bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of prophylactic lauromacrogol injection versus non-injection in patients with endogenous cesarean scar pregnancy treated by hysteroscopic surgery: a retrospective cohort study
Authors: Lu Lei , Shao Yiming , Qu Zhaoyang , Huang Guilian , Lang Suping , Yang Caiqun , Lang Siqi , Fang Shuying 
Published: November 2023

Abstract
Background
This study aimed to investigate the efficacy of hysteroscopic surgery for endogenous cesarean scar pregnancy (CSP) and the value of prophylactic ultrasound-guided local injection of lauromacrogol.

Methods
This retrospective study included 131 patients diagnosed with endogenous CSP who underwent hysteroscopic surgery at the Hangzhou Fuyang Women and Children Hospital between January 2018 and May 2022. Lauromacrogol (10–20 mL) was administered within 24 h preoperatively using an ultrasound-guided vaginal injection to 78 patients (L group) versus not administered to 53 patients (non-L group). Their clinical data and outcomes were analyzed.

Results
Mean gestational age, gestational mass size, and uterine scar thickness and median preoperative blood β-human chorionic gonadotropin levels of the non-L versus L groups were 46.26 versus 45.01 days, 2.05 versus 2.39 cm, 0.35 versus 0.32 cm, and 19850.0 versus 26790.0 U/L, respectively (P > 0.05 for each). The non-L and L groups had similar success rates (98.1% vs. 98.7%, P = 1.0). Complications related to lauromacrogol administration, including abdominal pain, massive bleeding, and bradycardia, were experienced by 46.2% (36/78; P < 0.001) of L group patients. The non-L had a significantly shorter mean hospital stay (4.85 ± 1.12 vs 5.44 ± 1.08 days) and lower total cost (6148.75 ± 1028.71 vs 9016.61 ± 1181.19) (P < 0.01).

Conclusions
Hysteroscopic surgery is effective and safe for patients with endogenous CSP. Prophylactic lauromacrogol injection increases the incidence of complications and costs. Direct hysteroscopic surgery can reduce pain and financial burden in patients with endogenous CSP and save medical resources for other patients.
Effect and mechanical mechanism of spontaneous breathing on oxygenation and lung injury in mild or moderate animal ARDS
Authors: Yang Rui , Zhou Leilei , Chen Zongyu , He Shuang , Lian Siyu , Shen Yi , Zhang Xianming 
Published: November 2023

Abstract
Objective
The present study aimed to determine the effect and mechanical mechanism of spontaneous breathing during mechanical ventilation on oxygenation and lung injury using Beagles dogs mild or moderate acute respiratory distress syndrome (ARDS) model.

Methods
After inducing mild or moderate ARDS by infusion of oleic acid, Eighteen Beagles dogs were randomly split into Spontaneous breathing group (BIPAPSB, n = 6), and Complete muscle paralysis group (BIPAPPC, n = 6),Six Beagles without ventilator support comprised the control group. Both groups were ventilated for 8 h under BIPAP mode. High-pressure was titrated TV to 6 ml/kg. A multi-pair esophageal balloon electrode catheter was used to measure respiratory mechanics and electromyogram. End-expiratory lung volume (EELV), gas exchange and respiratory variables were recorded in the process of mechanical ventilation. The contents of Interleukin (IL)-6 and IL-8 in lung tissue were measure using qRT-PCR. Besides, lung injury score was calculated in the end of mechanical ventilation.

Results
Based on the comparable setting of ventilator, BIPAPSB group exhibited higher safety peak transpulmonary pressure, abdominal pressure, EELV and P/F(PaO2/FiO2) than BIPAPPC group, whereas mean transpulmonary pressure, the mRNA levels of the IL-6 and IL-8 in the lung tissues and lung injury score in BIPAPSB group were lower than those in BIPAPPC group.

Conclusion
In mild to moderate ARDS animal models, during mechanical ventilation, SB may improve respiratory function and reduce ventilator-induced lung injury. The mechanism may be that spontaneous inspiration up-regulates peak transpulmonary pressure and EELV; Spontaneous expiration decreases mean transpulmonary pressure by up-regulating intra-abdominal pressure, thereby reducing stress and strain.
Evaluating the affordability of asthma, chronic obstructive pulmonary disease, and cystic fibrosis medicines in a middle-income country
Authors: Fathi Mahdieh , Moradi Najmeh , Yousefi Nazila , Peiravian Farzad , Shobeiri Nikta 
Published: November 2023

Abstract
Background
A heavy financial burden is imposed on patients suffering from chronic diseases due to medicine out-of-pocket payments.

