bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improved prediction of sepsis-associated encephalopathy in intensive care unit sepsis patients with an innovative nomogram tool
Authors: Jin Jun , Yu Lei , Zhou Qingshan , Zeng Mian 
Published: February 2024

BackgroundSepsis-associated encephalopathy (SAE) occurs as a result of systemic inflammation caused by sepsis. It has been observed that the majority of sepsis patients experience SAE while being treated in the intensive care unit (ICU), and a significant number of survivors continue suffering from cognitive impairment even after recovering from the illness. The objective of this study was to create a predictive nomogram that could be used to identify SAE risk factors in patients with ICU sepsis.MethodsWe conducted a retrospective cohort study using the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. We defined SAE as a Glasgow Coma Scale (GCS) score of 15 or less, or delirium. The patients were randomly divided into training and validation cohorts. We used least absolute shrinkage and selection operator (LASSO) regression modeling to optimize feature selection. Independent risk factors were determined through a multivariable logistic regression analysis, and a prediction model was built. The performance of the nomogram was evaluated using various metrics including the area under the receiver operating characteristic curve (AUC), calibration plots, Hosmer-Lemeshow test, decision curve analysis (DCA), net reclassification improvement (NRI), and integrated discrimination improvement (IDI).ResultsAmong the 4,476 sepsis patients screened, 2,781 (62.1%) developed SAE. In-hospital mortality was higher in the SAE group compared to the non-SAE group (9.5% vs. 3.7%, p &lt; 0.001). Several variables were analyzed, including the patient’s age, gender, BMI on admission, mean arterial pressure, body temperature, platelet count, sodium level, and use of midazolam. These variables were used to create and validate a nomogram. The nomogram’s performance, assessed by AUC, NRI, IDI, and DCA, was found to be superior to the conventional SOFA score combined with delirium. Calibration plots and the Hosmer-Lemeshow test confirmed the accuracy of the nomogram. The enhanced NRI and IDI values demonstrated that our scoring system outperformed traditional diagnostic approaches. Additionally, the DCA curve indicated the practicality of the nomogram in clinical settings.ConclusionThis study successfully identified autonomous risk factors associated with the emergence of SAE in sepsis patients and utilized them to formulate a predictive model. The outcomes of this investigation have the potential to serve as a valuable clinical resource for the timely detection of SAE in patients.
Connecting atrial fibrillation to digestive neoplasms: exploring mediation via ischemic stroke and heart failure in Mendelian randomization studies
Authors: Xu Zhijie , Rao Xuezhi , Xing Yaxuan , Zhu Zhiwei , Yan Longmei , Huang Jian , Zhang Jingchun , Zheng Ruwen 
Published: February 2024

BackgroundNotwithstanding the acknowledged interplay between atrial fibrillation (AF) and the emergence of digestive system neoplasms, the intricacies of this relationship remain ambiguous. By capitalizing univariable Mendelian Randomization (MR) complemented by a mediated MR tactic, our pursuit was to elucidate the causative roles of AF in precipitating digestive system malignancies and potential intermediary pathways.MethodThis research endeavor seeks to scrutinize the causal clinical implications of whether genetic predispositions to AF correlate with an increased risk of digestive system malignancies, employing MR analytical techniques. Utilizing a dataset amalgamated from six studies related to AF, encompassing over 1,000,000 subjects, we performed univariable MR assessments, employing the random-effects inverse-variance weighted (IVW) methodology as our principal analytical paradigm. Subsequently, a mediated MR framework was employed to probe the potential mediating influence of AF on the nexus between hypertension (HT), heart failure (HF), ischemic stroke (IS), coronary artery disease (CAD), and digestive system neoplasms.ResultThe univariable MR evaluation unveiled a notable causal nexus between the genetic inclination toward AF and the genetic susceptibility to colon, esophageal, and small intestine malignancies. The mediated MR scrutiny ascertained that the genetic inclination for AF amplifies the risk profile for colon cancer via IS pathways and partially explains the susceptibility to esophageal and small intestine tumors through the HF pathway.ConclusionOur investigative endeavor has highlighted a definitive causative association between genetic inclination to AF and specific digestive system neoplasms, spotlighting IS and HF as instrumental mediators. Such revelations furnish pivotal perspectives on the complex genetic interconnections between cardiovascular anomalies and certain digestive tract tumors, emphasizing prospective therapeutic and diagnostic worthy of pursuit.
Clinical application of endoscopic diaphragmotomy and dilation in a congenital duodenal diaphragm
Authors: Sun Song , Zheng Shan , Wu Jie , Tang Zifei , Shen Chun , Chen Gong , Dong Kuiran 
Published: February 2024

