bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting High-Grade Patterns in Stage I Solid Lung Adenocarcinoma: A Study of 371 Patients Using Refined Radiomics and Deep Learning-Guided CatBoost Classifier
Authors: Zheng Hong , Chen Wei , Liu Jun , Jian Lian , Luo Tao , Yu Xiaoping 
Published: December 2024

Introduction This study aimed to devise a diagnostic algorithm, termed the Refined Radiomics and Deep Learning Features-Guided CatBoost Classifier (RRDLC-Classifier), and evaluate its efficacy in predicting pathological high-grade patterns in patients diagnosed with clinical stage I solid lung adenocarcinoma (LADC). Methods In this retrospective study, a total of 371 patients diagnosed with clinical stage I solid LADC were randomly categorized into training and validation sets in a 7:3 ratio. Uni- and multivariate logistic regression analyses were performed to examine the imaging findings that can be used to predict pathological high-grade patterns meticulously. Employing redundancy and the least absolute shrinkage and selection operator regression, a radiomics model was developed. Subsequently, radiomics refinement and deep learning features were employed using a machine learning algorithm to construct the RRDLC-Classifier, which aims to predict high-grade patterns in clinical stage I solid LADC. Evaluation metrics, such as receiver operating characteristic curves, areas under the curve (AUCs), accuracy, sensitivity, and specificity, were computed for assessment. Results The RRDLC-Classifier attained the highest AUC of 0.838 (95% confidence interval [CI]: 0.766-0.911) in predicting high-grade patterns in clinical stage I solid LADC, followed by radiomics with an AUC of 0.779 (95% CI: 0.675-0.883), and imaging findings with an AUC of 0.6 (95% CI: 0.472-0.726). Conclusions This study introduces the RRDLC-Classifier, a novel diagnostic algorithm that amalgamates refined radiomics and deep learning features to predict high-grade patterns in clinical stage I solid LADC. This algorithm may exhibit excellent diagnostic performance, which can facilitate its application in precision medicine.
Quantification of Multi-Organ 11β-Hydroxysteroid Dehydrogenase Type 1 Enzyme Levels in a Zucker Fatty Rat Model: A PET Imaging Study
Authors: Bini Jason , Strober Jordan , Kapinos Michael , Zheng Ming-Qiang , Li Songye , Ropchan Jim , Nabulsi Nabeel , Huang Yiyun , Perry Rachel J. , Vatner Daniel F. , Carson Richard E. 
Published: December 2024

Background In rodents, 11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) catalyzes the conversion of inactive 11-dehydrocorticosterone to the active hormone corticosterone. Dysregulation of intracellular glucocorticoid action is implicated in metabolic diseases. Assessing 11β-HSD1 enzyme levels in vivo may be key to understanding obesity pathophysiology. Objective We used a Zucker Fatty (ZF) rat model and [18F]AS2471907 PET imaging to determine appropriate kinetic modeling methods and assess changes in 11β-HSD1 levels due to obesity in the liver, white and brown adipose tissue (WAT/BAT), and brain. Material and Methods To validate [18F]AS2471907 PET in preclinical models, time-activity curves (TACs) were generated and kinetic modeling was performed with image-derived input functions (IDIFs) extracted from multiple locations. Quantitative estimates of radioligand binding were compared with ex vivo 11β-HSD1 protein expression. Validated quantitative PET kinetic modeling methods were then used to assess differences in 11β-HSD1 between lean and obese ZF rats. Metabolic disease status was confirmed with stable isotopes tracer studies of glucose and fatty acid metabolism. Results Obesity is associated with decreased brain 11β-HSD1 levels, measured by [18F]AS2471907 PET, which correlated with measures of glucose and fatty acid metabolism. Conclusion We demonstrate that [18F]AS2471907 PET can provide useful quantification of 11β-HSD1 levels in a rodent model of obesity.
Macrowire for intracranial thrombectomy: An early experience of a new device and technique for anterior circulation large vessel occlusion stroke
Authors: Limaye Kaustubh , Al Kasab Sami , Dolia Jaidevsinh , Ezzeldin Mohamad , Duarte Daniel Vela , Doss Vinodh , Lahoti Sourabh , Hasan David , Spiotta Alejandro , Asi Khaled , Saini Vasu , Mehta Tapan , Hassan Ameer , Haussen Diogo , Yavagal Dileep , Jones Jesse , Tanweer Omar , Brinjikji Waleed 
Published: December 2024

