bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative factors predicting outcomes in patients with suspected perihilar cholangiocarcinoma referred for curative resection— a single-center 10-year experience
Authors: Al-Saffar Hasan Ahmad , Larsen Peter Nørrgaard , Schultz Nicolai , Kristensen Thomas Skårup , Ramirez Diana Elena Renteria , Knøfler Lucas Alexander , Pommergaard Hans-Christian 
Published: December 2024

Abstract

Background
Perihilar cholangiocarcinoma (pCCA) is a rare malignancy requiring resection of extrahepatic bile ducts with or without hepatectomy, for radicality. Prognostic models for post-operative outcomes in pCCA are unusable in pre-operative decision-making as most are based on post-operative variables. Additionally, no pre-operative model consider futile laparotomy or benign hilar stenosis (BHS) as an outcome, despite rates of up to 30 % and 15 % respectively. We investigated pre-operative predictive factors for non-resectability, disease-free survival (DFS), and overall survival (OS), in patients referred for resection of suspected pCCA.
Method
Patients with suspected pCCA evaluated at multidisciplinary team (MDT) conference and referred for curative resection at Rigshospitalet, from 2013-2023. All were identified from the Danish Liver Cancer Group (DLGCD). Patients were evaluated, starting from date of first MDT for suspected pCCA; and starting from date of surgery if proven pCCA. Outcomes were preoperative factors related to OS, DFS and non-resectability.
Results
Ninety-three patients with suspected pCCA were considered resectable at MDT, of which
74 (79.5 %) were resected. In resected patients 65 (87.8 %) had pCCA, 2 (2.1 %) had gallbladder cancer (GBC) and 7 (7.5 %) had BHS.
Patients with futile lapartomy (n=19 [20.4%]) had higher pre-operative p-bilirubin and ECOG-performance status (ECOG-PS) score >0 compared to resected pCCA and BHS (p=0.02 and 0.01). Portal vein embolization (p<0.001, HR 2.99 [95 % CI 1.61-5.53]) and ECOG-PS >0 (p=0.003, HR 2.32 [95% CI 1.31-4.11]) had worse OS. No preoperative factors were independently associated with non-resectability or DFS.
Conclusion
ECOG-PS >0 and PVE had worse survival in patients with suspected pCCA. Patients with futile laparotomy had higher frequency of ECOG-PS >0 and elevated p-bilirubin compared to resected pCCA and BHS.
Galectin-3: a novel biomarker of glycogen storage disease type III
Authors: HOCH Lucile , Rossiaud Lucille , Miagoux Quentin , Benabides Manon , Reiss Océane , Jauze Louisa , Jarrige Margot , Hélène Polvèche , Malfatti Edoardo , Laforêt Pascal , Ronzitti Giuseppe , Nissan Xavier 
Published: December 2024

Abstract

Glycogen storage disease type III (GSDIII) is a rare genetic disorder leading to abnormal glycogen storage in liver and skeletal muscle. In this study, we conducted a comparative gene expression analysis of several in vitro and in vivo models identifying galectin-3 as a potential biomarker of the disease. Interestingly, we also observed a significant decrease in galectin-3 expression in mice treated with an AAV gene therapy. Finally, galectin-3 expression was studied in muscle biopsies of GSDIII patients, confirming its increase in patient tissue. Beyond the identification of this novel biomarker, our study offers a new perspective for future therapeutic developments.
Emergence of a novel reassortant H3N3 avian inﬂuenza virus with enhanced pathogenicity and transmissibility in chickens in China
Authors: Zhang Chunping , Zhao Conghui , Huang Jiacheng , Wang Yang , Jiang Bo , Zheng Hangyu , Zhuang Mingzhi , Peng Yanni , Zhang Xiaoxuan , Liu Sha , Qiang Haoxi , Wang Huanhuan , Zeng Xiancheng , Guo Guijie , Chen Ji-Long , Ma Shujie 
Published: December 2024

