bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperatively Predicting Failure to Achieve the Minimum Clinically Important Difference and the Substantial Clinical Benefit in Patient-Reported Outcome Measures for Total Hip Arthroplasty Patients using Machine Learning
Authors: Park Jaeyoung , Zhong Xiang , Miley Emilie N. , Gray Chancellor F. 
Published: October 2024

Abstract

Background: Attention to the collection of patient-reported outcomes measures (PROMs) associated with total hip arthroplasty (THA) is growing. The aim of this study was to preoperatively predict failure to achieve the minimal clinically important difference (MCID) and substantial clinical benefit (SCB) between pre- and postoperative PROMs. In addition, we sought to identify factors predictive of failure to achieve MCID and SCB in patients undergoing a THA.
Methods: A retrospective query of the electronic health record data was performed at a single institution. Outcomes of interest were the anchor-based MCID, the distribution-based MCID, and the SCB for the Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement. Several machine learning models were built for each outcome, and areas under the receiver operating characteristic curve and the precision-recall curve were evaluated. Furthermore, logistic regression models were used to identify significant risk factors.
Results: Of the 857 patients who underwent THA, 350 patients completed both pre- and postoperative surveys. Of the final sample (i.e., 350 patients), 56 (16.0%), 29 (8.3%), and 71 (20.3%) failed to reach the anchor-based (i.e., 17.7 points) and distribution-based (10.6 points) MCIDs and the SCB (i.e., 22.0 points). The machine learning model performances were far beyond the baseline and comparable to the ones in existing studies, suggesting reliability in the prediction. Two shared factors associated with the failure in both MCIDs and the SCB were highlighted: a patient’s race and pre-existing mental illness.
Conclusion: Understanding the risk factors of failing to meet MCID and SCB may provide a more objective opportunity to quantify patient and surgeon expectations associated with THA. Our findings call stakeholders' particular attention to patients with preoperative mental disorders, and raise further questions regarding the impact of race, in the care of patients with degenerative hip disease.
The diagnostic value of NLR, PLR, SII and FAR in endometrioid carcinoma and their correlation analysis with clinicopathological characteristics of endometrioid carcinoma
Authors: zuo Hongling , Zong Yadi , Yao Zhi , Liu Yaxin , Du Juan , Liu Zhina , Liu Pan , Yang Yuxing , Guo Pengfei , Du Hui 
Published: October 2024

Abstract

Objective To investigate the potential utility of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), and fibrinogen-to-albumin ratio (FAR) in the diagnosis of endometrioid carcinoma (EEC). Additionally, to explore the correlation between these ratios and the clinicopathological characteristics of EEC.
Methods 1.113 patients with EECdiagnosed in our hospital from November 2018 to November 2023 were selected as the study group, and 113 patients with endometrial polyps in our hospital during the same period were selected as the control group. Both groups were confirmed by pathology. The differences of NLR, PLR, SIIand FAR in the pre-operation peripheral blood of patients in the two groups were analyzed, and the value of individual indicators in diagnosis of EEC was evaluated using the Receiver Operating Characteristic (ROC) curve. 2. 147 patients of EEC with complete clinic-pathological data were divided into groups according to postoperative FIGO stage, histological grade, depth of muscle invasion, presence or absence of lymph-vascular space invasion (LVSI) and lymph node metastasis (LNM). The correlations between NLR, PLR, SII, FAR and different clinicopathological characteristics were analyzed.
Results 1. The levels of NLR, SII and FAR in patients of EEC were significantly higher than those in patients with endometrial polyps (P<0.05). While PLR showed no significant difference between the two groups (P>0.05). The optimal cut-off values of NLR, SII, FAR were 1.650, 361.260 and 0.071. The area under the curve (AUC) were 0.621, 0.622 and 0.590. The sensitivity and specificity were 66.4%, 72.6%, 48.7% and 54.9%, 47.8%,70.8%. 2. Among 147 EEC patients, there were 130 (88.43%) cases in FIGOI+II stage and 17 (11.56%) cases in III+IV stage, 5 (3.40%) cases with LNM and 142 (96.59%) cases without LNM. Significant differences of NLR, PLR, SII were observed between different clinical stages and LNM status, while FAR only showed an advantage in clinical stage (P<0.05). However, NLR, PLR, SII and FAR showed no significant differences in histological grade, depth of myographic infiltration, and LVSI (P>0.05).
Conclusion As a simple and non-invasive preoperative hematological index, NLR, PLR and SII have certain predictive value for EEC. NLR, PLR, SII and FAR are closely correlated with the clinicopathologic features of EEC, may serve as potential discriminative biomarkers for the diagnosis and prognosis of EEC.
Effects of feeding empty fruit bunch extract on milk production and milk fatty acid profiles in goats
Authors: Harun Nur Liyana Akmal , Samsudin Anjas Asmara , Sazili Awis Qurni , Goh Yong Meng 
Published: October 2024

