bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of gas humidification and nebulizer position under invasive ventilation: preclinical comparative study of regional aerosol deposition.
Authors: MONTIGAUD Yoann , GEORGES Quentin , LECLERC Lara , CLOTAGATIDE Anthony , LOUF-DURIER Aurore , POURCHEZ Jérémie , PREVOT Nathalie , PERINEL-RAGEY Sophie 
Published: January 2023

Abstract
Background
Successful aerosol therapy in mechanically ventilated patients depends on multiple factors. Among these, position of nebulizer in ventilator circuit and humidification of inhaled gases can strongly influence the amount of drug deposited in airways. Indeed, the main objective was to preclinically evaluate impact of gas humidification and nebulizer position during invasive mechanical ventilation on whole lung and regional aerosol deposition and losses.
Methods
Ex vivo porcine respiratory tracts were ventilated in controlled volumetric mode. Two conditions of relative humidity and temperature of inhaled gases were investigated. For each condition, four different positions of vibrating mesh nebulizer were studied: (i) next to the ventilator, (ii) right before humidifier, (iii) 15 centimeters to the Y-piece adapter and (iv) right after the Y-piece. Aerosol size distribution were calculated using cascade impactor. Nebulized dose, lung regional deposition and losses were assessed by scintigraphy using 99mtechnetium-labeled diethylene-triamine-penta-acetic acid.
Results
Mean nebulized dose was 95% ± 6%. For dry conditions, the mean respiratory tract deposited fractions reached 18% (± 4%) next to ventilator and 53% (± 4%) for proximal position. For humidified conditions, it reached 25% (± 3%) prior humidifier, 57% (± 8%) before Y-piece and 43% (± 11%) after this latter.
Conclusions
Optimal nebulizer position is proximal before the Y-piece adapter showing a more than two-fold higher lung dose than positions next to the ventilator. Dry conditions tend to more peripheral lung deposition of aerosol. But gas humidification appears hard to interrupt efficiently and safely in clinical use. Considering the impact of optimized positioning, this study argues to maintain humidification.
Artificial intelligence to estimate the tear film breakup time and diagnose dry eye disease
Authors: Shimizu Eisuke , Ishikawa Toshiki , Tanji Makoto , Agata Naomichi , Nakayama Shintaro , Nakahara Yo , Yokoiwa Ryota , Sato Shinri , Hanyuda Akiko , Ogawa Yoko , Hirayama Masatoshi , Tsubota Kazuo , Sato Yasunori , Shimazaki Jun , Negishi Kazuno 
Published: January 2023

Abstract
Background: The use of artificial intelligence (AI) in the diagnosis of dry eye disease (DED) remains limited due to the lack of standardized image formats and analysis models. To overcome this issue, we used the Smart Eye Camera (SEC), a video-recordable slit-lamp device, and collected videos of the anterior segment of the eye. This study aimed to evaluate the accuracy of the AI algorithm in estimating the tear film breakup time and apply this model for the diagnosis of DED according to the Asia Dry Eye Society (ADES) DED diagnostic criteria.
Methods: Using the retrospectively corrected DED videos of 158 eyes from 79 patients, 22,172 frames were annotated by the DED specialist to label whether or not the frame had breakup. The AI algorithm was developed using the training dataset and machine learning. The DED criteria of the ADES was used to determine the diagnostic performance.
Results: The accuracy of tear film breakup time estimation was 0·789 (95% confidence interval (CI): 0·769–0·809), and the area under the receiver operating characteristic curve of this AI model was 0·877 (95% CI: 0·861–0·893). The sensitivity and specificity of this AI model for the diagnosis of DED was 0·778 (95% CI: 0·572–0·912) and 0·857 (95% CI: 0·564–0·866), respectively.
Conclusions: We successfully developed a novel AI-based diagnostic model for DED. Our diagnostic model has the potential to enable ophthalmology examination outside hospitals and clinics.
Status, sources and human health risk assessment of DDT pesticide residues in river sediments in a highly developed agricultural region in the upper Yangtze River in China
Authors: Zhu Yutong , Chai Yongzhen , Xu Chengbin , Guo Fei 
Published: January 2023

