bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimation of periodontal inflamed surface area by salivary lactate dehydrogenase level using a test kit
Authors: Irie Koichiro , Sato Satsuki , Kamata Yohei , Mochida Yuki , Hirata Takahisa , Komaki Motohiro , Yamamoto Tatsuo 
Published: March 2024

Abstract
Salivary lactate dehydrogenase (LD) level is a feasible and useful parameter for screening periodontal diseases. The periodontal inflamed surface area (PISA) is a useful index for clinical and epidemiological assessments. However, PISA is extremely difficult to calculate and PISA-compatible screening kits are required. We aimed to investigate the association between salivary LD level, using a test kit, and the PISA and PISA-Japanese, and determine the feasibility and reliability of the salivary LD test kit for evaluation of periodontal status. The study included 110 patients (66.4% female, median and 25–75 percentiles of age were 66.5 and 53.0–75.0 years, respectively) who visited the Dental University Clinic in Japan. Resting saliva samples were collected from each participant, and LD levels were evaluated in real-time using a kit featuring an integer scale ranging from 1 to 10. PISA and PISA-Japanese were calculated using periodontal parameters. The median of salivary LD level was 4.0. The medians of PISA and PISA-Japanese were 46.9 and 61.0, respectively. Salivary LD level was positively correlated with bleeding on probing rate (r = 0.626, p < 0.001), PISA (r = 0.560, p < 0.001), and PISA-Japanese (r = 0.581, p < 0.001). Our results suggest that salivary LD levels assessed using the salivary LD kit showed a significantly positive correlation with PISA and PISA-Japanese. In addition, we developed the PISA estimation formula using salivary LD level with a test kit, sex, and age.
Mass spectrometry-based metabolomics study of nicotine exposure in THP-1 monocytes
Authors: Uhlig Silvio , Olderbø Bergitte Pearl , Samuelsen Jan Tore , Uvsløkk Solveig , Ivanova Lada , Vanderstraeten Camille , Grutle Lene Aiko , Rangel-Huerta Oscar Daniel 
Published: March 2024

Abstract

The tobacco alkaloid nicotine is known for its activation of neuronal nicotinic acetylcholine receptors. Nicotine is consumed in different ways such as through conventional smoking, e-cigarettes, snuff or nicotine pouches. The use of snuff has been associated with several adverse health effects, such as inflammatory reactions of the oral mucosa and oral cavity cancer. We performed a metabolomic analysis of nicotine-exposed THP-1 human monocytes. Cells were exposed to 5 mM of the alkaloid for up to four hours, and cell extracts and medium subjected to untargeted liquid chromatography high-resolution mass spectrometry. Raw data processing revealed 17 nicotine biotransformation products. Among these, cotinine and nornicotine were identified as the two major cellular biotransformation products. The application of multi- and univariate statistical analyses resulted in the annotation, up to a certain level of identification, of 12 compounds in the cell extracts and 13 compounds in the medium that were altered by nicotine exposure. Of these, four were verified as methylthioadenosine, cytosine, uric acid, and L-glutamate. The effects of smoking on the pathways involving these metabolites have been previously demonstrated in humans. Most of the other discriminating compounds, which were merely tentatively or not fully identified, were amino acids or amino acid derivatives.
Development and Testing of a Novel Large Language Model-Based Clinical Decision Support Systems for Medication Safety in 12 Clinical Specialties
Authors: Ting Daniel Shu Wei , Ong Jasmine Chiat Ling , Jin Liyuan , Kabilan Elangovan , Lim Gilbert Yong San , Lim Daniel Yan Zheng , Sng Gerald Gui Ren , Ke Yuhe , Tung Joshua Yi Min , Zhong Ryan Jian , Koh Christopher Ming Yao , Lee Keane Zhi Hao , Chen Xiang , Ch'ng Jack Kian , Aung Than , Goh Ken Junyang 
Published: March 2024

