bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a telemedicine virtual clinic system for remote, rural, and underserved areas using user-centered design methods
Authors: Blocker Abby , Datay Mohammed Ishaaq , Mwangama Joyce , Malila Bessie 
Published: May 2024

Introduction Virtual clinics are an emerging form of telemedicine which can positively impact healthcare accessibility in remote, rural, and underserved areas. However, a virtual clinic system for these contexts must be designed appropriately. The user-centered design method can be employed to develop an appropriate virtual clinic. Methods The development of the virtual clinic used the user-centered design method. First, a situational analysis was conducted to understand the context of public primary healthcare facilities in South Africa. Literature review, observations, and interviews were conducted, which then informed system requirements. A virtual clinic system was then developed and its usability was evaluated with doctors and nurses in a lab setting using healthy participants acting as patients. Doctors and nurses completed system usability scale surveys and provided interview feedback. Results The situational analysis revealed 10 key themes which were translated into a problem statement and 10 system requirements. A virtual clinic system was then developed based on these requirements. 5 doctors and 11 nurses were recruited to complete usability testing with the system. The system received an average of 80.6 scores (good to excellent) out of 100 on the system usability scale. Feedback from participants revealed key areas for improvement of the virtual clinic system, as well as opportunities for further implementation. Conclusion The developed virtual clinic system demonstrated the application of the user-centered design method to telemedicine technologies for remote, rural, and underserved areas. The positive feedback received from the participants demonstrated the importance of the user-centered design method in developing technologies for enhancing service delivery in health systems. Further work will implement this system in real-world clinical settings.
Does Elevated Mean-Arterial Pressure Lead to Better Outcomes in Degenerative Cervical Myelopathy?- A Prospective, Pilot Randomized Control Trial
Authors: Sharma Ayush , Jaiswal Ajay , Marathe Nandan , Singh Vijay , Shakya Akash , Mangale Nilesh , Mhatre Pauras 
Published: May 2024

Study design Randomized Control Trial. Objective DCM refers to compression of spinal cord either due to static/dynamic causes or commonly, a result of combination of both. Number of variables exist, which determine prognosis post-surgery. Role of intra-operative blood pressure has not been analyzed in depth in current literature. Elevating MAP post SCI is widely practiced and forms a recommendation of AANS/CNS Joint Committee Guidelines. This led us to investigate role played by elevated MAP during surgery for DCM, in order to optimize outcomes. Methods This prospective randomized comparative pilot study was conducted at a tertiary care spine centre. 84 patients were randomly divided in two groups. Group 1 had intra-operative MAP in normal range. Group 2, had intra-operative BP 20 mmHg higher than preoperative average MAP with a variation of + 5 mmHg. Outcomes were recorded at 3 months, 6 months and 1 year by mJOA, VAS and ASIA scale. Results Neurological improvement was documented in 19/30 (63.3%) patients of hypertensive group compared to 16/30 (53.3%) patients of normotensive group. Improvements in mJOA scores were better for hypertensive group during the 1-year follow-up. Improvement in VAS scores were comparable between two groups, but at 1-year follow-up the VAS score of hypertensive groups was significantly lower. Conclusion MAP should be individualized according to preoperative average blood pressure assessment of patient. Keeping intraoperative MAP at higher level (preoperative MAP + 20 mmHg) during surgery for DCM can result in better outcomes.
Adaptive RISE Control of Winding Tension with Active Disturbance Rejection
Authors: Mi Junjie , Yao Jianyong , Deng Wenxiang 
Published: May 2024

