bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender Diversity in Orthopaedic Surgery Residencies Does Not Translate to Accreditation Council for Graduate Medical Education–Accredited Fellowships
Authors: Haddad David , Nelson Deborah , Sherman Nathan , Tatusko Megan , DeSilva Gregory 
Published: May 2024

Introduction:
Gender representation among orthopaedic surgery applicants and residents has increased over the past two decades. The aims of this study were to evaluate trends of female fellows in ACGME-accredited orthopaedic subspecialties between 2007 and 2021, and to compare the fellowship trends of female representation to those of ACGME-accredited orthopaedic residencies.

Methods:
We conducted a retrospective review of publicly available ACGME-accredited fellowship demographic data from 2007 to 2021. The distribution of genders (male vs. female) across subspecialties and orthopaedic surgery residency programs was compared. Chi-square, Spearman correlation, and logistic regression tests were performed to analyze the relationships between year, gender, and fellowship.

Results:
Chi-square analysis demonstrated a significant relationship between gender and year for orthopaedic residency (p < 0.001), but not for any fellowship. There was a significant negative Spearman correlation between the two variables for hand (r(1844) = −0.06, p = 0.02) and sports medicine (r(2804) = −0.05, p = 0.01) fellowships. The negative Spearman correlation for pediatrics (r(499) = −0.09, p = 0.054) approached but did not reach statistical significance. Logistic regression analysis revealed that, holding year constant and comparing to orthopaedic residency, the odds of male participation increased by 173% (95% CI, 1.8–4.1) in spine, increased by 138% (95% CI, 1.7–3.3) in adult reconstruction, increased by 51% (95% CI, 1.3–1.7) in sports medicine, decreased by 41% (95% CI, 0.5–0.7) in hand, decreased by 36% (95% CI, 0.5–0.9) in foot and ankle, decreased by 48% (95% CI, 0.4–0.7) in musculoskeletal oncology, and decreased by 68% (95% CI, 0.3–0.4) in pediatrics.

Conclusion:
Although the percentage of female orthopaedic residents in ACGME-accredited programs increased significantly from 2007 to 2021, this has not translated to ACGME-accredited fellowship positions. Future research optimizing methods to improve the representation of females in orthopaedic surgery should be considered.

Level of Evidence:
III
Clinical and genetic profiles of patients with hereditary and wild-type transthyretin amyloidosis: the Transthyretin Cardiac Amyloidosis Registry in the state of São Paulo, Brazil (REACT-SP)
Authors: Fernandes Fabio , Luzuriaga Georgina del Cisne Jadan , Fonseca Guilherme Wesley Peixoto da , Correia Edileide Barros , Carvalho Alzira Alves Siqueira , Macedo Ariane Vieira Scarlatelli , Filho Otavio Rizzi Coelho , Scheinberg Phillip , Antunes Murillo Oliveira , Schwartzmann Pedro Vellosa , Mangini Sandrigo , Marques Wilson , Simões Marcus Vinicius 
Published: May 2024

Abstract

Background: Transthyretin amyloidosis (ATTR) is a multisystem disease caused by the deposition of fibrillar protein in organs and tissues. ATTR genotypes and phenotypes are highly heterogeneous. We present data on physical signs and symptoms, cardiac and neurological assessments and genetics in patients enrolled in the Transthyretin Cardiac Amyloidosis Registry in the state of São Paulo, Brazil.
Results: Six hundred-forty-four patients were enrolled, 505 with the variant form (ATTRv) and 139 with wild-type (ATTRwt). Sixteen different mutations were detected, the most common being Val50Met (48.3%) and V142Ile (40.8%). Overall, more than half of the patients presented cardiological involvement, and the difference in this proportion between the ATTRv and ATTRwt groups was significant (43.9 vs. 89.9%; p<0.001). The neurological phenotype also differed between ATTRv and ATTRwt (56.8 vs. 31.7%; p<0.001). The mixed phenotype was found in 25.6% of the population, without a significant difference between the forms of amyloidosis. A group of patients remained asymptomatic (10.4%), with a lower proportion of asymptomatic ATTRwt patients.
Conclusions: This study details the clinical and genetic spectrum of patients with ATTR in São Paulo, Brazil. This preliminary analysis highlights the considerable phenotypic heterogeneity of neurological and cardiac manifestations in patients with variant and wild-type ATTR.
Evaluation of the Experiences of Mothers Using Silver Nipple Cups
Authors: Karabayir Nalan , Basibuyuk Mine , Askin Abdullah Emre , Bektas Sebnem , Aktura Bekir 
Published: May 2024