Abstract

Importance: We introduce a novel Retrieval Augmented Generation (RAG)-Large Language Model (LLM) framework as a Clinical Decision Support Systems (CDSS) to support safe medication prescription, a critical aspect of patient safety. This overcomes existing challenges of irrelevancy of alerts in rules-based CDSS in provision of prescribing error alerts that is relevant to the patient’s context and institutional medication use guides.
Objective: To evaluate the efficacy of LLM-based CDSS in correctly identifying medication errors in different patient case vignettes from diverse medical and surgical sub-disciplines, against a human expert panel derived ground truth. We compared performance for under 2 different CDSS practical healthcare integration modalities: LLM-based CDSS alone (fully autonomous mode) vs junior pharmacist + LLM-based CDSS (co-pilot, assistive mode).
Design, Setting, and Participants: Utilizing a RAG model with state-of-the-art medically-related LLMs (GPT-4, Gemini Pro 1.0 and Med-PaLM 2), this study used 61 prescribing error scenarios embedded into 23 complex clinical vignettes across 12 different medical and surgical specialties. A multidisciplinary expert panel assessed these cases for Drug-Related Problems (DRPs) using the PCNE classification and graded severity / potential for harm using revised NCC MERP medication error index. We compared.
Main Outcomes and Measures: This study compares the performance of an LLM-based CDSS in identifying DRPs. Key metrics include accuracy, precision, recall, and F1 scores. We also compare the performance of LLM-CDSS alone and junior hospital pharmacists (less than 2 years post licensure) + LLM-CDSS (co-pilot, assistive mode) in the provision of recommendations to clinicians. In addition, we present comparative results from different LLMs: GPT-4, Gemini Pro 1.0 and Med-PaLM 2.
Results
RAG-LLM performed better compared to LLM alone. When employed in a co-pilot mode, accuracy, recall, and F1 scores were optimized, indicating effectiveness in identifying moderate to severe DRPs. The accuracy of DRP detection with RAG-LLM improved in several categories but at the expense of lower precision.
Conclusions
This study established that a RAG-LLM based CDSS significantly boosts the accuracy of medication error identification when used alongside junior pharmacists (co-pilot), with notable improvements in detecting severe DRPs. This study also illuminates the comparative performance of current state-of-the-art LLMs in RAG-based CDSS systems.
High-brightness betatron emission from the interaction of a sub picosecond laser pulse with pre-ionized low-density polymer foam for ICF research
Authors: Gyrdymov Mikhail , Cikhardt Jakub , Tavana Parysatis , Borisenko Nataliya G. , Gus´kov Sergey Yu. , Yakhin Raphael A. , Vegunova Galina A. , Wie Wenqing , Ren Jieru , Zhao Yongtao , Hoffmann Dieter H. H. , Deng Zhigang , Zhou Weimin , Cheng Rui , Yang Jie , Novotny Jan , Shen Xiaofei , Pukhov Alexander , Jacoby Joachim , Spielmann Christian , Popov Vyacheslav S. , Veysman Mikhail E. , Andreev Nikolay E. , Rosmej Olga N. 
Published: March 2024

Abstract
Direct laser acceleration (DLA) of electrons in plasmas of near-critical density (NCD) is a very advancing platform for high-energy PW-class lasers of moderate relativistic intensity supporting Inertial Confinement Fusion research. Experiments conducted at the PHELIX sub-PW Nd:glass laser demonstrated application-promising characteristics of DLA-based radiation and particle sources, such as ultra-high number, high directionality and high conversion efficiency.
In this context, the bright synchrotron-like (betatron) radiation of DLA electrons, which arises from the interaction of a sub-ps PHELIX laser pulse with an intensity of 1019 W/cm2 with pre-ionized low-density polymer foam, was studied. The experimental results show that the betatron radiation produced by DLA electrons in NCD plasma is well directed with a half-angle of 100-200 mrad, yielding (3.4 ± 0.4)·1010 photons/keV/sr at 10 keV photon energy. The photon fluence in the energy range of 10–30 keV reaches (2.2 ± 0.3)·1011 photons/sr and the brilliance at 10 keV approaches ~2·1020 photons/s/mm2/mrad2/(0.1% BW), which agrees well with the particle-in-cell simulations. These results pave the way for innovative applications of the DLA regime using low-density pre-ionized foams in high-energy density research.
The role of emotions in academic performance of undergraduate medical students: a systematic review
Authors: Alshareef Nora , Fletcher Ian , Giga Sabir 
Published: March 2024

