bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Preliminary Analysis of Serum Iron's Role in Predicting Sepsis-associated Encephalopathy
Authors: Jin Jun , Du Qian , Cheng Beibei , Zhou Qingshan , Wu Lili , Yu Lei 
Published: September 2023

Abstract

Sepsis is a life-threatening condition characterized by organ dysfunction resulting from an uncontrolled response to infection, with the nervous system being particularly vulnerable. Iron is an essential trace element in the human body and is closely associated with sepsis and neurological diseases. The MIMIC-IV database was utilized for a retrospective cohort study involving 936 patients in the intensive care unit who experienced severe adverse events (SAE). These patients were randomly assigned to either a training or validation cohort. Independent risk factors for SAE were identified through LASSO logistic regression. Subsequently, a nomogram was developed incorporating these factors to predict the occurrence of SAE in sepsis patients. The efficacy of the nomogram was evaluated using several statistical measures, including the AUC, calibration curve, Hosmer-Lemeshow test, IDI, NRI, DCA. Furthermore, in order to delve deeper into the correlation between serum iron and the occurrence of SAE, both univariate and multivariate logistic regression analyses were conducted. The analysis revealed that out of the 936 patients, there were a total of 649 cases of SAE. Additionally, the implementation of LASSO regression analysis identified several independent risk factors for SAE, namely mean arterial pressure, respiratory rate, type of microorganism, serum iron levels, elective surgery, SASPIII score, and OASIS score. Moreover, the performance evaluation of the developed nomogram, based on metrics such as AUC, NRI, IDI, and DCA, demonstrated superior results compared to the conventional combination of SOFA and delirium. Moreover, the satisfactory calibration of the nomogram was confirmed by the calibration curve and results of the Hosmer-Lemeshow test. Our nomogram scoring system exhibited superior NRI and IDI values compared to conventional diagnostic methods. The DCA curves demonstrated favorable clinical utility for the nomogram. Multivariate logistic regression analysis revealed that serum iron remained an independent predictor of SAE. Specifically, lower serum iron levels were associated with a higher risk of SAE (OR = 0.997, 95% CI = 0.993-1.000). The findings of our study clearly indicate that serum iron levels significantly influence the diagnosis of SAE.
Synthesis of EPD, an established cytotoxic agent for ovarian cancer cells, and its efficacy in cisplatin and paclitaxel resistant tumor cells
Authors: Haaften Caroline , Koek Jan , Eendenburg Jaap D.H. , Hoeve Wolter ten 
Published: September 2023

Abstract
Ovarian cancer remains still the leading cause of death of gynaecological malignancy, for the greater part caused by tumour resistance to conventional treatment with cisplatin and paclitaxel. In the past a new compound, EPD, from the plant Calomeria amaranthoides has been isolated and proved to be a potential anti-cancer agent. The sesquiterpene lactone, EPD, or Eremophila-1(10)-11(13)-dien-12,8β-olide, has an alpha-methylene gamma-lactone ring, essential for its apoptotic activity. In order to have sufficient EPD material for further anti-tumour studies, a synthetic route has been developed. Drug combinations with synthesized EPD, cisplatin and paclitaxel were studied in four ovarian cell lines, and normal fibroblasts. EPD showed in particular strength in its effects with the cisplatin resistant cell line COV362 cl 4 and with a paclitaxel resistant cell line A2780. Compared to cisplatin and paclitaxel, less effects of EPD were shown to effect the viability of normal fibroblasts. Synthesized EPD proved to be promising both as an anti-ovarian cancer agent as well as a chemo-sensitizing agent in combination with other anti-cancer drugs. Synthesized EPD will facilitate pre-clinical studies.
A modified method for isolating sinoatrial node myocytes from adult mice
Authors: Li Qiang , Zhang Hanying , Liu Ronghua , Wang Luqi , Guo Xintong , You Hongjie , Xue Jingyi , Luo Dali 
Published: September 2023

