bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Ketogenic Diet for Infantile Spasms in Chinese Patients With or Without Monogenic Etiology
Authors: Wang Jun , Zhang Jie , Yang Ying , Gao Kai , Wu Ye , Zhang Yuehua , Jiang Yuwu 
Published: March 2022

ObjectiveThe aim of this study was to evaluate the efficacy of the ketogenic diet (KD) for infantile spasms (IS) in patients with and without different causative genetic mutations.MethodsWe retrospectively evaluated the data of 119 infants with IS who underwent whole-exome sequencing (WES) before KD treatment. The KD efficacy was analyzed at the 16th week after initiation. Patients showing ≥ 50% seizure reduction from baseline and/or the disappeared hypsarrhythmia were considered as the responders. Chi-squared tests or two-sided Fisher's exact tests were performed for categorical data and Mann–Whitney U-tests for non-parametric and continuous data.ResultsThe responder rate to KD in 119 patients was 47.90%. Six different causative monogenic mutations were identified in 32 (26.89%) patients with IS, including CDKL5 (n = 8), ALG13 (n = 3), KCNT1 (n = 8), SLC35A2 (n = 5), PCDH19 (n = 4), and STXBP1 (n = 4). Patients with CDKL5 mutations showed a significantly better response to KD (87.50%) than patients without CDKL5 mutations (p = 0.03). Seven of eight patients with CDKL5 mutations were responders, including five mutations located in functional motifs, and two mutations in the catalytic domain.ConclusionKD therapy was effective in infants with IS. Patients with CDKL5 mutations might have a better response to KD treatment.
External Evaluation of Risperidone Population Pharmacokinetic Models Using Opportunistic Pediatric Data
Authors: Karatza Eleni , Ganguly Samit , Hornik Chi D. , Muller William J. , Al-Uzri Amira , James Laura , Balevic Stephen J. , Gonzalez Daniel 
Published: March 2022

Risperidone is approved to treat schizophrenia in adolescents and autistic disorder and bipolar mania in children and adolescents. It is also used off-label in younger children for various psychiatric disorders. Several population pharmacokinetic models of risperidone and 9-OH-risperidone have been published. The objectives of this study were to assess whether opportunistically collected pediatric data can be used to evaluate risperidone population pharmacokinetic models externally and to identify a robust model for precision dosing in children. A total of 103 concentrations of risperidone and 112 concentrations of 9-OH-risperidone, collected from 62 pediatric patients (0.16–16.8 years of age), were used in the present study. The predictive performance of five published population pharmacokinetic models (four joint parent-metabolite models and one parent only) was assessed for accuracy and precision of the predictions using statistical criteria, goodness of fit plots, prediction-corrected visual predictive checks (pcVPCs), and normalized prediction distribution errors (NPDEs). The tested models produced similarly precise predictions (Root Mean Square Error [RMSE]) ranging from 0.021 to 0.027 nmol/ml for risperidone and 0.053–0.065 nmol/ml for 9-OH-risperidone). However, one of the models (a one-compartment mixture model with clearance estimated for three subpopulations) developed with a rich dataset presented fewer biases (Mean Percent Error [MPE, %] of 1.0% vs. 101.4, 146.9, 260.4, and 292.4%) for risperidone. In contrast, a model developed with fewer data and a more similar population to the one used for the external evaluation presented fewer biases for 9-OH-risperidone (MPE: 17% vs. 69.9, 47.8, and 82.9%). None of the models evaluated seemed to be generalizable to the population used in this analysis. All the models had a modest predictive performance, potentially suggesting that sources of inter-individual variability were not entirely captured and that opportunistic data from a highly heterogeneous population are likely not the most appropriate data to evaluate risperidone models externally.
WaSP-ECG: A Wave Segmentation Pretraining Toolkit for Electrocardiogram Analysis
Authors: Brisk Rob , Bond Raymond R. , Finlay Dewar , McLaughlin James A. D. , Piadlo Alicja J. , McEneaney David J. 
Published: March 2022

