bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Correlation Between Symptom Clusters and Quality of Life in Patients with Systemic Lupus Erythematosus: A Cross-Sectional Study
Authors: Bai Lina , Yang Xuying , Miao Huali , Shi Hong , Zhang Hong , Fu Xiaoxia , Li Wanling 
Published: January 2025

Background: Systemic lupus erythematosus (SLE) is characterized by a range of symptoms that often cluster together, impacting the quality of life (QoL) of affected individuals. Objective: To delineate the composition of symptom clusters in patients with SLE and analyze their correlation with QoL, thus providing a basis for symptom management. Methods: Using convenience sampling, 201 patients were recruited. Data were collected using a general information questionnaire, SLE Symptom Checklist and Lupus Quality of Life scale. Symptom clusters were identified using exploratory factor analysis, and their correlations with QoL were analyzed using Spearman correlation analysis. Results: The most common symptom among patients was fatigue (64.7%). Five symptom clusters were identified: fatigue-related symptoms, weight gain-related symptoms, itch-pain-related symptoms, skin change symptoms, and body image symptoms. Fatigue-related, weight gain-related, and body image symptom clusters showed significant negative correlations with overall QoL scores and scores in various dimensions ( P < .05). The itch-pain symptom cluster was negatively correlated with the total score of QoL and several dimensions such as pain status, burden status, mental health status, physical health status, and fatigue status ( P < .05). The skin change symptom cluster was negatively correlated with the total score of QoL and several dimensions, such as mental health, physical health, and fatigue status ( P < .05). Conclusion: Patients with SLE exhibit significant symptom clusters correlating with overall QoL. Such data highlight the need for nurses to evaluate symptom clusters and intervene in related factors, enhancing QoL.
Challenges for switching central nervous system and psychiatric medication products: A review of the literature
Authors: Procyshyn Ric M , Katzman Martin A , Margolese Howard C , Agid Ofer , Blier Pierre M 
Published: January 2025

Background: Switching between versions of medication products happens commonly despite challenges in achieving bioequivalence and therapeutic equivalence. Central nervous system and psychiatric drugs, especially those that are technically demanding to manufacture and have complex pharmacokinetic properties, such as long-acting injectables (LAIs), pose particular challenges to bioequivalence and safe and efficacious drug switching. Aims: To assess whether drugs deemed “bioequivalent” are truly interchangeable in drug switching. Methods: We assessed the published literature from January 2017 through June 2023 on PubMed using the MeSH terms “drugs, generic” OR “equivalency, generic” combined with terms for different psychiatric drug classes. Results: While most of the published studies returned in the search found that switching drug products was safe and clinically comparable, data on most drug classes other than those primarily indicated in the treatment of seizure disorder were sparse. Some studies also provided evidence that real-world outcomes such as adherence and hospitalizations may also be affected by switching. In addition, a review of bioequivalence testing guidance showed inconsistency across agencies and a lack of product-specific guidance from Health Canada, which raises questions about potential claims of bioequivalence for more complex products such as LAIs. Conclusions: Overall, given the difficulty in treating mental health disorders, prescribers should be cautious when switching products and formulations in a patient who has been stabilized on a drug.
Methyltrimethoxysilane (MTMS)
Authors:   Workplace Environmental Exposure Level (WEEL) Committee,   Occupational Alliance for Risk Science (OARS),   Toxicology Excellence for Risk Assessment (TERA)
Published: January 2025

