bluuebunny/crossref_metadata_2025_split huggingface dataset:
Criteria for assessing evidence for biomarker-targeted therapies in rare cancers—an extrapolation framework
Authors: Cho Doah , Lord Sarah J. , Ward Robyn , IJzerman Maarten , Mitchell Andrew , Thomas David M. , Cheyne Saskia , Martin Andrew , Morton Rachael L. , Simes John , Lee Chee Khoon 
Published: September 2024

Background: Advances in targeted therapy development and tumor sequencing technology are reclassifying cancers into smaller biomarker-defined diseases. Randomized controlled trials (RCTs) are often impractical in rare diseases, leading to calls for single-arm studies to be sufficient to inform clinical practice based on a strong biological rationale. However, without RCTs, favorable outcomes are often attributed to therapy but may be due to a more indolent disease course or other biases. When the clinical benefit of targeted therapy in a common cancer is established in RCTs, this benefit may extend to rarer cancers sharing the same biomarker. However, careful consideration of the appropriateness of extending the existing trial evidence beyond specific cancer types is required. A framework for extrapolating evidence for biomarker-targeted therapies to rare cancers is needed to support transparent decision-making. Objectives: To construct a framework outlining the breadth of criteria essential for extrapolating evidence for a biomarker-targeted therapy generated from RCTs in common cancers to different rare cancers sharing the same biomarker. Design: A series of questions articulating essential criteria for extrapolation. Methods: The framework was developed from the core topics for extrapolation identified from a previous scoping review of methodological guidance. Principles for extrapolation outlined in guidance documents from the European Medicines Agency, the US Food and Drug Administration, and Australia’s Medical Services Advisory Committee were incorporated. Results: We propose a framework for assessing key assumptions of similarity of the disease and treatment outcomes between the common and rare cancer for five essential components: prognosis of the biomarker-defined cancer, biomarker test analytical validity, biomarker actionability, treatment efficacy, and safety. Knowledge gaps identified can be used to prioritize future studies. Conclusion: This framework will allow systematic assessment, standardize regulatory, reimbursement and clinical decision-making, and facilitate transparent discussions between key stakeholders in drug assessment for rare biomarker-defined cancers.
Antithrombotic utilization, adverse events, and associations with treatment outcomes in multiple myeloma: pooled analysis of three clinical trials
Authors: Almansour Sara A. , Alqudah Mohammad A. Y. , Abuhelwa Ziad , Al-Shamsi Humaid O. , Alhuraiji Ahmad , Semreen Mohammad H. , Bustanji Yasser , Alzoubi Karem H. , Modi Natansh D. , Mckinnon Ross A. , Sorich Michael J. , Hopkins Ashley M. , Abuhelwa Ahmad Y. 
Published: September 2024

Background: Patients with multiple myeloma (MM) are at risk of venous thromboembolism (VTE), worsened by immunomodulatory drugs. Although antithrombotics are recommended for prophylaxis, existing guidelines are suboptimal and treatment outcomes remain unclear. Objectives: This study aimed to investigate adverse events, antithrombotic utilization, and their associations with survival outcomes in patients with MM initiating multi-drug immunomodulatory combinations. Design: A posthoc analysis of individual-participant level data (IPD). Methods: IPD from three daratumumab clinical trials (MAIA, POLLUX, and CASTOR) were pooled. Adverse events incidence and antithrombotic utilization were assessed. Logistic and Cox regression were utilized to examine associations between antithrombotics use with adverse events and survival outcomes at the baseline and 6-month landmark. Results: Among 1804 patients, VTE occurred in 10%, bleeding in 14%, ischemic heart disease in 4%, and stroke in 2%. Patients with these adverse events demonstrated elevated rates of any grade ⩾3 events. Antiplatelet (primarily aspirin) and anticoagulant (primarily LMWH and direct oral anticoagulants) prescriptions have seen an increase from baseline (25% and 14%, respectively) to 6 months (35% and 31%). The primary indication for their use was prophylaxis. Anticoagulant use within 6 months was associated with reduced VTE (OR (95% CI) = 0.45 (0.26–0.77), p = 0.004), while antiplatelet use showed no associations with any evaluated adverse events. Antithrombotics and survival outcomes had no significant associations. Conclusion: This study underscores the complexities of antithrombotic therapy and adverse events in MM and highlights the need for vigilant and proactive management due to increased grade ⩾3 adverse events. While anticoagulant use was associated with reduced VTE risk, further research is needed to optimize thromboprophylaxis guidelines and explore antithrombotic efficacy and safety in patients with MM. Trial registration: MAIA (NCT02252172), POLLUX (NCT02076009), CASTOR (NCT02136134).
YOLOv7-based automated detection platform for scalp lesions
Authors: Nguyen Hung Viet , Byeon Haewon 
Published: September 2024