IntroductionRepresentation learning allows artificial intelligence (AI) models to learn useful features from large, unlabelled datasets. This can reduce the need for labelled data across a range of downstream tasks. It was hypothesised that wave segmentation would be a useful form of electrocardiogram (ECG) representation learning. In addition to reducing labelled data requirements, segmentation masks may provide a mechanism for explainable AI. This study details the development and evaluation of a Wave Segmentation Pretraining (WaSP) application.Materials and MethodsPretraining: A non-AI-based ECG signal and image simulator was developed to generate ECGs and wave segmentation masks. U-Net models were trained to segment waves from synthetic ECGs. Dataset: The raw sample files from the PTB-XL dataset were downloaded. Each ECG was also plotted into an image. Fine-tuning and evaluation: A hold-out approach was used with a 60:20:20 training/validation/test set split. The encoder portions of the U-Net models were fine-tuned to classify PTB-XL ECGs for two tasks: sinus rhythm (SR) vs atrial fibrillation (AF), and myocardial infarction (MI) vs normal ECGs. The fine-tuning was repeated without pretraining. Results were compared. Explainable AI: an example pipeline combining AI-derived segmentation masks and a rule-based AF detector was developed and evaluated.ResultsWaSP consistently improved model performance on downstream tasks for both ECG signals and images. The difference between non-pretrained models and models pretrained for wave segmentation was particularly marked for ECG image analysis. A selection of segmentation masks are shown. An AF detection algorithm comprising both AI and rule-based components performed less well than end-to-end AI models but its outputs are proposed to be highly explainable. An example output is shown.ConclusionWaSP using synthetic data and labels allows AI models to learn useful features for downstream ECG analysis with real-world data. Segmentation masks provide an intermediate output that may facilitate confidence calibration in the context of end-to-end AI. It is possible to combine AI-derived segmentation masks and rule-based diagnostic classifiers for explainable ECG analysis.
The Effects of Patient Education on Psychological Status and Clinical Outcomes in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis
Authors: Wu Zugui , Zhu Yue , Wang Yi , Zhou Rui , Ye Xiangling , Chen Zehua , Li Congcong , Li Junyi , Ye Zixuan , Wang Zhenbang , Liu Wengang , Xu Xuemeng 
Published: March 2022

BackgroundRheumatoid arthritis (RA) is a common systemic inflammatory autoimmune disease. The disease has a serious impact on mental health and requires more effective non-pharmacological interventions.ObjectiveThis study aims to systematically evaluate the effectiveness of patient education on psychological status and clinical outcomes in rheumatoid arthritis.MethodsThis systematic review and meta-analysis was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Cochrane Library, EMBASE database, and Web of Science database were screened for articles published until November 2, 2021. Randomized controlled trials (RCTs) of patient education for RA were included. Outcomes measures included pain, physical function, disease activity, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), anxiety, depression, Arthritis Self-Efficacy (pain, other symptoms, total), and General health. For each outcome, standardized mean differences or mean differences and 95% confidence intervals (CIs) were calculated.ResultsA total of 24 RCTs (n= 2,276) were included according to the inclusion and exclusion criteria. Meta-analysis revealed a statistically significant overall effect in favor of patient education for physical function [SMD = −0.52, 95% CI (−0.96, −0.08),I2= 93%,P= 0.02], disease activity [SMD = −1.97, 95% CI (−3.24, −0.71),I2= 97%,P= 0.002], ASE (pain) [SMD = −1.24, 95% CI (−2.05, −0.43),I2= 95%,P= 0.003], ASE (other symptoms) [SMD = −0.25, 95% CI (−0.41, −0.09),I2= 25%,P= 0.002], ASE (total) [SMD = −0.67, 95% CI (−1.30, −0.05),I2= 90%,P= 0.03], and general health [SMD = −1.11, 95% CI (−1.36, −0.86),I2= 96%, P &lt; 0.00001]. No effects were found for anxiety [SMD = 0.17, 95% CI (−0.64, 0.98),I2= 82%,P= 0.68], depression [SMD = −0.18, 95% CI (−0.52, 0.15),I2= 52%,P= 0.28], pain [SMD = −0.37, 95% CI (−0.80, 0.05),I2= 89%,P= 0.08], and CRP [SMD = −0.27, 95% CI (−0.57, 0.02),I2= 0%,P= 0.07].ConclusionsPatient education may be effective in improving clinical outcomes and psychological status in patients with rheumatoid arthritis. Considering the methodological limitations of the included RCTs, more high-quality and large-sample RCTs are needed to confirm this conclusion in the future.Systematic Review Registrationhttp://www.crd.york.ac.uk/prospero, identifier: CRD42021250607.
The Impact of COVID-19 Surges in 2019–2021 on Patient-Reported Outcome Measures After Spine Surgery at an Academic Tertiary Referral Center in Taiwan: A Retrospective Observational Cohort Study
Authors: Lin Yu-Hsien , Wang Jun-Sing , Wang Wen-Chien , Lin Yu-Tsung , Wu Yun-Che , Chen Kun-Hui , Pan Chien-Chou , Chin Ning-Chien , Shih Cheng-Min , Lee Cheng-Hung 
Published: March 2022