Methyltrimethoxysilane (MTMS) has been used as a coupling agent in thermoplastics and thermosetting resins, a cross-linker in silicone sealants, a water repellent component, and in silicone hard-coats for plastics. Acute studies in experimental animals showed a low order of toxicity for MTMS via oral, dermal, and inhalation routes. MTMS was slightly irritating to both eyes and skin in rabbits. A weight of evidence assessment supports that MTMS is not a dermal sensitizer. Available in vitro and in vivo assays indicated MTMS has a low potential for genotoxicity. MTMS did not produce any changes in either reproductive or developmental parameters. Short-term, repeated inhalation in rats produced treatment-related observations in the urinary bladder and kidney. In a 90-day inhalation study in rats, MTMS was associated with production of urinary bladder epithelial hyperplasia, calculi formation, and moderate kidney dilation with hyperplasia of the pelvic epithelium and granulomatous inflammation. However, an expert panel review concluded that changes in the bladder and kidney were adaptive responses to physical or chemical irritation. The NOAEL of 100 ppm (557 mg/m3) from the 90-day inhalation study was considered the point of departure for the health-based WEEL derivation. After adjusting to account for duration of exposure and interindividual variability, the resulting 8-h TWA WEEL value of 10 ppm (55 mg/m3) is fully expected to provide a significant margin of safety against potential adverse health effects in workers.
Early brain stroke detection using multilayer perceptron of convolutional neural network-based residual network
Authors: Sree Usha , Krishna Praveen , Rao Dr. Ch. Mallikarjuna , Parameshwari Lalitha 
Published: January 2025

Background Stroke, medically known as the brain attack, refers to the stoppage or stoppage of blood from flowing into a particular region of the brain, or even from the breaking of a vessel, causing injury to and death of areas of the brain. It presents a medical emergency, with the potential of severe long-term neurological impairment, disability, and even death; thus, urgent detection and treatment are needed. Objective The study aims to develop a novel Multilayer Perceptron of Convolutional Neural Network-based Residual Network (MLPCNNbRN) for early brain stroke detection, focusing on improving the accuracy and reliability of detecting subtle stroke patterns in medical images. Methods The MLPCNNbRN provided resented in the context of residual connections within an architecture designed for deep network training in medical images. This allowed the overall model to learn complex relations very effectively. The system was implemented in the Python framework. Its performance was compared with other methods. The key metrics used in the evaluation were accuracy, precision, recall, and F-score. Results The MLPCNNbRN model demonstrated superior performance compared to existing methods, achieving higher levels of accuracy in stroke detection. Specifically, the model improved overall accuracy, precision, recall, and F-score, showcasing its robustness in identifying subtle stroke patterns. Conclusion The proposed MLPCNNbRN system enhances early brain stroke detection by extracting hierarchical features and residual network learning, offering a more accurate and reliable approach than previous methods. This system has the potential to aid medical professionals in timely diagnosis and treatment, ultimately improving patient outcomes.
Lung cancer diagnosis with GAN supported deep learning models
Authors: ÇAY Talip 
Published: January 2025

Background Lung cancer is a leading cause of cancer-related deaths worldwide, making early diagnosis crucial for improving treatment success and survival rates. Traditional diagnostic methods, such as biopsy and manual CT image interpretation, are time-consuming and prone to variability, highlighting the need for more efficient and accurate tools. Advances in deep learning offer promising solutions by enabling faster and more objective medical image analysis. Objective This study aims to classify benign, malignant, and normal lung CT images using advanced deep learning techniques, including a specially developed CNN model, to improve diagnostic accuracy. Methods A dataset of 1097 lung CT images was balanced using GANs and preprocessed with techniques like histogram equalization and noise reduction. The data was split into 70% training and 30% testing sets. Models including VGG19, AlexNet, InceptionV3, ResNet50, and a custom-designed CNN were trained. Additionally, Faster R-CNN-based region proposal methods were integrated to enhance detection performance. Results The custom CNN model achieved the highest accuracy at 99%, surpassing other architectures like VGG19, which reached 97%. The Faster R-CNN integration further improved sensitivity and classification precision. Conclusion The results demonstrate the effectiveness of GAN-supported deep learning models for lung cancer classification, highlighting their potential clinical applications for early detection and diagnosis.
Electroacupuncture improves cognitive impairment after subarachnoid hemorrhage in rats through the PI3K/AKT signaling pathway
Authors: Zhou Feng , Wang Zhenzhi , Xiong Kang , Fu Xiaoman , Jiang Hongru , Zhang Meiling , Wang Qiang , Wang Yuan 
Published: January 2025

