bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diet quality from mid to late life and its association with physical frailty in late life in a cohort of Chinese adults
Authors: Lai Jun S. , Chua Kevin Y. , Li Huiqi , Koh Woon-Puay 
Published: June 2024

Abstract
Background
It is unclear if improving diet quality after midlife could reduce the risk of physical frailty at late life. We aimed to associate changes in diet quality after midlife with physical frailty at late life.

Methods
Diet quality in 12,580 participants from the Singapore Chinese Health Study was assessed with the Dietary Approaches to Stop Hypertension (DASH) scores at baseline (1993–1998; mean age 53 years) and follow-up 3 (2014–2016; mean age 73 years). Physical frailty was assessed using the modified Cardiovascular Health Study phenotype at follow-up 3. Multivariable logistic regressions examined associations between DASH scores and physical frailty.

Results
Comparing participants in extreme quartiles of DASH scores, the odds ratios (OR) [95% confidence interval (CI)] for physical frailty were 0.85 (0.73,0.99) at baseline and 0.49 (0.41, 0.58) at follow-up 3. Compared to participants with consistently low DASH scores, participants with consistently high scores (OR 0.74, 95% CI: 0.59, 0.94) and those with > 10% increase in scores (OR 0.78, 95% CI: 0.64, 0.95) had lower odds of frailty. Compared to those in the lowest DASH tertiles at both time-points, significantly lower odds of physical frailty were observed in those who were in the highest DASH tertiles at both time points [0.59 (0.48, 0.73)], and in those who improved their scores from the lowest [0.68 (0.51, 0.91)] or second tertile at baseline [0.61 (0.48, 0.76)] to the highest tertile at follow-up 3.

Conclusions
Maintaining a high diet quality or a substantial improvement in diet quality after midlife could lower the risk of physical frailty at late life.
Diversifying the anthracycline class of anti-cancer drugs identifies aclarubicin for superior survival of acute myeloid leukemia patients
Authors: Qiao Xiaohang , van der Zanden Sabina Y. , Li Xiaoyang , Tan Minkang , Zhang Yunxiang , Song Ji-Ying , van Gelder Merle A. , Hamoen Feija L. , Janssen Lennert , Zuur Charlotte L. , Pang Baoxu , van Tellingen Olaf , Li Junmin , Neefjes Jacques 
Published: June 2024

AbstractThe efficacy of anthracycline-based chemotherapeutics, which include doxorubicin and its structural relatives daunorubicin and idarubicin, remains almost unmatched in oncology, despite a side effect profile including cumulative dose-dependent cardiotoxicity, therapy-related malignancies and infertility. Detoxifying anthracyclines while preserving their anti-neoplastic effects is arguably a major unmet need in modern oncology, as cardiovascular complications that limit anti-cancer treatment are a leading cause of morbidity and mortality among the 17 million cancer survivors in the U.S. In this study, we examined different clinically relevant anthracycline drugs for a series of features including mode of action (chromatin and DNA damage), bio-distribution, anti-tumor efficacy and cardiotoxicity in pre-clinical models and patients. The different anthracycline drugs have surprisingly individual efficacy and toxicity profiles. In particular, aclarubicin stands out in pre-clinical models and clinical studies, as it potently kills cancer cells, lacks cardiotoxicity, and can be safely administered even after the maximum cumulative dose of either doxorubicin or idarubicin has been reached. Retrospective analysis of aclarubicin used as second-line treatment for relapsed/refractory AML patients showed survival effects similar to its use in first line, leading to a notable 23% increase in 5-year overall survival compared to other intensive chemotherapies. Considering individual anthracyclines as distinct entities unveils new treatment options, such as the identification of aclarubicin, which significantly improves the survival outcomes of AML patients while mitigating the treatment-limiting side-effects. Building upon these findings, an international multicenter Phase III prospective study is prepared, to integrate aclarubicin into the treatment of relapsed/refractory AML patients.
Access to mifepristone, misoprostol, and contraceptive medicines in eight countries in the Eastern Mediterranean Region: descriptive analyses of country-level assessments
Authors: Afifi Mohamed , Hemachandra Nilmini , Sikandar Qais , Hajjeh Rana , Loi Ulrika Rehnström , Läser Laurence , Qato Dima , Abdul Zahir Sidiqui , Chikvaidze Paata , Abbas Raghad Abdul Redha , Al-Kinani Khalid , Hasan Hanan , El-Kak Faysal , Rady Alissar , Brngali Omelkheir , Hashem Mohamed , Bezad Rachid , Amine Cheikh , Hafid Hachri , Afzal Sabeen , Zaidi Raza , Thom Ellen , Uzma Qudsia , Al-Masri Hadeel , Qamar Zakri Abu , Ghanem Buthaina , Ward Itimad Abu , Shaar Ali Nashat , Farah Ubah , Mohamed Yusuf Omar , Umar Al-Umra , Eladawy Maha 
Published: June 2024