Abstract

Objectives:
Breastfeeding, which is the ideal feeding method for babies, has many benefits for both babies and mothers. However, nipple problems during breastfeeding can cause early weaning. One of the methods used for nipple care is the use of silver nipple cups. In this study, we aimed to evaluate the experiences of breastfeeding mothers using silver cups for nipple care.
Methods:
Mothers contacted via social media were asked to participate in a structured survey consisting of 33 questions related to breastfeeding, nipple care and silver cups use.
Results:
A total number of 298 women were assessed with a structured questionnaire. There was no significant difference between mothers using and not using silver cups regarding their demographic features, breastfeeding starting time, frequency, duration and pumping. Ninthy three percent (n = 290) of mothers used at least one method for nipple care. The first three commonly used methods for nipple care were lanoline (52,2%), breastmilk (51,2%) and silver cups (49,8%). It was reported by 36,6% (n = 109) of mothers that they have not experienced any nipple problems. Among the 147 mothers who had used silver cups 89,9% (132) claimed that this method was effective for them. There was no difference between the frequency of nipple fissures in mothers using silver cups when compared to mothers who did not use it.
Conclusion:
Nipple fissure is one of the most common causes of early cessation of breastfeeding. Mothers use many methods for nipple care. Silver cups is one of the methods preferred by mothers in the prevention of nipple fissures and it is reported to be beneficial.
Nursing Workload in Hospital Settings in South Korea: A Concept Analysis Using the Hybrid Model
Authors: Kang Younhee , Shin Nayeon 
Published: May 2024

Abstract

Background: Appropriate nursing personnel placement is conducted based on nursing workload, and it is necessary to investigate whether the concept of nursing workload is stipulated appropriately for this time in the south Korean nursing system, in which the turnover and resignation rates of nurses are high and nurse shortage is severe.
Aim: This study aimed to investigate the nature of the nursing workload in Korea’s clinical fields using a hybrid model and clarify its definitions and attributes.
Methods: This study employed a qualitative research method with a hybrid model. The definition and nature of nursing workload, determined through an extensive literature review at the theoretical stage, and the analysis findings of the in-depth interview data obtained in the fieldwork stage were compared, analyzed, and integrated in the last stage of the final analysis.
Results: Nursing workload was defined as the sum of nursing behaviors provided to nursing clients for the purpose of healing and achieving optimal well-being, the efforts and time required to perform roles as coordinators and experts, and all the activities associated with emotional labor during nursing care. Nursing workload was shown to have five dimensions: direct nursing, indirect nursing, coordinator role, nursing profession, and emotional labor.
Conclusion: Understanding the concept of “nursing workload” is fundamental to estimating nursing staffing. The findings of this study enabled a comprehensive review and definition of nursing workload in the context of Korean hospitals.
Causal relationship between Alzheimer's disease and retinal nerve fiber layer thickness, visual disturbance: a two-sample Mendelian randomization study.
Authors: Han Xuan , Su Xiaojuan , Wang Jinyan , Guo Xingyu , Ye Hejiang 
Published: May 2024

Abstract

Alzheimer's disease (AD) is a chronic, progressive, irreversible degenerative disorder of the central nervous system caused by multiple factors.Previous studies have demonstrated that patients with AD experience visual disturbances and reduced retinal nerve fiber layer (RNFL) thickness in the early stages. If a causal relationship can be established between AD and visual disturbances as well as RNFL thickness, then AD can be diagnosed by early visual disturbances and RNFL thickness changes.To investigate the causal relationship between AD and visual disturbances as well as RNFL thickness, we conducted a Mendelian randomization study.In this MR study, the main approach was inverse variance weighted (IVW) and evaluate the robustness of the results via sensitivity analysis. The IVW results revealed no significant evidence supporting a causal association between AD and RNFL thickness (P = 0.283, odds ratio [OR] [95% confidence interval (CI)] = 0.926[0.806-1.065]) as well as visual disturbances(P = 0.205, odds ratio [OR] [95% confidence interval (CI)] = 1.070[0.964-1.187]) .Consequently, the potential for diagnosing early-stage AD through alterations in RNFL thickness and visual disturbances remains controversial.
S. agalactiae Promote G. vaginalis Biofilm Formation Leading to Recurrence of Bacterial Vaginitis
Authors: Zhang Lei , Li Meng , Zeng Zhen , Wang Xiaoqian , Liu Ying , Wei Hongbo , Liu Jun , Zhu Simin , Jiang Qingyun , Zhang Ke , Wu Yifan , Liu Shuai , Kim Juhyun , Liao Qinping 
Published: May 2024

