bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transition to end-of-life care in patients with neurological diseases in an acute hospital ward
Authors: Jonsdottir Gudrun , Haraldsdottir Erna , Vilhjalmsson Runar , Sigurdardottir Valgerdur , Hjaltason Haukur , Klinke Marianne Elisabeth , Tryggvadottir Gudny Bergthora , Jonsdottir Helga 
Published: July 2024

Abstract
Background
Transitioning to end-of-life care and thereby changing the focus of treatment directives from life-sustaining treatment to comfort care is important for neurological patients in advanced stages. Late transition to end-of-life care for neurological patients has been described previously.

Objective
To investigate whether previous treatment directives, primary medical diagnoses, and demographic factors predict the transition to end-of-life care and time to eventual death in patients with neurological diseases in an acute hospital setting.

Method
All consecutive health records of patients diagnosed with stroke, amyotrophic lateral sclerosis (ALS), and Parkinson’s disease or other extrapyramidal diseases (PDoed), who died in an acute neurological ward between January 2011 and August 2020 were retrieved retrospectively. Descriptive statistics and multivariate Cox regression were used to examine the timing of treatment directives and death in relation to medical diagnosis, age, gender, and marital status.

Results
A total of 271 records were involved in the analysis. Patients in all diagnostic categories had a treatment directive for end-of-life care, with patients with haemorrhagic stroke having the highest (92%) and patients with PDoed the lowest (73%) proportion. Cox regression identified that the likelihood of end-of-life care decision-making was related to advancing age (HR = 1.02, 95% CI: 1.007–1.039, P = 0.005), ischaemic stroke (HR = 1.64, 95% CI: 1.034–2.618, P = 0.036) and haemorrhagic stroke (HR = 2.04, 95% CI: 1.219–3.423, P = 0.007) diagnoses. End-of-life care decision occurred from four to twenty-two days after hospital admission. The time from end-of-life care decision to death was a median of two days. Treatment directives, demographic factors, and diagnostic categories did not increase the likelihood of death following an end-of-life care decision.

Conclusions
Results show not only that neurological patients transit late to end-of-life care but that the timeframe of the decision differs between patients with acute neurological diseases and those with progressive neurological diseases, highlighting the particular significance of the short timeframe of patients with the progressive neurological diseases ALS and PDoed. Different trajectories of patients with neurological diseases at end-of-life should be further explored and clinical guidelines expanded to embrace the high diversity in neurological patients.
Association between CYP1A2 gene variants −163 C/A (rs762551) and −3860 G/A (rs2069514) and bladder cancer susceptibility
Authors: Iqbal Muhammad Sarfaraz , Sardar Nimra , Peng Kaoqing , Almutairi Layla A. , Duan Xialo , Tanvir Fouzia , Attia Kotb A. , Zeng Gouhua , Gu Di 
Published: July 2024

Abstract
Background
Bladder cancer (BLCA) poses a significant global health challenge due to its high incidence, poor prognosis, and limited treatment options.

Aims and objectives
This study aims to investigate the association between two specific polymorphisms, CYP1A2-163 C/A and CYP1A2-3860G/A, within the Cytochrome P450 1A2 (CYP1A2) gene and susceptibility to BLCA.

Methods
The study employed a case-control design, genotyping 340 individuals using Polymerase Chain Reaction-High-Resolution Melting Curve (PCR-HRM). Various genetic models were applied to evaluate allele and genotype frequencies. Genetic linkage analysis was facilitated using R packages.

Results
The study reveals a significant association with the − 163 C/A allele, particularly in the additive model. Odds ratio (OR) analysis links CYP1A2-163 C/A (rs762551) and CYP1A2-3860G/A(rs2069514) polymorphisms to BLCA susceptibility. The rs762551 C/A genotype is prevalent in 55% of BLCA cases and exhibits an OR of 2.21. The A/A genotype has an OR of 1.54. Regarding CYP1A2-3860G/A, the G/A genotype has an OR of 1.54, and the A/A genotype has an OR of 2.08. Haplotype analysis shows a predominant C-C haplotype at 38.2%, followed by a C-A haplotype at 54.7%, and a less frequent A-A haplotype at 7.1%. This study underscores associations between CYP1A2 gene variants, particularly rs762551 (CYP1A2-163 C/A), and an increased susceptibility to BLCA. Haplotype analysis of 340 individuals reveals a predominant C-C haplotype at 38.2%, followed by a C-A haplotype at 54.7%, and a less frequent A-A haplotype at 7.1%.

