bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of Patient-Oriented Approach to the Health Care Development in Kemerovo Region – Kuzbass: Strategic Analysis
Authors: Badlo Svetlana , Tabashnikova Olga 
Published: March 2024

Achieving the strategic goals of the Russian Federation for preserving the population and ensuring the health and well-being of people requires an effective health care system that can provide necessary medical services and technologies and systematically train residents in healthy lifestyle and disease prevention.
This necessitates a transition to patient-oriented medicine based on strategizing, which will ensure the coordination of federal, departmental and regional programs aimed at improving the medical care quality and the population health. The article analyses legislative, regulatory, organizational documents and statistical data at the federal, regional and departmental levels. The authors perform analysis of healthcare statistical indicators in the Siberian Federal District and its subjects in dynamics; OTSW analysis on the strategizing methodology; comparative analysis of long-term healthcare development goals. The expediency of applying strategic planning and management in the transition to patient-oriented medicine is established; interrelations between strategies of different levels are discovered; region’s strategic objectives for the healthcare sector transformation and the conditions for their implementation effectiveness are defined. The authors consider possibilities of implementing a strategy for the patient-oriented medicine development in Kuzbass on the basis of region’s strengths, identify the threats and risks of not achieving strategic objectives and formulate the proposals for their reduction. The article confirms the importance of strategies’ coherence and proactivity within the appropriate priorities; argues the potential for the patient-oriented medicine development in Kuzbass.
Significance of Aneuploidy in Predicting Prognosis and Treatment Response of Uveal Melanoma
Authors: Zhang Xiaoqian , Jin Ling , Zhou Chenchen , Liu Jinghua , Jiang Qin 
Published: March 2024

Aims:
This study aimed to improve personalized treatment strategies and predict
survival outcomes for patients with uveal melanoma (UM).

Background:
Copy number aberrations (CNAs) have been considered as a main feature
of metastatic UM.

Objective:
This study was designed to explore the feasibility of using copy number variation
(CNV) in UM classification, prognosis stratification and treatment response.

Methods:
The CNV data in the TCGA-UVM cohort were used to classify the samples.
The differentially expressed genes (DEGs) between subtypes were screened by the “Limma”
package. The module and hub genes related to aneuploidy score were identified by
performing weighted gene co-expression network analysis (WGCNA) on the DEGs. Univariate
Cox and least absolute shrinkage and selection operator (LASSO) regression
analysis were employed to train the hub genes for developing a prognosis model for
UM. Finally, the expression levels of the screened prognostic key genes were verified in
UM cells, and the cell migration and invasion abilities were detected using real-time
quantitative PCR (qRT-PCR) and transwell assay.

Results:
The UM samples were divided into 3 CNV subtypes, which differed significantly
in overall survival (OS) and disease-specific survival (DSS). C1 had the shortest OS
and DSS and the highest level of immune infiltration. A total of 2036 DEGs were obtained
from the three subtypes. Eighty hub genes with the closest correlation with aneuploidy
scores were selected by WGCNA. Univariate Cox and LASSO regression-based
analyses finally determined eight genes as the key prognostic genes, including HES6,
RNASEH2C, NQO1, NUDT14, TTYH3, GJC1, FKBP10, and MRPL24. A prognostic
model was developed using the eight genes, demonstrating a strong prediction power.
Differences in the response to immunotherapy among patients in different risk groups
were significant. We found that high-risk patients were more sensitive to two drugs (Palbociclib_
1054 and Ribociclib_1632), while low-risk patients were more sensitive to
AZD1208_1449, ERK_2440_1713, Mirin_1048, and Selumetinib_1736.

Conclusion:
UM in this study was divided into three CNV subtypes, and a model based
on eight aneuploidy score-related genes was established to evaluate the prognosis and
drug treatment efficacy of UM patients. The current results may have the potential to
help the clinical decision-making process for UM management.
Fluoropyrimidine Toxicity: the Hidden Secrets of DPYD
Authors: Manolopoulos Vangelis G. , Ragia Georgia 
Published: March 2024

Background::
Fluoropyrimidine-induced toxicity is a main limitation of therapy. Currently, polymorphisms
in the DPYD gene, which encodes the 5-FU activation enzyme dihydropyrimidine dehydrogenase
(DPD), are used to adjust the dosage and prevent toxicity. Despite the predictive value of DPYD genotyping, a
great proportion of fluoropyrimidine toxicity cannot be solely explained by DPYD variations.

