bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pancreatic cysts: can surveillance interval for small low-risk lesions be lengthened?
Authors: Chong Jingli , Wee Nicole Kessa , Tan Cher Heng , Low Hsien Min , Chew Wei Da , Vu Charles Kien Fong , Lee Chau Hung 
Published: January 2024

Background Surveillance of pancreatic cysts are necessary due to risk of malignant transformation. However, reported progression rates to advanced neoplasia are variable and the high frequency of surveillance scans may pose a considerable burden on healthcare resources. Purpose To validate the effectiveness of the Fukuoka Guidelines surveillance regime and determine if a longer surveillance interval can be established. Material and Methods All magnetic resonance imaging (MRI) studies of the pancreas performed at our institution between January 2014 and December 2016 with at least one pancreatic cystic lesion and follow-up MRI or computed tomography (CT) over at least two years were reviewed for size, worrisome feature (WF), and high-risk stigmata (HRS) at diagnosis and follow-up imaging (up to year 6). Reference standards for advanced neoplasia were based on endoscopic ultrasound, fine needle aspiration cytology, or the presence of ≥2 WF or ≥1 HRS on imaging. Comparison of MRI features of progression and outcomes of diagnostic endpoints between lesions <20 mm and ≥20 mm was performed. Results A total of 270 patients were included (201 cysts <20 mm, 69 cysts ≥20 mm). Compared with cysts <20 mm, cysts ≥20 mm were more likely to be associated with WF or HRS (40.6% vs. 12.4%; P ≤0.00001), demonstrate increase in size of ≥5 mm in two years (20.3% vs. 10.9%; P = 0.049), and develop advanced neoplasia (24.6% vs. 0.5%; P <0.00001). Conclusion Pancreatic cysts <20 mm have a low risk of developing WF and HRS and surveillance interval may be lengthened.
Intraoperative radiographic analysis and adjustment of the optimal position of plate in high tibial osteotomy
Authors: Zou Zihao , Wu Zhanyu , Yuan Daizhu , Xu Shunen , Yang Long , Ye Chuan 
Published: January 2024

Background When high tibial osteotomy is performed for genu varus deformity, it is not easy to determine the accurate placement of the plate. Purpose To determine a simple way to assess the position of the plate, to provide more effective mechanical support and to reduce the risk of implant rupture and vascular injury. Material and Methods Two human anatomical marks, the patellar ligament and semimembranosus, were connected and divided into four parts to identify points Ⅰ, Ⅱ, and Ⅲ. These points determined the areas for Tomofix placement: anterior, anterolateral, and lateral. Simulated internal fixation placed hole B of Tomofix at points Ⅰ (anterior), Ⅱ (anterolateral), and Ⅲ (lateral). We analyzed the pointing direction of the locking screws in Tomofix holes on MRI to assess potential injury risk to the popliteal neurovascular bundle. Results In the X-ray: holes B and C appeared as the plate in the anterior, only hole C appeared as the plate in the anterolateral, and none of the holes appeared as the plate in the lateral. In the general view of the sawbones, the screw pointed towards the popliteal neurovascular bundle when the plate was in the anterior. Conclusion If a small number of holes on the plate is visible under fluoroscopy, then several lateral positions of the plate can be obtained; the direction of the screw tunnel tends to deviate from the popliteal neurovascular bundle with the posterior position of the plate.
The hepatotoxicity of γ-radiation synthesized 5-fluorouracil nanogel versus 5-fluorouracil in rats model
Authors: Barakat Wael EM , Moawed Fatma SM , Ahmed Esraa SA , Abo-Zaid Omayma AR 
Published: January 2024