Abstract

The effect of feeding empty fruit bunch extract on milk production and milk fatty acid profiles of lactating Saanen goats was evaluated. A total of four lactating Saanen goats (14 days in milk, 54.3 ± 9 kg of body weight) were subjected to a crossover design with a 17-d period (10-day adaptation period and 7-day for data and sampling period) with a 12-day washout period in between both periods. The treatment diets were; CON; (0% extract, basal diet of 60:40 of napier grass and concentrate) and EFB (5% OPEFB extract per DM basal diet). The 5% EFB extract in EFB diet did not affects milk yield, milk fat, milk total solid and milk solid non-fat compared to the CON diet. The milk protein content was significantly higher in EFB diet (P < 0.05) while milk lactose content was significantly higher in CON diet (P < 0.001) when compared to the others. Milk from EFB diet shows significantly higher (P < 0.05) in capric, lauric, myristic acid, and total SFA concentration as compared with milk from CON diet. Goat fed with EFB diet significantly reduced (P < 0.05) in stearic, oleic, total UFA, total MUFA concentration and UFA: SFA ratio in milk when compared with goat fed with CON diet. Meanwhile, the content of myristoleic acid, linoleic acid and PUFA: SFA ratio was similar between both treatment diets. Hence, the supplementation of 5% OPEFB extract in EFB diet did not alter milk production but the composition of the milk especially the profiles of milk fatty acid.
MAPKAPK2 (MK2) facilitates the epithelial-mesenchymal transition in lung adenocarcinoma through activation of the AKT/MYC signaling pathway
Authors: Qi Rong , Fang Chen , Liu Penghui , Gu Weiguo , Shi Chao , Zhang Guohua , Qiu Feng 
Published: October 2024

Abstract

Purpose
The protein kinase Mitogen-Activated Protein Kinase-Activated Protein Kinase 2 (MK2) is linked to higher risks of metastasis and mortality in some cancers. Nonetheless, its precise function in lung adenocarcinoma (LUAD) is still not well understood. Thus, our research focuses on examining MK2’s role within LUAD cells and identifying the underlying mechanisms involved.
Methods
Differences in MK2 expression among patients with LUAD were confirmed through Timer2.0 database and tissue microarrays. The activity of MK2 in LUAD cell lines A549 and H358 was inhibited using a specific MK2 inhibitor. Thereafter, the viability, migration and mobility were analyzed. Gene expression changes were confirmed through Western blotting. Additionally, an AKT activator was used to validate the role of the MK2-regulated AKT/MYC signaling pathway.
Results
MK2 shows higher expression in LUAD tissues than in surrounding normal tissues. Reducing MK2 activity not only curtails cell proliferation, migration, and EMT-related invasion in vitro but also disrupts the AKT/MYC signaling axis. Nevertheless, activating the AKT/MYC pathway can counteract the effects of MK2 inhibition.
Conclusions
Our research shows that MK2 promotes migration and invasion in LUAD through the AKT/MYC signaling pathways, highlighting MK2 as a potential therapeutic target for LUAD.
Bedside Tracheostomy for Pediatric Critically Ill patients in PICU: Clinical Experience in a Single center
Authors: Lim Young Tae , Kwon Jung Eun 
Published: October 2024

