bluuebunny/crossref_metadata_2025_split huggingface dataset:
KXS Balances the Tryptophan Metabolism in Mild to Moderate Depressed Patients and Chronic Restraint Stress Induced Depressive Rats
Authors: Wang Yuanbo , Li Xia , Jing Rui , Yang Wenshan , Wang Yichen , Wang Chaochen , Yao Lei , Cui Xiaoming , Hu Yuan 
Published: June 2022

Abstract
Objective: Tryptophan metabolism is involved in the etiology and exacerbation of depressive disorders. Kai-Xin-San (KXS) has been widely used to treat depression, but how it regulates depressive-like behavior by shifting the balance of the tryptophan-serotonin metabolism and kynurenine pathway remains vague.Methods: Ten participants with mild to moderate depression treated with KXS (KXS preparation) were analyzed in this study. Depression rating scale score, the concentration of serum tryptophan, 5-hydroxytryptophan and kynurenine was measured at baseline and the endpoint of KXS treatment. To explore the specific regulatory mechanism of KXS in tryptophan metabolism, chronic restraint stress (CRS) induced depressive rats were conducted and the hippocampus level of tryptophan metabolites and key enzymes were analyzed respectively.Results: KXS significantly decreased depression rating scale scores and increased the serum tryptophan and kynurenine concentration in depressive patients. Also, it alleviated the depressive behavior in CRS rats obviously. Comparing with CRS group, KXS increased tryptophan, 5-hydroxytryptophan, kynurenine level in hippocampus. Furthermore, KXS decreased the expression of indoleamine 2,3-dioxygenase, increased kynurenic acid by upregulating the expression of kynurenine aminotransferase while decreased quinolinic acid level in hippocampus, which suggested that KXS more favored improving serotonin pathway and neuroprotective kynurenic acid branch in tryptophan metabolism.Conclusion: This is the first tryptophan metabolomic study of patients with depression undergoing KXS treatment. Combining these clinical results with CRS induced rat model studies, it verified that KXS achieves an excellent antidepressant effect and balances tryptophan-kynurenine metabolic pathways by regulating some key metabolic products and enzymes.
Risk factors predicting residual lesion in subsequent hysterectomy following cold knife conization(CKC) for high-grade squamous intraepithelial lesion(HSIL)
Authors: Yong Zeng , Tao Jiang , Yahong Zheng , Jing Yang , Hua Wei , Cunjian Yi , Liu Yan , Keming Chen 
Published: June 2022

Abstract
Objective
To determine risk factors predicting residual lesion in a subsequent hysterectomy follow a cold knife conization (CKC) for high-grade squamous intraepithelial lesion(HSIL).
Method
Between January 2010 and December 2021, a total of 740 patients who underwent a hysterectomy within 3 months after CKC for HSIL were included in this study. We analyzed their demographic features and pathological parameters. A logistic regression model was used to analyze the relationship between parameters and residual lesion in subsequent hysterectomy specimens.
Results
104 (14.1%) had residual lesion in the hysterectomy specimen, HSIL in 101 patients, 3 patients with microinvasive carcinoma which were positive combine margin. The rate of residual lesion in patients with positive endocervical margin was 31.3%, with positive ectocervical margin was 15.3%, with positive combine margin was 38.6%. In multivariate analysis, positive margin (OR,4.015; 95%CI,2.526–6.381; P < 0.001), glandular involvement (OR,3.484; 95%CI, 1.457–8.330; P = 0.005), HPV16/18 infection(OR,2.804; 95%CI, 1.705–4.611; P < 0.001) and multiple HR-HPV infection (P = 0.019, OR,1.813; 95%CI,1.130–2.909; P < 0.014) were independent risk factors for residual lesions. The AUC calculated by logistic regression model was 0.78.
Conclusion
positive margin, positive glandular involvement, HPV16/18 and multiple HR-HPV infection were independent high risk factors of residual lesion in a subsequent hysterectomy following CKC for HSIL.
Should evidence from controlled ART trials be excluded from systematic reviews concerning the clinical merits of directly placed posterior restorative materials? (Preprint)
Authors:   Steffen Mickenautsch1
Published: June 2022