Abstract

Sinoatrial node (SAN) is the pacemaker of the heart in charge of initiating spontaneous electronical activity and controlling heart rate. Myocytes from SAN can generate spontaneous rhythmic action potentials, which propagate through the myocardium thereby triggering cardiac myocyte contraction. Acutely, the method for isolating sinoatrial node myocytes (SAMs) is critical in studying the protein expression and function of myocytes in SAN. Currently, the SAMs were isolated by transferring SAN tissue directly into the digestion solution, but it is difficult to judge the degree of digestion, and the cell yield and viability. Here, we present a modified protocol for isolation of SAMs in mice, based on the collagenase II and protease perfusion of heart using a Langendorff-apparatus, and subsequent dissociation of SAMs. The appearance and droplet flow rate of the heart could be significantly changed during enzymatic digestion via perfusion, which allowed us to easily judge the degree of digestion and avoid incomplete or excessive digestion. The SAMs with stable yield and viability achieving from our optimized approach would facilitate the follow-up experiments.
Assessment of Nutritional and Subjective Health Status 0f Chronically Ill Children Aged 7-15 Years Attending Special Schools in Lahore
Authors: Ahmad Afaq , Shahbaz Hafiz Muhammad , Sohaib Muhammad , Bilal Muhammad 
Published: September 2023

Abstract
Background Malnutrition adversely impacts the health of chronically ill children, increasing the risk of infections, disabilities, and even mortality. This cross-sectional study aimed to determine the nutritional and subjective health status of children aged 7-15 years with chronic diseases attending special schools.
Methods A total of 172 children with chronic diseases attending seven schools for the disabled (Blind and Physically disabled) were included in the study. Socio-demographic parameters of nutritional status and subjective health status were assessed using questionnaires and anthropometric measurements. Malnutrition status was assessed as acute malnutrition (<-2 SDS for WFH) and chronic malnutrition (<-2 SDS for HFA). Malnutrition risk was evaluated using the STRONGkids screening tool. The EQ-5D tool was used to assess subjective health status.
Results Malnutrition prevalence was 52.9% among children with 19.2% acute and 30.2% chronic. Based on the STRONGkids questionnaire, 11.6% of children were at high risk and 31.4% were at moderate risk for developing malnutrition. Caretakers from different schools reported some/severe problems in health status dimensions of mobility 64%, self-care 45%, usual activities 45%, pain 49%, and anxiety/discomfort 36% in children. The mean VAS score was 67.5 (SD 11.8). Malnutrition explained 31% of the variation in the VAS score.
Conclusions The presence of malnutrition among chronically ill children going to special schools was significantly associated with low subjective health status. Addressing malnutrition can improve the subjective health status of chronically-ill children.
Predicting stone composition via machine-learning models trained on intra‐operative endoscopic digital images
Authors: 朱 冠华 , Li Chengbai , Guo Yinsheng , Sun Lu , Jin Tao , Wang Ziyue , Li Shiqing , Zhou Feng 
Published: September 2023

Abstract
Objectives
The aim of this study was to use deep learning (DL) of intraoperative images of urinary stones to predict the composition of urinary stones. In this way, the laser frequency and intensity can be adjusted in real time to reduce operation time and surgical trauma.
Materials and methods
A total of 490 patients who underwent holmium laser surgery during the two-year period from March 2021 to March 2023 and had stone analysis results were collected by the stone laboratory. A total of 1658 intraoperative stone images were obtained. The eight stone categories with the highest number of stones were selected by sorting. Single component stones include calcium oxalate monohydrate (W1), calcium oxalate dihydrate (W2), magnesium ammonium phosphate hexahydrate, apatite carbonate (CH) and anhydrous uric acid (U). Mixed stones include W2 + U, W1 + W2 and W1 + CH. All stones have intraoperative videos. More than 20 intraoperative high-resolution images of the stones, including the surface and core of the stones, were available for each patient via FFmpeg command screenshots. The deep convolutional neural network (CNN) ResNet-101 (ResNet, Microsoft) was applied to each image as a multiclass classification model.
Results
The composition prediction rates for each component were as follows: calcium oxalate monohydrate 99% (n = 142), calcium oxalate dihydrate 100% (n = 29), apatite carbonate 100% (n = 131), anhydrous uric acid 98% (n = 57), W1 + W2 100% (n = 82), W1 + CH 100% ( n = 20) and W2 + U 100% (n = 24). The overall weighted recall of the cellular neural network component analysis for the entire cohort was 99%.
Conclusion
This preliminary study suggests that DL is a promising method for identifying urinary stone components from intraoperative endoscopic images. Compared to intraoperative identification of stone components by the human eye, DL can discriminate single and mixed stone components more accurately and quickly. At the same time, based on the training of stone images in vitro, it is closer to the clinical application of stone images in vivo. This technology can be used to identify the composition of stones in real time and to adjust the frequency and energy intensity of the holmium laser in time. The prediction of stone composition can significantly shorten the operation time, improve the efficiency of stone surgery and prevent the risk of postoperative infection.
A disulfidptosis-related LncRNAs index predicting prognosis and tumor microenvironment in colorectal cancer
Authors: Xiao Lijun , Yin Wen , Chen Xuanqin , Zhang Xu , Zhang Chao , Yu Zehui , Lü Muhan 
Published: September 2023

