bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors affecting free vancomycin concentration and target attainment of free area under the concentration-time curve
Authors: Urakami Toshiharu , Oka Yusuke , Matono Takashi , Aoki Yosuke 
Published: February 2025

Abstract

Background
It has been reported that the protein binding rate of vancomycin (VCM) varies among individual patients. So, the authors investigated relevant factors that may affect free VCM concentration and target attainment of free area under the concentration-time curve (fAUC).

Methods
Thirty-nine patients were included. Multiple regression analysis was performed to determine the valuable factors in the free VCM concentration, and the target attainment of area under the concentration-time curve (AUC) 400–600 mg・h/L and fAUC200-300 mg・h/L was calculated.

Results
We found total protein was significant covariate for free VCM. Among 18 patients who were investigated for AUC and fAUC estimation, 9 patients (50.0%) and 12 patients (66.7%) reached AUC > 600 mg・h/L, and fAUC > 300 mg・h/L (p = 0.310), respectively.

Conclusions
Total protein is a significant predictor for free VCM estimation. And the fAUC-guided TDM for VCM TDM may contribute to more strict dosing than the AUC-guided TDM in hyper- or hypo-proteinemic population.

Trial registration
Retrospectively registered.
CT lymphangiography of the thoracic duct in mice: direct mesenteric versus popliteal lymph node puncture
Authors: Kato Shimpei , Sugawara Haruto , Furuta Toshihiro , Abe Osamu , Akai Hiroyuki 
Published: February 2025

Abstract

Background
To evaluate the efficacy of computed tomography (CT) lymphangiography after direct mesenteric lymph node injection for thoracic duct (TD) visualization in mice.

Methods
Twelve female BALB/c mice were injected with 35 μL of iodinated contrast medium (iomeprol 350 mgI/mL) into the mesenteric (mesenteric group) or popliteal (popliteal group) lymph nodes. CT images were acquired before injection and 1 min, 3 min, 5 min, 10 min, and 15 min after injection using a micro-CT scanner. Contrast ratios (CRs) were measured at the cisterna chyli and three levels of the TD (diaphragm, carina, and venous angle). Two experienced radiologists qualitatively assessed images as good, fair, or poor.

Results
The mesenteric group had significantly higher mean (± standard deviation) CRs than the popliteal group for all examined regions at 1 min after injection: cisterna chyli (14.01 ± 4.77 versus 1.47 ± 1.21, p < 0.001), diaphragm (7.28 ± 2.50 versus 0.85 ± 0.61, p = 0.0011), carina (10.33 ± 3.42 versus 0.44 ± 0.40, p < 0.001), and venous angle (6.26 ± 2.02 versus 0.79 ± 0.75, p < 0.001). For the TD between the cisterna chyli and the diaphragm, 6/6 mice in the mesenteric group showed strong enhancement, whereas 5/6 mice in the popliteal group showed minimal or no enhancement. The visual scores of the mesenteric group were significantly higher than those of the popliteal group for all the evaluated regions (p = 0.002).

Conclusion
CT lymphangiography via mesenteric lymph node injection provides better imaging of the TD in mice than popliteal lymph node injection.

Relevance statement
This study enhances TD visualization in mice, advancing preclinical research on lymphatic disorders and improving translational applications for better clinical diagnostics and treatments.

Key Points

Mesenteric lymph node injection improved the efficacy of TD CT lymphangiography in mice.

Mesenteric injection provided significantly better TD visualization than popliteal injection.

Enhanced TD visualization in mice advances preclinical research on lymphatic diseases.

