bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-grade inflammation in type 2 diabetes: a cross-sectional study from a Danish diabetes outpatient clinic
Authors: Okdahl Tina , Wegeberg Anne-Marie , Pociot Flemming , Brock Birgitte , Størling Joachim , Brock Christina 
Published: December 2022

ObjectivesTo investigate low-grade inflammation in type 2 diabetes and explore associations to clinical aspects as well as microvascular and macrovascular complications.DesignCross-sectional analysis.SettingThe outpatient diabetes clinic at the Department of Endocrinology at Aalborg University Hospital, Denmark.Participants100 participants with type 2 diabetes confirmed by a haemoglobin A1c (HbA1c)≥6.5% for a minimum of 1 year and 21 healthy controls.Outcome measuresSerum levels of 27 inflammation-related biomarkers measured by immunoassay. Associations with microvascular and macrovascular complications, body weight, glycaemic control, medication and sex were investigated in the diabetes cohort.ResultsSerum levels of tumour necrosis factor (TNF)-α and eotaxin were elevated in type 2 diabetes (p<0.05), while interleukin (IL)-7 was decreased (p<0.001). IL-12/IL-23p40, IL-15, macrophage-derived chemokine (MDC) and C reactive protein (CRP) levels were increased with body weight (p<0.05), while eotaxin and TNF-α were increased with elevated HbA1c levels (p<0.04). Dipeptidyl peptidase-4 inhibitor therapy was associated with lower levels of induced protein-10, MDC and thymus and activation regulated chemokine (p<0.02), while females had higher levels of MDC (p=0.027). Individuals with ≥3 diabetic complications had elevated levels of IL-6, IL-10, IL-12/IL-23p40, IL-15 and CRP compared with those with ≤3 (p<0.05).ConclusionThe level of low-grade inflammation in type 2 diabetes is associated with obesity, glycaemic regulation, therapeutical management, sex and complications. Our results underline the importance of addressing inflammatory issues in type 2 diabetes, as these may predispose for crippling comorbidities.
Who gets access to an interprofessional team-based primary care programme for patients with complex health and social needs? A cross-sectional analysis
Authors: Jopling Sydney , Wodchis Walter P , Rayner Jennifer , Rudoler David 
Published: December 2022

ObjectivesTo determine whether a voluntary referral-based interprofessional team-based primary care programme reached its target population and to assess the representativeness of referring primary care physicians.DesignCross-sectional analysis of administrative health data.SettingOntario, Canada.InterventionTeamCare provides access to Community Health Centre services for patients of non-team physicians with complex health and social needs.ParticipantsAll adult patients who participated in TeamCare between 1 April 2015 and 31 March 2017 (n=1148), and as comparators, all non-referred adult patients of the primary care providers who shared patients in TeamCare (n=546 989), and a 1% random sample of the adult Ontario population (n=117 753).ResultsTeamCare patients were more likely to live in lower income neighbourhoods with a higher degree of marginalisation relative to comparison groups. TeamCare patients had a higher mean number of diagnoses, higher prevalence of all chronic conditions and had more frequent encounters with the healthcare system in the year prior to participation.ConclusionsTeamCare reached a target population and fills an important gap in the Ontario primary care landscape, serving a population of patients with complex needs that did not previously have access to interprofessional team-based care.Strengths and limitationsThis study used population-level administrative health data. Data constraints limited the ability to identify patients referred to the programme but did not receive services, and data could not capture all relevant patient characteristics.
How much of the stalled mortality trends in Scotland and England can be attributed to obesity?
Authors: Walsh David , Tod Elaine , McCartney Gerry , Levin Kate Ann 
Published: December 2022