Abstract
Colorectal cancer(CRC) is a common and deadly cancer in the world with a high lethality rate. Disulfidptosis has been found to be an emerging mode of death in cancer, and the purpose of this study to explore the relationship between disulfidptosis-related lncRNAs and CRC, developing a prognostic model for CRC. The gene expression data and clinicopathologic information of colorectal cancer patients was from The Cancer Genome Atlas(TCGA) and screened for disulfidptosis-related lncRNAs based on correlation analysis. Using the least absolute shrinkage and selection operator(LASSO) and Cox regression to construct the prognostic modeling, and its validation was carried out by PCA and receiver operating characteristic(ROC) curves. Also, we constructed the nomograms combining with the model. Finally, the possible mechanisms how to affect CRC by lncRNAs were explored by functional enrichment analysis, immune infiltration and immune escape analysis. In a word, we developed a prognostic marker consisting of lncRNAs associated with disulfidptosis to help clinicians predict the survival of different CRC patients and use different therapies depending on the conditions.
Endothelial Calcium Dynamics Elicited by ATP Release from Red Blood Cells
Authors: Nayak Ananta Kumar , Das Sovan Lal , Misbah Chaouqi 
Published: September 2023

Abstract

Red blood cells (RBCs) exhibit an interesting response to hydrodynamic flow, releasing adenosine triphosphate (ATP). Subsequently, these liberated ATP molecules initiate a crucial interaction with endothelial cells (ECs), thereby setting off a cascade involving the release of calcium ions (Ca2+). Ca2+ exerts control over a plethora of cellular functions, and acts as a mediator for dilation and contraction of blood vessel walls. This study focuses on the relationship between RBC dynamics and Ca2+ dynamics, based on numerical simulations under Poiseuille flow within a linear two-dimensional channel. It is found that the concentration of ATP depends upon a variety of factors, including RBC density, channel width, and the vigor of the flow. The results of our investigation reveals several features. Firstly, the peak amplitude of Ca2+ per EC escalates in direct proportion to the augmentation of RBC concentration. Secondly, increasing the flow strength induces a reduction in the time taken to reach the peak of Ca2+ concentration, under the condition of a constant channel width. Additionally, when flow strength remains constant, an increase in channel width corresponds to an elevation in calcium peak amplitude, coupled with a decrease in peak time. This implies that Ca2+ signals should transition from relatively unconstrained channels to more confined pathways within real vascular networks. This notion gains support from our examination of calcium propagation in a linear channel. In this scenario, localized calcium release initiates a propagating wave that gradually encompasses the entire channel. Notably, our computed propagation speed agrees with observations.
Effects of simulated atmospheric nitrogen deposition on the bacterial community sructure and diversity of four distinct biocolonization types on stone monuments: a case study of the Leshan Giant Buddha, a World Heritage Site
Authors: Chen Xuli , Song Huixing , Sun Bo , Yang Tianyu 
Published: September 2023

