bluuebunny/crossref_metadata_2025_split huggingface dataset:
Packaging of supplemented urokinase into alpha granules of in vitro–grown megakaryocytes for targeted nascent clot lysis
Authors: Poncz Mortimer , Zaitsev Sergei V. , Ahn Hyunsook , Kowalska M. Anna , Bdeir Khalil , Dergilev Konstantin V. , Ivanciu Lacramioara , Camire Rodney M. , Cines Douglas B. , Stepanova Victoria 
Published: May 2024

Abstract
Fibrinolytics delivered into the general circulation lack selectivity for nascent thrombi, reducing efficacy and increasing the risk of bleeding. Urokinase-type plasminogen activator (uPA) transgenically expressed within murine platelets provided targeted thromboprophylaxis without causing bleeding but is not clinically feasible. Recent advances in generating megakaryocytes prompted us to develop a potentially clinically relevant means to produce “antithrombotic” platelets from CD34+ hematopoietic stem cell–derived in vitro–grown megakaryocytes. CD34+ megakaryocytes internalize and store in alpha granules (α-granules) single-chain uPA (scuPA) and a plasmin-resistant thrombin-activatable variant (uPAT). Both uPAs colocalized with internalized factor V (FV), fibrinogen and plasminogen, low-density lipoprotein receptor–related protein 1 (LRP1), and interferon-induced transmembrane protein 3, but not with endogenous von Willebrand factor (VWF). Endocytosis of uPA by CD34+ megakaryocytes was mediated, in part, via LRP1 and αIIbβ3. scuPA-containing megakaryocytes degraded endocytosed intragranular FV but not endogenous VWF in the presence of internalized plasminogen, whereas uPAT-megakaryocytes did not significantly degrade either protein. We used a carotid artery injury model in nonobese diabetic-severe combined immunodeficiency IL2rγnull (NSG) mice homozygous for VWFR1326H (a mutation switching binding VWF specificity from mouse to human glycoprotein Ibα) to test whether platelets derived from scuPA- or uPAT-megakaryocytes would prevent thrombus formation. NSG/VWFR1326H mice exhibited a lower thrombotic burden after carotid artery injury compared with NSG mice unless infused with human platelets or megakaryocytes, whereas intravenous injection of uPA-megakaryocytes generated sufficient uPA-containing human platelets to lyse nascent thrombi. These studies describe the use of in vitro–generated megakaryocytes as a potential platform for delivering uPA or other ectopic proteins within platelet α-granules to sites of vascular injury.
Scientific competence during medical education - insights from a cross-sectional study at a German Medical School
Authors: Vogt Maximilian , Schuchardt Nadja , Geissler Mark Enrik , Bereuter Jean-Paul , Geissler Rona Berit , Glauche Ingmar , Gerdes Sebastian , Deußen Andreas , Günther Lydia 
Published: May 2024

Abstract
Background
Medical knowledge regarding the pathophysiology, diagnosis and treatment of diseases is constantly evolving. To effectively incorporate these findings into professional practice, it is crucial that scientific competencies are a central component of medical education. This study seeks to analyse the current state of scientific education and students’ desires for integration into the curriculum.

Methods
From October to December 2022, a survey was distributed at the Medical Faculty Dresden to all medical students from the 1st to 5th academic year (AY). The survey investigates current expectations of applying scientific competencies later in professional life, and the students were asked to self-assess various scientific skills and in relation to the National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education. The self-assessments were objectified through a competence test with ten multiple-choice questions. The desire for curricular teaching was inquired.

Results
860 students completed the survey. This corresponds to a response rate of 64%. In the 5th AY, approximately 80% of the participants stated that they expected to work with scientific literature on a daily to monthly basis in future professional life and to communicate corresponding scientific findings to patients. Only 30–40% of the 5th AY rate their scientific competencies as sufficient to do this appropriately. This corresponds with the self-assessed competencies that only slightly increased over the 5 AYs from 14.1 ± 11.7 to 21.3 ± 13.8 points (max. 52) and is also reflected in the competence test (1st AY 3.6 ± 1.75 vs. 5th AY 5.5 ± 1.68, max. 10 points). Half of the students in the 4th and 5th AYs were dissatisfied with the current teaching of scientific skills. The majority preferred the implementation of a science curriculum (56%), preferably as seminars dealing with topics such as literature research, analysis, and science communication.