Abstract

Background
Children with neurological impairments, especially those who are bedridden, may require additional care services beyond what is available for the general pediatric population, and tracheostomy may be necessary for addressing respiratory problems, but no established consensus or clear guidelines have been established on the optimal timing of this procedure in the pediatric intensive care unit (PICU).
Methods
We conducted a study involving 39 bedridden patients with neurological impairments who underwent tracheostomy in the PICU from January 2017 to December 2022. We collected demographic, tracheostomy, and outcome data and compared the data between two groups based on the duration of mechanical ventilation before tracheostomy.
Results
The patients had heterogeneous neurological conditions, with refractory epilepsy being the most common. Almost all patients received tracheostomy for prolonged mechanical ventilation, with a median duration of 14.5 days of mechanical ventilation before the procedure. A majority of the patients (60.5%) experienced complications related to tracheostomy. The overall mortality rate was 36.8%, with 7.9% directly related to tracheostomy. When the patients were divided into two groups based on the median duration of mechanical ventilation before tracheostomy, the group that received tracheostomy earlier had significantly shorter total PICU stay and hospitalization stay compared to the group that received it later.
Conclusions
Tracheostomy is a procedure necessary for resolving respiratory difficulties in children with neurological impairments who are typically bedridden. As complications and mortality rates can be high in this population, careful and appropriate care is necessary.
Shape detection of cervical vertebrae growth stage using “No Coding” Deep Learning - Google’s Teachable Machine tool
Authors: Fattal Amine , Swinson Heather , Gudhimella Sudha , El-Baz Ayman , Deguchi Toru 
Published: October 2024

Abstract

Objective: Prediction of skeletal growth has always been an interest in the field of orthodontics. The shape of the cervical vertebrae was found to be correlated to different growth stages. Several studies have used machine learning to identify the cervical vertebrae maturation stage (CVMS), however, the accuracy was not as high as it was expected. Moreover, machine learning tool is complicated and is not familiar for most clinicians. Recently, user friendly and easily accessible website known as “Google’s Teachable Machine Tool” was introduced. If proved to be reliable, this kind of free and easy to use Ai tools can help expand and accelerate Ai applications in dentistry. The purpose of this study is to classify the CVMS using Google’s Teachable Machine tool and investigate the accuracy.
Materials and Method: Three hundred and sixty cephalograms (60 for each stage) were used in this study. Region of interests (ROIs) were cropped from each cephalogram to include the 2nd to 4th vertebrae. A different image type was made by using a digital edge detection tool to draw the shape of the vertebrae and construct a white mask of vertebrae with a black background. Both image types They were fed to Teachable Machine later to train the model. Furthermore, masks, which are often used for this task, were validated against human classifiers.
Results: F1 score was highest at 0.75 for post pubertal, 0.68 for Pre pubertal and 0.61 for pubertal. Accuracy was 0.81, 0.72, and 0.83 for pre pubertal, pubertal and post puberal. Mask were inferiorly classified by humans.
Conclusions: Google teachable can, with a reasonable accuracy, classify the CVMS in pre pubertal, pubertal and post pubertal classes and masks showed to be inferior image type to train the model and proved less valid in our study.
Association between advanced lung cancer inflammation index and all-cause and cardiovascular mortality among prediabetes patients: NHANES, 1999–2018
Authors: Yan Rui , Ma Xueping , Shi Bo , Ye Congyan , Fu Shizhe , Wang Kairu , Yan Ru , Jia Shaobin , Cong Guangzhi 
Published: October 2024

Abstract

Background
Prediabetes is a significant risk factor for type 2 diabetes and cardiovascular disease, yet effective prognostic tools are lacking. The Advanced Lung Cancer Inflammation Index (ALI), an emerging inflammatory marker, has shown prognostic value in various diseases. However, the role of ALI in prediabetic patients remains understudied. This study aims to evaluate the association between ALI and all-cause and cardiovascular disease (CVD) mortality in prediabetic patients, exploring its potential as a prognostic assessment tool.
Methods
This study utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. Multivariate Cox regression models were used to analyze the relationship between ALI and mortality risk. Their non-linear relationship was analyzed by restricted cubic spline analysis. Sensitivity analysis was constructed through stratified analysis and interaction analysis.
Results
The study incorporated a total of 16,670 patients. An increase in ALI was associated with a reduced risk of all-cause and CVD mortality in prediabetes patients. Compared to the lowest ALI quartile, the highest quartile showed a 30% reduction in all-cause mortality risk (HR = 0.70, 95%CI: 0.62–0.79) and a 44% reduction in CVD mortality risk (HR = 0.56, 95%CI: 0.44–0.73). In addition, there were L-shaped non-linear relationships between ALI and all-cause, CVD mortality in prediabetes patients. The inflection points were 40.50 and 37.35, respectively. For values below the inflection point, for every 10U increase in ALI, all-cause mortality risk decreased by 26%, and CVD mortality risk decreased by 32%. Beyond the inflection point, the effect weakened both all-cause and CVD mortality.
Conclusion
ALI is significantly negatively associated with all-cause and CVD mortality in prediabetic patients. ALI may serve as an effective tool for assessing long-term prognosis in prediabetic individuals.
Central Retinal Artery Occlusion Following Delayed Acute Retinal Necrosis Post-SARS-CoV- 2 Recovery: Clinical Practice and Literature Review
Authors: Jiang RunDong , Lin Dan , Feng Han , Chen WenJuan , Pan AnNa , Wang YuQin 
Published: October 2024

