bluuebunny/crossref_metadata_2025_split huggingface dataset:
Labial salivary gland biopsy: a crucial method for confirming seronegative Sjogren’s syndrome—a case report
Authors: Romala Satyasai S. G. , Moturi Kishore , Manyam Ravikanth , Vadupu Meghana , Lakshmi P. Divya Naga , Budumuru Anil , Shivajiraju U. , Hyma J. S. D. N. Sai , Ramachandrudu R. V. S. N. S. 
Published: December 2024

Abstract
Background
Sjogren’s syndrome is an autoimmune disease that affects exocrine glands like sweat glands, salivary glands, and lacrimal glands. Dentists frequently encounter these patients and have an important role in establishing the diagnosis. It is mainly diagnosed by clinical features like xerostomia and xerophthalmia, along with anti-Sjögren’s syndrome-related antigen A (anti-SSA/also called Ro antigen) and anti-Sjögren’s syndrome-related antigen B (anti-SSB/ also called La antigen) antibodies in the patients. However, there is a subset of the population where autonuclear antibodies cannot be detected but are still present with all clinical features of Sjogren’s syndrome. Such patients usually remain undiagnosed, and only symptomatic treatment is given in spite of repeated consultation with various medical specialists. Only after establishing a proper diagnosis can we initiate definitive treatment.

Case presentation
Here, we report a case of seronegative Sjogren’s syndrome in a patient with severe xerostomia without anti-SSA and anti-SSB antibodies. The focus score from the labial biopsy, co-relating with clinical presentation, helped us in establishing the diagnosis. After a definitive diagnosis, our patient is put on cholinergic therapy, which greatly reduced the symptoms of xerostomia.

Conclusions
Physicians and dentists should refer such patients to an oral and maxillofacial surgeon for a labial biopsy to consider “seronegative Sjogren’s syndrome." The “focus score” evaluation by the pathologist helps in establishing the diagnosis of “seronegative Sjogren’s syndrome”.
Assessing Large Language Models for Oncology Data Inference From Radiology Reports
Authors: Chen Li-Ching , Zack Travis , Demirci Arda , Sushil Madhumita , Miao Brenda , Kasap Corynn , Butte Atul , Collisson Eric A. , Hong Julian C. 
Published: December 2024

PURPOSE
We examined the effectiveness of proprietary and open large language models (LLMs) in detecting disease presence, location, and treatment response in pancreatic cancer from radiology reports.

METHODS
We analyzed 203 deidentified radiology reports, manually annotated for disease status, location, and indeterminate nodules needing follow-up. Using generative pre-trained transformer (GPT)-4, GPT-3.5-turbo, and open models such as Gemma-7B and Llama3-8B, we employed strategies such as ablation and prompt engineering to boost accuracy. Discrepancies between human and model interpretations were reviewed by a secondary oncologist.

RESULTS
Among 164 patients with pancreatic tumor, GPT-4 showed the highest accuracy in inferring disease status, achieving a 75.5% correctness (F1-micro). Open models Mistral-7B and Llama3-8B performed comparably, with accuracies of 68.6% and 61.4%, respectively. Mistral-7B excelled in deriving correct inferences from objective findings directly. Most tested models demonstrated proficiency in identifying disease containing anatomic locations from a list of choices, with GPT-4 and Llama3-8B showing near-parity in precision and recall for disease site identification. However, open models struggled with differentiating benign from malignant postsurgical changes, affecting their precision in identifying findings indeterminate for cancer. A secondary review occasionally favored GPT-3.5's interpretations, indicating the variability in human judgment.

