bluuebunny/crossref_metadata_2025_split huggingface dataset:
Construction of the prediction model for multiple myeloma based on machine learning
Authors: Cai Jiangying , Liu Zhenhua , Wang Yingying , Yang Wanxia , Sun Zhipeng , You Chongge 
Published: June 2024

AbstractIntroductionThe global burden of multiple myeloma (MM) is increasing every year. Here, we have developed machine learning models to provide a reference for the early detection of MM.MethodsA total of 465 patients and 150 healthy controls were enrolled in this retrospective study. Based on the variable screening strategy of least absolute shrinkage and selection operator (LASSO), three prediction models, logistic regression (LR), support vector machine (SVM), and random forest (RF), were established combining complete blood count (CBC) and cell population data (CPD) parameters in the training set (210 cases), and were verified in the validation set (90 cases) and test set (165 cases). The performance of each model was analyzed using receiver operating characteristic (ROC) curve, calibration curves, and decision curve analysis (DCA). Accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and area under the ROC curve (AUC) were applied to evaluate the models. Delong test was used to compare the AUC of the models.ResultsSix parameters including RBC (1012/L), RDW‐CV (%), IG (%), NE‐WZ, LY‐WX, and LY‐WZ were screened out by LASSO to construct the model. Among the three models, the AUC of RF model in the training set, validation set, and test set were 0.956, 0.892, and 0.875, which were higher than those of LR model (0.901, 0.849, and 0.858) and SVM model (0.929, 0.868, and 0.846). Delong test showed that there were significant differences among the models in the training set, no significant differences in the validation set, and significant differences only between SVM and RF models in the test set. The calibration curve and DCA showed that the three models had good validity and feasibility, and the RF model performed best.ConclusionThe proposed RF model may be a useful auxiliary tool for rapid screening of MM patients.
Alleviating severity of limb trauma pain with coadministration of topical sesame oil and standard treatments: A GRADE‐assessed systematic review and meta‐analysis of randomised controlled trials
Authors: Razani Omolbanin , Nasiri Morteza , Yarahmadi Fatemeh , Zonoori Sahar , Shamsi Afzal , Abbasi Mohammad , Asadi Masoomeh 
Published: June 2024

AbstractRecent randomised controlled trials (RCTs) have investigated the analgesic activity of sesame oil among patients with limb trauma; nevertheless, their findings are inconsistent. Hence, this review aimed to clarify the impact of topical administration of sesame oil on acute pain of adult outpatients with minor limb trauma. The online databases (e.g., Scopus, PubMed, Web of Science) were searched up to 31 January 2024. The RCTs were included if they compared the effect of applying standard treatments plus topical sesame oil to administering standard treatments alone or with a placebo/sham treatment. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) and the Cochrane Collaboration's risk of bias tool were applied to address the evidence quality and the study's methodological rigour, respectively. Four RCTs had the inclusion criteria, and their findings were pooled in a meta‐analysis employing a random‐effects approach. According to the pooled analysis, the reduction in mean change of the pain score from baseline to the second/third intervention day was significantly higher in favour of clients who received standard care plus daily massage of the trauma site with sesame oil compared to those who received a control condition (weighted mean difference: −1.10; 95% confidence interval [−1.62, −0.57]; p < 0.001). However, the evidence quality was moderate, and only two studies had good methodological rigour. Hence, more high‐quality studies are needed to make a solid evidence‐based conclusion about the favourable consequence of topical sesame oil on alleviating acute traumatic limb pain.
EuroGuiderm guideline on lichen sclerosus—Treatment of lichen sclerosus
Authors: Kirtschig G. , Kinberger M. , Kreuter A. , Simpson R. , Günthert A. , van Hees C. , Becker K. , Ramakers M. J. , Corazza M. , Müller S. , von Seitzberg S. , Boffa M. J. , Stein R. , Barbagli G. , Chi C. C. , Dauendorffer J. N. , Fischer B. , Gaskins M. , Hiltunen‐Back E. , Höfinger A. , Köllmann N. H. , Kühn H. , Larsen H. K. , Lazzeri M. , Mendling W. , Nikkels A. F. , Promm M. , Rall K. K. , Regauer S. , Sárdy M. , Sepp N. , Thune T. , Tsiogka A. , Vassileva S. , Voswinkel L. , Wölber L. , Werner R. N. 
Published: June 2024

