bluuebunny/crossref_metadata_2025_split huggingface dataset:
When In Doubt Rush To RUSH Protocol: Acute Pulmonary Embolism Secondary To A Lower Limb Penetrating Injury
Authors: Seddiq Mahdis , Zia Sania , Hamoud Khaled , Ali Maryam Al 
Published: January 2024

Abstract

Resuscitative ultrasound (US), along with protocols such as the RUSH (Rapid Ultrasound in SHock) protocol, provide a systematic approach for emergency physicians in assessing possible etiologies of undifferentiated shock. Role of Point-of-Care Ultrasound (POCUS) cannot be understated even in cases where often a medial case has an element of trauma, as often one may proceed or precede the other. A young male in his 20s, with a history of sustaining a superficial stab wound to his lower leg 1 day prior, presented to the emergency department (ED) with syncope and was found to be hypotensive. Despite adequate fluid resuscitation, his blood pressure continued to drop, and soon developed hypoxia and chest pain. The RUSH protocol was rapidly initiated, leading to a diagnosis of pulmonary embolism (PE) in a span of 8 minutes from when the patient first presented. Rapidly recognizing when a case of shock is undifferentiated, and subsequently utilizing bedside US, facilitates timely diagnosis especially when following protocols such as the RUSH protocol.
Diagnostic Accuracy and Predictors of Alpha-Synuclein Accumulation in Gastrointestinal Tract of Parkinson’s disease
Authors: Jeon Beom , Shin Chaewon , Kim Seong-Ik , Park Sung-Hye , Kim Jong-Min , Lee Jee-Young , Chung Sun Ju , Kim Jae Woo , Ahn Tae-Beom , Park Kye Won , Shin Jung , Lee Chan Young , Lee Hyuk-Joon , Kong Seong-Ho , Suh Yun-Suhk , Kim Han-Joon , Yang Han-Kwang 
Published: January 2024

Abstract

Background and objectives
This study aimed to determine the possibility as a biomarker and identify predictors of alpha-synuclein (AS) accumulation in the gastrointestinal (GI) tract of patients with Parkinson’s disease (PD).
Methods
The frequency of AS accumulation in the GI tract was compared between patients with PD (N = 97) who underwent radical GI surgery for cancer and individually matched controls (N = 94). Clinical characteristics were compared between patients with positive (AS+) and negative (AS−) AS accumulation. A multivariable logistic regression analysis was conducted to determine the predictors of AS accumulation in the GI tract of patients with PD.
Results
The frequency of AS accumulation was significantly higher in patients with PD (75.3%) than in controls (8.5%, p-value < 0.001). However, when the evaluation was confined to the mucosal/submucosal layer, the sensitivity and specificity were 46.9% and 94.7%, respectively. The rostrocaudal gradient of AS accumulation was found in patients with PD. The duration from symptom onset to surgery was significantly longer in patients with PD and AS+ (4.9 ± 4.9 years) than in AS– (1.8 ± 4.1 years, p-value = 0.005). Both disease duration and surgical site independently predicted the presence of AS accumulation in the GI tract of patients with PD.
Conclusions
The results suggest that the stomach is the optimal location for identifying pathological biomarkers using AS accumulation in the GI tract. Our study suggests PD-related AS accumulation in the GI tract follows temporally increasing but spatially static progression pattern.
Fostering Engagement in Virtual Anatomy Learning for Healthcare Students
Authors: Singer Lauren , Evans Lily , Zahra Daniel , Agbeja Ife , Moyes Siobhan 
Published: January 2024