Abstract

This study investigates acute retinal necrosis (ARN) complicated by central retinal artery occlusion (CRAO) post-SARS-CoV-2 infection, a rare clinical scenario. It highlights the clinical characteristics and potential pathogenesis of this condition based on a comprehensive literature review, emphasizing the role of SARS-CoV-2 in its development. The research demonstrates that cardiovascular or cerebrovascular diseases, herpes encephalitis, meningitis history, and immunocompromise are potential risk factors for CRAO in ARN patients. Misdiagnoses and delayed diagnoses are common in the initial stages of ARN complicated by CRAO, often leading to poor outcomes due to the lack of antiviral treatment or inappropriate use of corticosteroids. The study posits the synergistic role of SARS-COV-2 in activating herpes viruses and promoting thrombogenesis within the central retinal artery. Emphasizing the importance of dilated eye examinations in all new uveitis patients, particularly those with a history indicating a high risk for ARN, the study advocates for prophylactic antiviral therapy in such individuals following SARS-COV-2 infection. A multidisciplinary team (MDT) approach, combined with comprehensive antiviral treatment, is crucial for managing these cases, aiming to improve prognosis through urgent interventions for ARN-related CRAO.
The fire performance of GFRP-RC beams based on FE thermal analysis
Authors: Bolina Fabricio Longhi , Silva Débora Bretas , Pachla Eduardo Cesar 
Published: October 2024

Abstract

GFRP (glass fiber reinforced polymers) rebars can be used in RC (reinforced concrete) structures as an alternative to conventional steel rebars. Their application offers advantages, especially in chemically aggressive environments, as they can reduce the C (concrete cover) thickness required and also optimize the cross-sectional dimensions of these structures as well as their durability and service life. However, based on FE (finite element) numerical analysis solved by Abaqus software, this research has shown that the reduction in C-thickness promotes a notorious incongruity: an improvement in the fire sensitivity of these structures. The time in which GFRP-RC structures failed in fire can be around 400% lower in relation to identical conventional steel RC structures. In some cases, the fire resistance rate (FRR) of GFRP RC structures can be less than 10 min when the critical temperature of these rebars (around 100°C) is taken into account. The interest in structural durability criteria is not sufficient to justify the application of this new type of reinforcement in some concrete buildings.
The Prognostic Significance of Subcarinal Lymph Node Dissection in Esophagectomy for Middle and Lower Thoracic Squamous Cell Carcinoma
Authors: Xu Si Wei , Liu Jun Feng , Liu Xin-Bo , Shi Zhi Hua , Cao Bing Ji , Zhang Shao Wei 
Published: October 2024

Abstract

Background
This retrospective study assesses the prognostic value of subcarinal lymph node dissection (SCLND) in esophageal squamous cell carcinoma (SCC) of the middle and lower thoracic regions.
Methods
Conducted at the Fourth Hospital of Hebei Medical University, the study included 1588 patients with SCC who underwent radical resection from 2008 to 2014. After propensity score matching, 661 patients were analyzed, with 185 without and 476 with SCLND. Kaplan-Meier curves, Log-rank tests, and Cox regression were used for survival analysis, with SPSS 23.0.
Results
SCLN metastasis was found in 10.3% of patients. Factors influencing metastasis included tumor size, invasion depth, positive lymph node count, and smoking and alcohol history. SCLND significantly affected overall survival, with 5-year rates of 47.7% for non-metastatic versus 12.8% for metastatic patients. SCLND improved long-term survival for T3-T4a stage patients but not for T1-T2.
Conclusion
Despite a low SCLN metastasis rate, its presence significantly worsens prognosis. SCLND improves long-term survival, particularly for T3-T4a stage patients, guiding surgical decisions on lymph node dissection.
Correlation between circulating cell-free mitochondrial DNA content and severity of knee degeneration in patients with knee osteoarthritis
Authors: Wu Yan-lin , Wan Shao-gui , Long Yi , Ye Hua , Yang Jia-ming , Luo Yun , Zhong Yan-biao , Xiao Li , Chen Hai-yan , Wang Mao-yuan 
Published: October 2024

