bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of perioperative glucose variability on outcomes after hip fracture
Authors: Long Anhua , Xie Zongyan , Wang Xuefei , Zhang Yakui , Han Dacheng 
Published: January 2022

Abstract
Diabetes is considered an independent risk factor for hip fracture. In the present study, we evaluated whether perioperative glucose variability (GV) was a significant predictor of the outcomes of patients with diabetes after hip fracture.
We analyzed the characteristics and outcomes of all patients with hip fractures admitted to our hospital between September 2008 and December 2012. Patients with diabetes were grouped into tertiles for GV, and multivariate survival analysis included age, sex, fracture type, mean fasting plasma glucose, and GV.
Among the 1099 patients included in this study, 239 (21.7%) had diabetes. Patients with diabetes were more likely to develop infectious complications (5.4% vs 2.8%, P = .045), and experience mortality postoperatively (1 month: 5.5% vs 2.7%, P = .052; 12 months: 15.1% vs 8.7%, P = .006). The postoperative mortality rate was increased across the GV tertiles, and GV was an independent predictor of 1- and 12-month mortality after surgery.
Patients with diabetes had poor prognoses after hip fracture. Perioperative GV is an independent predictor of mortality in patients with diabetes. Therefore, GV might be considered a valid additional parameter to consider in the management of these patients.
Predictive value of arterial blood lactate/serum albumin ratio for myocardial injury in elderly patients with severe community-acquired pneumonia
Authors: Zhang Litao , Li Yanpeng , Lv Chang , Guo Hui , Xu Tieling , Ma Zhichao , Li Jianguo 
Published: January 2022

Abstract
To investigate the predictive value of arterial blood lactate (Lac)/serum albumin (Alb) ratio (Lac/Alb) on myocardial injury in elderly patients with severe community-acquired pneumonia (SCAP).
Seventy-two elderly SCAP patients hospitalized in the intensive care unit (ICU) of the emergency department of Hebei General Hospital from March 2020 to March 2021 were included, and the general data and arterial blood Lac and serum Alb levels were collected, and Lac/Alb values were calculated. The patients were divided into myocardial injury group (n = 25) and nonmyocardial injury group (n = 47) according to whether the myocardial injury occurred during their ICU stay, and the predictive value of Lac/Alb on myocardial injury in elderly patients with SCAP was assessed using receiver operating characteristic curve and area under the curve.
There were no statistically significant differences in age and gender between the 2 groups (both P > .05), and there were no statistical differences in oxygenation index, procalcitonin, C-reactive protein, lymphocyte count, and Alb levels between the 2 groups (all P > .05). Neutrophil count, neutrophil\lymphocyte ratio, serum creatinine, Lac, and Lac/Alb levels were significantly higher in patients in the myocardial injury group than in the nonmyocardial injury group [13.90 (11.07,19.67) × 109/L vs 10.79 (8.16,14.23) × 109/L, 26.48 (20.07,31.88) vs 17.79 (9.85,27.23), 135.71 (81.50,284.75) μmol/L vs 76.30 (60.30,140.30) μmol/L, 3.0 (2.2,4.5) mmol/L vs 2.1 (1.6,3.1) mmol/L, 1.34 (0.88,2.16) vs 0.78 (0.60,1.12), all P < .05]. Patients in the myocardial injury group had a significantly higher mortality rate in the ICU than in the nonmyocardial injury group (72.0% vs 36.2%, P < .01). Neutrophils, neutrophil/lymphocyte ratio, serum creatinine, Lac, and Lac/Alb showed a weak positive correlation with myocardial injury in patients (all P < .05). The area under the curve of Lac/Alb for predicting myocardial injury in elderly patients with SCAP was 0.737 (95% confidence interval 0.620–0.834), and the sensitivity and specificity of the prediction with 1.21 as the cutoff value were 60.00% and 78.72%, respectively.
Lac/Alb has an excellent predictive value for myocardial injury in elderly SCAP patients.
Effects of stabilizing reversal technique and vestibular rehabilitation exercise on dizziness and balance ability in patients with vestibular neuritis
Authors: Kim Beomryong , Lohman Everett , Yim JongEun 
Published: January 2022

