bluuebunny/crossref_metadata_2025_split huggingface dataset:
EFFECTS OF M101—AN EXTRACELLULAR HEMOGLOBIN—APPLIED DURING CARDIOPULMONARY RESUSCITATION: AN EXPERIMENTAL RODENT STUDY
Authors: Iten Manuela , Glas Michael , Kindler Manuel , Ostini Alessandro , Nansoz Sandra , Haenggi Matthias 
Published: April 2023

ABSTRACT
During and immediately after cardiac arrest, cerebral oxygen delivery is impaired mainly by microthrombi and cerebral vasoconstriction. This may narrow capillaries so much that it might impede the flow of red blood cells and thus oxygen transport. The aim of this proof-of-concept study was to evaluate the effect of M101, an extracellular hemoglobin-based oxygen carrier (Hemarina SA, Morlaix, France) derived from Arenicola marina, applied during cardiac arrest in a rodent model, on markers of brain inflammation, brain damage, and regional cerebral oxygen saturation. Twenty-seven Wistar rats subjected to 6 min of asystolic cardiac arrest were infused M101 (300 mg/kg) or placebo (NaCl 0.9%) concomitantly with start of cardiopulmonary resuscitation. Brain oxygenation and five biomarkers of inflammation and brain damage (from blood, cerebrospinal fluid, and homogenates from four brain regions) were measured 8 h after return of spontaneous circulation. In these 21 different measurements, M101-treated animals were not significantly different from controls except for phospho-tau only in single cerebellum regions (P = 0.048; ANOVA of all brain regions: P = 0.004). Arterial blood pressure increased significantly only at 4 to 8 min after return of spontaneous circulation (P < 0.001) and acidosis decreased (P = 0.009). While M101 applied during cardiac arrest did not significantly change inflammation or brain oxygenation, the data suggest cerebral damage reduction due to hypoxic brain injury, measured by phospho-tau. Global burden of ischemia appeared reduced because acidosis was less severe. Whether postcardiac arrest infusion of M101 improves brain oxygenation is unknown and needs to be investigated.
Why the Treatment Sequence Matters
Authors: Wu Victoria S. , Elshami Mohamedraed , Stitzel Henry J. , Lee Jonathan J. , Hue Jonathan J. , Kyasaram Ravi K. , Hardacre Jeffrey M. , Ammori John B. , Winter Jordan M. , Selfridge Jennifer Eva , Mohamed Amr , Chakrabarti Sakti , Bajor David , Mahipal Amit , Ocuin Lee M. 
Published: April 2023

Objective:
To define the optimal threshold of perioperative chemotherapy completion and relative dose intensity (RDI) for patients with resected pancreatic ductal adenocarcinoma (PDAC).

Background:
Many patients who undergo pancreatectomy for PDAC fail to initiate or complete recommended perioperative chemotherapy. The association between the amount of perioperative chemotherapy received and overall survival (OS) is not well-defined.

Methods:
Single-institution analysis of 225 patients who underwent pancreatectomy for stage I/II PDAC (2010–2021). Associations between OS, chemotherapy cycles completed, and RDI were analyzed.

Results:
Regardless of treatment sequence, completion of ≥67% of recommended cycles was associated with improved OS compared with no chemotherapy [median OS: 34.5 vs 18.1 months; hazard ratio (HR): 0.43; 95% CI: 0.25–0.74] and <67% of cycles (median OS: 17.9 months; HR: 0.39; 95% CI: 0.24–0.64). A near-linear relationship existed between cycles completed and the RDI received (β = 0.82). A median RDI of 56% corresponded to the completion of 67% of cycles. Receipt of ≥56% RDI was associated with improved OS compared with no chemotherapy (median OS: 35.5 vs 18.1 months; HR: 0.44; 95% CI: 0.23–0.84) and <56% RDI (median OS: 27.2 months; HR: 0.44; 95% CI: 0.20–0.96). Neoadjuvant chemotherapy is associated with increased odds of receiving ≥67% of recommended cycles (odds ratio: 2.94; 95% CI: 1.45–6.26) and ≥56% RDI (odds ratio: 4.47; 95% CI: 1.72–12.50).