Introduction: The clinical use of 5-fluorouracil (5-FU), a routinely used chemotherapy medication, has a deleterious impact on the liver. Therefore, it is necessary to find a less harmful alternative to minimize liver damage. This study was designed to see how 5-fluorouracil nanogel influenced 5-FU-induced liver damage in rats. Methods: To induce liver damage, male albino rats were injected intraperitoneally with 5-FU (12.5 mg/kg) three doses/week for 1 month. The histopathological examination together with measuring the activities of serum alanine and aspartate aminotransferase enzymes (ALT and AST) were used to evaluate the severity of liver damage besides, hepatic oxidative stress and antioxidant markers were also measured. The hepatic gene expression of heme oxygenase-1 (HO-1), nuclear factor erythroid 2-related factor 2 (Nrf2) and its inhibitor Kelch-like ECH-associated protein-1(Keap-1) in addition to hepatic inflammatory mediators including tumor necrosis factor-α (TNF- α) and interleukins (IL-1β, IL-6) were detected. Results: 5-Fu nanogel effectively attenuated 5-FU-induced liver injury by improving the hepatic structure and function (ALT and AST) besides the suppression of the hepatic inflammatory mediators (TNF- α, IL-1β and IL-6). Additionally, 5-FU nanogel alleviated the impaired redox status and restored the antioxidant system via maintaining the cellular homeostasis Keap-1/Nrf2/HO-1 pathway. Conclusion: Consequently, 5-Fu nanogel exhibited lower liver toxicity compared to 5-FU, likely due to the alleviation of hepatic inflammation and the regulation of the cellular redox pathway.
Lupus nephritis and socioeconomic status: Findings from the Southern California lupus registry
Authors: Sandhu Vaneet K. , Haghshenas Arezoo , Teh Phildrich , He Emily , Benitez Abigail , Salto Lorena M , Torralba Karina 
Published: January 2024

Objective Lupus nephritis (LN) is a major cause of morbidity and mortality in systemic lupus erythematosus (SLE). Despite multiple studies addressing healthcare disparities, disparate outcomes in LN persist. We investigate herein the association between socioeconomic status (SES) and LN as well as the association between SES, SLE disease activity index (SLEDAI), and treatment response. Methods Patients were selected from the Southern California Lupus Registry (SCOLR), a registry enrolling all-comers with SLE. Analysis was completed on individuals with public vs. private insurance. Insurance and ethnicity were used as surrogate variables for SES, and we tested differences in means. Results After adjusting for age and sex, public insurance was independently associated with the prevalence of LN. Analysis of 35 patients revealed greater proteinuria and mean SLEDAI in patients with public insurance at baseline and 6 months. Baseline, 6-, and 12-month SLEDAI means were significantly lower in Asian/Pacific Islanders (PI) compared to others. While non-Hispanic Whites demonstrated mean SLEDAI improvement over 6 months, Asians/PI, Blacks, and Hispanics demonstrated worsened disease activity on average. Conclusion Low SES, when defined by insurance, is associated with greater adverse outcomes in SLE. This is the first regional study that compares differences in treatment response in LN patients with low SES as well as association of SES with long-term outcomes in SLE and LN in southern California.
Predicting oil content of Australian beauty leaf tree kernel samples using near infrared spectroscopy combined with chemometrics
Authors: Sreekumar Rahul , Ashwath Nanjappa , Cozzolino Daniel , Walsh Kerry 
Published: January 2024

This study was conducted to evaluate the ability of near infrared (NIR) spectroscopy to estimate oil content, and per cent of cake, resin and residue in beauty leaf tree ( Calophyllum inophyllum L.) kernel samples. Fruits were collected from various geographical locations of tropical Australia (from Rockhampton to Darwin) and air dried before the kernels were manually separated from the fruits. Kernel samples were oven dried, crushed (5–10 mm) and their NIR spectra collected using a Fourier transform (FT) NIR instrument where the same batch of kernels were used to extract oil using a screw press. Calibration models between the NIR spectra and reference data were developed using partial least squares (PLS) regression. The cross-validation statistics including the coefficient of determination (r2) and standard error in cross validation (SECV) were 0.83 (SECV: 2.39%) for oil content, 0.89 (SECV: 2.81%) for cake, 0.88 (SECV: 1.92%) for resin and 0.79 (SECV: 2.15%) for residue, respectively. This research showed that NIR spectroscopy can be used as an alternative, faster and low-cost technique to predict oil content, per cent of cake, resins and residues in various genotypes of beauty leaf tree. Further studies should be carried out to increase the sample size and chemical variation, as well as to evaluate different methods of oil extraction (e.g., solvent extraction) to improve the reliability of the calibration models.
The Effects of Physical Activity on Experimental Models of Vascular Dementia: A Systematic Review and Meta-Analysis
Authors: Biose Ifechukwude J. , Chastain Wesley H. , Solch-Ottaiano Rebecca J. , Grayson Viktoriya S. , Wang Hanyun , Banerjee Somdeb , Bix Gregory J. 
Published: January 2024