AbstractIntroductionLichen sclerosus (LS) is an inflammatory skin disease affecting all ages. LS typically involves the anogenital site where it causes itching and soreness; it may lead to sexual and urinary dysfunction in females and males; however, it may be asymptomatic. First signs of LS are usually a whitening of the genital skin, sometimes preceded by redness and oedema; fissuring, scarring, shrinkage and fusion of structures may follow in its course. LS is associated with an increased risk of genital cancer. LS has a huge impact on the quality of life of affected patients, and it is important to raise more awareness of this not uncommon disease in order to diagnose and treat it early.ObjectivesThe guideline intends to provide guidance on the diagnostic of LS (part 1), highlight important aspects in the care of LS patients, generate recommendations and treatment algorithms (part 2) on topical, interventional and surgical therapy, based on the latest evidence, provide guidance in the management of LS patients during pregnancy, provide guidance for the follow‐up of patients with LS and inform about new developments and potential research aspects.Materials and MethodsThe guideline was developed in accordance with the EuroGuiDerm Methods Manual v1.3 https://www.edf.one/de/home/Guidelines/EDF‐EuroGuiDerm.html. The wording of the recommendations was standardized (as suggested by the GRADE Working Group). The guideline development group is comprised of 34 experts from 16 countries, including 5 patient representatives.ResultsUltrapotent or potent topical corticosteroids in females and males, adults and children remain gold standard of care for genital LS; co‐treatment with emollients is recommended. If standard treatment fails in males, a surgical intervention is recommended, complete circumcision may cure LS in males. UV light treatment is recommended for extragenital LS; however, there is limited scientific evidence. Topical calcineurin inhibitors are second line treatment. Laser treatment, using various wave lengths, is under investigation, and it can currently not be recommended for the treatment of LS. Treatment with biologics is only reported in single cases.ConclusionsLS has to be diagnosed and treated as early as possible in order to minimize sequelae like scarring and cancer development. Topical potent and ultrapotent corticosteroids are the gold standard of care; genital LS is often a lifelong disease and needs to be treated long‐term.
Bit by bit toward the diversity of metopids: Description of the genus Pidimetopus n. gen. (Ciliophora: Armophorea)
Authors: Pomahač Ondřej , Méndez‐Sánchez Daniel , Čepička Ivan 
Published: June 2024

AbstractWhile metopids (Armophorea: Metopida) represent the most species‐rich group of free‐living anaerobic ciliates thriving in hypoxic environments, our understanding of their true diversity remains incomplete. Most metopid species are still characterized only morphologically. Particularly, the so‐called IAC clade (named in the past after some of the taxa included, Idiometopus, Atopospira, and Clevelandellida), comprising free‐living members as well as the endosymbiotic ones (order Clevelandellida), is in serious need of revision. In our study, we establish a new free‐living genus in the IAC clade, Pidimetopus n. gen., with descriptions of two new species, P. nanus n. sp., and P. permonicus n. sp., using up‐to‐date molecular and morphologic methods. The genus is characterized by small cells (up to 75 μm long), not more than 10 adoral membranelles and eight somatic kineties, and usually, four long caudal cilia that can stiffen. In addition to morphologic and molecular characterizations, we also conducted a statistical morphotype analysis of the polymorphic species P. nanus n. sp. We discuss the relevance of the earlier morphologically described species Metopus minor as a putative collective taxon for several small metopids less than 50 μm long.
Changes in the cost‐effectiveness of pneumococcal vaccination and of programs to increase its uptake in U.S. older adults
Authors: Wateska Angela R. , Nowalk Mary Patricia , Altawalbeh Shoroq M. , Lin Chyongchiou J. , Harrison Lee H. , Schaffner William , Zimmerman Richard K. , Smith Kenneth J. 
Published: June 2024