Abstract
Background
Despite their importance in reducing maternal mortality, information on access to Mifepristone, Misoprostol, and contraceptive medicines in the Eastern Mediterranean Region is limited.

Methods
A standardized assessment tool measuring access to Mifepristone, Misoprostol, and contraceptive medicines included in the WHO essential medicines list (EML) was implemented in eight countries in the Eastern Mediterranean Region (Afghanistan, Iraq, Lebanon, Libya, Morocco, Palestine, Pakistan, and Somalia) between 2020–2021. The assessment focused on five access measures: 1) the inclusion of medicines in national family planning guidelines; 2) inclusion of medicines in comprehensive abortion care guidelines; 3) inclusion of medicines on national essential medicines lists; 4) medicines registration; and 5) procurement and forecasting of Mifepristone, Misoprostol, and contraceptive medicines. A descriptive analysis of findings from these eight national assessments was conducted.

Results
Only Lebanon and Pakistan included all 12 contraceptives that are enlisted in the WHO-EML within their national family planning guidelines. Only Afghanistan and Lebanon included mifepristone and mifepristone-misoprostol combination in post-abortion care guidelines, but these medicines were not included in their national EMLs. Libya and Somalia lacked a national regulatory authority for medicines registration. Most contraceptives included on the national EMLs for Lebanon, Morocco and Pakistan were registered. Misoprostol was included on the EMLs—and registered—in six countries (Afghanistan, Iraq, Lebanon, Morocco, Palestine, and Pakistan). However, only three countries procured misoprostol (Iraq, Morocco, and Somalia).

Conclusion
These findings can guide efforts aimed at improving the availability of Mifepristone, Misoprostol, and contraceptive medicines in the Eastern Mediterranean Region. Opportunities include expanding national EMLs to include more options for Mifepristone, Misoprostol, and contraceptive medicines and strengthening the registration and procurement systems to ensure these medicines’ availability were permitted under national law and where culturally acceptable.
Online training to improve BLS performance with dispatcher assistance? Results of a cluster-randomised controlled simulation trial
Authors: Bathe Janina , Daubmann Anne , Doehn Christoph , Napp Antonia , Raudies Marco , Beck Stefanie 
Published: June 2024

Abstract
Background
The prognosis for patients improves significantly with effective cardiopulmonary resuscitation (CPR) performed by bystanders. Current research indicates that individuals who receive CPR from trained bystanders have a greater likelihood of survival compared to those who receive dispatcher-assisted CPR from untrained laypersons. This cluster-randomised controlled trial assessed the impact of a 30-min online training session prior to a simulated cardiac arrest situation with dispatcher-assisted CPR (DA-CPR) on enhancing Basic Life Support (BLS) performance.

Methods
This study was performed in 2018 in Hamburg, Germany. The primary outcome was the practical BLS skills of high school students in simulated out-of-hospital cardiac arrest scenarios with dispatcher assistance. The intervention group participants underwent a 30-min online BLS training session, while the control group did not receive an intervention. It was hypothesized that the average practical BLS scores of the intervention group would be 1.5 points higher than those of the control group.

Results
BLS assessments of 286 students of 16 different classes were analysed. The estimated mean BLS score in the intervention group was 7.60 points (95% CI: 6.76 to 8.44) compared to 6.81 (95% CI: 5.97 to 7.65) in the control group adjusted for BLS training and class. Therefore, the estimated mean difference between the groups was 0.79 (95% CI: -0.40 to 1.97) and not significantly different (p-value: 0.176). Based on a logistic regression analysis the intervention had only a significant effect on the chance to pass the item “vertically above the chest” (OR = 4.99; 95% CI: 1.46 to 17.12) adjusted for BLS training and class.