Background and Purpose Mechanical thrombectomy (MT) has become the standard of care for treatment of acute ischemic stroke secondary to large vessel occlusion up to 24 h from the last known normal time. With ADAPT and SOLUMBRA techniques, classically, a large bore aspiration catheter is delivered over a microcatheter and microwire crossing the clot to perform thrombectomy. Recently, a novel macrowire (Colossus 035 in.) has been introduced as a potential alternative to the use of microwire-microcatheter to allow the delivery of the aspiration catheter (ID = 0.070 in. up to 0.088 in.) over a macrowire alone. Objective To test the feasibility of delivering an aspiration catheter to clot interface over a macrowire alone. Materials and Methods A retrospective evaluation of prospectively maintained Macrowire for Intracranial Thrombectomy (MINT) Registry where this novel technique was utilized for thrombectomy. Consecutive patients undergoing MT using the MINT technique were included. We collected baseline demographics, imaging and clinical characteristics, rate of procedural success, conversion to traditional MT, and complications. Results Fifty consecutive patients were recruited during the initial 4 months of the larger study duration. The aspiration catheter was able to be advanced to the clot interface successfully in 46/50 (92%) using the MINT technique. Median time from vascular access to the first pass was 11.30 min (IQR = 7.45–14.30 min) and successful thrombectomy was 14 min (IQR = 10–22.15). The modified first-pass effect with this procedure was 71%. One vasospasm was reported as a procedural complication. Conclusions MINT is safe and feasible for large vessel occlusion recanalization based on our initial clinical experience in this multicenter study.
Efficacy of different methods of compression therapy and its relation to venous disease and obesity
Authors: Primo Cleber , Erzinger Fabiano Luiz , Boim de Araújo Walter Junior , Pertile Remor Aline , Baptistella Antuani Rafael , de Carvalho Diego 
Published: December 2024

Objectives To evaluate the efficacy of different methods of interfacial elastic compression and their association with obesity and chronic venous insufficiency (CVI). Methods Forty legs with vascular disease and 40 control legs were analyzed. Four different methods of elastic compression were applied and interface pressure was measured. Blood flow volume and peak systolic velocity (SPV) were measured before and during compression. Results Although there are no general differences correlating higher interface pressures with higher blood flow volume and SPV in CVI patients and controls, there are specific differences related to obesity. Obese participants had lower CVI and higher blood flow volume, in whom higher interface pressure promoted better results. Conclusions There is no standard method of compression for all patients. Variables such as the presence of CVI, body mass index, and gender must be taken into account in order to achieve a better individual method of compression therapy.
Smoking and contraception containing ethinylestradiol: A mixed-methods study into women’s intentions to quit smoking
Authors: Hilverda Femke , Til Brigitte van der , Vonk Peter , van der Heijde Claudia 
Published: December 2024

Background: Smoking while using contraception containing ethinylestradiol increases the risk of cardiovascular diseases. Therefore, it is especially important to stimulate women who use these contraceptives to quit smoking. Objectives: This study aimed to examine the role of risk perception and coping in relation to the intention of these women to quit smoking, using the Protection Motivation Theory as the theoretical foundation. Design: This was an explanatory sequential mixed-methods design. Methods: An online survey ( n = 68) was used to examine the relationship among risk perception, coping assessment, and intention to quit smoking. After that 15 in-depth semi-structured interviews were conducted to understand how women appraised risk and coping strategies during their quit attempt(s). Results: Results from the survey showed that risk perception induces the intention to quit smoking. More specifically, perceived vulnerability appeared to be a significant predictor. The interviews showed that women were largely unfamiliar with the combined risks surrounding smoking and contraception use but acknowledged the risks of smoking. In the survey, women seemed to perceive themselves as self-efficacious. However, interview participants mentioned that they encountered many difficulties. Conclusion: Based on these findings, we conclude women are largely unaware of the synergetic risk of contraception use and smoking. Stimulating risk perception and knowledge might help women to create the intention to quit smoking. However, to turn this intention into behavior, providing women with concrete tools to assist them might successfully sustain their quit attempt.
Early discharge with elevated C-reactive protein levels is safe after endoscopic-assisted coronary bypass grafting: Optimisation of postoperative care
Authors: Görtzen De Qing , Sampon Fleur , Timmermans Naomi , Ter Woorst Joost , Akca Ferdi 
Published: December 2024