Objective::
We herein summarize additional sources of DPD enzyme activity variability, spanning from epigenetic
regulation of DPYD expression, factors potentially inducing protein modifications, as well as drug-enzyme
interactions that contribute to fluoropyrimidine toxicity.

Results::
While seminal in vitro studies provided evidence that DPYD promoter methylation downregulates
DPD expression, the association of DPYD methylation with fluoropyrimidine toxicity was not replicated in
clinical studies. Different non-coding RNA molecules, such as microRNA, piwi-RNAs, circular-RNAs and
long non-coding RNAs, are involved in post-transcriptional DPYD regulation. DPD protein modifications and
environmental factors affecting enzyme activity may also add a proportion to the pooled variability of DPD enzyme
activity. Lastly, DPD-drug interactions are common in therapeutics, with the most well-characterized
paradigm the withdrawal of sorivudine due to fluoropyrimidine toxicity deaths in 5-FU treated cancer patients;
a mechanism involving DPD severe inhibition.

Conclusions::
DPYD polymorphisms are the main source of DPD variability. A study on DPYD epigenetics
(both transcriptionally and post-transcriptionally) holds promise to provide insights into molecular pathways
of fluoropyrimidine toxicity. Additional post-translational DPD modifications, as well as DPD inhibition by
other drugs, may explain a proportion of enzyme activity variability. Therefore, there is still a lot we can learn
about the DPYD/DPD fluoropyrimidine-induced toxicity machinery.
Exploring the Social and Cognitive Factors Shaping the Acquisition of Science Concepts among Primary School Students in first and second languages
Authors: Adebusuyi O. F. , Adeleye A. O. , Jimoh D. O. , Ayide D. K. , Adedoyin A. B. 
Published: March 2024

This study investigates the intricate interplay of social and cognitive factors influencing the acquisition of science concepts among primary school pupils, with a focus on their first and second language. A survey research design was carried out across different primary schools in Ijebu Ode Government Area of Ogun State, during the third term of the 2022/2023 academic year. A sample size of 268 primary four pupils, 196 from eight private and seventy-two (72) from three public primary schools, were randomly selected through simple random sampling technique. A pilot survey was conducted by administering the research instruments to 46 male and 72 female randomly selected primary 4 pupils after which the instruments were subjected to analysis. The data collected were analyzed using a t-test and hierarchical regression analysis. Regression analysis showed that pupil motivation, teacher support, parent support, and school environment have a significant contribution to pupils’ science performance test (SPT). The results revealed a significant correlation between pupil motivation, teacher support, parental involvement, and the school environment, collectively influencing pupils' science performance. The study emphasizes addressing language disparities, enhancing student motivation, fostering collaborative support from parents and teachers, and creating a conducive learning environment in primary schools to improve overall science education performance.
Exploring Relations Between Unique Patient Characteristics and Virtual Reality Immersion Level on Anxiety and Pain in Patients Undergoing Venipuncture: Secondary Analysis of a Randomized Control Trial
Authors: Gold Jeffrey I , Akbar Krystal M , Avila Sandra , Ngo Nhat H , Klein Margaret J 
Published: March 2024

Background
Virtual reality (VR) is a well-researched digital intervention that has been used for managing acute pain and anxiety in pediatric patients undergoing various medical procedures. This study focuses on investigating the role of unique patient characteristics and VR immersion level on the effectiveness of VR for managing pediatric pain and anxiety during venipuncture.

Objective
The purpose of this study is to determine how specific patient characteristics and level of immersion during a VR intervention impact anxiety and pain levels for pediatric patients undergoing venipuncture procedures.