Objectives
This study focuses on assessing the affordability of medications used for chronic respiratory diseases (CRDs) such as asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF) in Iran, specifically on the category R medicines listed in the 2017 Iran drug list (IDL) that are used for the treatment of these diseases, based on the anatomical therapeutic chemical (ATC) drug code.

Methods
The affordability of medicines in mono and combination therapy approaches was assessed in CRDs using the World Health Organization/Health Action International (WHO/HAI) methodology. Accordingly, if out-of-pocket payment for 30-days of pharmacotherapy exceeds one day for the lowest-paid unskilled government worker (LPGW), it’s considered non-affordable.

Results
Based on the monotherapy approach, our finding demonstrates that all generic medicines of category R were affordable. However, branded drugs such as Symbicort®, Pulmicort Respules®, Flusalmex®, Seretide®, Fluticort Plus®, Seroflo®, and Salmeflo® cost between 1.2 and 2.5 days’ wage of LPGW and considered unaffordable despite 70% insurance coverage. Moreover, based on the affordability ratio in the combination therapy approach, all medicines used in asthma, COPD, and CF patients with mild respiratory problems are affordable except omalizumab (inj), which is non-affordable due to its high price and no insurance coverage.

Conclusion
Results showed that the existing insurance coverage does not protect households from hardship, so more considerations are needed such as different insurance schedules and patient support programs.
Integrated machine learning identifies epithelial cell marker genes for improving outcomes and immunotherapy in prostate cancer
Authors: Zhu Weian , Zeng Hengda , Huang Jiongduan , Wu Jianjie , Wang Yu , Wang Ziqiao , Wang Hua , Luo Yun , Lai Wenjie 
Published: November 2023

Abstract
Background
Prostate cancer (PCa), a globally prevalent malignancy, displays intricate heterogeneity within its epithelial cells, closely linked with disease progression and immune modulation. However, the clinical significance of genes and biomarkers associated with these cells remains inadequately explored. To address this gap, this study aimed to comprehensively investigate the roles and clinical value of epithelial cell-related genes in PCa.

Methods
Leveraging single-cell sequencing data from GSE176031, we conducted an extensive analysis to identify epithelial cell marker genes (ECMGs). Employing consensus clustering analysis, we evaluated the correlations between ECMGs, prognosis, and immune responses in PCa. Subsequently, we developed and validated an optimal prognostic signature, termed the epithelial cell marker gene prognostic signature (ECMGPS), through synergistic analysis from 101 models employing 10 machine learning algorithms across five independent cohorts. Additionally, we collected clinical features and previously published signatures from the literature for comparative analysis. Furthermore, we explored the clinical utility of ECMGPS in immunotherapy and drug selection using multi-omics analysis and the IMvigor cohort. Finally, we investigated the biological functions of the hub gene, transmembrane p24 trafficking protein 3 (TMED3), in PCa using public databases and experiments.

Results
We identified a comprehensive set of 543 ECMGs and established a strong correlation between ECMGs and both the prognostic evaluation and immune classification in PCa. Notably, ECMGPS exhibited robust predictive capability, surpassing traditional clinical features and 80 published signatures in terms of both independence and accuracy across five cohorts. Significantly, ECMGPS demonstrated significant promise in identifying potential PCa patients who might benefit from immunotherapy and personalized medicine, thereby moving us nearer to tailored therapeutic approaches for individuals. Moreover, the role of TMED3 in promoting malignant proliferation of PCa cells was validated.

