bluuebunny/crossref_metadata_2025_split huggingface dataset:
The feasibility of point-of-care testing for initial uninary liver fatty acid-binding protein to estimate pathophysiological severity in severe heatstroke
Authors: Yokobori Shoji , Shimazaki Junya , Kaneko Hitoshi , Asai Hideki , Kanda Jun , Takauji Shuhei , Sato Eiichi , Ichibayashi Ryo , Fujita Motoki , Shiraishi Shinichiro , Shimizu Keiki , Yokota Hiroyuki 
Published: June 2024

Abstract

Rapid assessment of severity is crucial for timely intervention and improved patient outcomes in heatstroke (HS). However, existing biomarkers are limited in their accuracy and accessibility in prehospital / ER settings. A prospective study was conducted to assess urinary liver fatty acid-binding protein (L-FABP) levels using a point-of-care testing upon HS. Pathophysiological severity was estimated using initial Sequential Organ Failure Assessment (SOFA) scores, and outcomes were measured using modified Rankin Scale (mRS) scores. In 78 severe HS patients, urinary L-FABP concentrations were measured on admission, with a median concentration of 48.3 ng/mL. Positive correlation was observed between urinary L-FABP concentration and pulse rate (r = 0.300), lactate (r = 0.259), and initial SOFA score (r = 0.211). The POCT of L-FABP showed promise in predicting pathophysiological severity, as indicated by higher concentrations in patients with higher initial SOFA scores. Additionally, patients in the POCT positive group had significantly worse outcomes at discharge compared to the negative group, although this difference diminished over time. The study demonstrates the feasibility and potential utility of POCT for initial L-FABP in estimating pathophysiological severity in HS patients. This rapid and accessible testing method may aid in early field triage and intervention, ultimately improving patient outcomes in the management of HS.
Deep Learning-Enabled Ultrasound Radiomics for Accurate Prediction of Breast Cancer Lymph Node Metastasis
Authors: Wang Man , Huang Weijia , Wu Erlv , Cen Qishan , Gao Shichun , Li Zhiyu , Dang Dejing , Chen Yanlin , wang Jiancheng , Chen Yeyang , Yang Hong , Wang Ye 
Published: June 2024

Abstract

Background: Lymph node metastasis serves as a pivotal prognostic marker in breast cancer progression. The present study endeavors to devise a deep learning-driven ultrasound radiomics model for precise forecasting of lymph node metastasis in breast cancer patients.
Methods: A retrospective analysis was conducted on clinical and ultrasound imaging data of breast cancer patients diagnosed surgically and pathologically at our institution between January 2018 and January 2023. The dataset was randomly stratified into training and testing subsets at a 7:3 ratio. Initially, tumor ultrasound images of breast cancer patients were annotated. Subsequently, a pre-trained Densenet121 convolutional neural network(CNN) was employed to extract intricate features from the annotated images. Principal component analysis (PCA) and feature selection techniques were implemented to diminish the dimensionality of the extracted features. These features were then consolidated and optimized using various machine learning algorithms to predict lymph node metastasis. The optimal algorithm was chosen to estimate the probability of lymph node metastasis for each patient utilizing the ultrasound radiomics model. Univariate and multivariate analyses were further conducted on clinical features to identify independent predictors of lymph node metastasis in breast cancer. Ultimately, these clinical predictors were integrated with the prediction probability of the ultrasound radiomics model to formulate a clinical-ultrasound fusion model, whose predictive accuracy was assessed on the testing subset.
Results: The ultrasound radiomics model grounded in deep learning exhibited remarkable performance in forecasting lymph node metastasis in breast cancer. Among the tested algorithms, Logistic Regression (LR) outperformed its counterparts, attaining an AUC (95%CI) of 0.823 (0.775-0.872), along with a sensitivity of 0.835 and specificity of 0.699. Notably, the clinical-ultrasound fusion model further enhanced the predictive accuracy, achieving an accuracy of 0.796 in the training set and 0.820 in the testing set. Moreover, the AUC (95%CI) values were 0.863 (0.837-0.890) and 0.885 (0.847-0.922) for the training and testing sets, respectively, with corresponding sensitivities of 0.744 and 0.741, and specificities of 0.854 and 0.912.
Conclusion: This study successfully developed and validated a deep learning-based ultrasound radiomics model, which exhibited high predictive accuracy and stability in forecasting lymph node metastasis in breast cancer. This model provides clinicians with valuable insights, enabling them to make more personalized and informed treatment decisions for breast cancer patients.
The Impact of Fear of Falling on Health-Related Quality of Life in Community-Dwelling Older Adults: Mediating Effects of Depression and Moderated Mediating Effects of Physical Activity
Authors: Lee Eunsook , Kim Boyoung 
Published: June 2024

