bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term outcomes of induction chemotherapy followed by concurrent chemoradiotherapy and adjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma: a retrospective study
Authors: Zhao Xiaoyan , Tian Ling , Chen Yun , Yang Qing , Xie Tao , Chen Modong , Rao Jinhui , Yang Meng , Huang Ning , Ren Yanxin 
Published: November 2024

BackgroundNasopharyngeal carcinoma (NPC) is a prevalent form of head and neck cancer, particularly in specific regions with a higher incidence. The optimal treatment strategy for locally advanced NPC (stage III and IVA, LA-NPC) involves various combinations of induction chemotherapy (IC), concurrent chemoradiotherapy (CCRT), and adjuvant chemotherapy (AC), each with distinct advantages. This one institutional study aims to retrospectively analysis the efficacy and clinical outcomes of IC with CCRT (IC+CCRT), CCRT with AC (CCRT+AC), and the comprehensive approach of IC followed by CCRT and subsequently AC (IC+CCRT+AC) in the management of LA-NPC.Materials and methodsA total of 352 LA-NPC patients were included: 173 accepted IC+CCRT, 60 received CCRT+AC, and 119 underwent IC+CCRT+AC. The primary endpoints including overall survival (OS) and progression-free survival (PFS), were assessed using the Kaplan-Meier method and log-rank test.ResultsThe median follow-up was 61.2 months (1-216 months). There was no significant difference in 5-year OS and PFS between IC group and no IC group, extending the observation time to 90 months, the OS and PFS were significantly better in IC group than no IC group (OS: 76% vs. 70%,P&lt;0.05; PFS: 76% vs. 71%, P&lt;0.05). Patients with 1, 2, or 3 cycles of IC had higher 5-year OS and PFS than those with more than 3 cycles (1-4 cycles IC OS: 89% vs. 87% vs. 88% vs. 79%, P&lt;0.05; 1-4 cycles IC PFS: 87% vs. 85% vs. 85% vs. 70%, P&lt;0.05). NP regimen demonstrated higher OS and PFS than TP, PF, and TPF regimens (OS: 95% vs. 82% vs. 85% vs. 71%, P&lt;0.05; PFS: 93% vs. 83% vs. 81% vs. 80%, P&lt;0.05). The 5-year OS and PFS were significantly better in AC group than no AC group (OS: 82% vs. 72%, P&lt;0.05; PFS: 81% vs. 69%, P&lt;0.05). In the AC group, there was no differential effect of chemotherapy cycles and chemotherapy regimens on patients’ OS and PFS. In the ThNh group, patients receiving IC+CCRT+AC had higher OS and PFS compared to those receiving IC+CCRT, with no significant difference in the rest (OS: 85% VS 66% P&lt;0.05; PFS: 78% VS 62%, P&lt;0.05).ConclusionCCRT combined with IC or AC could benefit LA-NPC patients. The IC+CCRT +AC regimen was most beneficial for NPC patients with later T and N stages.
Multimodal imaging diagnosis of pancreatic Castleman disease with abdominal and retroperitoneal lymphadenopathy: a case report and literature review
Authors: Jin Chunchun , Deng Meifang , Zhang Jing , Lu Jianghao , Hao Yanli 
Published: November 2024