Abstract

Background
This paper is devoted to a systematic review of the literature on emotions' role in academic performance in medicine. The review aims to examine the role emotions play in the academic performance of undergraduate medical students.
Methods
Eight electronic databases were used to search the literature from 2013 to 2023, including Academic Search Ultimate, British Education Index, CINAHL, Education Abstract, ERIC, Medline, APA Psych Articles and APA Psych Info. Using specific keywords and terms in the databases, 3,285,208 articles were found. After applying the predefined exclusion and inclusion criteria to include only medical students and academic performance as an outcome, 45 articles remained, and the quality of the retrieved literature was assessed by three reviewers, then Seventeen articles were selected for the narrative synthesis.
Result
The findings indicate that depression and anxiety are the most frequently reported variables in the reviewed literature, and they have negative and positive impacts on the academic performance of medical students. The included literature also reported that a high number of medical students experienced test anxiety during their study which affected their academic performance. Positive emotions lead to positive academic outcomes and vice versa. However, Feelings of shame did not have any effect on the academic performance of medical students.
Discussion
The review suggests a significant relationship between emotions and academic performance among undergraduate medical students. While the evidence may not establish causation, it underscores the importance of considering emotional factors in understanding student performance. However, reliance on cross-sectional studies and self-reported data may introduce recall bias. Future research should concentrate on developing anxiety reduction strategies and enhance mental wellbeing to improve academic performance
Association of novel inflammatory markers with gestational diabetes mellitus in a representative U.S. sample: evidence from NHANES 2007-2018
Authors: Chen Yanfen , Zeng Genping , Lu Xijing , Zeng Tan , Miao Yuxi , Li Peiyin , Luo Songping , Zeng Lei , Lu Ruling 
Published: March 2024

Abstract
Background
Early detection of gestational diabetes mellitus (GDM) can lower the chance of occurrence. Recent years have seen a surge in research on novel inflammatory indicators, such as systemic immune inflammatory index (SII), lymphocyte-monocyte ratio (LMR), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR). Inflammation is linked to the pathophysiology of GDM and can be targeted for treatment. However, the relationship between GDM and these novel inflammatory markers is unclear.
Methods
We included participants with a diagnosis of GDM who were between the ages of 20 and 44, as well as complete blood counts from the US National Health and Nutrition Examination conducted between 2007 and 2018. SII, LMR, NLR, and PLR were among the novel inflammatory markers. First, we logarithmically transformed the exposure components to account for skewed distribution. We tested the relationship between GDM and novel inflammatory markers using a multiple logistic regression model and subgroup analyses to analyze the stability. And RCS curves were created to evaluate the non-linear connection.
Results
Following the inclusion of 3,722 women aged 20–44 years with GDM, multivariate logistic regression analysis revealed a positive correlation between log2-LMR and GDM (OR = 1.55, 95% CI = 1.20–2.01, p = 0.001), while negative correlations were observed between log2-SII, log2-PLR, and log2-NLR with GDM (OR = 0.84, 95% CI = 0.71–0.99, p = 0.04; OR = 0.73, 95% CI = 0.56–0.94, p = 0.01; OR = 0.65, 95% CI = 0.47–0.97, p = 0.03), and the correlation remained significant even after controlling for all confounders. Correlations were consistently shown by subgroup analyses. When the log2-LMR value was less than 1.79, the risk of GDM reduced with rising log2-LMR, and this tendency was reversed when larger than 1.79.
Conclusions
Elevated levels of new inflammatory markers are correlated with an increased risk of GDM and may offer clinicians with information to screen for GDM and identify GDM therapeutic targets. Further studies are required to investigate the causal relationship between the new inflammatory markers and GDM.
The value of STE-LDDSE to detect viable myocardium
Authors: Qian Wei , Zhou Ran , Chen Tao , Zhang Xueshan , Ma Yanfeng 
Published: March 2024

Abstract
To explore the value of speckle tracking echocardiography (STE) with low dose dobutamine stress echocardiography (LDDSE) for evaluation of viable myocardium (VM) in the acute ST-elevation myocardial infarction (STEMI) patients with or without type 2 diabetes mellitus (DM). Here, we show that a total of 183 regional wall motion abnormalities (RWMA) were detected in the DM group, of which 117 (63.93%) segments were viable myocardium; 357 RWMA were detected in non DM patients, of which 248 (69.47%) segments of viable myocardium were detected by echocardiography. The sensitivity, accuracy, and specificity of STE-LDDSE in detecting viable myocardium in DM group were 70.94%、77.45%、87.88% ; 92.31%、72.73% and 85.25% for LS and LSr. In the non DM group, the sensitivity, specificity, and accuracy of LS and LSr were 68.95%、92.66%、76.19% ; 77.42%、88.07% and 80.67%, respectively. Further parallel diagnostic tests were conducted on LS and LSr parameters. The sensitivity, specificity, and accuracy of detecting viable myocardium in the DM and non DM groups were 84.62%、45.45%、70.49%, 66.53%、63.30% and 65.55%, respectively, at rest; They were 84.62%、45.45%、70.49%, 66.53%、63.30% and 65.55%, respectively, during low dose dobutamine stress. In summary, Parallel diagnostic test for LS and LSr is the best choice in detecting VM in the patients with STEMI and is more sensitive for the patients with type 2 DM.
Multi-institutional evaluation of guidance from International Ki67 Working Group vs National Health Commission of China on Immunohistochemistry-based Ki67 assessment
Authors: Wang Yin , Zou Jiarui , Cao Qinghua , Dai Guihong , Fan Panhong , Gong Xue , Jiang JinYan , Kong Yanqing , Liu Chao , Liu Chunhui , Lu Chenjia , Li Meiren , Lang Zhiqiang , Lin Yang , Peng Yan , Shi Haiyan , Wang Yuhuan , Wang Jiu , Xie Bichen , Yang Bing , Yu Guohua , Zhang Cuiping , Zhang Hengming , Zhou Luting , Zhang Zilan , Zhu Zhenli , Hao Junmei 
Published: March 2024