Abstract
Background: The use of virtual learning platforms is on the rise internationally, however, successful integration into existing curricula is a complex undertaking fraught with unintended consequences. Looking beyond medical and pedagogic literature can provide insight into factors affecting the user experience. The technology acceptance model, widely used in software evaluation, can be used to identify barriers and enablers of engagement with virtual learning platforms. Here, the technology acceptance model was used to scaffold the exploration of the factors that influenced students' perceptions of the virtual anatomy platform, Anatomage and how these shaped their intention to use it.
Methods: Focus groups identified factors influencing students use of the Anatomage tables. Interventions were rolled out to address these findings, then further focus groups and the technology acceptance model identified how factors including self-efficacy, enjoyment, and social norms influenced students’ intention to use the Anatomage table in the future.
Results: Students raised significant concerns about understanding how to use the Anatomage table. Moreover, students who considered themselves to be poor at using technology perceived the Anatomage table as more complicated to use. The subjective norm of the group significantly altered the perceived ease of use and usefulness of the Anatomage. However, enjoyment had the greatest impact in influencing both perceived usefulness and perceived ease of use. Indicating enjoyment as the largest contributing factor in altering technology engagement in healthcare cohorts.
Conclusions: Focus groups used in tandem with the technology acceptance model provide an effective way to understand student perceptions around technology used in the healthcare curricula. This research determined interventions that promote student engagement with virtual learning platforms, which are important in supporting all healthcare programmes that incorporate technology enhanced learning.
Social Determinants of Health and Medication Adherence in Older Adults with Prevalent Health Conditions in the United States: An analysis of the National Health and Nutrition Examination Survey (NHANES) 2009-2018
Authors: Adeoye-Olatunde Omolola A. , Hastings Tessa J. , Blakely Michelle L. , Boyd LaKeisha , Aina Azeez B. , Sherbeny Fatimah 
Published: January 2024

Abstract
Background
The older adult population is rapidly expanding in the United States (US), with high blood pressure, high cholesterol, and diabetes ranking among the top health conditions for older adults. Medication nonadherence, not taking medications as prescribed, is prevalent among those managing multiple chronic conditions. Despite its complexity, evidence is lacking on the social determinants of health (SDOH) influencing medication adherence among older adults with high blood pressure, high cholesterol, and/or diabetes in the US. Thus, the primary objective of this study was to identify and prioritize SDOH associated with medication adherence among a nationally representative sample of US older adults with high blood pressure, high cholesterol, and/or diabetes.
Methods
Using the World Health Organization Commission on Social Determinants of Health and Pharmacy Quality Alliance Medication Access Conceptual Frameworks, publicly available National Health and Nutrition Examination Survey datasets (2009–2018) were cross-sectionally analyzed among respondents aged 65 and older with study diseases. Respondents reporting taking their study disease state medication(s) were considered adherent. Data analysis included descriptive statistics, Rao-Scott Chi-Square tests, and logistic regression analyses. Highly correlated predictors were removed to address multicollinearity, and the rest were consolidated into a single variable. The study used a significance level of 0.05.
Results
Analyses included 5,513 respondents' data. Univariate analysis showed that several structural (gender, p = .009; ethnicity, p = .038; social class, p = .023) and intermediary (e.g., level of alcohol consumption, p = .004; disability status, p = .014; affordability of household balanced meals, p < .001) determinants of health were significantly associated with medication adherence. Multivariable analysis revealed significant differences in medication adherence for alcohol consumption (p = .034) and usual place for healthcare (p = .001). For instance, individuals who usually go to a doctor’s office or health maintenance organization have 330% higher odds of adhering to medications than those with no usual place for healthcare (p = .002).
Conclusions
Study findings underscore pertinent implications for public health and policy, prioritizing specific SDOH most likely to affect medication adherence in common chronic conditions among older adults in the US. Strikingly, the observed relationship between alcohol consumption trends and adherence is a distinct finding warranting further investigation.
Predicting Bladder Cancer Survival with High Accuracy: Insights from MAPK Pathway-related Genes
Authors: Cheng Gaungyang , Li Shiqi , Zhou Zhaokai , Wang Yan , Ye Zhuo , Ren Chuanchuan 
Published: January 2024