Graphical Abstract
Can ChatGPT and Gemini justify brain CT referrals? A comparative study with human experts and a custom prediction model
Authors: Potočnik Jaka , Thomas Edel , Kearney Dearbhla , Killeen Ronan P. , Heffernan Eric J. , Foley Shane J. 
Published: February 2025

Abstract

Background
The poor uptake of imaging referral guidelines in Europe results in a substantial amount of inappropriate computed tomography (CT) scans. Publicly available chatbots, ChatGPT and Gemini, offer an alternative for justifying real-world referrals. Recent research reports high ChatGPT accuracy when analysing American College of Radiology Appropriateness Criteria variants. We compared the chatbots’ performance in interpreting, justifying, and suggesting alternative imaging for unstructured adult brain CT referrals in accordance with the European Society of Radiology iGuide. Our prediction model for automated iGuide categorisation of referrals was also compared against the chatbots.

Methods
The iGuide justification of 143 real-world CT brain referrals, used to evaluate a prediction model, was analysed by two radiographers and radiologists. ChatGPT-4’s and Gemini’s imaging recommendations and pathology suspicions were compared with those of humans, with respect to referral completeness. Inter-rater reliability with κ statistics determined the agreement between entities.

Results
Chatbots’ performance was limited (κ = 0.3) but improved for more complete referrals. The prediction model outperformed the chatbots in justification analysis (κ = 0.853). The chatbots’ interpretations of complete referrals were highly consistent (49/52, 94.2%). The agreement regarding alternative imaging was high for both complete and ambiguous referrals, with ChatGPT and Gemini correctly identifying imaging modality and anatomical region in 83/96 (86.5%) and 81/96 (84.4%) cases, respectively.

Conclusion
The chatbots’ ability to analyse the justification of adult brain CT referrals is limited to complete referrals, unlike our prediction model. Further research is needed to confirm these findings for other types of CT scans and modalities.

Relevance statement
ChatGPT and Gemini exhibit potential in justifying free text brain CT referrals; however, further improvements are required to handle real-world referrals of varying quality.

Key Points

Custom prediction model’s justification analysis strongly aligns with iGuide and surpasses chatbots.

Chatbots incorrectly justified almost one-half of all CT brain referrals.

Chatbots have limited performance in justifying ambiguous CT brain referrals.

Chatbot performance improved when referrals were detailed and included suspected pathology.

Graphical Abstract
Pattern of traumatic brain injury in multiply injured patients at a Nigerian tertiary hospital: a 5-year retrospective study
Authors: Adedire Adejare , Rabiu Taopheeq Bamidele , Faniyi Akinwale John , Oyeniyi Adebukola Ganiyu , Ojewuyi Olajide Olufemi , Ogungbemi Ayodeji Oluwaseun 
Published: February 2025

Abstract

Introduction
Head injuries represent a significant global health concern, particularly among multiply injured patients, often leading to high morbidity and mortality rates. The UNIOSUN Teaching Hospital in Osogbo serves a diverse patient population, many of whom suffer from traumatic injuries. Therefore, a thorough examination of head injury patterns in this context is essential.

Aim
This study aimed to retrospectively analyze the patterns of head injuries among multiply injured patients at UNIOSUN Teaching Hospital over a five-year period, from January 2017 to January 2022.

Methodology
A retrospective analysis was conducted on the medical records of multiply injured patients with head injuries admitted to UNIOSUN Teaching Hospital during the specified period. Data on patient demographics, injury characteristics, treatment received, and outcomes (including referrals, mortality rates, and treatment outcomes) were collected and analyzed.

Results
The study included 56 multiply injured patients with head injuries. Among these patients, 10.7% required referral to another healthcare facility or specialist for further evaluation or treatment, while the remaining 89.3% did not necessitate additional referral. Additionally, 7.1% of patients succumbed to their injuries, resulting in mortality, while 92.9% survived. Regarding treatment outcomes, 71.4% of patients experienced favorable outcomes, while 28.6% had unfavorable outcomes.

