bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic review of adherence to swallow and trismus exercises during radiation therapy for head and neck cancer
Authors: Charters Emma , Ricketts Virginia , Sharman Ashleigh R. , Clark Jonathan 
Published: June 2024

AbstractUnderstanding the barriers and facilitators for prophylactic swallowing and trismus exercises for patients undergoing radiation to the head and neck may help exercise adherence. The analysis reviews all published reports of exercise adherence with a critical appraisal following PRISMA guidelines. A total of 137 potential papers were identified; 20 studies met the inclusion criteria. The most commonly reported facilitators for swallowing and trismus exercises were regular clinician contact and online resources to reinforce instructions, set goals, and manage radiation toxicities. Social support and perceived benefit from exercises were also reported to be of help. The most common barriers to exercise were radiation toxicities, anxiety, feeling overwhelmed with information, and not understanding the reason for the exercises. Understanding facilitators and barriers to adherence is critical when designing exercise interventions for patients undergoing radiation for head and neck cancer.
Comparison of clinical characteristics and outcomes of patients with sepsis identified by the Sepsis‐3 criteria by blood and urine culture results: A multicentre retrospective cohort study
Authors: Li Ling , Baker Jannah , Saavedra Aldo , Suster Carl , Moscova Michelle , Iredell Jonathan , Shetty Amith 
Published: June 2024

AbstractBackground and AimsBlood and urine are the most common culture testing for sepsis patients. This study aimed to compare clinical characteristics and outcomes of sepsis patients by blood and urine culture positivity and to identify factors associated with positive cultures.MethodsThis retrospective study included patients aged ≥16 years with sepsis identified by the Sepsis‐3 criteria presenting to the emergency department at four hospitals between 2017 and 2019 in Australia. Patient clinical outcomes were in‐hospital mortality, intensive care unit (ICU) admission, hospital length of stay, and representation following discharge. Four culture groups were defined based on the positivity of blood cultures (BC) and urine cultures (UC) ordered within 24 h of triage.ResultsOf 4109 patient encounters with sepsis, 2730 (66%) were nonbacteremic, urine culture‐negative (BC−UC−); 767 (19%) nonbacteremic, urine culture‐positive (BC−UC+); 359 (9%) bacteremic, urine culture‐negative (BC+UC−); and 253 (6%) bacteremic, urine culture‐positive (BC+UC+). Compared with BC−UC− patients, BC+UC− patients had the highest risk of ICU admission (adjusted odds ratio [AOR] 95% CI: 1.60 [1.18–2.18]) while BC−UC+ patients had lowest risk (adjusted odds ratio [AOR]: 0.56 [0.41–0.76]). BC+UC− patients had the highest risk of 3‐day representation (AOR: 1.51 [1.02–2.25]) and second longest hospital stay (adjusted relative risk 1.17 [1.03–1.34]). Antibiotic administration before sample collection for culture was associated with lower odds of positive blood or urine culture results (AOR: 0.38, p < 0.0001).ConclusionsEnhanced clinical care should be beneficial for nongenitourinary sepsis patients (BC+UC−) who had the highest comparative risk of adverse clinical outcomes. Every effort needs to be made to collect relevant culture samples before antibiotic administration, to follow up on culture results, and tailor treatment accordingly.
The role of TLC, RDW, and ESR in predicting short‐term prognosis among admitted patients with acute ischemic stroke: Insights from a cross‐sectional study
Authors: KC Suman , KC Rupak , Yadav Birendra Kumar , Basnet Birat , Basnet Anjuli 
Published: June 2024

AbstractBackgroundStroke is the third most common cause of disability and the second most common cause of death worldwide. Prognosis assessment in acute ischemic stroke is challenging for clinicians. The development of simple and easily performed prognostic markers that correlate with the outcome of patients can be of immense benefit. The aim of this study was to find out the prognostic significance of total leukocyte count, red cell distribution width and erythrocyte sedimentation rate in patients with acute ischemic stroke.MethodsA descriptive cross‐sectional study was conducted in a tertiary center after ethical approval from the Institutional Review Committee. The study period spanned from April 18, 2022 to June 17, 2023, a period of 14 months. 136 patients diagnosed with acute ischemic stroke with total leukocyte count (TLC), red cell distribution width (RDW), erythrocyte sedimentation rate (ESR), National Institutes of Health Stroke Scale (NIHSS), and modified Rankin Scale (mRS) were included in the study after fulfilling the inclusion criteria. The modified Rankin Scale (mRS) was obtained 28 days following admission. Data was collected and analyzed through Microsoft Excel 365 and SPSS version 22. Spearman Correlation and multivariate regression analysis were used to analyze the association.ResultsTLC, RDW, and ESR were significantly associated with an mRS at 28 days showing a positive correlation between them. Total in‐hospital mortality has been significantly associated with TLC only (p < 0.05).ConclusionsThe prognostic value of TLC, RDW, and ESR in patients with acute ischemic stroke was found to be significant and similar to the studies done in similar settings.
Multiplex assays reveal anti‐EBV antibody profile and its implication in detection and diagnosis of nasopharyngeal carcinoma
Authors: Ma Lin , Wang Tong‐Min , He Yong‐Qiao , Liao Ying , Yan Xiao , Yang Da‐Wei , Wang Rui‐Hua , Li Fa‐Jun , Jia Wei‐Hua , Feng Lin 
Published: June 2024