Objective: This study describes the perioperative kinetics of C-reactive protein in patients undergoing endoscopic coronary artery bypass grafting for single target vessel left anterior descending disease, with early postoperative discharge. Methods: From July 2021 to April 2024, patients were included in this single-centre retrospective study ( N = 208), excluding C-reactive protein-modulating complications. Perioperative and 14-day follow-up C-reactive protein levels and clinical signs of infections were analysed. Results: After endoscopic coronary artery bypass grafting, the C-reactive protein values on the first postoperative day were 44 [24–65] and 140 [88–200] mg/L at Day 3. Most patients were discharged after 3 days (64.4%), regardless of the level of C-reactive protein, and the majority experienced a return of C-reactive protein levels to baseline during follow-up, 6 [6–15] mg/L. Two patients had an infection requiring intervention and readmission (1.0%). Conclusion: The return of C-reactive protein to baseline levels at follow-up and the low incidence of clinical infections suggest that patients can be discharged safely, and prolonged hospitalisation is unnecessary. For perioperative care practitioners, these findings underscore the value of shorter hospital admissions in optimising resource use and improving patient flow, enhancing both patient outcomes and operational efficiency.
Cirrhosis associated with increased complications and healthcare utilization following total shoulder arthroplasty
Authors: Martino John A , Guareschi Alexander S , Rogalski Brandon L , Eichinger Josef K , Friedman Richard J 
Published: December 2024

Introduction Cirrhosis is a known risk factor for morbidity and mortality following surgical procedures and has been associated with increased complications, hospital length of stay (LOS), and cost of admission following total joint arthroplasty. However, a paucity of literature exists evaluating the effect of cirrhosis on postoperative outcomes following total shoulder arthroplasty (TSA). The purpose of this study is to evaluate the short-term outcomes following elective primary TSA in patients with cirrhosis compared to matched controls. Methods The Nationwide Readmissions Database was queried from 2016 to 2020 to identify patients who underwent elective primary TSA. Patients with a diagnosis of cirrhosis ( n = 627) were matched in a 1:1 proportion to patients who did not have cirrhosis. Bivariate statistical analyses were performed to compare preoperative demographic and comorbidity data, postoperative outcomes, and hospital utilization metrics between the two groups. Following Bonferroni correction, an alpha value of 0.003 defined significance. Results Patients with cirrhosis exhibited higher rates of postoperative medical and implant-related complications following primary TSA, including acute renal failure (6.3% vs 1.1%: p < 0.001), urinary tract infection (3.5% vs 0.6%; p < 0.001), transfusions (3.0% vs 0.2%; p < 0.001), acute respiratory distress syndrome (2.9% vs 0.2%: p = 0.002), surgical site infection (2.0% vs 0.2%: p = 0.001), dislocation (2.1% vs 0.0%: p < 0.001), and prosthetic loosening (1.5% vs 0.0%; p = 0.002). These patients also exhibited higher rates of all-cause complications (32% vs 9.2%: p < 0.001) and mortality (1.5% vs 0.0%; p = 0.002) within 180 days of surgery and had an increased cost of admission ($24,633 vs $18,500; p < 0.001) and LOS (2.6 vs 1.5 days; p < 0.001). Conclusion Patients with cirrhosis were found to have increased risk of medical and surgical complications, higher costs, and longer LOS following TSA. These findings can assist orthopedic surgeons in developing strategies in the preoperative period to mitigate complications in this at-risk patient group. Level of evidence Level III – Retrospective cohort study.
Evaluating the Association Between Vastus Medialis Oblique Characteristics and Patellar Instability: A Comprehensive Case-Control Study
Authors: Beit Ner Eran , Rabau Oded , Essa Ahmad , Vinograd Ofir , Asaaf Roy , Gilat Ron , Anekstein Yoram 
Published: December 2024

