bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research hotspots and future trends in sepsis-associated acute kidney injury: a bibliometric and visualization analysis
Authors: Chen Xing-Yue , Zhi Li-Jia , Chen Jun , Li Rong , Long Kun-Lan 
Published: January 2025

ObjectivesSepsis-associated acute kidney injury (SA-AKI) commonly occurs in critically ill patients and is closely associated with adverse outcomes. A comprehensive analysis of the current research landscape in SA-AKI can help uncover trends and key issues in this field. This study aims to provide a scientific basis for research directions and critical issues through bibliometric analysis.MethodsWe searched all articles on SA-AKI indexed in the SCI-Expanded of WoSCC up to May 7, 2024, and conducted bibliometric and visual analyses using bibliometric software CiteSpace and VOSviewer.ResultsOver the past 20 years, there has been a steady increase in literature related to renal repair following AKI. China and the United States contribute over 60% of the publications, driving research in this field. The University of Pittsburgh is the most active academic institution, producing the highest number of publications. J. A. Kellum is both the most prolific and the most cited author in this area. “Shock” and “American Journal of Physiology-Renal Physiology” are the most popular journals, publishing the highest number of articles. Recent high-frequency keywords in this field include “septic AKI,” “mitochondrial dysfunction,” “inflammasome,” “ferroptosis,” and “macrophage.” The terms “mitochondrial dysfunction,” “inflammasome,” “ferroptosis,” and “macrophage” represent current research hotspots and potential targets in this area.ConclusionThis is the first comprehensive bibliometric study to summarize the trends and advancements in SA-AKI research in recent years. These findings identify current research frontiers and hot topics, providing valuable insights for scholars studying SA-AKI.
Screening and evaluation of key technologies for non-bioartificial liver care: an empirical study
Authors: Zhang Yunzhi , Zhang Han , Luo Ling , Liu Zhen , Liu Anlin , Shi Lin , Liang Luwen , Zhao Jing , Chen Pu , Yang Yanli 
Published: January 2025

IntroductionTo identify key technologies within non-bioartificial liver (NBAL, an extracorporeal support system that temporarily replaces some of the liver’s functions) nursing to offer guidance for clinical practice. In the context of NBAL nursing, key technologies are crucial for successful implementation of artificial liver treatment, ensuring patient safety, and enhancing nursing quality. A review of both domestic and foreign literature revealed that studies on NBAL nursing technology are lacking and that the key technologies for NBAL nursing have not been clearly identified.MethodsUsing empirical research methods to collect and analyze data. First, the on-site survey method and literature research method were used to create a preliminary screening list of key technologies for NBAL care. Next, the focus group discussion method was used to establish the screening principles and evaluation indicators for these key technologies. Then, a two-round Delphi study via e-mail correspondence was used to screen and determine the key technologies for NBAL care. Finally, the analytic hierarchy process (AHP) and the technique for order preference by similarity to ideal solution (TOPSIS) comprehensive evaluation method were applied to evaluate these key technologies for NBAL care.ResultsSeventeen key technologies for NBAL care were identified. These include three basic nursing technologies, seven operating techniques, three items for treatment process monitoring technology, two items for health education, and two items for complication prevention and treatment technology.ConclusionThis study identified key NBAL nursing technologies, offering a systematic guide to enhance clinical practice. These technologies improve treatment safety, efficacy, and nursing standards, laying a foundation for NBAL care advancement.
The capacity and training needs of primary health care workers in Nyeri and Nakuru counties of Kenya: a cross-sectional study
Authors: Muchangi Josphat Martin , Kithuki Kioko , Kosgei Sarah Jebet , Mathenge Mary , Kioko Deborah , Sifuma Bryson , Sawenja Billian , Kamau Samuel 
Published: January 2025