Abstract
Objective: To investigate the argument’s validity that randomised control trials comparing high-viscosity glass-ionomer cement (HVGIC) placed using atraumatic restorative treatment, against amalgam or composite resin restorations (ART/RCTs) carry a confounder: a secondary comparison of incomplete against complete tooth excavation.Methods: The logical validity of the relationships between the argument’s components was assessed. The empirical validity of its key-assumptions was appraised by systematic review. Key-assumptions were converted into 3 search questions: Do treatment techniques that rely on complete excavation using different materials follow the same treatment steps? Is incomplete excavation during ART directly related to the material properties of HVGIC? Do restorations placed, after incomplete excavation have a higher failure rate than after direct excavation? PubMed and GoogleScholar were search (December 28, 2016). Reference check, journal hand searching was conducted. Bias risk was assessed. Data was extracted from accepted trials and statistically analyzed.Results: The relationship between the argument’s components was found logically valid but its underlying key-assumptions empirically invalid. The results suggest that: Differences in placement techniques are not unique to that between HVGIC/ART and amalgam or composite resin materials, but are also observable between that of amalgam and composite resin; HVGICs material properties appear appropriate to the consequences of incomplete excavation during ART; The current clinical evidence does not indicate a statistically significant higher failure rate of tooth restorations placed after incomplete excavation.Conclusions: ART/RCTs appear not to contain a confounder. Future systematic reviews and future updates of existing systematic reviews, may consider the inclusion of ART/RCTs for appraisal.
The Role of Continuing Medical Education Programs in Promoting Iranian nurses’ competency toward Non-communicable Diseases: a qualitative content analysis study
Authors: Zarei Maryam , Mojarrab Sadaf , Bazrafcan Leila 
Published: June 2022

Abstract
BackgroundContinuing professional education is essential for nurses to provide quality patient care and upgrade their professional skills and competence. The need for continuing medical education (CME) has become more apparent in the face of advances in medical science, the ever-changing healthcare system, and the vital role nurses play in improving health care. Therefore, it is imperative to explore nurses’ experience of CME courses and the extent to which such programs are effective.ObjectiveThe present qualitative study aimed to explore and describe nurses' experience on the effect of CE programs in promoting their competencies toward non-communicable diseases.MethodsThis qualitative content analysis study was conducted from December 2019 until April 2020 at various hospitals affiliated to Shiraz University of Medical Sciences (Shiraz, Iran) and based on the principles of conventional content analysis. The target population was nurses actively working on the chronic wards of these hospitals. The participants were selected using maximum variation sampling, including eight nursing managers, education and clinical supervisors, and staff nurses. Data were collected through individual, face-to-face, semi-structured interviews guided by an interview guide and data collection until data saturation was achieved. Each interview took about 30-45 minutes, and the follow-up questions were used for clarification when needed. Data trustworthiness was assessed according to the criteria proposed by Guba and Lincoln.ResultsAnalysis of the interview data resulted in 230 primary codes based on which 15 subcategories, six categories, and three themes were identified. The extracted themes were training to improve knowledge and attitude, training to improve professional skills and the need for adequate training programs. The associated categories were training to improve clinical knowledge, professional attitude training, clinical skills related to holistic and person-centered care, communication skills training, incorporating the fundamentals of adequate training, and recognizing common challenges and barriers to practical training.ConclusionProfessional competence and performance of nurses can be improved through intrinsic motivation stimulation, planning and implementation of training programs based on professional needs, and practical assessment of the teaching/learning process.
Evaluation of YouTube videos for information and education on amblyopia
Authors: Dhillon Hennaav Kaur , Jha Ujjwal Prakash , Goel Itisha , Singh Rohan Bir , Ichhpujani Parul , Parmar Uday Pratap Singh 
Published: June 2022