Conclusions:
Patients with PDAC who received ≥67% of recommended chemotherapy cycles or ≥56% cumulative RDI had improved OS. Neoadjuvant therapy was associated with increased odds of receiving ≥67% of cycles and ≥56% cumulative RDI and should be considered in all patients with resectable PDAC.
Understanding how and under what circumstances integrated knowledge translation works for people engaged in collaborative research: metasynthesis of IKTRN casebooks
Authors: Dunn Sandra I. , Bhati Divya Kanwar , Reszel Jessica , Kothari Anita , McCutcheon Chris , Graham Ian D. 
Published: April 2023

ABSTRACT

Introduction and aims:
Interaction and collaboration between researchers, patients/public, clinicians, managers and policy-makers are necessary to enhance the relevance and use of research, improve planning, and optimize healthcare delivery and outcomes. The Integrated Knowledge Translation Research Network (IKTRN) published four casebooks from 2019 to 2021, describing varied approaches to research co-production. Our aim was to examine the case studies to extend existing theoretical and empirical perspectives about how co-production works.

Methods:
We used metasynthesis, a qualitative research design that includes seven iterative steps (clarify the purpose, delineate the case studies included, extract and code the data, derive themes from the coded data, determine the relationships of the themes to research co-production, synthesize the concepts, and build theory).

Results:
A total of 35 cases was reviewed. The aggregate findings of this metasynthesis identified multiple contextual and process factors, barriers, and facilitators that influence integrated knowledge translation (IKT), and a range of IKT activities that increased the likelihood of success of co-production during research. In comparing the findings from the metasynthesis with existing literature, we found a number of consistencies, but also new information about barriers, facilitators, IKT activities and outcomes, thereby adding to our understanding about factors that influence co-production.

Conclusions:
This metasynthesis provided concrete examples to optimize co-produced clinical and health system research. More research is needed to fully understand how to overcome some challenging modifiable barriers, establish relationships, facilitate communication, overcome power differentials and create processes for knowledge-users working across boundaries (clinical practice and research) to stay engaged and participate fully in research endeavours.
A context-based chatbot surpasses trained radiologists and generic ChatGPT in following the ACR appropriateness guidelines
Authors: Rau A , Rau S , Fink A , Tran H , Wilpert C , Nattenmueller J , Neubauer J , Bamberg F , Reisert M , Russe MF 
Published: April 2023

AbstractBackgroundRadiological imaging guidelines are crucial for accurate diagnosis and optimal patient care as they result in standardized procedures and thus reduce inappropriate imaging studies. In the present study, we investigated the potential to support clinical decision-making using an interactive chatbot designed to provide personalized imaging recommendations based on indexed and vectorized American College of Radiology (ACR) appropriateness criteria documents.MethodsWe utilized 209 ACR appropriateness criteria documents as specialized knowledge base and employed LlamaIndex and the ChatGPT 3.5-Turbo to create an appropriateness criteria contexted chatbot (accGPT). Fifty clinical case files were used to compare the accGPT’s performance against radiologists at varying experience levels and to generic ChatGPT 3.5 and 4.0.ResultsAll chatbots reached at least human performance level. For the 50 case files, the accGPT provided a median of 83% (95% CI 82-84) ‘usually appropriate’ recommendations, while radiologists provided a median of 66% (95% CI 62-70). GPT 3.5-Turbo 70% (95% CI 67-73) and GPT 4 79% (95% CI 76-81) correct answers. Consistency was highest for the accGPT with almost perfect Fleiss’ Kappa of 0.82. Further, the chatbots provided substantial time and cost savings, with an average decision time of 5 minutes and a cost of 0.19 Euro for all cases, compared to 50 minutes and 29.99 Euro for radiologists (both p < 0.01).ConclusionChatGPT-based algorithms have the potential to substantially improve the decision-making for clinical imaging studies in accordance with ACR guidelines. Specifically, a context-based algorithm performed superior to its generic counterpart, demonstrating the value of tailoring AI solutions to specific healthcare applications.
AMYLASE DEPLETION SIGNIFICANTLY IMPROVES THE MALDI-TOF PROFILE OF SALIVA – APPLICATION TO COVID-19 DIAGNOSTICS
Authors: LaCasse Zane , Chivte Prajkta , Kress Kari , Seethi Venkata Devesh R. , Bland Joshua , Alhoori Hamed , Kadkol Shrihari S. , Gaillard Elizabeth R. 
Published: April 2023

