bluuebunny/crossref_metadata_2025_split huggingface dataset:
A telemonitoring system to support CPAP therapy in patients with obstructive sleep apnea: a participatory approach in analysis, design, and evaluation
Authors: Aalaei Shokoufeh , Amini Mahnaz , Mazaheri Habibi Mohammad Reza , Shahraki Hadi , Eslami Saeid 
Published: June 2022

Abstract
Background
Continues positive airway pressure (CPAP) therapy is a gold standard treatment for moderate to severe cases of OSA (obstructive sleep apnea). The present research aimed to describe the analysis, design, and evaluation of a telemonitoring system to improve CPAP adherence in patients afflicted with OSA.

Methods
The telemonitoring system was developed in five phases. In the exploratory phase, the body of related literature was reviewed. Then a need analysis was conducted through a focus group discussion with sleep medicine specialists and sales company representatives and an interview with patients. The third phase involved data integration. Then the content and system development were done based on the previous phases. Finally, usability and functionality tests were used to evaluate the system.

Results
The exploratory phase and the needs analysis were conducted by four sleep medicine specialists, two medical informatics specialists, six key figures of the sales companies, two system developers, and 46 patients in different phases. Based on the results obtained from the data integration phase, the telemonitoring system involved three main parts: a patient’s application, a doctor’s portal, a selling companies’ portal (operator’s portal) along with facilitating software for patients to send the CPAP data. Usability and functionality tests were given to 7 and 10 patients, respectively. The total number of usability issues reported by users in the evaluation process was 18, with an average of 2.5 issues per user. The installation problems, disrupted links and improper playing of videos were the main functionalities problems that were solved.

Conclusion
The telemonitoring system, as a means of communication between patients, doctors, and selling companies, can be used to support patients clinically and technically. It has the potential to improve CPAP adherence in patients with OSA.
Use of high flow nasal cannula in patients with acute respiratory failure in general wards under intensivists supervision: a single center observational study
Authors: Colombo Sebastiano Maria , Scaravilli Vittorio , Cortegiani Andrea , Corcione Nadia , Guzzardella Amedeo , Baldini Luca , Cassinotti Elisa , Canetta Ciro , Carugo Stefano , Hu Cinzia , Fracanzani Anna Ludovica , Furlan Ludovico , Paleari Maria Chiara , Galazzi Alessandro , Tagliabue Paola , Peyvandi Flora , Blasi Francesco , Grasselli Giacomo 
Published: June 2022

Abstract
Background
Few data exist on high flow nasal cannula (HFNC) use in patients with acute respiratory failure (ARF) admitted to general wards.

Rationale and objectives
To retrospectively evaluate feasibility and safety of HFNC in general wards under the intensivist-supervision and after specific training.

Methods
Patients with ARF (dyspnea, respiratory rate-RR > 25/min, 150 < PaO2/FiO2 < 300 mmHg during oxygen therapy) admitted to nine wards of an academic hospital were included. Gas-exchange, RR, and comfort were assessed before HFNC and after 2 and 24 h of application.

Results
150 patients (81 male, age 74 [60–80] years, SOFA 4 [2–4]), 123 with de-novo ARF underwent HFNC with flow 60 L/min [50–60], FiO2 50% [36–50] and temperature 34 °C [31–37]. HFNC was applied a total of 1399 days, with a median duration of 7 [3–11] days. No major adverse events or deaths were reported. HFNC did not affect gas exchange but reduced RR (25–22/min at 2–24 h, p < 0.001), and improved Dyspnea Borg Scale (3–1, p < 0.001) and comfort (3–4, p < 0.001) after 24 h. HFNC failed in 20 patients (19.2%): 3 (2.9%) for intolerance, 14 (13.4%) escalated to NIV/CPAP in the ward, 3 (2.9%) transferred to ICU. Among these, one continued HFNC, while the other 2 were intubated and they both died. Predictors of HFNC failure were higher Charlson’s Comorbidity Index (OR 1.29 [1.07–1.55]; p = 0.004), higher APACHE II Score (OR 1.59 [1.09–4.17]; p = 0.003), and cardiac failure as cause of ARF (OR 5.26 [1.36–20.46]; p = 0.02).