AbstractBackgroundMultiple factors, such as less complex U.S. adult pneumococcal recommendations that could increase vaccination rates, childhood pneumococcal vaccination indirect effects that decrease adult vaccination impact, and increased vaccine hesitancy (particularly in underserved minorities), could diminish the cost‐effectiveness of programs to increase pneumococcal vaccination in older adults. Prior analyses supported the economic favorability of these programs.MethodsA Markov model compared no vaccination and current recommendations (either 20‐valent pneumococcal conjugate vaccine [PCV20] alone or 15‐valent pneumococcal conjugate vaccine plus the 23‐valent pneumococcal polysaccharide vaccine [PCV15/PPSV23]) without or with programs to increase vaccine uptake in Black and non‐Black 65‐year‐old cohorts. Pre‐pandemic population‐ and serotype‐specific pneumococcal disease risk and illness/vaccine costs came from U.S. databases. Program costs were $2.19 per vaccine‐eligible person and increased absolute vaccination likelihood by 7.5%. Delphi panel estimates and trial data informed vaccine effectiveness values. Analyses took a healthcare perspective, discounting at 3%/year over a lifetime time horizon.ResultsUptake programs decreased pneumococcal disease overall. In Black cohorts, PCV20 without program cost $216,805 per quality‐adjusted life year (QALY) gained compared with no vaccination; incremental cost‐effectiveness was $245,546/QALY for PCV20 with program and $425,264/QALY for PCV15/PPSV23 with program. In non‐Black cohorts, all strategies cost >$200,000/QALY gained. When considering the potential indirect effects from childhood vaccination, all strategies became less economically attractive. Increased vaccination with less complex strategies had negligible effects. In probabilistic sensitivity analyses, current recommendations with or without programs were unlikely to be favored at thresholds <$200,000/QALY gained.ConclusionCurrent U.S. pneumococcal vaccination recommendations for older adults were unlikely to be economically reasonable with or without programs to increase vaccine uptake. Alternatives to current pneumococcal vaccines that include pneumococcal serotypes associated with adult disease should be considered.
Maternal immune activation with toll‐like receptor 7 agonist during mid‐gestation alters juvenile and adult developmental milestones and behavior
Authors: Sheng Julietta A. , Tobet Stuart A. 
Published: June 2024

AbstractInfections during pregnancy are associated with increased risk for adult neuropsychiatric disease, such as major depressive disorder, schizophrenia, and autism spectrum disorder. In mouse models of maternal immune activation (MIA), different toll‐like receptors (TLRs) are stimulated to initiate inflammatory responses in mother and fetus. The goal of this study was to determine sex‐dependent aspects of MIA using a TLR7/8 agonist, Resiquimod (RQ), on neurodevelopment. RQ was administered to timed‐pregnant mice on embryonic day (E) 12.5. At E15, maternal/fetal plasma cytokines were measured by enzyme‐linked immunosorbent assay (ELISA). Maternal cytokines interleukin (IL)‐6 and IL‐10 were higher while tumor necrosis factor (TNF)‐α and IL‐17 were lower in pregnant dams exposed to RQ. Fetal cytokines (E15) were altered at the same timepoint with fetal plasma IL‐6 and IL‐17 greater after RQ compared to vehicle, while IL‐10 and TNF‐α were higher in male fetuses but not female. Other timed‐pregnant dams were allowed to give birth. MIA with RQ did not alter the female to male ratio of offspring born per litter. Body weights were reduced significantly in both sexes at birth, and over the next 5 weeks. Offspring from RQ‐injected mothers opened their eyes 5 days later than controls. Similarly, female offspring from RQ‐injected mothers exhibited pubertal delay based on vaginal opening 2–3 days later than control females. On the behavioral side, juvenile and adult male and female MIA offspring exhibited less social‐like behavior in a social interaction test. Anhedonia‐like behavior was greater in MIA adult female mice. This study provides support for sex‐dependent influences of fetal antecedents for altered brain development and behavioral outputs that could be indicative of increased susceptibility for adult disorders through immune mechanisms. Future studies are needed to determine neural cellular and molecular mechanisms for such programming effects.
An inclusive anatomical network analysis of human craniocerebral topology
Authors: Schuurman Tim , Bruner Emiliano 
Published: June 2024

