bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Between the Level of Vitamin D3 Deficiency and Successful Osseointegration: A Prospective Clinical Study
Authors: Al-Quisi Ahmed Fadhel , A. Jamil Firas , M. AL-Anee Auday , Jassim Muhsen Salah 
Published: September 2024

Purpose: This study aimed to evaluate the influence of vitamin D3 levels on bone density, primary dental implant stability, and successful osseointegration.Materials and Methods: Clinical and radiological examination with a standardized cone‐beam computed tomography (CBCT) machine and laboratory investigation for serum levels of vitamin D3 were performed for all patients. Only patients in need of single or multiple straightforward dental implant surgery in either jaw with no history of systemic disease or condition that may interfere with bone healing were included in this study to receive the dental implant by the same oral and maxillofacial surgeon, which re‐opened 4 months later to assess the osseointegration and to complete the prosthetic part.Results: One hundred twenty‐eight dental implants were inserted into 108 patients. Most of the patients in the study had insufficient vitamin D3 levels. The prognosis of dental implants regarding successful osseointegration 4 months after implant placement had a weak positive association with the insertion torque and bone mineral density and a statistically significant positive correlation with the serum vitamin D3 level.Conclusion: Preoperatively, it is advisable to request the serum vitamin D3 level of the patients along with the standard clinical and radiological examination. Severe vitamin D3 deficiency could be associated with early dental implant failure despite the favorable bone density and primary dental implant stability achieved.Trial Registration: ClinicalTrials.gov identifier: TCTR20200304001.
Enfoque de género y representación femenina en escuelas de medicina en Chile: ¿qué sabemos?
Authors: Rivera Mercado Solange Tatiana , Garrido Meléndez Genesis , Espinosa Veas Pablo , Prado Pizarro Ester , Santis Lobos Josefa , Bernales Silva Margarita 
Published: September 2024

Introducción: el género es una determinante social de la salud de las personas. Integrar en la educación médica una perspectiva de género permite mejorar habilidades clínicas y pesquisar diferencias biopsicosociales, contribuyendo a la equidad en salud. A pesar de la preocupación global por reducir la brecha de género en educación y sociedad, la incorporación del enfoque de género en salud en las escuelas de medicina en Chile es incierta. El objetivo de este estudio es reportar si las representaciones estudiantiles de las escuelas de medicina de Chile perciben la incorporación de las temáticas de género en sus respectivos currículos y comprender estas percepciones considerando como contexto algunos indicadores de equidad de género de sus facultades de medicina y universidades. Material y método: se trata de un estudio exploratorio realizado el 2023 que encuestó integrantes de la representación estudiantil de todas las escuelas de medicina acreditadas en nuestro país. Resultados: con una tasa de respuesta del 75%, la mayoría del estudiantado identifica alguna intervención educativa relacionada con enfoque de género en salud en su formación. La revisión de los datos públicos arrojó un notorio avance en la presencia de organismos encargados de velar por la equidad de género en las universidades del país. Estos datos se observan en un momento en que el porcentaje de ingreso femenino es mayor que el masculino. Sin embargo, en la estructura organizacional de la unidad académica, la representación femenina disminuye conforme se asciende en cargos de autoridad. Discusión: existen instancias formativas relacionadas al género en las escuelas de medicina de nuestro país, sin embargo, se necesitan más estudios que exploren la percepción de la comunidad académica acerca de este tema e identifiquen oportunidades curriculares para implementar el enfoque de género en salud.
A Phase I Trial of Trebananib, an Angiopoietin 1 and 2 Neutralizing Peptibody, Combined with Pembrolizumab in Patients with Advanced Ovarian and Colorectal Cancer
Authors: Huffman Brandon M. , Rahma Osama E. , Tyan Kevin , Li Yvonne Y. , Giobbie-Hurder Anita , Schlechter Benjamin L. , Bockorny Bruno , Manos Michael P. , Cherniack Andrew D. , Baginska Joanna , Mariño-Enríquez Adrián , Kao Katrina Z. , Maloney Anna K. , Ferro Allison , Kelland Sarah , Ng Kimmie , Singh Harshabad , Welsh Emma L. , Pfaff Kathleen L. , Giannakis Marios , Rodig Scott J. , Hodi F. Stephen , Cleary James M. 
Published: September 2024