AbstractThe concentrations of DDT and its metabolites in 19 sediments samples from a highly developed agricultural region in the upper reaches of the Yangtze River were measured. Non-cancer hazard quotient for different age groups was evaluated using reference doses given by the USEPA, and the excess lifetime cancer risk due to eating fish was assessed based on the local eating habits. The results showed that this region has a high level of residual DDT (12.84 ± 8.97 ng/g), which mainly came from the historically used technical DDT in agriculture. The non-carcinogenic risk is just acceptable in the region, but 11 of the 19 sites had an unacceptable risk of carcinogenesis. Although DDT has been banned for decades, there is still notable health risks, especially for children. Special attention should be paid to human health risks in historical developed agricultural regions.
AXL up-regulates PD-L1 inducing gefitinib resistance in EGFR mutated NSCLC
Authors: Wu Mingsheng , Xiong Ran , Wang Gaoxiang , Chen Xiao , Wu Xianning , Sun Xiaohui , Xu Guangwen , Xu Meiqing , Xie Mingran 
Published: January 2023

Abstract
Targeted therapy for lung cancer research has advanced quickly in recent years, particularly EGFR-TKIs in the grouping of EGFR-mutant lung cancer, however clinical treatment has encountered difficulties with acquired drug resistance. Due to their great specificity, few adverse reactions, and prolonged tumor control duration, immune checkpoint inhibitors PD-1 and PD-L1 antibodies have emerged as a new therapy approach for NSCLC with the advancement of tumor biology. AXL, a gene that codes for receptor tyrosine kinases, has been linked to the growth, treatment resistance, and immunological imbalance of cancer cells. Its protein has been found to be abnormally expressed in NSCLC cancer tissues. Our study shows a positive regulatory link between AXL and PD-L1 expression, and AXL can upregulate PD-L1 to facilitate the development of acquired drug resistance in EGFR-mutant lung cancer treated with gefitinib. We offer additional understandings for AXL to overcome the gefitinib resistance mechanism in NSCLC, while also providing ideas for addressing targeted therapy resistance.
A Way Forward with Intersectionality: An Integrative Review of Women’s Experiences with Intimate Partner Violence
Authors: Mackey April , Petrucka Pammla 
Published: January 2023

Abstract
Background: Intimate partner violence (IPV) is uniquely posited as both a public health challenge and an affront to human rights that spares no social group. Women, as victims, constitute two thirds of all instances of IPV worldwide (United Nations, 2013), though it is likely that this number is much higher as it speaks nothing of the women who are at risk of violence due to circumstances beyond their control. Intimate partner violence is a complex, ‘wicked’ problem that requires a proactive and upstream approach to address with an intersectional and gender equity lens. Such opportunities must be innovative, universally accessible, and demonstrate awareness of the multitude of intersections experienced by women (I.e., race, education, social status). This study examines the application of intersectionality as a framework to women’s experiences of intimate partner violence.
Methods: The authors’ conducted an integrative review using the Whittemore and Knafl (2005) methodology. The search identified primary research papers from five databases, including Scopus, Soc Index, Criminal Justice Web of Science, and Public Health during March and April 2022. A total of 1686 articles were distilled into a final four articles that were that werereviewed and analysed extensively by two reviewers.
Results: The major themes that emerged from the review included: (a) intersectionality as a critical social framework can inform holistic IPV interventions across disciplines and sectors; (b) intersectionality provides a unique lens through which to address the inherent power imbalance of IPV; and (c) interventions framed within an intersectional framework can be used to promote women’s agency and reclamation of self.
Conclusions: The need for an intersectional approach to IPV is agreed upon and, given the urgency of this issue, the findings establish a way forward for intersectional research and presents connections between intersectionality and IPV. It is in these connections where interventions, policies, and programs can be developed to provide a holistic and comprehensive approach for survivors.
Measurement of work-related psychological injury with depressive symptoms
Authors: Tanaka Mari , Hirano Yoshiyuki , Takanashi Rieko , Numata Noriko , Sutoh Chihiro , Yoshikawa Tomohiro , Shimizu Eiji 
Published: January 2023