IntroductionCastleman’s disease (CD) represents a rare polyclonal lymphoproliferative disorder characterized by atypical lymph node hyperplasia, the precise etiology of which remains undefined. Pancreatic involvement of CD is particularly uncommon and often misdiagnosed due to its nonspecific clinical features, making it difficult to distinguish from tumors with abundant blood supply such as solid pseudopapillary tumors and neuroendocrine tumors. Multimodal imaging plays a crucial role in diagnosing pancreatic CD and determining the extent of lymph node involvement. Surgical resection is the preferred treatment for unicentric CD (UCD). Regular follow-up and monitoring are essential for optimal patient management and treatment outcomes.Case PresentationA 26-year-old female presented to our hospital with a pancreatic mass detected during a routine health examination. Physical and laboratory examinations were unremarkable. Conventional ultrasound revealed a hypoechoic, oval-shaped mass measuring approximately 34×31 mm in the pancreatic head, with clear boundaries and heterogeneous internal echoes, but no significant blood flow signals. Contrast-enhanced ultrasound showed hyperenhancement of the pancreatic head mass, raising suspicion for a solid pseudopapillary tumor or other entities. To clarify the diagnosis, Contrast enhanced CT, MRI, and FDG PET-CT were performed. Both Contrast enhanced CT and MRI demonstrated hyperenhancement of the lesion, and PET-CT showed hypermetabolism in the pancreatic head mass, along with multiple enlarged lymph nodes in the abdominal and retroperitoneal regions. These findings suggested a lymph node origin for the pancreatic head mass. Surgical resection was performed, and pathological examination confirmed UCD. The patient has been followed for 44 months without recurrence.ConclusionThis case illustrates the utility of multimodal imaging in diagnosing pancreatic CD. In cases of benign pancreatic lesions with enlarged abdominal and retroperitoneal lymph nodes, CD should be considered.
Congenital isolated adrenocorticotropic hormone deficiency in a newborn caused by TBX19 mutation: a case report and literature review
Authors: Dang Yinxia , Zhang Juanli , Wang Fan 
Published: November 2024

BackgroundTo investigate the clinical phenotype, genetic characteristics, and prognosis of isolated adrenocorticotropic hormone deficiency in a newborn (IAD, OMIM 201400) caused by mutation of the TBX19 gene.Case presentationThe clinical features, diagnosis, treatment, and prognosis of a newborn with IAD admitted to our hospital were retrospectively analyzed. The patient and his parents were also examined by whole exome sequencing. We used the terms “newborn”, “child”, “congenital isolated adrenocorticotropic hormone deficiency”, and “TBX19” to retrieve relevant studies published up to December 2023 from the following databases: China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Medical Journal Full-text Database, VIP database, Sinomed, PubMed, Embase, and Web of Science. The clinical and genetic characteristics of children from these other publications were summarized. The newborn boy with IAD was admitted to our hospital with poor mental response, feeding difficulties, hypoglycemia, and jaundice. The brain and adrenal MRI results were normal. Clinical whole exome sequencing showed that the boy carried compound heterozygous variants in the TBX19 gene. Specifically, the first exon had a novel frameshift mutation, c.240-246del(p.leu81Profs*54, NM_005149.3), and a missense mutation, c.377C&gt;T(p.Pro126leu, NM_005149.3). The literature search found 34 additional cases from 4 Chinese-language articles and 12 English-language articles. The main clinical manifestations were hypoglycemia, jaundice, convulsions, feeding difficulties, poor mental response, hypotonia, and growth retardation. There were 24 cases with TBX19 mutations, and 19 different mutation sites. Among the 15 patients with different degrees of nervous system developmental delays, 13 initiated treatment when more than 1-year-old.ConclusionIAD from TBX19 mutation causes nonspecific symptoms. Genetic testing is the key to diagnosis. Early diagnosis and treatment can help to improve the prognosis and prevent neurological complications.
Clinical Trial Registrationidentifier (2024A-796).
Efficacy and safety of glucocorticoid combined with cyclophosphamide therapy on membranous nephropathy: a systematic review and meta-analysis
Authors: Feng Chengcheng , Chen Xuexun , Wang Xiangming , Guo Min , Guo Zhentao 
Published: November 2024