AbstractThe human brain's complex morphology is spatially constrained by numerous intrinsic and extrinsic physical interactions. Spatial constraints help to identify the source of morphological variability and can be investigated by employing anatomical network analysis. Here, a model of human craniocerebral topology is presented, based on the bony elements of the skull at birth and a previously designed model of the brain. The goal was to investigate the topological components fundamental to the craniocerebral geometric balance, to identify underlying phenotypic patterns of spatial arrangement, and to understand how these patterns might have influenced the evolution of human brain morphology. Analysis of the craniocerebral network model revealed that the combined structure of the body and lesser wings of the sphenoid bone, the parahippocampal gyrus, and the parietal and ethmoid bones are susceptible to sustain and apply major spatial constraints that are likely to limit or channel their morphological evolution. The results also showcase a high level of global integration and efficient diffusion of biomechanical forces across the craniocerebral system, a fundamental aspect of morphological variability in terms of plasticity. Finally, community detection in the craniocerebral system highlights the concurrence of a longitudinal and a vertical modular partition. The former reflects the distinct morphogenetic environments of the three endocranial fossae, while the latter corresponds to those of the basicranium and calvaria.
The frequency of sepsis‐associated delirium in intensive care unit and its effect on nurse workload
Authors: Alıcı Şerife , Öztürk Birge Ayşegül 
Published: June 2024

AbstractAimTo determine the frequency of sepsis‐associated delirium (SAD) in the intensive care unit and its effect on nurse workload.DesignA cross‐sectional and correlational design was used.MethodsThe study was conducted with 158 patients in the adult intensive care unit of a hospital between October 28 and July 28, 2022. Data analysis included frequency, chi‐squared/fisher's exact test, independent samples t‐test, correlation analysis, simple and multiple linear regression analyses. The study adhered to the STROBE guidelines.ResultsSepsis was detected in 12.7% of the patients, delirium in 39.9%, and SAD in 10.1%. SAD was more common in males (19%) and 56.3% of the patients were admitted to the unit from the emergency department. Patients developing SAD had significantly higher age and mean sequential organ failure evaluation, acute physiology and chronic health evaluation II, and C‐reactive protein and lactate scores, but their Glasgow Coma Scale scores were significantly low. There was a moderate positive relationship between the patients' Sequential Organ Failure Assessment score and the presence of SAD. The most common source of infection in patients diagnosed with SAD was bloodstream infection (44.4%). SAD significantly increased nurse workload and average care time (1.8 h) and it explained 22.8% of the total variance in nurse workload. Additionally, the use of antibiotics, vasopressors and invasive mechanical ventilation significantly increased nurse workload.ConclusionIn the study, in patients who developed SAD increased nurse workload and average care time significantly. Preventive nursing approaches and effective management of SAD can reduce the rate of development of SAD and nurse workload.Implications for the profession and patient careIt is important to work with routine screening, prevention and patient–nurse ratio appropriate to the workload for SAD.
Listen to me, I really am sick! Patient and family narratives of clinical deterioration before and during rapid response system intervention
Authors: Bucknall Tracey K. , Guinane Jessica , McCormack Brendan , Jones Daryl , Buist Michael , Hutchinson Alison M. 
Published: June 2024

AbstractAimTo explore patient and family narratives about their recognition and response to clinical deterioration and their interactions with clinicians prior to and during Medical Emergency Team (MET) activations in hospital.BackgroundResearch on clinical deterioration has mostly focused on clinicians' roles. Although patients and families can identify subtle cues of early deterioration, little research has focused on their experience of recognising, speaking up and communicating with clinicians during this period of instability.DesignA narrative inquiry.MethodsUsing narrative interviewing techniques, 33 adult patients and 14 family members of patients, who had received a MET call, in one private and one public academic teaching hospital in Melbourne, Australia were interviewed. Narrative analysis was conducted on the data.ResultsThe core story of help seeking for recognition and response by clinicians to patient deterioration yielded four subplots: (1) identifying deterioration, recognition that something was not right and different from earlier; (2) voicing concerns to their nurse or by family members on their behalf; (3) being heard, desiring a response acknowledging the legitimacy of their concerns; and (4) once concerns were expressed, there was an expectation of and trust in clinicians to act on the concerns and manage the situation.ConclusionClinical deterioration results in an additional burden for hospitalised patients and families to speak up, seek help and resolve their concerns. Educating patients and families on what to be concerned about and when to notify staff requires a close partnership with clinicians.Implications for the Profession and/or Patient CareClinicians must create an environment that enables patients and families to speak up. They must be alert to both subjective and objective information, to acknowledge and to act on the information accordingly.Reporting MethodThe consolidated criteria for reporting qualitative research (COREQ) guidelines were used for reporting.Patient or Public ContributionThe consumer researcher was involved in design, data analysis and publication preparation.
Telediagnosis as an effective tool for assessment temporomandibular disorders
Authors: Corelhano Amanda Rossi , Hilgenberg‐Sydney Priscila Brenner , Bonotto Daniel , Torres‐Pereira Cassius Carvalho 
Published: June 2024