Conclusion
In patients with mild-moderate ARF admitted to general wards, the use of HFNC after an initial training and daily supervision by intensivists was feasible and seemed safe. HFNC was effective in improving comfort, dyspnea, and respiratory rate without effects on gas exchanges.
Trial registration This is a single-centre, noninterventional, retrospective analysis of clinical data.
Population genetic structure and evolutionary genetics of Anopheles sinensis based on knockdown resistance (kdr) mutations and mtDNA-COII gene in China–Laos, Thailand–Laos, and Cambodia–Laos borders
Authors: Zhang Yilong , Zhang Canglin , Wu Linbo , Luo Chunhai , Guo Xiaofang , Yang Rui , Zhang Yilong 
Published: June 2022

Abstract
Background
Vector control is still a pivotal method for preventing malaria, and its potency is weakened by the increasing resistance of vectors to chemical insecticides. As the most abundant and vital malaria vector in Southeast Asia, the chemical insecticide resistance status in Anopheles sinensis remains elusive in Laos, which makes it imperative to evaluate the true nature of chemical insecticide resistance-associated genetic mutations in An. sinensis in Laos.

Methods
Adult An. sinensis were collected from three border regions in Laos. DNA was extracted from individual mosquitoes. PCR amplification and DNA sequencing of a fragment containing codon 1014 of the voltage-gated sodium channel (vgsc) gene were completed to study the kdr allele frequency distribution, kdr intron polymorphism, population genetic diversity, and the evolutionary status of the kdr codon. The mitochondrial cytochrome c oxidase subunit II gene (COII) was amplified and sequenced to examine population variations, genetic differentiation, spatial population structure, population expansion, and gene flow patterns.

Results
Nine wild kdr haplotypes of the vgsc gene were detected in this study, and eight of them, namely 1014L1, 1014L2, 1014L4, 1014L7, 1014L9, 1014L10, 1014L11, and 1014L21, were discovered in the China–Laos border (northern Laos), while 1014L3 was only detected in the Thailand–Laos border (northwestern Laos) and Cambodia–Laos border (southern Laos). The newly identified haplotype, 1014L21, was uniquely distributed in the China–Laos border and was not identified in other countries. Based on sequence analysis of the mitochondrial COII genes, significant genetic differentiation and limited gene flow were detected between the China–Laos and Cambodia–Laos An. sinensis populations, which suggested that those two regions were genetically isolated. The distinct distribution of the kdr haplotype frequencies is probably the result of geographical isolation in mosquito populations.

Conclusions
Lack of kdr mutations in the vgsc gene was probably due to genetic isolation and the absence of intense selection pressure in the three border regions of Laos. This study reveals that pyrethroid-based chemical insecticides are still appropriate for battling An. sinensis in parts of Laos, and routine monitoring of chemical insecticide resistance should be continuously implemented and focused on more restricted areas as part of chemical insecticide resistance management.

Graphical Abstract
Prevalence, incidence, and risk factors associated with cytomegalovirus infection in healthcare and childcare worker: a systematic review and meta-analysis
Authors: Balegamire Safari Joseph , McClymont Elisabeth , Croteau Agathe , Dodin Philippe , Gantt Soren , Besharati Amir Abbas , Renaud Christian , Mâsse Benoît , Boucoiran Isabelle 
Published: June 2022

Abstract
Background
Cytomegalovirus (CMV) is transmitted by direct contact with body fluids from infected individuals. Transmission of CMV in households, particularly those with young children, contributes significantly to CMV infection in the general population. However, little is known about the contribution of occupational healthcare or childcare exposure to risk of CMV infection.

Objectives
To determine CMV seroprevalence, incidence of primary infection, and associated risk factors in healthcare and childcare workers.