CONCLUSION
LLMs, especially GPT-4, are proficient in deriving oncologic insights from radiology reports. Their performance is enhanced by effective summarization strategies, demonstrating their potential in clinical support and health care analytics. This study also underscores the possibility of zero-shot open model utility in environments where proprietary models are restricted. Finally, by providing a set of annotated radiology reports, this paper presents a valuable data set for further LLM research in oncology.
Phase II Trial of Nivolumab Plus Doxorubicin, Vinblastine, Dacarbazine as Frontline Therapy in Older Adults With Hodgkin Lymphoma
Authors: Torka Pallawi , Feldman Tatyana , Savage Kerry J. , Ganesan Nivetha , Drill Esther , Hancock Helen , Davey Theresa , Perez Leslie , Capadona Charisse , Subzwari Sarima , Galasso Natasha , Yang Jinshu , Post Michelle , Boardman Alexander , Caron Philip , David Kevin , Epstein-Peterson Zachary , Falchi Lorenzo , Ghione Paola , Hamlin Paul , Horwitz Steven M. , Intlekofer Andrew M. , Johnson William , Kumar Anita , Lue Jennifer , Noy Ariela , Owens Colette , Palomba M. Lia , Salles Gilles A. , Steiner Raphael , Stuver Robert , Vardhana Santosha , Yahalom Joachim , Dogan Ahmet , Zelenetz Andrew D. , Schöder Heiko , Moskowitz Alison J. 
Published: December 2024

PURPOSE

We conducted a phase I/II study evaluating nivolumab plus doxorubicin, vinblastine, dacarbazine (N-AVD) as frontline therapy for treatment-naïve older adults (OA) with classical Hodgkin lymphoma (cHL; ClinicalTrials.gov identifier:
NCT03033914
).

METHODS
Patients age ≥60 years with newly diagnosed, any stage, cHL were treated with six cycles of AVD at standard doses plus nivolumab 240 mg intravenously once every 2 weeks (on days 1 and 15) of each cycle. A geriatric assessment was performed before therapy initiation. The primary end point was progression-free survival (PFS).

RESULTS
Patient characteristics (N = 40) included median age of 66 years (range, 60-78 years) with 38% ≥70 years, 78% with stage III/IV disease, 68% with International Prognostic Score of ≥3, 82% dependent in ≥1 activities of daily living, 23% dependent in ≥1 instrumental activities of daily living, 50% with impaired timed up and go test, and 40% with polypharmacy. Among 37 response-evaluable patients, the median follow-up was 49 months and 3-year PFS and overall survival (OS) were 79% and 97%, respectively. Overall, 50% patients experienced grade 3/4 treatment-related adverse events (TRAEs), including febrile neutropenia in 8%. Four (10%) patients stopped therapy due to TRAEs. There was no correlation between baseline geriatric impairments and survival outcomes or toxicities. Positron emission tomography-2 was not predictive of PFS or OS.

CONCLUSION
N-AVD is a highly effective and well-tolerated frontline regimen in OA with cHL across a wide range of geriatric impairments.
Cost-Effectiveness of Remote Tailored Risk Communication and Navigation for Hereditary Genetic Risk Assessment Uptake: Economic Evaluation From the Genetic Risk Assessment for Cancer Education and Empowerment Trial
Authors: Handorf Elizabeth A. , McDougall Jean A. , Heidt Emily , An Jinghua , Walters Scott T. , Toppmeyer Deborah L. , Kinney Anita Y. 
Published: December 2024

PURPOSE

The Genetic Risk Assessment for Cancer Education and Empowerment Project demonstrated that tailored counseling and navigation (TCN) substantially increased the rate of genetic evaluation (GE) in women with high-risk breast or ovarian cancer (odds ratio, 8.9 [95% CI, 3.4 to 23.5] for TCN
v
usual care [UC]). This study sought to estimate the cost and cost-effectiveness of TCN in a clinic setting from a societal perspective.

METHODS
We identified the components of the intervention and downstream outcomes which would result in resource use. We assessed time spent by staff, cost of mailings, cost of patient time, and cost of testing and counseling in 6 months. Incremental cost-effectiveness ratios were calculated for outcomes of interest. We assessed the sensitivity of our results to assumptions via one-way sensitivity analyses. In addition, we assessed how results would change if a higher volume of patients was given TCN, with a health coach working full-time.

