bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defining the Learning Outcomes and Core Curriculum for Clinical Clerkships
Authors: KEMAHLI Sabri , TAŞKIRAN Hüseyin Cahit , Mohamed Ayman M.A. , ALBAR Raed A. , AlKattan Khaled 
Published: December 2024

Abstract

Background: The core curriculum is defined as a curriculum that is essential and common to all students. Defining the core curriculum for clinical clerkships will help to clarify the content to which disorders and skills must be mastered by students.
Objectives: This study aimed to define the content of the clinical clerkship core curriculum based on the expectations of graduates to work at the primary healthcare level.
Methods: The core learning outcomes of clinical clerkships were defined by starting from diseases, clinical presentations, conditions, and skills listed in SaudiMeds framework and the Saudi Medical Licensing Exam content outline. Although some diseases are expected to be managed at the primary care level, only emergency management or preliminary diagnosis with referral to a more advanced level is required. Thus, the knowledge and skills to be acquired for each disease/disorder are competencies in one or more of the following areas: preliminary diagnosis, diagnosis, treatment, emergency management, prevention, and follow-up.
Results and Conclusion: A total of 404 diseases/disorders and 137 skills (66 procedural and 71 examination skills) were listed, and their levels of knowledge and performance were defined. The clerkships where each clinical skill should be practiced and acquired were also identified.
The implementation of the clinical core curriculum faces challenges due to faculty practices and the misinterpretation of some hospital policies.
This final document can be shared with other medical schools to define the core curriculum on a national basis.
Association of Sociodemographic, Clinical factors, and Self-Care with Intrinsic Capacity in Older Adults with Heart Failure
Authors: PENG Ronggang , YANG Fang , WAN Xia , XU Yanhua , ZHAO Qing 
Published: December 2024

Abstract

Objective
This study aimed to examine the association between sociodemographic and clinical characteristics, self-care practices, and intrinsic capacity in older adults with heart failure.
Methods
A total of 215 heart failure patients aged 60 years or older were recruited from two tertiary hospitals in Wuxi, China. The intrinsic capacity composite score was derived from scores on the Montreal Cognitive Assessment (MoCA), Short Physical Performance Battery (SPPB), Mini Nutritional Assessment-Short Form (MNA-SF), Geriatric Depression Scale-15 (GDS-15), and self-reported visual or hearing impairments. Self-care was assessed using the Self-Care Heart Failure Index (SCHFI). Sociodemographic and clinical data were collected via a self-designed questionnaire. The associations between sociodemographic and clinical characteristics, self-care, and intrinsic capacity were explored using binary analysis, Spearman’s correlation coefficient analysis, and multiple linear regression analysis.
Results
98.1% of participants experienced a decline in at least one domain of intrinsic capacity. The most affected domains were vitality (87.9%) and cognition (60.95%). Reduced intrinsic capacity composite scores were associated with older age (β = 0.138, t = 2.163, p = 0.032), higher NYHA class grade (β = 0.466, t = 8.032, p < 0.001), and poorer self-care (β = -0.133, t = -2.140, p = 0.033).
Conclusion
Intrinsic capacity in older adults with heart failure was found to be related to age, NYHA class grade, and self-care practices. Healthcare professionals should focus on these factors and implement targeted interventions to support this population.
Pathological Response to Neoadjuvant Therapy in Breast Cancer Patients and Its Relationship with Survival: A Retrospective Cohort Study
Authors: Loaiza-Osorio Sara , Caicedo Ana María , Vásquez Elsa María , Quintero Néstor Llinás , Naranjo Ana María 
Published: December 2024