Methods
Six electronic databases were searched systematically for publications on CMV infection in healthcare and childcare workers until March 7, 2022. Two authors independently evaluated the literature for quality and inclusion in our analyses. The pooled results for seroprevalence, incidence, and relative risk (RR) were determined using a random effects model. Heterogeneity among studies was quantified and further investigated in subgroup analysis and meta-regression. Publication bias was assessed using funnel plot. Statistical analyses were preformed using R version 4.05.

Results
Forty-eight articles were included in this meta-analysis (quality assessment: 18 good, 14 fair, and 16 poor). Pooled CMV seroprevalence was 59.3% (95% CI: 49.8–68.6) among childcare workers and 49.5% (95% CI: 40.3–58.7) among healthcare workers, and pooled incidences of primary CMV infection per 100 person-years were respectively 7.4 (95% CI: 3.9–11.8) and 3.1 (95% CI: 1.3–5.6). RR for primary infection compared to controls were 3.4 (95% CI: 1.3–8.8) and 1.3 (95% CI: 0.6–2.7) for healthcare and childcare workers, respectively. The odds of CMV seropositivity were 1.6 (95% CI: 1.2–2.3) times higher for childcare workers compared to controls, but not significantly different between healthcare workers and controls (0.9; 95% CI: 0.6–1.2). CMV seropositivity in both groups was significantly associated with having one or more children residing at home, marital status, ethnicity, and age.

Conclusions
Childcare workers, but not healthcare workers, have an increased risk of prevalent and incident CMV infection, a risk that is further increased with the presence of at least one child living at home. These findings suggest that enforcing simple, conventional hygienic measures in childcare settings could help reduce transmission of CMV, and that special precautionary measures for preventing CMV infection may not be required for pregnant healthcare workers.

Systematic review registration
PROSPERO CRD42020139756
On a class of generalized saddle-point problems arising from contact mechanics
Authors: Matei Andaluzia 
Published: June 2022

AbstractIn the present paper we consider a class of generalized saddle-point problems described by means of the following variational system: $$\begin{aligned} &a(u,v-u)+b(v-u,\lambda )+j(v)-j(u)+J(u,v)-J(u,u)\geq (f,v-u)_{X}, \\ &b(u,\mu -\lambda )-\psi (\mu )+\psi (\lambda )\leq 0, \end{aligned}$$

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Post-fire Bond Behaviors Between Grout and Steel Rebar
Authors: Liu Liang-Lin , Luo Chun-Yong , Ouyang Lu-Xia , Xia Zhen-Hua , Li Wei-Hua 
Published: June 2022

AbstractFirstly, according to the theoretical analysis, the force mechanism and failure modes were assured for the bond behavior between grout and steel rebar. Then, a pull-out experiment was exerted to probe the bond behavior developments of specimens after exposed to 500 °C. It is found that the mixed measures of pre-drying and slow elevating rate, i.e., 5 °C/min, inhibits the explosive spalling in grout with compressive strength of 76.7 MPa. In addition, there are two failure modes including the steel rebar fracture and the bond slip failure in the test. Based on the elevated temperature, compressive strength of post-fire grout, diameter of steel rebar and its embedment length, a new expression has been built to calculate the bond strength between grout and steel rebar of post-fire specimens. Furthermore, the finite element simulation is employed to investigate the bond behaviors of pull-out specimens after exposed to elevated temperatures up to 500 °C. The steel rebar fracture is captured firstly in the pull-out test simulation. Moreover, it is found that the peak slips increase and peak loads decrease along with the temperature elevating. Finally, it is proposed that the crucial elevated temperatures of the failure mode change should be 300, 300 and 400 °C for the specimens with embedment lengths of 6, 7 and 8 times diameter of steel rebar with diameter of 16 mm, respectively, which is beneficial for evaluating the fire safety of the existing structure elements.
A systematic review of interventions aiming to improve newly-qualified doctors’ wellbeing in the United Kingdom
Authors: Krishnan Aditya , Odejimi Opeyemi , Bertram Ian , Chukowry Priyamvada Sneha , Tadros George 
Published: June 2022