Objective In dermatological research, the focus on scalp and skin health has intensified, particularly regarding prevalent conditions like dandruff and erythema. This study aimed to utilize YOLOv7 model to develop an automated detection web-based system for these specific scalp lesions. Methods Utilizing a dataset of 2200 clinical images, the model's accuracy and robustness were assessed. The raw images were initially preprocessed by the Roboflow tool. We then trained and evaluated the YOLOv7 model, comparing its performance with several baseline models including YOLOv5, YOLOF, and the single-shot detector. Finally, the proposed model was integrated into a flask API-based web application using the flask-ngrok library. Results The YOLOv7 demonstrated exceptional performance, attaining a mean average precision of 98.6%, with precision and recall rates of 98.6% and 97.2%, respectively. When benchmarked against baseline models, the YOLOv7 demonstrated enhanced performance metrics both during the training phase and the testing process on unseen data. Conclusions This study not only validates the potential of YOLOv7 for scalp lesion diagnostic applications but also brings the integration of sophisticated AI models into practical healthcare solutions.
Facilitators of and Barriers to Effective Preceptorships for Pre-licensure Nursing Students: What Nursing Faculty Need to Know
Authors: Davis Suja P. 
Published: September 2024

Introduction Preceptorships offer prelicensure nursing students the opportunity to meet their clinical objectives by working one-on-one with a registered nurse (RN). Although preceptorships can be provided for any clinical course, most prelicensure nursing programs offer them during the final semester. Preceptorships provide a bridge between academic study and the real world of nursing. By acting as a teacher, role model, evaluator, and person who can help a student to socialize with the profession, a preceptor can reduce the reality shock experienced by new nurses and provide them with realistic expectations about the nursing profession. The recent nursing shortage has inadvertently led to a preceptor shortage and forced the nursing leadership to become dependent on available RNs, including those without preceptor training or experience. Purpose This practice update paper aimed to address the facilitators and barriers associated with preceptorships for prelicensure nursing students and discuss the proposed solutions for effective clinical preceptorship based on evidence and the author's personal reflections. Conclusion The major facilitators were the discussion of nursing program expectations, the selection of teaching strategies with real-world examples, the creation of a structured weekly plan to promote learning, and the consideration of alternative teaching approaches. The major barriers were preceptors' dual responsibilities to students and patients, challenging students, and the lack of experienced preceptors. The proposed solutions included obtaining support from the nursing leadership team to ensure that the preceptor had a balanced workload, developing the emotional competence of the preceptor, addressing challenging students through a three-way conference with the student, the preceptor, and the clinical faculty and a written plan to ensure student progress, having the nursing leadership conduct periodic assessments of the preceptor pool, and ensuring that appropriate training was offered to candidates who were willing to become preceptors.
Patients’ Preferences for Antiretroviral Therapy Service in Northwest Ethiopia: A Discrete Choice Experiment
Authors: Belay Yihalem Abebe , Yitayal Mezgebu , Atnafu Asmamaw , Taye Fitalew Agimass 
Published: September 2024

