bluuebunny/crossref_metadata_2025_split huggingface dataset:
Generative AI-based knowledge graphs for the illustration and development of mHealth self-management content
Authors: Blanchard Marc , Venerito Vincenzo , Ming Azevedo Pedro , Hügle Thomas 
Published: October 2024

BackgroundDigital therapeutics (DTx) in the form of mobile health (mHealth) self-management programs have demonstrated effectiveness in reducing disease activity across various diseases, including fibromyalgia and arthritis. However, the content of online self-management programs varies widely, making them difficult to compare.AimThis study aims to employ generative artificial intelligence (AI)-based knowledge graphs and network analysis to categorize and structure mHealth content at the example of a fibromyalgia self-management program.MethodsA multimodal mHealth online self-management program targeting fibromyalgia and post-viral fibromyalgia-like syndromes was developed. In addition to general content, the program was customized to address specific features and digital personas identified through hierarchical agglomerative clustering applied to a cohort of 202 patients with chronic musculoskeletal pain syndromes undergoing multimodal assessment. Text files consisting of 22,150 words divided into 24 modules were used as the input data. Two generative AI web applications, ChatGPT-4 (OpenAI) and Infranodus (Nodus Labs), were used to create knowledge graphs and perform text network analysis, including 3D visualization. A sentiment analysis of 129 patient feedback entries was performed.ResultsThe ChatGPT-generated knowledge graph model provided a simple visual overview with five primary edges: “Mental health challenges”, “Stress and its impact”, “Immune system function”, “Long COVID and fibromyalgia” and “Pain management and therapeutic approaches”. The 3D visualization provided a more complex knowledge graph, with the term “pain” appearing as the central edge, closely connecting with “sleep”, “body”, and “stress”. Topical cluster analysis identified categories such as “chronic pain management”, “sleep hygiene”, “immune system function”, “cognitive therapy”, “healthy eating”, “emotional development”, “fibromyalgia causes”, and “deep relaxation”. Gap analysis highlighted missing links, such as between “negative behavior” and “systemic inflammation”. Retro-engineering of the self-management program showed significant conceptual similarities between the knowledge graph and the original text analysis. Sentiment analysis of free text patient comments revealed that most relevant topics were addressed by the online program, with the exception of social contacts.ConclusionGenerative AI tools for text network analysis can effectively structure and illustrate DTx content. Knowledge graphs are valuable for increasing the transparency of self-management programs, developing new conceptual frameworks, and incorporating feedback loops.
Dynamic adaptation in power transmission: integrating robust optimization with online learning for renewable uncertainties
Authors: Dongyang Cai , Jiewen Zuo , Xiaolong Hao 
Published: October 2024

IntroductionThe increasing integration of renewable energy sources, such as wind and solar, into power grids introduces significant challenges due to their inherent variability and unpredictability. Traditional fossil-fuel-based power systems are ill-equipped to maintain stability and cost-effectiveness in this evolving energy landscape.MethodsThis study presents a novel framework that integrates robust optimization with online learning to dynamically manage uncertainties in renewable energy generation. Robust optimization ensures system resilience under worst-case scenarios, while the online learning component continuously updates operational strategies based on real-time data. The framework was tested using an IEEE 30-bus test system under varying levels of renewable energy integration.ResultsSimulation results show that the proposed framework reduces operational costs by up to 12% and enhances system reliability by 1.4% as renewable energy integration increases from 10% to 50%. Additionally, the need for reserve power is significantly reduced, particularly under conditions of high variability in renewable energy outputs.DiscussionThe integration of robust optimization with online learning provides a dynamic and adaptive solution for the sustainable management of power transmission systems. This approach not only improves economic and environmental outcomes but also enhances grid stability, making it a promising strategy for addressing the challenges posed by the increasing reliance on renewable energy.
Sjögren syndrome induced by anti PDL-1 treatment for TNBC: case report and review of literature
Authors: Pellegrino Caterina , D’Antonio Chiara , Ierinò Debora , Onesti Concetta Elisa , Aschelter Anna Maria , Santini Daniele , Mazzuca Federica 
Published: October 2024

