bluuebunny/crossref_metadata_2025_split huggingface dataset:
"When Everyone is Responsible, No One Takes Responsibility": Pediatric Physiotherapy Services in Israel
Authors: Waiserberg Nilly , Horev Tuvia , Feder-Bubis Paula 
Published: November 2023

Abstract
Background
According to Israel's National Health Insurance Law (1994), the Ministry of Health is responsible for the provision of health services in the country including physiotherapy services; moreover, the Special Education Law (1988), stipulates that physiotherapy services for children with motor disabilities, as well as other allied health services, are provided by the Ministry of Education in educational settings. Thus, children with motor disabilities are entitled PT services under two different laws by two different ministries.
Method
To map the physiotherapy services for children with motor disabilities and examine how policymakers view these services, we conducted a qualitative study including in-depth semi-structured interviews with 10 policymakers from the Ministry of Health and the Ministry of Education, and the national directors of physiotherapy services from three of the four health maintenance organizations in Israel.
Results
Study results indicate that there is an array of physiotherapy services and providers. Despite the regulation of these services for children with motor disabilities, uncertainty and lack of knowledge were found about various issues. Therefore, the thematic analysis was structured around four descriptive questions: Where do the children receive physiotherapy? Who is eligible for physiotherapy treatment and who receives treatment? What interventions do children with motor disabilities receive? Who provides therapy for children with motor disabilities?
Conclusions
Policymakers are dubious regarding the provision of these services, questioning whether children with motor disabilities receive physiotherapy services according to their needs. In addition, the abundance of suppliers does not necessarily improve the quality of services provided to children with motor disabilities, which may ultimately harm their developmental potential.
Mechanisms of differential sensitivity to ethanol-induced apoptosis in mouse spinal cord at different developmental stages—Akt/GSK signaling and BAX
Authors: Sun Shuaichen , Wang Zizhuo , Xu Xiaoxiang , Ding Xihui , Xu jianguang , Nan Xiang , Li Xiaohui , Xu Jinyong , ren zhenhua 
Published: November 2023

Abstract

Aims
The current study investigated differences in ethanol-induced apoptosis of spinal cord dorsal horn neurons at different developmental stages, and the molecular mechanisms involved.
Methods
A mouse ethanol intervention model was established at postnatal days 4, 7, and 12. Primary cells were derived from the spinal cord at postnatal day 4. Western blotting, immunofluorescence, and flow cytometry were used to detect apoptosis-related proteins in spinal cord and primary cells. Kyoto Encyclopedia of Genes and Genomes enrichment analysis of differentially expressed genes originating from the Gene Expression Omnibus dataset GSE184615 was conducted. Effects on Akt/GSK3β pathway proteins were investigated using the GSK3β inhibitor AR-A014418, and the Akt inhibitor DHA. Lentiviral knockdown and overexpression of intervening GSK3β were used in HT22 cell lines to investigate the effects of alcohol on GSK 3β and caspase proteins. J-aggregates, reactive oxygen species assays, and calcein-AM assays were used to investigate mitochondrial function and cell viability.
Results
Ethanol caused downregulation of Akt activity, and upregulation of GSK3β activity and apoptosis. DHA, AR-A014418, and knockdown of GSK3β effectively counteracted ethanol-induced apoptosis, whereas overexpression of GSK3β enhanced the injury process. PI3K activity was unchanged during these processes. Fluorescence colocalization analysis indicated that BAX was translocated to mitochondria during the apoptotic process. BAX was downregulated as the spinal cord developed, consistent with a reduced susceptibility to ethanolinduced apoptosis.
Conclusions
Akt/GSK3β signaling, and BAX together determine the direction of alcoholinduced apoptosis and its susceptibility to change during developmental stages in the spinal cord.
Clinical characteristics and genetic analysis of children with Omicron BF.7.14 type novel coronavirus-related acute necrotizing encephalopathy
Authors: Zhang Jianzhao , Sun Jing , Li Dongqing , Xie Hua , Shangguan Shaofang , Ge Yangyang , Jiao Hui , Ma Caihui , Liu Zhao , Zhao Linqing , Chen Xiaoli , Yang Jian 
Published: November 2023

