaro Antonio , Ferri Paola 
Published: April 2024

Abstract
Background
The Satisfaction with Simulation Experience scale is a 5-point Likert scale that measures students’ satisfaction in medium and high-fidelity simulation scenarios. This study aims at investigating the psychometric properties of the Satisfaction with Simulation Experience - Italian Version scale.

Methods
A multi-centre cross-sectional study was conducted. The scale was administered to a sample of 266 undergraduate nursing students from two Italian universities after attending a medium- and high-fidelity simulation session in November 2022 and March 2023. Cronbach’s alpha coefficient and item-total correlation were sorted out to assess internal consistency and reliability. The test-retest method was used as a measure of scale stability over time as well as the confirmatory factor analysis to verify construct validity.

Results
The Cronbach’s alpha value was 0.94 for the overall scale, indicating excellent reliability, and it was 0.84 or higher for each subscales, indicating good reliability. A large correlation coefficient of 0.60 or higher was found between each item and its subscale and between each item and the overall scale score. A medium test-retest correlation coefficient was found for most items (r > 0.30). The confirmatory factor analysis confirmed the factorial structure found in the original study.

Conclusions
Satisfaction is an important teaching and learning quality indicator along with the achievement of learning outcomes in simulation. The Satisfaction with Simulation Experience - Italian Version scale showed good reliability and validity; therefore, it could be a useful tool to assess simulation impact in Italian nursing students. The extensive utilization of the Satisfaction with Simulation Experience scale, along with its various validated versions, could facilitate assessing satisfaction in simulation across diverse contexts and enable comparisons of findings across studies in different countries.
Blockade of PI3K/AKT signaling pathway by Astragaloside IV attenuates ulcerative colitis via improving the intestinal epithelial barrier
Authors: Zhang Xinhui , Zhang Fan , Li Yan , Fan Na , Zhao Ke , Zhang Anding , Kang Jiefang , Lin Yan , Xue Xiaochang , Jiang Xun 
Published: April 2024

Abstract
Background
The specific pathogenesis of UC is still unclear, but it has been clear that defects in intestinal barrier function play an important role in it. There is a temporary lack of specific drugs for clinical treatment. Astragaloside IV (AS-IV) is one of the main active ingredients extracted from Astragalus root and is a common Chinese herbal medicine for the treatment of gastrointestinal diseases. This study aimed to determine whether AS-IV has therapeutic value for DSS or LPS-induced intestinal epithelial barrier dysfunction in vivo and in vitro and its potential molecular mechanisms.

Methods
The intestinal tissues from UC patients and colitis mice were collected, intestinal inflammation was observed by colonoscopy, and mucosal barrier function was measured by immunofluorescence staining. PI3K/AKT signaling pathway activator YS-49 and inhibitor LY-29 were administered to colitic mice to uncover the effect of this pathway on gut mucosal barrier modulation. Then, network pharmacology was used to screen Astragaloside IV (AS-IV), a core active component of the traditional Chinese medicine Astragalus membranaceus. The potential of AS-IV for intestinal barrier function repairment and UC treatment through blockade of the PI3K/AKT pathway was further confirmed by histopathological staining, FITC-dextran, transmission electron microscopy, ELISA, immunofluorescence, qRT-PCR, and western blotting. Finally, 16 S rRNA sequencing was performed to uncover whether AS-IV can ameliorate UC by regulating gut microbiota homeostasis.

Results
Mucosal barrier function was significantly damaged in UC patients and murine colitis, and the activated PI3K/AKT signaling pathway was extensively involved. Both in vivo and vitro showed that the AS-IV-treated group significantly relieved inflammation and improved intestinal epithelial permeability by inhibiting the activation of the PI3K/AKT signaling pathway. In addition, microbiome data found that gut microbiota participates in AS-IV–mediated intestinal barrier recovery as well.

Conclusions
Our study highlights that AS-IV exerts a protective effect on the integrality of the mucosal barrier in UC based on the PI3K/AKT pathway, and AS-IV may serve as a novel AKT inhibitor to provide a potential therapy for UC.

Graphical abstract
Utility and usability of a wearable system and progressive-challenge cued exercise program for encouraging use of the more involved arm at-home after stroke—a feasibility study with case reports
Authors: Horder Jake , Mrotek Leigh A. , Casadio Maura , Bassindale Kimberly D. , McGuire John , Scheidt Robert A. 
Published: April 2024

Abstract
Background
Understanding the role of adherence to home exercise programs for survivors of stroke is critical to ensure patients perform prescribed exercises and maximize effectiveness of recovery.

Methods
Survivors of hemiparetic stroke with impaired motor function were recruited into a 7-day study designed to test the utility and usability of a low-cost wearable system and progressive-challenge cued exercise program for encouraging graded-challenge exercise at-home. The wearable system comprised two wrist-worn MetaMotionR+ activity monitors and a custom smartphone app. The progressive-challenge cued exercise program included high-intensity activities (one repetition every 30 s) dosed at 1.5 h per day, embedded within 8 h of passive activity monitoring per day. Utility was assessed using measures of system uptime and cue response rate. Usability and user experience were assessed using well-validated quantitative surveys of system usability and user experience. Self-efficacy was assessed at the end of each day on a visual analog scale that ranged from 0 to 100.

Results
The system and exercise program had objective utility: system uptime was 92 ± 6.9% of intended hours and the rate of successful cue delivery was 99 ± 2.7%. The system and program also were effective in motivating cued exercise: activity was detected within 5-s of the cue 98 ± 3.1% of the time. As shown via two case studies, accelerometry data can accurately reflect graded-challenge exercise instructions and reveal differentiable activity levels across exercise stages. User experience surveys indicated positive overall usability in the home settings, strong levels of personal motivation to use the system, and high degrees of satisfaction with the devices and provided training. Self-efficacy assessments indicated a strong perception of proficiency across participants (95 ± 5.0).

