bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of 90‐Day Home Time Among Patients With Medium‐Vessel Occlusion Undergoing Endovascular Thrombectomy
Authors: Singh Nishita , Bala Fouzi , Kashani Nima , Horn MacKenzie , Stang Jillian , Demchuk Andrew M. , Hill Michael D. , Almekhlafi Mohammed A. , Holodinsky Jessalyn K. 
Published: May 2023

Background
The benefit of endovascular thrombectomy for medium‐vessel occlusion (MeVO) strokes is unclear. We used 90‐day home time to explore outcomes in patients with MeVO versus large‐vessel occlusions treated with endovascular thrombectomy.

Methods
Data are from the QuICR (Quality Improvement and Clinical Research) provincial stroke registry and linked administrative data to identify patients who underwent endovascular thrombectomy in our center from January 2015 to December 2020. Imaging data were scored by 2‐physician consensus. We defined MeVO as occlusion beyond and including M2–middle cerebral artery, A2–anterior cerebral artery, or P2–posterior cerebral artery segments. Successful reperfusion was defined as Thrombolysis in Cerebral ischemia grades (≥2b/3). The primary outcome was patient home time (the number of nights a patient is back at their premorbid living situation without an increase in level of care within 90 days of the stroke) using random forest regression. Covariate contribution to home time was determined using partial dependence plots.

Results
Among 663 patients who underwent endovascular thrombectomy, 139 (20.9%) had MeVO (median age, 71 years; 50.4% women; median National Institutes of Health Stroke Scale, 16). The majority (82%) had good pial collaterals, 10.4% had a tandem extracranial carotid occlusion or stenosis, and 41.7% received intravenous thrombolysis. The most common site of occlusion was M2–middle cerebral artery (58.3%). One hundred eighteen (86.7%) patients achieved successful reperfusion (Thrombolysis in Cerebral Ischemia grades ≥2b/3). Using partial dependence plots, the mean predicted home times were similar in patients with MeVO (45.5 days) versus large‐vessel occlusions (44.6 days). Factors predicting lower 90‐day home time in patients with MeVOs were diabetes (−8.7 days), hypertension (−6.5 days), and atrial fibrillation (−3.5 days). There was no meaningful difference in predicted 90‐day home‐time by sex, baseline National Institutes of Health Stroke Scale, collateral grade, or thrombolysis.

Conclusion
Patients with MeVO who are selected for endovascular therapy with similar demographic and clinical profiles to large‐vessel occlusions can achieve similar 90‐day home time outcomes to large‐vessel occlusions.
The Minnesota attributable risk of kidney donation (MARKD) study: a retrospective cohort study of long-term (> 50 year) outcomes after kidney donation compared to well-matched healthy controls
Authors: Vock David M. , Helgeson Erika S. , Mullan Aidan F. , Issa Naim S. , Sanka Sujana , Saiki Alison C. , Mathson Kristin , Chamberlain Alanna M. , Rule Andrew D. , Matas Arthur J. 
Published: May 2023

Abstract
Background
There is uncertainty about the long-term risks of living kidney donation. Well-designed studies with controls well-matched on risk factors for kidney disease are needed to understand the attributable risks of kidney donation.

Methods
The goal of the Minnesota Attributable Risk of Kidney Donation (MARKD) study is to compare the long-term (> 50 years) outcomes of living donors (LDs) to contemporary and geographically similar controls that are well-matched on health status. University of Minnesota (n = 4022; 1st transplant: 1963) and Mayo Clinic LDs (n = 3035; 1st transplant: 1963) will be matched to Rochester Epidemiology Project (REP) controls (approximately 4 controls to 1 donor) on the basis of age, sex, and race/ethnicity. The REP controls are a well-defined population, with detailed medical record data linked between all providers in Olmsted and surrounding counties, that come from the same geographic region and era (early 1960s to present) as the donors. Controls will be carefully selected to have health status acceptable for donation on the index date (date their matched donor donated). Further refinement of the control group will include confirmed kidney health (e.g., normal serum creatinine and/or no proteinuria) and matching (on index date) of body mass index, smoking history, family history of chronic kidney disease, and blood pressure. Outcomes will be ascertained from national registries (National Death Index and United States Renal Data System) and a new survey administered to both donors and controls; the data will be supplemented by prior surveys and medical record review of donors and REP controls. The outcomes to be compared are all-cause mortality, end-stage kidney disease, cardiovascular disease and mortality, estimated glomerular filtration rate (eGFR) trajectory and chronic kidney disease, pregnancy risks, and development of diseases that frequently lead to chronic kidney disease (e.g. hypertension, diabetes, and obesity). We will additionally evaluate whether the risk of donation differs based on baseline characteristics.