Abstract

Objective To explore the clinical characteristics, etiological factors, and genetic analysis of children with acute necrotizing encephalopathy (ANE) related to the Omicron BF.7.14 novel coronavirus.
Methods We analyzed genomic variations in four ANE patients through pedigree full exon sequencing and a gene list focused on genomic intolerance. Additionally, we summarized the clinical data to explore the inheritance patterns associated with novel coronavirus-related ANE..
Results This study included four patients (2 males and 2 females) with an average age of 2.78 ±1.93 years. All the patients had prodromal symptoms of Omicron BF.7.14 virus infection, and exhibited symptoms such as altered consciousness, seizures and cognitive/language disturbances. Cranial MRI scans revealed damage to the thalamus, basal ganglia and brainstem. The cerebrospinal fluid (CSF) cell counts were nearly normal, but protein level in CSF increased significantly. Genetic analysis revealed a novel truncated mutation in the CRMP2 gene in one case, which had not been reported before. This case had a more severe coma score and prognosis, ultimately resulting in fatality in the later stages. All children exhibited a decrease in the absolute count of T lymphocytes, helper T cells, suppressor T cells, and NK cells tovarying degrees. Furthermore, levels of cytokines, including IL-1 β, IL-5, IL-6 and IL-8 were significantly elevated in the CSF, especially in patient with truncated mutation of DPYSL2 gene.
Conclusion The Omicron BF.7.14 type novel coronavirus can lead to ANE, characterized by T cell immunosuppression and a significant increase in cytokine levels in the CSF. . The truncated variation of CRMP2 gene may affect the prognosis of ANE by affecting the migration of cerebral T cells.
A Superior Prognostic Indicator for In-Hospital Mortality of Adult COVID-19 Patients
Authors: Li Dan , He Wu , Wang Dao Wen , Ni Li 
Published: November 2023

Abstract
Aims: Despite the progressive decline in the virulence of the novel coronavirus, there has been no corresponding reduction in its associated fatality rate. Our aim was to redefine an accurate predictor of mortality risk in COVID-19 patients, enabling effective management and resource allocation.
Methods: We conducted a retrospective analysis of 2917 adult patients diagnosed with COVID-19 who were admitted to our hospital during two waves of epidemics, involving the Beta and Omicron variants. Upon admission, NT-proBNP levels were measured, and we collected demographic, clinical, and laboratory data. We introduced a new concept called the NT-proBNP ratio, which measures the NT-proBNP level relative to age-specific maximum normal values. The primary outcome was all-cause in-hospital mortality.
Results: Our analysis revealed a higher in-hospital mortality rate in 2022, as shown by the Kaplan-Meier Survival Curve. To assess the predictive value of the NT-proBNP ratio, we employed the time-dependent receiver operator characteristic (ROC) curve. Notably, the NT-proBNP ratio emerged as the strongest predictor of mortality in adult hospitalized COVID-19 patients (area under the curve, AUC = 0.826; adjusted hazard ratio [HR], 3.959; 95% confidence interval [CI], 3.001–5.221; P < 0.001). This finding consistently held true for both the 2020 and 2022 subgroups.
Conclusions: The NT-proBNP ratio demonstrates superior predictive capability compared to several established risk factors, including NT-proBNP, hsCRP, and NLR, when it comes to forecasting in-hospital mortality among adult patients with COVID-19.
Clinical Trial Registration: www.chictr.org.cn ChiCTR2000031587 and www.clinicaltrials.gov NCT05615792
Spatio-temporal Modelling of Extreme Low Birth Rates in U.S. Counties
Authors: Zhang Yingqing , Wang Kai , Bai Long , Chen Ying , Ling Chengxiu 
Published: November 2023

Abstract

The continuous declining rate of birth may cause severe worldwide problems, including population ageing and demographic imbalance. This paper aims to identify the geographic disparities and potentially influential factors of the extreme downward excess of birth rates in the U.S. at the county level from 2003 to 2020. The innovative Bayesian generalized Pareto quantile regression model is employed for analysing the spatio-temporal pattern of stressful low birth rate and its association with socioeconomic, demographic, and meteorological factors. The optimal SPDE-AR(1) structured model is selected based on common Bayesian criteria and scaled threshold weighted continuous ranked probability score, indicating apparent spatial unbalance and increasing tendency of extremely low birth rate. The findings show that elderly, highly educated population structure, developed economic situation (GDP per capita, RUCC (degree of rurality)), average birth weight, and average age of mother have a significant impact on the stressful downward excess of birth rate, including Charlotte, Sarasota, Collier counties in Florida, and Marin, Santa, Cruuz, San Mateo in California. Conversely, the increasing female proportion, personal income, and temperature can alleviate the declining birth rate pressure. The methodology utilized here is productive for analysing extreme population stress, including but not limited to birth weight and cognitive impairment.
Prognostic Performance of MRI LI-RADS version 2018 Features and Clinical-Pathological Factors in Alpha-Fetoprotein-Negative Hepatocellular Carcinoma
Authors: Wang Leyao , Feng Bing , Liang Meng , Li Dengfeng , Cong Rong , Chen Zhaowei , Wang Sicong , Ma Xiaohong , Zhao Xinming 
Published: November 2023

