bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of clinical relevance of antigen improves diagnostic accuracy of hypersensitivity pneumonitis
Authors: Iijima Yuki , Ejima Masaru , Yamana Takashi , Sonoda Shiro , Shibata Sho , Shirai Tsuyoshi , Okamoto Tsukasa , Furusawa Haruhiko , Tateishi Tomoya , Adachi Takuya , Mori Mio , Kirimura Susumu , Anzai Tatsuhiko , Takahashi Kunihiko , Miyazaki Yasunari 
Published: February 2024

Abstract
Background
Exposure assessment is integral to the diagnosis of hypersensitivity pneumonitis (HP). Although the clinical relevance of exposed antigens is essential for the assessment, many of the previous guidelines or reports have only evaluated simple exposure histories or immunological tests. To overcome this problem, the Exposure Assessment Form (EAF) was developed as an assessment tool for classifying the exposure grade from G0 to G4. The EAF was modified from the description in the Japanese clinical practice guide 2022 for HP published by the Japanese Respiratory Society.

Methods
One hundred and seventy-two consecutive patients with interstitial lung disease who underwent multidisciplinary discussion (MDD) at our hospital were retrospectively examined. We assessed whether the use of the EAF improved the diagnostic performance of the international guideline of HP. We also evaluated whether the exposure grade affected the prognosis of HP.

Results
Even when a HP diagnosis was made with a confidence of 70% or higher according to the international guideline, less than half of these cases resulted in a final diagnosis of HP when the exposure grades were lower than G3. When the result of the EAF was integrated into the exposure definition of the international guideline, the specificity of the diagnostic performance improved, while sensitivity was maintained. Furthermore, HP patients with an exposure grade of G3 or higher showed a tendency to take a longer time to initiate medication.

Conclusions
This is the first study to evaluate the clinical relevance of possible antigens using the EAF. Assessing the exposure grade prevents overdiagnosis and improves the diagnostic performance of the international guideline.
Bronchoscopic lung volume reduction by instillation of fibrinogen and thrombin in COPD patients with homogenous emphysema
Authors: El Gohary Dina Abd El Wahab , Eltomey Mohamed Adel , Mohamed Ahmed Shawky , Farahat Amgad Abd El Raouf , Abd El Zaher Ayman Hassan 
Published: February 2024

Abstract
Background
The new endobronchial therapy called biological lung volume reduction (BioLVR) involves using a rapid polymerizing sealant to block off the most emphysematous portions of the lungs. The primary mechanism of action is resorption atelectasis, which is then followed by inflammation and remodeling of the airspace. The remodeling process will result in the formation of scars, leading to the contraction of the lung tissue. As a result, a decrease in functional lung volume is anticipated for a period of 6–8 weeks.

Objective
Assessing the safety and effectiveness of bronchoscopic installation of (fibrinogen and thrombin) in COPD patients with homogeneous emphysema in terms of radiological, physiological, and quality of life outcomes.

Methods
Between December 2017 and December 2019, 40 COPD patients with homogeneous emphysema were studied using a fiber optic bronchoscope while they were awake but sedated. Tanta University Hospitals’ chest medicine department collaborated with the diagnostic radiology department of the Faculty of Medicine.

Results
All the following parameters were reduced from their initial values: HRCT volumetry, RV/TLC, mMRC dyspnea scale, CAT score, 6MWT, FEV1, and the FEV1/FVC ratio at the first, third, and sixth months from the beginning (p = 0.001). One individual (0.025%) had pneumonia, whereas three individuals had COPD (0.075%). Using fibrin glue produced locally, biological lung volume reduction (Bio LVR) may be an effective treatment for advanced homogenous emphysema.

Conclusion
By using locally prepared fibrin glue the biologic lung volume reduction (Bio LVR) may be a convenient method to treat advanced homogenous emphysema.
Comparison of a novel hand-held retractor-assisted transforaminal lumbar interbody fusion by the wiltse approach and posterior TLIF: a one-year prospective controlled study
Authors: Shen Xing , Li Fu Tao , Quan Cheng Yong , Zheng Ming Hui , Yao Xin Qiang , Wang Hai Ming , Ting Chen Jian , Jiang Hui 
Published: February 2024

Abstract
Background
This study aims to compare the clinical outcomes and safety of a novel hand-held retractor system-assisted Wiltse TLIF with that P-TLIF and assess whether this hand-held retractor system assisted Wiltse TLIF can yield less paraspinal muscle injury.