AbstractA winding system is a time-varying system that considers complex nonlinear characteristics, and how to control the stability of the winding tension during the winding process is the primary problem that has hindered development in this field in recent years. Many nonlinear factors affect the tension in the winding process, such as friction, structured uncertainties, unstructured uncertainties, and external interference. These terms severely restrict the tension tracking performance. Existing tension control strategies are mainly based on the composite control of the tension and speed loops, and previous studies involve complex decoupling operations. Owing to the large number of calculations required for this method, it is inconvenient for practical engineering applications. To simplify the tension generation mechanism and the influence of the nonlinear characteristics of the winding system, a simpler nonlinear dynamic model of the winding tension was established. An adaptive method was applied to update the feedback gain of the continuous robust integral of the sign of the error (RISE). Furthermore, an extended state observer was used to estimate modeling errors and external disturbances. The model disturbance term can be compensated for in the designed RISE controller. The asymptotic stability of the system was proven according to the Lyapunov stability theory. Finally, a comparative analysis of the proposed nonlinear controller and several other controllers was performed. The results indicated that the control of the winding tension was significantly enhanced.
Theoretical Modeling and Surface Roughness Prediction of Microtextured Surfaces in Ultrasonic Vibration-Assisted Milling
Authors: Ni Chenbing , Zhu Junjie , Wang Youqiang , Liu Dejian , Wang Xuezhao , Zhu Lida 
Published: May 2024

AbstractTextured surfaces with certain micro/nano structures have been proven to possess some advanced functions, such as reducing friction, improving wear and increasing wettability. Accurate prediction of micro/nano surface textures is of great significance for the design, fabrication and application of functional textured surfaces. In this paper, based on the kinematic analysis of cutter teeth, the discretization of ultrasonic machining process, transformation method of coordinate systems and the cubic spline data interpolation, an integrated theoretical model was established to characterize the distribution and geometric features of micro textures on the surfaces machined by different types of ultrasonic vibration-assisted milling (UVAM). Based on the theoretical model, the effect of key process parameters (vibration directions, vibration dimensions, cutting parameters and vibration parameters) on tool trajectories and microtextured surface morphology in UVAM is investigated. Besides, the effect of phase difference on the elliptical shape in 2D/3D ultrasonic elliptical vibration-assisted milling (UEVAM) was analyzed. Compared to conventional numerical models, the method of the cubic spline data interpolation is applied to the simulation of microtextured surface morphology in UVAM, which is more suitable for characterizing the morphological features of microtextured surfaces than traditional methods due to the presence of numerous micro textures. The prediction of surface roughness indicates that the magnitude of ultrasonic amplitude in z-direction should be strictly limited in 1D rotary UVAM, 2D and 3D UEVAM due to the unfavorable effect of axial ultrasonic vibration on the surface quality. This study can provide theoretical guidance for the design and fabrication of microtextured surfaces in UVAM.
Role of Exosomes in Cancer and Aptamer-Modified Exosomes as a Promising Platform for Cancer Targeted Therapy
Authors: Wu Yating , Cao Yue , Chen Li , Lai Xiaofeng , Zhang Shenghang , Wang Shuiliang 
Published: May 2024

AbstractExosomes are increasingly recognized as important mediators of intercellular communication in cancer biology. Exosomes can be derived from cancer cells as well as cellular components in tumor microenvironment. After secretion, the exosomes carrying a wide range of bioactive cargos can be ingested by local or distant recipient cells. The released cargos act through a variety of mechanisms to elicit multiple biological effects and impact most if not all hallmarks of cancer. Moreover, owing to their excellent biocompatibility and capability of being easily engineered or modified, exosomes are currently exploited as a promising platform for cancer targeted therapy. In this review, we first summarize the current knowledge of roles of exosomes in risk and etiology, initiation and progression of cancer, as well as their underlying molecular mechanisms. The aptamer-modified exosome as a promising platform for cancer targeted therapy is then briefly introduced. We also discuss the future directions for emerging roles of exosome in tumor biology and perspective of aptamer-modified exosomes in cancer therapy.
SEDA 2024 update: enhancing the SEquence DAtaset builder for seamless integration into automated data analysis pipelines
Authors: Reboiro-Jato Miguel , Pérez-Rodríguez Daniel , Da Silva Miguel José , Vila-Fernández David , Vieira Cristina P. , Vieira Jorge , López-Fernández Hugo 
Published: May 2024

Abstract
Background
The initial version of SEDA assists life science researchers without programming skills with the preparation of DNA and protein sequence FASTA files for multiple bioinformatics applications. However, the initial version of SEDA lacks a command-line interface for more advanced users and does not allow the creation of automated analysis pipelines.

Results
The present paper discusses the updates of the new SEDA release, including the addition of a complete command-line interface, new functionalities like gene annotation, a framework for automated pipelines, and improved integration in Linux environments.