Abstract

Bacterial vaginosis (BV) is a condition with a high short-term cure rate and a high recurrence rate. The formation of Gardnerella vaginalis （GV） biofilm is one of the primary reasons for BV recurrence. This study was the first to explore the impact of Streptococcus agalactiae(group B Streptococcus, GBS), a symbiotic intravaginal bacterium, on G. vaginalis concerning biofilm biomass, biofilm structure, transcriptome, and proteome in a co-culture scenario. The results revealed that the supplementation of GBS to G. vaginalissignificantly increased the biomass in 48-hours dual-species biofilms. As confirmed by qPCR, the differentially expressed gene (DEG) luxS of GBS identified through transcriptome analysis was significantly higher in dual-species biofilm compared to mono-species biofilm. Subsequently, we developed a GBS luxS mutant strain (ΔGBS) and observed significant reductions in ΔGBS biofilms and ΔGBS+GV dual-species biofilms. Upon supplementing with exogenous AI-2 reagents, there was a substantial increase in biofilm biomass noted in GBS, ΔGBS, and GV mono- and dual-biofilms. Furthermore, we found that the expression of two genes related to biofilm formation, murG and GAVG_RS05105, was significantly elevated in GV after receiving AI-2 signals. Collectively, these findings suggest that GBS enhances biofilm formation by luxS/AI-2 in an in vitro co-culture model, potentially offering a new approach for treating RBV.
Efficiency of cysticidal therapy impacted by the host’s immune response in Neurocysticercosis patients
Authors: Mehta Yashvi , Kaur Davinder , Kaur Upninder , Shree Ritu , Singh Paramjeet , Modi Manish , Lal Vivek , Sehgal Rakesh 
Published: May 2024

Abstract

Neurocysticercosis (NCC) is a neurological condition caused by the presence of cysts from T. solium in the brain, which manifests with a range of clinical symptoms. The severity of NCC and its prognosis following Anti Helminth Drug (AHD) treatment are closely linked to peripheral and local inflammation. The study aims to analyse the efficiency of cysticidal therapy impacted by the host’s immune response in NCC patients. A total of 104 patients were enrolled in the study and blood samples were collected from 30 patients. The follow-up samples within 3 to 6 months of treatment were collected. Patients were categorised as - Responder (R) and Non-Responder (NR). Cytokines were estimated using ELISA kits in PBMCs cells. The responder patients showed significantly lower IL-10 & IL-6 levels in the supernatants at T0 as compared to T1, while in non-responder patients, IL-10 and IL-6 levels were higher at T0 as compared to T1. The IFN-γ and TNF-α levels were found to be higher in the supernatants at T0 as compared to T1 in both the responder and non-responder patients. These observations imply that these cytokines might have an impact on the efficacy of AHD treatment in individuals with NCC
Explainable GNN-Derived Structure-Property Relationships in Interstitial-Alloy Materials
Authors: Borge-Durán Ignacio , Bejarano Eduardo Aguilar , Araya Luis Arrieta , Arguedas Mauricio Gutierrez , Özcan Ender , Woodward Simon , Figueredo Grazziela 
Published: May 2024

Abstract

The properties of periodic solid-state materials are frequently modified by the inclusion of interstitial atoms deposited pseudo-randomly throughout the crystal lattice. Accurately calculating overall lattice properties currently requires time-intensive, high-level quantum (typically DFT) calculations, often on 1000s of stochastic lattices. 'Interatomic potential models' (IPM) can mitigate such computational burdens by awarding discrete coefficients to common interstitial geometric ensembles within the wider lattice, and then summing these in a simple regression. Human-designed IPMs however typically take years to be developed. Herein, using molybdenum carbide (Mo lattice, C interstitial added atom) as a model, we show a Crystal Graph Neural Network (CGNet) workflow that can derive near-perfect IPMs from <300 DFT inputs in seconds. Our pipeline (CGNet+CGExplainer) demonstrates high potential for generality in exploring lattice structure-property relations rapidly while maintaining accuracy and interpretability.
Deep Learning as Ricci Flow
Authors: Baptista Anthony , Barp Alessandro , Chakraborti Tapabrata , MacArthur Ben , Harbron Chris , Banerji Christopher 
Published: May 2024