Methods
56 patients (P-TLIF: 26, Wiltse TLIF: 30) were included in this one year prospective controlled study. The operation time, intraoperative blood loss, postoperative drainage, mobilization time, and discharge time were recorded. The clinical outcomes were evaluated by ODI, VAS, JOA, and SF-36 scores (7 days, 3, 6, and 12 months after surgery). Paraspinal muscle injury was assessed by postoperative MRI (6 months after surgery). CK and C-reaction protein were measured pre and postoperatively, and CT or X-ray (one year postoperatively) was used to assess bony union/non-union.

Results
The Wiltse (study) group was associated with significantly less estimated blood loss (79.67 ± 28.59 ml vs 192.31 ± 59.48 ml, P = 0.000*), postoperative drainage (43.33 ± 27.89 ml vs 285.57 ± 123.05 ml, P = 0.000*), and shorter mobilization (4.1 ± 1.2 d vs. 3.0 ± 0.9 d, P < 0.05) and discharge times (7.7 ± 1.9 d vs. 6.1 ± 1.2 d, P = 0.002*) than the P-TLIF (control) group. Serum CK activity at 24 h postoperatively in the study group was significantly lower than in the control group (384.10 ± 141.99 U/L vs 532.76 ± 225.76 U/L, P = 0.018*). At 7 days after surgery, VAS (2.3 ± 0.6 vs 3.2 ± 0.7, P = 0.000*)and ODI scores (43.9 ± 11.9 vs 55.2 ± 12.9, P = 0.001*) were lower, while the JOA scores (18.4 ± 3.4 vs 16.3 ± 4.2, P = 0.041*) was higher in the control group than in the study group. Results observed at 3 months of follow-up were consistent with those at 7 days. After six months postoperatively, paraspinal muscle degeneration in the control group was more significant than in the study group (P = 0.008*).

Conclusion
Our study showed that this novel hand-held retractor system assisted Wiltse approach TLIF can significantly reduce paraspinal muscle injury, postoperative drainage, and intraoperative blood loss, mobilization and discharge time, as well as yield better short-term outcomes compared to P-TLIF.

Trial registration
25/09/2023 NCT06052579.
Establishment and validation of a nomogram to predict postoperative anemia after total hip arthroplasty
Authors: Li Xiang , Jiang Hong-yang , Zhao Yong-jie , Liu Si-zhuo , Pan Ling-xiao 
Published: February 2024

Abstract
Background
Anemia is a common complication of total hip arthroplasty (THA). In this study, we evaluated the preoperative risk factors for postoperative anemia after THA and developed a nomogram model based on related preoperative and intraoperative factors.

Methods
From January 2020 to May 2023, 927 THA patients at the same medical center were randomly assigned to either the training or validation cohort. The correlation between preoperative and intraoperative risk factors and postoperative anemia after THA was evaluated using univariate and multivariate logistic regression analysis. A nomogram was developed using these predictive variables. The effectiveness and validation for the clinical application of this nomogram were evaluated using the concordance index (C-index), receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).

Results
Through univariate and multivariate logistic regression analysis, 7 independent predictive factors were identified in the training cohort: Lower body mass index (BMI), extended operation time, greater intraoperative bleeding, lower preoperative hemoglobin level, abnormally high preoperative serum amyloid A (SAA) level, history of cerebrovascular disease, and history of osteoporosis. The C-index of the model was 0.871, while the AUC indices for the training and validation cohorts were 84.4% and 87.1%, respectively. In addition, the calibration curves of both cohorts showed excellent consistency between the observed and predicted probabilities. The DCA curves of the training and validation cohorts were high, indicating the high clinical applicability of the model.