BackgroundA congenital duodenal diaphragm (CDD) is a rare cause of duodenal obstruction in infants and children. The traditional approach to treatment has been surgical intervention either with excision and duodenoplasty or with bypass through a duodenoduodenostomy, which is invasive and carries the risk of anastomotic leakage.AimsTo summarize the key points of differential diagnosis and treatment of a CDD under gastroscopy and to evaluate its efficacy and safety.MethodsThe clinical data of patients with a duodenal obstruction diagnosed and treated by gastroscopy in our hospital between January 2019 and December 2022 were retrospectively analyzed. The gastroscopic features of the CDD were summarized. The clinical outcomes of patients with CDD treated by gastroscopy were collected and investigated.ResultsA total of 13 children with a duodenal obstruction underwent a gastroscopic examination and/or treatment, and of these, 10 were diagnosed as having a CDD and 3 were finally diagnosed as having an annular pancreas. A dome-shaped structure during inspiration (9/10) and a guidewire that could be inserted through the opening into the distal lumen (6/10) were the gastroscopic features of the CDD, while the annular pancreas had none of these features. The 10 patients, 4 men and 6 women with the CDD, were treated through endoscopic diaphragmotomy and dilation. The age and weight at operation was 15 days to 7 years (M: 2.25 years) and 2.85–22 kg (M: 13.6 kg), respectively. A total of 11 endoscopic operations were performed in the 10 patients. The time of single operation was 15–55 min (M: 38 min). The patients did not experience complications such as bleeding, pneumoperitoneum, and duodenal papilla injury during the operation. Feeding was started 12–24 h after surgery, and the patients were discharged 2–10 days (M: 7 days) postoperatively. The patients were followed up for 3–36 months (M: 17 months), and none of them had a recurrence of vomiting. However, three showed a recurrence of stenosis in upper gastrointestinal imaging, one of whom underwent a partial diaphragm resection again 2 months after the primary treatment.ConclusionsA CDD can be confirmed by endoscopy based on its characteristic features. Endoscopic diaphragmotomy and balloon dilation are safe and effective, which can be a new option for minimally invasive treatment of a CDD.
Body morphology and handgrip strength parameters of the female canoe slalom paddlers
Authors: Busta Jan , Hellebrand Jaroslav , Kinkorová Ivana , Duchoňová Andrea , Hybská Tereza , Sánchez Carmen Costa , Vajda Matej 
Published: February 2024

Introduction: Canoe slalom is a physically very demanding discipline, in which body constitution, body composition, and relative strength are significant factors in high performance. Although anthropometric and strength parameters are relatively well-studied in male athletes, there is a lack of evidence for any conclusions in women. Therefore, the objective of this study was to determine the morphology and upper-limb strength parameters of female canoe slalom paddlers and identify whether morphological differences exist between performance groups.Methods: Altogether, 63 female competitors of the 2023 ICF Canoe Slalom World Cup (n = 29) and 2023 ICF Canoe Slalom World Ranking Competition (n = 34) in Prague (Czech Republic) were examined with a battery of anthropometric tests, segmental bioimpedance analysis, and handgrip strength test. The athletes were divided into groups according to age and performance: elite athletes belonging to the world top 10 according to the ICF World Ranking (WORLD, n = 7), international-level athletes competing during the World Cup (ELITE, n = 22), international-level junior athletes competing in the World Ranking Race (JUNIOR, n = 17), and other lower performance-level athletes competing in the World Ranking Race (REST, n = 17).Results: Female slalom paddlers are, in general, of average body height (∼165 cm), lower body mass (∼60 kg), BMI (∼22 kg/m2), and body fat (∼20%) and without exceptional anthropometric dimensions and proportions. However, differences were detected when performance was factored in. Female paddlers belonging to the world TOP 10 have the largest circumferences of arms and forearms, and their somatotype is more mesomorphic, with a lower proportion of total body fat and a higher proportion of muscle mass. In addition, the WORLD group differs significantly in upper-limb strength.Discussion: The results shows the significance of muscular strength and power for canoe slalom athletes and the importance of well-developed musculature in operating the boat in the unstable environment. Being a successful female canoe slalom athlete requires a well-developed musculature, maximizing strength capabilities while maintaining a low body weight through limited hypertrophy of the lower limbs and a low level of body fat.
Case report: Adult with bipolar disorder and autism treated with ketamine assisted psychotherapy
Authors: Harris Christopher P. , Jones Becky , Walker Kathryn , Berry Meredith S. 
Published: February 2024