Abstract
Ovarian cancers and microsatellite stable (MSS) colorectal cancers are insensitive to anti–programmed cell death 1 (PD-1) immunotherapy, and new immunotherapeutic approaches are needed. Preclinical data suggest a relationship between immunotherapy resistance and elevated angiopoietin 2 levels. We performed a phase I dose escalation study of pembrolizumab and the angiopoietin 1/2 inhibitor trebananib (NCT03239145). This multicenter trial enrolled patients with metastatic ovarian cancer or MSS colorectal cancer. Trebananib was administered intravenously weekly for 12 weeks with 200 mg intravenous pembrolizumab every 3 weeks. The toxicity profile of this combination was manageable, and the protocol-defined highest dose level (trebananib 30 mg/kg weekly plus pembrolizumab 200 mg every 3 weeks) was declared the maximum tolerated dose. The objective response rate for all patients was 7.3% (90% confidence interval, 2.5%–15.9%). Three patients with MSS colorectal cancer had durable responses for ≥3 years. One responding patient’s colorectal cancer harbored a POLE mutation. The other two responding patients had left-sided colorectal cancers, with no baseline liver metastases, and genomic analysis revealed that they both had KRAS wild-type, ERBB2-amplified tumors. After development of acquired resistance, biopsy of one patient’s KRAS wild-type ERBB2-amplified tumor showed a substantial decline in tumor-associated T cells and an increase in immunosuppressive intratumoral macrophages. Future studies are needed to carefully assess whether clinicogenomic features, such as lack of liver metastases, ERBB2 amplification, and left-sided tumors, can predict increased sensitivity to PD-1 immunotherapy combinations.
Patient-Specific Myocardial Infarction Risk Thresholds From AI-Enabled Coronary Plaque Analysis
Authors: Miller Robert J.H. , Manral Nipun , Lin Andrew , Shanbhag Aakash , Park Caroline , Kwiecinski Jacek , Killekar Aditya , McElhinney Priscilla , Matsumoto Hidenari , Razipour Aryabod , Grodecki Kajetan , Kwan Alan C. , Han Donghee , Kuronuma Keiichiro , Flores Tomasino Guadalupe , Geers Jolien , Goeller Markus , Marwan Mohamed , Gransar Heidi , Tamarappoo Balaji K. , Cadet Sebastien , Cheng Victor Y. , Achenbach Stephan , Nicholls Stephen J. , Wong Dennis T. , Chen Lu , Cao J. Jane , Berman Daniel S. , Dweck Marc R. , Newby David E. , Williams Michelle C. , Slomka Piotr J. , Dey Damini 
Published: September 2024

BACKGROUND:
Plaque quantification from coronary computed tomography angiography has emerged as a valuable predictor of cardiovascular risk. Deep learning can provide automated quantification of coronary plaque from computed tomography angiography. We determined per-patient age- and sex-specific distributions of deep learning–based plaque measurements and further evaluated their risk prediction for myocardial infarction in external samples.

METHODS:
In this international, multicenter study of 2803 patients, a previously validated deep learning system was used to quantify coronary plaque from computed tomography angiography. Age- and sex-specific distributions of coronary plaque volume were determined from 956 patients undergoing computed tomography angiography for stable coronary artery disease from 5 cohorts. Multicenter external samples were used to evaluate associations between coronary plaque percentiles and myocardial infarction.

RESULTS:

Quantitative deep learning plaque volumes increased with age and were higher in male patients. In the combined external sample (n=1847), patients in the ≥75th percentile of total plaque volume (unadjusted hazard ratio, 2.65 [95% CI, 1.47–4.78];
P
=0.001) were at increased risk of myocardial infarction compared with patients below the 50th percentile. Similar relationships were seen for most plaque volumes and persisted in multivariable analyses adjusting for clinical characteristics, coronary artery calcium, stenosis, and plaque volume, with adjusted hazard ratios ranging from 2.38 to 2.50 for patients in the ≥75th percentile of total plaque volume.

CONCLUSIONS:
Per-patient age- and sex-specific distributions for deep learning–based coronary plaque volumes are strongly predictive of myocardial infarction, with the highest risk seen in patients with coronary plaque volumes in the ≥75th percentile.
Longitudinal Impacts of High Versus Low Greenness on Cardiovascular Disease Conditions
Authors: Brown Scott C. , Aitken William W. , Lombard Joanna , Parrish Abraham , Dewald Julius R. , Nardi Maria I. , Mantero Alejandro M. A. , Metalonis Sarah W. , Szapocznik José 
Published: September 2024

Background
Greenness—or vegetative presence—has been identified as a factor in chronic disease. The present study examines the longitudinal relationship between objective measures of greenness at the residential block level and incidence of 6 cardiovascular disease conditions.