Abstract

Deep neural networks (DNNs) are powerful tools for approximating the distribution of complex data. It is known that data passing through a trained DNN classifier undergoes a series of geometric and topological simplifications. While some progress has been made toward understanding these transformations in neural networks with smooth activation functions, an understanding in the more general setting of non-smooth activation functions, such as the rectified linear unit (ReLU), which tend to perform better, is required.Here we propose that the geometric transformations performed by DNNs during classification tasks have parallels to those expected under Hamilton's Ricci flow - a tool from differential geometry that evolves a manifold by smoothing its curvature, in order to identify its topology. To illustrate this idea, we present a computational framework to quantify the geometric changes that occur as data passes through successive layers of a DNN, and use this framework to motivate a notion of 'global Ricci network flow' that can be used to assess a DNN's ability to disentangle complex data geometries to solve classification problems. By training more than $1,500$ DNN classifiers of different widths and depths on synthetic and real-world data, we show that the strength of global Ricci network flow-like behaviour correlates with accuracy for well-trained DNNs, independently of depth, width and data set. Our findings motivate the use of tools from differential and discrete geometry to the problem of explainability in deep learning.
Early physical rehabilitation dosage in the Intensive Care Unit predicts hospital outcomes after critical COVID-19
Authors: Mayer Kirby P. , Haezebrouck Evan , Ginoza Lori M. , Martinez Clarisa , Jan Minnie , Michener Lori A. , Fresenko Lindsey , Montgomery-Yates Ashley A. , Kalema Anna G. , Pastva Amy M. , Biehl Michelle , Mart Matthew F. , Johnson Joshua K. 
Published: May 2024

Abstract

Objective: to examine the relationship between physical rehabilitation parameters including a novel approach to quantifying dosage with hospital outcomes for patients with critical COVID-19.
Design: Retrospective practice analysis from March 5, 2020, to April 15, 2021.
Setting: Intensive care units (ICU) at four medical institutions
Patients: n = 3,780 adults with ICU admission and diagnosis of COVID-19
Interventions: We measured the physical rehabilitation treatment delivered in ICU and patient outcomes: 1) mortality; 2) discharge disposition; and 3) physical function at hospital discharge measured by the Activity Measure-Post Acute Care (AM-PAC) “6-Clicks” (6-24, 24=greater functional independence). Physical rehabilitation dosage was defined as the average mobility level scores in the first three sessions (a surrogate measure of intensity) multiplied by the rehabilitation frequency (PT + OT frequency in hospital).
Measurements and Main Results: The cohort was a mean 64 ± 16 years old, 41% female, mean BMI of 32 ± 9 kg/m2 and 46% (n=1739) required mechanical ventilation. For 2191 patients with complete data, rehabilitation dosage and AM-PAC at discharge were moderately, positively associated (Spearman’s rho [r] = 0.484, p < 0.001). Multivariate linear regression (model adjusted R2= 0.68, p <0.001) demonstrates mechanical ventilation (β = -0.86, p = 0.001), average mobility score in first three sessions (β = 2.6, p <0.001) and physical rehabilitation dosage (β = 0.22, p = 0.001) were predictive of AM-PAC scores at discharge when controlling for age, sex, BMI, and ICU LOS.
Conclusions: Greater physical rehabilitation exposure early in the ICU is associated with physical function at hospital discharge.
Spinocerebellar Ataxia in Brazil: A Comprehensive Genotype–Phenotype Analysis
Authors: Ganimi Maria Carolina Da Cunha , Couto Christian Marques , Ferreira Alessandra de La Rocque , Paiva Carmen Lucia Antão 
Published: May 2024