Conclusions
Lower BMI, extended operation time, increased intraoperative bleeding, reduced preoperative hemoglobin level, elevated preoperative SAA level, history of cerebrovascular disease, and history of osteoporosis were seven independent preoperative risk factors associated with postoperative anemia after THA. The nomogram developed could aid in predicting postoperative anemia, facilitating advanced preparation, and enhancing blood management. Furthermore, the nomogram could assist clinicians in identifying patients most at risk for postoperative anemia.
Construction and validation of a predictive model of invasive adenocarcinoma in pure ground-glass nodules less than 2 cm in diameter
Authors: Xue Mengchao , Li Rongyang , Wang Kun , Liu Wen , Liu Junjie , Li Zhenyi , Chen Guanqing , Zhang Huiying , Tian Hui 
Published: February 2024

Abstract
Objectives
In this study, we aimed to develop a multiparameter prediction model to improve the diagnostic accuracy of invasive adenocarcinoma in pulmonary pure glass nodules.

Method
We included patients with pulmonary pure glass nodules who underwent lung resection and had a clear pathology between January 2020 and January 2022 at the Qilu Hospital of Shandong University. We collected data on the clinical characteristics of the patients as well as their preoperative biomarker results and computed tomography features. Thereafter, we performed univariate and multivariate logistic regression analyses to identify independent risk factors, which were then used to develop a prediction model and nomogram. We then evaluated the recognition ability of the model via receiver operating characteristic (ROC) curve analysis and assessed its calibration ability using the Hosmer-Lemeshow test and calibration curves. Further, to assess the clinical utility of the nomogram, we performed decision curve analysis.

Result
We included 563 patients, comprising 174 and 389 cases of invasive and non-invasive adenocarcinoma, respectively, and identified seven independent risk factors, namely, maximum tumor diameter, age, serum amyloid level, pleural effusion sign, bronchial sign, tumor location, and lobulation. The area under the ROC curve was 0.839 (95% CI: 0.798–0.879) for the training cohort and 0.782 (95% CI: 0.706–0.858) for the validation cohort, indicating a relatively high predictive accuracy for the nomogram. Calibration curves for the prediction model also showed good calibration for both cohorts, and decision curve analysis showed that the clinical prediction model has clinical utility.

Conclusion
The novel nomogram thus constructed for identifying invasive adenocarcinoma in patients with isolated pulmonary pure glass nodules exhibited excellent discriminatory power, calibration capacity, and clinical utility.
How can technology be used to support communication in palliative care beyond the covid-19 pandemic: a mixed-methods national survey of palliative care healthcare professionals
Authors: Stanley Sarah , Finucane Anne , Thompson Anthony , Nwosu Amara Callistus 
Published: February 2024

Abstract
Background
Developments in digital health have the potential to create new opportunities for healthcare professionals support delivery of palliative care. Globally, many palliative care professionals used digital health innovations to support communication with staff, patients and caregivers, during COVID-19 pandemic. However, there is limited data about the views of palliative care professionals of using digital health to support communication during the pandemic. We aimed to describe how palliative care professionals used technology to support communication (multidisciplinary team working, education and with patients and family caregivers) during the COVID-19 pandemic.

Method(s)
UK based palliative care healthcare professionals completed an electronic questionnaire to describe their use of digital health, during the COVID-19 pandemic, to support (1) communication within the multidisciplinary team (MDT), (2) education and (3) to support communication with patients and carers.

Results
Two hundred and thirty-four palliative care professionals participated. Most (n = 227, 97%) described an increase in their use of digital health, to support communication, since the start of the COVID-19 pandemic. We identified benefits and challenges for digital health communication, which we summarised into themes, including ‘a new way of working’, ‘developing a new approach to learning’ and ‘impacting care’.

Conclusion(s)
Since the pandemic, palliative care professionals have increased their use of digital health to support communication in clinical practice. We have identified facilitators and barriers for future practice. Further work should identify the levels of support needed for organisations to ensure that digital health interventions are meaningfully used to help palliative care professionals effectively communicate with patients, caregivers and staff.
Exploring challenges and perceptions in the learning environment: an online qualitative study of medical students
Authors: Almansour Mohammed , Almoayad Fatmah 
Published: February 2024

Abstract
Background
The teaching and learning environment (TLE) in medical schools is critical for shaping the outcomes and competencies of graduates. Research on TLE has highlighted its influence on student learning approaches and outcomes, yet gaps remain, particularly in qualitative insights, especially in Saudi Arabian contexts. This study aims to explore the students’ experiences and perceptions of the TLE in a new medical college.