Abstract

Background
The fear of falling is a common issue among older adults that negatively affects both physical and psychological aspects of health-related quality of life, regardless of actual fall events. Interventions aimed at reducing fear of falling, independent of falls, may be effective in improving older adults’ quality of life. This study examined the moderated mediating effect of physical activity in how fear of falling affects health-related quality of life through depression in community-dwelling older adults. The specific purposes are as follows: 1) To evaluate the mediating effect of depression in the relationship between fear of falling and health-related quality of life; 2) To examine the moderating effect of physical activity on the relationship between depression and health-related quality of life. 3) To assess the moderated mediating effect of physical activity on fear of falling’s effect on health-related quality of life by mediating depression.
Methods
This study used secondary data from the Korea Centers for Disease Control and Prevention’s 2019 Community Health Survey. A total of 73,738 adults aged 65 years or older were included. Fear of Falling, International Physical Activity Questionnaire, Patient Health Questionnaire-9, and EuroQol 5 Dimension were used as research tools. Descriptive statistics, Pearson’s correlation coefficient, and SPSS PROCESS macro analysis were performed. For the adjusted mediating effect, samples were re-sampled 5,000 times by the bootstrapping method, and statistical significance was determined by setting a 95% confidence interval.
Results
In the model in which fear of falling affects health-related quality of life by mediating depression, the moderated mediating effect of physical activity was statistically significant as the bootstrapping result did not include 0 in the 95% confidence interval (Index of moderated mediation [95% CI] = 0.006 [0.004–0.007], 0.008 [0.006–0.009]). Depression and health-related quality of life impairment decreased as the level of physical activity increased through inactivity, minimal activity, and health promotion activities, as the negative mediating effects decreased.
Conclusion
Physical activity reduces depression and improves health-related quality of life by influencing older adults’ fear of falling. Community-based programs are needed to encourage and support older adults in maintaining moderate physical activity to manage the depression caused by fear of falling, common among older adults, and to improve their health-related quality of life.
Improvement in renal function after switching from entecavir to tenofovir alafenamide in chronic hepatitis B patients with low estimated glomerular filtration rates
Authors: Wang Liang , Ma Shipeng , Liu Liping , Wan Xin , Zhang Yuliang , Li Xiaopeng , Ge Shanfei 
Published: June 2024

Abstract

Both entecavir (ETV) and tenofovir alafenamide (TAF) are regarded as renal-friendly nucleoside/nucleotide analogs (NAs). However, the difference between ETV and TAF in terms of renal function remains unclear. This study aims to directly compare the renal safety profiles of two antiviral treatments, and evaluate the impact on renal function when switching from ETV to TAF treatment in chronic hepatitis B (CHB) patients with low estimated glomerular filtration rates(eGFR). The study enrolled 190 CHB patients who received ETV (n = 112) or TAF (n = 78) between the years 2019 and 2023. The effects of these NAs on renal function were assessed by measuring changes in eGFR levels from baseline to 72 weeks between the two treatment groups. Following a 1:1 propensity score matching procedure, each treatment group consisted of 76 patients. A significant disparity in the change of eGFR between the two cohorts was observed at week 36. Baseline eGFR and drug (ETV/TAF) were significant positive indicators for eGFR abnormality at week 36. In addition, 7 patients in the ETV group were switched to TAF due to eGFR abnormalities at week 48, and the eGFR changes from 48 to 72 weeks were significantly different between patients who remained on their initial treatment and those who switched from ETV to TAF. A significant difference in eGFR was observed between ETV and TAF treatments at week 36, and baseline eGFR and drug (ETV/TAF) were remarkable positive indicators for eGFR abnormality at week 36. Switching to TAF led to a substantial improvement in renal function among ETV-treated patients with eGFR abnormalities.
Evaluating the Multifaceted Impact of Induction Therapy on HbA1c, Quality of Life, Infection Risk, and TNF Levels in Acute Leukemia Patients
Authors: Chaudhary Nooreen , Karhana Sonali , Bhurani Dinesh , Khan Mohd. Ashif 
Published: June 2024