AbstractBackgroundNewly-qualified doctors in the United Kingdom experience a great deal of stress and have poor wellbeing when compared to more senior counterparts. A number of interventions have been put in place to boost healthcare professionals’ wellbeing, but little is known about interventions aimed to improve the wellbeing of newly-qualified doctors in the United Kingdom. This study aims to systematically review current evidence of interventions which improved the wellbeing of newly-qualified junior doctors in the United Kingdom.MethodsFive key electronic databases were searched. Subsequently, reference scanning and citation search was performed. Studies were included if they were conducted from the commencement of the Foundation Programme in 2004, until 2019. In addition, studies had to be performed on junior doctors: working in the United Kingdom and within their first five years post-qualification and have a quantitative outcome. Studies which did not meet these criteria were excluded. Quality was assessed using the modified Newcastle-Ottawa scale. Bias was not formally assessed using a standardised tool.ResultsSeven papers met the inclusion criteria and identified three main types of interventions: mentorship, mindfulness and clinical preparation interventions. The majority of included studies reported a positive result from the performed intervention, suggesting these to be beneficial in improving junior doctor wellbeing, and thereby reducing anxiety and stress levels. However, most of the studies used small sample sizes.ConclusionsThis review reveals that there is dearth of evidence on the effectiveness of intervention to improve the wellbeing of newly-qualified doctors in the United Kingdom. Most of the identified interventions focused on relieving stress and anxiety inherent within newly-qualified doctors’ training programmes. However, wellbeing interventions need to take into cognisance all the factors which impact on wellbeing, particularly job-related factors. We recommend that future researchers implement large-scale holistic interventions using appropriate research methods.Systematic review registration: PROSPERO CRD42019127341.
Application of a Convolutional Neural Network for Multitask Learning to Simultaneously Predict Microvascular Invasion and Vessels that Encapsulate Tumor Clusters in Hepatocellular Carcinoma
Authors: Chu Tongjia , Zhao Chen , Zhang Jian , Duan Kehang , Li Mingyang , Zhang Tianqi , Lv Shengnan , Liu Huan , Wei Feng 
Published: June 2022

AbstractBackgroundHepatocellular carcinoma (HCC) is the fourth most common cause of cancer death worldwide, and the prognosis remains dismal. In this study, two pivotal factors, microvascular invasion (MVI) and vessels encapsulating tumor clusters (VETC) were preoperatively predicted simultaneously to assess prognosis.MethodsA total of 133 HCC patients who underwent surgical resection and preoperative gadolinium ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) were included. The statuses of MVI and VETC were obtained from the pathological report and CD34 immunohistochemistry, respectively. A three-dimensional convolutional neural network (3D CNN) for single-task learning aimed at MVI prediction and for multitask learning aimed at simultaneous prediction of MVI and VETC was established by using multiphase Gd-EOB-DTPA-enhanced MRI.ResultsThe 3D CNN for single-task learning achieved an area under receiver operating characteristics curve (AUC) of 0.896 (95% CI: 0.797–0.994). Multitask learning with simultaneous extraction of MVI and VETC features improved the performance of MVI prediction, with an AUC value of 0.917 (95% CI: 0.825–1.000), and achieved an AUC value of 0.860 (95% CI: 0.728–0.993) for the VETC prediction. The multitask learning framework could stratify high- and low-risk groups regarding overall survival (p< 0.0001) and recurrence-free survival (p< 0.0001), revealing that patients with MVI+/VETC+ were associated with poor prognosis.ConclusionsA deep learning framework based on 3D CNN for multitask learning to predict MVI and VETC simultaneously could improve the performance of MVI prediction while assessing the VETC status. This combined prediction can stratify prognosis and enable individualized prognostication in HCC patients before curative resection.
Comparison of Redo percutaneous mitral valvuloplasty for mitral restenosis with first procedure for de novo mitral stenosis
Authors: Ramzan Muhammad , Kashif Javed Muhammad , Rizwan Hafiz Muhammad , ` Jahanzeb 
Published: June 2022