Discussion
Our study will provide a comprehensive assessment of long-term living donor risk to inform candidate living donors, and to inform the follow-up and care of current living donors.
Esculetin releases maturation arrest and induces terminal differentiation in leukemic blast cells by altering the Wnt signaling axes
Authors: Mathur Ankit , Gangwar Aman , Saluja Daman 
Published: May 2023

Abstract
Background
The “Differentiation therapy” has been emerging as a promising and more effective strategy against acute leukemia relapses.

Objective
In extension to the revolutionising therapeutic outcomes of All Trans Retinoic Acid (ATRA) to induce terminal differentiation of Acute Promyelocytic Leukemic (APL) blast cells, we decipher the potential effect of a natural compound “Esculetin” to serve as a differentiating agent in Acute Myeloid Leukemia (AML). Underlaying role of Wnt signaling pathways in esculetin mediated blast cell differentiation was also evaluated.

Methods
Human acute myeloid leukemic cells (Kasumi-1) with t(8;21/AML-ETO) translocation were used as a model system. Growth inhibitory and cytotoxic activity of esculetin were analysed using growth kinetics and MTT assay. Morphological alterations, cell scatter characteristics, NBT reduction assay and cell surface marker expression patterns were analysed to detect terminally differentiated phenotypes. We employed RT2profiler PCR array system for the analysis of transcriptome profile of Wnt signaling components. Calcium inhibitors (TMB8 and Amlodipine) and Transforming growth factor beta (TGF-β) were used to modulate the Wnt signaling axes.

Results
We illustrate cytotoxic as well as blast cell differentiation potential of esculetin on Kasumi-1 cells. Morphological alterations akin to neutrophilic differentiation as well as the corresponding acquisition of myeloid lineage markers indicate terminal differentiation potential of esculetin in leukemic blast cells. Exposure to esculetin also resulted in downregulation of canonical Wnt axis while upto ~ 21 fold upregulation of non-canonical axis associated genes.

Conclusions
Our study highlights the importance of selective use of calcium pools as well as “axis shift” of the canonical to non-canonical Wnt signaling upon esculetin treatment which might abrogate the inherent proliferation to release maturation arrest and induce the differentiation in leukemic blast cells. The current findings provide further therapeutic interventions to consider esculetin as a potent differentiating agent to counteract AML relapses.
Heterogeneity of non-suicidal self-injury behavior in adolescents with depression: latent class analysis
Authors: He He , Hong Lan , Jin Wei , Xu Yao , Kang Wei , Liu Jie , Song Jingyao , Zheng Tiansheng , Chen Hong , Zhao Ke 
Published: May 2023

Abstract
Background
Non-suicidal self-injury (NSSI) by adolescent patients with depression has become a serious public health problem. This cross-sectional study aims to identify subgroups of adolescents based on NSSI and explore the factors related to these subgroups.

Methods
The study recruited 326 in- and out-patient adolescents (263 girls and 63 boys) aged 12 to 18 years (mean = 14.7, SD = 1.6) who had self-injured in the past year. Latent class indicators included 12 NSSI variables, as well as suicidal ideation. Logistic regression examined associations between identified classes and related factors.