AimLimited data are available on the impact of the coronavirus disease 2019 (COVID-19) pandemic on patient-reported outcome measures (PROMs) in patients who underwent spine surgery. In this study, we aimed to investigate the associations between the COVID-19 outbreak in Taiwan (May 2021) and PROMs in patients who underwent spine surgery.MethodWe retrospectively identified patients who underwent spine surgery during identical defined 6-week time-intervals (May 16 to June 30) in 2019, 2020, and 2021. PROMs, including visual analog scale (VAS) score for pain, Oswestry disability index (ODI), and EuroQol-5D (EQ-5D), were investigated before surgical intervention and at a 1-month follow-up. Relevant clinical information was collected from the electronic medical records of patients. Linear regression analysis was used to examine the association between the pandemic in 2021 (vs. 2019/2020) and the PROMs after adjusting for age, sex, and relevant clinical variables.ResultsThe number of patients who underwent spine surgery at our hospital during the identical defined 6-week time-intervals in 2019, 2020, and 2021 was 77, 70, and 48, respectively. The surgical intervention significantly improved VAS, ODI, and EQ-5D of the patients (1 month after surgery vs. before surgery, all p &lt; 0.001) in all three study periods. However, there was a significant between-group difference in change from baseline in VAS (p = 0.002) and EQ-5D (p = 0.010). The decrease in VAS and increase in EQ-5D after surgery in 2021 were not as much as those in 2019 and 2020. The associations between the pandemic in 2021 (vs. 2019/2020) and changes in VAS (β coefficient 1.239; 95% confidence interval [CI] 0.355 to 2.124; p = 0.006) and EQ-5D (β coefficient, −0.095; 95% CI, −0.155 to −0.035; p = 0.002) after spine surgery were independent of relevant clinical factors.ConclusionThere was less improvement in short-term PROMs (VAS and EQ-5D) after spine surgery during the COVID-19 pandemic. Assessment of PROMs in surgical patients during a pandemic may be clinically relevant, and psychological support in this condition might help improve patients' outcomes.
The Neonatal Encephalopathy in Full-Term Newborns
Authors: Шалькевич Л.В. , Жевнеронок И.В. , Устинович Ю.А. , Ткаченко А.К. 
Published: March 2022

В статье рассматриваются основные дефиниции неонатальной энцефалопатии у доношенных новорожденных, критерии ее диагностики. Дана характеристика основных патогенетических звеньев развития постгипоксического поражения нервной системы у новорожденных, принципы их дифференциальной диагностики и лечения.
The main definitions of neonatal encephalopathy in full-term newborns and criteria for its diagnosis in the article are discussed. Characteristics of the main pathogenic links of development of post- hypoxic nervous system damage in newborns, principles of their differential diagnosis and treatment are given.
Complex Diagnostics of Mental and Behavioral Disorders in Combatants
Authors: Михайлов Б.В. , Мороз С.М. , Хаитов Р.П. , Галаченко А.А. 
Published: March 2022