BackgroundEvidence has increased in recent years regarding the potential for ketamine to serve as a novel treatment option for a range of conditions, particularly depression (unipolar and bipolar). However, research regarding ketamine as a potential therapeutic for Autism Spectrum Disorder (ASD) is lacking, despite high overlap with bipolar depression and theoretical foundations for its use.Case presentationA 29-year-old man with bipolar disorder and Autism Spectrum Disorder, type 2 diabetes, presented with mood swings and suicidal thoughts, and anger outbursts occurring daily. The patient was referred by a psychiatrist due to irritability and outbursts during the previous 5 months. These outbursts were unable to be controlled by the medications prescribed, included yelling and screaming, and the patient was unable to speak with the psychiatrist. The patient underwent ketamine assisted psychotherapy with 6 initial IV infusions of ketamine over a 1 month period followed by 2 booster IV ketamine infusions. Following ketamine treatment, dramatic reductions in outbursts were observed as well as reductions in anxiety, suicidality, and depression scores.ConclusionThis case study adds to the scant literature regarding ketamine treatment for individuals with bipolar disorder and ASD. We did not find ASD to be a contraindication for IV ketamine and ketamine assisted psychotherapy. Reductions in anger outbursts, anxiety, suicidality, and depression suggest ketamine treatment might be tailored to individuals with bipolar disorder and ASD, and additional systematized research is warranted. Although potential mechanisms of action are not clear, these data add to the discussion regarding clinical practice considerations and the potential for ketamine to improve quality of life and associated metrics.
A streamlined multidisciplinary metabolic clinic in psychiatric recovery service: a pilot study
Authors: Leung Kelvin CY. , Bakr Bianca , Chung Cindy , Parmar Mayuri , Elhindi James , Brakoulias Vlasios 
Published: February 2024

BackgroundThe metabolic syndrome (MetS) is a collection of risk factors for cardiovascular disease and type-2 diabetes, that includes central obesity, hypertension, hyperglycaemia and dyslipidaemia. An audit indicated inadequate MetS screening in an Australian psychiatric recovery service.ObjectivesWe aimed to improve MetS screening, identification and intervention by offering streamlined lifestyle education, clinical reviews and discharge planning. This pilot program prioritized holistic, culturally-sensitive, patient-centric, and trauma-informed approaches to enhance metabolic health outcomes.MethodsA Metabolic Clinic was piloted in two psychiatric rehabilitation cottages (n=35), which involved disciplines of dietetics, exercise physiology, diversional therapy, occupational therapy, peer workforce, social work, clinical psychology, pharmacy, nursing and medical. Another cottage (n=15) was assigned as the comparison and received standard care. A 12-week, 3-times-per-week lifestyle and behavioral program, called MetFit, was devised and offered to those identified at screening for the treatment cottages. Outcome measures were feasibility measures, the five metabolic parameters (waist circumference, blood pressure, fasting serum triglycerides, high-density lipoprotein, and glucose), functional measures, and a meal questionnaire.ResultsThe treatment cottages had qualitative advantages in screening and identifying MetS. Of four enrolled consumers in MetFit, an improvement of triglycerides (p=0.08), squats (p=0.02), and push-ups (p=0.07) was observed. Major challenges of enrolment included an overall lack of acknowledgment of its importance, poor motivation of consumers and resources limitation.ConclusionsThe one-stop provision of groups, peer support and inpatient pathway with multidisciplinary team-integration was generally accepted by consumers and the MDT and has iteratively demonstrated the urgent need for consumer-centered physical care and a cultural shift to foster collaboration within a psychiatric service.
Examining the dynamic and nonlinear impacts of public health events on the resilience of food supply chain: evidence from China
Authors: Li Jingdong , Li Zhi , Shi Zilong , Geng Hongjun 
Published: February 2024