Background Physical activity is associated with improved brain health and cognition in humans. However, the validity, range, and quality of evidence for the beneficial outcomes linked to exercise in experimental models of vascular dementia (VaD) have not been evaluated. We performed a systematic review and meta-analysis of studies that assessed the effect of exercise intervention on models of VaD to provide an unbiased and comprehensive determination of the cognitive function and brain morphology benefits of exercise. Summary A systematic search in three databases as well as study design characteristics and experimental data extraction were completed in December 2021. We investigated the effects of exercise on cognitive function and brain-morphology outcomes in VaD models. Twenty-five studies were included for systematic review, while 21 studies were included in the meta-analysis. These studies included seven models of VaD in rats (60%, 15 studies), mice (36%, 9 studies), and pigs (4%, 1 study). None of the included studies used aged animals, and the majority of studies (80%) used only male animals. Key Message: Exercise improves cognition but increased neuro-inflammation in VaD models. Exercise improved cognitive function as well as some markers of brain morphology in models of VaD. However, exercise increased anxiety and neuro-inflammatory signals in VaD models. Further, we observed increased reporting anomalies such as a lack of blinding to group treatment or data analysis and randomization of animals to groups. Our report could help in the appropriate design of experimental studies seeking to investigate the effects of exercise as a non-pharmacological intervention on VaD models with a high translational impact.
Neuro Receptor Signal Detecting and Monitoring Smart Devices for Biological Changes in Cognitive Health Conditions
Authors: M Vivek Reddy , GNK Ganesh , D Rudhresh , T Vaishnavi Parimala , Rao Gaddam Narasimha 
Published: January 2024

Background Currently, wearable sensors significantly impact health care through continuous monitoring and event prediction. The types and clinical applications of wearable technology for the prevention of mental illnesses, as well as associated health authority rules, are covered in the current review. Summary The technologies behind wearable ECG monitors, biosensors, electronic skin patches, neural interfaces, retinal prosthesis, and smart contact lenses were discussed. We described how sensors will examine neuronal impulses using verified machine-learning algorithms running in real-time. These sensors will closely monitor body signals and demonstrate continuous sensing with wireless functionality. The wearable applications in the following medical fields were covered in our review: sleep, neurology, mental health, anxiety, depression, Parkinson’s disease, epilepsy, seizures, and schizophrenia. These mental health conditions can cause serious issues, even death. Inflammation brought on by mental health problems can worsen hypothalamic-pituitary-adrenal axis dysfunction and interfere with certain neuroregulatory systems such as the neural peptide Y, serotonergic, and cholinergic systems. Severe depressive disorder symptoms are correlated with elevated Interleukin (IL-6) levels. On the basis of previous and present data collected utilizing a variety of sensory modalities, researchers are currently investigating ways to identify or detect the current mental state. Key message This review explores the potential of various mental health monitoring technologies. The types and clinical uses of wearable technology, such as ECG monitors, biosensors, electronic skin patches, brain interfaces, retinal prostheses, and smart contact lenses, were covered in the current review will be beneficial for patients with mental health problems like Alzheimer, epilepsy, dementia. The sensors will closely monitor bodily signals with wireless functionality while using machine learning algorithms to analyse neural impulses in real time.
A Quality Improvement Initiative to Increase the Supply of Mother’s Own Milk for Preterm Newborn Admitted in Neonatal Intensive Care Unit of Bangabandhu Sheikh Mujib Medical University
Authors: Afreen Shazia , Nasrin Ummey Tamima , Rahman K.M. Mahbubur , Jahan Ismat , Dey Sanjoy Kumer , Shahidullah Mohammod , Chowdhury Rumpa Mani , Mannan Md Abdul 
Published: January 2024