RESULTS
TCN costs $68,924 in US dollars (USD) to deliver per 212 patients, or $325 USD per patient. The intervention cost was $2,154 USD per record-verified GE. Much of this was attributed to training costs for health coaches ($50,223 USD). When including testing and counseling, the incremental cost effectiveness ratio (ICER) of TCN versus UC was $3,250 USD per additional GE. This was most sensitive to TCN effectiveness (ie, GE rate in TCN patients) and cost of testing. Cost-effectiveness would be more favorable with higher coaching volume (ICER of $1,730 USD/GE).

CONCLUSION
Implementing TCN in a clinic setting would come with notable costs, and current reimbursement policies for telemedicine may not be sufficient. Cost-effectiveness of TCN can be improved if subsequent interventions are more efficacious or are delivered to greater patient volumes.
Financial Toxicity Among Patients With Advanced Solid Tumors Participating in Early-Phase Clinical Trials
Authors: Blanter Julia , Van Hyfte Grace , Ahmad Maham , Xu Suzanne , Hapanowicz Olivia , Fazilov Gabriela , Lu Ashley , Lucas Natalie , Wu Kathy , Shelton Gary , DeMerchant Mandy , Lachowicz Michael , Kier Melanie , Werner Michael , Eder Joseph P. , Galsky Matthew D. , Marron Thomas U. , Smith Cardinale B. , LoRusso Patricia M. , Hofstatter Erin , Doroshow Deborah B. 
Published: December 2024

PURPOSE
Financial toxicity (FT) adversely influences patient quality of life and is a barrier to clinical trial enrollment. Early-phase clinical trials (EPCTs) recruit patients who may have high baseline FT and require additional visits and procedures, potentially increasing FT.

METHODS
In this prospective survey study, we sought to assess FT at baseline and after 2 months among patients with advanced solid malignancies participating in EPCTs. Participants were age 18 years and older, were English-speaking, and were treated at the Yale Cancer Center (Yale) and the Tisch Cancer Institute at Mount Sinai (Mount Sinai). At the time of consent and 2 months later, patients completed a sociodemographic questionnaire as well as the 11-item validated Comprehensive Score for Financial Toxicity (COST) instrument. Primary outcomes were baseline COST score and change in COST score from baseline to 2 months. Lower score is associated with higher FT.

RESULTS

One hundred forty-six patients completed survey 1. Mean age was 61.5 years and 50.7% were male. The most common histologies were lung (17.8%), colorectal (16.4%), and breast (12.3%) cancers. Mean baseline COST score was 22.12 (standard deviation, 8.01). FT was associated with being a primary wage earner (
P
= .044) and inversely associated with age (
P
= .025). Seventy-one patients completed survey 2. Among 71 patients who completed both surveys, there was no significant difference in COST score between surveys 1 and 2 (
P
= .28). Race, ethnicity, education, and household income were not associated with baseline COST score or change in FT.

CONCLUSION
Moderate FT was reported at baseline and on trial among EPCT participants. No change in FT was observed between time points. Additional efforts should be made to decrease FT associated with EPCT participation to maximize access to novel therapies.
Neuroendocrine and Developmental Impacts of Early Life Exposure to EDCs
Authors: Streifer Madeline , Thompson Lindsay M , Mendez Skylar A , Gore Andrea C 
Published: December 2024

