bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in Attitudes and Barriers Towards Advance Care Planning Amongst Ischemic Heart Disease Patients: A Cross-Sectional Study
Authors: Ng Alyssa , Khoo Athena Ming-Gui , Lau Jerrald , Ang Chermaine , Sim Hui-Wen , Tan Ker-Kan 
Published: February 2024

Objectives Perceptions towards advanced care planning (ACP) amongst individuals with Ischemic Heart Disease before or after a life-threatening Acute Myocardial Infarction event is underexamined and could impact the appropriate timing for ACP advocacy. This cross-sectional study assessed awareness and intentions regarding ACP in individuals with Ischemic Heart Disease, both before and after an Acute Myocardial Infarction, and explored the motivating effect of a near-fatal Acute Myocardial Infarction event on its engagement. Methods This study was conducted from 24 August 2021 through 13 March 2023, whereby patients were administered a one-time questionnaire with no follow-up required. Patients with either chronic Ischemic Heart Disease (group A) or a recent Acute Myocardial Infarction event (group B) were recruited from the outpatient National University Heart Centre, Singapore. Results 101 patients (n = 51 for Group A, n = 50 for Group B) were recruited. Mean age (SD) was 59 (10.5) years and 84 were male (83.2%). Between both groups, patients in group B reported significantly higher scores on ‘Lack of information’ and ‘Self-efficacy’ domains, and had no ACP awareness nor plans of doing an ACP compared to group A. ACP awareness was the sole significant predictor of intentions of doing an ACP in the final regression model ( P < .05). Conclusions Interestingly, this study suggests that surviving a potentially life-threatening heart condition did not result in higher intention of doing an ACP. Thus, advocacy of ACP in the community should simply start by raising awareness levels widely and may not need to be focused on individuals’ state of health.
ADHD and Anxiety Symptoms: Does Construct or Assessment Type Matter More?
Authors: Bucherbeam Thea R. , Lovett Benjamin J. , Harrison Allyson G. 
Published: February 2024

Objective: This study examined the relationships between self-reported ADHD symptoms, self-reported anxiety, and continuous performance test (CPT) performance. Method: 128 postsecondary students referred for clinical evaluation for possible ADHD and related conditions completed the Conners Adult ADHD Rating Scale, the Behavior Assessment Scale for Children, Third Edition, and either of two CPTs. Results: Multiple regression models found that when self-reported anxiety and CPT performance were used to simultaneously predict self-reported ADHD symptoms, CPT performance was not a significant predictor, whereas self-reported anxiety was. This finding was replicated across two different subsamples that took different CPTs. Conclusion: Self-reported anxiety and ADHD symptoms are strongly related, but neither of these variables is significantly related to CPT performance. Implications for clinical practice and future research are discussed.
Communicating About Precision Transplantation Tools
Authors: Murdoch Blake , Sapir-Pichhadze Ruth , de Chickera Sonali Natasha , Caulfield Timothy 
Published: February 2024

Purpose of review: Precision tools that ensure molecular compatibility can help prevent rejection and improve kidney transplantation outcomes. However, these tools will generate controversy because they are perceived to and can in fact impact equity in the ethics of allocation. They may also affect the extent to which physicians can advocate for their patient fiduciaries, as generally required by Canadian professional ethics and law. Sources of information: Electronic databases such as Google Scholar and PubMed were searched for peer-reviewed literature, and Google search engine was used to identify the news articles, jurisprudence, legal information, and other relevant websites cited. Methods: We discuss controversies precision transplantation tools will likely generate, consider what challenges will arise from their implementation, and provide recommendations of avenues and content for communication to address these issues. Key findings: Communication about the translation of new precision tools will be challenging as media portrayals of transplantation often focus on individual narratives about access to transplantation and fail to center the issues of utility, allocation, and rejection. Incomplete portrayals of this nature will need to be countered with explanations of how new precision tools can be of net benefit when implemented equitably, as maintaining trust in the donation and transplantation system is key. Limitations: Our manuscript focuses on precision medicine applications pertaining to the implementation of molecular compatibility in transplantation. Distinct communication content and avenues may need to be considered in other contexts. Implications: Clear, accurate, and strategic communication is key to managing translation of precision medicine tools. For this purpose, we provide detailed recommendations for stakeholder engagement, content, and avenues for communicating about precision transplantation tools.
The Influence of Comminution and Posterior Ligamentous Complex Integrity on Treatment Decision Making in Thoracolumbar Burst Fractures Without Neurologic Deficit?
Authors: Aly Mohamed M. , Dandurand Charlotte , Dvorak Marcel F. , Öner Cumhur F. , Schnake Klaus , Mujis Sanders , Benneker Lorin M. , Vialle Emiliano , Rajasekaran Shanmuganathan , El-Skarkawi Mohammad , Kanna Rishi M. , Holas Martin , Popescu Eugen Cezar , Tee Jin W. , Camino-Willhuber Gaston , Joaquim Andrei Fernandes , Kenyan Ory , Chhabra Harvinder Singh , Bigdon Sebastian , Spiegel Ulrich , Schroeder Gregory D. , Canseco Jose A. , Vaccaro Alexander R. , Bransford Richard J. 
Published: February 2024