BackgroundHealth systems based on primary healthcare (PHC) have reduced costs and are effective for improved health outcomes. Kenya’s health system grapples with providing equitable access to essential health services, but there is increasing commitment by the government to strengthen primary healthcare. The aim of this paper is to provide a baseline assessment of the capacity and training needs of healthcare workers (HCWs) in Nakuru and Nyeri Counties and identify priorities for intervention.MethodsA cross-sectional study was carried out among 171 healthcare workers in Nyeri and Nakuru counties. Multistage sampling was employed to select sub-counties in the first stage and health facilities by level within each sub-county in the second level. Systematic random sampling was then employed to select HCWs from each level of facility. We targeted healthcare workers of all cadres within the health facilities, and included all who consented to participating. Structured self-administered pen-and-paper questionnaires were used for data collection, and a five-point Likert scale was used to measure the perceived capacity of the healthcare workers to provide primary healthcare. As for the training needs data, the participants selected any of the 12 components that they needed training in. Descriptive statistics was employed, and stacked bar charts were used to visualize the capacity and training needs for the components of PHC adopted in Kenya.ResultsIn total, we obtained questionnaires from 95 participants in Nakuru and 76 participants in Nyeri. Nakuru HCWs rated themselves higher than their Nyeri counterparts in maternal and newborn child healthcare, local endemic disease control, appropriate treatment of common diseases and injuries, provision of essential basic medication, dental health, HIV/AIDs &amp; TB management, and primary eye care. In both counties, there were significant differences in capacity between the different levels of health facilities. We observed substantial capacity gaps for HIV/AIDs &amp; TB management, mental health and dental health services in both counties.ConclusionThis study found a substantial capacity gap in several of the elements of PHC, especially in Nyeri County. Critical areas for intervention are HIV/AIDs &amp; TB management and mental health training for both counties. Within the health system, there is need to strengthen the capacity of HCWs in lower-level health facilities to reduce the volume of referrals to secondary care facilities. We strongly recommend training programs in dental health, mental health, primary eye care, nutritional services and HIV/AIDs &amp;TB management, that are carefully designed to emphasize skills and abilities.
Transformer-based model for predicting length of stay in intensive care unit in sepsis patients
Authors: Kim Jeesu , Kim Geun-Hyeong , Kim Jae-Woo , Kim Ka Hyun , Maeng Jae-Young , Shin Yong-Goo , Park Seung 
Published: January 2025

IntroductionSepsis, a life-threatening condition with a high mortality rate, requires intensive care unit (ICU) admission. The increasing hospitalization rate for patients with sepsis has escalated medical costs due to the strain on ICU resources. Efficient management of ICU resources is critical to addressing this challenge.MethodsThis study utilized the dataset collected from 521 patients with sepsis at Chungbuk National University Hospital between July 2020 and August 2023. A transformer-based deep learning model was developed to predict ICU length of stay (LOS). The model incorporated global and local input data analysis through classification and feature-wise tokens, based on sequential organ failure assessment (SOFA) criteria. Model performance was evaluated using four-fold cross-validation.ResultsThe proposed model achieved a mean absolute error (MAE) of 2.05 days for predicting ICU LOS. The result demonstrates the ability of the proposed model to provide accurate and reliable predictions.DiscussionThe proposed model offers valuable insights for healthcare resource management by optimizing ICU resource allocation and potentially reducing medical expenses. These findings highlight the applicability of the proposed model to efficient healthcare cost management.
Utilizing innovative two curves in nomogram
Authors: Zhou Tianhan , Ni Zhongkai , Fan Hao , Huang Hai , Jin Haimin 
Published: January 2025

