bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Nausea and Vomiting in Palliative Care – Real Life Data From a Palliative Care Unit in Germany
Authors: Berner-Sharma Jennifer Marie , Bausewein Claudia , Rémi Constanze 
Published: January 2025

Background Nausea and vomiting significantly impact the quality of life in palliative care. Due to various underlying causes, treatment approaches vary. However, scientific evidence on pharmacotherapeutic management is limited, complicating treatment decisions. Objective is to assess the current antiemetic treatment approach in palliative care in Germany. Methods A retrospective observational study (15 months) was conducted, evaluating clinical records of adult patients admitted to palliative care in a German hospital. Symptom burden (Integrated Palliative care Outcome Scale (IPOS®)), suspected aetiology, antiemetics, treatment quality and drug-related problems (DRPs) were evaluated. Results We included 330 patients (median age 71 years, 50.9% female), of which 172 (52%) experienced nausea/vomiting in 230 treatment episodes. Symptoms were more prevalent in cancer-patients ( P = 0.002) and women ( P = 0.002). Main aetiologies were intestinal obstruction (59/230, 25.7%), hypomotility (31/230, 16.1%), and raised intracranial pressure (23/230, 10.0%). Nearly 70% experienced a reduction of symptom burden within the first 3 days, with faster symptom relief and shorter episodes in cancer patients compared to non-cancer patients (median length 3d vs 2d). DRPs were documented in 213/230 episodes (92.6%), indicating high interaction potential of antiemetics (87.4%). Manifest DRPs affected patients due to ineffective treatment (29.0%) or side effects (6.5%). Conclusions One-third experienced inadequate symptom control with the current treatment, underscoring the complexity of managing nausea/vomiting in palliative care and the need for a systematic approach. This study emphasizes the importance of evidence-based guidelines and further research into underutilized antiemetics, along with improved medical education in an interdisciplinary team to enhance treatment quality.
Lives of Irish Adolescents Who Were Born With a Cleft (LIA-Cleft)
Authors: Blacam Catherine de , Geoghegan Bridget , Nixon Elizabeth , Nolan Anne 
Published: January 2025

Objective The objective was to describe the lives of adolescents, who were born with cleft lip and palate (CL/P), in comparison to the general population as recorded in Growing up in Ireland (GUI), the national longitudinal study of children and youth. Design This was a cross-sectional study. Setting: The study was performed in a cleft center at a university teaching hospital. Participants: Adolescents born with CL/P in the years 2007 to 2009. Interventions: Growing up in Ireland questionnaires, which assessed demographics, health and experience of friendship, school, leisure, and social life, were adapted and administered to adolescents and their parents/guardians, who were identified from a prospectively maintained cleft database. Data were compared to that of GUI Cohort ‘08. Main Outcome Measures: Outcome measures comprised primary caregiver and young person self-report items. Mental health and psychological well-being were assessed using validated instruments including the Strengths and Difficulties Questionnaire. Results Thirty adolescents (10 female, 20 male) participated in the LIA-Cleft group. LIA-Cleft respondents indicated poorer ratings of both medical and dental health than the GUI group. Responses to questions regarding friendship, bullying, physical activity, social media, and screen time were similar in the GUI and LIA-Cleft groups. The LIA-Cleft group were less satisfied with their lives and exhibited lower self-esteem than the GUI group, but did not differ in measures of mental health and well-being or socioemotional well-being. Conclusions In spite of reporting poorer medical and dental health, young people who were born with CL/P in Ireland lead lives that are broadly similar to their peers in the general population.
Technical Validation of a Spatial Tracking Configuration for Augmented and Co-Localized Medical Assistance Under Gravity Variations in Parabolic Flights
Authors: Thierry Séamus , Querrec Ronan , Bernard Cécile Isabelle , Kubicki Sébastien , Bevacqua Elisabetta 
Published: January 2025