AbstractEpstein–Barr virus (EBV) is detected in nearly 100% of nonkeratinizing nasopharyngeal carcinoma (NPC) and EBV‐based biomarkers are used for NPC screening in endemic regions. Immunoglobulin A (IgA) against EBV nuclear antigen 1 (EBNA1) and viral capsid antigen (VCA), and recently identified anti‐BNLF2b antibodies have been shown to be the most effective screening tool; however, the screening efficacy still needs to be improved. This study developed a multiplex serological assay by testing IgA and immunoglobulin G (IgG) antibodies against representative EBV antigens that are highly transcribed in NPC and/or function crucially in viral reactivation, including BALFs, BNLF2a/b, LF1, LF2, and Zta (BZLF1). Among them, BNLF2b‐IgG had the best performance distinguishing NPC patients from controls (area under the curve: 0.951, 95% confidence interval [CI]: 0.913–0.990). Antibodies to lytic antigens BALF2 and VCA were significantly higher in advanced‐stage than in early‐stage tumors; in contrast, antibodies to latent protein EBNA1 and early lytic antigen BNLF2b were not correlated with tumor progression. Accordingly, a novel strategy combining EBNA1‐IgA and BNLF2b‐IgG was proposed and validated improving the integrated discrimination by 15.8% (95% CI: 9.8%–21.7%, p < .0001) compared with the two‐antibody method. Furthermore, we found EBV antibody profile in patients was more complicated compared with that in healthy carriers, in which stronger correlations between antibodies against different phases of antigens were observed. Overall, our serological assay indicated that aberrant latent infection of EBV in nasopharyngeal epithelial cells was probably a key step in NPC initiation, while more lytic protein expression might be involved in NPC progression.
Weakly Supervised Breast Cancer Classification on WSI Using Transformer and Graph Attention Network
Authors: Li Mingze , Zhang Bingbing , Sun Jian , Zhang Jianxin , Liu Bin , Zhang Qiang 
Published: June 2024

ABSTRACTRecently, multiple instance learning (MIL) has been successfully used in weakly supervised breast cancer classification on whole‐slide imaging (WSI) and has become an important assistance for breast cancer diagnosis. However, existing MIL methods have limitations in considering the global contextual information of pathological images. Additionally, their ability to handle spatial relationships among instances should also be improved. Therefore, inspired by transformer and graph deep learning, this study proposes a novel classification method of WSI breast cancer pathological images based on BiFormer and graph attention network (BIMIL‐GAT). In the first stage of instance selection, BiFormer utilizes the two‐stage self‐attention computation mechanism from coarse‐grained region to fine‐grained region to strengthen the global feature extraction ability, which can obtain accurate pivotal instances. Simultaneously, the aim of the second stage is to effectively strengthen the spatial correlation between instances through GAT, thereby improving the accuracy of bag‐level prediction. The experimental results show that BIMIL‐GAT achieves the area under curve (AUC) value of 95.92% on the Cameylon‐16 dataset, which outperforms the baseline model by 3.36%. In addition, our method also shows strong competitiveness in the MSK external extended dataset, which further proves its effectiveness and advancement.
3D printed scaffolds with quercetin and vitamin D3 nanocarriers: In vitro cellular evaluation
Authors: Bose Susmita , Chaudhari Vishal Sharad , Kushram Priya 
Published: June 2024