Conclusion
SEDA is an open-source Java application and can be installed using the different distributions available (https://www.sing-group.org/seda/download.html) as well as through a Docker image (https://hub.docker.com/r/pegi3s/seda). It is released under a GPL-3.0 license, and its source code is publicly accessible on GitHub (https://github.com/sing-group/seda). The software version at the time of submission is archived at Zenodo (version v1.6.0, http://doi.org/10.5281/zenodo.10201605).
A comparison between the role of enniatins and deoxynivalenol in Fusarium virulence on different tissues of common wheat
Authors: Beccari Giovanni , Tini Francesco , Foroud Nora A. , Ederli Luisa , Gardiner Donald M. , Benfield Aurelie H. , Harris Linda J. , Sulyok Michael , Romani Roberto , Bellezza Ilaria , Covarelli Lorenzo 
Published: May 2024

Abstract
Background
Fusarium graminearum and Fusarium avenaceum are two of the most important causal agents of Fusarium head blight (FHB) of wheat. They can produce mycotoxins that accumulate in infected wheat heads, including deoxynivalenol (DON) and enniatins (ENNs), produced by F. graminearum and F. avenaceum, respectively. While the role of DON as a virulence factor in F. graminearum toward wheat is well known, ENNs in F. avenaceum has been poorly explored. Results obtained to-date indicate that ENNs may confer an advantage to F. avenaceum only on particular hosts.

Results
In this study, with the use of ENN-producing and ENN non-producing F. avenaceum strains, the role of ENNs on F. avenaceum virulence was investigated on the root, stem base and head of common wheat, and compared with the role of DON, using DON-producing and DON non-producing F. graminearum strains. The DON-producing F. graminearum strain showed a significantly higher ability to cause symptoms and colonise each of the tested tissues than the non-producing strain. On the other hand, the ability to produce ENNs increased initial symptoms of the disease and fungal biomass accumulation, measured by qPCR, only in wheat heads, and not in roots or stem bases. LC-MS/MS analysis was used to confirm the presence of ENNs and DON in the different strains, and results, both in vitro and in wheat heads, were consistent with the genetics of each strain.

Conclusion
While the key role of DON on F. graminearum virulence towards three different wheat tissues was noticeable, ENNs seemed to have a role only in influencing F. avenaceum virulence on common wheat heads probably due to an initial delay in the appearance of symptoms.
Short‑ and long‑term outcomes after laparoscopic and open pancreatoduodenectomy for elderly patients: a propensity score‑matched study
Authors: Xu Shuai , Deng Xin , Wang Shulin , Yu Guangsheng , Liu Jun , Gong Wei 
Published: May 2024

Abstract
Background
The feasibility and safety of laparoscopic pancreatoduodenectomy (LPD) in elderly patients is still controversial. This study aimed to compare the clinical outcomes of LPD and open pancreatoduodenectomy (OPD) in elderly patients.

Methods
Clinical and follow-up data of elderly patients (≥ 65 years) who underwent LPD or OPD between 2015 and 2022 were retrospectively analyzed. A 1:1 propensity score-matching (PSM) analysis was performed to minimize differences between groups. Univariate and multivariate logistic regression analysis were used to select independent prognostic factors for 90-day mortality.

Results
Of the 410 elderly patients, 236 underwent LPD and 174 OPD. After PSM, the LPD group had a less estimated blood loss (EBL) (100 vs. 200 mL, P < 0.001), lower rates of intraoperative transfusion (10.4% vs. 19.0%, P = 0.029), more lymph node harvest (11.0 vs. 10.0, P = 0.014) and shorter postoperative length of stay (LOS) (13.0 vs. 16.0 days, P = 0.013). There were no significant differences in serious complications, reoperation, 90-day readmission and mortality rates (all P > 0.05). Multivariate logistic regression analysis showed that post-pancreatectomy hemorrhage (PPH) was an independent risk factor for 90-day mortality. Elderly patients with pancreatic ductal adenocarcinoma (PDAC) who underwent LPD or OPD had similar overall survival (OS) (22.5 vs.20.4 months, P = 0.672) after PSM.