Study Design A prospective study. Objective to evaluate the impact of vertebral body comminution and Posterior Ligamentous Complex (PLC) integrity on the treatment recommendations of thoracolumbar fractures among an expert panel of 22 spine surgeons. Methods A review of 183 prospectively collected thoracolumbar burst fracture computed tomography (CT) scans by an expert panel of 22 trauma spine surgeons to assess vertebral body comminution and PLC integrity. This study is a sub-study of a prospective observational study of thoracolumbar burst fractures (Spine TL A3/A4). Each expert was asked to grade the degree of comminution and certainty about the PLC disruption from 0 to 100, with 0 representing the intact vertebral body or intact PLC and 100 representing complete comminution or complete PLC disruption, respectively. Results ≥45% comminution had a 74% chance of having surgery recommended, while <25% comminution had an 86.3% chance of non-surgical treatment. A comminution from 25 to 45% had a 57% chance of non-surgical management. ≥55% PLC injury certainity had a 97% chance of having surgery, and ≥45-55% PLC injury certainty had a 65%. <20% PLC injury had a 64% chance of having non-operative treatment. A 20 to 45% PLC injury certainity had a 56% chance of non-surgical management. There was fair inter-rater agreement on the degree of comminution (ICC .57 [95% CI 0.52-.63]) and the PLC integrity (ICC .42 [95% CI 0.37-.48]). Conclusion The study concludes that vetebral comminution and PLC integrity are major dterminant in decision making of thoracolumbar fractures without neurological deficit. However, more objective, reliable, and accurate methods of assessment of these variables are warranted.
Robot-Assisted Lumbar Pedicle Screw Placement Based on 3D Magnetic Resonance Imaging
Authors: Altorfer Franziska C. S. , Burkhard Marco D. , Kelly Michael J. , Avrumova Fedan , Sneag Darryl B. , Chazen J. Levi , Tan Ek T. , Lebl Darren R. 
Published: February 2024

Study Design Human Cadaveric Study. Objective This study aims to explore the feasibility of using preoperative magnetic resonance imaging (MRI), zero-time-echo (ZTE) and spoiled gradient echo (SPGR), as source data for robotic-assisted spine surgery and assess the accuracy of pedicle screws. Methods Zero-time-echo and SPGR MRI scans were conducted on a human cadaver. These images were manually post-processed, producing a computed tomography (CT)-like contrast. The Mazor X robot was used for lumbar pedicle screw-place navigating of MRI. The cadaver underwent a postoperative CT scan to determine the actual position of the navigated screws. Results Ten lumbar pedicle screws were robotically navigated of MRI (4 ZTE; 6 SPGR). All MR-navigated screws were graded A on the Gertzbein-Robbins scale. Comparing preoperative robotic planning to postoperative CT scan trajectories: The screws showed a median deviation of overall 0.25 mm (0.0; 1.3), in the axial plane 0.27 mm (0.0; 1.3), and in the sagittal plane 0.24 mm (0.0; 0.7). Conclusion This study demonstrates the first successful registration of MRI sequences, ZTE and SPGR, in robotic spine surgery here used for intraoperative navigation of lumbar pedicle screws achieving sufficient accuracy, showcasing potential progress toward radiation-free spine surgery.
Step-by-Step Stereotactic Radiotherapy Planning of Liver Metastasis: A Radiation Oncology from Simulation to Execution (ROSE) Guide
Authors: Patro Kanhu Charan , Avinash Ajitesh , Boya Rakesh Reddy , Bhattacharya Partha Sarathi , Pilaka Venkata Krishna Reddy , Muvvala Mrutyunjayarao , Kumar Ayyalasomayajula Anil , Aketi Srinu , Kaliyappan Senthilnatham , Radhakrishnan Kaviya Lakshmi , Madasu Bhargava Krishna 
Published: February 2024