Conclusions
Our findings highlight ECMGPS as a powerful tool for improving PCa patient outcomes and supply a robust conceptual framework for in-depth examination of PCa complexities. Simultaneously, our study has the potential to develop a novel alternative for PCa diagnosis and prognostication.
Drone network for early warning of forest fire and dynamic fire quenching plan generation
Authors: Manoj S. , Valliyammai C. 
Published: November 2023

AbstractWildfires are one of the most frequent natural disasters which significantly harm the environment, society, and the economy. Transfer learning algorithms and modern machine learning tools can help in early forest fire prediction, detection, and dynamic fire quenching. A group of drones that has high-definition image processing and decision-making capabilities are used to detect the forest fires in the very early stage. The proposed system generates a fire quenching plan using particle swarm optimization technique and alerts the fire and rescue department for a quick action, thereby stop the forest fire at an early stage. Also, the drone network plays a major role to track the live status of forest fire and quenches the fire. ResNet, VGGNet, MobileNet, AlexNet, and GoogLeNet are used to detect the forest fire hazards. The experimental results prove that the proposed technique GoogLeNet-TL provides 96% accuracy and 97% F1 score in comparison with the state-of-the-art deep learning models.
CENPE and LDHA were potential prognostic biomarkers of chromophobe renal cell carcinoma
Authors: Wu Hui-feng , Liu Hao , Zhang Zhe-wei , Chen Ji-min 
Published: November 2023

AbstractBackgroundMost sarcomatoid differentiated renal cell carcinoma was differentiated from Chromophobe renal cell carcinoma (KICH) and related to a bad prognosis. Thus, finding biomarkers is important for the therapy of KICH.MethodsThe UCSC was used for determining the expression of mRNA and miRNA and clinical data in KICH and normal samples. KEGG and GO were used for predicting potential function of differently expressed genes (DEGs). Optimal prognostic markers were determined by Lasso regression. Kaplan–Meier survival, ROC, and cox regression were used for assessing prognosis value. GSEA was used for predicting potential function of markers. The relations between markers and immune cell infiltration were determined by Pearson method. The upstream miRNA of markers was predicted in TargetScan and DIANA.ResultsThe 6162 upregulated and 13,903 downregulated DEGs were identified in KICH. Further CENPE and LDHA were screened out as optimal prognostic risk signatures. CENPE was highly expressed while LDHA was lowly expressed in KICH samples, and the high expressions of 2 genes contributed to bad prognosis. The functions of CENPE and LDHA were mainly enriched in proliferation related pathways such as cell cycle and DNA replication. In addition, the correlation of 2 genes with immune infiltrates in KICH was also observed. Finally, we found that has-miR-577 was the common upstream of 2 genes and the binding sites can be predicted.ConclusionCENPE and LDHA were identified as the important prognostic biomarkers in KICH, and they might be involved in the proliferation of cancer cell.
Curriculum implementation challenges: Development and validation of an integrated curriculum implementation challenges tool
Authors: Aslam Kinza , Khan Rehan Ahmed , Aslam Mohammad Annas , Zaidi Fatima Zia 
Published: November 2023

Objective: To develop an instrument to identify the challenges faced by faculty while implementing an integrated curriculum in an undergraduate dentistry program.
Methods: The study was conducted between September 2020 and October 2021 at the University College of Medicine and Dentistry (UCMD), University of Lahore (UOL). A preliminary questionnaire, developed through literature review and faculty interviews was sent to 10 medical education experts for content validation via the Delphi technique. Content Validity Index (CVI) was calculated for individual items (I-CVI) as well as for the composite scale (S-CVI). A panel agreement of more than 75% was considered as the criterion for the inclusion of items in the questionnaire. Cognitive pretesting of five faculty members was conducted and pilot testing was subsequently done with 27 faculty members. The reliability of the tool was determined by Cronbach’s alpha.
Results: After the Delphi process, the final Integrated Curriculum Implementation Challenges (ICIC) questionnaire had 42 items. S-CVI was 0.87 and the cut-off value for I-CVI was taken as 0.78 as the criterion for item deletion. Cognitive interviews and pretesting revealed good item interpretation. Cronbach’s alpha for this tool was 0.87.
Conclusion: ICIC is a useful instrument with good reliability and content validity. It can be used to identify the presence and extent of challenges faced by the faculty while implementing an integrated curriculum.
doi: https://doi.org/10.12669/pjms.40.1.7258
How to cite this: Aslam K, Khan RA, Aslam MA, Zaidi FZ. Curriculum implementation challenges: Development and validation of an integrated curriculum implementation challenges tool. Pak J Med Sci. 2024;40(1):---------. doi: https://doi.org/10.12669/pjms.40.1.7258
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Gender‐affirming hysterectomy in the United States: A comparative outcomes analysis and potential implications for uterine transplantation
Authors: Siringo Nicolette V. , Boczar Daniel , Berman Zoe P. , Chaya Bachar F. , Kimberly Laura , Rodriguez Colon Ricardo , Trilles Jorge , Brydges Hilliard , Rodriguez Eduardo D. 
Published: November 2023