Methods and Results

Analyses examined the impact of consistently high versus consistently low “precision” greenness at the Census block level on the 5‐year incidence of cardiovascular disease conditions, including acute myocardial infarction, atrial fibrillation, heart failure, ischemic heart disease, stroke/transient ischemic attack, and hypertension, among 229 034 US Medicare beneficiaries in Miami‐Dade County, Florida, USA. Zero‐inflated Poisson regression was used to model the odds of developing any new cardiovascular disease and number of new cardiovascular disease conditions based on greenness tertiles computed across 2011 and 2016 Normalized Difference Vegetation Index values, adjusting for individual age, sex, race, ethnicity, baseline cardiovascular disease conditions, neighborhood income, and walkability in 2011 and 2016. When compared with individuals consistently in the low greenness tertile in 2011 and 2016, those consistently in the high greenness tertile in 2011 and 2016 had a 9% lower odds of having any new cardiovascular conditions (odds ratio [OR], 0.91 [95% CI, 0.84–0.99];
P
=0.021).

Conclusions
Over a 5‐year period, consistently high greenness, when compared with consistently low greenness, was associated with lower odds of any new cardiovascular disease conditions. Identifying the role of greenness exposure in such a small geographic area, the Census block on which the older adult resides, allows for more precise, strategic decisions on where additional trees can be added—by selecting at‐risk blocks rather than entire neighborhoods for tree‐planting interventions.
Diagnostic Potential of Combined Photoplethysmography and Ankle‐Brachial Index in Peripheral Arterial Disease: A Duplex Ultrasonography‐Based Comparative Study
Authors: Huang Han‐Luen , Chang Chia‐Hsiu , Lo Men‐Tzung , Lin Chen 
Published: September 2024

Background
Although ankle‐brachial index (ABI) and photoplethysmography (PPG) have also shown adequate sensitivity in detecting peripheral arterial disease, their diagnostic performance is less reliable in asymptomatic cases or those with high atherosclerotic cardiovascular risks.

Methods and Results

We evaluated 130 participants using ABI, PPG, and duplex ultrasonography, diagnosing 65 with peripheral arterial disease. From the PPG, we derived 2 parameters: PPG amplitude ratio of the lower‐to‐upper extremities (PPG
ratio
) and the PPG amplitude of the lower extremity (PPG
amp
). Sensitivity, specificity, accuracy, and the area under receiver operating characteristic (ROC) curve were calculated for PPG parameters and ABI, and their combination of both methods. Univariate and multivariate logistic regression assessed the prognostic potential of these parameters. ROC analysis revealed optimal cutoff values in diagnosing peripheral arterial disease were 0.417 for PPG
ratio
and “58” for PPG
amp
. Both PPG
ratio
and PPG
amp
demonstrated significantly higher sensitivities, 78.4% and 75.7%, respectively, compared with 55.9% for ABI <0.9 (
P
<0.05). The areas under the ROC curves of combination models, including model 1 (ABI <0.9 and PPG
ratio
), model 2 (ABI <0.9 and PPG
amp
), and model 3 (ABI <0.9, PPG
ratio
, and PPG
amp
), exhibited improved performance with areas under the ROC curves of 0.922, 0.922, and 0.931 (all
P
<0.01) compared with ABI alone (area under the ROC curve, 0.822). Additionally, the PPG parameters, both alone and combined with ABI, were associated with major adverse cardiac events and all‐cause mortality after adjusting for other relevant factors.

Conclusions
On the basis of duplex ultrasonography, combining ABI and PPG markedly improves peripheral arterial disease diagnosis in high‐risk individuals compared with either method alone and provides crucial insights into major adverse cardiac events and all‐cause mortality risks.
Association Between Stroke Lesion Size and Atrial Fibrillation Detected After Stroke: An Observational Cohort Study
Authors: Klammer Markus G. , Reimann Laura , Richter Oskar , Lieschke Simone , Stengl Helena , Hellwig Simon , Ganeshan Ramanan , Schöls Maximilian , Nelde Alexander , Meisel Christian , Villringer Kersten , Nolte Christian H. , Endres Matthias , Scheitz Jan Friedrich 
Published: September 2024

Background
Atrial fibrillation detected after stroke (AFDAS) is considered to be a distinct entity influenced by cardiogenic and neurogenic factors. We hypothesized that patients with AFDAS have larger stroke lesions than patients without atrial fibrillation (AF) and with known AF (KAF).