AbstractBackgroundThe use of communication technologies has allowed a substantial improvement in telediagnosis.ObjectivesTo evaluate the feasibility and diagnostic agreement of synchronous teleconsultation compared to physical standard examination for temporomandibular disorders (TMD) and orofacial pain.MethodsSixty‐one patients (50 women, 11 men) with a mean age of 46.07 years referred to the Orofacial Pain Ambulatory Service (SAMDOF —UFPR) were evaluated remotely. They were then examined in person by another evaluator, blinded for the first evaluation. Data on the experience and level of satisfaction with the teleconsultation were also collected.ResultsFor each type and subtype of TMD, diagnostic agreement values, sensitivity, specificity, positive predictive values and negative predictive values were calculated with a 95% confidence interval. ‘Almost perfect’ agreement was found for Myalgia (k = 0.915), Arthralgia (k = 0.863), disc displacement without reduction without limited opening (k = 0.955) and no TMD (k = 1.00). ‘Substantial’ agreement for the subtypes headache attributed to TMD (k = 0.761), disc displacement without reduction with limited opening (k = 0.659) and subluxation (k = 7.82). The diagnoses of local myalgia (k = 0.573), myofascial pain with referral (k = 0.524) and disc displacement with reduction (k = 0.563) obtained ‘moderate’ agreement. Degenerative joint disease (k = 0.170) and disc displacement with reduction with intermittent locking (k = 0.000) obtained ‘weak’ and ‘no agreement’, respectively. More than 90% of the participants were satisfied and reported no discomfort during the assessment, agreeing to participate in another teleconsultation.ConclusionSynchronous teleconsultation proved to be feasible and presented adequate diagnostic agreement for the main painful TMDs, especially for the diagnosis of myalgia and arthralgia. This format was also well accepted among patients.
Single centre observational study evaluating the impact of introducing High Flow Nasal Cannula outside of Paediatric Critical Care Unit
Authors: Patel Shil , Hunter John , Davies Patrick , Silvestre Catarina 
Published: June 2024

AimTo evaluate the impact of High Flow Nasal Cannula (HFNC) introduction outside of Paediatric Critical Care Units (PCCU), on PCCU admissions and intubation rates. Secondarily, to identify escalation predictors.MethodsRetrospective observational study with matched PCCU admissions and intubation rates, 2‐years before (Group 1) and 2‐years after (Group 2) HFNC introduction outside of PCCU.Within Group 2, we compared those admitted to PCCU (escalation) and those who did not (non‐escalation). Observations, change in observations and time to starting HFNC were analysed.ResultsPre‐ and post‐introduction comparison: Of 980 admissions in Group 1, 55 were admitted to PCCU, whereas of 1209 admission in Group 2, there were 85 admissions, P = 0.188. Group 1 had 25 intubations compared to 23 in Group 2, P = 0.309. Over twice as many children had some form of respiratory support in Group 2.Post‐introduction: 104 children commenced HFNC, 72% for bronchiolitis. Median age was 4 months in the non‐escalation group and 6.5 months in the escalation group, P = 0.663. Thirty‐eight children escalated to PCCU: 33 required CPAP/BiPAP, 4 were intubated with 1 remaining on HFNC. Comparisons of age, gender, comorbidities, observations, change in observations and time to starting HFNC showed no significant escalation predictors.ConclusionsThis study identified no statistically significant predictors of escalation. There was an observed increase in PCCU admissions with decreased intubations. The resource implications of this therapy are significant and further studies should examine cost effectiveness of HFNC use outside of PCCU.