Objective: Cognitive impairment (CI) is highly prevalent in subarachnoid hemorrhage (SAH) patients. The phosphatidylinositol 3-kinase (PI3K)/AKT pathway plays a critical role in neuronal survival in a variety of central nervous system injuries. This study aimed to determine whether electroacupuncture (EA) at Yintang and LI20 ameliorates SAH-CI in a rat model and to examine whether it modulates the PI3K/AKT pathway by administering a PI3K inhibitor (LY294002) versus dimethyl sulfoxide (DMSO) vehicle. Methods: Notably, 129 male Sprague–Dawley rats were divided into Blank, Sham, SAH and SAH + EA groups (Experiment 1, n = 54) and SAH, SAH + EA, SAH + LY294002, SAH + EA + LY294002 and SAH + EA + DMSO groups (Experiment 2, n = 75). Garcia scoring was used to evaluate neurological function. The moisture content of the rat brain was determined by dry‒wet method. The Morris water maze was used to assess learning and memory function. Pathological changes in neurons in the hippocampus were observed via hematoxylin–eosin (H&E) staining. The number of surviving neurons and the percentage of apoptotic cells in the hippocampus were detected via Nissl and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining. The expression of PI3K/AKT pathway-related proteins was detected via Western blotting. Results: The results indicated that EA intervention after SAH reduced brain water content, enhanced Garcia scores, improved neurological function and behavioral markers of CI, and increased the number of surviving neurons in the hippocampus. Moreover, EA significantly increased the expression of AKT, phosphorylated (p)-AKT, PI3K, p-PI3K, glycogen synthase kinase (GSK)-3β, p-GSK-3β and B cell lymphoma (Bcl)-2 proteins, and decreased the expression of Bcl-2-associated X (Bax) and caspase-3. In addition, the effects of EA were abolished by LY294002. Conclusion: EA appeared to improve CI in a rat model of SAH through the activation of the PI3K/AKT pathway.
Demographic and mental health characteristics of individuals in the NSW Housing and Accommodation Support Initiative (HASI), Community Living Supports and HASI Plus
Authors: Low Gary KK , Li Jason , Hielscher Emily , Sheanoda Veronica , Govindasamy Sumathi , Marasha Fadzi 
Published: January 2025

Objective To investigate the demographic characteristics associated with mental health recovery measures among individuals accessing the Housing and Accommodation Support Initiative (HASI) program over a 19-year period. Methods This was a retrospective cohort study conducted from January 2004 to October 2023. The Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) and Recovery Assessment Scale (RAS) were used as measures of mental health recovery. Findings A total of 2350 people with an average age of 42 years old were included. Female accounts for 46.0% of the total. The proportion of unmet needs in the CANSAS reduced from a median of 33.3% of the first follow-up to 5.8% in the 20th follow-up. The average RAS scores were above three, indicating agree and strongly agree in all domains and improved in each follow-up. First Nations were associated with higher unmet needs in ‘psychotic symptoms’, ‘safety to others’ and ‘transport’ CANSAS domains, and LGBTI had reduced RAS scores in all domains. Conclusion HASI program engagement is associated with the reduction of unmet needs and improvement of the recovery of individuals with severe mental illness. Age, sex, gender, LGBTI, First Nations and country of birth were associated with changes in the CANSAS and RAS outcomes.
Liposomal bupivacaine as one component of the postoperative management of limb amputations in cats: a retrospective study
Authors: Schrock Kelly , Gallaher Hayley M , Wilson Deborah V , Beaty Brenda 
Published: January 2025