Methods
This qualitative study consisted of a total of five focus group discussions (3consequtive sessions for male group and two for female group) conducted virtually using the Zoom videoconferencing application. All the discussion sessions took place during a lockdown because of the COVID-19 pandemic between December 2020 and February 2021. Each session lasted for 45–60 min. Each group was formed of 4–5 students from different academic levels in the Majmaah medical school, which was established 10 years ago and is located in a small city. After “verbatim transcription” of the sessions was made, a framework thematic analysis of the data was performed using the NVivo software.

Results
The study results revealed that various elements, such as educational content, faculty roles, and personal factors, collectively influenced the students’ educational experiences. The students valued educational relevance and autonomous decision-making. The multifunctional role of faculty as mentors, evaluators, and resource providers was considered essential in enhancing academic experiences. Additionally, there was an evident need to improve the physical learning environment and facilities to adapt to emerging educational needs. These results align with existing literature, emphasizing the integration of theory and practice and the significant impact of faculty roles in academic experiences.

Conclusion
The findings suggest that medical colleges should involve students more in decision-making related to their education and ensure the practical relevance of the educational content. Establishing open communication channels between students and faculty who act as mentors and evaluators is also essential. Furthermore, enhancing supportive infrastructures, such as mental health and financial services, and promoting extracurricular activities are crucial for fostering a more effective and nurturing learning environment.
Impact of a complex health services intervention in long-term care nursing homes on 3-year overall survival: results from the CoCare study
Authors: Kaier Klaus , Brühmann Boris A. , Fetzer Stefan , von der Warth Rieka , Farin-Glattacker Erik 
Published: February 2024

Abstract
Background
The Coordinated medical Care (CoCare) project aimed to improve the quality of medical care in nursing homes by optimizing collaboration between nurses and physicians. We analyze the impact of the CoCare intervention on overall survival.

Methods
The effect of time-varying treatment on 3-year overall survival was analyzed with treatment as time-varying covariate within the entire cohort. To reduce bias due to non-random assignment to treatment groups, regression adjustment was applied. Therefore, age, sex, and level of care were used as potential confounders.

Results
The study population consisted of 8,893 nursing home residents (NHRs), of which 1,330 participated in the CoCare intervention. The three-year overall survival was 49.8% in the entire cohort. NHRs receiving the intervention were associated with a higher survival probability compared to NHRs of the control group. In a univariable cox model with time-dependent treatment, the intervention was associated with a hazard ratio of 0.70 [95%CI 0.56–0.87, p = 0.002]. After adjustment for age, sex and level of care, the hazard ratio increased to 0.82 but was still significant [95%CI 0.71–0.96, p = 0.011].

Conclusion
The analysis shows that optimizing collaboration between nurses and physicians leads to better survival of NHRs in Germany. This adds to the already published favorable cost-benefit ratio of the CoCare intervention and shows that a routine implementation of optimized collaboration between nurses and physicians is highly recommended.
Citizens’ perspectives on relocating care: a scoping review
Authors: Damen L. J. , Van Tuyl L. H. D. , Korevaar J. C. , Knottnerus B. J. , De Jong J. D. 
Published: February 2024

Abstract
Background
Healthcare systems around the world are facing large challenges. There are increasing demands and costs while at the same time a diminishing health workforce. Without reform, healthcare systems are unsustainable. Relocating care, for example, from hospitals to sites closer to patients’ homes, is expected to make a key contribution to keeping healthcare sustainable. Given the significant impact of this initiative on citizens, we conducted a scoping review to provide insight into the factors that influence citizens’ attitudes towards relocating care.

Method
A scoping review was conducted. The search was performed in the following databases: Pubmed, Embase, Cinahl, and Scopus. Articles had to include relocating healthcare and citizens’ perspectives on this topic and the articles had to be about a European country with a strong primary care system. After applying the inclusion and exclusion criteria, 70 articles remained.

Results
Factors positively influencing citizens’ attitudes towards relocating care included: convenience, familiarity, accessibility, patients having more control over their disease, and privacy. Factors influencing negative attitudes included: concerns about the quality of care, familiarity, the lack of physical examination, contact with others, convenience, and privacy. Furthermore, in general, most citizens preferred to relocate care in the studies we found, especially from the hospital to care provided at home.