Background Stereotactic body radiotherapy (SBRT) is an important treatment modality in liver metastasis in which surgery is not feasible or when the patient denies surgery. With the recent advances in treatment planning systems and real-time image-guided treatment delivery, we can now deliver high doses of radiation in a small number of fractions to the target with high precision and minimal dose to the organs at risk (OARs). Objective To describe the procedural steps for radiation planning of SBRT of Liver Metastasis. Methods The step-by-step procedure for stereotactic planning of liver metastasis has been described using a clinical scenario of liver metastasis. Results The stereotactic radiation planning of liver metastasis starts with the basic history and relevant clinical evaluation followed by tissue confirmation of the diagnosis of liver metastasis. The SBRT planning for liver metastasis starts with the positioning of the patient using a body immobilization device. This is followed by the use of any of the motion management techniques during the computed tomography (CT) simulation. Magnetic resonance imaging (MRI) of the abdomen should be done in the prescribed format to achieve uniformity in radiation planning. After CT and MRI image fusion, contouring of the target, OARs, and radiation planning should be done. The plan evaluation includes target and OAR coverage index, conformity, homogeneity gradient index, and beam arrangement. After radiation plan evaluation, quality assurance and dry run are done. Then treatment is delivered using the same motion management technique that was used during the CT simulation. Conclusion The article highlights the sequential process of radiation planning for SBRT in liver metastasis―starting from simulation, planning, evaluation of plan, and treatment
Tibial Supra-Tubercular Deflexion Osteotomy During Revision Anterior Cruciate Ligament Reconstruction
Authors: Moran Thomas E. , Klosterman Emma L. , Tagliero Adam J. , Goodloe J. Brett , Miller Mark D. 
Published: February 2024

Background: A deflexion osteotomy may reduce anterior translational forces imparted upon an anterior cruciate ligament (ACL) reconstruction (ACL-R) graft, thereby reducing risk of ACL graft failure in patients with excessive congenital posterior tibial slope. Indications: A 13-year-old female competitive soccer player with 13.7° of posterior tibial slope presented with failure of a prior ACL-R. Technique Description: A vertical incision is made along the medial border of the patellar tendon and the proximal tibia is exposed. The planned osteotomy is templated under fluoroscopic guidance by placement of 2.4-mm Steinmann pins. A supra-tubercular deflexion osteotomy is made with a sagittal saw and osteotomes, with care to maintain the posterior cortical hinge. Compression staples are utilized for fixation of the osteotomy site. Revision ACL-R is then performed. Results: There were no immediate complications following surgery. Surgical management led to radiographic improvement of the patient's posterior tibial slope and clinical resolution of anterior translational knee instability. Discussion/Conclusion: The senior author's preferred technique for a tibial supra-tubercular deflexion osteotomy in association with a revision ACL-R is presented. A deflexion osteotomy is a surgical option for patients with excessive (>12°) posterior tibial slope in the setting of a prior failed ACL-R. This case demonstrates the efficacy of a tibial supra-tubercular deflexion osteotomy in the revision ACL-R setting by reducing posterior tibial slope, thereby lessening anterior translational forces on the ACL graft in a patient at high risk of graft failure. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Correlation Between Fetal Umbilical Artery and Middle Cerebral Artery Doppler Indices in Preeclamptic and Normotensive Pregnancies
Authors: Rose Sybil , Farooq Syed Muhammad Yousaf , Fatima Mehreen , Gilani Syed Amir , Shams Rana Athar , Ramzan Iqra 
Published: February 2024