IntroductionThe fragility of agriculture makes the food supply chain vulnerable to external risks such as epidemic, conflict, disaster, climate change, economic and energy crisis. The COVID-19 pandemic has spread and continued globally in recent years, resulting in food supply chain disruption and insecurity, which triggers profound reflection on the impacts of public health events (PHEs). Studying the impacts of PHEs on the resilience of food supply chain has great significance to effectively reduce the risks of disruption and insecurity in the future.MethodsBased on the composition of PHEs and the division of food supply chain, this paper adopted the nonlinear Granger causality test to verify the nonlinear causal relationship between PHEs and proxy variables in the food supply chain; then the TVP-VAR-SV model was constructed and its three-dimensional pulse response results were matched with the sensitivity, recovery, and adaptation of the food supply chain resilience to deeply explore the dynamic impacts of PHEs.ResultsPHEs has significant nonlinear conduction effects on the resilience of food supply chain, the impacts of PHEs on the partial sector resilience have significant dynamic characteristics in the whole sample period, and the impacts of PHEs on the recovery and adaptation aspects of food supply chain resilience have structural break characteristics.DiscussionThe differences, dynamic characteristics and structural breaks of the impacts of PHEs on the resilience of food supply chain are caused by the infectivity and mortality of PHEs, attributes of food products, regulation of supply and demand in the market, behavioral decisions of all participants, changes in the policy environment, and coordination and upgrading of all sectors in the supply chain.
A PRISMA-IPD systematic review and meta-analysis: does age and follow-up improve active range of motion of the wrist and forearm following pediatric upper extremity cerebral palsy surgery?
Authors: Song Amy X. , Saad Anthony , Hutnik Lauren , Chandra Onrina , McGrath Aleksandra , Chu Alice 
Published: February 2024

PurposeSurgical treatments such as tendon transfers and muscle lengthening play a significant role in cerebral palsy management,but timing of upper extremity cerebral palsy surgery remains controversial. This study systematically reviews the current literature and investigates the correlation between age at surgery and follow-up time with surgical outcomes in pediatric upper extremity cerebral palsy patients.MethodsA comprehensive search of PubMed, Cochrane, Web of Science, and CINAHL databases was performed from inception to July 2020 and articles were screened using PRISMA guidelines to include full-text, English papers. Data analysis was performed using itemized data points for age at surgery, follow-up length, and surgery outcomes, reported as changes in active forearm and wrist motion. A 3D linear model was performed, to analyze the relationship between age, follow-up length, and surgery outcomes.ResultsA total of 3,855 papers were identified using the search terms and a total of 8 studies with itemized patient data (n=126) were included in the study. The studies overall possessed moderate bias according to the ROBINS-I scale. Regression analysis showed that age is a significant predictor of change (|t| &gt; 2) in active forearm supination (Estimate = −2.3465, Std. Error = 1.0938, t-value= −2.145) and wrist flexion (Estimate = −2.8474, Std. Error = 1.0771, t-value = −2.643) post-intervention, with older individuals showing lesser improvements. The duration of follow-up is a significant predictor of improvement in forearm supination (Estimate = 0.3664, Std. Error = 0.1797, t-value = 2.039) and wrist extension (Estimate = 0.7747, Std. Error = 0.2750, t-value = 2.817). In contrast, forearm pronation (Estimate = −0.23756, Std. Error = 0.09648, t-value = −2.462) and wrist flexion (Estimate = −0.4243, Std. Error=0.1859, t-value = −2.282) have a significant negative association with follow-up time.ConclusionThese results suggest that there is significant correlation between the age and follow up after surgery with range of motion gains. Most notably, increased age at surgery had a significant negative correlation with select active range of motion postoperative outcomes. Future research should focus on identifying other factors that could affect results of surgical treatment in upper extremity.
Prevalence of pre-iridal monocellular and fibrovascular membranes in canine globes affected with congenital glaucoma associated with anterior segment dysgenesis, primary glaucoma associated with goniodysgenesis, and secondary glaucoma
Authors: Bedos Leila , Sandmeyer Lynne , Campbell John , Grahn Bruce H. 
Published: February 2024