AbstractHuman saliva contains a plethora of proteins whose presence and concentration can be monitored for diagnosis and progression of disease. Saliva has been extensively probed for the diagnosis of several systemic and infectious diseases because of the ease with which it can be collected. However, amylase, the most abundant protein found in saliva can obscure the detection of low-abundance proteins by MALDI-ToF MS (matrix-assisted laser desorption/ionization-time of flight mass spectrometry) and diminish the diagnostic utility of this specimen type. In the present study, we used a device to deplete salivary amylase from water-gargle samples through affinity adsorption. After depletion, profiling of the saliva proteome was performed by MALDI-ToF MS on gargle samples from subjects whose COVID-19 (coronavirus disease 2019) status was confirmed by NP (nasopharyngeal) swab RT-qPCR (reverse transcription polymerase chain reaction). Amylase depletion led to the enhancement of signal intensities of various peaks as well as the detection of previously unobserved peaks in the MALDI-ToF spectra. The overall specificity and sensitivity after amylase depletion was 100% and 85.17% respectively for detecting COVID-19. Our simple, rapid and inexpensive technique to deplete salivary amylase can be used to unmask spectral diversity in saliva by MALDI-ToF MS, reveal low-abundant proteins and aid in the establishment of novel biomarkers for diseases.
Malaria surveillance reveals parasite relatedness, signatures of selection, and correlates of transmission across Senegal
Authors: Schaffner Stephen F. , Badiane Aida , Khorgade Akanksha , Ndiop Medoune , Gomis Jules , Wong Wesley , Ndiaye Yaye Die , Diedhiou Younouss , Thwing Julie , Seck Mame Cheikh , Early Angela , Sy Mouhamad , Deme Awa , Diallo Mamadou Alpha , Sy Ngayo , Sene Aita , Ndiaye Tolla , Sow Djiby , Dieye Baba , Ndiaye Ibrahima Mbaye , Gaye Amy , Ndiaye Aliou , Battle Katherine E. , Proctor Joshua L. , Bever Caitlin , Fall Fatou Ba , Diallo Ibrahima , Gaye Seynabou , Sene Doudou , Hartl Daniel L. , Wirth Dyann F. , MacInnis Bronwyn , Ndiaye Daouda , Volkman Sarah K. 
Published: April 2023

AbstractParasite genetic surveillance has the potential to play an important role in malaria control. We describe here an analysis of data from the first year of an ongoing, nationwide program of genetic surveillance ofPlasmodium falciparumparasites in Senegal, intended to provide actionable information for malaria control efforts. Looking for a good proxy for local malaria incidence, we found that the best predictor was the proportion of polygenomic infections (those with multiple genetically distinct parasites), although that relationship broke down in very low incidence settings (r = 0.77 overall). The proportion of closely related parasites in a site was more weakly correlated (r= -0.44) with incidence while the local genetic diversity was uninformative. Study of related parasites indicated their potential for discriminating local transmission patterns: two nearby study areas had similarly high fractions of relatives, but one area was dominated by clones and the other by outcrossed relatives. Throughout the country, 58% of related parasites proved to belong to a single network of relatives, within which parasites were enriched for shared haplotypes at known and suspected drug resistance loci as well as at one novel locus, reflective of ongoing selection pressure.
Acceptability of Breast Milk Donor Banking: A qualitative study among Health Workers in Greater Accra Regional Hospital, Ghana
Authors: Tende Fred Kafui , Nwameme Adanna Uloaku , Tabong Philip Teg-Nefaah 
Published: April 2023

AbstractDespite the compelling evidence demonstrating the immediate and long-term health advantages of prompt breastfeeding beginning, not all newborns are breastfed exclusively for a variety of reasons. As a result, the World Health Organization has made new recommendations for the adoption of breastmilk donor banks to make sure that children receive breastmilk when mothers are unable to produce it. In order to better understand how health professionals at the Greater Accra Regional Hospital, who would be leading the charge in putting this policy into practice, perceive and accept the practice of storing breastmilk, this study was conducted. At the Greater Accra Regional Hospital, 18 healthcare professionals were chosen using maximum variation purposive sampling procedures. They were made up of eleven midwives, a medical officer, six nurses, and two nutritionists and all participants were interviewed face to face using a semi structured interview guide. Data was transcribed verbatim and was analyzed using thematic analysis. Participants in the study admitted that they would be open to using or contributing to a bank of breastmilk. Participants also said that if safety precautions are taken, they would urge their customers to give breastmilk and recommend breastmilk from a breastmilk bank to them when the situation calls for it. Health professionals recommended that education be provided prior to the installation of breast milk donor banking to lessen or eliminate any misconceptions people may have about it. The concept of breastmilk donor banking was fairly accepted among health workers. Misconceptions about the safety of breast milk was the main concern. The results emphasize the necessity of greater stakeholder engagement and education prior to the implementation of this policy in order to boost acceptance and uptake.
Granular analysis reveals smart insufflation to be operationally more efficient and financially net positive compared to traditional insufflation for laparoscopic surgery
Authors: Abbas Aazad , Saleh Imran , Hoit Graeme , Park Sam , Whyne Cari , Toor Jay 
Published: April 2023