Conclusion
Prior online training exhibits beneficial impacts on the BLS performance of bystanders during DA-CPR. To maximise the effect size, online training should be incorporated into a set of interventions that are mutually complementary and specifically designed for the target participants.

Trial registration
DRKS00033531. "Kann online Training Laien darauf vorbereiten Reanimationsmaßnahmen unter Anleitung der Leitstelle adäquat durchzuführen? " Registered on January 29, 2024.
Hooked on zombie worms? Genetic blueprints of bristle formation in Osedax japonicus (Annelida)
Authors: Tilic Ekin , Miyamoto Norio , Herranz Maria , Worsaae Katrine 
Published: June 2024

Abstract
Background
This study sheds light on the genetic blueprints of chaetogenesis (bristle formation), a complex biomineralization process essential not only for the diverse group of bristle worms (annelids) but also for other spiralians. We explore the complex genetic mechanisms behind chaetae formation in Osedax japonicus, the bone-devouring deep-sea worm known for its unique ecological niche and morphological adaptations.

Results
We characterized the chaetal structure and musculature using electron microscopy and immunohistochemistry, and combined RNAseq of larval stages with in-situ hybridization chain reaction (HCR) to reveal gene expression patterns integral to chaetogenesis. Our findings pinpoint a distinct surge in gene expression during the larval stage of active chaetogenesis, identifying specific genes and cells involved.

Conclusions
Our research underscores the value of studying on non-model, "aberrant" organisms like Osedax, whose unique, temporally restricted chaetogenesis provided insights into elevated gene expression across specific larval stages and led to the identification of genes critical for chaetae formation. The genes identified as directly involved in chaetogenesis lay the groundwork for future comparative studies across Annelida and Spiralia, potentially elucidating the homology of chaetae-like chitinous structures and their evolution.
Embryonic thermal manipulation: a potential strategy to mitigate heat stress in broiler chickens for sustainable poultry production
Authors: Al Amaz Sadid , Mishra Birendra 
Published: June 2024

AbstractDue to high environmental temperatures and climate change, heat stress is a severe concern for poultry health and production, increasing the propensity for food insecurity. With climate change causing higher temperatures and erratic weather patterns in recent years, poultry are increasingly vulnerable to this environmental stressor. To mitigate heat stress, nutritional, genetic, and managerial strategies have been implemented with some success. However, these strategies did not adequately and sustainably reduce the heat stress. Therefore, it is crucial to take proactive measures to mitigate the effects of heat stress on poultry, ensuring optimal production and promoting poultry well-being. Embryonic thermal manipulation (TM) involves manipulating the embryonic environment’s temperature to enhance broilers’ thermotolerance and growth performance. One of the most significant benefits of this approach is its cost-effectiveness and saving time associated with traditional management practices. Given its numerous advantages, embryonic TM is a promising strategy for enhancing broiler production and profitability in the poultry industry. TM increases the standard incubation temperature in the mid or late embryonic stage to induce epigenetic thermal adaption and embryonic metabolism. Therefore, this review aims to summarize the available literature and scientific evidence of the beneficial effect of pre-hatch thermal manipulation on broiler health and performance.
Assessing the interplay of contrast, defocus, and resolution in cryo-EM: a benchmark experiment for limited dataset screening
Authors: Lee Hayeon , Lee Yeseul , Lee Jinseok , Jeong Hyeongseop , Yon Dong Keon , Durie Clarissa L. , Ryu Bumhan , Chung Jeong Min 
Published: June 2024