Abstract

Background
Mitochondrial damage and increased inflammation are hallmarks of knee osteoarthritis (KOA). Circulating cell-free mitochondrial DNA (ccf-mtDNA), which originates from damaged mitochondria, is an endogenous damage-associated molecular patterns (DAMPs) molecule that may trigger inflammation and has been recognized as a potential biomarker for various diseases. In this study, we aimed to investigate whether there is a potential association between plasma ccf-mtDNA levels and the severity of knee injury and whether it can be used as an early diagnostic biomarker in patients with KOA.
Methods
Plasma was collected from KOA patients and healthy controls (HC). Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect ccf-mtDNA content in plasma samples. X-ray Kellgren-Lawrence (K-L) classification criteria were used to classify KOA patients into four groups of grades I-IV. The severity of disease in KOA patients was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and a Spearman analysis was performed to observe the correlation between ccf-mtDNA content and the K-L classification and WOMAC score. Logistic regression analysis was used to evaluate the relationship between ccf-mtDNA and the risk of KOA.
Results
60 patients with KOA and 60 HC matched for their age, sex, and body mass index (BMI) were enrolled. we found that plasma ccf-mtDNA contents were significantly higher in patients with KOA (median, 2.44; range, 1.10–3.79) than in HC (median, 1.08; range, 0.52–2.12) (P < 0.0001). Plasma ccf-mtDNA contents were sequentially higher in the KOA class I-IV group (P = 0.040), and positively correlated with K-L classification (r = 0.369, P = 0.004), and WOMAC scores (r = 0.343, P = 0.007). Subjects with high levels of ccf-mtDNA had a significantly increased risk of KOA compared with subjects with low levels of ccf-mtDNA [odds ratio (OR), 4.15, 95% confidence interval (CI), 1.71–10.07; P = 0.002]. Quartile analysis showed a significant dose-dependent effect for this association (P trend = 0.000).
Conclusion
Our study suggested that plasma ccf-mtDNA contents were significantly associated with the risk and severity of KOA. Plasma ccf-mtDNA may be a liquid biopsy biomarker for the early diagnosis of KOA and the assessment of its symptom severity and may shed light on the prevention and treatment of KOA.
Severe Perineal Tears during Childbirth: A Study of Ethnic Minority Women's lived Experiences and Healthcare Challenges
Authors: Olakotan Olufisayo Olusegun , Lim Jennifer , Bhavsar Mina , Siddiqui Farah , Ayaz Rabina , Henry Gillian O’Brady , Pillay Tilly 
Published: October 2024

Abstract

Background
The increasing incidence of Obstetric anal sphincter injury (OASI) has resulted in numerous reported cases of complications and risks among women, significantly impacting their quality of life. Qualitative studies focusing on lived experiences of women following OASI in the United Kingdom (UK) are scarce.
Aim
This study aims to explore the lived experiences of women with OASI from culturally diverse backgrounds in Leicester, UK.
Methodology:
A focus group discussions (FCDs) was held virtually with ten women from Leicester who had experienced third and fourth-degree tears in the last one to five years. Invitation to participate in the study were sent out by Leicester Mammas via email, attached with a flyer. The data was analysed using the five-step thematic analysis approach by Braun and Clarke.
Results
The study identified several key themes such as childbirth experiences, complications and reflection, societal influence and childbirth choices, cultural silence, stigmatization, and mental health issues. The women reported feeling uninformed and unprepared about possible complications and risks such as third and fourth-degree tears, resulting in traumatic birthing experiences, aggravated by inadequate healthcare communication and support from healthcare providers.
Conclusion
There is the need for future research to integrate physical, physiological and mental health support, as well as sustained follow-up into OASIS care bundle. This will essentially support women's health and well-being during the perinatal period.