Abstract
Atmospheric nitrogen deposition may affect the biodeterioration process of stone monuments through direct and indirect pathways, but relevant studies are lacking. Therefore, taking the biologically colonized rocks around the Leshan Giant Buddha (World Heritage - Mixed Property) as the research objects, we studied the effects of multiple nitrogen addition levels (0, 9, 18, 36, 72 kg N hm-2 a-1; N0, N1; N2 ; N3; N4) on the bacterial community structure and soil nutrients on the surfaces of stones with four biocolonization types, including naked rock (NR), and lichen (LR), bryophyte (BS) and vascular plant (VS) colonization, to investigate the potential effect of atmospheric nitrogen deposition on the rock weathering of the Leshan Giant Buddha. The results demonstrated that nitrogen addition impacted soil carbon, nitrogen and phosphorus nutrients, as well as bacterial community structure and composition, but the responses to nitrogen input varied among different colonization types. Nitrogen fertilization promoted the accumulation of total organic carbon and total nitrogen in NR and LR, and increased the content of total phosphorus but decreased the content of total nitrogen in VS. Bacterial α-diversity decreased with nitrogen addition in NR but increased with nitrogen addition in VS. Nitrogen addition significantly (R > 0.9, p < 0.01) changed the bacterial community composition in the four biocolonization types, and the changes were dominated by species replacement (contributed to 60.98%, 76.32%, 67.27% and 72.14% for bacterial diversity in NR, LR, BS and VS, respectively). Total nitrogen, dissolved organic nitrogen, dissolved organic nitrogen and total phosphorus were the most important ecological factors affecting bacterial community structure in NR, LR, BS and VS, respectively. Nitrogen addition enriched different bacterial taxa in the four biocolonization types. The results of this study provide basic data for the protection of stone monuments and the formulation of sustainable development strategies under a changing climate.
A qualitative study exploring the self-reported training and education needs of primary care pharmacists with a recent background in community pharmacy
Authors: Campbell Ian , Harrison Heather , Kurdi Amanj 
Published: September 2023

Abstract
Background
Pharmacists are an increasing part of the primary care health care team in Scotland. Recruitment to this expanding sector has largely come from community pharmacy. However, it is unknown if these pharmacists require specific training needs to fulfil their role within the primary care team.
Aim
To explore the training needs of primary care pharmacists who had joined the sector from community pharmacy in the last 6-24 months.
Method
Eight pharmacists across Scotland’s largest regional health board participated in a one off, recorded, semi-structured interview via Microsoft Teams®. Recordings were transcribed, verified, and thematic analysis then undertaken.
Result
Eight participants (5 female, 3 male, median age 32) were interviewed. Five themes were identified: challenging transition, transferable skills, transferable training from community pharmacy, training needs for primary care role, and benefits of structured learning. Participants reported lack of opportunity to apply their clinical knowledge and for professional development in community pharmacy. Themes were consistent across the range of gender, age and professional experience in pharmacists interviewed.
Conclusion
Primary care pharmacists in our study reported a range of needs (such as examination skills, improved clinical and therapeutics knowledge) required to practice in primary care. Previous sectors of work should be taken into consideration when inducting pharmacists into the new role and background specific inductions may need to be implemented to support these pharmacists work autonomously at an advanced level.
Assessing Visitors' Preferences and Willingness to Pay for Ecosystem Services in Mudumalai Tiger Reserve, Tamil Nadu, India: Insights from a Contingent Valuation Study for Conservation Policy
Authors: Rajkumar V , Boopathi S 
Published: September 2023

Abstract
Tiger reserves provide a wide range of ecosystem services, many of which are not traded in the market. Unfortunately, the economic significance of these reserves is often underestimated, resulting in insufficient resource allocation for tiger conservation and a loss of valuable ecosystem services. Mudumalai Tiger Reserve (MTR) in Tamil Nadu, India, the nation's first Biosphere Reserve and a significant protected area, is increasingly vulnerable due to negative externalities that affect the quantity and quality of ecosystem services benefiting society. To address this issue and enhance ecosystem services through tiger reserve conservation, it is crucial to understand the adverse impacts of these externalities and consider people's preferences. This study employed a dichotomous choice-contingent valuation method, surveying 372 visitors, to investigate the factors influencing their willingness to pay for improved ecosystem services through the conservation of Mudumalai Tiger Reserve in The Nilgiris District, Tamil Nadu. The study findings reveal that 64% of surveyed visitors express concerns about mitigating adverse impacts and are willing to provide financial support for preserving ecosystem services and human well-being. A Logit regression result shows a positive association between respondent education, monthly family income, and environmental awareness with willingness to pay (WTP). Conversely, family size and bid price have a negative impact on the likelihood of WTP. Incorporating these factors into conservation policies can significantly contribute to the sustainability of ecosystem benefits in the MTR and advance its long-term conservation goals. Policy recommendations include measures to enhance ecosystem benefits within the MTR, mitigate human-animal conflicts, and reduce invasive species.
The barriers and enablers to the integration of a clinical decision support systems into general practice medical software: A narrative review using a systematic approach
Authors: Hallinan Christine Mary , GP Libby Dai , Canaway Rachel , Hegarty Kelsey , Boyle Douglas 
Published: September 2023