Abstract
Polychlorinated biphenyls (PCBs) pose a global challenge to environmental and human health. Although toxic and carcinogenic at higher exposure levels, at lower concentrations they can act as endocrine-disrupting chemicals. Individuals are more vulnerable to endocrine-disrupting effects of PCB exposures during the perinatal period, when the neuroendocrine system is developing, although assessing the full impact of PCB exposure is difficult because of the often-latent onset of adverse effects. The goal of this study was to determine developmental effects of an estrogenic PCB mixture, Aroclor 1221 (A1221), on KNDy and kisspeptin neuron numbers in the hypothalamic arcuate nucleus and anteroventral periventricular nucleus (AVPV), together with measures of hypothalamic-pituitary-gonadal hormones and postnatal development. We conducted RNAscope of kisspeptin, prodynorphin, neurokinin B, and estrogen receptor alpha genes in the P30 hypothalamus. Early-life PCBs caused small but significant changes in development (body weight and anogenital index) but had no effect on puberty. We found sex-specific effects of treatment on serum LH, FSH, and estradiol in a sex- and developmental age-dependent manner. RNAscope results revealed increased prodynorphin in the AVPV of male rats, but no effects on kisspeptin or neurokinin B in AVPV or arcuate nucleus. An unexpected species difference was found: we were unable to detect prodynorphin coexpression with kisspeptin within KNDy neurons in rats, unlike mice, sheep, and primates. These data show that early-life PCBs can induce developmental and hormonal changes that together with other reports showing latent effects on behavior and the hypothalamic-pituitary-gonadal axis, indicate adverse endocrine and neurobehavioral outcomes.
High-Intensity Intervallic Exercise (HIIE) Is Superior to Isocaloric Moderate-Intensity Continuous Exercise (MICE) at Reducing Postprandial Hyperglycemia
Authors: Mora-Rodriguez Ricardo , Moreno-Cabañas Alfonso , Alvarez-Jimenez Laura , Mora-Gonzalez Diego , Morales-Palomo Felix 
Published: December 2024

ABSTRACT

Purpose
We investigated if a bout of HIIE is more efficacious at reducing postprandial hyperglycemia than an isocaloric bout of MICE.

Methods
Nineteen healthy physically active individuals (21% women) completed three trials in a randomized order: i) HIIE cycling consisting of 5 bouts of 4 min at 83 ± 9% of subjects’ maximal oxygen consumption (V˙O2 MAX) with active recoveries at 53 ± 8% for a total of 50 min; ii) MICE cycling at 65 ± 8% of V˙O2 MAX for 50 min, and iii) CONTROL no exercise. All trials were followed by a standard oral glucose tolerance test (OGTT) ingesting 74 grams of glucose traced with 1 gram of uniformly labeled [13C]-glucose. Plasma glucose and insulin concentrations, and plasma glucose kinetics ([6,6 2H2] glucose infusion) were measured before, during exercise, and during the OGTT. Insulin sensitivity was estimated by the Matsuda index (ISI). Energy expenditure and carbohydrate oxidation (CHOxid) were monitored.

Results
At rest, blood glucose, insulin concentrations, and CHOxid were similar in all three trials. During exercise, energy expenditure was similar in HIIE vs MICE (548 ± 131 vs 560 ± 125 kcals; p = 0.340). However, CHOxid, plasma glucose concentration, and its rates of appearance in plasma (Ra) were higher in HIIE vs MICE (Ra glucose 34.3 ± 9.8 vs 28.9 ± 6.8 μmol·kg-1·min-1; p = 0.021). During the OGTT, plasma glucose and insulin concentrations were lower, and insulin sensitivity higher in HIIE vs CONTROL (ISI MATSUDA; 12.4 ± 4.7 vs 10.8 ± 4.7 au; p = 0.007). Exercise delayed blood incorporation of [13C]-glucose into blood (p = 0.023). Early during the OGTT, glucose clearance rates were higher in HIIE vs CONTROL (7.1 ± 3.1 vs 5.5 ± 3.0 mL·kg-1·min-1; p = 0.015).