Abstract
Vestibular neuritis is a common disease of peripheral dizziness. Studies have shown that vestibular rehabilitation exercise (VRE) and proprioceptive neuromuscular facilitation (PNF) are effective to treat the symptoms of vestibular neuritis. However, the effect of VRE and PNF on the balance ability and dizziness in this patient cohort remains unclear.
The aim of our observational study was to determine the changes in dizziness and balance ability of patients with vestibular neuritis who participated in the VRE program with stabilizing reversal technique (SRT).
The reporting of this study conforms to the STROBE statement. Ten men and women aged ≥ 20 years who were diagnosed with vestibular neuritis were included. Patients performed VRE with SRT for 4 weeks with assistance from a therapist. VRE without SRT can also be performed at home. Dizziness was evaluated using the dizziness handicap inventory (DHI) and visual analog scale (VAS). Balance ability was assessed using the Berg's balance scale (BBS) and timed up and go test (TUG). At pre- and post-exercise, paired t test was performed to compare the within-group differences.
After the program, DHI (45.40 ± 6.74 to 21.00 ± 7.07), VAS (5.90 ± 1.20 to 2.80 ± 0.92), BBS (45.10 ± 2.77 to 52.70 ± 1.83), and TUG (15.29 ± 1.13 to 12.06 ± 1.61) scores improved significantly in the VRE program group (P = .05).
The VRE program combined with SRT was effective in reducing dizziness and increasing balance ability in patients with vestibular neuritis.
Occupational dose and associated factors during transarterial chemoembolization of hepatocellular carcinoma using real-time dosimetry
Authors: Kim Hyoung Ook , Lee Byung Chan , Park Chan , Kim Jae Kyu , Park Won-Ju , Lee Jong Eun , Lim Hyo Soon , Jeong Won Gi 
Published: January 2022

Abstract
Transarterial chemoembolization is the standard treatment option for intermediate-stage hepatocellular carcinoma (HCC). However, during the interventional procedure, occupational radiation protection is compromised. The use of real-time radiation dosimetry could provide instantaneous radiation doses. This study aimed to evaluate the occupational dose of the medical staff using a real-time radiation dosimeter during transarterial chemoembolization (TACE) for HCC, and to investigate factors affecting the radiation exposure dose.
This retrospective observational study included 70 patients (mean age: 66 years; age range: 38–88 years; male: female = 59: 11) who underwent TACE using real-time radiation dosimetry systems between August 2018 and February 2019. Radiation exposure doses of operators, assistants, and technicians were evaluated. Patients’ clinical, imaging, and procedural information was analyzed.
The mean dose–area product (DAP) and fluoroscopy time during TACE were 66.72 ± 55.14 Gycm2 and 12.03 ± 5.95 minutes, respectively. The mean radiation exposure doses were 24.8 ± 19.5, 2.0 ± 2.2, and 1.65 ± 2.0 μSv for operators, assistants, and technicians, respectively. The radiation exposure of the operators was significantly higher than that of the assistants or technicians (P < .001). The perpendicular position of the adjustable upper-body lead protector (AULP) on the table was one factor reducing in the radiation exposure of the assistants (P < .001) and technicians (P = .040). The DAP was a risk factor for the radiation exposure of the operators (P = .003) and technicians (P < .001).
Occupational doses during TACE are affected by DAP and AULP positioning. Placing the AULP in the perpendicular position during fluoroscopy could be a simple and effective way to reduce the radiation exposure of the staff. As the occupational dose influencing factors vary by region or institution, further study is needed.
An Investigation of Symptom Clusters and Sentinel Symptoms During the First 2 Cycles of Postoperative Chemotherapy in Patients With Lung Cancer
Authors: Ma Jingshuang , Xu Hui , Liu Shan , Wang Aiping 
Published: January 2022