Objective. We aim to evaluate patients’ preferences for antiretroviral therapy (ART) to enhance shared decision making in clinical practice in Northwest Ethiopia. Methods. A discrete choice experiment approach was used among adult patients from 36 randomly selected public health facilities from February 6, 2023, to March 29, 2023. A literature review, qualitative work, ranking and rating surveys, and expert consultation were used to identify the attributes. Location, provider, frequency of visit, appointment modality, refill time, and cost of visit were the 6 ART service features chosen. Participants were given the option of choosing between 2 hypothetical differentiated ART delivery models. Mixed logit and latent class analysis were used. Results: Four hundred fifty-six patients completed the choice task. Respondents preferred to receive ART refills alone at health facilities by health care workers without having to have frequent visits and with reduced cost of visit. Overall, the participants valued the cost of the visit the most while they valued the timing of ART refill the least. Participants were willing to pay only for the attributes of frequency of visit and medication refill time. The latent class model with 3 classes provided the best model fit. Location, cost, and frequency were the most important attributes in class 1, class 2, and class 3, respectively. Income and marital status significantly predicted class membership. Conclusions. Respondents preferred to receive refills at health facilities, less frequent visits, individual appointments, service provision by health care workers, and reduced cost of visit. The cost attribute had the greatest impact on the choice of patients. Health care workers should consider the preferences of patients while providing ART services to meet patients’ expectations and choices. Highlights A discrete choice experiment was used to elicit patient preferences. People living with HIV preferred receiving medication refills at health facilities, less frequent visits, individual appointments, service delivery by health care workers, and lower visit costs. Health care workers should consider the preferences of patients while providing ART service to meet their expectations and choices. Scaling up differentiated HIV treatment services is crucial for patient-centered care.
Wolbachia strain diversity in a complex group of sympatric cryptic parasitoid wasp species
Authors: Valerio Federica , Martel Cornelia , Stefanescu Constanti , van Nouhuys Saskya , Kankare Maaria , Duplouy Anne 
Published: September 2024

Abstract
Background
Maternally-inherited symbionts can induce pre-mating and/or post-mating reproductive isolation between sympatric host lineages, and speciation, by modifying host reproductive phenotypes. The large parasitoid wasp genus Cotesia (Braconidae) includes a diversity of cryptic species, each specialized in parasitizing one to few related Lepidoptera host species. Here, we characterized the infection status of an assemblage of 21 Cotesia species from 15 countries by several microbial symbionts, as a first step toward investigating whether symbionts may provide a barrier to gene flow between these parasitoid host lineages.

Results
The symbiotic microbes Arsenophonus, Cardinium, Microsporidium and Spiroplasma were not detected in the Cotesia wasps. However, the endosymbiotic bacterium Wolbachia was present in at least eight Cotesia species, and hence we concentrated on it upon screening additional DNA extracts and SRAs from NCBI. Some of the closely related Cotesia species carry similar Wolbachia strains, but most Wolbachia strains showed patterns of horizontal transfer between phylogenetically distant host lineages.

Conclusions
The lack of co-phylogenetic signal between Wolbachia and Cotesia suggests that the symbiont and hosts have not coevolved to an extent that would drive species divergence between the Cotesia host lineages. However, as the most common facultative symbiont of Cotesia species, Wolbachia may still function as a key-player in the biology of the parasitoid wasps. Its precise role in the evolution of this complex clade of cryptic species remains to be experimentally investigated.
The effectiveness and outcomes of epidural analgesia in patients undergoing open liver resection: a propensity score matching analysis
Authors: Pianngarn Isarapong , Lapisatepun Worakitti , Kulpanun Maytinee , Chotirosniramit Anon , Junrungsee Sunhawit , Lapisatepun Warangkana 
Published: September 2024

Abstract
Background
Open liver resection necessitates a substantial upper abdominal inverted-L incision, resulting in severe pain and compromising patient recovery. Despite the efficacy of epidural analgesia in providing adequate postoperative analgesia, the potential epidural-related adverse effects should be carefully considered. This study aims to compare the efficacy and safety of continuous epidural analgesia and intravenous analgesia in open liver resection.