ObjectivesThe rate of improvement in all-cause mortality rates has slowed in the UK since around 2012. While evidence suggests that UK Government ‘austerity’ policies have been largely responsible, it has been proposed that rising obesity may also have contributed. The aim here was to estimate this contribution for Scotland and England.MethodsWe calculated population attributable fractions (PAFs) resulting from changes in Body Mass Index (BMI) between the mid-1990s and late 2000s for all-cause mortality among 35–89-year olds in 2017–2019. We used BMI data from national surveys (the Scottish Health Survey and the Health Survey for England), and HRs from a meta-analysis of 89 European studies. PAFs were applied to mortality data for 2017–2019 (obtained from national registries), enabling comparison of observed rates, BMI-adjusted rates and projected rates. Uncertainty in the estimates is dominated by the assumptions used and biases in the underlying data, rather than random variation. A series of sensitivity analyses and bias assessments were therefore undertaken to understand the certainty of the estimates.ResultsIn Scotland, an estimated 10% (males) and 14% (females) of the difference between observed and predicted mortality rates in 2017–2019 may be attributable to previous changes in BMI. The equivalent figures for England were notably higher: 20% and 35%, respectively. The assessments of bias suggest these are more likely to be overestimates than underestimates.ConclusionsSome of the recent stalled mortality trends in Scotland and England may be associated with earlier increases in obesity. Policies to reduce the obesogenic environment, including its structural and commercial determinants, and reverse the impacts of austerity, are needed.
Dual-Channel Capsule Generative Adversarial Network Optimized with Golden Eagle Optimization for Pediatric Bone Age Assessment from Hand X-Ray Image
Authors: Jasper Gnana Chandran J. , Karthick R. , Rajagopal R. , Meenalochini P. 
Published: December 2022

Bone age assessment (BAA) is mainly utilized for detecting the growth of pediatrics because a large number of bone diseases occur at young age. Several algorithms related to BAAs were used for detecting the maturity of bones, but it does not provide sufficient accuracy, and also increased the error rate. To deal with these problems, the dual-channel capsule generative adversarial network optimized with Golden eagle optimization (GEO) is proposed in this paper for pediatric BAA from hand X-ray image (DCCGAN-GEO-BAA-HX-ray). Initially, the input hand X-ray imageries are collected from the dataset of Radiological Society of North America (RSNA) pediatric bone age (BA). Then, region of interest (RoI) of input hand X-ray imageries is segmented based on Tsallis entropy-based multilevel 3D Otsu thresholding (TE-3D-Otsu). Here, TE-3D-Otsu method segments the RoI region of wrist, thumb, middle finger, little finger, which enhance the classification accuracy. Moreover, the segmented RoI is given to DCCGAN that predicts the BAA. Generally, the DCCGAN does not reveal any adoption of optimization methods to scale the optimum parameters to ensure accurate classification. Therefore, GEO is used for optimizing the weight parameters of DCCGAN. The proposed DCCGAN-GEO-BAA-HX-ray method is executed in MATLAB and its performance is examined under performance metrics such as accuracy, precision, sensitivity, F-scores, specificity, concordance correlation coefficient (CCC) and computational time. Finally, the proposed DCCGAN-GEO-BAA-HX-ray approach attains 14.68%, 7.142%, 9.23% and 4.65% higher accuracy, 38.18%, 12.02%, 11.56% and 7.59% lower computational time is compared with existing FRCNN-AF-SFO-BAA-HX-ray, DCNN-W-CTO-BAA-HX-ray, CNN-MLP-BAA-HX-ray and CNN-BAA-HX-ray methods.
Global Characteristics and Dynamics of Single Immune Cells After Myocardial Infarction
Authors: Zhuang Lingfang , Wang Yaqiong , Chen Zhaoyang , Li Zhigang , Wang Ziyang , Jia Kangni , Zhao Jiaxin , Zhang Hang , Xie Hongyang , Lu Lin , Chen Kang , Chen Lei , Fukuda Keiichi , Sano Motoaki , Zhang Ruiyan , Liu Jun , Yan Xiaoxiang 
Published: December 2022

Background
Myocardial infarction (MI) is characterized by the emergence of dead or dying cardiomyocytes and excessive immune cell infiltration after coronary vessel occlusion. However, the complex transcriptional profile, pathways, cellular interactome, and transcriptional regulators of immune subpopulations after MI remain elusive.