Abstract
Objective
This study aimed to measure the level of psychological injury caused by work-related stress as well as the severity of depression among workers.
Method
Firstly, we conducted an online survey and recruited 500 workers diagnosed with depression or adjustment disorder to investigate what type of stress they experienced within six months before onset. Secondly, we conducted another online survey and recruited 767 participants who experienced some form of work-related stress. All the participants were classified into four groups by whether or not they were diagnosed with depression and whether or not they quit their jobs due to work-related stress. We used the Impact of Event Scale-Revised (IES-R) to measure psychological injury caused by work-related stressful events and the Patient Health Questionnaire (PHQ)-9 to assess the severity of depression.
Results
In study 1, 62.4% of workers diagnosed with depression or adjustment disorder experienced work-related stress within six months before onset. In study 2, the IES-R mean scores were 40.7 (SD = 23.1) for Group A (workers with depression and quit their jobs) and 36.67 (SD = 23.4) for Group B (workers with depression but stayed at their jobs), with both exceeding the cut-off point (24/25) of PTSD (Post-Traumatic Stress Disorder), while the mean score of Group C (workers who did not have depression but quit their jobs because of work-related stress) was 20.74 (SD = 21.2), and it was 13.89 (SD = 17.4) for Group D (workers who had work-related stress but stayed at their jobs), with both of them below the cut-off point of PTSD. The total scores of Group A and Group B were significantly higher than those of Group C and Group D(p < 0.001). There was a significant positive correlation between the scores of IES-R and PHQ-9 for all four groups (r = 0.708).
Conclusions
This study suggests that it is necessary to measure not only depressive symptoms but also the level of psychological injury resulting from stressful events in the workplace to assess workers with depression.
Relationship of stunting with water, sanitation, and hygiene (WASH) practices among children under the age of five: A cross-sectional study in southern Punjab, Pakistan
Authors: Batool Munazza , Saleem Javeria , Zakar Rubeena , Butt Muhammad Salman , Iqbal Sanaullah , Haider Shahroz , Fischer Florian 
Published: January 2023

Abstract
Background
Undernutrition can be caused by food insufficiency, impaired child care, limited access to healthcare, and maternal lack of health literacy. Similarly, there are various environmental factors, such as drinking water quality, poor sanitation, and hygienic practices that can lead to poor nutritional status in children. The present study aimed to compare household-associated risk factors, including water, sanitation, and hygiene (WASH) practices of mothers, with children’s stunting under the age of five.
Methods
A face-to-face cross-sectional survey was conducted with mothers of children under the age of five in the Dera Ghazi Khan district in southern Punjab, Pakistan. World Health Organization criteria for stunting were used to identify the participants. A sociodemographic questionnaire was used to collect information from consented parents/guardians on children’s age, feeding, and WASH practices. Pearson’s chi-square, simple regression, and hierarchical regression models were applied for data analysis.
Results
A total of 204 mothers of children of both genders participated in this study. The children’s mean (SD) age was 15.67 (± 10.2) months, their weight was 5.44 (± 1.45) kg, their height was 67.69 (± 10.05), and their mid-upper arm circumference was 9.75 (± 1.30) cm. Children’s stunting was mild (z-score > -2) at 17.6%, moderate (z-score − 2 to -3) at 16.7%, and severe (z-score < -3) at 65.7% of participants. A simple regression model showed a strong association, r2 = 0.062, p = 0.013, with age as the most significant sociodemographic factor. The hierarchical regression model showed a combined value of r2 = 0.0128, p = 0.027, with hand pump and tank water as the significant source of drinking water that was related to stunting among children.
Conclusion
Stunting can be associated with several risk factors, including WASH parameters. This study concluded that children aged under five years are susceptible to stunting in southern Punjab, Pakistan. The contamination of hand pumps and tank water resources was found to be the major contributing factor to stunting.
Meta-Analysis Evaluating Risk of Hyperkalemia Stratified by Baseline MRA Usage in Patients with Heart Failure Receiving SGLT2 Inhibitors
Authors: Ahmed Aymen , Ahmed Warda , Arshad Muhammad Sameer , Suri Azeema , Amin Emaan , Shahid Izza , Memon Muhammad Mustafa 
Published: January 2023