BackgroundThis review systematically evaluates the efficacy and safety of the combined treatment of glucocorticoids (GC) and cyclophosphamide (CTX) in patients with membranous nephropathy (MN).MethodsAs of June 2024, a comprehensive literature search was performed utilizing several reputable databases, including PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang. A meta-analysis was then carried out using Review Manager 5.4 and STATA/SE-15 software.ResultsThis research evaluated a total of 22 articles involving 1,971 patients. The findings revealed that patients with MN receiving combined GC and CTX therapy had significantly higher complete remission rates (odds ratio = 1.78, p = 0.02) and total remission rates (odds ratio = 2.14, p = 0.01) when the follow-up period exceeded 12 months. Additionally, this treatment demonstrated greater efficacy in lowering serum creatinine levels compared to the control group (standardized mean difference = −0.19, p = 0.04), while its relapse rate was also lower than that of the control group (odds ratio = 0.51, p = 0.009). However, it has a high incidence of serious adverse effects (odds ratio = 2.32, p = 0.03).ConclusionOur systematic review highlights that the combination of GC and CTX demonstrates superior long-term effectiveness and reduced relapse rates in managing membranous nephropathy (MN). Furthermore, this drug combination is considered the optimal choice for normalizing serum creatinine levels. Data on the effectiveness and safety of glucocorticoids alone versus other drugs alone, and the treatment of secondary membranous nephropathy (SMN), are limited.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=566477, identifier CRD42024566477.
Contactless and continuous monitoring of respiratory rate in a hospital ward: a clinical validation study
Authors: Toften Ståle , Kjellstadli Jonas T. , Kværness Jørn , Pedersen Line , Laugsand Lars E. , Thu Ole K. F. 
Published: November 2024

IntroductionContinuous monitoring of respiratory rate in hospital wards can provide early detection of clinical deterioration, thereby reducing mortality, reducing transfers to intensive care units, and reducing the hospital length of stay. Despite the advantages of continuous monitoring, manually counting every 1–12 h remains the standard of care in most hospital wards. The objective of this study was to validate continuous respiratory rate measurements from a radar-based contactless patient monitor [Vitalthings Guardian M10 (Vitalthings AS, Norway)] in a hospital ward.MethodsAn observational study (clinicaltrials.gov: NCT06083272) was conducted at the emergency ward of a university hospital. Adult patients were monitored during rest with Vitalthings Guardian M10 in both a stationary and mobile configuration simultaneously with a reference device [Nox T3s (Nox Medical, Alpharetta, GA, United States)]. The agreement was assessed using Bland-Altman 95% limits of agreement. The sensitivity and specificity of clinical alarms were evaluated using a Clarke Error grid modified for continuous monitoring of respiratory rate. Clinical aspects were further evaluated in terms of trend analysis and examination of gaps between valid measurements.Results32 patients were monitored for a median duration of 42 min [IQR (range) 35–46 (30–59 min)]. The bias was 0.1 and 0.0 breaths min−1 and the 95% limits of agreement ranged from −1.1 to 1.2 and −1.1 to 1.1 breaths min−1 for the stationary and mobile configuration, respectively. The concordances for trends were 96%. No clinical alarms were missed, and no false alarms or technical alarms were generated. No interval without a valid measurement was longer than 5 min.ConclusionVitalthings Guardian M10 measured respiratory rate accurately and continuously in resting patients in a hospital ward.
The relationship between physical activity and psychological sub-health among high altitude region Tibetan college students
Authors: Wang Shoudu , Niu Zhining , Xiong Jianping , Chai Guangxin , Ye Xingli 
Published: November 2024

BackgroundThe reduction in moderate to vigorous physical activity (MVPA) and the increased prominence of psychological sub-health (PSH) have had a serious negative impact on the health of Tibetan college students. Few studies have been conducted on college student populations at high altitude region in China. Therefore, the study investigated MVPA and PSH in 8721 Tibetan college students to analyze the relationship that exists between them.MethodsIn this study, subjects were selected by cluster sampling method, and 8,721 high altitude region Tibetan college students were questioned about MVPA, PSH, family situation, BMI, and lifestyle. One-way ANOVA, chi-square test, and stepwise logistic regression analysis were used to analyze the relationship between MVPA and PSH.ResultsThe proportion of Chinese Tibetan college students at high altitude region with MVPA duration ≤30 Mins/Day, 31–60 Mins/Day, and ≥ 61 Mins/Day were 76.7, 18.7, and 4.7%, respectively. The proportion of Tibetan college students in China experiencing PSH was 16.41%. The percentage of emotional symptoms, behavioral symptoms, and social adaptation difficulties were 17.61, 18.04, and 14.59%, respectively. Logistic regression analysis showed that after adjusting for relevant covariates, Tibetan college students with MVPA ≤30 Mins/Day had a higher odds ratio of PSH compared to college male students with MVPA ≥61 Mins/Day (OR = 2.95, 95% CI: 1.79,4.84). In contrast, there was no significant relationship between MVPA and PSH in college females. Overall, Tibetan college students with MVPA ≤30 Mins/Day had a higher odds ratio of PSH compared to Tibetan college students with MVPA ≥61 Mins/Day (OR = 2.99, 95% CI: 2.00,4.47).ConclusionChinese Tibetan college students from high altitude region areas had lower levels of MVPA and higher rates of PSH. There is an relationship between MVPA time and PSH among high altitude region Tibetan college students, and the incidence of PSH is higher among high altitude region Tibetan college students with shorter MVPA time.
Revitalizing preschool minds: a fresh approach to arts-based brain health interventions
Authors: Siette Joyce , Anderson Emily , Catanzaro Michelle 
Published: November 2024

