bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns of lymph node metastasis in 441 patients with sinonasal squamous cell carcinoma
Authors: Wang Li , Wang Jie , Wang Tian , Li Yi , Song Xinmao 
Published: November 2024

Background: Due to the rarity of sinonasal squamous cell carcinoma (SNSCC), the distribution patterns of lymph node metastasis (LNM), the relationship between LNM and prognosis, and the optimal treatment of LNM lack sufficient evidence-based support. Objectives: To investigate the patterns of LNM in SNSCC and evaluate the impact of LNM on prognosis. Design: This was a retrospective cohort study. Methods: The medical records of 441 patients with SNSCC between 2009 and 2022 in one institution were retrospectively reviewed. We assessed the incidence, the distribution of LNM, and the relationship between LNM and long-term survival. Results: Seventy-three out of 441 patients (16.6%) presented LNM initially. Among the 73 patients, 34 patients (46.6%) had LNM in the region of ipsilateral level II; 22 patients (30.1%) had positive retropharyngeal lymph nodes; 20 patients (27.4%) had LNM in the region of ipsilateral level Ib; and nine patients (12.3%) had evidence of parotid LNM. Poor differentiation ( p = 0.001), nasal cavity ( p = 0.018), skin involvement ( p = 0.036), and nasopharynx involvement ( p = 0.009) were the risk factors for LNM. In the univariate and multivariate analyses, the overall survival ( p = 0.25), progression-free survival ( p = 0.22), regional failure-free survival ( p = 0.20), and distant metastasis-free survival ( p = 0.14) rates were not significantly decreased by the LNM. After the propensity score matching, LNM was still not correlated with poor long-term survival. Conclusions: The incidence of retropharyngeal and parotid LNM was higher than in previous studies. At initial diagnosis, the risk factors for LNM were identified, and LNM was not associated with poor survival outcomes.
Disrupted emotion regulation and spontaneous neural activity in panic disorder: a resting-state fMRI study
Authors: Wang Hai-Yang , Guan Bei-Yan , Wang Shi-Yao , Ni Ming-Fei , Miao Yan-Wei , Tian Feng , Chen Yumin , Wu Meng-Li , Li Rui , Zhang Bing-Wei 
Published: November 2024

Background: Emotional dysregulation, particularly unconscious catastrophic cognitions, plays a pivotal role in the genesis of panic disorder (PD). However, no studies have yet applied the percentage of amplitude fluctuation (PerAF) metric in resting-state functional magnetic resonance imaging to examine spontaneous neural functioning and its relation to catastrophic cognitions in PD. Objectives: To explore the interplay between resting-state neural activity, functional connectivity (FC), and unconscious emotion regulation in individuals with PD. Design: Cross-sectional study. Methods: The study encompassed 51 participants, including 26 PD patients and 25 healthy individuals. The PerAF algorithm was employed to explore the local spontaneous neural activity in PD. Regions exhibiting aberrant spontaneous neural activity were used as seed points for whole-brain FC analysis. Correlations were utilized to examine associations between local neural activity patterns and neurocognitive assessments in PD. Results: The study revealed that compared to healthy individuals, PD patients exhibited elevated PerAF values in key emotion-regulation-related brain regions, including the ventromedial prefrontal cortex (vmPFC), striatum, amygdala, dorsomedial prefrontal cortex (dmPFC), and cerebellum. In addition, the resting-state FC between vmPFC and precuneus, as well as between the cerebellum and precuneus, was weakened in PD patients. Furthermore, positive associations were noted between PerAF measurements of vmPFC and amygdala and catastrophizing scores. Conclusion: PD involves regional and network-level alterations in resting-state brain activity. The fronto-striatal-limbic circuits play a critical role in catastrophic-style emotion regulation in PD patients. Reduced FC within the default mode network and cerebellum-default mode network may signify a coordination anomaly in introspection and cognitive activities in PD. These findings complement the model of implicit emotion regulation in PD and suggest potential intervention targets.
The crosstalk between alternative splicing and circular RNA in cancer: pathogenic insights and therapeutic implications
Authors: Hu Hongkun , Tang Jinxin , Wang Hua , Guo Xiaoning , Tu Chao , Li Zhihong 
Published: November 2024