Methods
This study is a secondary data analysis of 2 combined, previously published randomized control trials on 252 pediatric patients aged 10-21 years observed at Children’s Hospital Los Angeles from April 12, 2017, to July 24, 2019. One randomized clinical trial was conducted in 3 clinical environments examining peripheral intravenous catheter placement (radiology and an infusion center) and blood draw (phlebotomy). Conditional process analysis was used to conduct moderation and mediation analyses to assess the impact of immersion level during the VR intervention.

Results
Significant moderation was found between the level of immersion and anxiety sensitivity when predicting postprocedural anxiety (P=.01). Patients exhibiting the highest anxiety sensitivity within the standard of care yielded a 1.9 (95% CI 0.9-2.8; P<.001)-point elevation in postprocedural anxiety relative to individuals with high immersion levels. No other significant factors were found to mediate or moderate the effect of immersion on either postprocedural anxiety or pain.

Conclusions
VR is most effective for patients with higher anxiety sensitivity who report feeling highly immersed. Age, location of the procedure, and gender of the patient were not found to significantly impact VR’s success in managing levels of postprocedural pain or anxiety, suggesting that immersive VR may be a beneficial intervention for a broad pediatric population.

Trial Registration
ClinicalTrials.gov NCT04268901; https://clinicaltrials.gov/study/NCT04268901
Examining Passively Collected Smartphone-Based Data in the Days Prior to Psychiatric Hospitalization for a Suicidal Crisis: Comparative Case Analysis
Authors: Jacobucci Ross , Ammerman Brooke , Ram Nilam 
Published: March 2024

Background
Digital phenotyping has seen a broad increase in application across clinical research; however, little research has implemented passive assessment approaches for suicide risk detection. There is a significant potential for a novel form of digital phenotyping, termed screenomics, which captures smartphone activity via screenshots.

Objective
This paper focuses on a comprehensive case review of 2 participants who reported past 1-month active suicidal ideation, detailing their passive (ie, obtained via screenomics screenshot capture) and active (ie, obtained via ecological momentary assessment [EMA]) risk profiles that culminated in suicidal crises and subsequent psychiatric hospitalizations. Through this analysis, we shed light on the timescale of risk processes as they unfold before hospitalization, as well as introduce the novel application of screenomics within the field of suicide research.

Methods
To underscore the potential benefits of screenomics in comprehending suicide risk, the analysis concentrates on a specific type of data gleaned from screenshots—text—captured prior to hospitalization, alongside self-reported EMA responses. Following a comprehensive baseline assessment, participants completed an intensive time sampling period. During this period, screenshots were collected every 5 seconds while one’s phone was in use for 35 days, and EMA data were collected 6 times a day for 28 days. In our analysis, we focus on the following: suicide-related content (obtained via screenshots and EMA), risk factors theoretically and empirically relevant to suicide risk (obtained via screenshots and EMA), and social content (obtained via screenshots).

Results
Our analysis revealed several key findings. First, there was a notable decrease in EMA compliance during suicidal crises, with both participants completing fewer EMAs in the days prior to hospitalization. This contrasted with an overall increase in phone usage leading up to hospitalization, which was particularly marked by heightened social use. Screenomics also captured prominent precipitating factors in each instance of suicidal crisis that were not well detected via self-report, specifically physical pain and loneliness.

Conclusions
Our preliminary findings underscore the potential of passively collected data in understanding and predicting suicidal crises. The vast number of screenshots from each participant offers a granular look into their daily digital interactions, shedding light on novel risks not captured via self-report alone. When combined with EMA assessments, screenomics provides a more comprehensive view of an individual’s psychological processes in the time leading up to a suicidal crisis.
Minimally invasive interventions on celiac plexus in patients with persistent abdominal pain caused by pancreatic cancer
Authors: Eroshkin О.A. , Romanukha D.M. 
Published: March 2024