Abstract
PURPOSE YouTube is a popular social media platform accessed by people to obtain relevant health and disease-related information. In this study, we evaluate the videos on the platform as a source of information about amblyopia.METHODSIn this prospective, cross-sectional study, a YouTube search was conducted using three keywords, “Lazy eye”, “amblyopia,” and “Lazy eye treatment,” on January 26, 2022. Video quality assessment was done using Modified DISCERN (mDISCERN), Global Quality Score, and the Health on the Net Foundation Code of Conduct (HON code) scale. Video content was analyzed as health professional and non-health professional, video length, release date, daily view count, and video power index. We evaluated the relationship between the groups and video quality on the platform.RESULTSOf the 300 initial videos investigated for the study, 219 met the inclusion criteria and were added to the final statistical analysis. Of the selected videos, nearly 50% contained content related to medical education. More than half of the videos analyzed (130; 59.36%) were uploaded by healthcare professionals (HCP). The mDISCERN mean (± SD)score for the videos was 2.65 ± 1.24, 2.37 ± 1.02 for the JAMA scoring scale, and 3.72 ± 1.75 for the HON code. All the scoring systems were better for HCP than non-healthcare professionals (NHCPs). CONCLUSIONSA wide variety of information about Amblyopia is available on YouTube. The videos uploaded by NHCP had suboptimal flow and information of limited use to patients.
Multilocular thymic cyst in a HIV positive adult man detected during COVID-19 treatment: A case report and literature review
Authors: Hatano Hiroto , Sumiya Ryusuke , Misumi Kento , Miyazaki Hideki , Ikeda Takeshi , Nagasaka Satoshi 
Published: June 2022

Abstract
Background
Multilocular thymic cysts (MTC) are rare mediastinal tumors with multiloculated cyst-like structures in the anterior mediastinum. It is associated with a good prognosis when accurately diagnosed using needle biopsy or surgical removal but must be carefully differentiated from other cyst-forming tumors such as thymoma, thymic carcinoma, Hodgkin lymphoma, and seminoma. MTC is associated with inflammatory diseases, such as Sjogren’s syndrome and human immunodeficiency virus (HIV) infection. To date, only 15 cases of HIV infection have been reported in adult patients, and most cases show HIV infection-related symptoms such as lymphoid interstitial pneumonia and parotid gland enlargement. We report a case of asymptomatic MTC in an HIV-positive adult patient treated for coronavirus disease 2019 (COVID-19).
Case presentation:
An anterior mediastinal tumor was incidentally detected on computed tomography of a 52-year-old man with a 20-year history of HIV infection during COVID-19 treatment. The patient was asymptomatic with no notable physical findings. Magnetic resonance imaging revealed a 28 mm bilocular cyst. Robot-assisted thoracoscopic tumor resection was performed. Intraoperatively, the tumor was found to be a cystic lesion within the thymus, and the thymic tissue showed hyperplasia and diffuse smaller cystic changes. Pathological examination showed that the cysts were lined with squamous or cuboidal epithelium, and the cyst wall was mainly composed of thymic tissue with follicular hyperplasia. Hassall’s corpuscles and cholesterol granulomas are also observed. Signs of malignancy were not observed. Based on these findings, the patient was diagnosed with MTC. The patient is currently being followed up at an outpatient clinic without any signs of recurrence.
Conclusion
We report a case of MTC detected during COVID-19 treatment in an adult HIV-positive patient. Accumulation of cyst formation cases in COVID-19 patients is needed to elucidate the relationship between MTC and COVID-19.
Artificial Intelligence for Clinical Decision Support in Acute Ischemic Stroke Care: A Systematic Review
Authors: Hilbert Adam , Akay Ela M. , Carlisle Benjamin G. , Madai Vince I. , Mutke Matthias A. , Frey Dietmar 
Published: June 2022

Abstract
Established randomized-trial-based parameters for acute ischemic stroke care fail to consider individualized patient data, leading to attempts to support or automate treatment and diagnosis decisions using artificial intelligence methods. We review existing research, specifically regarding methodological robustness, thereby identifying constraints for clinical AI implementation. Our systematic review of clinical decision support systems (CDSS) includes full-text English language publications proposing AI-based methods for decision support in acute ischemic stroke cases in adult patients. We (a) describe data and outcomes used in those systems, (b) estimate the systems’ benefits compared to traditional stroke diagnosis and treatment, and (c) report concordance with the MINIMAR checklist. 121 studies met our inclusion criteria. 65 were included for full extraction. In our sample, utilized data sources, methods, and reporting practices were highly heterogeneous; adherence to the MINIMAR checklist was low. Our results suggest significant validity threats, dissonance in reporting practices and challenges to clinical translation. We outline practical recommendations for successful implementation of AI in acute ischemic stroke treatment and diagnosis.Ela M. Akay and Adam Hilbert contributed equally
Masticatory Performance in Patients with Jaw Muscle Pain: A Case Control Study
Authors: Sayegh Samaa Al , Christidis Nikolaos , Kumar Abhishek , Svensson Peter , Grigoriadis Anastasios 
Published: June 2022