AbstractIntroductionSmart insufflation (SI) techniques relying on valve and membrane-free insufflation are increasing in usage. Although considerable literature exists demonstrating the benefits of SI on procedural ease and patient outcomes, there remains a paucity describing the financial impact of these devices. The purpose of this study was to determine the financial and efficiency impact of these devices on the operating room (OR) and inpatient wards of a hospital.MethodsA discrete event simulation model representing a typical mid-sized North American hospital comparing SI to TI was generated. The National Surgical Quality Improvement (NSQIP) database from 2015 to 2019 was used to populate the model with data supplemented from literature. Outcomes included length of stay (LOS), duration of surgery (DOS), annual procedure volume, profit, return on investment (ROI), and gross profit margin (GPM).ResultsThe operational parameters demonstrating favorability of SI to TI were DOS and LOS. DOS savings were 10-32 minutes/case while LOS savings were 0-3 days/case. Implementation of an SI led to an increase in annual throughput of 148 cases (12%). LOS decreased by 189 days (19%). This resulted in an increase in net profit of $104,675 per annum. The ROI of SI over TI device was >1000%.ConclusionDespite the initial financial investment being greater, the implementation of SI offsets these expenses and yields significant financial benefits. Our study demonstrates the financial benefits of SI over TI and illustrates how granular operational and financial analysis of technologies are essential to aid in sound healthcare procurement decision making.
Intra-urban inequalities in modern family planning use in Uganda’s urban settings: the role of place of residence, socio-economic, family, and individual factors
Authors: Kananura Rornald Muhumuza , Birabwa Catherine , Wasswa Ronald , Ssanyu Jacquellyn Nambi , Muluya Kharim Mwebaza , Namutamba Sara , Kyangwa Moses , Kizito Felix , Kakaire Othman , Mugahi Richard , Waiswa Peter 
Published: April 2023

AbstractEvidence of how intra-urban inequalities could steer the use of modern family planning (mFP) services remains elusive. In this study, we examined the role of residence, socio-economic, family, and individual factors in shaping access to mFP use in Iganga Municipality and Jinja city, in central eastern Uganda.We used cross-sectional household survey data that were collected between November-December 2021 from 1023 women aged 15-49 years. We used logistic regression to assess the factors associated with mFP use and Stata user written command –iop, to assess the inequality in mFP due to different factors. We considered unfair circumstances as socio-economic status (wealth quartile, education level, and working level), place of residence, age, religion affiliation, and authority. The time of sexual intercourse was considered as fair circumstance.Overall mFP use was estimated at 48.8%, with close to 60% using long-term acting reversible methods. Overall, 24% of all heterogeneity in modern FP use was due to the observed circumstances and 18% was due to differential in unfair circumstances. An increase in age was inversely associated with mFP use [adjusted Odds Ratio (aOR) [95% Confidence Interval (95%CI)] =0.976[0.966-0.986]), while an increase in parity was positively associated with mFP use (aOR [95%CI]=1.404[1.249-1.578]). Compared to mainland non-slum and landing site residents, mainland slum residents were two-fold (aOR[95%CI]=2.065[1.735-2.458]) and three-fold (aOR[95%CI]=2.631[1.96-3.531]) more likely to use mFP, respectively. Whereas the odds of using mFP increased with the wealth status (Middle: aOR[95%CI]=1.832[1.52-2.209] and Better: aOR[95%CI]=5.276[4.082-6.819]), an interaction between the place of residence and wealth index showed that wealth index mattered only in non-slum mainland areas. Women with secondary or higher level of education and whose decisions to use mFP were independent of other authorities were more likely to use mFP. Lastly, there were region affiliation and type of work differential in the use of mFP.In conclusion, about one-fifth of all heterogeneity in mFP use was due to differentials in unfair circumstances. The findings highlight the need for intervention that are tailored to the different groups of urban residents. For instance, the package of interventions should consider the places of work and places of residences regardless of socioeconomic status.
Improvement in drug prescription skills in medical students through in-person and remote simulated interviews
Authors: Malca C Michan , Siccha S Christian , Cardenas F Ernesto , Placencia M Maritza 
Published: April 2023