Abstract
Mineralocorticoid receptor antagonists (MRAs) are guideline-recommended medications for patients with heart failure (HF) that reduce the risk of cardiovascular death and hospitalization, and improve survival. Evidence from recent clinical trials has indicated that the use of SGLT2is reduces the risk of HF hospitalization in HF patients with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF). The clinical benefit of these two drugs is based on highest level of clinical trial evidence. However, the risk of hyperkalemia limits the usage of MRAs (1). Considering this risk, both the current European Society of Cardiology (ESC) and American Heart Association/ American College of Cardiology (AHA/ACC) guidelines practice caution and recommend halving the dose and cessation of MRA therapy at serum potassium levels of >5.5 mmol/L and >6.0 mmol/L, respectively (2 – 4). SGLT2is exert diuretic effects and initially impair kidney function in patients. The combination of these two drugs is therefore expected to cause severe exacerbation in hyperkalemia. However, evidence from recent clinical trials has demonstrated that the use of SGLT2i may potentially reduce the rate of hyperkalemia when added to MRA therapy, and thus, can be used to optimize guideline-recommended MRA usage among patients with HF (5 – 7). Data regarding whether the concomitant use of both therapies reduces the risk of precipitating hyperkalemia among patients with HF is unclear. Therefore, we conducted a meta-analysis to evaluate the effect of baseline MRA therapy on the incidence of hyperkalemia in patients taking SGLT2is.
Development and validation of a nomogram for predicting overall survival in patients with early-onset endometrial cancer
Authors: Zhang Meng , Li Ruiping , Zhang Jiaxi , Wang Yunyun , Wang Yunlu , Guo Yuzhen 
Published: January 2023

Abstract
Background
The aim of this study was to investigate the differences in the clinicopathological characteristics of younger and older endometrial cancer (EC)patients, and further assess the prognosis of early-onset EC in terms of overall survival by developing a nomogram.
Methods
Patients with EC diagnosed from surveillance, epidemiology and end results (SEER) between 2004 and 2015 were selected. Clinicopathological characteristics were compared between younger and older patients, and survival analysis was performed in both groups. Prognostic factors affecting overall survival in young EC patients were identified by Cox regression, a nomogram was created and internal validation was performed by consistency index, decision curve analysis, receiver operating characteristic curves and calibration curves. Data from 70 early-onset EC patients for external validation. Finally, Kaplan-Meier curves were plotted to compare survival outcomes across risk subgroups.
Results
A total of 5037 young patients and 60612 older patients were included in this study. Younger patients were divided into a training cohort (3526) and a validation cohort (1511) in a 7:3 ratio. Cox analysis yielded age, marital status, race, SEER stage and T stage as independent risk factors for overall survival, and a nomogram was constructed based on these factors. Internal and external validation demonstrated the good predictive power of the nomogram. In particular, the C-index for the overall survival nomogram was 0.839 [95% confidence interval (0.814–0.864)] in the training cohort and 0.826 (0.785–0.867) in the internal validation cohort. The differences in Kaplan-Meier curves between the different risk subgroups were statistically significant.
Conclusions
In this study, the nomogram predicting overall survival of early-onset endometrial cancer patients based on the SEER database was developed to help assess the prognosis of patients and guide clinical treatment.
A method to evaluate the difficulty of atlantoaxial dislocation reduction based on CT quantitative analysis
Authors: Wang Jianhua , Yang Haozhi , Zhang Shuang , Xie Ningling , Liu Guoqiang , Qiao Guoqing 
Published: January 2023