BackgroundLung cancer has the highest incidence and mortality of all cancers in China. Patients after a lobectomy experience serious physical and psychological symptoms during chemotherapy. Studies are lacking about symptom clusters (SCs) and sentinel symptoms during the postoperative chemotherapy period in lung cancer patients.ObjectiveThe aim of this study was to explore SCs and sentinel symptoms during cycles 1 and 2 of postoperative chemotherapy in patients with lung cancer.MethodsUsing a longitudinal study design, patients in treatment for lung cancer were measured at 2 separate points following a lobectomy: chemotherapy cycle 1 and chemotherapy cycle 2. The MD Anderson Symptom Inventory lung cancer–specific module and First Appearance of Symptoms Time Sheet were completed.ResultsA total of 180 postoperative patients with lung cancer participated in the study. Four SCs were identified at chemotherapy cycle 1: gastrointestinal SC, respiratory tract SC, psychological SC, and somatic SC. The sentinel symptoms were nausea, cough, sadness, and fatigue. At chemotherapy cycle 2, similar SCs were identified, with the exception of merging the psychological SC and somatic SC, resulting in 3 clusters: gastrointestinal SC, respiratory tract SC, and psychological-somatic SC. The sentinel symptoms were nausea, cough, and fatigue.ConclusionsSymptom clusters and sentinel symptoms were stable during the first 2 cycles of postoperative chemotherapy in patients with lung cancer.Implications for PracticeThe understanding of SCs and sentinel symptoms could be beneficial to assess and manage both in postoperative patients with lung cancer during chemotherapy. Nurses should pay close attention to sentinel symptoms and develop effective interventions.
Exploring Uniformity of Clinical Judgment: A Vignette Approach to Understanding Healthcare Professionals’ Suicide Risk Assessment Practices
Authors: Sequeira Lydia , Strudwick Gillian , De Luca Vincenzo , Strauss John , Wiljer David 
Published: January 2022

Objectives
Suicide risk assessment often requires health professionals to consider a complex interplay of multiple factors, with a significant reliance on judgment, which can be influenced by factors such as education and experience. Our study aimed at assessing the uniformity of decision making around suicide risk within healthcare professionals.

Methods
We used a factorial survey approach to gather information on healthcare professionals’ demographics, clinical experience, and their decision on 3 vignettes of patients with suicidal ideation. We used Kruskal-Wallis tests for determining if there were significant differences between groups for continuous variables and Spearman rank correlation for measuring the association between continuous variables. Content analysis was used for analyzing free-text comments.

Results
Responses were gathered from 79 healthcare professionals (nurses, nurse practitioners, physicians) who worked in primary care, mental health, or emergency department settings. Median suicide risk rates across all respondents were 90%, 50%, and 53% for vignettes 1, 2, and 3, respectively. Confidence in healthcare professionals’ decisions was significantly associated with the clinical designation and personal risk profile of the healthcare professional in certain vignettes, with nurses and those willing to take more risks having a higher confidence in their decisions for vignettes 1 and 3, respectively. Treatment decision was significantly associated with mental health experience (i.e., those with lengthier mental health experiences were less likely to choose “admit to psychiatry ward” for vignette 2), clinical designation (i.e., nurses were more likely to “admit to psychiatry ward” for vignette 1), and practice setting. It should be noted that these associations were not consistent across all 3 vignettes, and results for each association were only specific to 1 of the 3 vignettes.

Discussion
Findings compare decision-making practices for suicide risk assessment across several types of healthcare professions over a range of practice settings, with the high-risk vignette showing the least variability. Insights from this study are relevant when building clinical decision support systems for suicide risk assessment. Designers should think about incorporating tailored messaging and alerts to health professionals’ mental health experience and/or designation.

Conclusions
Within our Canadian sample, there was considerable variability among healthcare professionals assessing the risk of suicide, with important implications for tailoring education and decision support.
Effects of Meditation for Surgeons
Authors: Capodici Angelo , Sanmarchi Francesco , Golinelli Davide 
Published: January 2022

Objective:
The aim of this study was to systematically review the available evidence about meditation's effects on surgeons.

Summary Background Data:
Meditation and Mindfulness are positively associated with better mental health and performance in different types of workers and professionals needing high levels of concentration. Surgery is one of the activities with the greatest need for high concentration. Even though these findings are supported by a number of studies, evidence is lacking on the effect of meditation on surgeons.

Methods:
We searched PubMed for meditation-related studies that focused on surgeons. A total of 243 articles were retrieved and after screening 8 were selected for data extraction. Four of these studies were pilot studies; 3 of them were randomized controlled trials.