Objectives The objective of this study was to evaluate the impact of liposomal bupivacaine (LB) as part of an opioid-sparing multimodal analgesic protocol on postoperative pain control in cats undergoing limb amputation surgery compared with traditional pain management protocols more heavily reliant on injectable opioid and non-opioid analgesics. Methods Medical records of 29 cats that underwent forelimb or hindlimb amputation were reviewed to evaluate postoperative systemic pain medications utilized, appetite and time to discharge as presumptive gauges of postoperative pain. Statistical analysis of the data included Wilcoxon’s rank-sum test and Fisher’s exact test. Results Of the 29 cats, seven (24%) did not receive LB and 22 (76%) did. No statistically significant differences were found between the two groups in the outcome variables evaluated. The median time to eating was similar (6.0 h in the LB group vs 5.0 h in the non-LB group), the median time to discharge was shorter in the LB group (25.0 h vs 42.0 h in the non-LB group) and the median time to discontinuation of opioids in the LB treatment group was shorter than the non-LB group (18.0 h in LB group vs 22.0 h non-LB). A lower proportion of the LB group needed adjuvant systemic analgesics compared with the non-LB group (5% LB vs 29% non-LB). Conclusions and relevance The addition of liposomal bupivacaine to an analgesic protocol after limb amputation in cats is associated with reduced opioid dosing, earlier return to eating and earlier hospital discharge. The use of LB may minimize the negative side effects associated with systemic opioid administration and therefore decrease patient morbidity. Future studies are needed to definitively compare LB efficacy and safety for postoperative pain control and traditional systemic analgesic medications.
Information About the Gut Microbiome’s Connection to Health and Disease can Impact Knowledge: Feasibility of an Education-Based Intervention in a General Internal Medicine Clinic
Authors: Knudsen Benjamin , Narain Sasha , Moore Brad B. , Corr Patrick G. , Frame Leigh A. 
Published: January 2025

The gut microbiome (gMicrobiome)—a dynamic ecosystem of microorganisms—is emerging as a correlate of healthy lifestyle. Patients may not be aware of this. General Internal Medicine patients completed surveys evaluating gMicrobiome knowledge, lifestyle knowledge, dietary intake, physical activity, sleep, and stress. Surveys were given pre-/post-education (n = 112) and at 1 month follow-up (n = 60). The educational-module comprised a video and handout describing how lifestyle enhances gMicrobiome and health outcomes. Post-educational-module, 9 of 19 (47%) statements showed favorable change in knowledge ( P < 0.05). Two statements reached statistical significance at 1-month follow-up: “Exercise influences the types of bacteria present in the digestive system” [7 (12%) to 24 (41%), P = 0.004] and “An inactive lifestyle promotes the growth of healthy types of digestive system bacteria” [12 (20%) to 24 (41%), P = 0.035]. We observed a small but favorable change in knowledge but not behavior. Large lifestyle changes are challenging to adopt, and education alone is necessary but insufficient for change. Our results confirm that education is a viable first step to establish the importance of pursuing lifestyle changes, perhaps moving from pre-contemplation to contemplation. Baseline knowledge in our participants was higher than anticipated, indicating that this intervention may have been too introductory. Future interventions should investigate baseline knowledge.
Utility of modified endoscopic radial incision and selective cutting combined with short-term stenting for refractory stricture in patients undergoing endoscopic submucosal dissection of superficial esophageal carcinoma
Authors: Chen Lu , Tang Xiajiao , Jiang Jingjing , Yin XiaoChun , Wang Yuxin , Li Mingyue , Shi Ruihua 
Published: January 2025

Background: Refractory esophageal stricture is the common complication of extensive endoscopic submucosal dissection (ESD), without satisfactory endoscopic treatment strategies. We evaluated the efficacy, safety, and long-term patency of the modified endoscopic radial incision and selective cutting combined with short-term stenting (RISC-STS) for the treatment of refractory esophageal stenosis. Methods: This was a retrospective study. Patients diagnosed with refractory esophageal stricture from June 2016 to June 2023 were enrolled. Efficacy, safety, and risk factors for dysphagia after RISC-STS operation were assessed. Results: Compared with clinical symptoms before RISC-STS, there was no significant improvement in the times of stricture recurred ( p = 0.75). However, the narrowest diameter of esophageal stenosis was significantly larger after RISC-STS treatment ( p = 0.04). Corresponding dysphagia scores after RISC-STS were obviously lowered according to the Mellow–Pinkas grading scale ( p = 0.002). More cases ((14 (60.87%) vs 5 (21.74%)) received valid symptom-relief periods after RISC-STS ( p = 0.0004). The complications of RISC-STS include perforation (4.35%), fever (4.35%), and pain (30.43%). Univariate Cox analysis suggested that resection length >7 cm of scar tissue was a risk factor for refractory dysphagia after RISC-STS. Conclusion: The present study revealed that RISC-STS is an effective and safe technique for refractory esophageal stricture with lower restenosis, higher valid symptom-relief rate, and fewer complications.
How eHealth use and cancer information-seeking influence older adults’ acceptance of genetic testing: Mediating roles of PIGI and cancer worry
Authors: Zhu Yingxia , Xiao Qian Erica , Ao Man Chon , Zhao Xinshu 
Published: January 2025

