bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating AI in Clinical Education: Evaluating General Practice Residents’ Proficiency in Distinguishing AI-Generated Hallucinations and Its Impacting Factors
Authors: Zhou Jiacheng , Zhang Jintao , Wan Rongrong , Cui Xiaochuan , Liu Qiyu , Guo Hua , Shi Xiaofen , Fu Bingbing , Meng Jia , Yue Bo , Zhang Yunyun , Zhang Zhiyong 
Published: November 2024

Abstract

OBJECTIVE To evaluate the ability of general practice residents to detect AI-generated hallucinations and assess the influencing factors.METHODS This multi-center study involved 142 general practice residents, all of whom were undergoing standardized general practice training and volunteered to participate. The study evaluated AI’s accuracy and consistency, along with the residents’ response time, accuracy, sensitivity(d’), and standard tendencies (β). Binary regression analysis was used to explore factors affecting the residents' ability to identify AI-generated errors.RESULTS 137 participants ultimately included had an mean (SD) age 25.93 ± 2.10, with 46.72% male, 81.75% undergraduates, and 45.26% from Jiangsu. Regarding AI, 52.55% were unfamiliar with it, 35.04% had never used it. ChatGPT demonstrated 80.8% overall accuracy, including 57% in professional practice. 87 AI-generated hallucinations were identified, primarily in the level of application and evaluation. The mean (SD) accuracy was 55% ±4.3%, and the mean (SD) sensitivity (d') was 0.39 ± 0.33. The median response bias (β) was 0.74 (0.31). Regression analysis revealed that shorter response times (OR = 0.92, P = 0.02), higher self-assessed AI understanding (OR = 0.16, P = 0.04), and frequent AI use (OR = 10.43, P = 0.01) were associated with stricter error detection criteria.CONCLUSIONS The study concluded that residents struggled to identify AI errors, particularly in clinical cases, emphasizing the importance of improving AI literacy and critical thinking for effective integration into medical education.
Novel Gene expression-based Risk Stratification tool predicts recurrence in Non-muscle invasive Bladder cancer
Authors: N Srivatsa , S Hari P , P Rahul , Paul Lista , Veeraiyan Durgadevi , Narikot Ambili , Veldore Vidya , Tanwar Nishtha , P Srikanthreddy , Goswami Hitesh , Kumar Rekha V , S Srinath B , Korlimarla Aruna 
Published: November 2024

Abstract

Bladder cancer is a heterogeneous disease that has a very unique challenge in treatment and management. The disease at the start could be indolent and slow growing and display low potential for further progression to muscle-invasive. Once it is frankly muscle invasive, there is a high risk of distant metastasis. NMIBC can be managed with conservative treatment with the procedure TURBT (Transurethral resection of bladder tumor) whereas an aggressive surgical intervention is required if it is muscle invasive. Risk stratification, traditionally used, like the EORTC score, employs clinicopathologic features of the disease to provide prognostic information that assists in choosing the best therapy for each individual patient. Most important decisions to be made are type of intravesical therapy and whether or not to administer neoadjuvant chemotherapy. Though the EORTC scores are of great utility in making these decisions, they frequently fall short and are successful only 70% of the time and results in local recurrence as well as muscle invasion. Much of the research in the recent past has adopted tumor genetic sequencing and correlated with clinical outcomes. In the current study we have explored a transcriptomics-based mRNA score that successfully predicts early NMIBC recurrence with median 90% accuracy and arrived at a comprehensive gene set. The gene set demonstrates a comparable and higher predictive trend as compared to other score based predictive tools. We clearly demonstrate that risk score-based sub stratifications by mRNA expression could potentially reduce over investigation and improve surveillance costs after TURBT in patients with primary high-risk NMIBC.
Mapping the Landscape of Hospital at Home (HaH) Care: A Validated Taxonomy for HaH Care Model Classification
Authors: Denecke Kerstin 
Published: November 2024