Abstract

The mitogen-activated protein kinase (MAPK) pathway plays a critical role in tumor development and immunotherapy. Nevertheless, additional research is necessary to comprehend the relationship between the MAPK pathway and the prognosis of bladder cancer (BLCA), as well as its influence on the tumor immune microenvironment.To create prognostic models, we screened ten genes associated with the MAPK pathway using COX and least absolute shrinkage and selection operator (LASSO) regression analysis. These models were validated in the Genomic Data Commons (GEO) cohort and further examined for immune infiltration, somatic mutation, and drug sensitivity characteristics. Finally, the findings were validated using The Human Protein Atlas (HPA) database and through Quantitative Real-time PCR (qRT-PCR).Patients were classified into high-risk and low-risk groups based on the prognosis-related genes of the MAPK pathway. The high-risk group had poorer overall survival than the low-risk group and showed increased immune infiltration compared to the low-risk group. Additionally, the nomograms built using the risk scores and clinical factors exhibited high accuracy in predicting the survival of BLCA patients.The prognostic profiling of MAPK pathway-associated genes represents a potent clinical prediction tool, serving as the foundation for precise clinical treatment of bladder cancer.
Impacts of Corporate Governance, Life Cycle, and Asset Liquidity on the Effective Tax Rate and Tax Gap: Empirical Evidence from Iranian Emerging Stock Market
Authors: Rostamy Ali Asghar Anvary 
Published: January 2024

Abstract

This research investigates the effects of four major corporate governance mechanisms encompassing board independence, institutional ownership, internal auditor, and managerial ownership, and the role of life cycle and liquidity of assets on the effective tax rate and tax gap. The statistical population includes manufacturing companies listed on the Tehran Stock Exchange during the years 2010–2022, and the sample consists of 100 manufacturing companies selected from the population. Data was collected from the Tehran Stock Exchange website. Multivariate panel data regression method and E-views software were used to analyze the data. The findings support the positive effects of institutional ownership, internal auditor, life cycle, and the liquidity of assets, and the negative effect of managerial ownership on the effective tax rate. However, the impact of board independence (percentage of non-executive members of the board) on the effective tax rate is not confirmed. In addition, the results confirm the positive effects of internal auditor, life cycle, and the liquidity of assets, and the negative effects of board independence on the tax gap, while the impacts of institutional ownership and managerial ownership on the tax gap are not verified. Finally, the research concludes by explaining the limitations and recommendations. Accordingly, incorporating these influencing variables potentially improves the accuracy of the tax predictions.
Environmental Assessment of Artisanal Gold Mining on Soils of a Community within Southwestern, Nigeria
Authors: Laniyan T. A. , Kolawole T. O. , Kenjinu S. S. 
Published: January 2024

Abstract
Artisanal gold mining a means of livelihood comes with its public health challenge in most Sub-Saharan African countries. The study therefore evaluates extent of artisanal gold mining pollution on the environment and public health in communities within Ilesha Osun Nigeria. The study was field and laboratory based. Thirty–five (35) top soil samples (0-20cm) were randomly collected around Ijana, Itagunmodi, Epe, Igbadae and Ifewara communities. Samples were analyzed using an Agilent 700 series Inductively Coupled Plasma (ICP) for the 35 element suite in Acme Laboratory, Canada. Statistical evaluation was done using geo–accumulation index, enrichment Factor, contamination factor, pollution load index, contamination degree and nemerow pollution Index. The heavy metal pollution level in soils was assessed using potential ecological risk index. Human health risk was assessed using hazard index, carcinogenic risk index and non–carcinogenic risk index. Results of metal content in the soils revealed wide variation in heavy metal concentration. The mean metal content of soil when compared with crustal average was higher with decreasing order Cr > Bi > Sb > Sn > W > As > Mo > Ag > Cd. The results of the contamination indices carried out showed that Bi, Sc and V contributed greatly to very high contamination of the soils. Health risk assessment revealed that the children are more prone to non–carcinogenic diseases than adults in the area. However, carcinogenic health risk showed that adults are prone to this type of health risk through oral ingestion of Cr. This study therefore uncovered that heavy metals extending over large areas may pose great threat to the environmental media.
Are there conserved biosynthetic genes in lichens? Genome-wide assessment of terpene biosynthetic genes suggests conserved evolution of the squalene synthase cluster
Authors: Singh Garima , Pasinato Anna , Yriarte Alejandra López-Chicheri , Pizarro David , Divakar Pradeep K. , Schmitt Imke , Grande Francesco Dal 
Published: January 2024