Abstract
Background Clinical decision support systems (CDSS) have become an integral part of clinical software management systems in Australian general practices. These systems encompass a range of tools that support patient data management, medication management, patient diagnosis, decision support, pharmacovigilance, drug control, and clinical guidance. They provide functionalities such as computerised alerts, recalls, reminders, clinical guidelines, patient data reports, documentation templates, clinical workflow tools, and prescribing guidance. In this research we aim to explore the enablers and barriers related to the integration of clinical decision support tools into existing clinical management software systems, by undertaking a systematic search of the literature.Methods For this narrative review, MEDLINE (Web of Science) and Scopus databases were searched for peer reviewed articles published in English between January 1980 and March 2023. All study types that examined clinical decision support in medicine were included in the review.Results Thirty-nine studies were included in this review. Of these studies, most reported CDSS varied widely in application, scope, functionality, type, and complexity. Differences in CDSS technical and clinical interface functionality provide options around the type of prompts delivered to a general practitioner (GP). Passive prompts provide clinical guidance to the GP end-user without requiring any action on their part, while active prompts are automated clinical actions or alerts, which the user must either accept or override to proceed with their workflow. CDSS applications include those for the detection and management of cancer, sepsis, acute pain, hypertension, asthma, diabetes, alcohol and tobacco use, antibiotic prescribing, vaccination, medication adverse events, and pregnancy care. For CDSS to provide maximum utility, co-design between the GP end-user and developer needs to be embedded in the functionality.Conclusion Implementation of an integrative multidisciplinary CDSS is not static, it involves multiple iterations of development and re-design that is based on both staged and ad-hoc usability evaluations. This narrative review found the use of co-design provides opportunities for a deeper understanding of the barriers and enablers to the integration of CDSS in clinical practice. Co-design also facilitates the development of more individualised ‘bespoke’ CDSS so the specific needs of clinician end-users can be fulfilled.
Causal impacts of Helicobacter pylori infection on coronary atherosclerosis and the mediating pathways: A Mendelian randomization study
Authors: Yu Jiang , Shen Yue , Wu Lingling , Zhang Ronglin 
Published: September 2023

Abstract
Background While numerous studies have indicated that infection with Helicobacter pylori (H. pylori) may elevate the risk of coronary atherosclerosis, the potential causal relationship remains uncertain. Therefore, we used Mendelian randomization (MR) analysis to investigate the causal association between H. pylori infection and coronary atherosclerosis. And quantify the potential mediating pathways.Methods We employed a two-step Mendelian randomization model to evaluate the intermediate effects of risk elements such as inflammatory markers, lipid characteristics, and glucose levels on the causal connections between H. pylori infection and the development of coronary atherosclerosis. A multivariable Mendelian randomization (MVMR) study was designed to estimate potential mediators and their corresponding mediation proportions.Results H. pylori infection has a positive causal relationship with coronary atherosclerosis (n = 11 SNPs, OR = 1.162, 95% CI: 1.006–1.342, p = 0.041). Two causal mediators, C-X-C motif chemokine 10 and HDL-C, were identified after a thorough screening of all potential causal mediators, which accounted for 17.8% and 9.07% of the mediating effect, respectively. Importantly, these results remained robust in sensitivity analyses.Conclusion Our study substantiates a causal relationship between H. pylori infection and coronary atherosclerosis, which is, to some extent, mediated by the influence of CXCL10 and HDL-C. Intervening on CXCL10 and HDL-C may reduce the susceptibility to coronary atherosclerosis.