Conclusions
HIIE is more effective than MICE to reduce hyperglycemia and hyperinsulinemia after glucose ingestion. HIIE improves glycemic control by increasing splanchnic glucose retention and glucose clearance rates.
Autismo, estratégias aba e educação: uma revisão de escopo
Authors: Barbosa Leopoldo , Lúcia Cruz de Oliveira Torres Raiane , Nelson Fernandes Barbosa Leopoldo 
Published: December 2024

Introdução: A Análise do Comportamento Aplicada (ABA) contribui para promover a inclusão escolar de crianças com autismo, sendo a formação contínua dos professores essencial para uma educação verdadeiramente inclusiva e social desses alunos que deve considerar práticas pedagógicas que contribuam para um ambiente escolar adaptado e integrador, visando ao desenvolvimento acadêmico. Objetivo: Mapear o conhecimento e a preparação de professores em estratégias de Análise do Comportamento Aplicada (ABA) para a alfabetização de crianças com Transtorno do Espectro do Autismo (TEA). Método: Utilizou-se uma Revisão de Escopo, com protocolos rigorosos e enfoque na reprodutibilidade, para avaliar a eficácia de práticas de ABA em contextos específicos. Foram consultadas as bases de dados PUBMED e BVS, e aplicadas diretrizes aprimoradas como o PRISMA para revisões sistemáticas. Resultados: Foram incluídos sete artigos que exploram temas como desenvolvimento profissional, aplicação de práticas baseadas em evidências (PBE), barreiras à inclusão e a autoeficácia dos professores no ensino inclusivo de alunos com TEA. Discussão: As práticas de ABA e PBE são destacadas como fundamentais para a inclusão de alunos com TEA. A formação continuada é considerada essencial para criar um ambiente escolar inclusivo e adaptado às necessidades desses estudantes. Conclusão: ABA e PBE mostram-se eficazes no ensino de crianças com TEA, evidenciando a necessidade de capacitação contínua e de suporte especializado aos educadores para enfrentar os desafios da inclusão escolar.
Effects of vitamin K supplementation on bone mineral density at different sites and bone metabolism in the middle-aged and elderly population
Authors: Xie Chenqi , Gong Jianbao , Zheng Chenglong , Zhang Junwei , Gao Jie , Tian Chunyan , Guo Xiaofei , Dai Shiyou , Gao Tianlin 
Published: December 2024

AimsThis meta-analysis and systematic review aimed to comprehensively investigate the effects of vitamin K supplementation on bone mineral density (BMD) at various sites and bone metabolism in middle-aged and older adults.MethodsThe databases of PubMed, Web of Science, and Cochrane Library were thoroughly searched from inception to July 2023.ResultsThe results revealed that vitamin K supplementation increased BMD at the lumbar spine (p = 0.035). Moreover, the pooled effects demonstrated a notable increase in carboxylated osteocalcin (cOC) (p = 0.004), a decrease in uncarboxylated osteocalcin (ucOC) (p < 0.001), and no significant effect on total osteocalcin (tOC) (p = 0.076). Accordingly, the ratio of cOC to ucOC (p = 0.002) significantly increased, while the ratio of ucOC to tOC decreased (p = 0.043). However, there was no significant effect of vitamin K supplementation on other bone metabolism markers, such as cross-linked telopeptide of type 1 collagen (NTx), bone alkaline phosphatase (BAP), and procollagen I N-terminal propeptide (PINP). Subgroup analysis revealed that vitamin K notably enhanced bone health in females by increasing lumbar spine BMD (p = 0.028) and decreasing ucOC (p < 0.001). Vitamin K, especially vitamin K2, exhibited effects on maintaining or increasing lumbar spine BMD, and influencing the balance of cOC and ucOC.ConclusionThis review suggests that the beneficial effects of vitamin K supplementation on bone health primarily involve enhancing the carboxylation of OC rather than altering the total amount of OC.Cite this article: Bone Joint Res 2024;13(12):750–763.
Metatranscriptomic analysis reveals the diversity of RNA viruses in ticks in Inner Mongolia, China
Authors: Su Si , Cui Meng-Yu , Xing Li-Li , Gao Rui-Juan , Mu Lan , Hong Mei , Guo Qi-Qi , Ren Hong , Yu Jing-Feng , Si Xiao-Yan , Eerde Mutu 
Published: December 2024

Background
Ticks are widely distributed throughout China and are the second most prevalent pathogen vectors in the world, following only mosquitoes. Tick bites can lead to Lyme disease, forest encephalitis, and other illnesses that may result in death under severe circumstances. Materials and methods: Ticks collected from March 2021 to May 2023 were pooled and used in metatranscriptomic analyses to gain insight into the diversity and distribution of tick-borne viruses in Inner Mongolia. Next-generation sequencing (NGS) outcomes were validated, and viral prevalence across distinct tick species was determined through the application of polymerase chain reaction (PCR) paired with Sanger sequencing.