Abstract

Lichen-forming fungi (LFF) are prolific producers of functionally and structurally diverse secondary metabolites, most of which are taxonomically exclusive delivering lineage-specific roles. But are there evolutionary conserved biosynthetic pathways in lichens? Based on the current evidence it seems there aren’t any. This notion is derived from polyketide-derivatives as most biochemical investigations on lichens focused on PKSs whereas the other class of compounds remain mostly unexplored. Here we present first systematic identification and comparison of lichenized fungal terpene synthases which are ever-present in the LFF, however, they have never been systematically analyzed. We gathered 111 genomes of LFF representing 60 genera and 23 families and implemented genome mining and gene clustering approaches to identify and group the clusters into networks of similar biosynthetic clusters. Our large-scale analysis led to the identification of 733 terpene BGCs with varying degrees of mutual similarity, most of them were unique. Remarkably, we found two widely distributed and homologous networks – both squalene/phytoene clusters - putatively involved in sterol/ergosterol biosynthesis. These clusters contain the same core gene, but different sets of accessory genes. This indicates an early gene duplication event, followed by gene losses and gains of accessory genes, leading to different architecture of the two clusters. We show that sequence divergence, gene duplications, losses and rearrangement and are the major factors driving the evolution of this cluster across LFF. Our study shows lichenized fungi do have a core biosynthetic cluster, bringing the first indication that a biosynthetic gene may form an essential gene content in lichens.
Liquid Crystal-Based Reconfigurable Antenna for 5G Millimeter-Wave
Authors: Chen Peng , Wang Dan , Wang Lihua , Liu Lu , Gan Zongsheng 
Published: January 2024

Abstract

This paper proposed a frequency reconfigurable antenna that utilizes a multilayer structure of liquid crystal (LC) material. This antenna design incorporates a three-layer stacked structure to create an LC-injected cavity. The inverted microstrip line structure is designed to be in contact with the LC, serving as both a radiating element and a bias electrode. A parasitic patch is placed at the top of the antenna to enhance bandwidth. To prevent interference with DC and RF sources, a bias tee is integrated into the microstrip line input. Experimental results demonstrate that the proposed antenna exhibits excellent impedance matching and stable radiation patterns within the operational frequency range. By comparing the simulated performance of the existing LC antenna with our proposed design, the bandwidth is tripled at a center frequency of 30.3 GHz. In addition, the effective area of the proposed reconfigurable antenna (154 mm2) is 24.6% of the area of the previous reconfigurable antenna (625 mm2).
Optimising the diagnostic accuracy of First post-contrAst SubtracTed breast MRI (FAST MRI) through interpretation-training: a multicentre e-learning study, mapping the learning curve of NHS Breast Screening Programme (NHSBSP) mammogram readers using an enriched dataset
Authors: Jones Lyn I , Marshall Andrea , Geach Rebecca , Elangovan Premkumar , O’Flynn Elizabeth , Timlin Tony , McKeown-Keegan Sadie , Rose Janice , Vinnicombe Sarah , Taylor-Phillips Sian , Halling-Brown Mark , Dunn Janet A 
Published: January 2024