Conclusions
It is safe and feasible for elderly patients to undergo LPD with less EBL and a shorter postoperative LOS. There was no statistically significant difference in long-term survival outcomes between elderly PDAC patients who underwent LPD or OPD.
HIV self-testing adoption and post-test linkage to care among men who have sex with men in China: a nationwide cross-sectional survey
Authors: Yang Fan , Zhao Peizhen , Tang Weiming , Tucker Joseph D. , Xu Wenqian , Wang Cheng 
Published: May 2024

Abstract
Background
HIV self-testing (HIVST) was recommended to improve HIV testing services. China initiated some of the first HIVST pilots in the world, providing a unique opportunity for implementation research. We aim to investigate HIVST adoption and its following linkage to care among Chinese men who have sex with men (MSM).

Methods
Data were collected using an online questionnaire distributed on major social media platforms in 2018, one year after HIVST was officially endorsed and allowed for sale. MSM who were at least 16 years old, assigned as male at birth, and ever tested for HIV were eligible. Primary outcome, adoption was defined as ever use of HIVST. Bivariate and multivariable logistic regressions were performed to explore the association between HIVST adoption and sociodemographic and behavioral factors. Linkage to care was also described via the following sequential events as indicators: (1) receiving result after recent test (2), seeking care from healthcare facility if test result was positive or indeterminate, and (3) delayed time before seeking care.

Results
A total of 540 participants were included with an average age of 27.4 ± 6.6. Most were never married (87.4%) and half completed college (52.2%). Overall, 75.2% had adopted HIVST. Self-test kits were commonly obtained from community-based organizations (54.4%) and from online (46.6%). HIVST adoption was positively associated with having college or higher education (OR = 1.66, 95%CI: 1.07–2.57), and negatively associated with age older than 30 (AOR = 0.52, 95%CI: 0.32–0.84). Adoption was not associated with other socio-demographic or behavioral factors. After receiving HIV-positive or indeterminate results, 25/25 of HIVST adopters sought care while 3 out of 7 (42.9%) non-adopters sought care (p < 0.001). Delays before seeking care were not significantly different between HIVST adopters compared to non-adopters (P = 0.366).

Conclusion
Many MSM adopted HIVST shortly after its launch. Our findings suggested that HIVST linkage to care is promising among MSM in China. Integration of HIVST with other essential sexual health services is needed.
Malignant tumor increases the risk of all causes in-hospital mortality in critically ill patients with ischemic stroke: analysis of the MIMIC-IV database
Authors: Wang Qiwei , Fu Wang , Wang Feng 
Published: May 2024

Abstract
Background
Ischemic stroke (IS) and malignant tumor (MT) have high morbidity and mortality rates worldwide, and several associations exist between them. This study aimed to determine the effect of MT on hospital mortality in patients with IS.

Methods
Based on their MT status, participants with IS in the Medical Information Mart for Intensive Care IV (MIMIC-IV) were divided into two groups. The primary outcome was in-hospital all causes mortality. Kaplan-Meier survival analysis was performed to evaluate the intergroup in-hospital mortality, and three Cox regression models were used to determine the association between MT and in-hospital mortality.

Results
A total of 1605 participants (749 males and 856 females) were included in the study. The mean age was 72.030 ± 15.463 years. Of these, 257 (16%) patients died in the hospital. Kaplan-Meier analysis showed that the MT group had a significantly lower possibility of in-hospital survival than the non-MT group. In the unadjusted model, in-hospital mortality among MT patients had a higher odds ratio (OR) of 1.905 (95% CI, 1.320–2.748; P < 0.001) than the non-MT group. After adjusting for basic information, vital signs, and laboratory data, MT was also associated with increased in-hospital mortality (OR = 1.844, 95% CI: 1.255–2.708; P = 0.002).

Conclusions
Among the patients with IS, the risk of all causes in-hospital mortality was higher for MT than for patients non-MT. This finding can assist clinicians in more accurately assessing prognosis and making informed treatment decisions.
Patients’ satisfaction with cancer pain treatment at adult oncologic centers in Northern Ethiopia; a multi-center cross-sectional study
Authors: Amsalu Molla , Ashagrie Henos Enyew , Getahun Amare Belete , Berhe Yophtahe Woldegerima 
Published: May 2024

Abstract
Background
Patient satisfaction is an important indicator of the quality of healthcare. Pain is one of the most common symptoms among cancer patients that needs optimal treatment; rather, it compromises the quality of life of patients.