Methods and Results

Here, male C57BL/6 mice were subjected to MI surgery and monitored for 1 day and 7 days, or sham surgery for 7 days, then cardiac CD45‐positive immune cells were collected for single‐cell RNA sequencing to determine immune heterogeneity. A total of 30 135 CD45
+
immune cells were partitioned into macrophages, monocytes, neutrophils, dendritic cells, and T or B cells for further analysis. We showed that macrophages enriched for Olr1 and differentially expressed Gpnmb represented 2 crucial ischemia‐associated macrophages with distinct proinflammatory and prophagocytic capabilities. In contrast to the proinflammatory subset of macrophages enriched for Olr1, Gpnmb‐positive macrophages exhibited higher phagocytosis and fatty acid oxidation preference, which could be abolished by etomoxir treatment. In addition to macrophages, MI triggered prompt recruitment of neutrophils into murine hearts, which constituted the sequential cell‐fate from naïve S100a4‐positive, to activated Sell‐high, to aging Icam1‐high neutrophils. In silico tools predicted that the excessively expanded neutrophils at 1 day were attributed to chemokine C‐C motif ligand/chemokine C‐X‐C motif ligand pathways, whereas CD80/inducible T‐cell costimulator (ICOS) signaling was responsible for the immunosuppressive response at day 7 after MI. Finally, the Fos/AP‐1 (activator protein 1) regulon was identified as the critical regulator of proinflammatory responses, which was significantly activated in patients with dilated cardiomyopathy and ischemic cardiomyopathy. We showed the enriched Fos/AP‐1 target gene loci in genome‐wide association study signals for coronary artery diseases and MI. Targeting Fos/AP‐1 with the selective inhibitor T5224 blunted leukocyte infiltration and alleviated cardiac dysfunction in the preclinical murine MI model.

Conclusions
Taken together, this single‐cell RNA sequencing data lay the groundwork for the understanding of immune cell heterogeneity and dynamics in murine ischemic hearts. Moreover, Fos/AP‐1 inhibition mitigates inflammatory responses and cardiac dysfunction, which might provide potential therapeutic benefits for heart failure intervention after MI.
Healthcare use and healthcare costs for patients with advanced cancer; the international ACTION cluster-randomised trial on advance care planning
Authors: Korfage Ida J , Polinder Suzanne , Preston Nancy , van Delden Johannes JM , Geraerds Sandra (A)JLM , Dunleavy Lesley , Faes Kristof , Miccinesi Guido , Carreras Giulia , Moeller Arnfeldt Caroline , Kars Marijke C , Lippi Giuseppe , Lunder Urska , Mateus Ceu , Pollock Kristian , Deliens Luc , Groenvold Mogens , van der Heide Agnes , Rietjens Judith AC 
Published: December 2022

Background: Advance care planning supports patients to reflect on and discuss preferences for future treatment and care. Studies of the impact of advance care planning on healthcare use and healthcare costs are scarce. Aim: To determine the impact on healthcare use and costs of an advance care planning intervention across six European countries. Design: Cluster-randomised trial, registered as ISRCTN63110516, of advance care planning conversations supported by certified facilitators. Setting/participants: Patients with advanced lung or colorectal cancer from 23 hospitals in Belgium, Denmark, Italy, the Netherlands, Slovenia and the UK. Data on healthcare use were collected from hospital medical files during 12 months after inclusion. Results: Patients with a good performance status were underrepresented in the intervention group ( p< 0.001). Intervention and control patients spent on average 9 versus 8 days in hospital ( p = 0.07) and the average number of X-rays was 1.9 in both groups. Fewer intervention than control patients received systemic cancer treatment; 79% versus 89%, respectively ( p< 0.001). Total average costs of hospital care during 12 months follow-up were €32,700 for intervention versus €40,700 for control patients ( p = 0.04 with bootstrap analyses). Multivariable multilevel models showed that lower average costs of care in the intervention group related to differences between study groups in country, religion and WHO-status. No effect of the intervention on differences in costs between study groups was observed ( p = 0.3). Conclusions: Lower care costs as observed in the intervention group were mainly related to patients’ characteristics. A definite impact of the intervention itself could not be established.
Therapeutic uses of psychedelics for eating disorders and body dysmorphic disorder
Authors: Ledwos Nicole , Rodas Justyne D. , Husain M. Ishrat , Feusner Jamie D. , Castle David J. 
Published: December 2022

Background: Clinical use of psychedelics has gained considerable attention, with promising benefits across a range of mental disorders. Current pharmacological and psychotherapeutic treatments for body dysmorphic disorder (BDD) and eating disorders (EDs) have limited efficacy. As such, other treatment options such as psychedelic-assisted therapies are being explored in these clinical groups. Aims: This systematic review evaluates evidence related to the therapeutic potential of psychedelics in individuals diagnosed with BDD and EDs. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic review of all study designs published to the end of February 2022 that identified changes in ED/BDD symptom severity from psychedelics using validated measures to assess symptom changes. Results: Our search detected a total of 372 studies, of which five met inclusion criteria (two exploratory studies, two case reports, and one prospective study). These were included in the data evaluation. Effects of psychedelics on BDD and various ED symptoms were identified mostly through thematic analyses and self-reports. Conclusions: Our findings highlight that more research is needed to determine the safety and efficacy of psychedelics in BDD and EDs and we suggest avenues for future exploration.
Urethral rupture concomitant with penile fracture does not adversely affect functional outcomes
Authors: Yilmaz Hasan , Avci Ibrahim Erkut , Cinar Naci Burak , Akdas Enes Malik , Unal Muhlis , Baynal Enes Abdullah , Kara Onder , Teke Kerem 
Published: December 2022