Abstract

The H3N3 avian influenza viruses (AIVs) are not as prevalent as H3N8 viruses in poultry. Yet, reassortant H3N3 viruses are occasionally detected in domestic poultry and wild birds. In this study, we isolated an H3N3 virus in chickens from a live poultry market in China. Full genomic analysis revealed that the virus had a single basic amino acid in the cleavage site of the hemagglutinin (HA) gene. Phylogenetic analysis revealed that eight genes of the H3N3 virus belong to the Eurasian lineage and the HA and NA genes were clustered with H3N2 and H11N3, respectively, while the internal genes were closely related to H3N8 and H9N2 viruses. The H3N3 virus demonstrated high and moderate stability in thermal and acid conditions, respectively, along with efficient replication capabilities in mammalian cells. Moreover, the H3N3 virus could infect and replicate in the upper and lower respiratory tract of BALB/c mice without prior adaptation, triggering hemagglutination inhibition (HI) antibody titers ranging from 80 to 160. The H3N3 virus replicated vigorously within the chicken respiratory and digestive tracts, transmitted efficiently and swiftly among chickens via direct contact, and resulted in elevated HI antibody titers in both the inoculated and contact birds. These findings indicate that the H3N3 virus might be a novel reassortant originating from viruses circulating in domestic poultry, demonstrating increased pathogenicity and transmissibility in chickens. Our findings demonstrate that H3N3 AIV may pose a potential threat to poultry industry and public health, thereby highlighting the importance of active surveillance of AIVs.
Health benefits and economical aspects on laparoscopic vs open Nissen fundoplication in children
Authors: Högberg Niclas , Danielson Johan , Westblom Amanda , Gustafson Elisabet 
Published: December 2024

Abstract

Background
Nissen fundoplication is one of the most common surgical procedures for gastroesophageal reflux. Current and previous research comparing laparoscopic Nissen fundoplication (LNF) versus open Nissen fundoplication (ONF) in children suggest ambiguous conclusions. The purpose of this retrospective study was to compare the outcome for children operated with LNF or ONF at our institution, and to evaluate the economic aspects.
Methods
32 consecutive patients (LNF: n = 18, ONF: n = 14) operated with Nissen fundoplication between the years 2011–2017 were included in the study. Data was collected by examination of the patient journals and preoperative, operative, postoperative, and post-discharge parameters were analyzed.
Results
Compared to ONF, the LNF group had shorter operating time (165.2 vs 216.6 min, p < 0.05), shorter overall operating room duration (315.0 vs 334.9 min, p < 0.05) and shorter postoperative hospital stay (3.8 vs 8.1 days, p < 0.05). The LNF group also required less morphine (1.2 vs 1.7 mg/kg, p < 0.05) and the total cost per case was 39% lower (261.1 vs 427.4 kSEK, p < 0.05). No difference was seen in postoperative complications and results.
Conclusion
Laparoscopic Nissen fundoplication is more beneficial for patients compared to open surgery, and at a lower cost.
Effectiveness and safety of opioid-free anaesthesia and analgesia in pain control and postoperative recovery of patients undergoing gynaecologic oncologic surgery: a retrospective cohort study
Authors: Garcia Jose Alexander Puentes , Tocancipa Daniel Rivera , Medina Eugenio , Díaz Julián Jovel , Pisso Francisco Javier Quinayas , Gil Vincent Jean Carlo García , Hernandez Fredy Leonardo Carreño 
Published: December 2024

Abstract

Introduction: Opioids have been essential for the anesthesiologic management of patients undergoing surgical procedures such as gynecologic oncology. However, the use of opioids brings with it hemodynamic problems, which is why opioid-free anesthesia (OFA) and multimodal postoperative analgesia techniques that restrict the excessive use of opioids are necessary.
Objective: To determine the effectiveness and safety of opioid-free anesthesia and analgesia in pain control and postoperative recovery of adult patients undergoing gynecologic oncology surgery.
Methodology: A retrospective observational cohort study was conducted by reviewing the medical records of patients at the Neiva University Hospital. Female patients who underwent gynecologic oncology surgery at the Neiva University Hospital and who received OFA, or opioid-based anesthesia (OBA) were identified. Data on pain were collected using a visual analog pain scale (VAPS), along with hemodynamic variables and adverse events at 7 different times from admission to the operating room until discharge from the hospital. A bivariate analysis was performed for the type of anesthesia, comparing frequencies of VAPS and adverse events with chi2 and mean difference for hemodynamic variables with t student. A multivariate analysis was performed with multiple logistic regression to evaluate differences in frequency of pain by VAPS based on the anesthesia regimen and other clinical variables for statistical difference times.
Results: Data were collected from 335 patients, of whom 196 (58.5%) received an OBA regimen and 139 (41.5%) an OFA regimen. A difference was identified for greater pain in OFA than in OBA (p<0.001) for the times before surgery, recovery discharge, and 24 hours after surgery. For heart rate, significant differences were only identified at admission to the operating room, 30 minutes of induction and admission to the recovery room. For respiratory rate, the differences were only significant at admission to the operating room, 30 minutes of induction. For mean arterial pressure, it was significant only in the recovery room and for oxygen saturation at admission to the operating room and discharge from recovery. As an adverse event, a higher frequency of requiring antiemetics was only identified in patients with AFO than with ABO on the fifth day of surgery. No significance was identified in multivariate analysis between OBA and OFA controlled for VAPS by other factors at 24 hours.
Conclusions: Opioids for gynecologic oncologic surgery patients have a partial impact on pain control, with poor control upon discharge to recovery areas, at 24 and 48 hours, and no clinically relevant differences in hemodynamic variables or adverse events.
Environmental Actions, Support for Policy, and Information’s provision Experimental Evidence from the US
Authors: Binelli Chiara , Loveless Matthew 
Published: December 2024