Results:
Meditation was found to be beneficial for surgeons. Benefits span from motor skills to mental and physiological improvements.

Conclusion:
More awareness and attention on this subject could improve surgeons’ well-being as well as patients’ outcomes.
Intraoperative Deterioration of Neurophysiological Potentials of the Spinal Tracts in Cervical Spine Surgery: Correlation With Patient-Related and Procedure-Related Variables
Authors: Michaeli Avner , Appel Shmuel , Danto Joseph , Korn Akiva , Schroeder Josh E. 
Published: January 2022

Purpose:
To identify characteristics associated with higher incidence of intraoperative deterioration of neurophysiological potentials related to spinal tracts in cervical spine surgeries.

Methods:
Electrophysiological raw data and neurophysiological case reports of 1,611 patients from multiple medical centers, who underwent cervical spine surgery for decompression and/or fusion, were retrospectively reviewed. Patient-related and procedure-related variables were identified and analyzed for correlation with intraoperative neurophysiological event of the spinal tracts. The neurophysiological events were analyzed for identification of collective characteristics.

Results:
The study cohort presented consistent dominancy of male over female patients (67% vs. 33%). Intraoperative deterioration of spinal tract–derived potentials was noted in 10.5% of the total cases, which was not correlated with gender, age, or indication of the surgery. Higher incidence of neurophysiological events was noted in patients with impaired baseline of motor evoked potentials from the thenar muscle (P = 0.01) or somatosensory evoked potentials of the posterior tibial nerve (P = 0.0002). Procedures of circumferential approach or procedures that involved ≥3 spinal levels demonstrated higher incidence of neurophysiological events as well (P = 0.0003 and 0.001, respectively).

Conclusions:
Patients with deteriorated neurophysiological baseline and procedures of extensive intervention are at higher risk of intraoperative neurophysiological event in cervical spine surgery. Inclusion of intraoperative neurophysiological monitoring should be encouraged in complicated cases of cervical spine surgeries.
SARS-CoV-2 Omicron Variant AI-based Primers
Authors: Perez-Romero Carmina A. , Tonda Alberto , Mendoza-Maldonado Lucero , MacSharry John , Szafran Joanna , Claassen Eric , Garssen Johan , Kraneveld Aletta D. , Lopez-Rincon Alejandro 
Published: January 2022

ABSTRACTAs the COVID-19 pandemic continues to affect the world, a new variant of concern, B.1.1.529 (Omicron), has been recently identified by the World Health Organization. At the time of writing, there are still no available primer sets specific to the Omicron variant, and its identification is only possible by using multiple targets, checking for specific failures, amplifying the suspect samples, and sequencing the results. This procedure is considerably time-consuming, in a situation where time might be of the essence. In this paper we use an Artificial Intelligence (AI) technique to identify a candidate primer set for the Omicron variant. The technique, based on Evolutionary Algorithms (EAs), has been already exploited in the recent past to develop primers for the B.1.1.7/Alpha variant, that have later been successfully tested in the lab. Starting from available virus samples, the technique explores the space of all possible subsequences of viral RNA, evaluating them as candidate primers. The criteria used to establish the suitability of a sequence as primer includes its frequency of appearance in samples labeled as Omicron, its absence from samples labeled as other variants, a specific range of melting temperature, and its CG content. The resulting primer set has been validated in silico and proves successful in preliminary laboratory tests. Thus, these results prove further that our technique could be established as a working template for a quick response to the appearance of new SARS-CoV-2 variants.
A real-time cellular thermal shift assay (RT-CETSA) to monitor target engagement
Authors: Sanchez Tino W. , Ronzetti Michael H. , Owens Ashley E. , Antony Maria , Voss Ty , Wallgren Eric , Talley Daniel , Balakrishnan Krishna , Rai Ganesha , Marugan Juan J. , Michael Sam , Baljinnyam Bolormaa , Southall Noel , Simeonov Anton , Henderson Mark J. 
Published: January 2022