Introduction Augmented reality is a promising technology for enhancing remote medical assistance. It assists users by directly projecting the relevant virtual assistance in the real world at the right moment and at the right location. This modality is called colocalization but has not been validated in parabolic flights. Our hypothesis was that this modality is technically feasible in weightlessness and is superior to a paper checklist in assisting a caregiver during a simulated medical emergency. Methods During parabolic flight campaigns, we conducted an abdominal pain simulation scenario and sought to compare procedural assistances. Participants performed a basic medical examination using either classic cognitive aids (such as a paper checklist) or an augmented-reality device projecting visual co-localized (situated or embedded) assistance. Results Gravity variations induced technical difficulties in the nominal functioning of augmented-reality headsets due to the native accelerometers in these devices. Clinical data were not interpretable due to small sample size secondary to the technical difficulties encountered. Finally, an efficient and stable spatial tracking configuration was found during the last flight, offering future research perspectives. Conclusions Our study validated the first achievement of a stable co-localized assistance under gravity variation. The augmented-reality headset required an external tracking system based on surrounding infrared cameras and an in-flight calibration to recreate the virtual environment (spatial mapping) independently of gravity conditions. Further studies are needed to clinically validate the potential benefits of co-localized augmented reality for space medicine.
Diagnostic Significance of Serum VEGF, bFGF, and Wound Tissue EGFR in Diabetic Chronic Refractory Wounds
Authors: Wang Xuanyu , Que Huafa 
Published: January 2025

Background Patients with diabetes mellitus (DM) face a higher risk of developing chronic refractory wounds. Vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and epidermal growth factor receptor (EGFR) plays an important role in diabetes-related complications. This study aims to analyze the correlation between the 3 indicators and diabetic chronic refractory wounds, in order to establish the diagnostic value of these 3 indicators and provide reference for the treatment. Material and Methods We selected 168 patients, with 84 in healing group and 84 in refractory group. The levels of serum VEGF, bFGF, and wound tissue EGFR were compared before treatment, and the correlation between the 3 indicators and the refractory wounds was analyzed. After the specific treatment in refractory group, the clinical efficacy and wound closure index was recorded, and the correlation between them and the 3 indicators were analyzed. Results The 3 indicators were all protective factors for diabetic chronic refractory wounds ( p < .05). The serum VEGF and bFGF had relatively low diagnostic value for diabetic chronic refractory wounds, while wound tissue EGFR demonstrated higher diagnostic value ( p < .05). The 3 indicators had a positive correlation with both the clinical efficacy and the wound closure index ( p < .05). Conclusion Higher levels of serum VEGF, bFGF, and wound tissue EGFR are conducive to reducing the incidence of diabetic chronic refractory wounds. The combined measurement of these indicators holds high diagnostic value for the disease. Moreover, the higher the expression levels of these 3 indicators, the more favorable the clinical outcomes.
Deep Learning-Derived Quantitative Scores for Chronic Rhinosinusitis Assessment: Correlation With Quality of Life Outcomes
Authors: Shen Zhefan , Wei Ying , Liu Kexin , Ma Zhiqi , Zhang Zhiliang , Wang Xuechun , Li Yong , Shi Feng , Ding Zhongxiang 
Published: January 2025

Background Computed tomography (CT) plays a crucial role in assessing chronic rhinosinusitis, but lacks objective quantifiable indicators. Objective This study aimed to use deep learning for automated sinus segmentation to generate distinct quantitative scores and explore their correlations with disease-specific quality of life. Methods From July 2021 to August 2022, 445 CT data were collected from 2 medical centers. A deep learning model based on nnU-Net was trained for automatic sinus segmentation and internally validated using 300 cases. The remaining 145 cases were split into an external testing set (74 cases) and an independent testing set (71 cases). Two quantitative scores, the quantitative Lund-MacKay score and the quantitative opacification score (QOS), were derived from the segmentation results. The quantitative scores’ efficacy was assessed by comparing them with the Lund-MacKay score (LMS), the 22-item Sinonasal Outcome Test score (SNOT-22), and other clinical variables through correlation analyses. Furthermore, the relationship between quantitative scores and postoperative quality of life improvement was explored using single-factor logistic regression. Result The segmentation model achieved average Dice similarity coefficients of 0.993, 0.978, 0.958, and 0.871 for the training, validation, external testing, and independent testing sets, respectively. Both quantitative scores significantly correlated with the LMS ( rho = 0.87 and rho = 0.70, P < .001). Neither score correlated with the total SNOT-22 score, although the modified QOS showed significant correlations with the nasal and sleep subdomains ( rho = 0.26 and rho = 0.27, P <  .05). No significant association was found between quantitative score and postoperative improvement in quality of life. Conclusion Deep learning enables the automated segmentation of sinuses on CT scans, producing quantitative scores of sinus opacification. These automatic quantitative scores may serve as tools for chronic rhinosinusitis assessment.
Current practice of using the airway pressure release ventilation mode in acute respiratory distress syndrome patients among respiratory therapists in Saudi Arabia
Authors: Alqarni Abdullah A , Aldhahir Abdulelah M , Siraj Rayan A , Alasimi Ahmed H , Alqahtani Jaber S , Alwafi Hassan , Almeshari Mohammed A , Alobaidi Nowaf Y , Majrshi Mansour S , Alghamdi Saeed M , Alyami Mohammed M 
Published: January 2025