AbstractPurposeHysterectomy is a gynecological procedure sometimes performed as part of the gender‐affirming process for transgender and gender‐expansive patients assigned female at birth. Our goal was to compare surgical outcomes between patients undergoing gender‐affirming hysterectomy and patients undergoing hysterectomy for benign menstrual disorders. We then explored the implications of gender‐affirming hysterectomy for uterine transplantation.MethodsWe performed a retrospective cohort study using data from the American College of Surgeons National Surgical Quality Improvement Program database from 2009 through 2018. We identified patients undergoing hysterectomy in the United States based on Current Procedural Terminology code. We used the International Classification of Diseases 9 or 10 codes to identify patients with benign menstrual disorders (non‐gender‐affirming group) and gender dysphoria (gender‐affirming group). We compared patient characteristics and surgical complications.ResultsOf the 40,742 patients that met inclusion criteria, 526 (1.3%) patients were individuals with gender dysphoria. Compared to patients who underwent hysterectomy for benign menstrual disorders, gender‐affirming patients were younger, were healthier, had a lower prevalence of diabetes, and were more likely to undergo surgery in the outpatient setting, with shorter time to discharge. Complication rates were similar between groups. Logistic regression controlling for the American Society of Anesthesiology classification determined the difference of return to the operating room was not statistically significant (OR 1.082; 95% CI, 0.56–2.10; p = 0.816).ConclusionGender‐affirming hysterectomy has a safety profile similar to hysterectomy performed for benign menstrual disorders. Researchers should further explore the possibility of uterus donation among these patients as they may be suitable candidates.
Effects of N2O elimination on the elimination of second gases in a two‐step mathematical model of heterogeneous gas exchange
Authors: Korman Ben , Dash Ranjan K. , Peyton Philip J. 
Published: November 2023

AbstractWe have investigated the elimination of inert gases in the lung during the elimination of nitrous oxide (N2O) using a two‐step mathematical model that allows the contribution from net gas volume expansion, which occurs in Step 2, to be separated from other factors. When a second inert gas is used in addition to N2O, the effect on that gas appears as an extra volume of the gas eliminated in association with the dilution produced by N2O washout in Step 2. We first considered the effect of elimination in a single gas‐exchanging unit under steady‐state conditions and then extended our analysis to a lung having a log‐normal distribution of ventilation and perfusion. A further increase in inert gas elimination was demonstrated with gases of low solubility in the presence of the increased ventilation‐perfusion mismatch that is known to occur during anesthesia. These effects are transient because N2O elimination depletes the input of that gas from mixed venous blood to the lung, thereby rapidly reducing the magnitude of the diluting action.
Targeted quantitative lipidomic uncovers lipid biomarkers for predicting the presence of compensated cirrhosis and discriminating decompensated cirrhosis from compensated cirrhosis
Authors: Zeng Yongbin , Zhang Li , Zheng Zhiyi , Su Jingyi , Fu Ya , Chen Tianbin , Lin Kun , Liu Can , Huang Huanhuan , Ou Qishui , Zeng Yongjun 
Published: November 2023

Abstract

Objectives
This study aimed to characterize serum lipid metabolism and identify potential biomarkers for compensated cirrhosis (CC) predicting and decompensated cirrhosis (DC) discrimination using targeted quantitative lipidomics and machine learning approaches.

Methods
Serum samples from a cohort of 120 participants was analyzed, including 90 cirrhosis patients (45 CC patients and 45 DC patients) and 30 healthy individuals. Lipid metabolic profiling was performed using targeted LC-MS/MS. Two machine learning methods, least absolute shrinkage and selection operator (LASSO), and random forest (RF) were applied to screen for candidate metabolite biomarkers.