Abstract

We investigate the effectiveness of providing prospective versus retrospective information on local climate change to promote pro-environmental behavior and support for green policies. A randomized experiment on a representative sample of American adults finds that providing prospective local climate change information is most effective at increasing pro-environmental actions and policy support, regardless of partisanship. The impact of this information provision increases when individuals feel responsible for addressing climate change, have young children, and trust the central government. Prospective information on local climate change can thus contribute to promoting the vast support for the necessary actions to address the climate crisis.
JEL Codes: Q54; D84; C93.
Clinical and MRI Markers for Acute vs Chronic TMD Using a Machine Learning and Deep Learning Approach
Authors: Lee Yeon-Hee , Jeon Seonggwang , Auh Q-Schick , Lee Jeong- Hoon , Noh Yung-Kyun 
Published: December 2024

Abstract

This study aimed to identify factors that significantly contribute to the chronicity of symptoms in patients with temporomandibular disorders (TMD). Statistical, machine learning, and deep learning models were used for analysis. The study include 239 patients with TMD (161 women and 78 men; mean age 35.60 ± 17.93 years), diagnosed using Diagnostic Criteria for TMD (Axis I). Participants were categorized into: acute TMD (< 6 months) and chronic TMD (≥ 6 months) (51.05%). Significance clinical findings revealed that temporomandibular joint (TMJ) noise and bruxism were more frequently reported in patients with chronic TMD than in those with acute TMD. The visual analog scale (VAS) score, reflecting subjective pain intensity, was significantly higher in chronic TMD than in acute TMD. Additionally, patients with chronic TMD had shorter average sleep durations than their acute counterparts. STOP-Bang total scores were higher in chronic TMD (3.02 ± 2.09 vs. 2.39 ± 1.73, p = 0.012) than in acute TMD. Magnetic resonance imaging revealed structural abnormalities in patients with chronic TMD, with significantly higher rates of anterior disc displacement (ADD), TMJ osteoarthritis, and joint space narrowing. Using logistic regression—a widely recognized machine learning model—the AUROC for predicting chronic TMD was 0.7550 (95% CI]: 0.6550–0.8550). Significant predictors of chronic TMD included TMJ noise, bruxism, VAS score, sleep disturbance, STOP-Bang total score ≥ 5 (high risk of obstructive sleep apnea), ADD, and joint space narrowing. Deep learning (multilayered perceptron) improved prediction performance by 3.99% over logistic regression (79.49% vs. 75.50%, p = 0.3067). These findings may help clinicians prevent symptom chronicity and mitigate the progression to chronic TMD, ultimately improving patient care.
Correlation between diabetic retinopathy and bone mineral density and bone metabolism indexes：a case-control study
Authors: Li Ning , Dang Yalong , Qu Guodong , Huang Xiufeng , Ye Guangbin , Wang Changli , Liu Haodan , Ma Fuwei , Zhang Fangfang , Huang Kairi , Bin Xiaoyun 
Published: December 2024