Abstract
Background
To evaluate the difficulty of reduction of atlantoaxial dislocation based on CT quantitative analysis, and to provide guidance for surgical decision-making.
Methods
From March 2018 to December 2019, the CT features of 88 patients with atlantoaxial dislocation were analyzed retrospectively. Quantitative scores were defined according to imaging features, including: 0 point, flat and horizontal lateral mass joints; 1 point, slightly sloped lateral mass joints; 1.5 points, more severe sloped lateral mass joints; 2 points, osteophyte in atlantoaxial joint; 3 points, ball-and-socket deformity, interlocking, callus in atlantoaxial joint, and atlanto-odontoid bony fusion or blocking. The total scores of lateral mass joints and atlanto-odontoid joints on both sides were calculated separately. Grades were as follows according to the sum of points of the atlanto-odontoid joint and lateral mass joints: Grade I, 0–1 points; Grade Ⅱ, 2–3 points; Grade Ⅲ, 4–6 points; and Grade IV, 7–9 points. After one week of bidirectional cervical traction, CT scans were peformed and atlantodens interval (ADI) and vertical distance from dens to Chamberlain line (VDDC) were measured before and after traction. The vertical reduction rate, horizontal reduction rate and overall reduction rate of atlantoaxial dislocation were calculated. The difference in reduction rate of each grade was compared and the value of CT quantitative score in judging the degree of reduction were analyzed.
Results
Of the 88 patients, the pre- and after- traction ADI values showed 15 cases of grade I ( 7.3 ± 3.4 mm vs 1.5 ± 1.5 mm, p < 0.05), 23 cases of grade II ( 8.1 ± 3.7 mm vs 2.0 ± 1.0 mm, p < 0.05), 38 cases of grade III ( 8.8 ± 4.1 mm vs 5.7 ± 1.7 mm, p < 0.05) and 12 cases of grade IV ( 8.9 ± 3.9 mm vs 6.8 ± 3.6 mm, p > 0.05). The pre-traction VDDC values were improved than that of after-traction, including grade I (11.9 ± 3.9 mm vs 0.8 ± 0.5 mm, p < 0.05), grade II (12.2 ± 3.6 mm vs 3.1 ± 1.1 mm, p < 0.05), grade III (13.6 ± 3.8 mm vs 5.9 ± 1.5 mm, p < 0.05) and grade IV (12.3 ± 3.2 mm vs 8.2 ± 2.0 mm, p < 0.05). The overall reduction rates were respectively 86.4 ± 12.0%, 67.6 ± 8.0%, 45.9 ± 9.0% and 28.4 ± 13.0% after one week of bi-directional traction of the skull, and the statistical differences between groups were significant (p < 0.05).
Conclusions
The CT quantitative scores can help judge the difficulty of atlantoaxial reduction and provide a reference for surgical decision-making. It is an effective non-invasive preoperative evaluation for the difficulty of reduction of atlantoaxial dislocation.
2S albumin from crambe (Crambe abyssinica) against Trypanosoma cruzi
Authors: Araujo J. S. , S Galossi F. , Carvalho L. P. , Melo E. J.T. , Machado O. L.T. 
Published: January 2023

Abstract
Introduction: Seed storage proteins provide a store of amino acids for use during germination and seedling growth but can also play a defensive role in their insecticidal and antimicrobial properties. We determined the potential toxic activity of a 2S albumin, isolated, from crambe seeds, on the growth of Trypanosoma cruzi,a protozoan that causes Chagas disease. Human Chagas disease is a tropical illness that affects 6-8 million people worldwide, causing approximately 8000 deaths in 2015.
Methods: Crambe seed proteins were extracted in phosphate buffer and chromatographically partitioned. The fractions were submitted to a growth-inhibition assay against T. cruzi epimastigotes and amastigotes in LLC-MK2 host cells. The cells were examined by light and transmission electron microscopy.
Results: The 2S albumin protein was not toxic to LLC-MK2 cells at 500 µg/mL but eliminated 70% of the epimastigotes after 48 h and reduced the number of amastigotes infected cells. Amastigotes are the protozoa form found in the bloodstream or within host cells. Morphological and ultrastructural analyses demonstrated the parasite's deformation and organelles, including membrane damage and fragmentation of intracellular amastigotes.
Conclusions: 2S albumin from crambe exhibits activity against both amastigote and epimastigote T. cruzi forms and may be sources of new compounds clinically active against T. cruzi.