Conclusions
The results show discrepancies between expectations of using scientific knowledge in everyday professional life, self-rated and objectively recorded competencies, and the current state of curricular teaching of scientific competencies. There is a strong need for adequate practical training, particularly in critical analyses of scientific literature, which enables the communication of scientific knowledge to patients.
The development of a serious game for laser applications in dentistry and the evaluation of dental students' satisfaction
Authors: Khorasanchi Maryam , Hoseinzadeh Melika , Khadem Rezaeian Majid , Kazemian Ali , Moradi Ali , Sarabadani Javad 
Published: May 2024

AbstractBackgroundThis study aimed to design and implement a gamified application about the theoretical aspects of laser applications in dentistry and investigate students' satisfaction with their learning experience.MethodsAn engaging educational program named Essential Skills and Knowledge in Learning Laser (ESKILLD) was developed to teach laser applications in dentistry. The program comprises two primary components: a “Tutorial and Quiz” section and a “Games” section. Final-year dental students were tasked with installing and using this application. A 29-item validated questionnaire (Cronbach's alpha = 0.97, ICC = 0.94) was used to evaluate students' perceptions of the applications' design and functionality. The influence of participants' gender and Grade Point Average (GPA) on their satisfaction levels was examined via the student t-test and Pearson's correlation, with a significance level of 0.05.ResultsThe study had 56 participants, of which 37 were female (66.07%), and 19 were male (33.92%). The students' average GPA was 15.16 out of 20. The mean rating for ESKILLD's design and functionality was 1.39 ± 0.47 and 1.37 ± 0.46, respectively, signifying a high satisfaction level. Female students rated the application's coherence and learning perception significantly higher than their male counterparts (p < 0.05). However, gender did not significantly influence scores on other perception aspects or overall scores. Students' GPAs and their perception scores did not have a significant correlation.ConclusionsThe results indicate that the participants were generally satisfied with the game's features and attitudes towards it, which underscores the potential effectiveness of gamification in dental courses focused on laser applications.
Determining capacity of people with dementia to take part in research: an electronic survey study of researcher confidence, competence and training needs
Authors: Griffiths Sarah , Shepherd Victoria , Volkmer Anna 
Published: May 2024

Abstract
Background
Researchers are required to determine whether a person has capacity to consent to a research study before they are able to participate. The Mental Capacity Act and accompanying Code of Practice for England and Wales provide some guidance on this process, but researchers have identified that it can be difficult to determine capacity to consent when a person has complex cognitive or communication needs. This study aimed to understand the experiences and opinions of researchers who recruit people with dementia to research projects, to inform the future development of training resources.

Methods
A mixed method, cross-sectional, electronic survey was circulated via social media and research networks in England and Wales. The survey remained open for ten weeks and included open and closed questions exploring respondents’ confidence in determining capacity in the context of recruiting people with dementia to consent, their views on training and support they have experienced and their suggestions for future training and support needs.

Results
60 respondents completed the survey from across England and Wales. Although 75% of respondents had experience of determining capacity to consent with people with dementia to research, only 13% rated themselves as feeling ‘very confident’ in this. Qualitative content analysis of open responses led to the generation of six themes, explaining researchers’ confidence, competence and future training needs in this area: (1) Researcher uncertainties, (2) Lack of time, (3) Balancing information complexity with accessibility, (4) Gatekeepers, (5) Existing enablers and (6) Envisioning future training.