Results
In this study, two distinct subgroups were identified: a “high suicidal ideation NSSI group” (n = 129, 39.6%) and a “low suicidal ideation NSSI group” (n = 197, 60.4%). Depression (OR = 1.10; 95% CI, 1.05–1.16), female (OR = 2.01; 95% CI, 1.09–3.69), left-behind experience (OR = 2.08; 95% CI, 1.17–3.71), single-parent family (OR = 1.84; 95% CI, 1.11–3.04) and peer victimization (OR = 1.04; 95% CI, 1.02–1.05) increases the probability of belonging to the “high suicidal ideation NSSI group”. A high level of perceived social support (OR = 0.99; 95% CI, 0.97–0.99) was a protective factor towards NSSI.

Conclusions
This study identifies two subgroups of NSSI and the factors associated with each subgroup. The early identification of high-risk groups for major NSSI in adolescents diagnosed with depression is possible due to the identification of correlating factors. Different treatment plans can be developed for different subtypes of NSSI to improve the effectiveness of prevention and intervention, promoting the healthy physical and mental development of adolescents with depression.
The Bergen 4-day treatment for panic disorder: implementation in a rural clinical setting
Authors: Eide Thorstein Olsen , Hjelle Kay Morten , Sætre Ida Ueland , Solem Stian , Olsen Thorbjørn , Sköld Rolf Olof , Kvale Gerd , Hansen Bjarne , Hagen Kristen 
Published: May 2023

Abstract
Introduction
The Bergen 4-Day Treatment (B4DT) is a concentrated treatment with individually tailored exposure exercises. The format has shown promising results in the treatment of panic disorder.

Aim
The aim of the current study was to investigate the effectiveness of the B4DT in a large sample in a rural clinical setting.

Method
Fifty-eight patients with panic disorder were consecutively included using an open trial design. The primary outcome measure was the Panic Disorder Severity Scale. The Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-9 were used as secondary outcome measures. Assessments were conducted at pretreatment, posttreatment, and 3-month follow-up. Treatment satisfaction was measured at posttreatment using the Client Satisfaction Questionnaire-8.

Results
There was a significant reduction in symptoms of panic disorder from pre- to posttreatment (d = 3.36) and from pretreatment to follow-up (d = 3.63). At posttreatment and follow-up, 72.4% and 81.0% of patients, respectively, were classified as in remission. Patients reported high treatment satisfaction, and there were significant reductions in symptoms of generalized anxiety and depression.

Conclusion
The results from the current study replicated the findings from previous studies using a larger sample size. The findings indicate that the B4DT is a promising treatment format for panic disorder. The study also demonstrated that the treatment format can be successfully implemented in new rural clinics.
A descriptive study on clinical department managers’ cognition of the Plan-Do-Check-Act cycle and factors influencing their cognition
Authors: Zhong Xuemin , Wu Xiaoxiao , Xie Xue , Zhou Qian , Xu Ronghua , Wang Jian , He Lanying , He Yawei , Qiu Xiaobo 
Published: May 2023

Abstract
Background
The mastery and application of the “Plan-Do-Check-Act” (PDCA) cycle by hospital clinical department managers are essential for hospitals to carry out total quality management and continuously improve medical quality. This study investigated the degree of cognition of the PDCA cycle by clinical department managers and the factors affecting their cognition.

Methods
A self-designed questionnaire was used to evaluate the cognition of clinical department managers regarding the PDCA cycle in 11 municipal public Class III Grade A hospitals in Western China.

Results
More than 25% of clinical department managers in the surveyed hospitals are unaware or partially aware of the PDCA cycle. Logistic regression analysis showed that sex (P = 0.049), education (P < 0.001), duty (P < 0.001), and tenure (P = 0.002) had a significant influence on managers’ cognition of PDCA. Participants who were female (P < 0.001), undergraduate (P < 0.001), head nurses, or deputy head nurses (P < 0.001), with a tenure of 5–10 years (P = 0.024) had a better cognition of the PDCA cycle. In the daily management of the department, the vast majority of managers do not implement the Check and Action steps. Among the trained managers, only 65.44% applied the complete PDCA cycle in daily management. Nearly a third of managers thought PDCA was a response to hospital demands; 82.83% of the managers need to receive PDCA cycle training, and half of them indicated a preference for online training.