Abstract

Aim The cross-sectional study aimed to evaluate the effect of induction chemotherapy on HbA1c levels in non-diabetic Acute leukaemia patients and its association with risk of infection and Quality of Life.Methods The study involved four groups with distinct timelines for sample collection, i.e. before induction chemotherapy, within 7 days, within 14 days, and within 30 days after treatment initiation. Participants were screened based on specific criteria, and written informed consent was obtained. Quality of life, glycated haemoglobin (HbA1C), and TNF alpha levels were assessed.Results The second week following the initiation of induction therapy for acute leukemia is characterized by elevated levels of TNF alpha, and increased risk of infection. However, these parameters tend to normalize after approximately 30 days of commencing the induction therapy. No significant change in HbA1c was observed between the initiation of induction therapy and 30 days after initiation. Additionally, a weak positive correlation between HbA1c and TNF alpha was observed (r = 0.072, p > 0.05), suggesting a non-significant association between blood sugar levels and inflammation. Quality of life assessments showed that patients experienced notably improved overall health outcomes within 30 days of treatment initiation while exhibiting significantly higher global and functional scores on the EORTC QLQ C30 scale.Conclusion During the initial stages of chemotherapy for acute leukemia, it is crucial for medical professionals to consistently monitor the blood glucose levels and the presence of infections in patients and provide appropriate interventions as needed.
Efficacy of surgery in the management of multiple recurrences of retroperitoneal dedifferentiated liposarcoma
Authors: Yamada Yoshiki , Wakamatsu Toru , Imura Yoshinori , Tamiya Hironari , Yagi Toshinari , Suzuki Rie , Inoue Akitomo , Takami Haruna , Nakai Sho , Outani Hidetatsu , Kakunaga Shigeki , Takenaka Satoshi 
Published: June 2024

Abstract

BACKGROUND: Retroperitoneal dedifferentiated liposarcoma is associated with a high risk of recurrence; however, treatment strategies that are more effective than surgery remain to be established. This study aimed to determine the optimal number of surgeries that would be effective in patients with recurrent disease. Furthermore, the improvement in the prognosis was evaluated according to the malignancy level.
METHODS:
The impact of each type of surgery on the prognosis of 118 patients with retroperitoneal dedifferentiated liposarcoma treated at our hospital was investigated. Among these 118 patients, 103 underwent an initial surgery. Fifty-four and 30 patients underwent a second and third surgery, respectively. The overall and disease-free survival rates of each group were compared using the Kaplan–Meier method the log-rank test was used to determine statistical significance in univariate analysis. 18F-Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) was used for the assessment of malignancy. The maximum standardized uptake value (SUVmax) of ≥4 and <4 was classified as high and low malignancy, respectively.
RESULTS: The first and second surgeries resulted in a significant improvement in the overall survival rate, despite the malignancy level (p <0.001); however, no significant improvement in prognosis was observed after the third surgery (p = 0.077). Low-grade malignancies were associated with a better postoperative prognosis, even in cases with recurrence; in contrast, high-grade malignancies exhibited a reduction in surgical efficacy.
CONCLUSIONS: Surgical treatment can prolong overall survival, even in cases with recurrence; however, it is advisable to assess the malignancy levels when determining the suitability of surgery beyond the second recurrence.
Cooccurrence of noncommunicable disease risk factors and their determinants among the Afghan population: WHO STEPS Survey 2018
Authors: Noormal Ahmad Siyar , Winkler Volker , Mokhamed Safa Marva Gulam , Noormal Ajmal Shekeb , Dambach Peter 
Published: June 2024