Background. Chronic abdominal pain is common in 50 % of patients with intra-abdominal malignancies and has a huge impact on quality of their lives. As the number and doses of systemic analgesics increase, so does the frequency of side effects that can further worsen functional status, which is important for this cohort of patients who have a five-year survival rate of only 8 %. The purpose of the study: to assess the efficacy and safety of computed tomography-guided celiac plexus neurolysis as a method of reducing persistent, severe pain in patients with pancreatic cancer that affects their functional status. Materials and methods. The analysis of the results of 17 interventional procedures on the celiac plexus in 16 participants was conducted, sympatholysis was performed twice in one patient. Inclusion criteria: pancreatic cancer with persistent pharmacoresistant neuropathic abdominal pain for ≥ 3 months, which did not respond to medications, including opioids, anti-inflammatory drugs, and other conservative methods of treatment. Age of patients was 39 to 72 years (mean of 62.6 ± 8.2 years), 10 (62.5 %) research participants were male and 6 (37.5 %) were female. Results. Interventions were successfully performed for all patients on the first attempt. There were no cases of perforations of hollow organs, damage to blood vessels, pleural sinuses, or other structures of the abdominal and thoracic cavities. No neurological complications were recorded, and no one required blood transfusion. All study patients had a significant reduction in pain on the visual analogue scale compared to baseline, both one week after the procedure, from 9.7 ± 0.6 to 4.7 ± 1.4 (P < 0.001), and in six months, from 9.7 ± 0.6 to 4.1 ± 1.4 (P < 0.001). The average Karnofsky Performance Status Scale score compared to the data before the procedure, one week after increased from 64.7 ± 7.9 to 78.2 ± 6.4 (P < 0.001). A significant improvement in functional status was maintained up to three months — 71.2 ± 6.9 (P < 0.001). However, in six months, this indicator was 63.5 ± 6.0 (Р = 0.668), which may be related not only to the intensity of the pain syndrome, but also to other complications of the underlying disease (ascites, cachexia, tumor growth, palliative surgical interventions, etc.). Conclusions. Computed tomography-guided celiac plexus neurolysis is a safe and effective procedure for patients with abdominal pain caused by inoperable pancreatic cancer. Sympatholysis provides a long-term significant reduction in pain syndrome according to the visual analogue scale after 1, 3, 6 months (Р < 0.001) and increases the functional status of patients according to the Karnofsky Performance Status Scale in 1 (Р < 0.001), 3 months (Р = 0.023). Celiac plexus neurolysis should be considered as part of a multidisciplinary approach to the comprehensive treatment of upper abdominal pain associated with cancer in the early stages of the disease.
The role of clinical characteristics of Lyme borreliosis in predicting cognitive impairment
Authors: Malysh T.Yu. 
Published: March 2024

Background. Lyme disease is characterized by a wide polymorphism of clinical manifestations, including various lesions of the central and peripheral nervous systems. Along with neurological disorders, diverse manifestations and signs of cognitive impairments are often found. Despite the high prevalence of cognitive disorders in Lyme borreliosis, data on their frequency and risk factors are contradictory. The examination of cognitive status is still not included in the standard clinical examination of this category of patients. The aim of the study is to identify predictors that may independently influence the development of cognitive dysfunction in patients with Lyme borreliosis. Materials and methods. A prospective cohort study of 69 patients (47 females, 22 males) diagnosed with Lyme borreliosis, aged between 23 and 77 (average of 49.90 ± 16.26) years, was carried out. The Montreal Cognitive Assessment was used to evaluate cognitive function. To determine the relationship between cognitive dysfunction and its potential predictors, the participants were divided into two groups: patients without cognitive impairment (n = 30) and those with cognitive dysfunction (n = 39) based on the Montreal Cognitive Assessment score. Results. It was found that risk factors for the development of cognitive impairment include: diagnosis of Lyme borreliosis at the age of 45.5 years and older (hazard ratio (HR) 5.09; 95% confidence interval (CI) [1.82–14.27]; p = 0.001), presence of neuroborreliosis (HR 5.98; 95% CI [2.0–17.8]; р < 0.001), Lyme carditis (HR 8.7; 95% CI [1.04–73.06]; р = 0.021), hypertension (HR 7.19; 95% CI [2.32–22.28]; р < 0.001), anxiety disorders. Conclusions. The prospect for further research is to study and analyze the features of the correlation between cognitive and psycho-emotional disorders and the quality of life of patients with different forms and duration of Lyme borreliosis.
Peculiarities of the daily profile of blood pressure and heart activity in patients with arrhythmias depending on the severity of cognitive disordersPeculiarities of the daily profile of blood pressure and heart activity in patients with arrhythmias depending on the severity of cognitive disorders
Authors: Stadnik S.M. , Radchenko O.M. 
Published: March 2024