Conclusions
The cognition level of hospital clinical department managers regarding the PDCA cycle is relatively low, especially among the clinical department heads, and most of them are willing to accept PDCA cycle training.
Encountering suffering in digital care: a qualitative study of providers’ experiences in telemental health care
Authors: Åhs Jill W. , Ranheim Albertine , Eriksson Henrik , Mazaheri Monir 
Published: May 2023

Abstract
Background
Encountering patients who are suffering is common in health care, and particularly when providing mental health care. Telehealth technologies are increasingly used to provide mental health care, yet little is known about the experiences of providers when encountering patients who are suffering within remote care. The present study explored health care providers’ lived experiences of encountering patient suffering during telemental health care.

Methods
A qualitative phenomenological approach was used to uncover participants’ experiences. In-depth interviews were conducted with a purposive sample of physicians, psychologists, and therapists who used telemental health in varied clinical practices in Sweden. Data were analyzed using descriptive phenomenology.

Results
Telehealth care with patients who were suffering was experienced by providers as loose connections, both literally in compromised functioning of the technology and figuratively in a compromised ability connecting emotionally with patients. Providers’ lived experiences were explicated into the following aspects: insecurity in digital practice, inaccessibility of the armamentarium, and conviction in the value of telehealth care. Interpersonal connection between patient and provider is necessary. Worry and guilt arose for providers with fears that technology would not work, patient status was deteriorated, or the care needed could not be delivered. Providers overcame barriers in telehealth encounters, and expressed they perceived that patients appreciated the care received, and through it found relief.

Conclusions
This study brings an understanding of experiences in providing telemental care for patients who are suffering. Providers experience challenges in connecting with patients, and in accessing tools needed to enable reaching the goals of the caring encounter. Efforts to ensure functioning of technology, comfort with its use, and accessibility of tools might be some accommodations to support providers for successful and rewarding telehealth care encounters.
Comparative assessment of the bacterial communities associated with Anopheles darlingi immature stages and their breeding sites in the Brazilian Amazon
Authors: Mosquera Katherine D. , Nilsson Louise K. J. , de Oliveira Marta Rodrigues , Rocha Elerson Matos , Marinotti Osvaldo , Håkansson Sebastian , Tadei Wanderli P. , de Souza Antonia Queiroz Lima , Terenius Olle 
Published: May 2023

Abstract
Background
The neotropical anopheline mosquito Anopheles darlingi is a major malaria vector in the Americas. Studies on mosquito-associated microbiota have shown that symbiotic bacteria play a major role in host biology. Mosquitoes acquire and transmit microorganisms over their life cycle. Specifically, the microbiota of immature forms is largely acquired from their aquatic environment. Therefore, our study aimed to describe the microbial communities associated with An. darlingi immature forms and their breeding sites in the Coari municipality, Brazilian Amazon.

Methods
Larvae, pupae, and breeding water were collected in two different geographical locations. Samples were submitted for DNA extraction and high-throughput 16S rRNA gene sequencing was conducted. Microbial ecology analyses were performed to explore and compare the bacterial profiles of An. darlingi and their aquatic habitats.

Results
We found lower richness and diversity in An. darlingi microbiota than in water samples, which suggests that larvae are colonized by a subset of the bacterial community present in their breeding sites. Moreover, the bacterial community composition of the immature mosquitoes and their breeding water differed according to their collection sites, i.e., the microbiota associated with An. darlingi reflected that in the aquatic habitats where they developed. The three most abundant bacterial classes across the An. darlingi samples were Betaproteobacteria, Clostridia, and Gammaproteobacteria, while across the water samples they were Gammaproteobacteria, Bacilli, and Alphaproteobacteria.

Conclusions
Our findings reinforce the current evidence that the environment strongly shapes the composition and diversity of mosquito microbiota. A better understanding of mosquito–microbe interactions will contribute to identifying microbial candidates impacting host fitness and disease transmission.

Graphical Abstract
Perspectives of adults living with HIV attending the opportunistic infections clinic at Chitungwiza central hospital in Zimbabwe towards physical activity: a cross-sectional survey
Authors: Kaseke Farayi , Pamire Precious R , Mlambo Tecla , Nhunzvi Clement 
Published: May 2023

Abstract
Background
Regular physical activity and exercise have been shown to be of benefit in managing the HIV disease, its complications and the side effects of HAART. The perceptions of those living with HIV toward physical activity and exercises is a key factor in advocating for participation of rehabilitation personnel in the management of this disease. However, this domain remains underexplored in Zimbabwe.