Abstract

Introduction:
Breast cancer is the most common cancer among women worldwide. Neoadjuvant therapy (NAC) aims to reduce tumor size before surgery and assess the tumor's biological response to treatment. Pathological complete response (pCR) is an important marker of oncological outcomes, but its evaluation in the Colombian population is limited. This study aimed to evaluate pCR and its relationship with overall survival in breast cancer patients who received NAC at a hospital in Medellín.
Methodology:
This is a retrospective cohort observational study conducted at Clínica Vida, Medellín, between 2017 and 2023, including 1,008 breast cancer patients treated with NAC. Sociodemographic, histological, and treatment variables were evaluated. Bivariate analyses and the Kaplan-Meier test were used to assess survival.
Results
A total of 36.2% of the patients achieved pCR, which was associated with better overall survival (95.1% vs. 91.1%). Factors associated with pCR included younger age, higher histological grade, elevated Ki67, negative hormone receptors, and lower lymph node involvement. The use of anthracycline-based chemotherapy, taxanes, and Trastuzumab was more common in pCR. Most patients with pCR underwent conservative surgery and sentinel lymph node biopsy.
Conclusions
Factors such as tumor biology and therapeutic regimen significantly influence the likelihood of achieving pCR and improving long-term survival. This highlights the importance of personalizing NAC in breast cancer, guided by specific biological characteristics of the tumor to optimize clinical outcomes.
Dual Epigenetic Targeting with Chidamide and Azacitidine after Allogeneic Hematopoietic Stem Cell Transplantation for High-Risk Acute Myeloid Leukemia Patients
Authors: HU Xiao-Hui , Wu Yaxue , Wan Chao-Ling , Li Zheng , Zhang Yang , Wu Depei , Chen Suning , Wang Ying , Ma Xiao , Dai Haiping , QIAN Chongsheng , Bao Haiyan , Jiang Shanshan , Zhang Hao , Zhang Yanming , Li Ling-Hao , Xue Sheng-Li 
Published: December 2024

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is potentially the only curative option for high-risk acute myeloid leukemia (AML) patients. However, disease relapse remains the principal cause of treatment failure of these patients, and outcomes of salvage treatments are poor. Azacitidine (AZA), a DNA methyltransferase inhibitor, shows anti-leukemia activity in myeloid diseases. Chidamide, a selective histone deacetylase inhibitor, effectively induces apoptosis in AML cells. When combined, these agents have a synergistic inhibitory effect on AML cells. A multicenter, prospective study (ChiCTR2300067593) was conducted with 48 high-risk AML patients after allo-HSCT. Patients received chidamide 5 mg/d plus azacitidine 75 mg/m²/d for 5 days. Additionally, 28 patients who received azacitidine alone as maintenance therapy after allo-HSCT were reviewed as a control group. With a median follow-up of 448 days (range 151–918), the chidamide plus azacitidine (CHI-AZA) regimen demonstrated superior 2-year relapse-free survival (RFS) (93.3% vs 71.6%, P = 0.039) and overall survival (OS) (96.3% vs 75.3%, P = 0.011) compared to AZA alone. The difference of 2-year cumulative incidence of relapse (CIR) was not significantly (6.7% vs 22.1%, P = 0.163). In conclusion, the CHI-AZA maintenance therapy could be an effective method to improve outcomes of high-risk AML patients after allo-HSCT.
Objective Evaluation of the Prognostic Value of Common Nutritional Indicators in Patients with Different Inflammatory States after Radical Gastrectomy for Gastric Cancer: A Real-world Study Running Head：Nutritional Indicators in Inflammatory State
Authors: Zheng Hua-Long , Zheng Zhi-Wei , Wei Ling-Hua , Wang Jia-Bin , Lin Jian-Xian , Xue Zhen , Xu Bin-Bin , Shen Li-Li , Lin Jia , Zhang Ling-Kang , Huang Chang-Ming , Li Ping 
Published: December 2024

Abstract

Background and aim:
Few studies have investigated the prognostic significance of nutritional indicators in patients with various inflammatory states.
Methods
Patients who underwent radical gastrectomy for TNM stages I–III gastric cancer were included. Nutritional assessment was performed using commonly used indicators. The patients were categorized into two groups with high and low inflammatory status using the X-tile analysis.
Results
A total of 1327 patients were enrolled in this study, including 843 and 484 patients in the low- and high-SII groups, respectively. Compared with the SII-low group, the SII-high group exhibited significantly lower GNRI, PNI, CXI, and SMI indices and a higher proportion of patients with malnutrition based on the GLIM and CONUT criteria(all P < 0.05). Multivariate COX analysis revealed that GLIM criteria (overall survival [OS]: P = 0.002; recurrence-free survival [RFS]: P = 0.007) and CONUT (OS: P = 0.010; RFS:P = 0.001) were independent prognostic factors for OS and RFS in the SII-low group. In the SII-high group, the GLIM criteria, GNRI, and SMI were the independent prognostic factors for OS(all P < 0.05), the GLIM criteria and SMI were the independent influencing factors for RFS(all P < 0.05). The TimeROC curve and AUC demonstrated the robustness of the GLIM criteria in predicting prognosis across various inflammatory states.
Conclusions
Different nutritional indicators should be considered while evaluating the prognosis of patients with gastric cancer with varying inflammatory states. Compared with other nutritional indicators, the GLIM criteria are more suitable for patients with different inflammatory conditions.
The effectivity of Zero-Profile in treating Single-Level Traumatic Cervical Disc Herniation: A 3- year follow-up Retrospective Cohort Study
Authors: Qin Guang bing , Zhao Wen jie , Nong Zhuo , Qin zhaojie 
Published: December 2024