Objective: To assess the correlation between fetal umbilical artery (UA) and middle cerebral artery (MCA) Doppler indices in a cohort of preeclamptic and normotensive pregnancies. Materials and Methods: This cross-sectional analytical study recruited 70 pregnant women (28–40 weeks of gestation) using a non-probability convenient technique. The study included 33 patients with preeclampsia and 37 normotensive participants. Results: In the normotensive group, a significant ( P = .00) strong correlation ( r = 0.72) was observed between UA velocity, systolic/diastolic (S/D) ratio, and pulsatility index (PI), and MCA velocity; a significant ( P = .00) correlation ( r = 0.56) between UA, S/D ratio, and the MCA resistive index (RI); a significant ( P = .00) moderate correlation ( r = 0.66) between S/D ratio, UA velocity, and MCA velocity; a significant ( P = .00) negative correlation ( r = −0.50) between UA velocity, RI, and MCA PI; a significant ( P = .01) negative correlation ( r = −0.44) between UA velocity, RI, and MCA S/D ratio. In contrast, in the preeclamptic group, we observed a substantial ( P = .01) moderate correlation ( r = 0.43) between UA, PI, and MCA velocity; a significant ( P = .04) correlation ( r = 0.368) between UA, RI, and MCA PI; a significant ( P = .05) moderate correlation ( r = 0.35) between UA, PI, and MCA RI; a significant ( P = .00) strong correlation ( r = 0.83) between UA S/D ratio UA and MCA velocity. Conclusion: This study suggests potential diagnostic value in Doppler measurements for assessing preeclampsia-related vascular changes. However, caution is warranted owing to a split sample and limited statistical power, necessitating further research for validation.
Impact of folic acid supplementation on ischemia‒reperfusion-induced kidney injury in rats: folic acid prophylactic role revisited
Authors: Hamed Aya E. H. , Khedr Sherif , Ghonamy Elsayed , Mahmoud Faten A. , Ahmed Mona A. 
Published: February 2024

AbstractFolic acid (FA), with its anti-inflammatory and antioxidant properties, may offer protection against ischemia–reperfusion (IR) injury. This study investigated whether FA safeguards rat kidneys from IR by targeting high mobility group box-1 (HMGB1), a key inflammatory mediator. Fifty adult male Wistar rats were randomly allocated into four groups: control, IR, IR + FA pretreatment, and FA alone. Compared to controls, IR significantly impaired renal function and elevated levels of malondialdehyde, HMGB1, NF-κB, and caspase 3. FA pretreatment effectively reversed these detrimental changes, protecting renal function and minimizing tissue damage. The FA-alone group showed no significant differences compared to the control group, indicating no adverse effects of FA treatment. Mechanistically, FA inhibited HMGB1 expression and its downstream activation of NF-κB and caspase 3, thereby quelling inflammation and cell death. FA shields rat kidneys from IR-induced injury by suppressing HMGB1-mediated inflammation and apoptosis, suggesting a potential therapeutic avenue for IR-associated kidney damage.
Enabling personalised disease diagnosis by combining a patient’s time-specific gene expression profile with a biomedical knowledge base
Authors: Verma Ghanshyam , Rebholz-Schuhmann Dietrich , Madden Michael G. 
Published: February 2024

Abstract
Background
Recent developments in the domain of biomedical knowledge bases (KBs) open up new ways to exploit biomedical knowledge that is available in the form of KBs. Significant work has been done in the direction of biomedical KB creation and KB completion, specifically, those having gene-disease associations and other related entities. However, the use of such biomedical KBs in combination with patients’ temporal clinical data still largely remains unexplored, but has the potential to immensely benefit medical diagnostic decision support systems.