Background: The contribution of vastus medialis oblique muscle (VMO) weakness or dysfunction to patellofemoral pain syndrome is well recognized, yet its role in lateral patellar instability and recurrent patellar dislocations remains unclear. This study investigates the association between VMO characteristics and patellar instability. Hypothesis: Altered VMO structure, characterized by differences in muscle elevation and cross-sectional area (CSA), is associated with patellar instability. Study Design: A case-control study. Level of Evidence: Level 3. Methods: The study included 204 participants, matched on a 1:1 ratio by age and sex, from a local hospital registry from 2005 to 2020. VMO measurements were taken via magnetic resonance imaging, and included muscle elevation, CSA, fiber angulation, and CSA-to-thigh circumference ratio. Univariate analysis, and multivariable regression model with adjustment for potential confounders were constructed. In addition, a secondary analysis was performed to evaluate the variations in VMO characteristics and mass across primary and recurrent patellar instability groups. Results: Patients with patellar instability demonstrated significant differences in VMO characteristics compared with controls, including increased muscle elevation (13 mm vs 5.9 mm; P < 0.01), increased muscle fiber angulation (42.5° vs 35.3°; P < 0.01), reduced CSA (716 mm2 vs 902 mm2; P < 0.01), and a lower CSA-to-thigh circumference ratio (0.05 vs 0.07; P < 0.01). These findings remained significant in the multivariable adjusted model. Moreover, the secondary analysis revealed that both primary and recurrent instability patients had similar VMO characteristics alterations compared with controls, with slightly more pronounced reductions in VMO CSA in those sustaining recurrent instability episodes. Conclusion: This study confirms a statistically significant association between altered VMO characteristics and patellar instability, emphasizing the importance of considering VMO characteristics in the evaluation and management of patients with patellar instability.
Dementia knowledge and attitudes of healthcare staff: A community hospitals’ perspective
Authors: Han Weiyao , Low Jia Hua , Yee Gabriel Gerard Wenjun , Chan Catherine Qiu Hua , Low Lian Leng 
Published: December 2024

Background As the global population ages, the prevalence of dementia increases, and the need for healthcare services increases. Healthcare workers should possess necessary knowledge and appropriate attitudes to care for dementia patients. Objectives There is a lack of studies of dementia knowledge and attitudes of healthcare workers in post-acute and intermediate care settings. Our study aims to address this gap and evaluate factors associated with dementia knowledge and attitudes in community hospitals. Methods Eligible healthcare workers from three community hospitals in Singapore were invited to fill in anonymous, self-administered questionnaires consisting of sociodemographic, work or training-related, assessment of self-competence factors together with Dementia Knowledge Assessment Scale (DKAS) and Approaches to Dementia Questionnaire (ADQ). Univariate analysis followed by multiple linear regression was conducted to determine the association between covariates with DKAS and ADQ scores. Results A total of 500 responses were obtained, giving a response rate of 60.2%. Mean DKAS and ADQ scores were 27.8 and 68.4 respectively. Multiple linear regression revealed better dementia knowledge was associated with occupation, highest education level, having attended a dementia training course, experience in caring for dementia patients and self-assessment of dementia knowledge. More positive attitudes towards dementia care were associated with occupation, time spent providing dementia care and self-assessment of attitude towards dementia care. Conclusion Healthcare workers in community hospitals exhibit positive attitudes towards providing dementia care but have a lower level of dementia knowledge compared to other study populations. Modifiable factors can be targeted to improve dementia knowledge and attitudes amongst healthcare workers.
An Evaluation of Primary Care Clinician Referrals for Behavioral Weight Loss Counseling
Authors: Saraiya Veeral M. , Berkowitz Seth A. , Johnston Larry F. , Couper David J. , Sotres-Alvarez Daniela , Lyons Kiira M. , Thaxton Cheyenne K. , Skinner Harlyn G. , Samuel-Hodge Carmen D. , Keyserling Thomas C. 
Published: December 2024

Introduction/Objectives: In the context of enrolling patients from primary care practices into a weight loss research study, this study describes the percentage of patients primary care clinicians (PCCs) considered appropriate for referral and study participation rates among those referred. Methods: An electronic health record review identified 5322 patients aged 18 to 75 years with BMI ≥ 30 kg/m2 as eligible for review by community, attending, and resident PCCs for referral to a weight loss study. Referrals and patient interest in participating in the study are reported overall and by PCC type. Results: The mean (SD) age was 53.1 (13.9) years, mean BMI 36.5 (6.2) kg/m2, 41.5% were male, and 30.9% were African American. PCCs reviewed 3882 patients and referred 2762 (71.1%) to the study. Of 1120 not referred, 260 (23.2%) were not known well enough by PCCs to assess for referral. The most common reasons for not referring included too much comorbidity (171, 15.3%), psychological reasons (170, 15.2%), and non-English speaking (125, 11.2%). Among 1897 patients invited to participate, 676 (35.6%) expressed interest and 360 (19.0%) were enrolled. Conclusions: PCCs referred 71.1% of their eligible patients. Among those referred, interest in participation was modest and enrollment was low. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04302727
Strategies for Positive Outcomes of Negative Mentoring Experiences at Workplace: Protege Perspectives
Authors: Gupta Amit 
Published: December 2024