Abstract

Objective
The objective of this research is to examine the correlation between diabetic retinopathy and bone mineral density(BMD), as well as bone metabolism indicators, through clinical research and bioinformatics analysis.
Methods
① 64 patients diagnosed with both diabetes mellitus and retinopathy constituted the observation group, whereas 91 patients with diabetes mellitus alone formed the control group. Their BMD and bone metabolism indices were then compared.② Disease genes were searched in the relevant databases for diabetic retinopathy and osteoporosis respectively.Common target genes were obtained after de-replicating the intersections. The common target genes were constructed through theSTRING database to construct PPI network maps and screen common core targets, and finally, GO and KEGG enrichment analyses were performed.
Results
The observation group exhibited lower levels of BMD, BMC, T-Score, and Z-Score than the control group(P < 0.05).and the common core targets of diabetic retinopathy and osteoporosis were INS, IL6, AKT1, TNF, etc. Their common core targets mainly act on the AGE-RAGE, lipid and atherosclerosis, HIF-1 and other specific pathways in diabetic complications to play a regulatory role in the regulation of bone metabolism and thus trigger osteoporosis.
Conclusion
The decrease in BMD and diabetic osteoporosis is probably another manifestation of diabetic microangiopathy, and the common core targets and signalling pathways involved in the two diseases can regulate both diseases and have an impact on them, suggesting that there is a close correlation between diabetic retinopathy and BMDin terms of pathology and molecular mechanisms.
Integrative Bioinformatics Analysis of m1A Genes in Periodontitis and Diabetes: Identifying Potential Diagnostic Biomarkers
Authors: Wang Kai , Qiu Liewang , Wang Aiguo , Xu Ling , Wei Jingjing 
Published: December 2024

Abstract

Periodontitis (PD) and type 2 diabetes mellitus (T2DM) are common chronic diseases with an established bidirectional relationship. This study investigates the expression patterns and regulatory roles of m1A-modified genes in PD and T2DM, aiming to explore potential molecular mechanisms, and evaluate their potential as diagnostic biomarkers.Transcriptomic data for PD and T2DM patients were integrated from GEO to analyze m1A-related gene expression. A diagnostic model was developed using ridge and logistic regression. Gene function enrichment, immune infiltration, and PPI analyses explored m1A regulatory mechanisms based on m1A scoring and patient clustering models. And the expression of specific genes was further validated by qRT-PCR. Differential expression of m1A-related genes was significant in PD and T2DM, with BMT2 downregulated in both and RRP8 upregulated in T2DM. RRP8 and ALKBH3 had high predictive value in the diagnostic model. Immune infiltration and PPI analyses indicated marked differences in immune cell infiltration between disease groups. Hub genes MAK16 and DDX18 were associated with T cell activity and immune infiltration, suggesting relevance to the PD-T2DM relationship. This study provides preliminary evidence supporting the potential use of m1A-modified genes as diagnostic biomarkers for both conditions. Additional research is necessary to confirm these mechanisms and explore their clinical applicability.
Prediction Models for Early Post-Discharge Falls Among Older Adults Using Machine Learning: A Prospective Cohort Study
Authors: Onishi Mai , Takeshita Yuko , Masuda Hirotada , Katsuhisa Mizuki , Saizen Yuichiro , Ikuta Kasumi , Kasamatsu Misaki , Fujii Misaki , Moriki Yuki , Koujiya Eriko , Yamakawa Miyae , Takeya Yasushi 
Published: December 2024

Abstract

Purpose
To construct a prediction model for early post-discharge falls among older adults in Japan using machine learning, leveraging patient information collected during hospitalization.
Methods
This prospective cohort study was conducted at an acute care hospital in Osaka, Japan. Participants were inpatients aged ≥ 65 years admitted to the geriatric ward between February 2022 and July 2023. At admission and discharge, 83 patient information items were collected from electronic medical records. The outcome, recorded within three months of discharge, was collected telephonically. Variables used in the model were selected based on statistical analyses and clinical findings, and the model was constructed using five algorithms.
Results
The analysis included 156 patients [mean age: 78.1 ± 5.8 years; women: 79 (50.6%)], 19 (12.2%) of whom had fallen within three months of discharge. Six variables were used in the model: “alanine aminotransferase (ALT),” “self-assessment of health status,” “decrease in grip strength,” “Clinical Frailty Scale ≥ 4,” “fecal incontinence,” and “urinary incontinence.” The best area under the precision-recall curve (AUPRC) and area under the receiver operating characteristic curve (AUROC) values were obtained using CatBoost (AUROC: 0.801; AUPRC: 0.392; sensitivity: 0.375; specificity: 0.964). The highest sensitivity was found for ExtraTrees (AUROC: 0.719; AUPRC: 0.331; sensitivity: 0.500: specificity: 0.964).
Conclusion
The results demonstrate the potential of using machine learning to construct a model for predicting early post-discharge falls in hospitalized older adult patients.
Evaluating women’s experiences and satisfaction with labour induction in India: a comparison of the Participant Generated Experience and Satisfaction (PaGES) Index with standard methods
Authors: Patel Avni , Howard Rachel , Faragher Brian , Durocher Jill , Winikoff Beverly , Symon Andrew , Weeks Andrew , Mundle Shuchita , Lightly Kate 
Published: December 2024