BackgroundRheumatological toxicity associated with immunotherapy, particularly Sjögren’s syndrome (SjS), has been observed with variable incidence in patients treated with immune checkpoint inhibitors (ICIs). Although SjS is a well-known autoimmune disease, its occurrence as an immune-related adverse event (irAE) during cancer treatment is less well understood. Current literature documents a range of incidence rates and clinical manifestations of SjS in patients undergoing ICI therapy, highlighting the need for early diagnosis and multidisciplinary management.Case presentationA 40-year-old woman underwent mammography, which revealed a 43 mm mass in the left breast. Core biopsy confirmed grade 3 infiltrating triple negative ductal carcinoma with high MIB-1. She received neoadjuvant chemotherapy, followed by surgery and radiotherapy. A CT scan in September 2022 showed lung nodules and lymph node involvement. A lung biopsy confirmed breast cancer metastasis. She started treatment with atezolizumab and nab-paclitaxel with evidence of a partial response. Nab-paclitaxel was discontinued due to side effects and atezolizumab was continued as maintenance therapy. After four cycles, the patient developed symptoms consistent with Sjögren’s syndrome (SjS), which were confirmed by diagnostic tests. Treatment with prednisone, pilocarpine and hydroxychloroquine was initiated alongside ongoing immunotherapy. The patient continues to receive atezolizumab with stable disease and good quality of life.ConclusionThis case highlights the importance of recognizing SjS as a potential irAE in patients treated with ICIs, particularly those with TNBC. Multidisciplinary collaboration is essential for the prompt diagnosis and effective management of SjS to maintain both cancer control and patient quality of life. Given the recent emergence of these events and the lack of specific guidelines, our case report may provide valuable insights into the management of a little-known adverse event and pave the way for further real-world data collection on the management of these rare but significant toxicities that impact on patient quality of life. Further research is needed to optimize treatment protocols and outcomes for patients experiencing rheumatological irAEs during cancer immunotherapy.
SMAD4 enhances the cytotoxic efficacy of human NK cells against colorectal cancer cells via the m6A reader YTHDF2
Authors: Li Xinxin , Wang Yilin , Cai Lei , Huang Siyong 
Published: October 2024

BackgroundColorectal cancer (CRC) ranks as the third most prevalent malignant neoplasm in terms of both morbidity and mortality. Within the tumor microenvironment (TME) of CRC, the diminished presence and diminished cytotoxic function of natural killer (NK) cells serve as important factors driving the advancement of CRC; however, the precise regulatory mechanisms governing this phenomenon remain incompletely understood. Consequently, the identification of novel, potential anti-CRC targets associated with NK cells emerges as a pressing and paramount concern warranting immediate attention.MethodsWe examined the regulatory mechanism of SMAD4-mediated NK cell cytotoxicity on CRC by utilizing various experimental techniques, such as qRT-PCR, flow cytometry.ResultsOur findings revealed that the expression of SMAD4 is decreased in NK cells within the TME of human CRC. Furthermore, we observed that enforced upregulation of SMAD4 resulted in enhanced cytotoxicity of NK cells towards CRC cells. Furthermore, our research has revealed that YTHDF2 functions as a downstream effector of SMAD4, playing a crucial role in the control of transcription and translation of m6A-modified RNA. Moreover, our investigation demonstrated that increased expression of SMAD4 promoted the activating receptor NKG2D by elevating levels of YTHDF2. Ultimately, the SMAD4-YTHDF2 regulatory axis significantly enhanced the cytotoxicity of NK cells against human CRC cells.ConclusionOur study unveils a novel mechanism through which SMAD4 modulates the cytotoxicity of NK cells towards CRC cells, suggesting that SMAD4 may hold promise as a potential therapeutic target for NK cell therapy in CRC.
Effect of closed-loop vibration stimulation on sleep quality for poor sleepers
Authors: Kwon Hyun Bin , Jeong Jonghyeok , Choi Byunghun , Park Kwang Suk , Joo Eun Yeon , Yoon Heenam 
Published: October 2024