ObjectivesThe objectives of this study were to (i) evaluate the prevalence of pre-iridal monocellular and fibrovascular membranes in canine globes affected with congenital glaucoma associated with anterior segment dysgenesis (ASD), primary glaucoma associated with goniodysgenesis (GD), and secondary glaucoma, and (ii) examine the associations between monocellular and fibrovascular membranes by breed, gender, age and histopathologic ocular changes on light microscopic examination.MethodsRecords of dogs who had eyes enucleated due to blindness and uncontrolled glaucoma were reviewed. Glaucoma was categorized clinically and histologically into three groups: congenital/ASD, primary/GD, and secondary glaucoma. The presence or absence and type of pre-iridal membrane (monocellular or fibrovascular) and other intraocular histologic findings were reviewed and compared statistically for each group.ResultsIn total, 108 canine globes (101 dogs) were included. Pre-iridal monocellular membranes were identified with light microscopy in 10 out of 19 congenital/ASD, 29 out of 40 primary, and 23 out of 49 secondary glaucoma globes. Fibrovascular membranes were observed in 3 out of 19 congenital/ASD, 9 out of 40 in primary, and 24 out of 49 secondary glaucoma globes. There were no associations between the type of membrane and breed, gender, or age. Peripheral anterior synechiae were more common in globes with fibrovascular membranes, and uveal atrophy was more common in globes with monocellular membranes.ConclusionPre-iridal monocellular membranes are common in all types of canine glaucoma. They are identified with light microscopy most easily in cases of primary glaucoma, and they are masked by pre-iridal fibrovascular membranes in other forms of glaucoma.
Sri Dewi
Authors: Sri Dewi Santika , Hidayanti Desi 
Published: February 2024

Asuhan komprehensif merupakan asuhan yang diberikan secara menyeluruh dan berkesinambungan selama kehamilan, persalinan, bayi baru lahir, nifas, dan keluarga berencana. Selama kehamilan seorang ibu dapat mengalami ketidaknyamanan seperti sakit pinggang, punggung dan kecemasan menghadapi persalinan. Bidan dapat memfasilitasi ketidaknyamanan tersebut dengan menerapkan asuhan komplementer salah satunya adalah prenatal yoga. Penelitian menunjukan bahwa prenatal yoga memiliki dampak positif baik secara fisik ataupun psikologis selama kehamilan dalam menghadapi proses persalinan. Laporan kasus ini bertujuan untuk mendeskripsikan penerapan prenatal yoga dalam asuhan kebidanan komprehensif. Laporan ini menggunakan metode studi kasus yang dilakukan penulis secara komprehensif kepada Ny.H yang diberikan asuhan sejak usia kehamilan 37 minggu sampai dengan nifas beserta asuhan pada bayinya. Asuhan dilaksanakan di wilayah kerja Puskesmas Gadog Kabupaten Garut.
Asuhan diberikan sesuai dengan diagnosa dan permasalahan yang dialami klien, dimulai pada kehamilan trimester III sampai dengan minggu terakhir masa nifas. Keluhan yang dialami dalam kehamilan trimester III dapat teratasi dengan prenatal yoga. Proses persalinan ibu berlangsung normal dan terdapat laserasi perineum derajat dua. Asuhan pada bayi baru lahir dalam batas normal. Asuhan kebidanan komprehensif dengan penerapan prenatal yoga sudah dilakukan dengan baik. Bidan sebagai provider kesehatan dapat memfasilitasi prenatal yoga pada ibu hamil untuk mengatasi ketidaknyamanan trimester III