Conclusion
In conclusion, the − 163 C/A allele, C/A genotype of rs762551, and G/A genotype of rs2069514 emerge as potential genetic markers associated with elevated BLCA risk.
Differentiation of granulomatous nodules with lobulation and spiculation signs from solid lung adenocarcinomas using a CT deep learning model
Authors: Wen Yanhua , Wu Wensheng , Liufu Yuling , Pan Xiaohuan , Zhang Yingying , Qi Shouliang , Guan Yubao 
Published: July 2024

Abstract
Background
The diagnosis of solitary pulmonary nodules has always been a difficult and important point in clinical research, especially granulomatous nodules (GNs) with lobulation and spiculation signs, which are easily misdiagnosed as malignant tumors. Therefore, in this study, we utilised a CT deep learning (DL) model to distinguish GNs with lobulation and spiculation signs from solid lung adenocarcinomas (LADCs), to improve the diagnostic accuracy of preoperative diagnosis.

Methods
420 patients with pathologically confirmed GNs and LADCs from three medical institutions were retrospectively enrolled. The regions of interest in non-enhanced CT (NECT) and venous contrast-enhanced CT (VECT) were identified and labeled, and self-supervised labels were constructed. Cases from institution 1 were randomly divided into a training set (TS) and an internal validation set (IVS), and cases from institutions 2 and 3 were treated as an external validation set (EVS). Training and validation were performed using self-supervised transfer learning, and the results were compared with the radiologists’ diagnoses.

Results
The DL model achieved good performance in distinguishing GNs and LADCs, with area under curve (AUC) values of 0.917, 0.876, and 0.896 in the IVS and 0.889, 0.879, and 0.881 in the EVS for NECT, VECT, and non-enhanced with venous contrast-enhanced CT (NEVECT) images, respectively. The AUCs of radiologists 1, 2, 3, and 4 were, respectively, 0.739, 0.783, 0.883, and 0.901 in the (IVS) and 0.760, 0.760, 0.841, and 0.844 in the EVS.

Conclusions
A CT DL model showed great value for preoperative differentiation of GNs with lobulation and spiculation signs from solid LADCs, and its predictive performance was higher than that of radiologists.
Symptom impact and health-related quality of life (HRQoL) assessment by cancer stage: a narrative literature review
Authors: Chung Karen C. , Muthutantri Anushini , Goldsmith Grace G. , Watts Megan R. , Brown Audrey E. , Patrick Donald L. 
Published: July 2024

Abstract
Background
Cancer stage at diagnosis is an important prognostic indicator for patient outcomes, with detection at later stages associated with increased mortality and morbidity. The impact of cancer stage on patient-reported outcomes is poorly understood. This research aimed to understand symptom burden and health related quality of life (HRQoL) impact by cancer stage for ten cancer types: 1) ovarian, 2) lung, 3) pancreatic, 4) esophageal, 5) stomach, 6) head and neck, 7) colorectal, 8) anal, 9) cervical, and 10) liver and bile duct.

Methods
Ten narrative literature reviews were performed to identify and collate published literature on patient burden at different stages of disease progression. Literature searches were conducted using an AI-assisted platform to identify relevant articles published in the last five (2017–2022) or ten years (2012–2022) where articles were limited. Conference abstracts were searched for the last two years (2020–2022). The geographic scope was limited to the United States, Canada, Europe, and global studies, and only journal articles written in English were included.

Results
A total of 26 studies with results stratified by cancer stage at diagnosis (and before treatment) were selected for the cancer types of lung, pancreatic, esophageal, stomach, head and neck, colorectal, anal, and cervical cancers. Two cancer types, ovarian cancer, and liver and bile duct cancer did not return any search results with outcomes stratified by disease stage. A general trend was observed for worse patient-reported outcomes in patients with cancer diagnosed at an advanced stage of disease compared with diagnosis at an earlier stage. Advanced disease stage was associated with greater symptom impact including general physical impairments such as pain, fatigue, and interference with functioning, as well as disease/region-specific symptom burden. Poorer HRQoL was also associated with advanced disease with commonly reported symptoms including anxiety and depression.