Abstract

Objective: This study aims to compare the mid-term efficacy and safety of anterior cervical discectomy and fusion (ACDF) using the Zero-Profile device versus a cage-and-plate construct in treating single-level traumatic cervical disc herniation.
Background：While the Zero-Profile device demonstrates comparable functional and radiological outcomes to the cage-and-plate system in single- and multi-level ACDF for cervical degenerative disc diseases, and reduces complication rates, particularly dysphagia, its suitability for single-level symptomatic traumatic cervical disc herniation remains unclear.
Methods: Between August 2020 and August 2023, 50 patients with symptomatic traumatic cervical disc herniation underwent ACDF using either the Zero-Profile device (Group ZP) or the cage-and-plate system (Group CP). Clinical outcomes, including Japanese Orthopedic Association (JOA) scores, Neck Disability Index (NDI) scores, Visual Analogue Scale (VAS) scores, Hospital Anxiety and Depression Scale (HADS) scores, radiological outcomes, and complications, were evaluated and compared.
Results: All procedures were successfully completed. Both groups demonstrated significant postoperative improvements in JOA, NDI, VAS scores, and cervical lordosis, with no significant differences between groups at any follow-up interval. Fusion and cage subsidence rates were also comparable. Notably, dysphagia rates immediately postoperatively, at 1 week, and at 1 month were lower in Group ZP (14.8%, 11.1%, and 3.7%) compared to Group CP (21.7%, 17.4%, and 13.0%) (P =0.79, 0.82 and 0.49). All patients achieved solid fusion, and no cases of dysphagia were observed at the final follow-up. In terms of HADS scores, no significant differences were observed between the two groups.
Conclusions: ACDF using the Zero-Profile device provides comparable surgical outcomes to the cage-and-plate system for single-level traumatic cervical disc herniation while potentially reducing early postoperative dysphagia rates. Thus, it represents an effective and reliable treatment option for this condition.
LACC with low ERCC1 expression has better survival
Authors: Zhongxin Zhang , Wei Chen , Junwei Qin , Meiye Ge , Baopeng Li 
Published: December 2024

Abstract

Aims and background. To investigate the ERCCl protein in locally advanced cervical cancer tissues and its relationship with the efficacy of radiotherapy and chemotherapy.
Methods and study design. Immunohistochemistry was used to detect ERCCl protein in 74 locally advanced cervical cancer tissues treated with intensity-modulated conformal radiotherapy. According to the strength of immune response, they were divided into a high expression group of 32 cases and a low expression group of 42 cases; During radiotherapy, cisplatin 40mg/m2/week is synchronized. Analyze the relationship between ERCCl protein expression status and the clinical pathological characteristics and prognosis of patients.
Result. The total effective rate CR+PR of high expression of ERCC1 protein was 84.37% (27/32), while the CR+PR of low expression of ERCC1 was 88.10% (37/42), with no statistically significant difference (χ2=0.016, p=0.901). ERCC1 protein expression was not related to age, FIGO stage, pathological type, differentiation degree, lymph node metastasis, or A point dose (χ 2=3.094, 2.250, 0.002, 0.301, 0.360, 0.604, all p>0.05), but was related to recurrence and metastasis (χ2=4.160, 4.142, p<0.05). The 5-year survival rates of the two group were 34.38% and 78.57%, respectively, with a significant difference (χ2=3.965, p=0.046).
Conclusion. The group with high expression of ERCCl protein is more prone to local recurrence and distant metastasis than the group with low expression of ERCCl protein. The expression status of ERCCl protein may become one of the biological indicators for predicting the prognosis of cervical cancer, which has certain guiding significance for the judgment of patient prognosis.
Arginyltransferase1 drives a mitochondria-dependent program to induce cell death
Authors: Zhang Fangliang , Kumar Akhilesh , O'Shea Corin , Yadav Vikas , Kandasamy Ganapathih , Moorthy Balaji , Ambrose Evan , Mulati Aliya , Fontanesi Flavia 
Published: December 2024