ObjectiveNomograms are valuable tools in clinical research for predicting patient outcomes. Understanding threshold values within these models is crucial for assessing the model’s effectiveness and practical application in clinical environments.MethodsWe developed two novel interpretive curves to enhance the utility of nomograms. These curves were designed to provide clear visualization of how clinical prediction models perform across various thresholds. The curves are applied to two case studies to demonstrate their practical application and efficacy.ResultsIn both examples, the novel curves successfully highlighted critical threshold values and revealed changes in prediction accuracy across these thresholds. This enhanced the understanding of the nomogram’s performance, providing clinicians with more informative decision-making tools.ConclusionsThe introduction of these interpretive curves allows for a more nuanced understanding of nomogram-based predictions, offering insights into threshold effects that can inform clinical decisions.
New insight into the role of the pathway NLRP1 and NLRP3 inflammasomes and IL-33 in ultraviolet-induced cutaneous carcinogenesis
Authors: Lesiak Aleksandra , Wodz Karolina , Ceryn Justyna , Sobolewska-Sztychny Dorota , Bednarski Igor , Piekarski Janusz , Pabianek Marta , Nejc Dariusz , Dróżdż Izabela , Narbutt Joanna , Noweta Marcin , Ciążyńska Magdalena 
Published: January 2025

IntroductionInflammasomes NLRP1 (NLR family pyrin domain containing 1) and NLRP3 are pivotal regulators of the innate immune response, activated by a spectrum of endogenous and exogenous stressors, including ultraviolet radiation (UVR). The precise molecular mechanisms underlying the activation of these inflammasomes remain unclear. Furthermore, the involvement of interleukin-33 (IL-33) in UVR-induced skin carcinogenesis is not well defined.PurposeThe objective of this study is to evaluate the expression of interleukin genes (IL-33, IL-18, IL-1β) following the activation and silencing of NLRP1 and NLRP3 at various wavelengths and doses of UV radiation, and to correlate these expressions with pertinent tumor markers (e.g., Gli1, Gli2, FOXO3A, SerpinA1, SerpinA3, and EphB2).Methods and materialsCultures of keratinocyte cell lines were exposed to varying doses of UV radiation using specific lamps. To inhibit the expression of NLRP1 and NLRP3 genes, cells were transfected with targeted siRNAs. Gene expression of inflammasome components and effector proteins was quantified using Real-time PCR and ELISA.ResultsThere was a marked upregulation in the expression levels of cytokine genes IL-18, IL-1β, and IL-33 upon exposure to UVB and UVA radiation, compared to non-irradiated keratinocytes. Silencing NLRP1 or NLRP3 via RNA interference in primary human keratinocytes resulted in a significant reduction of cytokine gene expression. Additionally, a notable increase in tumor marker gene expression was observed in cells with functional NLRP1 and NLRP3 following UV radiation, whereas silencing these inflammasome genes altered the expression profiles of these markers.ConclusionThis study provides a pioneering comprehensive assessment of the roles of NLRP1, NLRP3, and IL-33 in the pathogenesis of UV-induced cutaneous carcinogenesis. Our findings substantiate the role of IL-33 as a critical early danger signal elicited in response to inflammatory UV radiation, presumably regulated by inflammasomes.
Colostrum feeding practice and associated factors among mothers who come for postnatal care to Asella referral and teaching hospital, Arsi Zone, South-East Ethiopia
Authors: Haji Gisha , Agero Gebi , Eshete Amde , Hasan Abdurahman , Hiko Ahmed 
Published: January 2025