Abstract
Background: Masticatory function is often impaired in patients with painful temporomandibular disorders (TMD) therefore more detailed studies on comminution and mixing ability are warranted in well-defined TMD patients with chronic myalgia. Moreover, there is a need to explore the correlation between any changes in perceived pain or fatigue in such patients and the masticatory function.Methods: Self-assessments using questionnaires regarding pain, oral health, jaw function, masticatory ability, fear of movement and psychosocial signs were answered by all the participants. A series of chewing tasks involving viscoelastic food and two-colored gum was performed. Optical imaging and analyzing was conducted. Bite force as well as characteristics of pain and fatigue were assessed. Results: In patients, the fragmented soft candy particles were less in number and had larger median of area and minimum Feret’s diameter after standardized chewing compared to healthy individuals (P = 0.02). Surprisingly, the two-colored Hue-Check gum was less mixed by the healthy controls since they displayed a greater variance of the hue (P = 0.04). There were significant differences between the patients and the healthy controls in the self-assessed masticatory ability mainly regarding pain-related variables.Conclusions: Objectively, TMD patients with chronic myalgia exhibited an impaired masticatory performance with less efficiency in comminuting soft viscoelastic food compared to the pain-free healthy control group. There was an agreement between the patients’ self-assessed masticatory ability and the efficiency of their masticatory function.
Indications and outcomes of patients receiving therapeutic plasma exchange under critical care conditions: a retrospective eleven-year single-center study at a tertiary care center
Authors: Ring Alexander , Sieber Wolfgang Alexander , Studt Jan Dirk , Schuepbach Reto , Ganter Christoph Camille , Manz Markus Gabriel , Müller Antonia Maria Susanne , David@usz Sascha. 
Published: June 2022

Abstract
Background: Therapeutic plasma exchange (TPE) to remove harmful or replace missing circulating plasma components is a well-established procedure with a wide range of disease indications. While per se is not among the daily routine of the intensivist TPE is frequently be performed under critical care conditions. However, data regarding TPE indications, patient characteristics and technical details on the intensive care unit (ICU) are sparse. Methods: We performed a retrospective, single-center study using data from January 2010 until August 2021 for patients treated with TPE in an ICU setting at the University Hospital Zurich. Data was collected from de-identified electronic patient medical records using specific search terms. Patient characteristics (including demographics, BMI, comorbidities, lab values and ICU-specific parameters, outcome), apheresis-specific technical parameters and complications were recorded and analyzed.Results: We identified n=105 patients meeting our inclusion criteria, with an even sex distribution (50.5% women) and median age of 56 (17-85) years. These 105 patients received a total of n=408 TPE treatments for 25 different indications. The most common indication were thrombotic microangiopathies (TMA) (38%), with thrombotic thrombocytopenic purpura (TTP) being the most prevalent sub-indication (27.6%). Level of evidence according to ASFA (American Society for Apheresis) guidelines varied and was well established in 63.8% of cases. Ten patients presented with TPE-related complications, with anaphylaxis being the most common. Bleeding complications were rare (1%). Median duration of ICU treatment was 8 ± 14 days. A total of 59 (56.2%), 26 (24.8%), and 35 (33.3%) patients needed ventilator, renal replacement or vasopressor support, respectively, with 6 (5.7%) needing extracorporeal membrane oxygenation. The overall survival in our critically ill patients treated with TPE was 88.6%.Conclusion: Our study provides a comprehensive overview of TPE indications in ICU patients at a major tertiary academic medical center and could serve as a point of reference for other comparable hospitals. Similar studies should be encouraged to establish reliable standards and ultimately improved treatment outcomes.
Anatomical distribution of Cancer Stem Cells between Enhancing Nodule and FLAIR hyperintensity in supratentorial Glioblastoma: time to recalibrate the surgical target?
Authors: Altieri Roberto , Broggi Giuseppe , Certo Francesco , Pacella Daniela , Cammarata Giacomo , Maione Massimiliano , Garozzo Marco , Barbagallo Davide , Purrello Michele , Caltabiano Rosario , Magro Gaetano , Barbagallo Giuseppe 
Published: June 2022