AbstractRNA splicing is a fundamental step of gene expression. While constitutive splicing removes introns and joins exons unbiasedly, alternative splicing (AS) selectively determines the assembly of exons and introns to generate RNA variants corresponding to the same transcript. The biogenesis of circular RNAs (circRNAs) is inextricably associated with AS. Back-splicing, the biogenic process of circRNA, is a special form of AS. In cancer, both AS and circRNA deviate from the original track. In the present review, we delve into the intricate interplay between AS and circRNAs in the context of cancer. The relationship between AS and circRNAs is intricate, where AS modulates the biogenesis of circRNAs and circRNAs in return regulate AS events. Beyond that, epigenetic and posttranscriptional modifications concurrently regulate AS and circRNAs. On the basis of this modality, we summarize current knowledge on how splicing factors and other RNA binding proteins regulate circRNA biogenesis, and how circRNAs interact with splicing factors to influence AS events. Specifically, the feedback loop regulation between circRNAs and AS events contributes greatly to oncogenesis and cancer progression. In summary, resolving the crosstalk between AS and circRNA will not only provide better insight into cancer biology but also provoke novel strategies to combat cancer.
Graphical Abstract
Molecular mechanism and application of emerging technologies in study of bacterial persisters
Authors: Yuan Shuo , Shen Yamin , Quan Yingying , Gao Shuji , Zuo Jing , Jin Wenjie , Li Rishun , Yi Li , Wang Yuxin , Wang Yang 
Published: November 2024

AbstractSince the discovery of antibiotics, they have served as a potent weapon against bacterial infections; however, natural evolution has allowed bacteria to adapt and develop coping mechanisms, ultimately leading to the concerning escalation of multidrug resistance. Bacterial persisters are a subpopulation that can survive briefly under high concentrations of antibiotic treatment and resume growth after lethal stress. Importantly, bacterial persisters are thought to be a significant cause of ineffective antibiotic therapy and recurrent infections in clinical practice and are thought to contribute to the development of antibiotic resistance. Therefore, it is essential to elucidate the molecular mechanisms of persister formation and to develop precise medical strategies to combat persistent infections. However, there are many difficulties in studying persisters due to their small proportion in the microbiota and their non-heritable nature. In this review, we discuss the similarities and differences of antibiotic resistance, tolerance, persistence, and viable but non-culturable cells, summarize the molecular mechanisms that affect the formation of persisters, and outline the emerging technologies in the study of persisters.
Prediction of Salicornia europaea L. biomass using a computer vision system to distinguish different salt-tolerant populations
Authors: Cárdenas-Pérez S. , Grigore M. N. , Piernik A. 
Published: November 2024

Abstract
Background
Salicornia europaea L. is emerging as a versatile crop halophyte, requiring a low-cost, non-destructive method for salt tolerance classification to aid selective breeding. We propose using a computer vision system (CVS) with multivariate analysis to classify S. europaea based on morphometric and colour traits to predict plant biomass and the salinity in their substrate.

Results
A trial and validation set of 96 and 24 plants from 2 populations confirmed the efficacy. CVS and multivariate analysis evaluated the plants by morphometric traits and CIELab colour variability. Through Pearson analysis, the strongest correlations were between biomass fresh weight (FW) vs. projected area (PA) (0.91) and anatomical cross-section (ACS) vs. shoot diameter (Sd) (0.94). The PA and FW correlation retrieved different equation fits between lower and higher salt-tolerant populations (R2 = 0.93 for linear and 0.90 for 2nd-degree polynomial), respectively. The higher salt-tolerant reached a maximum biomass PA at 400 mM NaCl, while the lower salt-tolerant produced less under 200 and 400 mM. A second Pearson correlation and PCA described sample variability with 80% reliability using only morphometric-colour parameters. Multivariate discriminant analysis (MDA) demonstrated that the method correctly classifies plants (90%) depending on their salinity level and tolerance, which was validated with 100% effectiveness. Through multiple linear regression, a predictive model successfully estimated biomass production by PA, and a second model predicted the salinity substrate (Sal.s.) where the plants thrive. Plants' Sd and height influenced PA prediction, while Sd and colour difference (ΔE1) influenced Sal.s. Models validation of actual vs. predicted values showed a R2 of 0.97 and 0.90 for PA, and 0.95 and 0.97 for Sal.s. for lower and higher salt-tolerant, respectively. This outcome confirms the method as a cost-effective tool for managing S. europaea breeding.