AbstractDetermining a molecule’s mechanism of action is paramount during chemical probe development and drug discovery. The cellular thermal shift assay (CETSA) is a valuable tool to confirm target engagement in cells for a small molecule that demonstrates a pharmacological effect. CETSA directly detects biophysical interactions between ligands and protein targets, which can alter a protein’s unfolding and aggregation properties in response to thermal challenge. In traditional CETSA experiments, each temperature requires an individual sample, which restricts throughput and requires substantial optimization. To capture the full aggregation profile of a protein from a single sample, we developed a prototype real-time CETSA (RT-CETSA) platform by coupling a real-time PCR instrument with a CCD camera to detect luminescence. A thermally stable Nanoluciferase variant (ThermLuc) was bioengineered that withstood unfolding at temperatures greater than 90 degrees Celsius and was compatible with monitoring target engagement events when fused to diverse targets. Utilizing well-characterized inhibitors of lactate dehydrogenase alpha, RT-CETSA showed significant correlation with enzymatic, biophysical, and other cell-based assays. A data analysis pipeline was developed to enhance the sensitivity of RT-CETSA to detect on-target binding. The RT-CETSA technology advances capabilities of the CETSA method and facilitates the identification of ligand-target engagement in cells, a critical step in assessing the mechanism of action of a small molecule.SignificanceValidating target engagement is a critical step when characterizing a small molecule modulator. The cellular thermal shift assay (CETSA) is a common approach to examine target engagement, as alterations in the thermal stability of a protein can be conferred by ligand binding. An advantage of CETSA is that it does not require modification of the protein target or small molecule. Major limitations are the throughput and ease-of-use, as the traditional detection method uses western blots, which limits the number of samples that can be processed. Higher-throughput CETSA methods have been developed but are performed at a single temperature and require target-specific optimization. We developed a high-throughput real-time CETSA to circumvent these challenges, providing a rapid and cost-effective strategy to assess on-target activity of a small molecule in living cells.
Computational modeling of macrophage iron sequestration during host defense againstAspergillus
Authors: Adhikari Bandita , Scindia Yogesh , Vieira Luis Sordo , de Assis Lopes Ribeiro Henrique , Masison Joseph , Yang Ning , Fonseca Luis L. , Wheeler Matthew , Knapp Adam C. , Mei Yu , Helba Brian , Atkinson Carl , Schroeder Will , Mehrad Borna , Laubenbacher Reinhard 
Published: January 2022

AbstractIron is essential to the virulence ofAspergillusspecies, and restricting iron availability is a critical mechanism of antimicrobial host defense. Macrophages recruited to the site of infection are at the crux of this process, employing multiple intersecting mechanisms to orchestrate iron sequestration from pathogens. To gain an integrated understanding of how this is achieved in invasive aspergillosis, we generated a transcriptomic time-series of the response of human monocyte-derived macrophages toAspergillusand used this and the available literature to construct a mechanistic computational model of iron handling of macrophages during this infection. We found an overwhelming macrophage response beginning 2-4 hours after exposure to the fungus, which included upregulated transcription of iron import proteins transferrin receptor-1, divalent metal transporter-1, and ZIP family transporters, and downregulated transcription of the iron exporter ferroportin. The computational model, based on a discrete dynamical systems framework, consisted of 21 3-state nodes, and was validated with additional experimental data that were not used in model generation. The model accurately captures the steady state and the trajectories of most of the quantitatively measured nodes. In the experimental data, we surprisingly found that transferrin receptor-1 upregulation preceded the induction of inflammatory cytokines, a feature that deviated from model predictions. Model simulations suggested that direct induction of TfR1 after fungal recognition, independent of the Iron Regulatory Protein - Labile Iron Pool system, explains this finding. We anticipate that this model will contribute to a quantitative understanding of iron regulation as a fundamental host defense mechanism during aspergillosis.ImportanceInvasive pulmonary aspergillosis is a major cause of death among immunosuppressed individuals despite the best available therapy. Depriving the pathogen of iron is an essential component of host defense in this infection, but the mechanisms by which the host achieves this are complex. To understand how recruited macrophages mediate iron deprivation during the infection, we developed and validated a mechanistic computational model that integrates the available information in the field. The insights provided by this approach can help in designing iron modulation therapies as anti-fungal treatments.