IntroductionBrain health interventions seek to cultivate enduring, health-promoting behaviors for an enhanced quality of life. Despite this objective, achieving sustained adoption and engagement of healthy lifestyle behaviors remains a challenge, prompting the exploration of innovative avenues for promoting brain health. The potential of integrating brain health education in younger populations is particularly promising, given the likelihood of these habits persisting into adulthood. This study thus aimed to identify parental perspectives on a performing arts-based brain health intervention for implementation in preschool settings.MethodsPreschool parents and early learning center staff participated in three focus co-design groups (n = 12) to create a prototypical performing arts brain health intervention. Each focus group was recorded, transcribed and analyzed using deductive thematic analysis.ResultsThree main themes for effective brain health interventions in preschool settings were identified: optimizing logistical processes to ensure efficient delivery and scalability, recognizing motivation as a central factor influencing sustained engagement across all stakeholders, and tailoring educational content with specialized explanations for children to enhance comprehension and relatability. A new implementation approach was proposed to support an arts-based brain health intervention designed for preschools.ConclusionsThese findings have important implications for the future of brain health education focusing on youth populations and a lifelong approach to dementia risk prevention strategies. By addressing logistical challenges, prioritizing motivation, and tailoring explanations to the unique needs of children, future programs can be more adaptable and successful in fostering positive and sustainable brain health behaviors.
Association of mixed polycyclic aromatic hydrocarbons exposure with hearing loss and the mediating role of blood cell markers of inflammation in U.S. adults
Authors: Shen Peixuan , Hu Dan , Shen Meiyue , Du Tingwei , Zhao Longzhu , Han Miaomiao , Song Ruihan , Guo Rongrong , Lu Xiaochuan , Liu Shengnan , Shen Xiaoli 
Published: November 2024

IntroductionStudies on the effects of polycyclic aromatic hydrocarbons (PAHs) on hearing loss (HL) are limited and often focus on individual PAH compounds. The present study aimed to explore the individual and combined effects of PAH exposure on hearing loss, with a focus on the mediating role of inflammatory blood cell markers.MethodsThis cross-sectional study included 1,409 participants from 3 cycles of the National Health and Nutrition Examination Survey (2001–2002, 2003–2004, and 2011–2012). Seven monohydroxylated PAH metabolites (OH-PAHs) in the urine were measured. Multivariable logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) were applied to assess both the individual and combined effects of OH-PAHs on hearing loss. Moreover, mediation analysis was employed to examine the mediating role of inflammatory blood cell markers in these associations.ResultsAmong the 1,409 participants, 59.1% had hearing loss. The WQS model revealed a positive association between PAH mixtures and HL (OR: 1.290; 95% CI: 1.042, 1.597), LFHL (OR: 1.363; 95% CI: 1.130, 1.644), and HFHL (OR: 1.299; 95% CI: 1.022, 1.626). Additionally, the WQS model identified hydroxynaphthalene (1-OHNAP) primarily contributed to HL and LFHL, while 2-hydroxyfluorene (2-OHFLU) was the primary contributor to HFHL. BKMR analysis demonstrated positive associations between PAH mixtures and all three types of hearing loss. Mediation analysis revealed that the association between OH-PAHs and LFHL was mediated by neutrophil (NEU) and basophil (BAS) counts.DiscussionThese results confirmed that exposure to PAH mixtures was positively associated with the odds of hearing loss and that inflammatory blood cell markers mediated this association.
Current data science capacity building initiatives for health researchers in LMICs: global & regional efforts
Authors: Kiosia Agklinta , Boylan Sally , Retford Matthew , Marques Larissa Pruner , Bueno Flávia Thedim Costa , Kirima Christine , Islam Md Saimul , Naheed Aliya , Wozencraft Anne 
Published: November 2024