Methods and Results

Consecutive patients with magnetic resonance imaging–confirmed acute ischemic stroke admitted to a university hospital between October 2020 and January 2023 were prospectively registered. We categorized patients as AFDAS, no AF or KAF upon hospital discharge. We manually segmented diffusion‐weighted imaging lesions to determine lesion volume. We analyzed 1420 patients (median age, 78; 47.2% women, median National Institutes of Health Stroke Scale score, 3; median hospital stay, 5 days). Of these, 81 had AFDAS (5.7%), 329 had KAF (23.2%) and 1010 had no AF (71.1%). Lesion volume was larger in patients with AFDAS (median, 5.4 mL [interquartile range, 1.0–21.6]) compared with patients with no AF and KAF (median, 0.7 [interquartile range,0.2–4.4] and 2.0 [interquartile range,0.3–11.1] mL, respectively; both
P
<0.001). Lesion volume was independently associated with AFDAS compared with no AF (adjusted odds ratio, 1.37 [95% CI, 1.20–1.58] per log mL) and KAF (adjusted odds ratio, 1.22 [95% CI, 1.07–1.41] per log mL). Patients in the highest lesion volume quartile (>6.5 mL) were more likely to be diagnosed with AFDAS compared with the lowest quartile (<0.22 mL, 13.6% versus 2.1%; adjusted odds ratio, 5.88 [95% CI, 2.30–17.40]). These associations were more pronounced when excluding 151 patients with nonembolic lesion pattern and similar when excluding 199 patients with KAF on oral anticoagulation.

Conclusions
Larger stroke lesions were independently associated with AFDAS diagnosis during index stroke hospitalization highlighting a potential neurogenic contribution to AFDAS pathogenesis.
Deep Learning Virtual Contrast‐Enhanced T1 Mapping for Contrast‐Free Myocardial Extracellular Volume Assessment
Authors: Nowak Sebastian , Bischoff Leon M. , Pennig Lenhard , Kaya Kenan , Isaak Alexander , Theis Maike , Block Wolfgang , Pieper Claus C. , Kuetting Daniel , Zimmer Sebastian , Nickenig Georg , Attenberger Ulrike I. , Sprinkart Alois M. , Luetkens Julian A. 
Published: September 2024

Background
The acquisition of contrast‐enhanced T1 maps to calculate extracellular volume (ECV) requires contrast agent administration and is time consuming. This study investigates generative adversarial networks for contrast‐free, virtual extracellular volume (vECV) by generating virtual contrast‐enhanced T1 maps.

Methods and Results

This retrospective study includes 2518 registered native and contrast‐enhanced T1 maps from 1000 patients who underwent cardiovascular magnetic resonance at 1.5 Tesla. Recent hematocrit values of 123 patients (hold‐out test) and 96 patients from a different institution (external evaluation) allowed for calculation of conventional ECV. A generative adversarial network was trained to generate virtual contrast‐enhanced T1 maps from native T1 maps for vECV creation. Mean and SD of the difference per patient (ΔECV) were calculated and compared by permutation of the 2‐sided
t
test with 10 000 resamples. For ECV and vECV, differences in area under the receiver operating characteristic curve (AUC) for discriminating hold‐out test patients with normal cardiovascular magnetic resonance versus myocarditis or amyloidosis were tested with Delong's test. ECV and vECV showed a high agreement in patients with myocarditis (ΔECV: hold‐out test, 2.0%±1.5%; external evaluation, 1.9%±1.7%) and normal cardiovascular magnetic resonance (ΔECV: hold‐out test, 1.9%±1.4%; external evaluation, 1.5%±1.2%), but variations in amyloidosis were higher (ΔECV: hold‐out test, 6.2%±6.0%; external evaluation, 15.5%±6.4%). In the hold‐out test, ECV and vECV had a comparable AUC for the diagnosis of myocarditis (ECV AUC, 0.77 versus vECV AUC, 0.76;
P
=0.76) and amyloidosis (ECV AUC, 0.99 versus vECV AUC, 0.96;
P
=0.52).