Conclusions
Researchers would benefit from specific training in undertaking conversations around consent with people with dementia. People with dementia may have fluctuating capacity, and despite support from caregivers, researchers have little practical guidance on methods of determining a person’s ability to understand or appreciate the information they have provided during the consent process. Given the development of large complex trials within dementia research, there is an urgency to develop specific and practical guidance and training for researchers working with people with dementia and their families.
Neonatal jaundice detection in low-resource Mexican settings: possibilities and barriers for innovation with mobile health
Authors: Jiménez-Díaz Gabriela , Aune Anders , Elizarrarás-Rivas Jesús , Gierman Lobke M. , Keitsch Martina , Marcuzzi Anna , Infanti Jennifer J. 
Published: May 2024

Abstract
Background
Neonatal jaundice is a common condition that can lead to brain damage and disabilities when severe cases go undetected. Low- and middle-income countries often lack accurate methods for detecting neonatal jaundice and rely on visual assessment, resulting in a higher incidence of adverse consequences. Picterus Jaundice Pro (Picterus JP), an easy-to-use and affordable smartphone-based screening device for the condition, has demonstrated higher accuracy than visual assessment in Norwegian, Philippine and Mexican newborns. This study aimed to identify the barriers and facilitators to implementing Picterus JP in public health services in low-income settings in Mexico by exploring the current process of neonatal jaundice detection and stakeholders’ perspectives in that context.

Methods
Qualitative data collection techniques, including one focus group, 15 semi-structured interviews and four observations, were employed in urban and rural health facilities in Oaxaca, Mexico. The participants included medical doctors, nurses and health administrators. The data were analysed by thematic analysis guided by the Consolidated Framework for Implementation Research.

Results
The analysis yielded four main themes: (I) the current state of neonatal care and NNJ detection, (II) the needs and desires for enhancing NNJ detection, (III) the barriers and facilitators to implementing Picterus JP in the health system and (IV) HCWs’ expectations of Picterus JP. The findings identify deficiencies in the current neonatal jaundice detection process and the participants’ desire for a more accurate method. Picterus JP was perceived as easy to use, useful and compatible with the work routine, but barriers to adoption were identified, including internet deficiencies and costs.

Conclusions
The introduction of Picterus JP as a supporting tool to screen for neonatal jaundice is promising but contextual barriers in the setting must be addressed for successful implementation. There is also an opportunity to optimise visual assessment to improve detection of neonatal jaundice.
Blood metabolites and chronic kidney disease: a Mendelian randomization study
Authors: Hou Yawei , Xiao Zhenwei , Zhu Yushuo , Li Yameng , Liu Qinglin , Wang Zhenguo 
Published: May 2024

Abstract
Background
Human blood metabolites have demonstrated close associations with chronic kidney disease (CKD) in observational studies. Nonetheless, the causal relationship between metabolites and CKD is still unclear. This study aimed to assess the associations between metabolites and CKD risk.

Methods
We applied a two-sample Mendelian randomization (MR) analysis to evaluate relationships between 1400 blood metabolites and eight phenotypes (outcomes) (CKD, estimated glomerular filtration rate(eGFR), urine albumin to creatinine ratio, rapid progress to CKD, rapid decline of eGFR, membranous nephropathy, immunoglobulin A nephropathy, and diabetic nephropathy). The inverse variance weighted (IVW), MR-Egger, and weighted median were used to investigate the causal relationship. Sensitivity analyses were performed with Cochran’s Q, MR-Egger intercept, MR-PRESSO Global test, and leave-one-out analysis. Bonferroni correction was used to test the strength of the causal relationship.

Results
Through the MR analysis of 1400 metabolites and eight clinical phenotypes, a total of 48 metabolites were found to be associated with various outcomes. Among them, N-acetylleucine (OR = 0.923, 95%CI: 0.89–0.957, PIVW = 1.450 × 10–5) has a strong causal relationship with lower risk of CKD after the Bonferroni-corrected test, whereas Glycine to alanine ratio has a strong causal relationship with higher risk of CKD (OR = 1.106, 95%CI: 1.063–1.151, PIVW = 5.850 × 10–7). No horizontal pleiotropy and heterogeneity were detected.