Conclusion
This study provides valuable insights into the patterns of head injuries among multiply injured patients at UNIOSUN Teaching Hospital over a five-year period. These findings underscore the importance of timely and effective medical interventions in improving patient outcomes.
COSMIC-021 Phase Ib Study of Cabozantinib Plus Atezolizumab: Results from the Locally Advanced or Metastatic Urothelial Carcinoma Cohorts
Authors: Pal Sumanta K. , Loriot Yohann , Necchi Andrea , Singh Parminder , Castellano Daniel , Pagliaro Lance , Suarez Cristina , McGregor Bradley A. , Vaishampayan Ulka N. , Hauke Ralph J. , Powles Thomas , Van Herpen Carla M.L. , Courtney Kevin D. , Dreicer Robert , Sudhagoni Ramu , Schwickart Martin , Andrianova Svetlana , Agarwal Neeraj 
Published: February 2025

PURPOSE
The COSMIC-021 study assessed the safety and efficacy of cabozantinib plus atezolizumab in advanced solid tumors. Presented here are results from the expansion cohorts with advanced urothelial carcinoma (UC).

METHODS

This phase Ib study (ClinicalTrials.gov identifier:
NCT03170960
) enrolled patients with inoperable locally advanced/metastatic UC into four tumor cohorts: first-line cisplatin-eligible (cis-eligible), first-line cisplatin-ineligible (cis-ineligible), previous platinum-containing chemotherapy (previous chemotherapy-treated), and previous immune checkpoint inhibitor (ICI)–treated. Patients received oral cabozantinib 40 mg once daily and intravenous atezolizumab 1,200 mg once every 3 weeks. The primary end point was objective response rate (ORR), as assessed by the investigator per RECIST v1.1 every 6 weeks for 12 months and every 12 weeks thereafter; the secondary end point was safety.

RESULTS
A total of 121 patients (previous ICI-treated cohort, n = 31, and each of the other cohorts, n = 30) received study treatment from March 2018 to November 2021. The ORR (95% CI) was 30% (15 to 49) for cis-eligible, 20% (8 to 39) for cis-ineligible, 27% (12 to 46) for previous chemotherapy-treated, and 10% (2 to 26) for previous ICI-treated cohorts. The median progression-free survival (95% CI) was 5.5 (1.6 to 11.6), 5.6 (3.1 to 11.1), 5.4 (1.6 to 7.6), and 3.0 (1.8 to 5.5) months, respectively. Grade 3 or 4 treatment-related adverse events (TRAEs) were experienced by 43%, 67%, 57%, and 45% of patients, respectively. TRAEs led to discontinuation of all treatment components in 17%, 13%, 3%, and 19%, respectively. No grade 5 TRAEs were reported in any cohort.

CONCLUSION
The novel combination of cabozantinib plus atezolizumab exhibited clinical activity in advanced UC that is cis-eligible, cis-ineligible, or previously treated with platinum-containing chemotherapy; clinical activity in previous ICI-treated UC was modest. The toxicity profile was consistent with that previously reported for the combination.
The Unfolding Story of Protein Misfolding Causing Alzheimer Disease in Recipients of Human Pituitary Growth Hormone
Authors: Graber Evan G , Hosseini Sayed M Hadi , Wilson Darrell M , Rogol Alan D 
Published: February 2025

Abstract
Human growth hormone (hGH) has been in clinical use for children with GH deficiency (GHD) since the late 1950s. The original formulations were considered very safe with few adverse events reported. That changed remarkably in 1985 when the first patients with GHD, who had been treated with cadaveric hGH, were diagnosed with Creutzfeldt-Jakob disease (CJD).
Fortunately, that same year a robust supply of recombinant hGH was released to the market whose adverse event profile did not include CJD. Patients who had received National Hormone and Pituitary Program hGH have been continuously followed since 1985.
It is clear that prions are causative for CJD. Within the last 10 years there have been reports that similar preparations of cadaveric hGH may have been contaminated with amyloid β (Aβ) protein, a material that is related to Alzheimer disease. Eight patients in the United Kingdom, who had received cadaveric hGH extracted in an analogous manner to that in the United States, had conditions compatible with Alzheimer disease, although they did not fulfill all of the requirements for that diagnosis. In this report we discuss the findings of both CJD and Alzheimer disease, especially as they relate to a possible transmission of the diseases by prions and Aβ protein.
Time Trends in Survival After Surgery for Esophageal Cancer in a National Population-Based Study in Sweden
Authors: Lundberg Ellinor , Mattsson Fredrik , Gottlieb-Vedi Eivind , Lagergren Jesper 
Published: February 2025