Background Mother’s own milk for preterm infants is a complete nutrition. In NICUs, there is a delay in starting and decreased frequency of breast milk expression leading to inadequate supply of mother’s own milk for preterm babies. There is a lack of knowledge about the importance of mother’s own milk for preterm babies in the general population and a paucity of studies on this topic from Bangladesh. This quality improvement initiative will serve as a baseline study for increasing the use of mother’s own milk for preterm babies in our country. Objectives To observe the effects of the quality improvement initiative to increase the supply of mother’s own milk for preterm newborns admitted in the NICU. Methods This QI study was conducted in the Department of Neonatology, in collaboration with the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University, Dhaka, over the period of 1 year. Inborn Preterm neonates ≤34 weeks and/or ≤1800 gm and mother dyads, anticipated to stay in NICU for ≥ 7 days, were included in this study. In the observation phase, baseline data were collected. The intervention phase was started with a comprehensive counseling package, the demonstration of breast milk expression, and the early (within 6 h of delivery) and frequent (2 h) expression of breast milk. Results A total of 96 preterm newborns and mother dyads were enrolled. There was an improvement in the percentage of mothers expressing breast milk within 6 h of birth and on day 1 from 0% to 100% and from 14.5% to 100%, respectively, after implementing the QI initiative. The amount of expressed breast milk on days 1, 3, and 7 in the intervention group was higher than that of the observation group. The percentage of neonates receiving only mother’s own milk on day 1 was increased from 14.5% to 100% after giving intervention. Conclusion A significant improvement in early expression of breast milk, an increase in total amount of expressed breast milk, and an exclusive mother’s own milk feeding among the preterm neonates admitted in the NICU were observed.
Effect of Breast Milk Feeding on Retinopathy of Prematurity in Neonates Less than 1800 Grams: A Cohort
Authors: Goyal Kavya , Arya Sugandha , Guliani BP 
Published: January 2024

Introduction Human milk has many antioxidants like Docosahexaenoic acid (DHA), inositol, and vitamin E that combat oxidative stress deregulating VEGF which is implicated in the pathogenesis of retinopathy of prematurity (ROP). Thus, it is biologically plausible that human milk is protective towards ROP. Aim and objective The study aimed to find the association between ROP and breast milk feeding. Methodology The prospective cohort study was carried out for 18 months at the Newborn unit, SJH. In our study, mothers were asked to maintain a feeding diary (type of milk fed) and history was taken from the mother regularly. Each neonate was later assigned a feeding category including exclusively breast milk fed, more than 50% breast milk fed, more than 50% top milk-fed, and exclusively top milk fed. At four weeks of age, all these neonates were called to undergo screening for ROP. In the case of immature retina, neonates were followed up for repeat fundus exams and results were included in the study. Result A study on 521 neonates between birth weight of 1–1.8 kgs found that predominant breast milk feeding reduces the chance of any stage ROP (needing repeat screening or intervention). The total incidence of any stage ROP in this study was noted to be 16.2% where 4.1% of total neonates from the predominantly breastfed group as compared to 37.8% from the predominantly top-fed group developed any stage ROP. Conclusion Breast milk feeding has a significant benefit in reducing any stage ROP and ROP needing intervention, thus it has the potential to prevent a significant cause of childhood blindness. What is already known – Breast milk feeding may be protective towards ROP What the study adds – Breast milk feeding is independently protective towards ROP
Impact of Resilience on Nursing Students’ Perceptions of Stress, Anxiety, and Fear Associated with COVID-19 Pandemic
Authors: Vijayalakshmi P. , Kathyayani B. V. , Sreelatha M. , Reddy S. Sai Yathin , Manjunatha Narayana , Kumar C. Naveen , Math Suresh Bada 
Published: January 2024