AbstractIncreasing bone diseases and anomalies significantly challenge bone regeneration, necessitating the development of innovative implantable devices for effective healing. This study explores the potential of 3D‐printed calcium phosphate (CaP) scaffolds functionalized with natural medicine to address this issue. Specifically, quercetin and vitamin D3 (QVD) encapsulated solid lipid nanoparticles (QVD‐SLNs) are incorporated into the scaffold to enhance bone regeneration. The melt emulsification method is utilized to achieve high drug encapsulation efficiency (~98%) and controlled biphasic release kinetics. The process‐structure–property performance of these systems allows more controlled release while maintaining healthy cell–material interactions. The functionalized scaffolds show ~1.3‐ and ~‐1.6‐fold increase in osteoblast cell proliferation and differentiation, respectively, as compared with the control. The treated scaffold demonstrates a reduction in osteoclastic activity as compared with the control. The QVD‐SLN‐loaded scaffolds show ~4.2‐fold in vitro chemopreventive potential against osteosarcoma cells. Bacterial assessment with both Staphylococcus aureus and Pseudomonas aeruginosa shows a significant reduction in bacterial colony growth over the treated scaffold. These findings summarize that the release of QVD‐SLNs through a 3D‐printed CaP scaffold can treat various bone‐related disorders for low or non‐load‐bearing applications.
Gelatin maleimide microgels for hematopoietic progenitor cell encapsulation
Authors: Thompson Gunnar B. , Gilchrist Aidan E. , Lam Vincent M. , Nunes Alison C. , Payan Brittany A. , Mora‐Boza Ana , Serrano Julio F. , García Andrés J. , Harley Brendan A. C. 
Published: June 2024

AbstractHematopoietic stem cells (HSCs) are the apical cells of the hematopoietic system, giving rise to cells of the blood and lymph lineages. HSCs reside primarily within bone marrow niches that contain matrix and cell‐derived signals that help inform stem cell fate. Aspects of the bone marrow microenvironment have been captured in vitro by encapsulating cells within hydrogel matrices that mimic native mechanical and biochemical properties. Hydrogel microparticles, or microgels, are increasingly being used to assemble granular biomaterials for cell culture and noninvasive delivery applications. Here, we report the optimization of a gelatin maleimide hydrogel system to create monodisperse gelatin microgels via a flow‐focusing microfluidic process. We report characteristic hydrogel stiffness, stability, and swelling characteristics as well as encapsulation of murine hematopoietic stem and progenitor cells, and mesenchymal stem cells within microgels. Microgels support cell viability, confirming compatibility of the microfluidic encapsulation process with these sensitive bone marrow cell populations. Overall, this work presents a microgel‐based gelatin maleimide hydrogel as a foundation for future development of a multicellular artificial bone marrow culture system.
The role of different physical function tests for the prediction of fracture risk in older women
Authors: Gregori Giulia , Johansson Lisa , Axelsson Kristian F. , Jaiswal Raju , Litsne Henrik , Larsson Berit A. M. , Lorentzon Mattias 
Published: June 2024

AbstractBackgroundPhysical function is an important risk factor for fracture. Previous studies found that different physical tests (e.g., one‐leg standing [OLS] and timed up and go [TUG]) predict fracture risk. This study aimed to determine which physical function test is the most optimal independent predictor of fracture risk, together with clinical risk factors (CRFs) used in fracture risk assessment (FRAX) and bone mineral density (BMD).MethodsIn total, 2321 women out of the included 3028 older women, aged 77.7 ± 1.6 (mean ± SD), in the Sahlgrenska University Hospital Prospective Evaluation of Risk of Bone Fractures study had complete data on all physical function tests and were included in the analysis. At baseline, hand grip strength, OLS, TUG, walking speed and chair stand tests were performed. All incident fractures were confirmed by X‐ray or review of medical records and subsequently categorized as major osteoporotic fractures (MOFs), hip fractures and any fracture. Multivariate Cox regression (hazard ratios [HRs] and 95% confidence intervals [CIs]) analyses were performed with adjustments for age, body mass index (BMI), FRAX CRFs, femoral neck BMD and all physical function tests as predictors both individually and simultaneously. Receiver operating characteristic (ROC) analyses and Fine and Gray analyses were also performed to investigate associations between physical function and incident fractures.ResultsOLS was the only physical function test to be significantly and independently associated with increased risk of any fracture (HR 1.13 [1.04–1.23]), MOF (HR 1.15 [1.04–1.26]) and hip fracture (HR 1.34 [1.11–1.62]). Adjusting for age, BMI, CRFs and femoral neck BMD did not materially alter these associations. ROC analysis for OLS, together with age, BMI, femoral neck BMD and CRFs, yielded area under the curve values of 0.642, 0.647 and 0.732 for any fracture, MOF and hip fracture, respectively. In analyses considering the competing risk of death, OLS was the only physical function test consistently associated with fracture outcomes (subhazard ratio [SHR] 1.10 [1.01–1.19] for any fracture, SHR 1.11 [1.00–1.22] for MOF and SHR 1.25 [1.03–1.50] for hip fracture). Walking speed was only independently associated with the risk of hip fracture in all Cox regression models and in the Fine and Gray analyses.ConclusionsAmong the five physical function tests, OLS was independently associated with all fracture outcomes, even after considering the competing risk of death, indicating that OLS is the most reliable physical function test for predicting fracture risk in older women.
Swallowing muscle mass contributes to post‐stroke dysphagia in ischemic stroke patients undergoing mechanical thrombectomy
Authors: Pinho João , Meyer Tareq , Schumann‐Werner Beate , Becker Johanna , Tauber Simone , Nikoubashman Omid , Wiesmann Martin , Schulz Jörg B. , Werner Cornelius J. , Reich Arno 
Published: June 2024