Conclusion
Several factors influencing the attitude of citizens towards relocating care were found. These factors are very important when determining citizens’ preferences for the location of their healthcare. The majority of studies in this review reported that citizens are in favour of relocating care. In general citizens’ perspectives on relocating care are very often missing in articles. It was significant that very few studies on relocation from the hospital to the general practitioner were identified.
The effectiveness of Bio-plus2B®, Techno Mos® and their mixture on the rate of egg production, egg characteristics, retention of nutrients and blood metabolites through the early period of production
Authors: Salem Fayza M. , El-Dayem A. A. Abd 
Published: February 2024

Abstract
Background
The trend of using probiotic, prebiotic and their mixture as alternative feed additives which works as growth promoters in poultry diets to increase the productive performance and the immunity of the flock still have an importance consideration. So that the aim of this study is to estimate the impact of Bio-plus2B® (probiotic), Techno Mos® (prebiotic) or their mixture (synbiotic) on egg production, egg and shell quality, some blood metabolites and retention of nutrients between 28 and 40 weeks of age. The hens (ISA brown laying) were allocated randomly in 40 cages; 10 cages/treatment with two hens each. The treatments were the control (T1), T2 (Probiotic: 1 g Bio-plus2B® (Bacillus licheniformis plus Bacillus subtilis)/kg feed), T3 (Prebiotic: 1 g Techno Mos® (Mannanoligosaccarides (MOS) and 1,3 B-glucan) /kg feed) and T4 (Synbiotic: 1 g Bio-plus2B® plus 1 g Techno Mos®/ kg feed).

Results
Hen-day egg production% and mass were significantly increased (P < 0.05) with T2 and T4 treatments. The experimental treatments recorded an increase in albumen index, Haugh unit (P < 0.01), shell thickness (P < 0.05), the retention of crude protein (CP), crude fiber (CF) and ether extract (EE) (P < 0.05), plasma globulin, albumin and total protein (P < 0.001) versus to the untreated group, while egg weight was not affected. Synbiotic treatment showed a significant (P < 0.001) increase in shell calcium content. T3 and T4 treatments were significantly decreased plasma cholesterol (P < 0.001) and low density lipoprotein (LDL) (P < 0.05). Alanine transaminase (ALT) was significantly (P < 0.001) decreased and estradiol hormone was increased (P < 0.001) in the experimental groups versus to the control.

Conclusions
It concluded that adding probiotic and/or prebiotic in the early age laying hens diets had beneficial effects for productivity with improving the egg shell thickness.
The recombinant l-lysine α-oxidase from the fungus Trichoderma harzianum promotes apoptosis and necrosis of leukemia CD34 + hematopoietic cells
Authors: Costa Mariana do Nascimento , Silva Thiago Aparecido , Guimarães Dimitrius Santiago Passos Simões Fr , Ricci-Azevedo Rafael , Teixeira Felipe Roberti , Silveira Leonardo Reis , Gomes Marcelo Damário , Faça Vítor Marcel , de Oliveira Eduardo Brandt , Calado Rodrigo T. , Silva Roberto N. 
Published: February 2024

Abstract
Background
In hematologic cancers, including leukemia, cells depend on amino acids for rapid growth. Anti-metabolites that prevent their synthesis or promote their degradation are considered potential cancer treatment agents. Amino acid deprivation triggers proliferation inhibition, autophagy, and programmed cell death. l-lysine, an essential amino acid, is required for tumor growth and has been investigated for its potential as a target for cancer treatment. l-lysine α-oxidase, a flavoenzyme that degrades l-lysine, has been studied for its ability to induce apoptosis and prevent cancer cell proliferation. In this study, we describe the use of l-lysine α-oxidase (LO) from the filamentous fungus Trichoderma harzianum for cancer treatment.

Results
The study identified and characterized a novel LO from T. harzianum and demonstrated that the recombinant protein (rLO) has potent and selective cytotoxic effects on leukemic cells by triggering the apoptotic cascade through mitochondrial dysfunction.

Conclusions
The results support future translational studies using the recombinant LO as a potential drug for the treatment of leukemia.