Background: There is a limited data examining the practice of using the airway pressure release ventilation mode for patients with acute respiratory distress syndrome among respiratory therapists. Objectives: To evaluate the current practice and barriers when using airway pressure release ventilation mode in the management of patients with acute respiratory distress syndrome. Methods: A cross-sectional online survey was disseminated between November 2022 and April 2023 to respiratory therapists in Saudi Arabia. Descriptive statistics were used to analyze the respondents’ characteristics. Results: Overall, 802 respiratory therapists (male: 59.60%) completed the survey. Five hundred nineteen (64.71%) did not receive training on airway pressure release ventilation mode. Moreover, 325 (40.52%) and 391 (48.75%) did not know if airway pressure release ventilation was used at their hospitals and if the mode was managed via protocol with acute respiratory distress syndrome patients. Of the participants, 276 (34.41%) reported that plateau pressure should be used as a target when setting P-high initially, while 427 (53.24%) believed that the initial P-low should be equal to 0 cmH2O. Moreover, 468 (58.36%) believed that the initial T-high should be between 4 and 6 s, while 548 (68.33%) believed the initial T-low should be a set time (between 0.4 and 0.8) seconds. The most appropriate intervention to improve ventilation and oxygenation was to increase the P-high, which was reported by 370 (46.14%) and 326 (40.65%) respiratory therapists, respectively. Inadequate training was the most common barrier (678, 84.54%) to airway pressure release ventilation implementation. Conclusion: Airway pressure release ventilation management varies between respiratory therapists which may be due to inadequate training and the absence of protocols.
Interactive 3D visualisation technique used in pulmonary rehabilitation in chronic obstructive pulmonary disease: A randomised controlled study evaluating quality of life, compliance and use of health care
Authors: Sönnerfors Pernilla , Nordlin Anna-Karin , Nykvist Maria , Thunström Ulrika , Einarsson Ulrika 
Published: January 2025

Introduction A pulmonary rehabilitation (PR) programme, including exercise training, education, and behaviour change, is highly recommended in treatment guidelines for chronic obstructive pulmonary disease (COPD). A new PR educational material for PR using an interactive three-dimensional (3D) visualisation technique was developed. There is little known regarding using 3D in this setting. The aim was to evaluate, within a PR programme setting, differences between outcomes of education through interactive 3D compared with education by means of 2D visualisation in patients with COPD regarding health-related quality of life (HRQL), physical capacity, exercise self-efficacy, compliance to exercise training, compliance to medication, and the use of health care and to describe learning styles. Methods Patients were cluster randomised to PR at the University Hospital clinic, including exercise training, for 10 weeks with education by 3D ( n = 27) or education by traditional 2D technique ( n = 17). At follow-ups, HRQL, physical capacity, self-efficacy, handgrip strength, compliance to exercise training, compliance to medication and health care utilisation were assessed. Results No significant differences were observed in HRQL in relation to COPD between the groups after 10 weeks. Differences were found in handgrip strength at baseline and at 10 weeks ( p < 0.01). The 3D group had improved scores in HRQL assessed with the Leicester Cough Questionnaire (LCQ-S) psychological domain ( p = 0.022). In the 2D group, the LCQ-S social domain ( p = 0.028), psychological domain ( p = 0.021) and the St George’s Respiratory Questionnaire total ( p = 0.050) were increased. The most common learning mode and learning style in both groups was reflective observation and divergent style. Conclusion An interactive education in 3D technique used in a PR programme for patients with COPD yielded no significant differences compared to conventional techniques. Three-dimensional techniques can be used in PR for COPD as an alternative to conventional techniques. ClinicalTrials.gov (identifier:NCT02802618).
A multi-patch-based deep learning model with VGG19 for breast cancer classifications in the pathology images
Authors: Ponraj Anitha , Nagaraj Palanigurupackiam , Balakrishnan Duraisamy , Srinivasu Parvathaneni Naga , Shafi Jana , Kim Wonjoon , Ijaz Muhammad Fazal 
Published: January 2025