Abstract

Background
Although induction of labour is becoming more common worldwide, there are few studies that assess women’s satisfaction with it. The newly developed Participant Generated Experience and Satisfaction (PaGES) Index collects brief qualitative data and quantifies it, allowing detailed satisfaction data to be collected on large populations. The PaGES data has never previously been compared to other methods of assessing study participants’ satisfaction. We aimed to triangulate PaGES Index, Likert questionnaire and interview data from a large, randomised trial of labour induction to fully understand women’s priorities, experience and satisfaction and to compare the findings of the three instruments.
Methods
A convergent parallel multi-methods research design was used. Participants in the Misoprostol or Oxytocin for Labour Induction (MOLI) trial (n=520) completed the PaGES Index before and after birth, listing priorities and allocating spending points to demonstrate their relative importance. Postnatally, participants scored their satisfaction with each item. Quantitative data was collected postnatally on the acceptability of augmentation, delivery time, pain and anxiety using a Likert scale. Semi-structured interviews were also conducted, and thematic analysis was carried out using a framework approach. The data from 20 participants who had completed all three outcome measures were integrated and compared.
Results
Although common themes, such as pain, emerged from participants’ responses to the three instruments, each provided different insights. The Likert responses demonstrated overall satisfaction with the induction process but with high levels of pain and anxiety. Semi-structured interviews highlighted that safety and health of the baby was a key priority. The PaGES Index confirmed that the baby’s wellbeing was most important to women, but women also expressed a strong preference for vaginal delivery.
Conclusions
The PaGES Index, Likert questionnaire and semi-structured interview data provide varied but complimentary insights on women’s birth experiences and their satisfaction with their induction process. The outputs of the three methods align, but the PaGES index was unique in capturing both detailed qualitative and quantitative information for all study participants.
Trial registration
The MOLI study is registered in ClinicalTrials.gov (NCT03749902, Registration date: 21st Nov 2018) and Clinical Trial Registry, India (CTRI/2019/04/018827)
ESI Triage Level Assignment for Headache Patients: Comparative Analysis of ChatGPT and Gemini Performance for Supporting Care Provider Decisions and Self-triage
Authors: Samadpour Hamed , Kalhori Sharareh Rostam Niakan , Tahmasebi Masoumeh , Rakhshi Mahla , Lotfi Fatemeh 
Published: December 2024

Abstract

Objective
This study evaluated the performance of two advanced large language models (LLMs), ChatGPT and Gemini, in supporting triage decisions for headache patients in emergency settings via the Emergency Severity Index (ESI) from both patient self-triage and healthcare provider perspectives.
Methods
Data, including 500 records of patients presenting with headache complaints, were obtained from the MIMIC-IV-ED database. Two distinct prompt types were created: one for self-triage to assist patients in assessing their care needs on the basis of symptom descriptions and another for healthcare providers to determine ESI levels. Each model's output was compared to actual ESI levels via precision, recall, and F1 scores to measure performance.
Results
ChatGPT achieved greater accuracy at lower acuity levels (ESIs 3 and 4), accurately identifying patients who did not require urgent care. Gemini demonstrated improved performance at higher acuity levels (ESIs 1 and 2), indicating its ability to recognize critical cases effectively. Both models showed stronger performance with healthcare provider prompts than with self-triage prompts, underscoring the importance of structured input for accurate triage assessments. This variation highlights the need to refine self-triage prompts to ensure safe and precise use.
Conclusion
ChatGPT and Gemini show promise as decision-support tools for ED triage, particularly for assisting healthcare providers in prioritizing cases on the basis of acuity. However, further refinement is needed to increase accuracy in self-triage scenarios. Future studies should validate these findings across a broader dataset and explore the integration of LLMs into clinical decision support systems to strengthen triage reliability and effectiveness.