Abstract

Background: Abbreviated breast MRI (FAST MRI) is being introduced into clinical practice. Specificity optimisation is essential to minimise harm through false positive results for populations with low pre-test probability. This study aimed to optimise diagnostic accuracy through the adaptation of a FAST MRI interpretation-training programme.
Methods: A FAST MRI interpretation-training programme was adapted to provide additional training during the assessment task (interpretation of an enriched dataset of 125 FAST MRI scans) by giving readers feedback about the true outcome of each scan immediately after each scan was interpreted (formative assessment). The training programme was additionally adapted for remote e-learning delivery.
Study design: prospective, blinded interpretation of an enriched dataset by multiple readers.
Results: 43 mammogram readers completed the training, 22 who interpreted breast MRI in their clinical role (Group 1) and 21 who did not (Group 2).
Overall sensitivity was 83% (95%CI 81-84%; 1994/2408), specificity 94% (95%CI 93–94%; 7806/8338), readers’ agreement with the true outcome kappa = 0.75 (95%CI 0.74-0.77) and diagnostic odds ratio = 70.67 (95%CI 61.59-81.09). Group 1 readers showed similar sensitivity (84%) to Group 2 (82% p=0.14), but slightly higher specificity (94% v. 93%, p=0.001).
Concordance with the ground truth increased significantly with the number of FAST MRI scans read through the formative assessment task (p=0.002) but by differing amounts depending on whether or not a reader had previously attended FAST MRI training (interaction p=0.02). Concordance with the ground truth was significantly associated with reading batch size (p=0.02), tending to worsen when more than 50 scans were read per batch.
Group 1 took a median of 56 seconds (range 8-47466) to interpret each FAST MRI scan compared with 78 seconds (14-22830, p <0.0001) for Group 2.
Conclusions: Provision of immediate feedback to mammogram readers during the assessment test set reading task increased specificity for FAST MRI interpretation and achieved high diagnostic accuracy.
Optimal reading-batch size for FAST MRI was 50 reads per batch.
Trial registration (25/09/2019): ISRCTN16624917
Placental-derived mesenchymal stem cells restore ovarian function and metabolic profile in the rat model for polycystic ovarian syndrome
Authors: Sarvestani Mojtaba , Rajabzadeh Alireza , Mazoochi Tahereh , Samimi Mansooreh , Navar Mohsen , Moradi Faezeh 
Published: January 2024

Abstract
Introduction
Polycystic ovary syndrome (PCOS) is an endocrine and metabolic disturbance that affects many women worldwide and is characterized by chronic anovulation, hyperandrogenism, and ovarian dysfunction. Infertility, insulin resistance, dyslipidemia, and liver dysfunction are perturbations induced by PCOS. Mesenchymal stem cells (MSCs) have recently emerged as a potential therapy for metabolic disorders such as PCOS due to their anti-inflammatory, antiapoptotic, proangiogenic, and proliferative properties. Placenta-derived mesenchymal stem cells (PDMSCs) are derived from the placenta and have advantages over other sources of MSCs in terms of availability, safety, and immunomodulation.
Materials and Methods
In this experimental study, we assigned twenty female Wistar rats into four groups (n = 5): control, sham, PCOS, and PCOS-PDMSCs. We induced PCOS in the rats by administering letrozole for 21 days. PDMSCs (1 × 106 cells) were injected through the tail vein. Fourteen days after cell infusion, we evaluated the number of healthy follicles, corpus luteum, and cystic follicles, as well as the levels of testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), fasting blood glucose, fasting insulin, and insulin resistance. Moreover, we measured the serum levels of cholesterol, triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL). Liver function was determined by evaluating aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels.
Results
The number of corpora luteum, primordial, primary, secondary, and antral follicles significantly elevated in the PCOS-PDMSCs group versus the PCOS group. The number of cystic follicles significantly decreased in the PCOS-PDMSCs group. LH and testosterone levels decreased significantly, while FSH levels increased significantly in the PCOS-PDMSCs group. Fasting blood glucose levels, fasting insulin levels, and insulin resistance notably decreased in the PCOS-PDMSCs group. The lipid profile improved in the PCOS-PDMSCs group with significant cholesterol, LDL, and TG decreases and an increase in HDL. The PCOS-PDMSCs group exhibited marked decreases in the AST and ALT levels.
Conclusion
Our results suggest that PDMSCs are a potential treatment option for PCOS because they can effectively restore folliculogenesis, correct hormonal imbalances, modify metabolic/lipid profiles, and alleviate liver dysfunction in a rat model of PCOS. However, further research is needed to establish the safety and effectiveness of PDMSCs for treating PCOS.