Conclusions
The CVS effectively extracted morphological and colour features from S. europaea cultivated at different salinity levels, enabling classification and plant sorting through image and multivariate analysis. Biomass and salinity substrate were accurately predicted by modelling non-destructive parameters. Enhanced by AI, machine learning and smartphone technology, this method shows great potential in ecology, bio-agriculture, and industry.
Analysis of cutaneous leishmaniasis among military personnel in the Islamic Republic of Iran: a spatiotemporal study between 2018 and 2022, trend forecasting based on ARIMA model
Authors: Tadayonfar Reza , Dabbagh-Moghaddam Arasb , Barati Mohammad , Kazemi-Galougahi Mohammad Hassan , Aminifarsani Zahra , Jalallou Nahid , Shirzadi Mohammad Reza , Ghrachorloo Faranak , Khaghani Ramin 
Published: November 2024

Abstract
Background
Cutaneous leishmaniasis is one of the few infectious diseases whose global prevalence is on the rise. Iran ranks among the eight most affected countries in the world. Iranian military personnel are often sent to endemic areas for cutaneous leishmaniasis without prior immunity, and they have fewer health facilities in military centers than the general population. This study aims to comprehensively investigate the situation of cutaneous leishmaniasis in Iranian military personnel across all units from 2018 to 2022 and predict the disease trend using time series analysis up to the end of 2025.

Methods
We analyzed data from the Iranian Ministry of Health to perform spatiotemporal and descriptive analyses based on patient frequency. Variables examined included age distribution, cutaneous leishmaniasis types (zoonotic or anthroponotic), month of healthcare facility visits, and lesion locations. This study employed the ARIMA model (p = 2, d = 0, q = 1)(P = 3, D = 0, Q = 0), for time series analysis and forecasting the disease trend up to 36 months after 2022.

Results
Over five years, 2,894 patients were reported. The Esfahan, Khuzestan, and Ilam provinces had the highest average patient counts, with hot spots primarily found in central, south, southwestern, and western Iran. Although the total number of patients with zoonotic cutaneous leishmaniasis was almost equal to anthroponotic cutaneous leishmaniasis, in high-risk provinces such as Esfahan, Khuzestan, and Ilam, the confirmed cases of zoonotic cutaneous leishmaniasis were much more than anthroponotic cutaneous leishmaniasis. patient numbers peak in October and November. Demographic analysis revealed that younger patients outnumbered older patients. Lesion locations were frequent on the forelimbs and lower limbs. The time series analysis for 36 months after 2022 indicated the seasonal pattern of the disease and predicted an upward trend after 2022.

Conclusion
While overall cases have declined, provinces such as Esfahan exhibit an upward trend. The expansion of hotspots from the west and southwestern to the center and south of Iran, coupled with an increasing trend in time series analysis, suggests the potential emergence of new foci and a rise in patient numbers in the future. In provinces with high disease prevalence, preventive measures should be prioritized, particularly in Ilam, Khuzestan, and Esfahan.
Development of a habit-based intervention to support healthy eating and physical activity behaviours for pregnant women with overweight or obesity: Healthy Habits in Pregnancy and Beyond (HHIPBe)
Authors: McClelland Julia , Gallagher Dunla , Moore Sarah E , McGirr Caroline , Beeken Rebecca J , Croker Helen , Eastwood Kelly-Ann , O’Neill Roisin F , Woodside Jayne V , McGowan Laura , McKinley Michelle C 
Published: November 2024

Abstract
Background
The number of women entering pregnancy with overweight or obesity is increasing. This can increase the risk for excessive gestational weight gain (GWG) which is associated with health complications for mother and baby. There are limited evidence-based interventions within antenatal care settings to encourage healthy eating and physical activity behaviours and support women with managing GWG.

Methods
A previous habit-based intervention ‘Ten Top Tips for a Healthy Weight’ (10TT) was adapted and made suitable for pregnancy in line with the Medical Research Council’s (MRC) complex intervention development guidelines. It involved three key activities: (1) identifying the evidence base; (2) identifying appropriate theory; and, (3) modelling processes. A core element was integrating lived experience via personal and public involvement (PPI).

Results
The original 10TTs were adapted with PPI in line with current advice on nutrition and physical activity in pregnancy. New intervention materials were devised, including a leaflet and a logbook and app for self-monitoring to be delivered alongside a brief 1:1 conversation. Behaviour change techniques (BCTs) included in the new materials were coded using a number of behavioural taxonomies. An E-learning resource was created to help standardise the approach to delivery of the intervention and avoid stigmatising conversations.