Abstract

Background: Hospital at home (HaH) care models have gained significant attention due to their potential to reduce healthcare costs, improve patient satisfaction, and lower readmission rates. However, the lack of a standardized classification system has hindered systematic evaluation and comparison of these models. Taxonomies serve as classification systems that simplify complexity and enhance understanding within a specific domain.
Objective: This paper introduces a comprehensive taxonomy of HaH care models, aiming to categorize and compare the various ways HaH services are delivered as an alternative to traditional hospital care.
Methods: We developed a taxonomy of characteristics for HaH care models based on scientific literature and by applying a taxonomy development framework. To validate the taxonomy, and to analyze the current landscape of HaH models we matched the taxonomy to HaH care models described in literature. Finally, to identify archetypes of care models, we applied the k-means clustering method to the care models described using the taxonomy.
Results: Our taxonomy consists of 12 unique dimensions structured into 5 perspectives following the progression from triaging, through care delivery, operational processes, and metrics for success: Persons and roles (2 dimensions), Target population (1 dimension), Service delivery and care model (6 dimensions), outcomes and quality metrics (2 dimensions),and training and education (1 dimension). Each dimension aggregates between 1 and 20 characteristics. We identified three clusters within a dataset of 34 HaH care approaches.
Conclusions: The developed taxonomy offers a valuable framework for healthcare providers, policymakers, and researchers to systematically evaluate and implement HaH care models. The challenges encountered in collecting information on different characteristics of the taxonomy underscore the urgent need for more comprehensive and standardised reporting in scientific papers on HaH interventions.
The biomechanical study of different fixation techniques for combination fractures of atlas and axis: a finite element analysis.
Authors: Liu Chao , Huang Kai , Dai Lei , Huang Xiaogang , Zhang Xinjun 
Published: November 2024

Abstract

Combination atlas-axis fractures are less studied but relatively common with a higher incidence of neurological deficits than isolated C1 or C2 fractures. Several authors focused on the treatment strategies, but there is no study to compare the stability of different fixation methods; neither not yet cleared which technique represents the best choice and whether stabilization devices can be efficient and beneficial for complex atlantoaxial fractures. The aim of this study was to compare the biomechanical properties of three fixation techniques: atlantoaxial pedicle screws fixation(PSF), occipital-cervical fusion(OCF) and transarticular screw fixation(TSF) based on combination factures model. Our results showed the range of motion(ROM) of fracture model increased obviously than intact model. The ROM in flexion/extension and rotation of C0-C1 in PSF and TSF models were increased. The ROM of C1-C2 in all conditions in PSF, OCF and TSF models were decreased. The ROM of C2-C3 was decreased in OCF but remain the same stage in PSF and TSF. These suggested that three surgical methods are effective for the combination fractures of atlas and axis, which can ensure good stability. It can properly increase the ROM of C0-C1 when use PSF. These findings would aid in the treatment of this complex fractures.
Experimental Modeling and Process Optimization of Laser Transmission Welding with Fiber Optic Laser for Polymethyl Methacrylate in Zigzag Path
Authors: Rahmaninia Milad , Ghoreishi Majid 
Published: November 2024

Abstract

This study experimentally evaluated Laser Transmission Welding (LTW) between two transparent and identical Polymethyl Methacrylate (PMMA) sheets using a fiber optic laser following a zigzag path. The research focused on the effects of laser power, welding speed, and distance between scan lines on lap-shear force, weld-seam width, and changes in weld morphology. Pyrometry was used to measure the welding temperature and determine input parameters. Analysis of Variance (ANOVA) and Response Surface Methodology (RSM) were employed to analyze and optimize the input parameters for maximum lap-shear force and minimal weld-seam width. The findings indicated that higher laser power, slower welding speed, and a reduced distance between scan lines increased heat input, leading to enhanced polymer melting and improved weld strength, reflected by higher lap-shear force and broader weld-seam width. Conversely, lower heat input decreased both lap-shear force and weld-seam width. Optimal values for lap-shear force and weld-seam width were determined to be 886.4 N and 26.37 mm, respectively, through multi-objective optimization. The zigzag welding path contributed to uniform heat distribution, even mixing of melted materials, and better structural integrity in the weld zone. Morphological analysis revealed that the weld strength was enhanced due to the presence of smaller, evenly distributed bubbles in the weld pool, attributed to the zigzag path. These findings highlight the significance of controlling welding parameters to optimize strength and seam quality in laser transmission welding of PMMA.
Global Trends in Polycystic Ovarian Syndrome Over 30 Years: An Age-Period-Cohort Study of 204 Countries and Territories (1990- 2021)
Authors: Lin Lanxiang , Li Wenhui , Xu Baozhu , Li Yuefeng , Li Jin , Kong Xiangjun , Du Xin 
Published: November 2024

Abstract

Objective
Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder affecting women globally, with significant increases in incidence over the past three decades. Despite the rising prevalence, limited data exist on the global incidence trends of PCOS, especially across diverse socio-demographic contexts.
Methods
This study analyzed PCOS incidence trends from 1990 to 2021 across 204 countries using an age-period-cohort (APC) analysis. Data were sourced from the Global Burden of Disease Study 2021, focusing on crude and age-standardized incidence rates, disaggregated by region and socio-demographic index (SDI).
Results
The global incidence of PCOS increased from 1.48 million cases in 1990 to 2.3 million in 2021. The age-standardized incidence rate in 2021 was 63.26 per 100,000 population (95% CI: 45.41 to 87.28). High SDI regions recorded the highest incidence rates, with a rate of 90.13 per 100,000 (95% CI: 66.94 to 122.36). In contrast, low SDI regions had the lowest incidence rates at 36.8 per 100,000 (95% CI: 25.83 to 52.19). The APC model revealed a global net drift of 0.18 (95% CI: -0.02 to 0.37), with significant age and period effects, particularly among younger age groups.
Conclusion
The study underscores a significant global rise in PCOS incidence, particularly in high SDI regions and among younger age groups. These findings highlight the need for targeted public health interventions and further research to address the growing burden of PCOS.
Superiority of photon-counting computed tomography for detecting high-risk unstable angina patients: two case reports
Authors: Ho Thuong Dung , Nguyen Duong Quoc Anh , Tran Thi Quynh Huong , Mai Hoang Dil , Nguyen Duc Chinh 
Published: November 2024