Abstract
It is generally accepted that Glioblastoma (GBM) arise from cancer stem cells (CSC), however, there is little evidence on their anatomical distribution. We investigated the expression and distribution of SOX-2-positive and CD133-positive CSCs both in the enhancing nodule (EN) of GBM and in the FLAIR hyperintensity zones on a surgical, histopathological series of 33 GBMs.The inclusion criterion was the intraoperative sampling of different tumor regions individualized thanks to Neuronavigation and positivity to intraoperative fluorescence with the use of 5-aminolevulinic acid (5-ALA). 33 patients (20 males and 13 females with a mean age at diagnosis of 56 years) met the inclusion criterion. A total of 109 histological samples were evaluated, 52 for ENs and 57 for FLAIR hyperintensity zone. Considering the quantitative distribution of levels of intensity of staining (IS), ES (extent score) and immunoreactivity score (IRS), no difference was found between ENs and FLAIR regions for both the SOX-2 biomarker (respectively, IS p=0.851, ES p=0.561, IRS p=1.000) and the CD133 biomarker (IS p=0.653, ES p=0.409, IRS p=0.881). This evidence suggests to recalibrate the target of surgery for FLAIRECTOMY and 5-ALA could improve the possibility to achieve this goal.
Effects of sample preservation methods and duration of storage on the performance of mid-infrared spectroscopy for predicting the age of malaria vectors
Authors: Mgaya Jacqueline N. , Siria Doreen J. , Makala Faraja E. , Mgando Joseph P. , Vianney John-Mary , Mwanga Emmanuel P. , Okumu Fredros O. 
Published: June 2022

Abstract
Background
Monitoring the biological attributes of mosquitoes is critical for understanding pathogen transmission and estimating the impacts of vector control interventions. Infrared spectroscopy and machine learning techniques are increasingly being tested for this purpose, and can accurately predict the age, species, blood-meal sources, and pathogen infections in Anopheles and Aedes mosquitoes. Since the techniques are still in early-stage development, there are no standardized procedures for handling mosquito samples. We therefore assessed the effects of different preservation methods and storage durations on the performance of mid-infrared spectroscopy for age-grading malaria-transmitting mosquitoes.
Methods
Laboratory-reared Anopheles arabiensis (N = 3,681) were collected as 5 or 17-day olds and killed with ethanol then preserved using either silica desiccant at 5°C, freezing at -20°C, or absolute ethanol at room temperatures. For each preservation method, the mosquitoes were divided into three groups and stored for 1, 4 or 8 weeks, then scanned using attenuated total reflection-Fourier transform infrared spectrometer on the mid-infrared wavelengths. Supervised machine learning classifiers were trained with the infrared spectra, and used to predict the mosquito ages.
Results
The classification of mosquito ages (as 5 or 17-day olds) was most accurate when the samples used to train the models (training samples) and samples being tested (test samples) were preserved the same way or stored for equal durations. However, when the test and training samples were handled differently, the classification accuracies declined significantly. Support vector machine classifiers (SVMs) trained using spectra of silica-preserved mosquitoes achieved 95% accuracy when predicting the ages of other silica-preserved mosquitoes, but this declined to 72% and 66% when age-classifying mosquitoes preserved using ethanol and freezing respectively. Similarly, models trained on one-week stored samples had declining accuracies of 97%, 83% and 72% when predicting ages of mosquitoes stored for 1, 4 or 8 weeks respectively.
Conclusions
When using mid-infrared spectroscopy and supervised machine learning to age-grade mosquitoes, the highest accuracies are achieved when the training and test samples are preserved the same way and stored for the same durations. Protocols for infrared-based entomological studies should therefore emphasize standardized sample-handling procedures; and possibly, additional statistical procedures such as transfer learning for greater accuracy.
A generalized reciprocally convex inequality and its application to time-varying delay systems
Authors: Ren Zerong , Tian Junkang 
Published: June 2022

Abstract
This paper studies the stability of systems with time-varying delay. Firstly, a generalized reciprocally convex inequality is introduced which includes some existing inequalities as special cases. Secondly, a new stability criterion is obtained in terms of linear matrix inequalities(LMIs) by using the new reciprocally convex inequality. Finally, two numerical examples are provided to show the effectiveness of the presented method.