Conclusions
Overall, the general trend for greater symptom burden and poorer HRQoL seen in late stage versus early-stage disease across the included cancer types supports the importance for early diagnosis and treatment to improve patient survival and decrease negative impacts on disease burden and HRQoL.
Increasing serum miR-223-3p indicates the onset, severe development, and adverse prognosis of bronchiectasis: a retrospective study
Authors: Fang Jia , Xu Yao , Lin Chenghui , Yang Jiewen , Zhai Dongxu , Zhuang Qingyuan , Qiu Wangli , Wang Yun , Zhang Longjuan 
Published: July 2024

Abstract
Background
miR-223-3p has been demonstrated as a Pseudomonas aeruginosa colonization-related miRNA in bronchiectasis (BE), but its clinical value in BE has not been revealed, which is of great significance for the clinical diagnosis and monitoring of BE. This study aimed to identify a reliable biomarker for screening BE and predicting patients’ outcomes.

Methods
The serum expression of miR-223-3p was compared between healthy individuals (n = 101) and BE patients (n = 133) and evaluated its potential in distinguishing BE patients. The severity of BE patients was estimated by BSI and FACED score, and the correlation of miR-223-3p with inflammation and severity of BE patients was evaluated by Pearson correlation analysis. BE patients were followed up for 3 years, and the predictive value of miR-223-3p in prognosis was assessed by logistic regression analysis.

Results
Significant upregulation of miR-223-3p was observed in BE patients, which significantly distinguished BE patients and showed positive correlations with C-reactive protein (CRP), procalcitonin (PCT), interleukin 6 (IL-6), and neutrophil-to-lymphocyte ratio (NLR) of BE patients. Additionally, miR-223-3p was also positively correlated with BSI and FACED scores, indicating its correlation with inflammation and severity of BE. BE patients with adverse prognoses showed a higher serum miR-223-3p level, which was identified as an adverse prognostic factor and discriminated patients with different prognoses.

Conclusion
Increasing serum miR-223-3p can be considered a biomarker for the onset, severity, and prognosis of BE.
Interpretable machine learning models for detecting peripheral neuropathy and lower extremity arterial disease in diabetics: an analysis of critical shared and unique risk factors
Authors: Wu Ya , Dong Danmeng , Zhu Lijie , Luo Zihong , Liu Yang , Xie Xiaoyun 
Published: July 2024

Abstract
Background
Diabetic peripheral neuropathy (DPN) and lower extremity arterial disease (LEAD) are significant contributors to diabetic foot ulcers (DFUs), which severely affect patients’ quality of life. This study aimed to develop machine learning (ML) predictive models for DPN and LEAD and to identify both shared and distinct risk factors.

Methods
This retrospective study included 479 diabetic inpatients, of whom 215 were diagnosed with DPN and 69 with LEAD. Clinical data and laboratory results were collected for each patient. Feature selection was performed using three methods: mutual information (MI), random forest recursive feature elimination (RF-RFE), and the Boruta algorithm to identify the most important features. Predictive models were developed using logistic regression (LR), random forest (RF), and eXtreme Gradient Boosting (XGBoost), with particle swarm optimization (PSO) used to optimize their hyperparameters. The SHapley Additive exPlanation (SHAP) method was applied to determine the importance of risk factors in the top-performing models.

Results
For diagnosing DPN, the XGBoost model was most effective, achieving a recall of 83.7%, specificity of 86.8%, accuracy of 85.4%, and an F1 score of 83.7%. On the other hand, the RF model excelled in diagnosing LEAD, with a recall of 85.7%, specificity of 92.9%, accuracy of 91.9%, and an F1 score of 82.8%. SHAP analysis revealed top five critical risk factors shared by DPN and LEAD, including increased urinary albumin-to-creatinine ratio (UACR), glycosylated hemoglobin (HbA1c), serum creatinine (Scr), older age, and carotid stenosis. Additionally, distinct risk factors were pinpointed: decreased serum albumin and lower lymphocyte count were linked to DPN, while elevated neutrophil-to-lymphocyte ratio (NLR) and higher D-dimer levels were associated with LEAD.