Цель. Определение наиболее существенных диагностических критериев оценки нарушений психической сферы у участников боевых действий.Дизайн: описательное, проспективное, клиническое исследование.Материалы и методы. В статье представлены результаты комплексной оценки клинико-диагностических характеристик расстройств психики и поведения у комбатантов. Обследовано 126 участников боевых действий для выявления наличия психиатрических, неврологических, офтальмологических, отоларингологических, нейрофизиологических и нейропсихологических нарушений. Проанализированы феноменология, динамика, специфические проявления. Результаты. У всех обследованных комбатантов выявлены нарушения психической сферы различной нозосиндромальной принадлежности. Наиболее выраженными были эмоционально-аффективные, когнитивные и соматовегетативные нарушения. Выраженность нарушений психической сферы коррелировала с нарушениями биоэлектрической активности головного мозга по данным ЭЭГ-мозгового картирования. Выявлены диагностические критерии акубаротравмы.Заключение. Клинико-психопатологические особенности нарушений психической сферы у комбатантов показывают их полиморфность. Это обусловливает необходимость тщательной оценки их структуры, степени отягощенности со стороны соматической сферы и коморбидности. Необходим учет социально-биологических характеристик пациентов и данных инструментальных исследований. Это повысит эффективность дифференциально-диагностических и лечебно-реабилитационных мероприятий.
Purpose. To determine the features and the most significant diagnostic criteria of mental disorders in combatants. Design – descriptive, prospective, clinical study.Materials and methods. In the article, there were represented the results of a comprehensive assessment of clinical and diagnostic patterns of mental and behavioral disorders of combatants. There were examined 126 combat participants to reveal the presence of psychiatric, neurological, ophthalmological, otolaryngological, neurophysiological, and neuropsychological disorders. Their phenomenology, dynamics, and specificity were analyzed.Results. All observed combatants demonstrated different nosological and syndromological origin of mental disorders. The most significant were emotional-affective, cognitive, and somatic- vegetative disorders. The severity of mental disorders correlated with bioelectric brain activity on the EEG-brain mapping. The diagnostic criteria of acubarotrauma were revealed.Conclusion. Clinical-psychopathological features of mental disorders in combatants demonstrated their polymorphic structure. It is necessary to pay more attention to the assessment of the structure of mental disorders, the degree of burden of somatic sphere, and comorbidity. It is absolutely necessary to pay attention to social-biological characteristics of patients and instrumental investigations. That will increase the effectiveness of differential diagnostic and therapeutic-rehabilitation programs.
Clinical and Epidemiological Features of Suicidal Behaviour in Young People in the Krasnodar Territory
Authors: Бойко Е.О. , Ложникова Л.Е. , Зайцева О.Г. 
Published: March 2022

В результате проведенного комплексного клинико-эпидемиологического исследования изучены распространенность суицидального поведения и показатели смертности от суицидов у лиц молодого возраста в Краснодарском крае за период 2015–2019 гг. (на 100 тысяч населения); клиническим методом с использованием патопсихологического исследования определены виды и структура суицидального поведения у 240 пациентов молодого возраста с суицидальным поведением в анамнезе, с различной нозологической принадлежностью с учетом диагностических критериев МКБ-10.
In the course of the complex clinico-epidemiological research, there were studied the prevalence of suicidal behaviour and mortality from suicide in young people in the Krasnodar region for the period 2015–2019 (per 100 thousand population). The clinical method with pathopsychological research was used to identify the types and structure of suicidality in 240 young patients with suicidal behaviour history, with different nosology, taking into account the diagnostic criteria of ICD-10.
Psychoemotional Synergy Registerof Non-chemical Addiction and Tobacco Smoking in Young People
Authors: Табачников С.И. , Осуховская Е.С. , Васильева А.Ю. , Харченко Е.Н. , Салдень В.И. , Чепурная А.Н. 
Published: March 2022