Objective
To assess the levels and associated factors of satisfaction with cancer pain treatment among adult patients at cancer centers found in Northern Ethiopia in 2023.

Methods
After obtaining ethical approval, a multi-center cross-sectional study was conducted at four cancer care centers in northern Ethiopia. The data were collected using an interviewer-administered structured questionnaire that included the Lubeck Medication Satisfaction Questionnaire (LMSQ). The severity of pain was assessed by a numerical rating scale from 0 to 10 with a pain score of 0 = no pain, 1–3 = mild pain, 4–6 = moderate pain, and 7–10 = severe pain Binary logistic regression analysis was employed, and the strength of association was described in an adjusted odds ratio with a 95% confidence interval.

Result
A total of 397 cancer patients participated in this study, with a response rate of 98.3%. We found that 70.3% of patients were satisfied with their cancer pain treatment. Being married (AOR = 5.6, CI = 2.6–12, P < 0.001) and being single (never married) (AOR = 3.5, CI = 1.3–9.7, P = 0.017) as compared to divorced, receiving adequate pain management (AOR = 2.4, CI = 1.1–5.3, P = 0.03) as compared to those who didn’t receive it, and having lower pain severity (AOR = 2.6, CI = 1.5–4.8, P < 0.001) as compared to those who had higher level of pain severity were found to be associated with satisfaction with cancer pain treatment.

Conclusion
The majority of cancer patients were satisfied with cancer pain treatment. Being married, being single (never married), lower pain severity, and receiving adequate pain management were found to be associated with satisfaction with cancer pain treatment. It would be better to enhance the use of multimodal analgesia in combination with strong opioids to ensure adequate pain management and lower pain severity scores.
Immune cell patterns before and after neoadjuvant immune checkpoint blockade combined with chemoradiotherapy in locally advanced esophageal squamous cell carcinoma
Authors: Zheng Dan-Dan , Li Yu-Ying , Yuan Xiao-Yi , Lu Jiang-Li , Zhang Mei-Fang , Fu Jia , Zhang Chris Zhiyi 
Published: May 2024

Abstract
Background
Neoadjuvant immune checkpoint blockade (ICB) combined with chemoradiotherapy offers high pathologic complete response (pCR) rate for patients with locally advanced esophageal squamous cell carcinomas (ESCC). But the dynamic tumor immune microenvironment modulated by such neoadjuvant therapy remains unclear.

Patients and methods
A total of 41 patients with locally advanced ESCC were recruited. All patients received neoadjuvant toripalimab combined with concurrent chemoradiotherapy. Matched pre- and post-treatment tissues were obtained for fluorescent multiplex immunohistochemistry (mIHC) and IHC analyses. The densities and spatial distributions of immune cells were determined by HALO modules. The differences of immune cell patterns before and after neoadjuvant treatment were investigated.

Results
In the pre-treatment tissues, more stromal CD3 + FoxP3 + Tregs and CD86+/CD163 + macrophages were observed in patients with residual tumor existed in the resected lymph nodes (pN1), compared with patients with pCR. The majority of macrophages were distributed in close proximity to tumor nest in pN1 patients. In the post-treatment tissues, pCR patients had less CD86 + cell infiltration, whereas higher CD86 + cell density was significantly associated with higher tumor regression grades (TRG) in non-pCR patients. When comparing the paired pre- and post-treatment samples, heterogeneous therapy-associated immune cell patterns were found. Upon to the treatment, CD3 + T lymphocytes were slightly increased in pCR patients, but markedly decreased in non-pCR patients. In contrast, a noticeable increase and a less obvious decrease of CD86 + cell infiltration were respectively depicted in non-pCR and pCR patients. Furthermore, opposite trends of the treatment-induced alterations of CD8 + and CD15 + cell infiltrations were observed between pN0 and pN1 patients.

Conclusions
Collectively, our data demonstrate a comprehensive picture of tumor immune landscape before and after neoadjuvant ICB combined with chemoradiotherapy in ESCC. The infiltration of CD86 + macrophage may serve as an unfavorable indicator for neoadjuvant toripalimab combined with chemoradiotherapy.