BackgroundEvery day throughout the world more than 4,000 infants and young children die because colostrum feeding was not initiated within an hour of birth as recommended by the World Health Organization (WHO)/United Nations Children’s Fund. Even though breastfeeding is common in Ethiopia, the widespread belief that colostrum feeding causes morbidity and mortality among neonates still exists.ObjectiveTo assess the colostrum feeding practice and It’s associated factors among mothers who come for Post-natal care at Asella Referral and Teaching Hospital, Asella Town, Southeast Ethiopia from November 20, 2023, to January 25, 2024.MethodThis study employed an institutional-based cross-sectional study among 301 surveyed postnatal care mothers from November 20, 2023, to January 25, 2024. Systematic random sampling was employed to select study participants. A pretest was performed to check the reliability and clarity of the study questionnaires. The tool to examine the practice of colostrum feeding and related aspects was modified from earlier studies. The collected data were input into Epi Info version 7.2.5.0 and exported to SPSS version 26 for analysis. Bivariate and multivariable logistic regression analyses were used to identify variables associated with the practice of colostrum feeding. The variables with significant association were identified based on p-value &lt; 0.05.ResultsIn this study, 301 study participants took part, with a 99% response rate. The mean age of mothers was found to be 27.13 ± 5.46. This study’s overall prevalence of practice was 57.8% (95% CI, 52.2–63.35). Being Urban residence (AOR = 4.05, 95%CI: 2.18–7.52), health education counseling (AOR = 4.31, 95%CI: 1.27–10.73), and favorable attitude toward colostrum milk (AOR = 6.64, 95% CI: 3.61–12.2) were factors significantly associated with colostrum feeding practice.Conclusion and recommendationsIn comparison to WHO recommendations, the study area had a low rate of colostrum feeding practice. Additionally, this study also identified factors associated with maternal colostrum feeding practice level such as urban residence, counseling on timely initiation of breastfeeding during antenatal care, and good maternal attitude toward colostrum feeding. Therefore, Health education dissemination should be given to postnatal mothers regarding the importance of colostrum feeding.
The lysosome-related characteristics affects the prognosis and tumor microenvironment of lung adenocarcinoma
Authors: Chang Wuguang , Gao Wuyou , Wu Yawei , Luo Bin , Zhong Lekai , Zhong Leqi , Lin Wenqian , Wen Zhesheng , Chen Youfang 
Published: January 2025

BackgroundThe lysosome plays a vitally crucial role in tumor development and is a major participant in the cell death process, involving aberrant functional and structural changes. However, there are few studies on lysosome-associated genes (LAGs) in lung adenocarcinoma (LUAD).MethodsBulk RNA-seq of LUAD was downloaded from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO). The lysosome risk signature was constructed after univariate and least absolute shrinkage and selection operator (Lasso) cox regression analysis of the TCGA training set, and its capability was validated by additional validation sets from GEO. Single cell sequencing (scRNA) was obtained from GEO to analyze the differences of lysosome risk signature at the single-cell level and the differences in the function and pathway. In vitro experiments have validated the function of CTSH in LUAD.ResultsThe risk signature contained seven key LAGs, and patients were categorized into high- and low-risk groups based on a specific calculation formula. The LAG risk signature, which accurately predicted the prognostic status of LUAD patients, was still regarded as an independent prognostic indicator in multifactorial cox regression analysis. Subsequently, the combination of the signature and key clinical information was used to construct a column-line diagram for clinical assessment, which had a high discriminatory power. Immune infiltration analysis from bulk RNA-seq and scRNA-seq indicated that the low-risk group was immune-activated and had a better benefit in the prediction of immunotherapy. Finally, we validated its role in inhibiting tumor proliferation and metastasis in LUAD cells by knockdown of CTSH.ConclusionWe defined a new biomarker that provided unique insights for individualized survival prediction and immunotherapy recommendations for LUAD patients.
From shadowing to active learning: exploring the impact of supervised teaching clinics on gynecology education
Authors: Ren Sangsang , Zhan Hong , Fernando Asanga , Xu Xiangrong , Lu Weiguo 
Published: January 2025

BackgroundSupervised Teaching Clinics (STCs) have emerged as an innovative approach to medical education, particularly in specialties like gynecology, where hands-on experience is crucial. Traditional clinical rotations often leave students in passive roles, limiting their active participation and the development of essential clinical skills.AimThis study aimed to evaluate the impact of STCs on the clinical competencies and professional development of medical students within a gynecological clinic, comparing the outcomes with those of traditional clinic shadowing.MethodsA total of 144 fifth-year medical students were randomly assigned to either a control group, which participated in traditional clinic shadowing, or an STC group, which engaged in both shadowing and supervised teaching activities. The study utilized the Generalized Self-Efficacy Scale (GSES) and the mini-Clinical Evaluation Exercise (mini-CEX) to assess clinical performance. Feedback was also collected from students, tutors, and patients to gage satisfaction and perceived effectiveness.ResultsStudents in the STC group demonstrated significantly higher improvements in clinical skills, particularly in medical interviewing, counseling, and overall clinical competence, compared to the control group. The STC group also reported greater satisfaction with their learning experience, citing enhanced confidence and a deeper understanding of gynecological practice. Tutors and patients provided positive feedback, noting the STC’s role in fostering effective student-patient interactions and comprehensive learning.ConclusionThe structured design of the STC, with a focus on goal direction, relationships, and supporting services, significantly improved educational outcomes in gynecology. By fostering active learning and delivering constructive feedback, STCs effectively enhance students’ clinical competencies and professional development. The study suggests that integrating STCs into traditional clinical education models could substantially optimize medical training.
A comparative cross-sectional study of psychological distress, fatigue, and physical activity in patients with rheumatoid arthritis, systemic lupus erythematosus, and Sjögren's disease
Authors: Beider Sonja , Stephan Michael , Seeliger Tabea , Skripuletz Thomas , Witte Torsten , Ernst Diana 
Published: January 2025