Methods
A descriptive cross-sectional quantitative study was conducted with 327 people living with HIV. Participants were consecutively sampled from Chitungwiza Central Hospital Opportunistic Clinic. The International Physical Activity Questionnaire (IPAQ) and the Exercise Benefits/Barriers Scale (EBBS) were respectively used to measure the physical activity level and perceived benefits/barriers of physical exercise among adults living with HIV. The tools were self-administered. The analyses were done for 323 participants using the Statistical Package for the Social Sciences (SPSS).

Results
The mean age was 41.1 ± 11.0. Females constituted 69.7% (n = 225) of the sample. The majority of participants (n = 184; 57%) described themselves as being highly physically active (3204;IQR = 2139–4441 MET-minutes/week). Most of the participants agreed that physical activity prevented heart attacks with a mean value of 3.34 ± 0.65. The majority perceived psychological outlook as the greatest benefit from physical activity among the benefit sub-scales. Furthermore, most of the participants agreed that it cost too much for them to exercise which had a mean of 3.00 ± 0.88. Family discouragement was the most agreed perceived barrier to physical activity with a mean of 2.91 ± 0.67. Those who perceived physical activity as being beneficial reported less barriers. A statistically significant association was found between level of physical activity and CD4 cell count (p = 0.035) as well as with employment status (p < 0.05). No statistically significant association was reported between the perceived benefits and the level of physical activity (p = 0.214). A statistically significant association was reported between the perceived barriers and age (p < 0.05) as well as with employment status (p = 0.006).

Conclusion
Adults living with HIV receiving HAART at Chitungwiza Central Hospital are highly active when compared to other studies done in Sub-Saharan Africa. It is also important to create interventions that promote physical activity considering what this population considers as perceived benefits and barriers to physical activity.
An RMT-based generalized Bayesian information criterion for signal enumeration
Authors: Yuan Shoucheng , Zhang Bin 
Published: May 2023

AbstractThis paper provides a method for enumerating signals impinging on an array of sensors based on the generalized Bayesian information criterion (GBIC). The proposed method motivates by a statistic for testing the sphericity of the covariance matrix when the sample size n is less than the dimension m. The statistic consists of the first four moments of sample eigenvalue distribution and relaxes the assumption of Gaussian distribution. We derive the asymptotical distribution of the statistic as m, n tends to infinity at the same ratio by random matrix theory and propose the expression of GBIC for determining the signal number. Numerical simulations demonstrate that the proposed method has a high probability of detection in both the Gaussian and the non-Gaussian noise, and performs better than other methods.
Seal call recognition based on general regression neural network using Mel-frequency cepstrum coefficient features
Authors: Yao Qihai , Wang Yong , Yang Yixin , Shi Yang 
Published: May 2023

AbstractIn this paper, general regression neural network (GRNN) with the input feature of Mel-frequency cepstrum coefficient (MFCC) is employed to automatically recognize the calls of leopard, ross, and weddell seals with widely overlapping living areas. As a feedforward network, GRNN has only one network parameter, i.e., spread factor. The recognition performance can be greatly improved by determining the spread factor based on the cross-validation method. This paper selects the audio data of the calls of the above three kinds of seals and compares the recognition performance of three machine learning models for inputting MFCC features and low-frequency analyzer and recorder (LOFAR) spectrum. The results show that at the same signal-to-noise ratio (SNR), the recognition result of the MFCC feature is better than that of the LOFAR spectrum, which is verified by statistical histogram. Compared with other models, GRNN for inputting MFCC features has better recognition performance and can still achieve effective recognition at low SNRs. Specifically, the accuracy is 97.36%, 93.44%, 92.00% and 88.38% for cases with an infinite SNR and SNR of 10, 5 and 0 dB, respectively. In particular, GRNN has the least training and testing time. Therefore, all results show that the proposed method has excellent performance for the seal call recognition.