Methods
A retrospective study was conducted, collecting data from patients who underwent open liver resection between 2007 and 2017. Propensity score matching was implemented to mitigate confounding variables, with patients being matched in a 1:1 ratio based on propensity scores. The primary outcome was the comparison of postoperative morphine consumption at 24, 48, and 72 hours between the two groups. Secondary outcomes included pain scores, postoperative outcomes, and epidural-related adverse effects.

Results
A total of 612 patients were included, and after matching, there were 204 patients in each group. Opioid consumption at 24, 48, and 72 hours postoperatively was statistically lower in the epidural analgesia group compared to the intravenous analgesia group (p < 0.001). However, there was no significant difference in pain scores (p = 0.422). Additionally, perioperative hypotension requiring treatment, as well as nausea and vomiting, were significantly higher in the epidural analgesia group compared to the intravenous analgesia group (p < 0.001).

Conclusions
Epidural analgesia is superior to intravenous morphine in terms of reducing postoperative opioid consumption within the initial 72 h after open liver resection. Nevertheless, perioperative hypotension, which necessitates management, should be approached with consideration and vigilance.

Trial registration
The study was registered in the Clinical Trials Registry at www.clinicaltrials.gov/, NCT number: NCT06301932.
Clinical outcome of ampicillin or ampicillin/sulbactam versus glycopeptides in ampicillin-susceptible Enterococcus faecalis/faecium bacteremia: a 10-year retrospective cohort study
Authors: Seong Yeol Jung , Song Je Eun , Lee Eugene , Kim Eun Jin , Heo Jung Yeon , Choi Young Hwa , Kim Yong Chan 
Published: September 2024

Abstract
Background
Glycopeptides for ampicillin-susceptible Enterococcus faecalis/faecium bacteremia are readily prescribed depending on the severity of the condition. However, there is limited data on the outcomes of glycopeptide use compared to ampicillin-containing regimens for ampicillin-susceptible E. faecalis/faecium bacteremia. From an antibiotic stewardship perspective, it is important to determine whether the use of glycopeptides is associated with improved clinical outcomes in patients with ampicillin-susceptible E. faecalis/faecium bacteremia.

Methods
This retrospective cohort study was conducted at a university-affiliated hospital between January 2010 and September 2019. We collected data from patients with positive blood cultures for Enterococcus species isolates. The clinical data of patients who received ampicillin-containing regimens or glycopeptides as definitive therapy for ampicillin-susceptible E. faecalis/faecium bacteremia were reviewed. Multivariate logistic regression analysis was performed to identify risk factors for 28-day mortality.

Results
Ampicillin-susceptible E. faecalis/faecium accounted for 41.2% (557/1,353) of enterococcal bacteremia cases during the study period. A total of 127 patients who received ampicillin-containing regimens (N = 56) or glycopeptides (N = 71) as definitive therapy were included in the analysis. The 28-day mortality rate was higher in patients treated with glycopeptides (19.7%) than in those treated with ampicillin-containing regimens (3.6%) (p = 0.006). However, in the multivariate model, antibiotic choice was not an independent predictor of 28-day mortality (adjusted OR, 3.7; 95% CI, 0.6–23.6).

Conclusions
Glycopeptide use was not associated with improved mortality in patients with ampicillin-susceptible E. faecalis/faecium bacteremia. This study provides insights to reduce the inappropriate use of glycopeptides in ampicillin-susceptible E. faecalis/faecium bacteremia treatment and promote antimicrobial stewardship.
Association between nighttime sleep duration, nap time, and mild cognitive impairment in Chinese older adults: a cross-sectional study
Authors: Song Yanliqing , Liu Haoqiang , Gu KeNan , Liu Yue 
Published: September 2024

Abstract
Objective
This study aims to investigate the relationship between midday nap time, nighttime sleep duration, and mild cognitive impairment (MCI) in Chinese older adults and determine the recommended sleep duration to provide a scientific basis for preventing and managing MCI in this population.