Abstract

Cell death regulation is essential for stress adaptation and/or signal response. Past studies have shown that eukaryotic cell death is mediated by an evolutionarily conserved enzyme, arginyltransferase1 (Ate1). The downregulation of Ate1, as seen in many types of cancer, prominently increases cellular tolerance to a variety of stressing conditions. Conversely, in yeast and mammalian cells, Ate1 is elevated under acute oxidative stress conditions and this change appears to be essential for triggering cell death. However, studies of Ate1 were conventionally focused on its function in inducing protein degradation via the N-end rule pathway in the cytosol, leading to an incomplete understanding of the role of Ate1 in cell death. Our recent investigation shows that Ate1 dually exists in the cytosol and mitochondria, the latter of which has an established role in cell death initiation. Here, by using budding yeast as a model organism, we found that mitochondrial translocation of Ate1 is promoted by the presence of oxidative stressors and is essential for inducing cell death with characteristics of apoptosis. Also, we found that Ate1-induced cell death is dependent on the formation of the mitochondrial permeability pore and at least partly dependent on the action of mitochondria-contained factors including the apoptosis-inducing factor, but is not directly dependent on mitochondrial electron transport chain activity or its derived reactive oxygen species (ROS). Furthermore, our evidence suggests that, contrary to widespread assumptions, the cytosolic protein degradation pathways including ubiquitin-proteasome, autophagy, or endoplasmic reticulum (ER) stress response has little or negligible impacts on Ate1-induced cell death. We conclude that Ate1 controls the mitochondria-dependent cell death pathway.
Antibiotics for UTIs Cause Distinct Alterations in Gut Microbiome and Host Health Compared to Enteritis Treatment
Authors: Xu Zhengyi , Xu Jianshu , Jiang Peng , Wei Shichao , Gu Chaoqun , Gu Yifeng , Wei Qun , Guo Hao , Wang Shiyu , Li Zhi , Liu Fengping , Feng Ninghan , Zhao YU , Li Zhou , Zhou Xiang 
Published: December 2024

Abstract

Background
Fecal microbiota transplantation (FMT) has gained attention as a potential treatment for various chronic inflammatory diseases, including colitis and urinary tract infections (UTIs). However, the effects of different antibiotics, especially those used for UTIs, on the gut microbiota and host are not well-studied.
Methods
Male Sprague-Dawley rats, 8 weeks old, were subjected to antibiotic cocktails for the treatment of enteritis and UTIs, receiving daily doses of 0.5g and 1g via gavage over a 2-week period. Following this treatment, samples of feces and jejunal tissue were collected for microbiota analysis, and bacterial DNA was subsequently isolated and sequenced using 16S rRNA. The microbial composition, diversity, and abundance were thoroughly assessed. Additionally, a comprehensive evaluation included histomorphological analysis, body weight measurement, food intake monitoring, as well as assessments of liver, renal function, and urinary parameters.
Results
Fecal and tissue samples exhibited distinct microbial profiles, with fecal samples being more diverse. Antibiotics, both for enteritis and UTIs, significantly altered microbial communities in fecal samples, reducing richness and diversity. The effects were less pronounced in tissue samples. UTI antibiotics had a more detrimental impact on intestinal histomorphology compared to enteritis antibiotics. Rats on higher UTI antibiotic doses showed lower body weight and reduced food intake. Liver, renal function, and urinary parameters were affected, indicating potential systemic consequences.
Conclusions
This study underscores the differential impacts of antibiotics on gut microbiota and host health, particularly emphasizing caution in UTI antibiotic use and advocating further research for mitigation.
Citric acid water as an alternative to food restriction to motivate task performance in mice during touchscreen testing
Authors: Dzinic Leila , Ghosh-Swaby Olivia , Antolin Joel , Dumont Julie , Sheppard Paul , Bussey Timothy , Saksida Lisa 
Published: December 2024