Conclusion
Our study offers groundbreaking insights into the integration of metabolomics and genomics to reveal the pathogenesis of and therapeutic strategies for CKD. It underscores 48 metabolites as potential causal candidates, meriting further investigation.
Clinical efficacy and complications of MIS-TLIF and TLIF in the treatment of upper lumbar disc herniation: a comparative study
Authors: An Bochen , Ren Bowen , Liu Yihao , Han Zhenchuan , Wu Jianhui , Mao Keya , Liu Jianheng 
Published: May 2024

Abstract
Background
The optimal treatment modality for upper lumbar disc herniation remains unclear. Herein, we compared the clinical efficacy and application value of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and transforaminal lumbar interbody fusion (TLIF) for upper lumbar disc herniation. We aimed to provide new evidence to guide surgical decisions for treating this condition.

Methods
We retrospectively analyzed the clinical data of 81 patients with upper lumbar disc herniation admitted between January 2017 and July 2018, including 41 and 40 patients who underwent MIS-TLIF and TLIF, respectively. Demographic characteristics, preoperative functional scores, perioperative indicators, and postoperative complications were compared. We performed consecutive comparisons of visual analog scale (VAS) scores of the lumbar and leg regions, Oswestry disability index (ODI), Japanese Orthopaedic Association scores (JOA), and MacNab scores at the final follow-up, to assess clinical outcomes 5 years postoperatively.

Results
VAS scores of the back and legs were significantly lower in the MIS-TLIF than the TLIF group at 3 months and 1 year postoperatively (P < 0.05). Intraoperative bleeding and postoperative hospitalization time were significantly lower, and the time to return to work/normal life was shorter in the MIS-TLIF than in the TLIF group (P < 0.05). The differences in JOA scores and ODI scores between the two groups at 3 months, 1 year, and 3 years postoperatively were statistically significant (P < 0.05).

Conclusion
The early clinical efficacy of MIS-TLIF was superior to that of TLIF, but no differences were found in mid-term clinical efficacy. Further, MIS-TLIF has the advantages of fewer medical injuries, shorter hospitalization times, and faster postoperative functional recovery.
Zinc deficiency deteriorates ovarian follicle development and function by inhibiting mitochondrial function
Authors: Liu Wen-Jiao , Li Li-Shu , Lan Meng-Fan , Shang Jian-Zhou , Zhang Jin-Xin , Xiong Wen-Jie , Lai Xin-Le , Duan Xing 
Published: May 2024

AbstractZinc (Zn) is a crucial trace element essential for human growth and development, particularly for reproductive health. Previous research has shown a decrease in serum zinc concentration with age and individuals with conditions such as polycystic ovary syndrome (PCOS) and diabetes mellitus. However, the specific effects of zinc deficiency on the female reproductive system, especially ovarian function, are not fully understood. In our study, we observed a significant reduction in the total number of follicles and mature follicles in the zinc deficiency group. This reduction correlated with decreased level of anti-Mullerian hormone (AMH) and abnormal gene expression affecting hormone secretion regulation. Furthermore, we found that zinc deficiency disrupted mitochondrial dynamics, leading to oxidative stress in the ovaries, which further inhibited autophagy and increased ovarian apoptosis. These changes ultimately resulted in the failure of germinal vesicle breakdown (GVBD) and reduced oocyte quality. Meanwhile, administration of zinc glycine effectively alleviated the oocyte meiotic arrest caused by dietary zinc deficiency. In conclusion, our findings demonstrated that dietary zinc deficiency can affect hormone secretion and follicle maturation by impairing mitochondrial function and autophagy.
A scoping review of machine learning for sepsis prediction- feature engineering strategies and model performance: a step towards explainability
Authors: Bomrah Sherali , Uddin Mohy , Upadhyay Umashankar , Komorowski Matthieu , Priya Jyoti , Dhar Eshita , Hsu Shih-Chang , Syed-Abdul Shabbir 
Published: May 2024

Abstract
Background
Sepsis, an acute and potentially fatal systemic response to infection, significantly impacts global health by affecting millions annually. Prompt identification of sepsis is vital, as treatment delays lead to increased fatalities through progressive organ dysfunction. While recent studies have delved into leveraging Machine Learning (ML) for predicting sepsis, focusing on aspects such as prognosis, diagnosis, and clinical application, there remains a notable deficiency in the discourse regarding feature engineering. Specifically, the role of feature selection and extraction in enhancing model accuracy has been underexplored.