IntroductionRecent studies have investigated the autonomic modulation method using closed-loop vibration stimulation (CLVS) as a novel strategy for enhancing sleep quality. This study aimed to explore the effects of CLVS on sleep quality, autonomic regulation, and brain activity in individuals with poor sleep quality.MethodsTwenty-seven participants with poor sleep quality (Pittsburgh sleep quality index &gt;5) underwent two experimental sessions using polysomnography and a questionnaire, one with CLVS (STIM) and the other without (SHAM).ResultsSleep macrostructure analysis first showed that CLVS significantly reduced the total time, proportion, and average duration of waking after sleep onset. These beneficial effects were paralleled by significantly increased self-reported sleep quality. Moreover, there was a significant increase in the normalized high-frequency (nHF) and electroencephalography relative powers of delta activity during N3 sleep under STIM. Additionally, coherence analysis between nHF and delta activity revealed strengthened coupling between cortical and cardiac oscillations.DiscussionThis study demonstrated that CLVS significantly improves sleep quality in individuals with poor sleep quality by enhancing both subjective and objective measures. These findings suggest that CLVS has the potential to be a practical, noninvasive tool for enhancing sleep quality in individuals with sleep disturbances, offering an effective alternative to pharmacological treatments.
POLQ immunostaining behaves as a prognostic factor for pancreatic carcinoma
Authors: del Puerto-Nevado Laura , Fernández-Aceñero María J. , Cebrián Arancha , Fatych Yuliia , Díez-Valladares Luis I. , Pérez-Aguirre Elia , de la Serna Sofía , García-Botella Alejandra , Martínez-Useros Javier , García-Foncillas Jesús , Mateos-Gómez Pedro A. 
Published: October 2024

BackgroundDNA polymerase theta (POLQ) is a translesion synthesis polymerase essential for the repair of double strand breaks by the error-prone TMEJ (Theta Mediated End Joining) pathway. Although POLQ participates in maintaining genome stability, several studies have shown that its overexpression correlates with cancer progression and poor prognosis. Due to the fact that its role as a biomarker in pancreatic cancer remains unexplored, we aimed to study the usefulness of POLQ H-score as a prognostic factor in a pancreatic cancer patient cohort.MethodsWe evaluated POLQ gene expression using a web-based tool to deliver gene expression profiling and interactive analyses based on TCGA and GTEx (GEPIA) and we examined the POLQ immunostaining in 152 biliopancreatic cancer surgical specimens using tissue microarrays. Association with survival was evaluated by Kaplan Meier curves and uni-multivariate Cox regression.ResultsGEPIA analysis showed statistical differences according to POLQ mRNA levels in Disease Free Survival (DFS) (log rank 0.023, HR 2.8, p=0.029) and Overall Survival (OS) (log rank 0.011, HR 3.1, p=0.016). For immunohistochemistry (IHC) evaluation, POLQ H-score was calculated, and showed statistical differences for OS in Kaplan Meier curves (log rank 0.001) and uni-multivariate analysis (HR 2.27; 95% CI 1.24-4.15, p=0.008).ConclusionsOur results indicate that POLQ is an independent prognostic factor in pancreatic cancer when analyzed by immunostaining, which is in agreement with the results shown by the POLQ gene expression analysis (GEPIA).
Microwave ablation for high-risk pulmonary nodules in patients infected with the Omicron variant of Sars-Cov-2 within 3 months: a retrospective analysis of safety and efficacy
Authors: Chen Yuxian , Li Yang , Meng Hong , Li Chunhai , Kong Fanlei 
Published: October 2024