Purpose Breast cancer encompasses various subtypes with distinct prognoses, necessitating accurate stratification methods. Current techniques rely on quantifying gene expression in limited subsets. Given the complexity of breast tissues, effective detection and classification of breast cancer is crucial in medical imaging. This study introduces a novel method, MPa-DCAE, which uses a multi-patch-based deep convolutional auto-encoder (DCAE) framework combined with VGG19 to detect and classify breast cancer in histopathology images. Methods The proposed MPa-DCAE model leverages the hierarchical feature extraction capabilities of VGG19 within a DCAE framework, designed to capture intricate patterns in histopathology images. By using a multi-patch approach, regions of interest are extracted from pathology images to facilitate localized feature learning, enhancing the model's discriminatory power. The auto-encoder component enables unsupervised feature learning, increasing resilience and adaptability to variations in image features. Experiments were conducted at various magnifications on the CBIS-DDSM and MIAS datasets to validate model performance. Results Experimental results demonstrated that the MPa-DCAE model outperformed existing methods. For the CBIS-DDSM dataset, the model achieved a precision of 97.96%, a recall of 94.85%, and an accuracy of 98.36%. For the MIAS dataset, it achieved a precision of 97.99%, a recall of 97.2%, and an accuracy of 98.95%. These results highlight the model's robustness and potential for clinical application in computer-assisted diagnosis. Conclusion The MPa-DCAE model, integrating VGG19 and DCAE, proves to be an effective, automated approach for diagnosing breast cancer. Its high accuracy and generalizability make it a promising tool for clinical practice, potentially improving patient care in histopathology-based breast cancer diagnosis.
Associations of Concordant and Shared Lung Cancer Screening Decision Making with Decisional Conflict: A Multi-Institution Cross-Sectional Analysis
Authors: Sullivan Donald R. , Golden Sara E. , Schweiger Liana , Melzer Anne C. , Datta Santanu , Davis James M. , Wiener Renda Soylemez , Slatore Christopher G. 
Published: January 2025

Introduction. Many organizations recommend structured communication processes, including formal shared decision making (SDM), for patients undergoing lung cancer screening (LCS) using low-dose computed tomography (LDCT). We sought to understand if concordant and shared LCS decision making was associated with decisional conflict. Methods. In this prospective, observational study, we enrolled patients from 3 medical centers (2 Veterans Health Administration, 1 academic facility) after a decision-making interaction about undergoing LCS but before receiving the LDCT. We included patients who indicated they accepted or declined to undergo the LDCT. We evaluated preferred and actual decision-making roles and used multivariable linear and logistic regression models to measure the association of concordant (congruence between actual and preferred roles) and shared LCS decision making with decisional conflict to report adjusted odds ratios (AOR). Results. Of the 409 participants with nonmissing information, 83% reported LCS decision-making role concordance. In addition, 223 (58%) reported an indeterminate level and 56 (14%) reported decisional conflict. LCS decision-making role concordance was not associated with decisional conflict (AOR = 0.86, 95% confidence interval [CI]: 0.38–1.94, P = 0.71) compared with role discordance. Participant-reported actual LCS SDM role was not associated with decisional conflict (AOR = 0.99, 95% CI: 0.51–1.93, P = 0.98) compared with patient- or provider-controlled roles. Conclusions. LCS decisional conflict was uncommon, although many patients reported an indeterminate level of decisional conflict. Neither concordant nor shared LCS decision-making role was associated with decisional conflict. Clinicians may be unable to decrease LCS decisional conflict using efforts to enhance decision-making interactions. Highlights We evaluated patients’ preferred and actual decision-making role and decisional conflict following a decision-making interaction about lung cancer screening (LCS). Concordant decision-making preference was not associated with decisional conflict. Actual decision-making role was also not associated with decisional conflict. Efforts to enhance decision-making interactions may not decrease LCS decisional conflict.
Incidence and outcomes of neonatal group B streptococcal sepsis in Qatar-a multicentre study
Authors: Thyvilayil Sajid Salim , Vellamgot Anvar Paraparambil , Salameh Khalil , Kurunthattilthazhe Sudheer Babu , Elikkottil Abdurahiman , Dominguez Liliana Llerena , Banarjee Dhanya 
Published: January 2025