Results
A total of 20 RNA viruses belonging to at least 8 families, including Chuviridae, Flaviviridae, Solemoviridae, Nairoviridae, Partitiviridae, Phenuiviridae, Rhabdoviridae, and Totiviridae, and to unclassified families were identified by NGS. Five of the identified RNA viruses (Nuomin virus, Yezo virus, tick-borne encephalitis virus, Alongshan virus, and Beiji nairovirus) are considered human pathogens. A potential human pathogen, Mukawa virus, was also among the identified viruses. Ixodes persulcatus carried a significantly greater number of viral species than did Dermacentor nuttalli, Hyalomma marginatum, and Haemaphysalis concinna. The prevalence of coinfection with multiple viruses differed in I. persulcatus from Hinggan League and Hulun Buir, and Beiji nairovirus was the codominant virus species.

Conclusions
There is a remarkable diversity of RNA viruses harboured by ticks in Inner Mongolia, with variations observed in the distribution of these tick-borne viruses across different regions and tick hosts.
Power analysis for personal light exposure measurements and interventions
Authors: Zauner Johannes , Udovicic Ljiljana , Spitschan Manuel 
Published: December 2024

Background
Light exposure regulates the human circadian system and more widely affects health, well-being, and performance. With the rise in field studies on light exposure’s effects, the amount of data collected through wearable loggers and dosimeters has also grown. These data are more complex than stationary laboratory measurements. Determining sample sizes in field studies is challenging, as the literature shows a wide range of sample sizes (between 2 and 1,887 from a recent review of the field and approaching 105 participants in first studies using large-scale ‘biobank’ databases). Current decisions on sample size for light exposure data collection lack a specific basis rooted in power analysis. Therefore, there is a need for clear guidance on selecting sample sizes.

Methods
Here, we introduce a novel procedure based on hierarchical bootstrapping for calculating statistical power and required sample size for wearable light and optical radiation logging data and derived summary metrics, taking into account the hierarchical data structure (mixed-effects model) through stepwise resampling. Alongside this method, we publish a dataset that serves as one possible basis to perform these calculations: one week of continuous data in winter and summer, respectively, for 13 early-day shift-work participants (collected in Dortmund, Germany; lat. 51.514° N, lon. 7.468° E).

Results
Applying our method on the dataset for twelve different summary metrics (luminous exposure, geometric mean, and standard deviation, timing/time above/below threshold, mean/midpoint of darkest/brightest hours, intradaily variability) with a target comparison across winter and summer, reveals required sample sizes ranging from as few as 3 to more than 50. About half of the metrics–those that focus on the bright time of day–showed sufficient power already with the smallest sample. In contrast, metrics centered around the dark time of the day and daily patterns required higher sample sizes: mean timing of light below mel EDI of 10 lux (5), intradaily variability (17), mean of darkest 5 hours (24), and mean timing of light above mel EDI of 250 lux (45). The geometric standard deviation and the midpoint of the darkest 5 hours lacked sufficient power within the tested sample size.

Conclusions
Our novel method provides an effective technique for estimating sample size in light exposure studies. It is specific to the used light exposure or dosimetry metric and the effect size inherent in the light exposure data at the basis of the bootstrap. Notably, the method goes beyond typical implementations of bootstrapping to appropriately address the structure of the data. It can be applied to other datasets, enabling comparisons across scenarios beyond seasonal differences and activity patterns. With an ever-growing pool of data from the emerging literature, the utility of this method will increase and provide a solid statistical basis for the selection of sample sizes.