Abstract

Purpose
To evaluate the performance of the magnetic resonance imaging (MRI) Liver Imaging Reporting and Data System (LI-RADS) version 2018 features and clinical-pathological factors for predicting the prognosis of alpha-fetoprotein (AFP)-negative (≤ 20 ng/ml) hepatocellular carcinoma (HCC) patients, and to compare with other traditional staging systems.
Methods
We retrospectively enrolled 169 patients with AFP-negative HCC who received preoperative MRI and hepatectomy between January 2015 and August 2020 (derivation dataset: validation dataset = 118: 51). A prognostic model was constructed using the risk factors identified via Cox regression analysis. Predictive performance and discrimination capability were evaluated and compared with those of two traditional staging systems.
Results
Six risk factors, namely the LI-RADS category, blood products in mass, microvascular invasion, tumor size, cirrhosis, and albumin–bilirubin grade, were associated with recurrence-free survival. The prognostic model constructed using these factors achieved C-index of 0.705 and 0.674 in the derivation and validation datasets, respectively. Furthermore, the model performed better in predicting patient prognosis than traditional staging systems. The model effectively stratified patients with AFP-negative HCC into high- and low-risk groups with significantly different outcomes (p < 0.05).
Conclusions
A prognostic model integrating the LI-RADS category, blood products in mass, microvascular invasion, tumor size, cirrhosis, and albumin–bilirubin grade may serve as a valuable tool for refining risk stratification in patients with AFP-negative HCC.
Bang and the Artefacts are Gone! Rapid Artefact Removal and Tissue Segmentation in Haematoxylin and Eosin Stained Biopsies
Authors: Schreiber Benjamin , Denholm James , Jaeckle Florian , Arends Mark , Branson Kim , Schönieb Carola-Bibane , Soilleux Elizabeth 
Published: November 2023

Abstract
We present H&E Otsu thresholding, a scheme for rapidly detecting tissue in whole-slide images (WSIs) that eliminates a wide range of undesirable artefacts such as pen marks and scanning artefacts. Our method involves obtaining a bimodal representation of a low-magnification RGB overview image which enables simple Otsu thresholding to separate tissue from background and artefacts. We demonstrate our method on WSIs prepared from a wide range of institutions and WSI digital scanners, each containing substantial artefacts that cause other methods to fail. The beauty of our approach lies in its simplicity: manipulating RGB colour space and using Otsu thresholding allows for the rapid removal of artefacts and segmentation of tissue.
Classifying Emergency Patients into Fast-Track and Complex Cases Using Machine Learning
Authors: Karajeh Ala' , Eskicioglu Rasit 
Published: November 2023

Abstract

Background: Emergency medicine is a lifeline specialty at hospitals that patients head to for various reasons, including serious health problems, traumas, and adventitious conditions. Emergency departments are restricted to limited resources and personnel, which complicates handling all received cases optimally. Therefore, crowded waiting areas and long waiting durations result, which prompts some patients to leave before being examined.
Methods: We utilized the databases (MIMIC-IV-ED and MIMIC-IV) to obtain records of patients who visited the Beth Israel Deaconess Medical Center in the USA. Triage and demographic data, dispositions, and length of stay of these individuals were extracted accordingly. Subsequently, the urgency of these cases was inferred based on standards stated in the literature and followed in developed countries, which are less than four-hour lengths of stay besides being discharged at the end of the emergency visit. Five classifying models were established by utilizing logistic regression, random forests, stochastic gradient boosting, classification and regression trees besides multi-layer perceptron algorithms.
Results: A comparative framework using the five different machine learning algorithms was developed to classify these patients into two categories where the multi-layer perceptron model outperformed the others. Moreover, the relative importance of the outcome predictors was determined.
Conclusions: This study suggests an approach to deal with non-urgent visits and lower overall waiting times at the emergency by utilizing the powers of machine learning to identify fast-track patients and discern them from critical cases.
Gingival mesenchymal stem cells derived from patients with rheumatoid arthritis treats experimental arthritis
Authors: Hou Yuluan , Zeng Donglan , Yang luo , Zhang Ximei , Dang Jun , Wu wenbin , Xiong Yiding , Zhao jun , Zhu Shangling , Huang Jianlin , Yuan jia , Wang Shuhong , Wang julie , Xu Hanshi , Chen zheng , Zheng Song Guo 
Published: November 2023