Abstract

Background
Noncommunicable diseases (NCDs) pose a significant public health challenge globally, contributing to substantial morbidity and mortality. This study examined the prevalence and the cooccurrence of NCD risk factors and their sociodemographic determinants among the Afghan population.
Method
The 2018 Afghanistan WHO STEPS survey was analyzed to investigate the prevalence and determinants of NCD risk factors and their cooccurrence. This was a nationally representative household-based cross-sectional study that included 3955 participants. Poisson regression was employed to explore associations between the number of cooccurring risk factors and demographic characteristics.
Results
A high prevalence of both behavioral and metabolic risk factors were observed in this study. Smoking (8.9%), sedentary behaviour (43.8%), unhealthy diet (18.2%), hypertension (12.2%), diabetes (9.6%), and obesity (16.9%) were among the prevalent risk factors identified. A significant portion of the population exhibited multiple concurrent risks. Only 9% had no risk factors, while 40% exhibited at least 3 risk factors. The regression analysis revealed associations between demographic factors and having multiple risk factors. Notably, females, older individuals, urban residents, and married individuals exhibited a higher likelihood of cooccurring risk factors.
Conclusion
Our findings revealed a high prevalence of NCD risk factors in Afghanistan and explored the complex interplay between demographics and cooccurrence of NCD risk factors. These findings contribute to the understanding of NCD epidemiology in the country and underscore the importance of specific interventions to alleviate the burden of NCDs and improve population health.
A Comparative Study of Two Deep learning Architectures for Gesture Recognition on ArSL2018 Dataset
Authors: Lahiani Houssem , Frikha Mondher 
Published: June 2024

Abstract

This research paper conducts a comparative analysis of two convolutional neural network (CNN) architectures to examine their performance in recognizing gestures using the ArSL2018 dataset, a significant resource comprising 54,049 images across 32 classes representing Arabic Alphabet Sign Language (ArASL). Our goal is to determine the most effective technological application for facilitating communication within the Arabic-speaking deaf community, thereby enhancing their interaction with digital platforms and everyday technology interfaces. The first architecture employs a pre-trained MobileNetV2 model as a feature extractor followed by a fully connected layer, while the second architecture builds upon the MobileNetV2 by incorporating additional convolutional and pooling layers. Through rigorous evaluation using multiple metrics including accuracy, precision, recall, and F1-score, we discovered that the first architecture achieved a higher overall accuracy of 95% on the test set compared to 93.85% for the second, with per-class accuracies ranging from 82.91–99.10%. These findings suggest that simpler CNN architectures with pre-trained feature extractors are not only effective but also potentially more efficient for integrating into assistive technologies. This study underscores the potential of gesture recognition systems to improve the quality of life for the deaf and hard-of-hearing by providing more natural, intuitive ways to interact with technology. By focusing on user-centric design and ethical AI deployment, our findings contribute to the broader discourse on developing responsible, inclusive technologies that uphold human dignity and foster social inclusion.
Evaluation of Pharmacokinetic Pharmacodynamic Target Attainment and Hematological Toxicity of Linezolid in Pediatric Patients
Authors: Abouelkheir Manal , Aldawsari Maram R , Ghonem Leen , Almomen Aliyah , Alsarhani Emad , Alsubaie Sarah , Alqahtani Saeed , Kurdee Zeyad , Alsultan Abdullah 
Published: June 2024

Abstract

Background
Linezolid is commonly used to treat severe and/or resistant Gram-positive infections. Few studies have assessed its pharmacokinetics/pharmacodynamics (PK/PD) in pediatrics.
Objective
to evaluate the percentage of pediatric patients achieving the PK/PD target of linezolid using standard dosing regimens and to assess the incidence and risk factors associated with its hematologic toxicity.
Methods
This prospective observational study included pediatric patients aged 0–14 years who received linezolid for suspected or proven Gram-positive infections. Linezolid trough concentrations were measured, and hematologic toxicity was assessed.
Results
In total, 17 pediatric patients (5 neonates and 12 older pediatrics) were included in the analysis. The median trough concentration in neonates was significantly higher than that of the older pediatrics (7.1 [6.2–11.0] vs. 3.9 [1.95–6.5] mg/L, respectively, P = 0.04). Out of all patients, 53% achieved the therapeutic trough level of 2–7 mg/L, 18% had subtherapeutic levels, and 23% had higher-than-optimal troughs. Linezolid-associated hematological toxicity was documented in 53% of cases. Identified significant risk factors include treatment duration of more than 7 days, baseline platelet counts of less than 150 x 109/L, sepsis/septic shock, and concomitant use of meropenem.
Conclusions
Linezolid's standard dosing failed to achieve its PK/PD target in approximately half of our pediatric cohort. Our findings underscore the complex interplay between the risk factors of linezolid-associated hematological toxicity and highlight the importance of its vigilant use and monitoring if it is to be initiated in pediatrics with concomitant multiple risk factors.
Value of intraoperative post-conisation human papillomavirus testing in predicting residual or recurrence after treatment with a loop electrosurgical excision procedure in women with HR-HPV positive and cervical high-grade squamous intraepithelial lesion
Authors: Xia Weiting , Dai Shenyue , Hu Yan , Yang Simeng , Chen Cheng , Li Xiaolin 
Published: June 2024