Conclusions
This study demonstrates that a low-cost wearable system providing frequent haptic cues to encourage graded-challenge exercise after stroke can have utility and can provide an overall positive user experience in home settings. The study also demonstrates how combining a graded exercise program with all-day activity monitoring can provide insight into the potential for wearable systems to assess adherence to—and effectiveness of—home-based exercise programs on an individualized basis.
Clinical and epidemiological characteristics of 96 pediatric human metapneumovirus infections in Henan, China after COVID-19 pandemic: a retrospective analysis
Authors: Ji Wangquan , Chen Yu , Han Shujie , Dai Bowen , Li Kang , Li Shuang , Li Zijie , Chen Shouhang , Zhang Yaodong , Zhang Xiaolong , Li Xiaolong , Wang Qingmei , Zheng Jiaying , Wang Chenyu , Liang Qiujing , Han Shujuan , Zhang Ruyu , Wang Fang , Jin Yuefei 
Published: April 2024

AbstractBackgroundIn the aftermath of the COVID-19 pandemic, there has been a surge in human metapneumovirus (HMPV) transmission, surpassing pre-epidemic levels. We aim to elucidate the clinical and epidemiological characteristics of HMPV infections in the post-COVID-19 pandemic era.MethodsIn this retrospective single-center study, participants diagnosed with laboratory confirmed HMPV infection through Targeted Next Generation Sequencing were included. The study encompassed individuals admitted to Henan Children's Hospital between April 29 and June 5, 2023. Demographic information, clinical records, and laboratory indicators were analyzed.ResultsBetween April 29 and June 5, 2023, 96 pediatric patients were identified as infected with HMPV with a median age of 33.5 months (interquartile range, 12 ~ 48 months). The majority (87.5%) of infected children were under 5 years old. Notably, severe cases were statistically younger. Predominant symptoms included fever (81.3%) and cough (92.7%), with wheezing more prevalent in the severe group (56%vs21.1%). Coinfection with other viruses was observed in 43 patients, with Epstein–Barr virus (EBV) (15.6%) or human rhinovirus A (HRV type A) (12.5%) being the most common. Human respiratory syncytial virus (HRSV) coinfection rate was significantly higher in the severe group (20%vs1.4%). Bacterial coinfection occurred in 74 patients, with Haemophilus influenzae (Hin) and Streptococcus pneumoniae (SNP) being the most prevalent (52.1% and 41.7%, respectively). Severe patients demonstrated evidence of multi-organ damage. Noteworthy alterations included lower concentration of IL-12p70, decreased lymphocytes percentages, and elevated B lymphocyte percentages in severe cases, with statistical significance. Moreover, most laboratory indicators exhibited significant changes approximately 4 to 5 days after onset.ConclusionsOur data systemically elucidated the clinical and epidemiological characteristics of pediatric patients with HMPV infection, which might be instructive to policy development for the prevention and control of HMPV infection and might provide important clues for future HMPV research endeavors.
Health-related quality of life in children and adolescents with Marfan syndrome or related disorders: a controlled cross-sectional study
Authors: Edouard Thomas , Picot Marie-Christine , Bajanca Fernanda , Huguet Helena , Guitarte Aitor , Langeois Maud , Chesneau Bertrand , Van Kien Philippe Khau , Garrigue Eric , Dulac Yves , Amedro Pascal 
Published: April 2024

AbstractBackgroundThis cross-sectional controlled study aims to assess health-related quality of life (HRQoL) of children and adolescents with a molecular diagnosis of Marfan syndrome (MFS) or related disorders and to evaluate the factors associated with HRQoL in this population. Sixty-three children with MFS and 124 age- and sex-matched healthy children were recruited. HRQoL was assessed using the Pediatric Quality of Life Inventory (PedsQL™) generic questionnaire. The correlation between HRQoL scores and the different continuous parameters (age, body mass index, disease severity, systemic score, aortic sinus diameter, and aerobic physical capacity) was evaluated using Pearson’s or Spearman’s coefficient. A multiple linear regression analysis was performed on the two health summary self-reported PedsQL™ scores (physical and psychosocial) to identify the factors associated with HRQoL in the MFS group.ResultsExcept for emotional functioning, all other domains of HRQoL (psychosocial and physical health, social and school functions) were significantly lower in children with MFS compared to matched healthy children. In the MFS group, the physical health summary score was significantly lower in female than in male patients (self-report: absolute difference [95%CI] = -8.7 [-17.0; -0.47],P = 0.04; proxy-report: absolute difference [95%CI] = -8.6 [-17.3; 0.02],P = 0.05) and also negatively correlated with the systemic score (self-report:R = -0.24,P = 0.06; proxy-report:R = -0.29,P = 0.03) and with the height Z-score (proxy-report:R = -0.29,P = 0.03). There was no significant difference in the physical health summary scores between the different genetic subgroups. In the subgroup of 27 patients who performed a cardiopulmonary exercise test, self- and proxy-reported physical health summary scores were highly correlated with their aerobic physical capacity assessed by peak oxygen consumption (VO2max) and ventilatory anaerobic threshold (VAT). In the multivariate analysis, the most important independent predictors of decreased physical health were increased height, decreased body mass index, decreased VAT and use of prophylactic therapy.ConclusionsThis study reports an impaired HRQoL in children and adolescents with MFS or related conditions, in comparison with matched healthy children. Educational and rehabilitation programs must be developed and evaluated to improve exercise capacity and HRQoL in these patients.Trial registrationClinicalTrials.gov,NCT03236571. Registered 28 July 2017.