Background: The COVID-19 pandemic had affected negatively the mental well-being of nursing students. However, limited research is currently available that explored mental health issues of nursing students. Aim: To investigate the impact of resilience on stress, anxiety, and fear of COVID-19 among the nursing students. Methods: A cross-sectional research design was adopted for this study. A total of 268 nursing students from three universities in South India. responded to an Online survey. Data was collected using self-reported questionnaires in June 2021. Results: The findings revealed that most of the students had a normal level of resilience (3.06 ± 0.39) and low levels of stress (17.885 ± 0.09). The mean scores on fear of COVID-19 (18.31 ± 5.68) and COVID-19 Anxiety Syndrome Scale (C-19ASS) (21.67 ± 7.42) suggest that around half of the participants had a high level of fear and anxiety. The resilience of the participants was negatively correlated with fear ( r = −260, p < .001) and perceived stress ( r = −0.307, p < .001). Similarly, fear was positively correlated with anxiety ( r = 0.211, p < .001) and perceived stress ( r = 0.418, p < .001). Conclusion: Our findings showed that nearly 50% of the nursing students had a high level of COVID-19 associated fear and anxiety. Therefore, we suggest that innovative strategies are needed to improve students’ resilience and mental health during highly stressful situations such as the COVID-19 pandemic.
Punnett Farms: Developing An Immersive Educational Game-Based Platform for Learning Genetics
Authors: Low Henry G.H. , Ellefson Marina 
Published: January 2024

Background Serious games (SGs) have emerged as promising tools for life science education, providing interactive learning experiences that bolster accessibility and engagement. In the context of genetics education, which emphasizes hands-on problem-solving, SGs offer a potential platform to augment learning. Aim This article presents the detailed design of a new educational SG, titled Punnett Farms, along with a pilot evaluation of the game. Designed to help students learn the fundamentals of Mendelian/molecular genetics, the game offers a colorful virtual world with embedded educational content aimed at cultivating interactive learning and engagement. Methods Development of Punnett Farms was guided by principles of educational game design models. The game was implemented in Unity and C#. A pilot study was conducted with community college students (n = 22) to assess the game’s strengths and areas for improvement. Pre-/post-intervention knowledge assessments, along with questionnaires inspired by the GEM and MEEGA+ frameworks, were used to obtain insights into participants’ interest, enjoyment, and short-term learning outcomes. Results Participants exhibited possible short-term knowledge gains after playing Punnett Farms, as reflected by improved quiz scores. In questionnaire responses, participants also reported improved content understanding, interest towards the subject, and overall enjoyment in learning genetics. Additionally, players rated the game highly for presentation and educational utility. Conclusion By integrating educational game design principles, Punnett Farms aims to provide an immersive environment that supports learning of essential Mendelian genetics topics. Results from the pilot study were positive, suggesting the game has potential to be a helpful resource for genetics learners. Future efforts will focus on continuing to improve and evaluate the game across different contexts.
Uncovering Patient and Caregiver Goals for Goal-Concordant Care in Kidney Therapy Decisions
Authors: Sampath Ramya , Seshadri Sandhya , Phan Tramanh , Allen Rebecca , Duberstein Paul R. , Saeed Fahad 
Published: January 2024

Context In kidney therapy (KT) decisions, goal-concordant decision-making is recognized to be important, yet alignment with patients' goals during dialysis initiation is not always achieved. Objectives To explore older patients’ and caregivers’ hopes, goals, and fears related to KT and communication of these elements with members of their health care team. Methods The study included patients aged ≥75 years with an estimated glomerular filtration rate ≤25 mL/min/1.73 m2 and their caregivers enrolled in a palliative care intervention for KT decision-making. Patients and caregivers were asked open-ended questions about their hopes, goals, and fears related to KT decisions. A survey assessed if patients shared their goals with members of their health care team. Qualitative data underwent content analysis, supplemented by demographic descriptive statistics. Results The mean age of patients (n = 26) was 82.7 (±5.7) years, and caregivers (n = 15) had a mean age of 66.4 (±13.7) years. Among the participants, 13 patients and 11 caregivers were women, and 20 patients and 12 caregivers were White. Four themes emerged: (1) Maintaining things as good as they are by avoiding dialysis-related burdens; (2) seeking longevity while avoiding dialysis; (3) avoiding pain, symptoms, and body disfigurement; and (4) deferring decision-making. Patients rarely had shared their goals with the key members of their health care team. Conclusion Patients and caregivers prioritize maintaining quality of life, deferring decision-making regarding dialysis, and avoiding dialysis-related burdens. These goals are often unshared with their family and health care teams. Given our aging population, urgent action is needed to educate clinicians to actively explore and engage with patient goals in KT decision-making.