Патологическое влечение к азартным играм как вариант нехимической зависимости и табакокурение как один из видов химической аддикции на современном этапе являются актуальной проблемой как в Украине, так и в зарубежных странах, где легализован игорный бизнес. В статье изучены показатели психоэмоционального состояния здоровых молодых людей и игроманов, курящих и некурящих с помощью метода «САН». Среди респондентов, не курящих табак, самочувствие и настроение у здоровых молодых людей получили высокую оценку, а активность – среднюю; у лиц, страдающих лудоманией, показатели самочувствия, активности и настроения находятся в пределах средней оценки. У курящих обследуемых, как здоровых, так и игроманов, достоверных различий по шкалам самочувствия, активности и настроениявыявлено не было: вышеупомянутые показатели соответствуют высокой оценке, что в совокупности с результатами корреляционного анализа доказывает синергию возникновения и функционирования нехимической и химической аддикции. На основании полученных данных сделан вывод об актуальности проведения психогигиенических и психокоррекционных мероприятий среди населения для предотвращения процессов дальнейшей эпидемической экспансии лудомании и табакокурения.
Pathological attraction to gambling, as a variant of non-chemical dependence, and smoking, as one of the types of chemical addiction, is a pressing problem today both in Ukraine and in foreign countries, where the gambling business has been legalized. In the article, there are studied the indicators of the psycho-emotional state of healthy young people and gamers, smokers and non- smokers using the method of "WAM". Among respondents, who do not smoke tobacco, health and mood were highly appreciated, and the activity was moderate; in individuals with ludomania, the indicators of well-being, activity and mood were within the average of the assessment. In smokers, both healthy and gamers, there were no significant differences in the scales of well-being, activity and mood: the above indicators correspond to a high score, which together with the results of correlation analysis proves the synergy of the emergence and functioning of non-chemical and chemical addiction. On the base of the obtained data, the conclusion about the relevance of psychohygienic and psychocorrectional measures in the population to prevent the processes of further epidemic expansion of drug addiction and smoking was made.
Clinical Laboratory Diagnostics in Undergraduate and Postgraduate Training of Physician
Authors: Коневалова Н.Ю. , Козловская С.П. , Фомченко Г.Н. , Телепнева Е.Ю. , Головко Е.С. , Тихон Т.В. 
Published: March 2022

Неуклонное развитие и расширение спектра современных медицинских технологий, методов диагностики и способов лечения существенно повысило значимость лабораторных исследований в практике врача-клинициста. Для повышения качества подготовки квалифицированных специалистов возникает необходимость постоянного совершенствования системы преподавания и обновления теоретической базы программ по клинической лабораторной диагностике в медицинских вузах. В статье представлены вопросы преподавания дисциплины «Клиническая лабораторная диагностика» на кафедре общей и клинической биохимии с курсом факультета повышения квалификации и переподготовки кадров Витебского государственного медицинского университета.С учетом применения современных технологий обучения определен состав элементов образовательного процесса и предложен алгоритм обучения. Представлены достижения научной деятельности сотрудников кафедры, результаты которых внедряются в образовательный процесс. Данная модель обучения способствует достижению оптимальных учебных результатов и воспроизводит опыт профессионального и личностного развития современного врача.
Steady development and expansion of medical technologies, diagnostic and treatment methods significantly increased the importance of laboratory research in the practice of clinician. To increase the quality of specialist training, there is the need to constantly improve the teaching system and update the theoretical base of the programs for clinical laboratory diagnostics in medical universities. The article presents the issues of teaching the discipline "Clinical laboratory diagnostics" at the General and Clinical Biochemistry Department with the course of the Faculty of Advanced Training and Retraining of Vitebsk State Medical University. Taking into account the use of modern teaching technologies, the composition of the education process elements is determined and the learningalgorithm is proposed. There are presented the achievements of scientific activity of the staff, the results of which are implemented in the educational process. This learning model contributes to optimal academic results and reproduces the experience of professional and personal development of a modern doctor.