Objectives
This scoping review aims to fulfill two primary objectives: To identify pivotal features for predicting sepsis across a variety of ML models, providing valuable insights for future model development, and To assess model efficacy through performance metrics including AUROC, sensitivity, and specificity.

Results
The analysis included 29 studies across diverse clinical settings such as Intensive Care Units (ICU), Emergency Departments, and others, encompassing 1,147,202 patients. The review highlighted the diversity in prediction strategies and timeframes. It was found that feature extraction techniques notably outperformed others in terms of sensitivity and AUROC values, thus indicating their critical role in improving sepsis prediction models.

Conclusion
Key dynamic indicators, including vital signs and critical laboratory values, are instrumental in the early detection of sepsis. Applying feature selection methods significantly boosts model precision, with models like Random Forest and XG Boost showing promising results. Furthermore, Deep Learning models (DL) reveal unique insights, spotlighting the pivotal role of feature engineering in sepsis prediction, which could greatly benefit clinical practice.
HybOff: a Hybrid Offloading approach to improve load balancing in fog environments
Authors: Sulimani Hamza , Sulimani Rahaf , Ramezani Fahimeh , Naderpour Mohsen , Huo Huan , Jan Tony , Prasad Mukesh 
Published: May 2024

AbstractLoad balancing is crucial in distributed systems like fog computing, where efficiency is paramount. Offloading with different approaches is the key to balancing the load in distributed environments. Static offloading (SoA) falls short in heterogeneous networks, necessitating dynamic offloading to reduce latency in time-sensitive tasks. However, prevalent dynamic offloading (PoA) solutions often come with hidden costs that impact sensitive applications, including decision time, networks congested and distance offloading. This paper introduces the Hybrid Offloading (HybOff) algorithm, which substantially enhances load balancing and resource utilization in fog networks, addressing issues in both static and dynamic approaches while leveraging clustering theory. Its goal is to create an uncomplicated low-cost offloading approach that enhances IoT application performance by eliminating the consequences of hidden costs regardless of network size. Experimental results using the iFogSim simulation tool show that HybOff significantly reduces offloading messages, distance, and decision-offloading consequences. It improves load balancing by 97%, surpassing SoA (64%) and PoA (88%). Additionally, it increases system utilization by an average of 50% and enhances system performance 1.6 times and 1.4 times more than SoA and PoA, respectively. In summary, this paper tries to introduce a new offloading approach in load balancing research in fog environments.
Integration of feature enhancement technique in Google inception network for breast cancer detection and classification
Authors: Admass Wasyihun Sema , Munaye Yirga Yayeh , Salau Ayodeji Olalekan 
Published: May 2024

AbstractBreast cancer is a major public health concern, and early detection and classification are essential for improving patient outcomes. However, breast tumors can be difficult to distinguish from benign tumors, leading to high false positive rates in screening. The reason is that both benign and malignant tumors have no consistent shape, are found at the same position, have variable sizes, and have high correlations. The ambiguity of the correlation challenges the computer-aided system, and the inconsistency of morphology challenges an expert in identifying and classifying what is positive and what is negative. Due to this, most of the time, breast cancer screen is prone to false positive rates. This research paper presents the introduction of a feature enhancement method into the Google inception network for breast cancer detection and classification. The proposed model preserves both local and global information, which is important for addressing the variability of breast tumor morphology and their complex correlations. A locally preserving projection transformation function is introduced to retain local information that might be lost in the intermediate output of the inception model. Additionally, transfer learning is used to improve the performance of the proposed model on limited datasets. The proposed model is evaluated on a dataset of ultrasound images and achieves an accuracy of 99.81%, recall of 96.48%, and sensitivity of 93.0%. These results demonstrate the effectiveness of the proposed method for breast cancer detection and classification.