Conclusions
This study demonstrated the effectiveness of ML models in predicting DPN and LEAD in diabetic patients and identified significant risk factors. Focusing on shared risk factors may greatly reduce the prevalence of both conditions, thereby mitigating the risk of developing DFUs.
Principles of digital professionalism for the metaverse in healthcare
Authors: Mohammadzadeh Zahra , Shokri Mehdi , Saeidnia Hamid Reza , Kozak Marcin , Marengo Agostino , Lund Brady D , Ausloos Marcel , Ghiasi Nasrin 
Published: July 2024

Abstract
Background
Experts are currently investigating the potential applications of the metaverse in healthcare. The metaverse, a groundbreaking concept that arose in the early 21st century through the fusion of virtual reality and augmented reality technologies, holds promise for transforming healthcare delivery. Alongside its implementation, the issue of digital professionalism in healthcare must be addressed. Digital professionalism refers to the knowledge and skills required by healthcare specialists to navigate digital technologies effectively and ethically. This study aims to identify the core principles of digital professionalism for the use of metaverse in healthcare.

Method
This study utilized a qualitative design and collected data through semi-structured online interviews with 20 medical information and health informatics specialists from various countries (USA, UK, Sweden, Netherlands, Poland, Romania, Italy, Iran). Data analysis was conducted using the open coding method, wherein concepts (codes) related to the themes of digital professionalism for the metaverse in healthcare were assigned to the data. The analysis was performed using the MAXQDA software (VER BI GmbH, Berlin, Germany).

Results
The study revealed ten fundamental principles of digital professionalism for the metaverse in healthcare: Privacy and Security, Informed Consent, Trust and Integrity, Accessibility and Inclusion, Professional Boundaries, Evidence-Based Practice, Continuous Education and Training, Collaboration and Interoperability, Feedback and Improvement, and Regulatory Compliance.

Conclusion
As the metaverse continues to expand and integrate itself into various industries, including healthcare, it becomes vital to establish principles of digital professionalism to ensure ethical and responsible practices. Healthcare professionals can uphold these principles to maintain ethical standards, safeguard patient privacy, and deliver effective care within the metaverse.
Refugee and immigrants’ food consumption, housing and sociodemographic characteristics in southern Brazil
Authors: Vacca Eduarda Fellomena , Vinholes Daniele Botelho 
Published: July 2024

Abstract
Objective
To describe the food consumption of immigrants and refugees in a city in southern Brazil and evaluate the associations with sociodemographic and housing characteristics.

Method
This is a cross-sectional study with users of an association specialized in assisting refugees and immigrants in Porto Alegre-RS. Individuals aged 18 or over of both sexes with an understanding of Portuguese were included. An online questionnaire with sociodemographic, housing, and food characteristics was available to service users, and data analysis was performed using SPSS, considering p < 0.05.

Results
The study included 68 individuals, predominantly women (76.5%) with a mean age of 34.39 (± 8.9) years and mainly from Venezuela. The food group most frequently consumed daily was the cereal group. Groups such as legumes and vegetables, meat and eggs, biscuits, and cold meats presented a higher weekly consumption frequency. Fruit, Brazil nuts and walnuts, dairy products, regular soda, ready-made desserts, frozen ready-made meals, and fried foods had the highest monthly consumption. There was an association between the consumption of fried foods and sex, cereal consumption and self-declared color, the consumption of biscuits, chocolate drinks, schooling, and cold meats consumption and age.