Abstract

Background: Spinocerebellar ataxias (SCAs) are a diverse group of hereditary neurodegenerative disorders marked by progressive degeneration of the cerebellum and other nervous system parts. In this study, we aimed to reveal the genotype‒phenotype correlations in SCAs within the Brazilian population by leveraging a comprehensive dataset of 763 individuals from the SARAH Network of Rehabilitation Hospitals.
Methods: Using a retrospective, cross-sectional, observational, multicentric approach, we analysed medical records and conducted standardized molecular testing to explore the epidemiological characteristics, clinical manifestations, and genetic profiles of SCAs in Brazil.
Results: Our findings revealed the predominance of SCA3, followed by SCA7 and SCA2, aligning with global trends and reflecting the specific genetic landscape of Brazil. A significant inverse relationship between the age of symptom onset and CAG repeat length in the mutated allele was observed across SCAs 2, 3, and 7. The study also highlights a trend towards paternal inheritance in SCA2 and details the distribution of CAG repeat expansions, correlating larger expansions with earlier onset and specific symptomatology.
Conclusion: This extensive analysis underscores the critical importance of genetic testing in the diagnosis and management of SCAs, shedding light on intricate genotype‒phenotype interplay within a genetically diverse population. Despite certain limitations, such as potential selection bias and the retrospective nature of the study, our research provides invaluable insights into the prevalence, genetic underpinnings, and clinical variability of SCAs in Brazil. We suggest a broader demographic scope and investigations into nonmotor symptoms in future studies to obtain a more comprehensive understanding of SCAs.
Ascorbic acid improves cognitive levels in middle-aged mice and increases CD8 + T cells by binding Myh9 protein and enriches gut microbiota Akkermansia muciniphila
Authors: Mi Taotao , Yang Shanshan , Huo Fengjiao , Zhao Meili , Lv Shuyao , Su Tingting , Feng Shengyu , Wang Hao , Guo Liuling , Liu Yue , Liu Qing , Wang Nan , Zhu Jian-Kang , Liu Hailiang 
Published: May 2024

Abstract

Background: Immunosenescence accelerates systemic aging and influences cognitive function, with antioxidants potentially mitigating these effects. The significance of ascorbic acid (vitamin C) as a crucial antioxidant in anti-aging and cognition, as well as the potential impact of the gut microbiome on this process, has yet to be investigated.
Results: In this study, we systematically assessed the impact of ascorbic acid on immunosenescence and cognitive function in middle-aged and aged mice. The findings demonstrated a notable rise in peripheral blood lymphocytes, a decline in myeloid immune cells, and enhanced cognitive performance. In vitro studies indicated that ascorbic acid facilitated the differentiation of mouse hematopoietic stem cells (HSCs) and spleen monocytes into CD8+ T cells, with its efficacy primarily mediated by its interaction with the protein Myh9 protein. A positive correlation was observed between CD8+ T cells and cognitive function. Furthermore, a distinction exists between the efficacy of oral and intravenous administration of ascorbic acid in enhancing cognitive function, potentially attributable to the modulation of the gut microbiome Akkermansia muciniphila. Intravenous delivery notably enhances A. muciniphila abundance and significantly enhances cognitive performance in middle-aged and elderly mice, whereas oral ascorbic acid supplementation increases CD8+ T cell count and cognitive function in this demographic only when co-administered with A. muciniphila.
Conclusion: This study demonstrated that the administration of ascorbic acid can mitigate immunosenescence and, in conjunction with A. muciniphila, improves cognitive function in mice. These findings offer a mechanistic rationale for utilizing nutritional interventions to mitigate immunosenescence and enhance cognitive function, and underscores the importance of selecting the optimal route of administration for achieving the intended effects.
Serum LDH and α-HBDH levels as biomarkers predicting the staging in lung adenocarcinoma patients
Authors: Li Qianhong , Xiao Ling , Zheng Zhongsheng , Ye Mingzhi 
Published: May 2024

Abstract

Background
Lung adenocarcinoma (L-ADC) is one of the major types of non-small cell lung carcinomas (NSCLC). This retrospective study aimed to assess correlations between the serum lactate dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase (α-HBDH), and carcinoembryonic antigen (CEA) levels and treatment responses in L-ADC patients, including the advanced-stage patients receiving platinum-based chemotherapies.
Methods
L-ADC patients were separated into two groups- the advanced (stage III-IV) and the early-middle (stage I-II) groups by the seventh edition of the Union for International Cancer Control (UICC) TNM classification. Serum LDH, α-HBDH, and CEA levels were measured by internationally standardized spectrophotometric methods.
Results
This retrospective study recruited 100 patients with L-ADC. Group A had lower LDH (P = 0.042), α-HBDH (P = 0.013), and CEA (P = 0.017) levels than those of group B. The level of total protein (TP) was increased in Group A than that in group B (P = 0.006). Serum LDH level was significantly correlated with that of CEA (P = 0.003), albumin (ALB; P = 0.013), and alkaline phosphatase (ALP; P = 0.02). Serum α-HBDH level also was correlated with that of CEA (P = 0.008). The change in serum LDH levels in these groups after 4 cycles of chemotherapy was not associated with an improved radiological response (P > 0.05).
Conclusions
Serum LDH and α-HBDH levels may have substantial application values for staging in and prognosis of L-ADC patients, but there were no significant changes in levels of other serum biomarkers in terms of evaluating the efficacy of chemotherapy.