Abstract

Background
The long-term survival after surgery for esophageal cancer has improved over the past few decades, but studies that assess recent survival trends are lacking.

Methods
This population-based cohort study included 2291 patients who underwent esophagectomy for esophageal cancer in Sweden between 2000 and 2020, with follow-up until 2024. Data came from medical records and national registries. Calendar time was analyzed as a continuous and categorized variable. The main outcome was all-cause 5-year mortality. Secondary outcomes were disease-specific 5-year mortality and 1-year all-cause mortality. Multivariable Cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for age, sex, comorbidity, tumor histology, neoadjuvant therapy, hospital volume, and pathological tumor stage.

Results
The study period witnessed increasing resection rates, centralization to fewer hospitals, and improving postoperative 5-year survival. When analyzing calendar time as a continuous variable, the adjusted HR for all-cause 5-year mortality was 0.97 (95% CI 0.95–0.98). In categorized analyses, the HRs decreased for each later time period and was 0.57 (95% CI 0.47–0.69) comparing the surgery period 2015–2020 with 2000–2004. The trends were similar for disease-specific 5-year mortality and all-cause 1-year mortality. In stratified analyses, patients with Charlson comorbidity score ≥2 had the strongest improvement in all-cause 5-year mortality (HR 0.45, 95% CI 0.30–0.69 comparing surgery in 2015–2020 with 2000–2004).

Conclusions
The recent 5-year survival has improved after surgery for esophageal cancer in Sweden. This improvement is not explained by lower surgery rates or selection of surgical candidates of younger age, fewer comorbidities, or earlier tumor stage.
Promoting autonomous practice in pre-registration student nurses
Authors: Heath Shaun 
Published: February 2025

General Practice Nurses are autonomous or semi-autonomous practitioners, functioning and working behind closed doors. Shaun Heath looks at how pre-registration students can be helped to experience semi-autonomous practice. Pre-registration student nurse placements have been increasing over the last few years; there is an expectation that by the time a student reaches their final year that they should be practising (semi) autonomously. This article explores how the General Practice Nurse (GPN) can help students experience semi-autonomous practice; patient safety is paramount, however structured assessments developed reflecting educational theory can provide reassurance in autonomy.
Prevalence of antibodies against dengue virus in the city of Buenos Aires: Results of a probabilistic population survey
Authors: Biscayart Cristián , Angeleri Patricia , Bouzas María Belén , Mammana Lilia , Macchia Alejandro 
Published: February 2025

Objective
Dengue is a rapidly growing global health issue. In Argentina, the disease burden is primarily based on case reports or retrospective series; however, there are no prospective probabilistic studies available. To estimate the seroprevalence of antibodies against the dengue virus (DENV) in adult residents of Buenos Aires, at the end of the 2023 season, which culminated in Argentina’s largest recorded dengue outbreak, and immediately before the subsequent outbreak at the beginning of 2024.

Methods
A stratified, multi-stage probabilistic population survey was conducted to ensure representativeness of the adult population of Buenos Aires, considering geographical and socio-economic diversity.The survey determined the seroprevalence rate of DENV IgG and IgM antibodies using a rapid chromatographic immunoassay. Antibody positive participants were invited for re-testing to confirm antibody result using an enzyme-linked fluorescence assay (ELFA) technique.