Objectives: To evaluate and compare the effects of redo percutaneous mitral valvuloplasty with initial percutaneous mitral valvuloplasty (PMV) in mitral restenosis (MR) and de novo mitral stenosis (MS) patients, respectively.
Methods: A retrospective study was conducted at the cardiology department of Ch. Pervaiz Elahi Institute of Cardiology Multan for the period of one year from 6th July 2020 to 6th July 2021. A total of 50 patients were recruited in the study. Out of them, 20 de novo MS patients were placed in one group, while 30 patients with mitral restenosis, after successful initial percutaneous mitral valvuloplasty, were placed in another group. Ante grade trans-septal approach was adopted to perform percutaneous mitral valvuloplasty. The procedure was considered successful in achieving a 50% increase in the area of the mitral valve, without any major complication.
Results: Procedural success in first PMV patients was more (18 patients; 90.0%) than in redo PMV patients (26 patients; 86.6%) (Non-significant). The patients in both groups didn’t differ significantly in terms of MVA after the procedure, the increase of MVA, the average difference in blood pressure across the mitral valve, and the complications experienced after the complete procedure. However, the final mitral valve area was negatively correlated with the initial area in both groups.
Conclusion: Redo PMV for MR when performed after successful initial PMV is effective, has considerable rate of procedural success, which is achieved with a complication rate less as compared to initial PMV for de novo mitral stenosis.
doi: https://doi.org/10.12669/pjms.38.6.5447
How to cite this:Ramzan M, Javed MK, Rizwan HM, Jahanzeb. Comparison of Redo percutaneous mitral valvuloplasty for mitral restenosis with first procedure for de novo mitral stenosis. Pak J Med Sci. 2022;38(6):---------. doi: https://doi.org/10.12669/pjms.38.6.5447
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Clinicopathological features and prognostic factors for uterine myoma
Authors: Wu Xiaoli , Zheng Yanqing 
Published: June 2022

Objectives: To investigate the clinicopathological features of patients with uterine myoma and to analyze and summarize factors affecting patient prognosis.
Methods: This study retrospectively investigated records of uterine myoma patients treated at Huzhou Central Hospital between June 2018 and May 2020. A total of 149 patients were included in this study, including 121 patients with good prognosis and 28 patients with poor prognosis. Clinical and pathological characteristics, including age, average body mass index (BMI), menopausal status, average lesion diameter, presence of hypertension or diabetes mellitus, operation method, myoma type, location, and quantity, number of fibroids, and presence of pelvic adhesion were analyzed via multivariate analysis.
Results: Among the 149 patients with uterine uterine myoma, 92 had anterior wall uterine myoma, 36 had posterior wall uterine myoma, and 21 had uterine fundus uterine myoma. In terms of location, 94 cases were intramural and 55 cases were subserosal. Quantity-wise, 107 had 1-3 myomas while 42 had four or more. Moderate or more severe pelvic adhesions were present in 33 cases. Univariate analysis showed significant differences in age, operation method, myoma type, myoma location, myoma number, and pelvic adhesion severity between patients with good and poor prognosis. Multivariate analysis showed that age, surgical method, uterine myoma type, uterine myoma location, uterine myoma quantity, and pelvic adhesion severity were risk factors affecting the prognosis.
Conclusion: Many prognostic factors, including age, operation method, myoma type, myoma location, myoma number, and pelvic adhesion severity are linked to uterine myoma patient prognosis.
doi: https://doi.org/10.12669/pjms.38.6.5455
How to cite this:Wu X, Zheng Y. Clinicopathological features and prognostic factors for uterine myoma. Pak J Med Sci. 2022;38(6):---------. doi: https://doi.org/10.12669/pjms.38.6.5455
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.