Mentoring literature is skewed towards positive experiences, and we have limited knowledge about negative mentoring experiences (NMEs) and the value such experiences bring to protégés. Hence, scholars have sought more research on the case of NMEs including their outcomes for protégés. This qualitative study, conducted with 12 protégés in India, bridges the above gaps and makes significant contributions. First, it pioneers in informing us about the strategies adopted by protégés in handling NMEs and extends the literature by discovering relational outcomes from NMEs for protégés. Second, it suggests a new expanded model of mentoring, with dimensions beyond the classical phases of mentorship postulated by Kram (1985 , Mentoring at Work: Developmental Relationships in Organisational Life). Third, it extends the NME literature beyond the Western models and introduces Indian values in handling NMEs. This article suggests avenues for further research on the new models of mentoring and the applicability of Indian management principles in mentorship practice.
Findings From the Todurujo na Kadurok (Empowering Youth) HIV Self-Testing and Edutainment Comic Randomized Controlled Trial With Refugee Youth in a Humanitarian Setting in Uganda
Authors: Logie Carmen H. , Loutet Miranda G. , Okumu Moses , MacKenzie Frannie , Coelho Madelaine , Lukone Simon Odong , Kisubi Nelson , Malhi Aiman , Kyambadde Peter , Mbuagbaw Lawrence 
Published: December 2024

Introduction Humanitarian settings are underserved by HIV self-testing (HIV-ST). Methods We conducted a randomized controlled trial to evaluate the effectiveness of HIV-ST (Arm 1), HIV-ST alongside edutainment comics (Arm 2), and edutainment comics (Arm 3), compared with the standard of care (SOC), in increasing HIV testing with refugee youth aged 16–24 in the Bidi Bidi Refugee Settlement, Uganda. Intervention effects on HIV testing at 3-month follow-up (T2) were assessed using generalized estimating equation models alongside open-ended questions. Results Retention was 98% ( n = 117/120) at T2. In adjusted analyses compared with the SOC, HIV testing changes from baseline to T2 were highest in Arm 2 (adjusted odds ratio [aOR]: 8.46; 95% confidence interval [CI]: 2.87–24.97), followed by Arm 3 (aOR: 4.14; 95% CI: 1.58–10.87), with no significant differences in Arm 1. Conclusion HIV self-testing is feasible for refugee youth in Uganda and can be supplemented with edutainment comics to advance HIV prevention efforts.
Medical Humanities in Resident Training: A Pilot Study of Specific Courses in a Large Comprehensive Hospital in China
Authors: Yang Xiaoyun , Guo Lifang , Chen Xiaoxiong , Zhang Ju , Xiang Qiang 
Published: December 2024

Background The importance of integrating humanities into medical education has been recognized. However, the medical humanities curriculum is usually lacking during standardized training for residents in China. This study aims to determine the feasibility and effectiveness of pilot-specific courses in medical humanities in standardized residency training. Methods We designed specific courses in medical humanities, composed of 3 courses: Identifying and Managing Common Psychological Disorders of Patients, Patient-Clinician Communication, and Medical Dispute Cases Analysis and Resolution. The courses were scheduled monthly throughout the one semester, and a total of 118 residents participated in the curriculum. Participants completed the evaluation containing ethic-legal knowledge and humanistic competencies related to course content before and after the curriculum. Results Most participant residents had a bachelor's degree (85.6%) and were in the first year of standardized residency training (61.0%). Their disciplinary backgrounds are diverse, encompassing 18 different clinical medical specialties. The residents’ average scores of postcourse self-assessments keep a steady increase in humanistic competencies compared with precourse average scores. All postcourse self-assessments showed significant improvement compared to precourse ( P < .05), particularly in influential communication skills and diagnostic associations of processing ability. Conclusion The specific courses in medical humanities are feasible and effective in teaching residents in China. The pre-post course evaluation indicates that this humanities-based curriculum significantly improved residents’ ethic-legal knowledge and humanistic competencies during standardized residency training.