Methods
Utilizing the 2020 China Health and Retirement Longitudinal Study database, the demographic data, health status, and lifestyle information of the study participants were collected. A total of 5,314 valid samples were included in the analysis. Logistic regression and restricted cubic spline plots were employed to explore the relationship between sleep patterns and MCI.

Results
In the cross-sectional analysis, a linear relationship was observed between midday nap duration and MCI among Chinese elderly. The probability of MCI was lowest among those who napped for less than 30 min at noon. Compared with individuals who napped for30-90 min, those who did not nap were more likely to have MCI (OR = 1.30, 95% CI: 1.05–1.60). Older adults with napping duration < 30 min (OR = 0.73, 95% CI:0.56–0.95) also exhibited lower probability of MCI when compared those without napping habit, Nighttime sleep duration exhibited a U-shaped relationship with MCI. Individuals with less than approximately 6 h of nighttime sleep showed a gradual decrease in the probability of MCI with increasing sleep duration, whereas those with more than 7.5 h demonstrated an increase in the probability of MCI with longer sleep duration. Older adults who slept less than 6 h at night (OR = 1.22, 95% CI: 1.01 ~ 1.46) or more than 8 h (OR = 1.78, 95% CI: 1.35–2.33) were more likely to develop MCI compared with those who slept 6 to 8 h.

Conclusion
After controlling for potential confounding variables, both nighttime sleep duration and midday nap duration exhibited a nonlinear “U”-shaped relationship with MCI among the elderly. The probability of depression was lower with a nap duration of approximately 60 min, and the optimal nighttime sleep duration was 6–8 h, with around 7 h providing the greatest cognitive benefits.
Does combining numerous data types in multi-omics data improve or hinder performance in survival prediction? Insights from a large-scale benchmark study
Authors: Li Yingxia , Herold Tobias , Mansmann Ulrich , Hornung Roman 
Published: September 2024

Abstract
Background
Predictive modeling based on multi-omics data, which incorporates several types of omics data for the same patients, has shown potential to outperform single-omics predictive modeling. Most research in this domain focuses on incorporating numerous data types, despite the complexity and cost of acquiring them. The prevailing assumption is that increasing the number of data types necessarily improves predictive performance. However, the integration of less informative or redundant data types could potentially hinder this performance. Therefore, identifying the most effective combinations of omics data types that enhance predictive performance is critical for cost-effective and accurate predictions.

Methods
In this study, we systematically evaluated the predictive performance of all 31 possible combinations including at least one of five genomic data types (mRNA, miRNA, methylation, DNAseq, and copy number variation) using 14 cancer datasets with right-censored survival outcomes, publicly available from the TCGA database. We employed various prediction methods and up-weighted clinical data in every model to leverage their predictive importance. Harrell’s C-index and the integrated Brier Score were used as performance measures. To assess the robustness of our findings, we performed a bootstrap analysis at the level of the included datasets. Statistical testing was conducted for key results, limiting the number of tests to ensure a low risk of false positives.

Results
Contrary to expectations, we found that using only mRNA data or a combination of mRNA and miRNA data was sufficient for most cancer types. For some cancer types, the additional inclusion of methylation data led to improved prediction results. Far from enhancing performance, the introduction of more data types most often resulted in a decline in performance, which varied between the two performance measures.

Conclusions
Our findings challenge the prevailing notion that combining multiple omics data types in multi-omics survival prediction improves predictive performance. Thus, the widespread approach in multi-omics prediction of incorporating as many data types as possible should be reconsidered to avoid suboptimal prediction results and unnecessary expenditure.