Abstract
Purpose: Recommendations from National Health Commission of China (NHCC) and International Ki67 Working Group (IKWG) were issued respectively to guide immunohistochemistry (IHC)-based Ki67 scoring for breast cancer patients in daily clinical practice. They were evaluated in this multi-institutional study alongside with results from Quantitative Dot Blot (QDB) method.
Method: Three sections each from 40 primary ER+ breast cancer resection blocks were randomly assigned a number from 1 to 120 for Ki67 staining and reviewed by 21 pathologists while the other three alternative sections were sent for QDB analysis of Ki67 protein levels. Ki67 scores were grouped by 5/30% (IKWG), 10/30% (NHCC) and 20/30% (NHCC appendix 9, NHCCa9) respectively while QDB results were grouped by C5-C95 of 2.31 nmole/g defined in previous study as low, intermediate and high risk groups.
Results: The overall Intraclass Correlation Coefficient (ICC) was 0.785 for IHC evaluations from 21 pathologists, with the Fleiss Kappa at 0.555, 0.628 and 0.480 when Ki67 scores were grouped by the guidance from IKWG, NHCC and NHCCa9 respectively. In comparison, the ICC and Fleiss kappa for QDB analysis were at 0.939 and 0.831. When IHC and QDB results were cross-referenced, more specimens were grouped as high risk by QDB than IHC, and NHCCa9 led to highest percentage of disagreement between two methods.
Conclusion: The IKWG recommendation was harder to achieve categorized agreement among pathologists than that of NHCC, yet it led to best agreement with QDB to define low-risk group. QDB method offered significantly improved consistency over current IHC-based Ki67 assessment.
Preparation and property of PVA-based colorful coating composite reinforced with silica aerogel particles filled by high-loaded flame retardant
Authors: Feng Yilin , Ran Xu , Li Ying , Zhang Beibo , Wang Jiali , Chen Zhi , Wang Luoxin , Wang Hua 
Published: March 2024

Abstract
Hydrophilic mesoporous silica aerogel particles were synthesized via self-assembly of amphiphilic polymer (Ph8-PEG6-PEOS) and its instantaneous hydrolysis and condensation in the alkaline environment. Meanwhile, the capture and encapsulation of flame retardant (IPPP) and oil soluble dyes were successively completed during the two processes above. Observed by thermal field scanning electron microscopy (TFESEM), the average diameter of aerogel particles reached about 10 µm. BET surface area analysis displayed that the existence of oil-phase component (IPPP) can result in the expansion of pore diameter, and promote the evolution of mesopores into macropores. Then, IPPP@SiO2 aerogel particles were utilized to improve the flame retardancy of poly (vinyl alcohol) (PVA) coatings implemented onto cotton yarns, by employing developed knife coating procedure in an aqueous suspension. The thermal stabilities and flammability behaviors of the samples were evaluated by thermogravimetric analysis (TGA), limiting oxygen index (LOI), and vertical burning test, respectively. Both thermal decomposition temperature and LOI value of coating composites gradually increased with the increment of IPPP@SiO2-n (n = 10, 30, 50, 70), attaching to the synchronous advancement in stretching property. Furthermore, coatings were thickened by degrees from 0.4 mm to 4 mm, based on knife coating in multi-stage layer-by-layer mode, to build an ordered porous structure with the assisted adhesion of PVA. The following sintering preserved the close packing of silica aerogel particles and facilitate the formation of a coherent porous monolithic material with excellent thermal insulation performance.
A study on various types of immobilization of enzyme kinetic mechanisms by comparing with the solutions obtained from AGM and MADM
Authors: Saravanakumar K. , Veeramuni M. , Veeramani S. , Thomas Praveen , Ahmed L. Niyaz 
Published: March 2024