Conclusion
Following MRC guidance for the development of complex interventions alongside significant PPI allowed for the adaption of 10TT habit-based weight management intervention into the ‘Healthy Habits in Pregnancy and Beyond’ (HHIPBe) intervention. The feasibility and acceptability of implementing this intervention in the antenatal setting will be explored in a feasibility randomised controlled trial.

Trial Registration
This study was registered on Clinical Trials as ‘Healthy Habits in Pregnancy and Beyond (HHIPBe)’ ClinicalTrials.gov Identifier: NCT04336878. The study was registered on 07/04/2020.
“It was really helpful for me, and at the same time it was really tough”: a qualitative study among Afghan peer refugee helpers in Greece
Authors: Lavdas Michalis , Sandal Gro Mjeldheim , Bendixsen Synnøve 
Published: November 2024

Abstract
Background
Aid workers with a refugee background are increasingly engaged in the humanitarian field. These individuals, known as peer refugee helpers (PRHs), contribute to providing psychosocial support for other refugees. However, few studies have focused on the mental health and wellbeing of PRHs.

Objectives
This study aims to investigate the experiences of PRHs of Afghan origin in the humanitarian field in Greece.

Methods
Seven focus group interviews took place in a hybrid format, online or in-person. PRHs of Afghan origin (N = 18), working for various Aid/Humanitarian Organizations (AOs), participated. Data was analyzed using template analysis.

Results
The analysis identified job resources reflected in the dimensions of sense of coherence (meaningfulness, manageability, comprehensibility) and job demands associated with role overload, role conflict, and role boundaries. Gender differences were noticeable. Specifically, female PRHs experienced empowerment, through accessing new opportunities often not available within Afghan communities. Female PRHs frequently reported going against traditional gender roles and faced negative reactions from their peers. Male PRHs reported feeling empowered through their engagement as a PRH, as it helped them fulfill their personal goals, such as becoming a good example within their families or communities.

Conclusions
Recommendations for policymakers and AOs based on the study results include: (1) Offer training, supervision, and psychosocial support for PRHs to enhance work engagement and prevent emotional exhaustion; (2) Address gender differences ensuring the protection and support of female PRHs; (3) Adopt scalable psychosocial interventions to promote agency and a concrete way of engaging with beneficiaries; (4) Formalize job roles outlining responsibilities and expectations for PRHs.
Self-directed learning in Orthopaedic trainees and contextualisation of knowledge gaps, an exploratory study
Authors: Maksoud Ahmed , AlHadeed Farah 
Published: November 2024

Abstract
Background
Self-Directed Learning (SDL) is a subjective concept with no universally agreed definition. The aim of this project was to obtain the perspectives of Orthopaedic trainee registrars on SDL.

Methods
Seven Orthopaedic trainees in the Southwest Peninsula region were recruited in person by the primary author as an Orthopaedic trainee on the same programme as the participants. A one-hour Microsoft teams video interview was arranged at a mutually convenient time exploring several topics including learning resources, experiential learning, learning strategies, training programme requirements and assessment. The interviews were audio recorded and transcribed verbatim. Transcripts were coded using Corbin’s and Strauss’s published coding method and analysed to develop a model of SDL in this training context.

Results
Six learning stages were identified from the coded transcripts and these stages were like Knowles’s stages of SDL. Participants felt less autonomous during the identification of knowledge gaps, goal setting and evaluation of learning stages. Participants perceived to have more control over the selection of strategies, and learning stages of SDL. The factors which influenced autonomy at various stages of SDL included supervisors, experiential learning opportunities, service provision competing with learning opportunities, training programme requirements and the power dynamic between trainees and supervisors. Self-advocacy by the trainees for experiential learning opportunities and for their progression was an additional action relevant to SDL that was evident. Online learning resources such as Orthobullets.com, YouTube videos, external revision courses, collaboration and webinars encouraged more autonomy with SDL.