AbstractIntroductionDevelopment of drug prescription skills poses critical challenges in medical education. This study determined the effects of simulated interviews on the improvement of drug prescription skills among medical students in 2020.MethodologyThis was a quantitative, cross-sectional, analytical, quasi-experimental study of simulated interviews for improving rational drug prescription skills in medical students. Baseline, pre-, and post-intervention assessments of prescription skills were performed using an expert-validated instrument constructed from the WHO Good Prescribing Guide. Three simulated interviews with different simulated patients were conducted in two groups: in-person in the first batch and remotely in the second batch due to mandatory social distancing during the Covid-19 pandemics. Friedman, Dunn-Bonferroni, and Wilcoxon tests were used, considering a significance of levelp<.05 and standardized mean difference (Hedges g); data were analyzed using Excel 2016 and SPSS 28.ResultsFifty-four students completed the required assessments; in-person 28 and remotely 26. The total score for pharmacological prescription skills increased significantly from pre- to post-intervention measurements, from 12.72 +/-2.94 to 15.44 +/-2.50, respectively (p<.0001) (g: 0.996), and the increase from baseline to post-intervention scores for drug prescription knowledge was 5.39 +/-3.67, 11.28 +/-3.50, respectively (p<.01).DiscussionOur results suggest that the implementation of pre-briefing and debriefing strategies in remote and in-person clinical interviews with simulated patients significantly improved drug prescription skills and pharmacological knowledge among medical students. The logical sequence of the WHO Guide for Good Prescribing may have facilitated debriefing, knowledge acquisition, and transfer to various clinical contexts.
Theraputic Effects of Brain-Computer Interface on Motor Recovery of Stroke Patients: A Meta-analysis
Authors: Guo Zhiwei , Gao Qiang , Jiang Yi , Jiang Hanhong , Jiang Ning 
Published: April 2023

AbstractBackgroundPrevious clinical studies have demonstrated the effects of brain-computer interface (BCI) on the motor recovery of stroke patients. The aim of this study was to evaluate the therapeutic effects of BCI on improving motor functions of stroke patients.MethodsWe conducted a meta-analysis on randomized controlled trials (RCTs) on BCI training for post-stroke motor rehabilitation. Relevant publications were identified from the databases of PubMed, Embase, ScienceDirect, and Cochrane Library. The standardized mean difference (SMD) with 95% confidence intervals (CI) were calculated as the pooled effect size of the motor outcome.ResultsThirty-five of the 43 candidate articles involving 749 participants were included in this meta-analysis. Overall, both the significant immediate effect size of 0.53 and long-lasting effect size of 0.26 were found for motor outcome measured by Fugl-Meyer Assessment. A further subgroup-analysis observed larger therapeutic effects on lower-limb than upper-limb. A subgroup-analysis also indicated that stroke patients may gain better functional outcome in the subacute phase than in the chronic phase. Superior effect of BCI training was also detected for distal function of upper-limb over proximal function. BCI training combined with functional electrical stimulation (FES) was more effective than BCI combined with robot. No significant effect was found in other combined interventional methods, especially the use of transcranial direct current stimulation, which cannot potentiate the effects of BCI training. In addition, subgroup-analysis also indicated a greater effect for longer durations of intervention. And the dosage between 15 min and 180 min was found to be optimal.ConclusionsBCI has significant immediate and long-lasting effects on improving motor function of both upper-limb and lower-limb of stroke patients. Superior therapeutic could be delivered to patients in the subacute phase and clearer benefits are evident in distal functions of upper extremity. When combined with FES, BCI seems to be more effective than when combined with robot and other external devices. Longer durations of intervention could provide better effects. But bigger is not always better for weekly dosage.