Abstract
Background
Therapeutic strategy using mesenchymal stem cells (MSCs) has been accepted as a novel therapy for treating rheumatoid arthritis (RA). Human gingiva derived MSCs (GMSCs) are superior in regulating immune responses. To avoid the potential risks of allogenic MSC, autologous MSCs are the optimal candidate. However, whether autologous GMSCs from RA patients are therapeutic remains unknown.
Methods
In this study, we compared the therapeutic efficacy of GMSCs derived from patients with RA (RA-GMSCs) and that from health donors (H-GMSCs) in vivo and in vitro. Then, we utilized RNA-sequencing, the molecular and cellular assays to determine the immunomodulatory molecules that contribute to therapeutic effect of RA-GMSCs on both collagen-induced arthritis (CIA) and humanized synovitis models.
Results
We demonstrated that GMSCs derived from patients with RA (RA-GMSCs) and that from health donors (H-GMSCs) shared the similar expression of immunomodulatory molecules. Moreover, RA-GMSCs were as effective as H-GMSCs in suppressing T cell proliferation, proinflammatory cytokines secretion, as well as osteoclast differentiation in vitro. In addition, RA-GMSCs had a robust therapeutic effect on collagen-induced arthritis (CIA) model. Specifically, RA-GMSCs decreased the frequency of Th1 and Th17 cells whereas enhanced Treg cells, reducing the joint histopathological scores of lymphocytes, osteoclasts and cartilages. Importantly, RA-GMSCs were also effective in suppressing inflamed synoviocytes (RA-FLSs) proliferation, migration and invasion in vitro, and cartilage invasion in a humanized synovitis model in vivo.
Conclusion
Our study implies that manipulation of RA-GMSCs is therapeutic in CIA mice and humanized synovitis models and may have a therapeutic potential in RA patients using autologous GMSCs in the future.
Graphical abstract
Cytological mapping of a powdery mildew resistance locus PmRc1 by the construction of wheat-Roegneria ciliaris structural aberration library
Authors: Cheng Menghao , Zhang Huajian , Zhang Yao , Tang Xiong , Wang Zongkuan , Zhang Xu , Song Xinying , Li Xingyue , Cui Huimin , Wang Tong , Song Rongrong , Xiao Jin , Wang Haiyan , Wang Xiue 
Published: November 2023

Abstract
Powdery mildew (Pm) is a fungal disease threatening wheat production. The identification of novel Pm resistance genes, especially those from wild relatives, will greatly broaden the genetic diversity of wheat breeding. Roegneria ciliaris (2n=4x=28, genome ScScYcYc) is a wheat relative. We developed 14 disomic addition lines in previous research. In this study, we identified addition line DA1Sc exhibited stable improved Pm resistance. We confirmed the Pm resistance was attributed by the added 1Sc in wheat background, and designated the locus as PmRc1. To develop translocation lines for facilitate the breeding use of PmRc1, we induced 1Sc chromosomal structural aberrations by irradiation and the Chinese Spring ph1b deletion mutant. Forty-three wheat-R. ciliaris 1Sc aberrations were identified and characterized by GISH/FISH and marker analysis using 1Sc diagnostic markers. The 1Sc cytological bin map was constructed and 1Sc was dissected into 28 bins. Pm resistance evaluation of the aberrations enabled us to allocate the PmRc1 into bin 1ScS-8, flanked by markers CMH93-2 and CMH114-1. Two compensative translocation lines (T1ScS•1BL and T1ScS-1AS•1AL), both carrying the PmRc1 and Pm resistant, were investigated for agronomic traits. T1ScS•1BL had increased grain size and weight, while decreased grain numbers. T1ScS-1AS•1AL had increased number of spikelet per spike. The translocation lines provide new genetic resource for improving Pm resistance in wheat breeding program.
In Silico Predictive Homology Modeling of PKHD-1 Protein: A Comparative Study among Three Different Species
Authors: SB Arunannamalai 
Published: November 2023