Conclusion
In this study we observed that men consumed more fried foods than women and low education level was associated with the frequent consumption of biscuits, chocolate drinks, ham, salami or mortadella and ready-made meals. This study allowed us to investigate the profile and diet of people among refugees and immigrants in the South of Brazil since most of the data on food consumption of this type of population are from the North, and these regions are different in relation to socioeconomic characteristics. It is essential to become aware of the health and food situation of this population group to assist in the acculturation process and ensure adequate reception.
Hsa_circ_0043532 contributes to PCOS through upregulation of CYP19A1 by acting as a ceRNA for hsa-miR-1270
Authors: Zhang Huimin , Fang Jianye , Liu Yingxue , Zhu Wenqian , Xu Yangying , Zhang Yu , Shen Wei , Li Duan , Hao Cuifang 
Published: July 2024

Abstract
Background
Polycystic ovarian syndrome (PCOS) accounts for about 75% of anovulatory infertility. The cause of PCOS is not clear. CircRNAs acting as miRNA sponges mediate the post-transcriptional regulation of multiple genes. CYP19A1 is a limiting enzyme in the ovarian steroidogenesis pathway. However, the mechanism of circRNAs regulating granulosa cell (GC) estradiol secretion in PCOS remains to be elucidated.

Methods
Bioinformatics was used to predict the potential target miRNAs of circ_0043532 and target genes of miR-1270. Target miRNAs and mRNA expression were verified by qRT-PCR in GCs from 45 women with PCOS and 65 non-PCOS. Western blot, ELISA and dual-luciferase reporter assays were applied to confirm the substrate of miR-1270.

Results
Circ_0043532 and CYP19A1 were significant up-regulation in GCs from patients with PCOS. The predicted target miRNAs of circ_0053432, miR-1270, miR-576-5p, miR-421 and miR-142-5p, were notably decreased in GCs from patients with PCOS. Mechanistic experiments showed that circ_0043532 specifically binds to miR-1270. MiR-1270 was negatively regulated by circ_0043532. Concomitantly, miR-1270 inhibited CYP19A1 expression and estradiol production, which could be reversed by circ_0043532 over-expression.

Conclusion
We identified that circ_0043532/miR-1270/CYP19A1 axis contributes to the aberrant steroidogenesis of GCs from patients with PCOS. This study broadens the spectrum of pathogenic factors of PCOS, and circ_0043532 might be a potential therapeutic target for PCOS.
Continuous non-invasive vs. invasive arterial blood pressure monitoring during neuroradiological procedure: a comparative, prospective, monocentric, observational study
Authors: Chapalain Xavier , Morvan Thomas , Gentric Jean-Christophe , Subileau Aurélie , Jacob Christophe , Cadic Anna , Caillard Anaïs , Huet Olivier 
Published: July 2024

Abstract
Background
In the perioperative setting, the most accurate way to continuously measure arterial blood pressure (ABP) is using an arterial catheter. Surrogate methods such as finger cuff have been developed to allow non-invasive measurements and are increasingly used, but need further evaluation. The aim of this study is to evaluate the accuracy and clinical concordance between two devices for the measurement of ABP during neuroradiological procedure.

Methods
This is a prospective, monocentric, observational study. All consecutive patients undergoing a neuroradiological procedure were eligible. Patients who needed arterial catheter for blood pressure measurement were included. During neuroradiological procedure, ABP (systolic, mean and diatolic blood pressure) was measured with two different technologies: radial artery catheter and Nexfin. Bland-Altman and error grid analyses were performed to evaluate the accuracy and clinical concordance between devices.

Results
From March 2022 to November 2022, we included 50 patients, mostly ASA 3 (60%) and required a cerebral embolization (94%) under general anaesthesia (96%). Error grid analysis showed that 99% of non-invasive ABP measures obtained with the Nexfin were located in the risk zone A or B. However, 65.7% of hypertension events and 41% of hypotensive events were respectively not detected by Nexfin. Compared to the artery catheter, a significant relationship was found for SAP (r2 = 0.78) and MAP (r2 = 0.80) with the Nexfin (p < 0.001). Bias and limits of agreement (LOA) were respectively 9.6 mmHg (− 15.6 to 34.8 mmHg) and − 0.8 mmHg (− 17.2 to 15.6 mmHg), for SAP and MAP.

Conclusions
Nexfin is not strictly interchangeable with artery catheter for ABP measuring. Further studies are needed to define its clinical use during neuroradiological procedure.

Trial registration
Clinicaltrials.gov, registration number: NCT05283824.