Results
We propose two new algorithms, LOADDx and SCADDx, to combine a patient’s gene expression data with gene-disease association and other related information available in the form of a KB, to assist personalized disease diagnosis. We have tested both of the algorithms on two KBs and on four real-world gene expression datasets of respiratory viral infection caused by Influenza-like viruses of 19 subtypes. We also compare the performance of proposed algorithms with that of five existing state-of-the-art machine learning algorithms (k-NN, Random Forest, XGBoost, Linear SVM, and SVM with RBF Kernel) using two validation approaches: LOOCV and a single internal validation set. Both SCADDx and LOADDx outperform the existing algorithms when evaluated with both validation approaches. SCADDx is able to detect infections with up to 100% accuracy in the cases of Datasets 2 and 3. Overall, SCADDx and LOADDx are able to detect an infection within 72 h of infection with 91.38% and 92.66% average accuracy respectively considering all four datasets, whereas XGBoost, which performed best among the existing machine learning algorithms, can detect the infection with only 86.43% accuracy on an average.

Conclusions
We demonstrate how our novel idea of using the most and least differentially expressed genes in combination with a KB can enable identification of the diseases that a patient is most likely to have at a particular time, from a KB with thousands of diseases. Moreover, the proposed algorithms can provide a short ranked list of the most likely diseases for each patient along with their most affected genes, and other entities linked with them in the KB, which can support health care professionals in their decision-making.
Maternal sepsis and factors associated with poor maternal outcomes in a tertiary hospital in Tigray, Ethiopia: a retrospective chart review
Authors: Abera Bisrat Tesfay , Teka Hale , Gebre Daniel , Gebremariam Tsega , Berhe Ephrem , Gidey Hagos , Amare Birhane , Kidanemariam Rahel , Gebru Marta Abrha , Tesfay Fireweyni , Zelelow Yibrah Berhe , Yemane Awol , Gebru Fanus , Tekle Ashenafi , Tadesse Habtom , Yahya Mohammedtahir , Tadesse Ytbarek , Abraha Hiluf Ebuy , Alemayehu Mussie , Ebrahim Mohamedawel Mohamedniguss 
Published: February 2024

Abstract
Background
Maternal sepsis is the third leading cause of maternal death in the world. Women in resource-limited countries shoulder most of the burdens related to sepsis. Despite the growing risk associated with maternal sepsis, there are limited studies that have tried to assess the impact of maternal sepsis in resource-limited countries. The current study determined the outcomes of maternal sepsis and factors associated with having poor maternal outcomes.

Methods
A facility-based retrospective cross-sectional study design was employed to assess the clinical presentation, maternal outcomes, and factors associated with maternal sepsis. The study was conducted in Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia, from January 1, 2017, to December 31, 2021. Sociodemographic characteristics, clinical characteristics and outcomes of women with maternal sepsis were analyzed using a descriptive statistic. The association between dependent and independent variables was determined using multivariate logistic regression.

Results
Among 27,350 live births, 298 mothers developed sepsis, giving a rate of 109 maternal sepsis for every 10,000 live births. There were 22 maternal deaths, giving rise to a case fatality rate of 7.4% and a maternal mortality ratio of 75 per 100,000 live births. Admission to the intensive care unit and use of mechanical ventilator were observed in 23.5% and 14.1% of the study participants, respectively. A fourth (24.2%) of the mothers were complicated with septic shock. Overall, 24.2% of women with maternal sepsis had severe maternal outcomes (SMO). Prolonged hospital stay, having parity of two and above, having the lung as the focus of infection, switchof antibiotics, and developing septic shock were significantly associated with SMO.

Conclusions
This study revealed that maternal sepsis continues to cause significant morbidity and mortality in resource-limited settings; with a significant number of women experiencing death, intensive care unit admission, and intubation attributable to sepsis. The unavailability of recommended diagnostic modalities and management options has led to the grave outcomes observed in this study. To ward off the effects of infection during pregnancy, labor and postpartum period and to prevent progression to sepsis and septic shock in low-income countries, we recommend that concerted and meticulous efforts should be applied to build the diagnostic capacity of health facilities, to have effective infection prevention and control practice, and to avail recommended diagnostic and management options.