Introduction: The aim of this study was to identify possible risk factors for urethral rupture and to evaluate the effect of urethral rupture repair on long-term functional outcomes and complications. Materials and methods: The medical records of consecutive penile fracture patients were retrospectively reviewed. Penile fracture patients with and without urethral rupture were compared according to demographics, clinical and intraoperative findings. Comparisons of postoperative functional results of the groups were performed using the 5-item version of the International Index of Erectile Function (IIEF-5) and the International Prostate Symptom Score (IPSS). Finally, among them, long-term penile complications including penile curvature, painful erection, palpable nodule, and paresthesia were assessed. Results: Fifty-three patients participated. Patients with urethral rupture ( n = 8) were older (44.50 ± 10.69, 36.58 ± 10.33 years, p = 0.052). There was no significant difference in fracture etiology ( p = 0.64). Urethral bleeding was present only in patients with urethral rupture ( p < 0.001). Although no bilateral corpus cavernosum rupture was encountered in penile fracture patients without urethral rupture, this rate was significantly higher in those with urethral rupture at a rate of 62.5% ( p < 0.001). The time from surgical repair to sexual activity was similar in both groups ( p = 0.66). There was no significant difference in IPSS and IIEF-5 scores, the presence of erectile dysfunction and complication rates ( p > 0.05). Conclusions: Older age is a possible risk factor for a concomitant urethral rupture with penile fracture and it seems to be associated with urethral bleeding and bilateral corpus cavernosum involvement. Additionally, urethral rupture repair neither adversely affected functional outcomes nor increased penile complication rates.
Neuropathological Findings in Short-Chain enoyl-CoA Hydratase 1 Deficiency (ECHS1D): Case Report and Differential Diagnosis
Authors: Pena-Burgos Eva Manuela , Regojo Rita María , Sáenz de Pipaón Miguel , Santos-Simarro Fernando , Ruiz-Sala Pedro , Pérez Belén , Esteban-Rodríguez María Isabel 
Published: December 2022

Short-chain enoyl-CoA hydratase 1 (ECHS1) is an enzyme that participates in the metabolism of valine, transforming methacrylyl-CoA in β–hydroxy–isobutyryl-CoA. There is an accumulation of intermediate acids and ammonium as a consequence of its deficit. This background generates a harmful environment for the brain causing neuronal death and severe brain lesions. We present a case of a 39 weeks newborn that died at 31 hours old. We found vacuolization in basal areas, brain stem, cerebellum and spinal cord white matter (spongiform myelinopathy). These vacuoles were periodic acid–Schiff stain negative, there were neither acompanion gliosis nor macrophagic reaction. These findings were suggestive of metabolism acid disorders. The final diagnosis was confirmed by genetic study by massive parallel sequencing, showing 2 previously described pathogenic variants (c.160C > T and c.394G > A) of short-chain enoyl-CoA hydratase 1 gene. To our knowledge, this is the first case reporting the histological changes in short-chain enoyl-CoA hydratase 1 deficiency. Histological study provides useful information to orientate the diagnostic and clarify the clinical manifestations, especially in hospitals where urine or blood samples are not taking routinely or where genetic studies may not be performed. Synopsis: The main neuropathological findings in Short-chain enoyl-CoA hydratase 1 deficiency are the presence of whitte matter vacuoles in basal areas, brain stem and spinal cord.
Acute Interstitial Nephritis in the Pediatric Population: A Review of Etiologic Associations, Histologic Findings, and Clinical Outcome
Authors: Biederman Laura E. , Conces Miriam , Shenoy Archana 
Published: December 2022