Abstract

Background
Group B Streptococcus (GBS) is the most common cause of neonatal early onset sepsis in term infants and a major cause of late onset sepsis in both term and preterm infants.

Aim
To estimate the incidence of GBSS among neonates born in Qatar between July 2015 and June 2020 (5 years). A secondary aim was to describe the outcomes of the affected babies.

Materials and Methods
A retrospective chart review of all neonates born during the study period was performed with the help of medical records departments of the four main maternity hospitals in Qatar, where > 90% of the births occurred.

Results
From 123,878 live births, 113 babies grew GBS in blood culture, during the first 90 days. 72 cases of early-onset GBS sepsis (EOGBSS) and 41 cases of late-onset GBS sepsis (LOGBSS) were identified. The estimated incidence of EOGBSS and LOGBSS were 0.58/1000 live births (95% CI 0.46- 0.73) and 0.33/1000 live births (95% CI 0.24- 0.45) respectively. The overall mortality was 7%, and the chart review identified severe neurodisability among at least 11% of survivors.

Conclusion
The incidences of EOGBSS and LOGBSS in Qatar are 0.58/1000 live births (LB) and 0.33/1000 LB, respectively. The relatively high incidence of EOGBSS probably reflects the high rate of carrier state among pregnant mothers. We did not observe any significant change in incidence after introducing the universal maternal screening for GBS. The overall mortality was similar to previously published data. Further prospective studies are recommended.
Impact of psychotropic pro re nata prescription-monitoring programme on prescriptions for inpatients with psychiatric disorders: a retrospective observational study
Authors: Saito Yoshitaka , Sumida Kyohei , Muraoka Hiroyuki , Oishi Satoru , Suzuki Ryutaro , Nishikawa Taiyo , Miyake Shin , Tanno Yukihiro , Tobita Yuki , Otori Katsuya , Inada Ken 
Published: January 2025

Abstract

Background

Pro re nata (PRN) medication is used “as needed” for symptoms such as agitation and insomnia, in addition to regular daily pharmacotherapy of mental disorders. However, there is no high-quality evidence on the effectiveness of psychotropic PRN medications and concerns have been raised about their potential to contribute to polypharmacy. This study introduced a psychotropic PRN prescription-monitoring programme for psychiatric inpatients with the aim of examining the change before and after the implementation of the programme.

Method
This study included 389 patients admitted to the psychiatric department between 1 July 2021 and 30 June 2023. The psychotropic PRN prescription-monitoring programme was implemented in July 2022, and the participants were classified into monitoring and non-monitoring groups. Demographic data (age, sex, and diagnosis), regular prescriptions before admission and at discharge, psychotropic PRN prescriptions before admission and at discharge, and the total number of psychotropic PRN prescriptions during hospitalisation were compared between the two groups. Data on psychotropic prescription were collected by psychotropic category. The significance level of 5% was set at 1.67 × 10−3 using the Bonferroni correction for multiple testing.

Results
The psychotropic PRN prescription ratio at discharge in the monitoring group was 9.3%, which was significantly lower than the 28.1% in the non-monitoring group. The percentage of patients with a PRN prescription during hospitalisation in the monitoring group was 29.8%, which was significantly lower than the 64.5% in the non-monitoring group. In the non-monitoring group, there was no statistically significant difference in the number of psychotropic drugs prescribed regularly before and after admission. However, in the monitoring group, the number of psychotropic drugs in the regular prescriptions at discharge was 1.87 ± 1.24, which was significantly lower than 2.47 ± 1.90 in the regular prescription before admission.

Conclusions
Our findings suggest that a psychotropic PRN prescription-monitoring programme may contribute to the elimination of polypharmacy, including regular prescriptions. Further research is required to optimise psychotropic PRN prescriptions and reduce polypharmacy.