Objective This study aims to investigate how eHealth use and information-seeking behavior affect older adults’ acceptance of genetic testing, focusing on their participation in genetic tests and their willingness to adopt lifestyle changes based on test results. The research highlights the mediating roles of the perceived importance of genetic information (PIGI) and cancer worry. Methods This cross-sectional study used secondary data from the Health Information National Trends Survey (HINTS 5, Cycle 4), conducted in 2020. The analysis included 1852 adults aged 60 and above. Two mediation models were tested using SPSS 25. Model 1 examined the relationship between eHealth use, perceived importance of genetic information (PIGI), and genetic test behavior. Model 2 analyzed how cancer information-seeking influences willingness to change lifestyle behavior (WCLB) based on genetic test results, with cancer worry as a mediator. Results Both models showed statistically significant mediation effects ( p < 0.05). Model 1 found that eHealth use positively influences genetic test behavior through PIGI. Model 2 revealed that cancer information-seeking indirectly impacts willingness to change lifestyle behavior (WCLB) based on the genetic test results via cancer worry, confirming a full mediation effect. Additionally, among demographic variables, educational level was the strongest predictor of genetic test behavior, while gender significantly predicted WCLB, with older female adults showing higher intentions to change their lifestyle based on genetic test results than males. Conclusion The study highlights the pivotal roles of PIGI and cancer worry in shaping older adults’ acceptance of genetic testing, encompassing both performing genetic test behaviors and adopting lifestyle changes based on test results. These findings offer actionable insights for designing targeted health communication strategies and interventions to enhance genetic testing uptake and foster proactive health management among older populations.
Automated computed tomographic analysis of bronchial thickness and mucus plugs in bronchiectasis with asthma
Authors: van der Veer Tjeerd , Andrinopoulou Eleni-Rosalina , Makani Punitkumar , Braunstahl Gert-Jan , Tiddens Harm A.W.M. 
Published: January 2025

IntroductionBronchiectasis disease is characterised by cough, sputum, and exacerbations, with chest CT typically showing bronchial wall thickening, and mucus plugging in addition to bronchial dilation. Asthma is a common comorbidity and associated with increased, eosinophilic, airway inflammation. Automated measurements of bronchial wall thickening and mucus plugs may serve as biomarkers for inflammation and associated with clinical characteristics such as spirometry, blood eosinophil count, and disease severity in patients with bronchiectasis and asthma co-diagnosis.MethodsIn a cross-sectional retrospective cohort of 64 patients with bronchiectasis disease and asthma, we applied automated image analysis to assess bronchial dimensions and mucus plug metrics on chest CT scans. These metrics were correlated with spirometry,blood eosinophil counts as well as Bronchiectasis Severity Index (BSI) and FEV1, Age, Colonization, Extension and Dyspnea (FACED) scores using correlations and multiple regression analyses.ResultsIn 63 patients, bronchial wall thickness and mucus plugs were quantified. ] Negative correlations were observed between bronchial wall thickness markers and spirometry (Bwt/A and FEV1, r=-0.37; FEV1/FVC, r=-0.30). Mucus plugs correlated negatively with spirometry and positively with BSI and FACED scores (no.of mucus plugs and BSI,r=0.45). Correlations with blood eosinophil counts were very weak. In multiple regression analyses, independent associations were observed for FEV1,Pseudomonas aeruginosaand frequent exacerbations.ConclusionThis study identified key relationships between automated measurements of bronchial wall thickness and mucus plugs with clinical characteristics, highlighting their potential as imaging biomarkers to enhance phenotyping, improve risk assessment, and facilitate tailored treatment strategies in bronchiectasis.