IntroductionTo evaluate the safety and efficacy of microwave ablation (MWA) for high-risk pulmonary nodules in patients infected with the Omicron variant within 3 months, a retrospective study was conducted.MethodsThe study included patients with multiple high-risk nodules who underwent CT-guided MWA from April 2022 to April 2023. Patients were divided into an observation group and a control group. The primary endpoints were postoperative complications and hospital length of stay, while the secondary endpoint was progression-free survival (PFS).ResultsA total of 157 patients were included in the analysis, with 64 in the observation group and 93 in the control group. No deaths occurred within 30 days after MWA. In the observation group, the median follow-up time was 7 months, during which 5 patients experienced disease progression after MWA, including 3 cases of pulmonary metastases. Complications were primarily pneumothorax, pleural effusion, and hemorrhage, with an incidence rate of 57.8%, which was statistically significant (p=0.005). The median length of hospital stay was 5 days for the observation group and 6 days for the control group. There was no statistically significant difference in PFS between the two groups after the removal of lung metastases (p=0.265).DiscussionCT-guided MWA is an alternative treatment for patients with high-risk lung nodules who have been infected with Omicron within the past 3 months.
Evaluation of prognostic factors for late recurrence in clear cell renal carcinoma: an institutional study
Authors: Voskuil-Galoş Diana , Călinici Tudor , Piciu Andra , Nemeş Adina 
Published: October 2024

Background and objectivesFollowing nephrectomy with curative intent, a subset of patients diagnosed with non-metastatic renal cell carcinoma (nmRCC) will present late recurrences, with metastatic relapses after 5 years from the surgical intervention. The aim of this study is to evaluate the prevalence of late recurrences in Romanian patients with nmRCC that have undergone surgery and to assess the clinicopathological characteristics prognostic for late-relapse RCC.Materials and methodsThis is a single-center, retrospective and observational study that analyzed patients with nmRCC with clear cell histology who underwent surgical resection of the primary tumor with curative intent. The patients included in the study were treated and further surveilled according to a personalized follow-up plan between January 2011 and December 2012 in The Oncology Institute "Prof. Dr. Ion Chiricuţă", Cluj-Napoca, Romania. Study endpoints included median disease-free survival (DFS), median overall survival (OS), as well as evaluation of possible prognostic factors indicative of late relapse.ResultsIn the study cohort (n=51), the median DFS was 46 months and median OS was 130 months. DFS was significantly correlated with the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) score (p=0.04, HR=2.48; 95% CI [1.02, 6.01]), neutrophil to lymphocyte ratio (NLR) (a higher NLR value was associated with a poorer DFS, p=0.035), tumor size (T4 tumors vs. T1 p&lt;0.05, HR=9,81; 95% CI [2.65, 36.27]) and Fuhrman nuclear grade (Fuhrman grade 1 vs. Fuhrman grade 3 p&lt;0.05, HR=4,16; 95% CI = [1.13,15.22]). Fifty one percent of the patients included experienced disease relapse. From this subgroup, a significant percentage of 42% patients presented disease recurrence after 60 months from nephrectomy. OS was correlated to IMDC score (p=0.049, HR=2.36; 95% CI [1, 5.58]) and Fuhrman nuclear grade (Fuhrman grade 1 vs. Fuhrman grade 3 p&lt;0.05, HR=3,97; 95% CI [1.08, 14.54]).ConclusionsThe results of this study support the previously presented biological behavior of RCC, demonstrating that late recurrences in RCC are not uncommon occurrences and patients with localized RCC should be followed up for a longer interval after the surgery for the primary tumor. In addition, the study strengthens the data supporting certain biomarkers as valuable prognostic factors determining survival outcomes of patients with RCC.
Hygienic practice during complementary feeding and associated factors among mothers of children aged 6–24 months in Borecha Woreda, southwestern Ethiopia: a community-based cross-sectional study
Authors: Birdida Rabira Tariku , Malka Erean Shigign , Negash Kush Efrem , Tolesa Alemu Fikadu 
Published: October 2024