Background. The purpose of our work was to reveal the dependence of changes in the cognitive sphere on the peculiarities of the daily profile of blood pressure (BP) and heart activity in patients with arrhythmias. Materials and methods. We examined 139 patients with different clinical forms of arrhythmias. All of them underwent extended neuropsychological testing, a study of the daily BP profile and heart activity. Hemodynamic status was assessed by daily BP and ECG monitoring. Average daily, average daytime and nighttime systolic (SBP), diastolic blood pressure (DBP) and heart rate (HR) were evaluated. The analysis of spectral indicators of heart rate variability was performed to assess the state of the autonomic nervous system. Correlations of hemodynamic indicators with the results of neuropsychological testing were determined. Results. In patients with cognitive disorders (CD), there was an increase in SBP in all periods of the day, most pronounced in patients with moderate CD (p = 0.049). In patients with mild CD and without CD, there were no significant intergroup differences in the level of average daily, daytime and night SBP, DBP and pulse pressure (p > 0.05). Patients with moderate CD had significantly higher SBP and time index of SBP at the expense of average daytime and average night values of these indicators compared to those without CD (p < 0.05). During the active period of the day, time index of DBP was significantly higher in patients with moderate CD (p = 0.002) who also had an increase in average daily, daytime and night SBP variability compared to participants without CD (p = 0.041). The differences between the groups were not significant in terms of DBP variability (р = 0.07). In 61 (54 %) patients with CD, non-dipper SBP prevailed in the structure of disorders of the daily BP profile, with the highest indicators in moderate CD (55.6 %). The presence of adverse daily DBP profiles — night-peaker (6.2 %) and over-dipper (8.8 %), which prevailed in patients with moderate CD, is hidden behind normal indicators of the daily BP index. Increased average SBP24 (odds ratio (OR) = 3.26, 95% confidence interval (CI): 1.45–5.35, p < 0.001), DBP24 (OR = 3.06, 95% CI: 1.41–4.79, p < 0.001), average HR24 (OR = 2.67, 95% CI: 1.32–4.14, p < 0.001), average SBP24 variability (OR = 2.13, 95% CI: 1.11–3.32, p < 0.001) are the main factors of central hemodynamic disorders that increase the risk of developing CD in patients with arrhythmias. Conclusions. The identified associations between cognitive dysfunction, indicators of daily BP monitoring and heart activity are important in the context of their comprehensive accounting for optimizing an individualized approach to patient management and predicting the development of CD.
QUALITY OF SERVICES PROVIDED TO THE PATIENTS IN GOVERNMENT GENERAL HOSPITAL, SRIKAKULAM–A CROSS-SECTIONAL STUDY
Authors: RAO TATAVARTI SRINIVASA , SUBBALAKSHMI TELIDEVARA DURGA POORNA , KANTA HELENA 
Published: March 2024

Objective: To assess the quality of services provided in Outpatient department (OPD), to the Inpatients (IP) and quality of Supportive services.
Methods: This is a hospital-based cross-sectional study. Feedback was taken from the 150 patients after taking permission from the concerned authorities of the hospital, after taking Institutional ethical committee approval and after written consent from the patients. Feedback is taken from the patients attending 5 departments, namely (Medicine, Surgery, Gynaecology and Obstetrics, Orthopaedics and Paediatrics. Opinion from30 patients from each department covering 15 Outpatients and 15 inpatients were taken.
Results: Most of the patients of Out Patient Department (OPD) and Inpatients (IP) have expressed satisfaction regarding the services they are receiving/received from the hospital.
Conclusion: Utilizing the available hospital resources judiciously with wholehearted commitment from the available manpower with time to time needed budgetary support from the Government can improve the quality of services in the Government hospitals at par with the corporate hospitals.