AbstractBackgroundNeurogenic dysphagia is a frequent complication of stroke and is associated with aspiration pneumonia and poor outcomes. Although ischaemic lesion location and size are major determinants of the presence and severity of post‐stroke dysphagia, little is known about the contribution of other acute stroke‐unrelated factors. We aimed to analyse the impact of swallowing and non‐swallowing muscles measurements on swallowing function after large vessel occlusion stroke.MethodsThis retrospective study was based on a prospective registry of consecutive ischaemic stroke patients. Patients who underwent mechanical thrombectomy between July 2021 and June 2022 and received a flexible endoscopic evaluation of swallowing (FEES) within 5 days after admission were included. Demographic, anthropometric, clinical, and imaging data were collected from the registry. The cross‐sectional areas (CSA) of selected swallowing muscles (as a surrogate marker for swallowing muscle mass) and of cervical non‐swallowing muscles were measured in computed tomography. Skeletal muscle index (SMI) was calculated and used as a surrogate marker for whole body muscle mass. FEES parameters, namely, Functional Oral Intake Scale (FOIS, as a surrogate marker for dysphagia presence and severity), penetration aspiration scale, and the presence of moderate‐to‐severe pharyngeal residues were collected from the clinical records. Univariate and multivariate ordinal and logistic regression analyses were performed to analyse if total CSA of swallowing muscles and SMI were associated with FEES parameters.ResultsThe final study population consisted of 137 patients, 59 were female (43.1%), median age was 74 years (interquartile range 62–83), median baseline National Institutes of Health Stroke Scale score was 12 (interquartile range 7–16), 16 patients had a vertebrobasilar occlusion (11.7%), and successful recanalization was achieved in 127 patients (92.7%). Both total CSA of swallowing muscles and SMI were significantly correlated with age (rho = −0.391, P < 0.001 and rho = −0.525, P < 0.001, respectively). Total CSA of the swallowing muscles was independently associated with FOIS (common adjusted odds ratio = 1.08, 95% confidence interval = 1.01–1.16, P = 0.029), and with the presence of moderate‐to‐severe pharyngeal residues for puree consistencies (adjusted odds ratio = 0.90, 95% confidence interval = 0.81–0.99, P = 0.036). We found no independent association of SMI with any of the FEES parameters.ConclusionsBaseline swallowing muscle mass contributes to the pathophysiology of post‐stroke dysphagia. Decreasing swallowing muscle mass is independently associated with increasing severity of early post‐stroke dysphagia and with increased likelihood of moderate‐to‐severe pharyngeal residues.
GDF‐15 is associated with sarcopenia and frailty in acutely admitted older medical patients
Authors: Kamper Rikke S. , Nygaard Hanne , Praeger‐Jahnsen Louis , Ekmann Anette , Ditlev Sisse Bolm , Schultz Martin , Hansen Sofie Krarup , Hansen Pernille , Pressel Eckart , Suetta Charlotte 
Published: June 2024