IntroductionComplementary feeding is a critical transitional phase in the life of an infant, and complementary foods should be prepared, stored, and fed hygienically, with clean hands, dishes, and utensils to prevent diseases. However, the prevalence and risk factors associated with hygienic complementary feeding practice have not been well addressed in Ethiopia, especially in the study area.ObjectiveThis study aimed to assess hygienic practices and associated factors during complementary feeding among mothers with children aged 6–24 months in Borecha Woreda, Buno Bedele Zone, southwestern Ethiopia, in 2022.MethodsA community-based cross-sectional study was conducted using a multistage sampling technique. The study was conducted on 536 mothers of children aged 6–24 months in Borecha Woreda from 1 March to 1 April 2022. Data were collected using an interviewer-administered questionnaire. The data were coded, cleaned, edited, and entered into Epi-Data version 4.6 and then exported to SPSS version 20.0 for further analysis. Both bivariate and multivariable logistic regression models were fitted. Moreover, crude (for bivariate) and adjusted (multivariable) odds ratios (AORs) with 95% confidence intervals (CIs) were computed to assess the association between independent factors and outcome variables. A p-value of &lt;0.05 was considered statistically significant.ResultOut of 536 respondents, 350 (65.3%) exhibited poor hygienic practices during complementary feeding. The risk of poor hygienic practices was about two times higher among women over 30 than those under 25 (AOR: 1.8; 95% CI: 1.11–2.90). Mothers whose husbands had primary education or higher had a 50% reduced risk (AOR: 0.50; 95% CI 0.31–0.83) of poor hygienic care practices during complementary feeding compared to their counterparts. The odds of poor hygiene practice among mothers with poor knowledge of hygienic care were 2.71 times higher than those with good knowledge (AOR: 2.71; 95% CI: 1.60–4.61).ConclusionThe prevalence of poor hygienic practices during the preparation and handling of complementary foods among mothers in Borecha Woreda is high compared to other studies. Therefore, improving hygiene practices during complementary food preparation requires the involvement and responsibility of policymakers, the community, and families.
Children with sickle cell disease: are they protected from serious COVID-19?
Authors: Shahin Walaa Aboulkasem , Aldeeb Hayam , Alsulami Majed , Tammas Abdullah , Albatniji Fatma , Almanea Aljawhara , Zayed Abdalla Mohamed , Alabbas Fahad , Alzahrani Azzah , Bin Ali Tahani , Elyamany Ghaleb , Almaghrabi Rana Hassan , Elfaraidi Huda 
Published: October 2024

BackgroundCOVID-19, the pandemic that hit the world in 2020, resulted in millions of deaths, with the elderly and adults succumbing to the disease more often than children. However, the presence of underlying morbidities increased the risk of death. Sickle cell disease (SCD) was previously classified as a major risk factor for severe COVID-19 disease. However, presently, there are only a limited number of studies that identify the clinical course of children with SCD and COVID-19.MethodsWe conducted a retrospective observational study on children with SCD admitted due to COVID-19 at three different institutions in Saudi Arabia between March 2020 and March 2022. We studied the demographic and clinical characteristics of patients admitted to the hospital.ResultsSeventy-six patients with SCD had PCR-confirmed SARS-CoV-2 during the study period; 50.0% of our patient population were children (6–12 years old). Gender was evenly distributed, with 53.9% girls and 46.1% boys. Symptoms more commonly related to the COVID-19 infection included fever, cough, malaise, and vomiting. Chest x-ray findings revealed mild and non-specific symptoms only in approximately one-third (28) of the included children. The most common symptoms associated with SCD were vaso-occlusive crisis (47.4%) and abdominal pain (11.8%). The overall general appearance of most of the patients was reassuring. The median length of hospital stay was 4.2 ± 2.7 days. The mean white blood cell count was 11.4 ± 5.2 × 109/L, and the mean hemoglobin level was 8.3 ± 1.5 g/dl. Despite the fact that higher levels of mean D-dimer, lactate dehydrogenase, and ferritin were reported in these patients, the clinical outcome was not affected. All recruited patients received hydroxyurea as maintenance therapy. The outcome of our study was reassuring, with no significant morbidity or mortality observed among the recruited patients.ConclusionDespite SCD being a chronic disease with known specific complications, there has been a claim that COVID-19 infection adds further risk. The results of this study suggest that the overall outcome of COVID-19 was favorable, with no reported mortality. Further research is needed to understand the factors that contributed to this favorable outcome. In children with SCD, it is still questionable whether hydroxyurea is one of the protective factors against severe COVID-19. Validation through large-scale research is recommended.