Abstract
PKHD-1 (Polycystic Kidney and Hepatic Disease-1) gene encodes a vital pro- tein critical for renal and hepatic functions. Mutations in PKHD-1 lead to a severe type of disorder in early infancy called Autosomal Recessive Polycystic Kidney Disease (ARPKD). The PKHD-1 protein structure remains unavailable in databases such as PDB, with only a few low-resolution structures accessible in the Swiss Model Template Library. Therefore, Homology Modeling was employed to generate structural models of PKHD-1 proteins derived from three different species [Homo sapiens (Human), Mus musculus (Mouse), Canis lupus familiaris (Dog)]. The mouse PKHD-1 protein was structurally predicted by employing the AlphaFold DB model based on the PKHD1 ciliary IPT domain of fibro- cystin/polyductin from Rattus norvegicus as a reference template. Additionally, the human and dog PKHD-1 proteins were modeled using the AlphaFold DB model of the G8 domain-containing protein from Marmota monax as the template for the prediction process. In addition, we employ GOR4 for analyzing secondary structure, ProtParam for assessing physicochemical properties, QMEAN for eval- uating the quality of protein structure, and MolProbity for validating protein structures along with obtaining the Ramachandran plot. The binding pockets were also predicted using P2Rank tool (PrankWeb web server).
Epidemiological characteristics and outcomes of special-cause burns: analysis of 33,619 burn patients in a major regional burn center in China from 2004 to 2021
Authors: Li Ze , Jiang Meijun , Xi Maomao , Xie Weiguo 
Published: November 2023

Abstract
Special-cause burn injuries are usually more severe and difficult to manage, and often and often contribute a high mortality in severely injured patients. The aim of this study was to present the epidemiological characteristics of special-cause burn in a major regional burn center in China between 2004 and 2021 and determine the risk factors associated with the mortality of burn patients. A total of 33619 burn patients were included the study, among which 4452 (13.2%) were special-cause burn patients. Compared to the thermal burn group, the special-cause burn patients were usually male, elder, married and III-IV degree of burn with onset of upper extremity in summer and autumn. Moreover, a greater proportion of patients in the special-cause burn group underwent surgical treatment and amputation and had a higher median hospital stay and treatment costs. During the multivariate logistic regression, older age, male, unmarried, winter, III-IV degree of burn, ≥ 3 burn sites, and larger total body surface area (TBSA) of burn were significantly associated with higher burn mortality (all P < 0.05), however, patients with special-cause burn injuries have not increased odds for mortality (P > 0.05). These results suggested that special cause-burn patients suffer more severe injuries, resulting in longer hospital stays and higher health care expenditures, but it did not significantly improve the mortality risk. Therefore, burn clinicians should not only have the responsibility to cure burns, but also need to know and popularize burn epidemiological characteristic and precaution.
The Effect of Intratesticular Injection of Autologous Platelet Rich Plasma (PRP) on Sperm Retrieval Rates and IVF Outcomes in Men with Non-Obstructive Azoospermia and History of Failed Testicular Sperm Extraction
Authors: Güdelci Tansu , Çakıroğlu Yiğit , Yücetürk Ayşen , Batır Sevil , Karaosmanoğlu Özge , Korun Zeynep , Tüfek İlter , Kural Ali , Tıraş Bülent 
Published: November 2023

Abstract
In this study, we aimed to assess the impact of intratesticular injection of autologous platelet-rich plasma (PRP) on sperm retrieval rates and in vitro fertilization outcomes in men with non-obstructive azoospermia (NOA) who had previously undergone at least one unsuccessful microscopic testicular sperm extraction (micro-TESE) procedure. We divided participants into two groups: Group 1 with one prior failed micro-TESE procedure and Group 2 with two or more previous failures.
Three months after the PRP injection, micro-TESE procedure was done on the day of egg retrieval. Sperm was successfully retrieved in 22 out of 80 of patients (27.5%) in Group 1, and 9 out of 55 patients (16.4%) in Group 2. Fertilization rates after intracytoplasmic sperm injection was 86.4% (19/22) in Group 1 and 100% (9/9) in Group 2. In Group 1, 31.81% of cases (7/22) and, in Group 2, 22.22 % of cases (2/9) resulted in live births.
The use of autologous PRP in men with the diagnose of NOA who had a history of failed micro-TESE is a promising new experimental method in the field of male infertility. Nevertheless, additional investigation through randomized controlled trials is necessary to refine the technique and determine its effectiveness.