Conclusions
Although the United kingdom’s Trauma and Orthopaedic curriculum is described as trainee led and SDL is encouraged, in practice Orthopaedic trainees felt limited autonomy with the various stages of SDL due to external factors including their level of experience and the training environment. Trainees’ experiences around self-advocacy highlighted the importance of a collaborative and supportive learning culture emphasising dialogue, receiving high quality feedback, and openness for successful progression.
Accuracy of healthcare systems data for identifying cardiovascular outcomes after stroke due to intracerebral haemorrhage in the United Kingdom
Authors: Hosking Alice , Stephen Jacqueline , Drever Jonathan , Whiteley William N. , Sudlow Cathie L. M. , Al-Shahi Salman Rustam ,   for the RESTART Trial Steering Committee, Baigent Colin , Lasserson Daniel , Sullivan Frank , Carrie Johanna , Dennis Martin S , Murray Gordon D , Newby David E , Sandercock Peter AG , Sprigg Nikola , Werring David J , White Phil M 
Published: November 2024

Abstract
Background
Healthcare systems data (HCSD) could improve the efficiency of clinical trials, but their accuracy and validity are uncertain. Our objective was to assess the accuracy of HCSD as the sole method of outcome detection in the REstart or STop Antithrombotics Randomised Trial (RESTART; ISRCTN71907627) compared with adjudicated questionnaire follow-up and compare estimates of treatment effect.

Methods
RESTART was a prospective, open, assessor-blind, parallel-group randomised controlled trial (RCT) of antiplatelet therapy after intracerebral haemorrhage (ICH) in the UK.
We included 496 (92%) of 537 RESTART participants, who were resident in England or Scotland at randomisation. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy.
RESTART used annual questionnaires to detect its primary outcome (recurrent ICH) and secondary outcome (a composite of haemorrhagic or ischemic major adverse cardiovascular events [MACE]) over a median of 2.0 years; an independent adjudication committee verified outcomes using medical records and brain imaging. We obtained ICD10-coded HCSD on hospital admissions and deaths in England and Scotland to identify primary and secondary outcomes. We compared HCSD with a reference standard of adjudicated outcomes. We estimated the effects of antiplatelet therapy using HCSD alone in a Cox proportional hazards model adjusted for minimisation variables.

Results
In the original RESTART trial, 31 people experienced a primary outcome event. HCSD had sensitivity of 84% (95% CI 66 to 95%) and positive predictive value of 68% (51 to 82%) for recurrent ICH. HCSD estimated an effect of antiplatelet therapy (adjusted hazard ratio [aHR] 0.51, 95% CI 0.27 to 0.98; p = 0.044) that was almost identical to adjudicated outcomes (aHR 0.51, 95% CI 0.25 to 1.03; p = 0.060). HCSD had sensitivity of 84% (76 to 91%) and positive predictive value of 78% (69 to 85%) for MACE, on which HCSD estimated an effect of antiplatelet therapy (aHR 0.81, 95% CI 0.56 to 1.16; p = 0.247) that was similar to adjudicated outcomes (aHR 0.65, 95% CI 0.44 to 0.95; p = 0.025).

Conclusions
In a RCT of antiplatelet therapy for people with ICH, HCSD was reasonably accurate and provided similar estimates of treatment effect compared with adjudicated outcomes.

Trial registration
ISRCTN71907627. Registered on 25 April 2013.
Chromatographic assay of recently approved co-formulation of Vonoprazan fumarate with low dose Aspirin: AGREE, Complex MoGAPI, and RGB 12-model assessments
Authors: Moneim Mona M. Abdel , Hamdy Mohamed M. A. 
Published: November 2024

AbstractTwo simple, valid and green chromatographic based techniques are developed in the present work for first time to simultaneously analyze the recently approved combination of Aspirin (ASP) with the novel gastro-protective agent Vonoprazan (VON). First method is an HPLC-DAD “diode array detection”, where separation was successful using C18 (250 × 4.6 mm) column with isocratic elution of phosphate buffer-pH 6.8 and acetonitrile in ratio of 63:37 with detection at 230 nm. Second method is an HPTLC method on HPTLC silica plates using ethyl acetate: ethanol (75%): ammonia (5:5:0.05 v/v) mobile phase followed by densitometric scanning at 230 nm. The methods were applied successfully for analysis of VON and ASP mixture in laboratory-prepared tablets and the methods were validated in regards to linearity, precision, accuracy and selectivity. The proposed methods are assessed for their greenness and whiteness as well using the “Analytical GREEnness Metric Approach”, “Complementary Modified Green Analytical Procedure Index” and the new algorithm “RGB 12 model” (Red-Green-Blue) and proved the greenness and the sustainability of the methods in the routine assay of the newly marketed formulation.