IntroductionAnxiety and depression are common in patients with rheumatic diseases, but their impact across conditions like rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and primary Sjögren's disease (SjD) is still not well understood. This study aims to compare depression, anxiety, and fatigue, and their effects on disease activity and physical activity in these conditions.MethodsFrom January 2019 to March 2021, patients with RA, primary SjD and SLE were assessed consecutively in a monocentric cross-sectional study at the rheumatology outpatient clinic of the Hannover Medical School. Standardized questionnaires were used to assess depression, anxiety, fatigue, disease activity, functional impairment, and physical activity in these patients.ResultsOf 445 patients, 36.9% had RA, 32.8% SLE, and 30.3% SjD, with most being female (RA 76.2%, SLE 85.6%, SjD 87.4%). Depression (28.5%) and anxiety (31.2%) were common, particularly in SLE (28.8%) and SjD (36.3%) vs. RA (22%, p 0.002). Physical inactivity was higher in SLE (44.5%) and SjD (44.4%) than in RA (39.0%), especially in depressed patients (p 0.011). A significant proportion of patients retired early, especially in SLE (85%) and SjD (66%) vs. RA (49%, p 0.001). Disease activity correlated with psychological status (p &lt; 0.05).ConclusionsDepression and anxiety are highly prevalent in RA, SLE, and SjD, particularly in SLE and SjD. The study highlights the need for early psychological evaluation and integrated care involving rheumatologists and mental health professionals to address these issues and improve physical and mental well-being.
Invasive Klebsiella pneumoniae liver abscess syndrome complicated by carbapenem-resistant Acinetobacter baumannii infection: a case report
Authors: Feng Qiupeng , Yuan Hua , Ma Jin , Guo Zhiqiang , Xia Xiaohua , Zhao Guang 
Published: January 2025

BackgroundA liver abscess caused by hypervirulent Klebsiella pneumoniae can lead to multiple invasive extrahepatic infections, including lung abscesses, endophthalmitis, brain abscesses, and necrotizing fasciitis. This condition, known as Klebsiella pneumoniae liver abscess invasion syndrome, progresses rapidly and is associated with severe illness, high disability rates, and significant mortality. However, bloodstream infections with co-infection involving carbapenem-resistant Acinetobacter baumannii are exceedingly rare.Case presentationThe Emergency Medicine Department of the First People’s Hospital of Kunshan successfully treated a male patient diagnosed with liver, lung, and prostate abscesses. The patient underwent puncture and drainage, with analysis of the drainage fluid, sputum culture, and metagenomic next-generation sequencing (m-NGS) revealing a co-infection with blood-borne Klebsiella pneumoniae and Acinetobacter baumannii. Guided by drug sensitivity test results, the patient received treatment with polymyxin and cefoperazone sodium-sulbactam sodium for infection control and liver protection. The treatment was successful, and the patient fully recovered and was discharged.ConclusionBy reporting this rare case and highlighting the drug resistance of the bacteria, we propose a new diagnosis and treatment plan for managing Klebsiella pneumoniae combined with carbapenem-resistant Acinetobacter baumannii infection, along with a literature review.