Conclusions
Generation of vECV on the basis of native T1 maps is feasible. Multicenter training data are required to further enhance generalizability of vECV in amyloidosis.
Effects of Locus Coeruleus Activation on n-Back Performance and Frontoparietal Activity
Authors: Negelspach David , Alkozei Anna , Huskey Alisa , Killgore William D. S. 
Published: September 2024

Abstract
Previous studies have linked working memory capacity to restricted hemodynamic responses within critical nodes of the frontoparietal network. Emerging evidence suggests a potential role of the locus coeruleus (LC) in modulating activation of key regions essential for working memory function. This study investigated this hypothesis by examining changes in BOLD signal within the LC and cortex during a parametrically designed verbal working memory task (n-back). fMRI revealed load-dependent task activation, with maximum activation of presumed LC neurons positively correlating with working memory capacity. Furthermore, increased hemodynamic responses in the superior parietal lobes and dorsolateral pFC corresponded with the magnitude of LC activation near working memory capacity limits. An exploratory functional connectivity analysis suggests improvements in working memory performance rely on negative functional connectivity between the LC and cortical regions not primarily involved in task completion. On the basis of previous evidence, this association may represent inhibitory input from cortical regions, enabling phasic bursts of activity from LC neurons, thereby facilitating enhanced cortical activation. This result may also indicate noradrenergic suppression of cortical regions that are not crucial for task completion, leading to enhanced network efficiency. These findings suggest a mechanism by which the LC may improve verbal working memory performance by facilitating enhanced activation in regions critical for visual working memory capacity and active maintenance, potentially enhancing network efficiency.
Incorporating costs and benefits to the evaluation of uncertain research results: Applications to cancer research funding
Authors: Zhuang Han , Acuna Daniel E. 
Published: September 2024

Abstract
Correctness is a key aspiration of the scientific process, yet recent studies suggest that many high-profile findings may be difficult to replicate or require considerable evidence for verification. Proposals to fix these issues typically ask for tighter statistical controls (e.g., stricter p-value thresholds or higher statistical power). However, these approaches often overlook the importance of contemplating research outcomes’ potential costs and benefits. Here, we develop a framework grounded in Bayesian decision theory that seamlessly integrates cost-benefit analysis into evaluating research programs with potentially uncertain results. We derive minimally acceptable prestudy odds and positive predictive values for cost and benefit levels. We show that tolerance to inaccurate results changes dramatically due to uncertainties posed by research. We also show that reducing uncertainties (e.g., by recruiting more subjects) may have limited effects on the expected benefit of continuing specific research programs. We apply our framework to several types of cancer research and their funding. Our analysis shows that highly exploratory research designs are easily justifiable due to their potential benefits, even when probabilistic models suggest otherwise. We discuss how the cost and benefit of research could and should always be part of the toolkit used by scientists, institutions, or funding agencies.
Propagation from Meteorological to Hydrological Drought considering Nonstationarity in the Luanhe River Basin: Spatiotemporal Pattern and Driving Factors
Authors: Dai Meng , Feng Ping , Huang Shengzhi , Li Jianzhu , Huang Qiang , Gao Yuejiao , Zheng Xudong , Cheng Liwen , Wang Hanye , Guo Wenwen 
Published: September 2024

Abstract
Under the joint effects of climate change and human activities, the assumption of the stationarity of hydrological series has been overturned, which is of great significance in the field of hydrology. However, the current research on drought propagation is generally based on the assumption of sequence stationarity, in which related results may be biased. To this end, the Generalized Additive Models for Location, Scale, and Shape (GAMLSS) model was used to construct a time-varying drought index. The seasonal propagation characteristics from meteorological to hydrological drought were examined based on conditional probability. The dynamic change of propagation characteristics was explored by utilizing the moving window, and the driving factors were revealed by using the variable importance in projection. The Luanhe River basin, which has a fragile ecological environment, was selected as a case study. The results indicated that 1) using a time-varying drought index was more reasonable than using a stationary assumption, and the latter relatively easily underestimated the propagation time, especially in summer; 2) drought propagation in summer and autumn was faster than that in spring and winter, and the propagation time showed a significant downward trend; 3) the trigger threshold (absolute value) of meteorological drought in spring was significantly higher than that in other seasons, and hydrological drought was more likely to be triggered by meteorological drought in autumn and winter; and 4) the precipitation P, decreasing runoff R, and increasing evaporation E were the main factors affecting the seasonal propagation characteristics. The findings of this study are of great significance for water resource management and further understanding of drought propagation mechanisms.