Background: Acute interstitial nephritis (AIN) is an infrequent cause of acute kidney injury in the pediatric population with a broad range of etiologies. This retrospective review attempts to characterize AIN in the pediatric population, delineate etiologic factors, histologic features, and clinical outcome. Materials and Methods: Institutional pathology reports were queried for a diagnosis of AIN between 1/2010 and 10/2021. Archived slides and reports and clinical records were reviewed. Results: Twenty-four patients were identified whose ages ranged from 5 to 20 years. A 8 cases (37.5%) were characterized as tubulointerstitial nephritis and uveitis (TINU), 4 cases (16.7%) were associated with an autoimmune disease, 4 cases (16.7%) were likely drug induced, and 8 cases (37.5%) had unclear etiology. Discussion: Although all cases of drug induced interstitial nephritis contained eosinophils they were not exclusive to drug induced interstitial nephritis. A prominent plasma cell infiltrate was seen in both cases of Sjögren’s associated interstitial nephritis. The vast majority (n = 18, 75%) showed an improved serum creatinine (<1 mg/dL) 1 year post diagnosis/at last follow-up. In this pediatric series of AIN, TINU contributed to a large subset of cases with known etiologies. On follow up, majority of the cases demonstrated recovery of renal function.
Transverse incision versus longitudinal incision in the implantation of PICC-port: A before-after study
Authors: Shen Yan , Wang Qianqian , Li Xin , Chang Jian , Zhou Xingmei 
Published: December 2022

Background: The peripherally inserted central catheter-port (PICC-port) technique is an innovation of the standard arm-totally implantable vascular access device. The design of surgical skin incision may have an important impact on the postoperative life of patients, the cosmetic result is important for patient satisfaction as well. Objectives: To compare two different incision methods in the implantation of PICC-port. Design: A before-after study. Settings and participants: A total of 62 adult patients with malignant tumor requiring chemotherapy in Shanghai General Hospital were selected by convenience sampling, 31 in each group. All participants agreed to install PICC-port with signature from 1 Jan to 30 April, 2022. Methods: 31 patients were given longitudinal incision, about 3 cm below the puncture point obliquely. Another 31 patients were given transverse incision, about 3 cm below the puncture point. T-test, chi-square test and rank sum test were used to compare the differences between the two groups in incision healing, scar score, and operation time. Results: There was no statistically significant difference in incision healing between the two groups( p > 0.05). The scar scores of patients with transverse incision were higher than that of patients with longitudinal incision at 3 months ( p < 0.05). And the operation time of longitudinal incision group was longer than that of transverse incision group( p < 0.05). Conclusions: Our study revealed that PICC-port implantation could be considered as safe as PICC insertion conducted by nurse. During our follow-up, all patients with PICC-port implantation had good wound healing, and there were no complications such as local infection happened. The transverse incision was more easier to be operated in bag making in PICC-port implantation.
The medical profession transformed by artificial intelligence: Qualitative study
Authors: Mosch Lina , Fürstenau Daniel , Brandt Jenny , Wagnitz Jasper , Klopfenstein Sophie AI , Poncette Akira-Sebastian , Balzer Felix 
Published: December 2022

Background Healthcare delivery will change through the increasing use of artificial intelligence (AI). Physicians are likely to be among the professions most affected, though to what extent is not yet clear. Objective We analyzed physicians’ and AI experts’ stances towards AI-induced changes. This concerned (1) physicians’ tasks, (2) job replacement risk, and (3) implications for the ways of working, including human–AI interaction, changes in job profiles, and hierarchical and cross-professional collaboration patterns. Methods We adopted an exploratory, qualitative research approach, using semi-structured interviews with 24 experts in the fields of AI and medicine, medical informatics, digital medicine, and medical education and training. Thematic analysis of the interview transcripts was performed. Results Specialized tasks currently performed by physicians in all areas of medicine would likely be taken over by AI, including bureaucratic tasks, clinical decision support, and research. However, the concern that physicians will be replaced by an AI system is unfounded, according to experts; AI systems today would be designed only for a specific use case and could not replace the human factor in the patient–physician relationship. Nevertheless, the job profile and professional role of physicians would be transformed as a result of new forms of human–AI collaboration and shifts to higher-value activities. AI could spur novel, more interprofessional teams in medical practice and research and, eventually, democratization and de-hierarchization. Conclusions The study highlights changes in job profiles of physicians and outlines demands for new categories of medical professionals considering AI-induced changes of work. Physicians should redefine their self-image and assume more responsibility in the age of AI-supported medicine. There is a need for the development of scenarios and concepts for future job profiles in the health professions as well as their education and training.