Abstract
In this article, the kinetic mechanisms are based on Michaelis-Menten reaction in presence of substrate inhibition have been solved by techniques ‘Akbari-Ganji’s Method’ (AGM) and ‘Modified Adomian decomposition method’ (MADM). Comparisons of solution of dimensionless substrate and product concentrations for various kinetic mechanisms have been carried out using AGM, MADM and numerical simulation. We assessed the impact of Thiele modulus, dimensionless inhibition degree, and concentration of substances outside the support on changing nature of substrate and product concentrations within the boundary layer in this study. The obtained results depict that the used methods have good accuracy for different values of kinetic parameters. Furthermore, the mean integrated effectiveness factor has been derived for all the mechanisms employing AGM solutions. This paper clearly illustrates the distinctions between MADM and AGM.
Optimal development of apoptotic cells-mimicking Liposomes Targeting Macrophages
Authors: Zhang Li , Li Yujiao , Liu Xing , He Xiaolu , Zhang Jieyu , Zhou Jun , Qiao Youbei , Wu Hong , Sun Fangfang , Zhou Qing 
Published: March 2024

Abstract

Macrophages are multifunctional innate immune cells that play indispensable roles in homeostasis, tissue repair, and immune regulation. However, dysregulated activation of macrophages is implicated in the pathogenesis of various human disorders, making them a potential target for treatment. Through the expression of pattern recognition and scavenger receptors, macrophages exhibit selective uptake of pathogens and apoptotic cells. Consequently, the utilization of drug carriers that mimic pathogenic or apoptotic signals shows potential for targeted delivery to macrophages. In this study, a series of mannosylated or/and phosphatidylserine (PS) -presenting liposomes were developed to target macrophages via the design of experiment (DoE) strategy and the trial-and-error (TaE) approach. The optimal molar ratio for the liposome formulation was DOPC:DSPS:Chol:PEG-PE = 20:60:20:2 based on the results of cellular uptake and cytotoxicity evaluation on RAW 264.7 and THP-1 in vitro. Results from in vivo distribution showed that, in the DSS-induced colitis model and collagen II-induced rheumatoid arthritis model, PS-presenting liposomes (PS-Lipo) showed the highest accumulation in intestine and paws respectively, which holds promising potential for macrophage target therapy since macrophages are abundant at inflammatory sites and contribute to the progression of corresponding diseases. Organs such as the heart, liver, spleen, lung, and kidney did not exhibit histological alterations such as inflammation or necrosis when exposed to PC-presenting liposomes (PC-Lipo) or PS-Lipo. In addition, liposomes demonstrated hemobiocompatibility and no toxicity to liver or kidney for circulation and did not induce metabolic injury in the animals. Thus, the well-designed PS-Lipo demonstrated the most potential for macrophage target therapy.
A qualitative study exploring adolescents’ perspectives of resilience trainings for chronic medical conditions
Authors: Sieper Larissa , Kerth Janna-Lina , Schneble Dominik , Tomoiaga Cristina , David Oana , Mayatepek Ertan , Meissner Thomas , Bischops Anne Christine 
Published: March 2024

Abstract

Background
Adolescents with a chronic medical condition (CMC) are often affected by mental health disorders coexisting with their physical conditions. Resilience-strengthening interventions can be beneficial for the adolescents’ mental health. However, evidence-based programs among this target group remain scarce. Here, we evaluated the wishes and needs of adolescents with CMC for resilience trainings to improve adherence.
Methods
This qualitative study analyzed the experience of 46 adolescents aged 12–16 years receiving resilience training at a German University Hospital. They were randomly assigned to a combined app and cognitive-behavioral coaching intervention (CBT) or stand-alone resilience app game (REThink). Postintervention semi-structured qualitative interviews were conducted and analyzed by the standards of qualitative content analysis.
Results
Both the REThink game app and coaching were considered helpful by the participants. Adolescents’ preferable resilience strengthening methods were coping skills training, mental health education, building of self-esteem and mindfulness exercises. Adolescents emphasized the importance of age-adapted difficulty levels, graphical design and native language content. Appointment scheduling was identified as a major barrier leading to a preference for online coachings.
Conclusions
This study highlighted key preferences of adolescents with CMC for resilience trainings. Adolescents acknowledged the value of both the app game and coaching format. Insights on coaching and app design preferences emphasize the importance of age-adapted and customizable interventions. The identified resilience training criteria provide a solid foundation for the development of forthcoming interventions.
Trial registration number:
DRKS00027870, registered 24.01.2022.