Abstract

Coronary artery disease is the leading cause of death among non-communicable diseases. The management strategy prioritizes early detection and optimal treatment, with emerging roles for imaging approaches. Photon-counting computed tomography is a new non-invasive diagnostic imaging tool that can detect high-risk plaques in coronary artery disease patients. Using photon-counting computed tomography in screening and intravascular ultrasound later in verifying diagnosis and intervention guidance could be a new technique to swiftly discover unstable plaques, prepare lesions for surgery, and determine the optimal percutaneous intervention strategy. However, there is no documentation available for this new approach. We reported two acute coronary syndromes managed with a combination of two imaging methods. Despite receiving medical therapy, the first case continued to experience chest pain, leading to the detection of plaque ulceration in the left anterior descending artery. On the other hand, two PCCT screenings within 6 months revealed plaque progression in the second case. We then used IVUS to confirm the lesions and proceed to intervention. We successfully discharged both cases, and they showed no symptoms 6 months after discharge.
Modified End-Expiratory Occlusion Test in Older Adults during Intraoperative Lung-Protective Ventilation: A Randomized Two-period Crossover Trial
Authors: Chen Han , Li Xiao-Xiao , Zhou Jian-Wen , Zhu Yu-Jing , Zhang Tan , Tang Jun 
Published: November 2024

Abstract

Background
The end-expiratory occlusion (EEO) test is a valuable tool for predicting fluid responsiveness, yet its efficacy during lung-protective ventilation remains debated. This study aimed to evaluate the efficacy and safety of a modified 30-second EEO in older patients undergoing surgery.
Methods
This randomized, controlled, two-period crossover trial included 66 patients receiving elective general anesthesia. Patients were randomized into two groups. Group A received a 15-second EEO followed by a 30-second EEO, while Group B received the tests in reverse order. A fluid challenge of 250 ml 0.9% saline was administered to identify fluid responders, defined as an increase in stroke volume index (ΔSV) ≥ 10%. Hemodynamic parameters were recorded using pulse contour analysis.
Results
Of the 63 patients analyzed, 41 were classified as responders. A 6% increase in ΔSV after the 15-second EEO identified responders with an AUC of 0.86, while a 10% increase after the 30-second EEO had an AUC of 0.91. Although both EEO durations effectively predicted fluid responsiveness, the 30-second EEO showed higher specificity (100%) compared to the 15-second EEO (82%).
Conclusion
Stroke volume changes induced by the EEO test can predict fluid responsiveness in older adults undergoing lung-protective ventilation. Extending the occlusion time improves the specificity of the test. The modified 30-second EEO may offer a practical and reliable method to enhance intraoperative safety.
Trial Registration
The study was retrospectively registered at Chictr.org.cn with the number ChiCTR2100049587 on 08/05/2021.
Intraoperative hypotension and postoperative risks in non-cardiac surgery: A meta- analysis
Authors: Qin Guanchao , Du Ming-cheng , Yi Ke-xin , Gong Yuan 
Published: November 2024