BackgroundData science approaches have proved crucial for generating major insights to address public health challenges. While such approaches have played significant roles during the COVID-19 pandemic, there has been limited investment in capacity building in data science skills and infrastructure for health researchers in LMICs.ObjectivesThis review aims to identify current health data science capacity building initiatives and gaps in Africa, Asia, and Latin America and the Caribbean (LAC), to support knowledge sharing and collaborations, and inform future initiatives and associated investment.MethodsWe conducted a literature review using PubMed and Scopus, supplemented by a grey literature search on Google to identify relevant initiatives. Articles were screened based on inclusion criteria.FindingsFrom 212 records, 85 met inclusion criteria, with 20 from PubMed and Scopus, and 65 from grey literature. The majority of programmes are tailored to specific disease areas, varying by region. Despite these efforts, there are limited initiatives with a clear, documented strategy on data science capacity building to accelerate global research insights, with the majority adopting a fragmented approach.Conclusion and future directionsDespite the integration of data science approaches into health research initiatives in LMICs, there is a need for a standardised framework on data science capacity building to facilitate multidisciplinary and global collaboration. Structured approaches, inter-disciplinary, inter-regional connections and robust impact measurement will all be vital for advancing health research insights in these settings.
Predicting place of delivery choice among childbearing women in East Africa: a comparative analysis of advanced machine learning techniques
Authors: Ngusie Habtamu Setegn , Tesfa Getanew Aschalew , Taddese Asefa Adimasu , Enyew Ermias Bekele , Alene Tilahun Dessie , Abebe Gebremeskel Kibret , Walle Agmasie Damtew , Zemariam Alemu Birara 
Published: November 2024

BackgroundSub-Saharan Africa faces high neonatal and maternal mortality rates due to limited access to skilled healthcare during delivery. This study aims to improve the classification of health facilities and home deliveries using advanced machine learning techniques and to explore factors influencing women's choices of delivery locations in East Africa.MethodThe study focused on 86,009 childbearing women in East Africa. A comparative analysis of 12 advanced machine learning algorithms was conducted, utilizing various data balancing techniques and hyperparameter optimization methods to enhance model performance.ResultThe prevalence of health facility delivery in East Africa was found to be 83.71%. The findings showed that the support vector machine (SVM) algorithm and CatBoost performed best in predicting the place of delivery, in which both of those algorithms scored an accuracy of 95% and an AUC of 0.98 after optimized with Bayesian optimization tuning and insignificant difference between them in all comprehensive analysis of metrics performance. Factors associated with facility-based deliveries were identified using association rule mining, including parental education levels, timing of initial antenatal care (ANC) check-ups, wealth status, marital status, mobile phone ownership, religious affiliation, media accessibility, and birth order.ConclusionThis study underscores the vital role of machine learning algorithms in predicting health facility deliveries. A slight decline in facility deliveries from previous reports highlights the urgent need for targeted interventions to meet Sustainable Development Goals (SDGs), particularly in maternal health. The study recommends promoting facility-based deliveries. These include raising awareness about skilled birth attendance, encouraging early ANC check-up, addressing financial barriers through targeted support programs, implementing culturally sensitive interventions, utilizing media campaigns, and mobile health initiatives. Design specific interventions tailored to the birth order of the child, recognizing that mothers may have different informational needs depending on whether it is their first or subsequent delivery. Furthermore, we recommended researchers to explore a variety of techniques and validate findings using more recent data.