Abstract

Rodent behavioural testing paradigms in touchscreen operant chambers have successfully provided insight into the neural mechanisms underlying various cognitive domains in healthy and disease models. Touchscreen testing has previously required food restriction to sufficiently motivate rodents to complete behavioural tests, limiting the use of interventions, for example diet-based interventions, that alter animals’ motivation for food in experimental design. Here, we explored the safety and efficacy of water manipulation via addition of citric acid in motivating behavioural performance in touchscreen operant chambers 1) in comparison with food restriction and 2) when mice are fed an obesogenic high-fat, high-sugar (HFHS) diet. Water manipulation and food restriction produced similar performance on the progressive ratio task in non-obesogenic, standard-fed mice. However, when water-manipulated mice were fed a HFHS diet they showed deficits in this motivation-sensitive task. Critically, all groups, regardless of restriction type or diet, showed similar learning curves during a pairwise visual discrimination task. Together, these findings demonstrate that water manipulation can safely and effectively motivate mice to perform touchscreen tasks for reward, even when fed a highly satiating HFHS diet, which opens the possibility of using interventions, especially diet-based, in conjunction with touchscreen cognitive testing batteries.
Is It Necessary To Use A Drain After Perineal Urethroplasty If We Can Avoid Complications By Pressure Dressing?
Authors: Sarıkaya Ege A. , Terzi Sümeyye , Çakmak Atahan , Özer M. Selçuk , Şen Volkan , Bozkurt Ozan 
Published: December 2024

Abstract

Purpose
Peri-operative management of urethroplasty is yet to be standardized. One of the major obscure issues in perioperative management is the use of perineal drainage. Some reconstructive urologists prefer to use drain as a routine while others never use one. Although the main purpose of drain placement is to prevent collection and related wound complications, no study up-to-date refers to these complications neither with nor without drain usage.
Methods
152 consecutive patients who underwent perineal urethroplasty without perineal drain were included. Strict pressure dressing was applied to all patients. Presence of any perineal fluid collection, wound related complications and need for re-operation for these complications were recorded.
Results
Despite 42.1% of patients having a smoking history and other potential risk factors for wound related complications, there were no instances of fluid collection or wound dehiscence post-operatively.
Conclusion
Given the absolute absence of drainage related complications by applying only pressure dressing, we suggest that perineal drain is not necessary after perineal urethroplasty. Applying pressure dressing is an effective method to prevent fluid collections and related morbidities.
Development of machine learning Predictive Model for Type 2 Diabetic Retinopathy Using the Triglyceride-glucose index explained by SHAP method
Authors: Liu XiaoQin , Wu ShuYing , Yang Yue , Li Yang , Zhang XinTing , Qin Ling , Li Fei 
Published: December 2024

Abstract

Introduction: This study aimed to develop a diabetic retinopathy (DR) Prediction model using various machine learning algorithms incorporating the novel predictor Triglyceride-glucose index (TyG). Furthermore, the model was interpreted using the SHapley Additive exPlanations (SHAP) method.
Method: Real-world data were collected from a general hospital in a major city and a county clinic, then divided into the DR Group (1392) and non-DR group (2358). Baseline data were collected, and variables were selected using Recursive Feature Elimination with Cross-Validation (RFECV). The performance of five machine learning algorithms, including Logistic Regression model (LR), Decision Tree (DT), Random Forest (RF), Support Vector Machine (SVM), and XGBoost (XGB), was assessed based on accuracy, sensitivity, specificity, and Area Under the Curve (AUC) of the Receiver Operating characteristic Curve (ROC). The optimal model was interpreted using SHAP.
Result：SVM and LR demonstrated superior performance in both the test set and training set (ROC, 0.85 and 0.82, respectively). The top five predictors identified by SHAP analysis included TyG, Insulin therapy, HbA1c, Diabetes Course, HDL. HDL was identified as a protective factor, while the remaining factors were associated with retinopathy.
Conclusion：LR and SVM demonstrated the best performance. This is the first study constructing a DR Prediction model using TyG index. Notably, TyG significantly predicted DR and may serve as a crucial indicator for guiding clinical screening of high DR Risk.