Abstract

Objective
To evaluate the feasibility of intraoperative human papillomavirus (IOP-HPV) testing for the prediction of postoperative treatment failure in patients with high-grade squamous intraepithelial lesion (HSIL) undergoing loop electrosurgical excisional procedure (LEEP)
Methods
A total of 114 women diagnosed with HSIL by biopsy and/or endocervical curettage who underwent LEEP were included in a prospective cohort study. IOP-HPV testing was performed immediately after the procedure. Patients were followed up for 24 months. Logistic regression was used to analyse the factors influencing the residual or recurrent lesions. Further stratified analyses were performed to investigate the differences in prognosis of IOP-HPV positivity in patients of different age and menopausal status.
Results
1. Of the 114 patients, 6 (5.26%) were pathologically upgraded to cervical cancer, and 21 (18.42%) were lost to follow-up. Recurrence or residual HSIL lesions occurred in 9.20% (8/87) of cases. Of the 8 women who developed post-treatment HSIL, 7 (26.92%) were positive for IOP-HPV, and only 1 (1.64%) was negative for IOP-HPV (<0.01).
2. Transformation zones of type 2 (P =0.0306) or type 3 (P =0.0446) , diagnosed as LSIL/negative by cervical biopsy (P=0.0396), margin involvement (P=0.0233), positive endocervical curettage after conisation (P=0.0028), intraoperative HPV (P <0.01), cytological abnormalities (P=0.0038), DNA ploidy (P =0.0172), and postoperative HPV (P <0.01) and DNA ploidy (P=0.0078) positivity at 6 months were associated with a higher risk of residual or recurrent lesions.
3. The results of the multivariate regression analysis showed that IOP-HPV positivity was the independent risk factor for residual or recurrent lesions (OR=10.69 , 95% CI:3.41, 33.51, P<0.01). IOP-HPV positivity was strongly associated with the occurrence of residual/recurrent LSIL (OR=6.42 , 95% CI:1.74, 23.70, P=0.0053) and HSIL (OR=32.08 , 95% CI:3.60, 285.64, P=0.0019).
4. Stratified analyses showed that IOP-HPV positive in patients younger than 50 years or premenopausal patients was associated with a significantly higher risk of recurrence or residual lesions (p<0.05).
Conclusions
IOP-HPV positivity is an independent risk factor for residual or recurrent HSIL lesions. In addition, IOP-HPV positivity was more associated with residual or recurrent lesions in those younger than 50 years or premenopausal. IOP-HPV testing may be of critical clinical value in providing the early and accurate prediction of residual or recurrent lesions.
MG-DIFF: A Novel Molecular Graph Diffusion Model for Molecular Generation and Optimization
Authors: Zhang Xiaochen , Wang Shuangxi , Fang Ying , Zhang Qiankun 
Published: June 2024

Abstract

Recent advancements in denoising diffusion models have revolutionized image, text, and video generation. Inspired by these achievements, researchers have extended denoising diffusion models to the field of molecule generation. However, existing molecular generation diffusion models are not fully optimized according to the distinct features of molecules, leading to suboptimal performance and challenges in conditional molecular optimization. In this paper, we introduce the MG-DIFF model, a novel approach tailored for molecular generation and optimization. Compared to previous methods, MG-DIFF incorporates three key improvements. Firstly, we propose a mask and replace discrete diffusion strategy, specifically designed to accommodate the complex patterns of molecular structures, thereby enhancing the quality of molecular generation. Secondly, we introduce a graph transformer model with random node initialization, which can overcome the expressiveness limitations of regular graph neural networks defined by the first-order Weisfeiler-Lehman test. Lastly, we present a graph padding strategy that enables our method to not only do conditional generation but also optimize molecules by adding certain atomic groups. In several molecular generation benchmarks, the proposed MG-DIFF model achieves state-of-the-art performance and demonstrates great potential molecular optimization.