Abstract

Background
Postoperative complications are often associated with the severity and duration of intraoperative hypotension. However, the optimal approach to manage hypotension during surgery remains controversial. The aim of this meta-analysis of randomized controlled trials was to compare the incidence of common postoperative complications with different levels of hypotension management.
Methods
We searched PubMed, the Cochrane Database, and Embase from August 2014 to August 2024 for studies comparing different levels of hypotension management (low [mean arterial pressure < 60 mmHg], moderate [60–75 mmHg], and high levels [> 75 mmHg]). Only randomized controlled trials conducted during 2014–2024 were included in this meta-analysis without language restrictions. Studies with the following characteristics were included: randomized controlled study; involved non-cardiac, non-obstetric surgery; included different blood pressure management strategies; evaluated major postoperative complications; and included acute kidney injury, myocardial injury, altered consciousness, or infection. Data included patient age, type of surgery, group criteria, and adverse events. Mantel–Haenszel method was used for analysis. The primary outcomes were postoperative complications, including acute kidney injury. The secondary outcomes included length of hospital stay and all-cause mortality.
Results
Of the 2160 studies identified, eight randomized controlled trials with 9108 participants were included. No significant differences in postoperative complications were observed between the moderate and high mean arterial pressure management groups (risk ratio = 1.0, 95% confidence interval = 0.86–1.18, P = 0.96). Sensitivity analysis confirmed these findings. Length of hospitalization was not significantly different between the groups (standardized mean difference = -0.39; 95% confidence interval = -0.69 to 1.31; P = 0.03). Limited data prevented meta-analysis of mean arterial pressure management at lower levels.
Conclusion
Moderate hypotension management may reduce the length of hospital stay. However, the available evidence suggests no significant differences in postoperative complications between moderate and high levels of hypotension management.
The level of routine health information system data quality and associated factors at public hospitals in the Silte Zone, Central Region, Ethiopia, 2023: A mixed study
Authors: Dukamo Nigussie , Tamiso Alemu , Adane Adugnaw , Asefa Abriham , Misganaw Samuel , Belayneh Mehretu 
Published: November 2024

Abstract

Background
Routinely collected data of poor quality can compromise the validity of effectiveness evaluations and lead to poor decision-making, inappropriate resource allocation, and a loss of trust in the health system. Routine health information system data are seen as poor in quality, are not used for decisions in Ethiopia, and continue to be a significant problem.
Methods and materials:
A facility-based mixed-method study with an embedded design was conducted. A total of four public hospitals, 32 departments or units, 605 healthcare workers, and 12 key informant interviews were selected. Simple random sampling and purposive sampling techniques were used for selecting study participants in the quantitative and qualitative studies, respectively. The data were entered into Epi-data version 4.4, Open Code version 4.03, and exported to SPSS version 26, and descriptive statistics were used to assess the level of data quality. Binary logistic regression and thematic analysis were run to identify factors affecting data quality. Adjusted odds ratios with 95% confidence intervals and themes or subthemes were reported.
Results
The overall facility data quality level was 90.84%; and the completeness and consistency of the data were 85.5% and 85.3%, respectively. Easy understandability of registration and report formats [AOR 1.92; CI 1.11–3.33], receiving training [AOR 1.62; CI 1.07–2.44], receiving supervision [AOR 1.66; CI 1.05–2.61], providing regular feedback [AOR 1.72; CI 1.07–2.75], the team's work being appreciated and valued by supervisors [AOR 1.61; CI 1.04–2.75] and making decisions and follow-up actions identified in performance monitoring team meetings [AOR 1.73; CI 1.12–2.67] were significantly associated with data quality; and thematic analysis was performed and categorized into four themes and twelve subthemes.
Conclusion and recommendation:
The level of data quality at the public hospital in the Silte Zone is almost equal to the national expected level of data quality, but the completeness and consistency of the data were lower than the national expected level. The Minister of Health and other supporting organizations should intervene in the identified gaps, especially to reduce incompleteness and inconsistency of data.
A New Scoring System to Predict Febrile Urinary Tract Infection After Retrograde Intrarenal Surgery
Authors: Senel Cagdas , Erkan Anil , Keten Tanju , Aykanat İbrahim Can , Ozercan Ali Yasin , Tatlici Koray , Basboga Serdar , Saracli Sinan , Guzel Ozer , Tuncel Altug 
Published: November 2024

Abstract

Purpose: To determine the risk factors and define a new scoring system for predicting febrile urinary tract infection (F-UTI) following retrograde intrarenal surgery (RIRS) by using machine learning methods.
Methods: We retrospectively analyzed the medical records of patients who underwent RIRS and 511 patients were included in the study. The patients were divided into two groups: Group 1 consisted of 34 patients who developed postoperative F-UTI, and Group 2 consisted of 477 patients who did not. We applied feature selection to determine the relevant variables. Consistency subset evaluator and greedy stepwise techniques were used for attribute selection. Logistic regression analysis was conducted on the variables obtained through feature selection to develop our scoring system. The accuracy of discrimination was assessed using the receiver operating characteristic curve.
Results: Five of the 19 variables, namely diabetes mellitus, hydronephrosis, administration type, a history of post-ureterorenoscopy (URS) UTI, and urine leukocyte count, were identified through feature selection. Binary logistic regression analysis showed that hydronephrosis, a history of post-URS UTI, and urine leukocyte count were significant independent predictors of F-UTI following RIRS. These three factors demonstrated good discrimination ability, with an area under curve value of 0.837. In the presence of at least one of these factors, 32 of 34 patients who developed postoperative F-UTI were successfully predicted.

Conclusion: This new scoring system developed based on hydronephrosis, a history of post-URS UTI, and urine leukocyte count can successfully discriminate patients at risk of F-UTI development after RIRS.