AbstractThe selection of defocus ranges for small datasets in cryo-electron microscopy (cryo-EM) is under-researched. We present a comprehensive benchmark experiment that aimed to evaluate the relationship between contrast, defocus, and resolution, particularly in the context of limited datasets. We conducted a detailed analysis of beta-galactosidase, apo-ferritin, and connexin-46/50 datasets to optimize pre-screening strategies for cryo-EM. Our approach involved classifying micrographs based on image contrast using an artificial intelligence (AI) model without considering the defocus level. This method allowed us to investigate the optimal defocus range for pre-screening in a limited dataset and its impact on the overall image processing. The micrographs were categorized into good, moderate, and bad contrast groups. Subsequent analysis revealed that, contrary to the prevailing assumption that lower contrast (associated with lower defocus) leads to higher resolution, in scenarios with limited datasets higher contrast images yield superior resolution. This finding was consistent across all three protein samples, underscoring the critical role of contrast in determining the quality of 3D reconstructions in limited datasets. This significant finding challenges conventional cryo-EM methodologies. In conclusion, our study provides new benchmarks for selecting appropriate contrast and defocus levels in cryo-EM, particularly for screening approaches that use limited datasets. This strategy promises to enhance the data quality and efficiency in structural biology research, particularly in resource-constrained scenarios.
Gameful strategies in the education of autistic children: a systematic literature review, scientometric analysis, and future research roadmap
Authors: Honorato Noemi , Soltiyeva Aiganym , Oliveira Wilk , Delabrida Saul Emanuel , Hamari Juho , Alimanova Madina 
Published: June 2024

AbstractThe education of autistic children presents significant challenges, compelling various educational stakeholders to seek solutions that can enhance teaching and learning experiences for these individuals. Among the most promising strategies are gameful approaches, including gamification, card games, and simulators. Despite recent efforts, understanding the development and application (i.e., the state of the art) of these approaches in the education of autistic children remains a complex task. To address this issue, we conducted a thorough systematic literature review and scientometric analysis to explore the design and implementation of gameful approaches for the education of children with autism. Our findings highlight the predominant use of 2D games designed for personal computers, focusing on natural, home, and urban settings. Additionally, we observed that the studies were primarily qualitative. Based on these results, we proposed a research agenda. We offer a comprehensive overview and a research agenda for the design, use, and assessment of gameful approaches in the education of children with autism.
Brain age gap estimation using attention-based ResNet method for Alzheimer’s disease detection
Authors: Aghaei Atefe , Ebrahimi Moghaddam Mohsen ,   Alzheimer’s Disease Neuroimaging Initiative
Published: June 2024

AbstractThis study investigates the correlation between brain age and chronological age in healthy individuals using brain MRI images, aiming to identify potential biomarkers for neurodegenerative diseases like Alzheimer's. To achieve this, a novel attention-based ResNet method, 3D-Attention-Resent-SVR, is proposed to accurately estimate brain age and distinguish between Cognitively Normal (CN) and Alzheimer’s disease (AD) individuals by computing the brain age gap (BAG). Unlike conventional methods, which often rely on single datasets, our approach addresses potential biases by employing four datasets for training and testing. The results, based on a combined dataset from four public sources comprising 3844 data points, demonstrate the model's efficacy with a mean absolute error (MAE) of 2.05 for brain age gap estimation. Moreover, the model's generalizability is showcased by training on three datasets and testing on a separate one, yielding a remarkable MAE of 2.4. Furthermore, leveraging BAG as the sole biomarker, our method achieves an accuracy of 92% and an AUC of 0.87 in Alzheimer's disease detection on the ADNI dataset. These findings underscore the potential of our approach in assisting with early detection and disease monitoring, emphasizing the strong correlation between BAG and AD.
Clinical characteristics and treatment strategies for pituitary adenoma associated with intracranial aneurysm
Authors: Huang Zheng , Yang Zeng , Xu Lixin , Leng Haibin , Yang Kui , Ding Wei , Xie Bo , Chen Fenghua , Liu Zhixiong , Li Zhenyan 
Published: June 2024

Abstract
Background
This study aimed to investigate clinical features and treatment strategies for intracranial aneurysm (IA) associated with pituitary adenoma (PA).

Methods
We enrolled patients with lesions in the sellar region and age-matched general population who were confirmed with IA from two hospitals. Four types of treatment strategies were performed, which included Type I (both IA and PA were treated with surgery), Type II (IA was treated with surgery and PA was performed by non-surgical treatment), Type III (PA was performed with surgery and observation was available for IA) and Type IV (both IA and PA were performed with non-surgical treatment).

Results
The incidence of IA was 2.2% in the general population, 6.1% in patients with PA, 4.3% in patients with Rathke cleft cyst, 2.8% in patients with meningioma and none were found with IA in patients with craniopharyngioma. Age over 50 years (OR, 2.69; 95% CI, 1.20–6.04; P = 0.016), female (OR, 3.83, P = 0.003), and invasive tumor (OR, 3.26, P = 0.003) were associated with a higher incidence of IA in patients with PA. During the mean follow-up of 49.2 months, no patients experienced stroke, and recurrence of aneurysms and aneurysms treated with observation were stable. Of four patients with recurrence of PA, three patients were treated for type I and one patient for type III.