Results
Out of a sampling frame of 2,998 selected households, the interviewers visited 100% of the residences. The overall response rate was 26.8%. A total of 804 participants were enrolled, representing the city’s 2.38 million adult population. Weighted estimates showed a total of 193,707 people aged 18 and over have antibodies to DENV. This implies a weighted prevalence [95% CI] of 8.12% [8.08%–8.15%]. The prevalence varied across different areas of the city. In the slums, the overall prevalence was twice as high (14.7% [14.5%–14.9%]) compared to the rest of the city (7.67% [7.63%–7.70%]).

Conclusion
Seroprevalence results in adults in Buenos Aires show a moderate DENV infection rate, although still far from the thresholds usually considered for initiating a mass vaccination campaign. These results underscore the need for frequent surveys.
Development of a conceptual framework of sexual health for married elderly women: An exploratory mixed method study
Authors: Saadatmand Farzaneh , Savabi-Esfahani Mitra , Heidari Zahra , Beigi Marjan 
Published: February 2025

Background
Identifying elderly women’s sexual health demands based on their lived experience is essential since it leads to their sexual rights promotion. The present framework was designed to identify sexual demands, develop a reliable and valid questionnaire, and present it to policymakers.

Methods
This conceptual framework was designed in four phases using an exploratory sequential approach. The first phase included a review of related literature to identify elderly women’s sexual health demands. In the second phase, the qualitative phase, the participants will be interviewed to identify their sexual health demands. Data will be collected through in-depth semi-structured interviews until data saturation. In the third phase, a draft questionnaire will be provided using the data from the qualitative study and literature review to measure the sexual health demands of elderly women. Afterward, the face and content validity, as well as the construct and criterion validity, will be determined. The construct and criterion validity will be assessed using exploratory factor analysis and a cross-sectional study on elderly women, respectively. Finally, the reliability of the questionnaire will be determined. In the fourth phase, using the classical Delphi technique, the panel of experts will select the most important demands to present to policymakers.

Results
Based on a literature review conducted from October 20, 2023, to March 15, 2024, the demands were categorized into three main groups: “the elimination of ageist attitudes,” “the elimination of sexism,” and “the elimination of sexual retirement.” Other data and their integration with the literature review data to finalize the categories will be obtained after conducting qualitative interviews. Afterward, the questionnaire will be developed and psychometrically evaluated. Finally, the demands will be prioritized for policymakers.

Conclusion
According to the results, elderly women face social and cultural challenges in maintaining sexual health. Based on the presented methods, comprehensive and complete identification of demands in different cultures can facilitate sexual health planning.
The Cancer Tracking System (CATSystem): Study protocol of a randomized control trial to evaluate a systems level intervention for cervical cancer screening, treatment, referral and follow up in Kenya
Authors: Maloba May , Finocchario-Kessler Sarah , Wexler Catherine , Staggs Vincent , Maosa Nicodemus , Babu Shadrack , Goggin Kathy , Hutton David , Ganda Gregory , Mabeya Hilary , Robertson Elise , Mabachi Natabhona 
Published: February 2025

Background
Cervical cancer (CC) is preventable, yet remains a significant public health threat, particularly in Sub-Saharan Africa. Despite considerable awareness, screening rates for CC in Kenya are low and loss to follow-up following treatment for premalignant cervical lesions remains high. This study investigates the efficacy of the Cancer Tracking System (CATSystem), a web-based intervention, to improve CC screening and treatment retention.

Methods
A matched, cluster randomized controlled trial will be conducted in Kenyan government hospitals (n = 10) with five intervention and five standard-of-care (SOC) sites. The primary outcome is the proportion of women with a positive screen who receive appropriate treatment (onsite or referral). Secondary outcomes include CC screening uptake among all women and timeliness of treatment initiation. We will utilize mixed methods to assess intervention feasibility, acceptability, and cost-effectiveness.

Discussion
The CATSystem has the potential to improve CC care in Kenya by leveraging existing technology to address known barriers in the screening and treatment cascade. This study will provide valuable evidence for potential scale-up of the intervention.