AbstractBackgroundGrowth differentiation factor‐15 (GDF‐15) has been associated with senescence, lower muscle strength, and physical performance in healthy older people. Still, it is not clear whether GDF‐15 can be utilized as a biomarker of sarcopenia and frailty in the early stages of hospitalization. We investigated the association of plasma GDF‐15 with sarcopenia and frailty in older, acutely admitted medical patients.MethodsThe present study is based on secondary analyses of cross‐sectional data from the Copenhagen PROTECT study, a prospective cohort study including 1071 patients ≥65 years of age admitted to the acute medical ward at Copenhagen University Hospital, Bispebjerg, Denmark. Muscle strength was assessed using handgrip strength, and lean mass was assessed using direct segmental multifrequency bioelectrical impedance analyses and used to clarify the potential presence of sarcopenia defined according to guidelines from the European Working Group on Sarcopenia in Older People. Frailty was evaluated using the Clinical Frailty Scale. Plasma GDF‐15 was measured using electrochemiluminescence assays from Meso Scale Discovery (MSD, Rockville, MD, USA).ResultsWe included 1036 patients with completed blood samples (mean age 78.9 ± 7.8 years, 53% female). The median concentration of GDF‐15 was 2669.3 pg/mL. Systemic GDF‐15 was significantly higher in patients with either sarcopenia (P < 0.01) or frailty (P < 0.001) compared with patients without the conditions. Optimum cut‐off points of GDF‐15 relating to sarcopenia and frailty were 1541 and 2166 pg/mL, respectively.ConclusionsSystemic GDF‐15 was higher in acutely admitted older medical patients with sarcopenia and frailty compared with patients without. The present study defined the optimum cut‐off for GDF‐15, related to the presence of sarcopenia and frailty, respectively. When elevated above the derived cutoffs, GDF‐15 was strongly associated with frailty and sarcopenia in both crude and fully adjusted models.
Changes in pre‐haemodialysis serum creatinine levels over 2 years and long‐term survival in maintenance haemodialysis
Authors: Kang Seok Hui , Kim Gui Ok , Kim Bo Yeon , Son Eun Jung , Do Jun Young , Lee Jung Eun 
Published: June 2024

AbstractBackgroundPre‐haemodialysis (HD) serum creatinine levels are reliable and inexpensive markers of muscle mass and important predictors of survival in patients with stable chronic HD. We aimed to assess whether changes in pre‐HD serum creatinine levels during a 2‐year period are linked to long‐term patient survival.MethodsWe retrospectively analysed patients enrolled in a periodic HD quality assessment program. Of the 21 846 participants in the fourth HD quality assessment program, 13 765 were presented in the fifth, of which 10 299 eligible patients were included in this study. We assessed the change in serum creatinine levels over 2 years. The patients were categorized into the following three groups: stable group (patients with change in serum creatinine < 1 mg/dL during 2 years of HD, n = 5664), increasing group (patients with increase in serum creatinine ≥ 1 mg/dL, n = 2419) and decreasing group (patients with decrease in serum creatinine ≥ 1 mg/dL, n = 2216).ResultsThe duration of HD at baseline was 62–83 months, with diabetic kidney disease being the most common cause of kidney failure in 36.4% of patients. The 5‐year patient survival rates in the stable, increasing and decreasing groups were 69.1%, 71.3% and 66.8%, respectively. The decreasing group had poorer patient survival than the other two groups (P = 0.083 for stable vs. increasing group; P = 0.011 for stable vs. decreasing group; P < 0.001 for increasing vs. decreasing group). There was no significant difference in the cardiovascular event‐free survival rate among the three groups. Multivariable Cox regression analyses revealed the highest hazard ratio (HR) for mortality in the decreasing group (HR 1.33, 95% confidence interval [CI] 1.21–1.45, P < 0.001 vs. stable group; HR 1.50, 95% CI 1.34–1.69, P < 0.001 vs. increasing group). The increasing group exhibited a lower risk of mortality than the stable group (HR 0.88, 95% CI 0.81–0.97, P = 0.008). Subgroup analyses based on age, HD vintage, sex, Charlson comorbidity index score, presence of diabetes and baseline serum creatinine level tertiles revealed that the decreasing group exhibited the highest mortality among all subgroups.ConclusionsOur results demonstrate that changes in pre‐HD serum creatinine levels over 2 years of HD were associated with all‐cause mortality in patients undergoing HD. This finding suggests a simple and promising approach for clinicians in the prognosis and management of patients undergoing HD.
Pseudoaneurysm of the mitral‐aortic intervalvular fibrosa in children diagnosed by echocardiography: Two case reports
Authors: Liu Xiaofang , Liu Qinghua , Miao Lili , Yan Yuxi , Pang Huanping , Li Xianjun , Zou Qiushi 
Published: June 2024

AbstractPseudoaneurysm of the mitral‐aortic intervalvular fibrosa is rare, particularly in children, and is potentially fatal. This article presents two cases of pediatric mitral‐aortic intervalvular fibrosa pseudoaneurysm: one secondary to infective endocarditis and the other confirmed to be congenital in nature. The characteristic echocardiographic manifestations of mitral‐aortic intervalvular fibrosa pseudoaneurysm demonstrated in this study will enhance diagnostic efficacy and guide early clinical intervention.