Results
The metabolic profiling analysis showed a significant disruption in patients with CC and DC. Compared to the CC group, the DC group exhibited a significant upregulation in the abundance of glycochenodeoxycholic acid (GCDCA), glyco-ursodeoxycholic acid (GUDCA), glycocholic acid (GCA), phosphatidylethanolamine (PE), N-acyl-lyso-phosphatidylethanolamine (LNAPE), and triglycerides (TG), and a significant downregulation in the abundance of ceramides (Cer) and lysophosphatidylcholines (LPC). Machine learning identified 11 lipid metabolites (abbreviated as BMP11) as potential CC biomarkers with excellent prediction performance, with an AUC of 0.944, accuracy of 94.7 %, precision of 95.6 %, and recall of 95.6 %. For DC discrimination, eight lipids (abbreviated as BMP8) were identified, demonstrating strong efficacy, with an AUC of 0.968, accuracy of 92.2 %, precision of 88.0 %, and recall of 97.8 %.

Conclusions
This study unveiled distinct lipidomic profiles in CC and DC patients and established robust lipid-based models for CC predicting and DC discrimination.
Deutsche Banken auf dem Weg in die zweite Globalisierung
Authors: Sattler Friederike , Ziegler Dieter 
Published: November 2023

Abstract
This article introduces the problematic situation of the great German banks and some non-German banks during the so-called second globalization since the 1970s. It formulates the questions that should be answered in the following contributions, each for a particular bank or group of banks. The most important overarching questions are firstly, to what extent banks were the driving force in the interconnectedness of cross-border money and capital flows and, secondly, to what extent they acted as triggers of the severe financial and/or sovereign debt crises during the last half century.
Neuer Aufbruch ins globale Bankgeschäft: Die Personal- und Steuerungsprobleme der Deutschen Bank beim Einstieg ins internationale Investmentbanking
Authors: Sattler Friederike 
Published: November 2023

Abstract
The article examines the genesis, perception and handling of the staffing and governance problems of Deutsche Bank, which stemmed from its entry into international investment banking in the mid-1980s and which have remained virulent into the bank’s recent past. Why was it not possible to prevent the blatant, extremely costly and permanently reputation-damaging breaches of rules by many investment bankers in this business area? An important explanatory factor seems to be the only half-hearted adherence to the concept of a global universal bank with integrated investment banking, while investment banking – which expanded strongly through the acquisitions of Morgan Grenfell (1989) and Bankers Trust (1998) – was de facto granted extensive autonomy within the group and a continuous but not precisely recorded transfer of resources by the parent company.
Latin American Banks and Euromarkets: A View on the Process of Early Bank Globalization from the Periphery
Authors: Alvarez Sebastian 
Published: November 2023

Abstract
Global banks and interconnected national banking sectors have been a main characteristic of the modern international financial systems over the last half century. After a sluggish wake up in the early postwar years, international banking took off in the 1970s as the Euromarkets gained traction and strongly developed in the lead up to the international debt crisis of 1982. This article examines the birth of bank globalization in Latin America, a region of the developing world at the centre of global finance and Euromarket developments during this period. It shows that, like their counterparts in industrial countries, leading banking institutions from the region also went international, expanding their presence overseas and their participation in the Euromarkets. The world leading financial centres of London and New York were the main destinations, but they also settled in offshore centres in the Caribbean and other US financial districts from where they conducted international business on their own or in collaboration with other banks. The presence in Germany along with the joint business between Latin American and German banks in the Euromarkets are explored as well. While assessing the extent and scope of early Latin American bank globalization for the first time, the article also provides insights on the evolution and changing nature of this process over the following period.
Banking in Globalisation: Commerzbank in the New Economic Course of the People’s Republic of China and the Role of Hong Kong
Authors: Liu Yi 
Published: November 2023

Abstract
Since the open-up policy at the end of the 1970s, China – the largest single market in Asia – received growing attention from foreign investors and banks. However, the fragile domestic market and undeveloped financial system in China did not allow a rapid inflow of foreign banks, given that the foreign banks could exert suppression on the domestic banks. As a result, it took several years for most foreign banks to gain a foothold in mainland China. This article demonstrates how Commerzbank – one of the German Big Three – entered the Chinese market in the 1980s by establishing a branch in Hong Kong and opening a representative office in Beijing. On the basis of archival evidence and other contemporary sources, the case of China provides one slice of the history of Commerzbank’s expansion and illustrates how it coped with the surge of internationalisation in the 1980s.