Conclusions
Preoperative evaluation for aneurysm screening is necessary due to the high incidence of IA in PA patients. Our current treatment strategies may provide a benefit for these patients.
Debriefer cognitive load during Traditional Reflective Debriefing vs. Rapid Cycle Deliberate Practice interdisciplinary team training
Authors: Wiltrakis Susan , Hwu Ruth , Holmes Sherita , Iyer Srikant , Goodwin Nandranie , Mathai Claire , Gillespie Scott , Hebbar Kiran B. , Colman Nora 
Published: June 2024

Abstract
Background
Cognitive load impacts performance of debriefers and learners during simulations, but limited data exists examining debriefer cognitive load. The aim of this study is to compare the cognitive load of the debriefers during simulation-based team training (SbTT) with Rapid Cycle Deliberate Practice (RCDP) debriefing and Traditional Reflective Debriefing (TRD). We hypothesize that cognitive load will be reduced during RCDP compared to TRD.

Methods
This study was part of a large-scale, interdisciplinary team training program at Children’s Healthcare of Atlanta Egleston Pediatric Emergency Department, with 164 learners (physicians, nurses, medical technicians, paramedics, and respiratory therapists (RTs)). Eight debriefers (main facilitators and discipline-specific coaches) led 28 workshops, which were quasi-randomized to either RCDP or TRD. Each session began with a baseline medical resuscitation scenario and cognitive load measurement using the NASA Task Load Index (TLX), and the NASA TLX was repeated immediately following either TRD or RCDP debriefing. Raw scores of the NASA TLX before and after intervention were compared. ANOVA tests were used to compare differences in NASA TLX scores before and after intervention between the RCDP and TRD groups.

Results
For all debriefers, mean NASA TLX scores for physical demands and frustration significantly decreased (− 0.8, p = 0.004 and − 1.3, p = 0.002) in TRD and mean perceived performance success significantly increased (+ 2.4, p < 0.001). For RCDP, perceived performance success increased post-debriefing (+ 3.6, p < 0.001), time demands decreased (− 1.0, p = 0.04), and frustration decreased (− 2.0, p < 0.001). Comparing TRD directly to RCDP, perceived performance success was greater in RCDP than TRD (3.6 vs. 2.4, p = 0.04). Main facilitators had lower effort and mental demand in RCDP and greater perceived success (p < 0.001).

Conclusion
RCDP had greater perceived success than TRD for debriefers. Main facilitators also report reduced effort and baseline mental demand in RCDP. For less experienced debriefers, newer simulation programs, or large team training sessions such as our study, RCDP may be a less mentally demanding debriefing methodology for facilitators.
Cognitive profile in Egyptian multiple sclerosis patients has no correlation with serum neurofilament level
Authors: Sayed Amira , Ashmawy Ghada Abdelhadi , Ramadan Ismail , Galeel Aya Abdel , Hamed Mervat 
Published: June 2024

Abstract
Background
Grey matter loss is thought to be the primary reason of cognitive disability in MS, with trans-synaptic axonal degeneration acting a supportive role. This research sought to evaluate cognitive profile of Egyptian multiple sclerosis patients and find out if it has a correlation with serum neurofilament or not.

Methods
This was a cross-sectional research performed on a total of 60 patients with MS and 30 healthy controls. BICAMS battery of neuropsychological tests was used which includes SDMT, CVLT and BVMT. Serum NFLs using ELISA technique.

Results
Mean ± SD of NFL in RRMS was 82.25 ± 170.9, in PPMS was 22.08 ± 7.26, in SPMS was 95.82 ± 187.5, and in control group was 56.65 ± 125.4, there was high statistical substantial variations among the different groups while there was non-statistical variation between RRMS and PPMS groups, also there was no variation between PPMS and SPMS with regard to serum level of NFL. There is no significant correlation between the NFL and different cognitive tests.

Conclusion
Since sNfL did not strongly connect with cognitive function in MS patients, it is possible that it cannot be used as a substitute indicator for neuropsychological state in these groups.