bluuebunny/crossref_metadata_2025_split huggingface dataset:
A retrospective study on adjuvant chemotherapy in retinoblastoma: validation of the new recommendation against treatment for pT2a tumors based on the 8th AJCC classification
Authors: Alkatan Hind Manaa , Almuzaini Alaa , Helmi Hala A. , Maktabi Azza MY 
Published: July 2024

Abstract
Background
Retinoblastoma (RB) is an intraocular malignant tumor detected in early childhood with variable global impact. Histopathological classification of the tumor in enucleated globes with RB is the key for the decision of adjuvant chemotherapy use. We aim to validate the use of adjuvant chemotherapy in cases with combined pre-laminar/intralaminar optic nerve (ON) invasion and focal choroidal invasion according to the American Joint Committee on Cancer (AJCC) 8th classification.

Methods
This is a retrospective study conducted at King Abdulaziz University Hospital (KAUH) and King Khalid Eye Specialist Hospital (KKESH) in Riyadh, Saudi Arabia of all RB cases who underwent enucleation over 22 years (2000 to 2021). The histopathological findings were reviewed to identify the enucleated globes classified as pT2a tumors, as an inclusion criterion. Basic demographic and clinical data were collected via chart review Simple descriptive and basic statistical analysis of the data was used where applicable.

Results
Thirty-one patients who had an enucleated globe with RB that fit into the above classification were included. Sixteen were males and 15 were females. The median age was 14 months (IQR = 14 months). Most of the patients (93.5%) had no family history of RB. The commonest presentation was leukocoria in 87.1% followed by squint in 32.3%. Fourteen patients (45.2%) were treated by enucleation alone while 17 patients (54.8%) received adjuvant chemotherapy. Out of these, 7 patients had unilateral RB and the remaining 10 patients had bilateral RB. None of our patients developed recurrence or metastatic disease irrespective of the indication for adjuvant chemotherapy use after a maximum period of follow up reaching 17.84 years and a median of 10.6 years (IQR = 5.92).

Conclusions
In patients with 8th AJCC histopathological classification of pT2a, chemotherapy following enucleation might not be justified. The outcome in our untreated group of patients did not differ from the treated group with the absence of metastasis after a relatively long period of follow up with a median exceeding 10 years in both groups. Therefore, the risk and benefit of post enucleation adjuvant chemotherapy in the treatment of unilateral RB should be carefully decided and discussed with the primary caregivers taking into consideration the most recent evidence and recommendations in the literature.
Nurses’ knowledge, attitude and practice regarding non-pharmacologic interventions for behavioral and psychological symptoms of dementia
Authors: Du Hongdi , Wang Xiaojing , Lai Xiaoxing , Wang Wei , Huo Xiaopeng 
Published: July 2024

Abstract
Background
To evaluate the knowledge, attitude and practice of nurses regarding non-pharmacologic therapies for behavioral and psychological symptoms of dementia (BPSD).

Methods
This cross-sectional, questionnaire-based study enrolled nurses at Peking Union Medical College Hospital (Beijing, China) between September 2022 and October 2022. Correlations between knowledge, attitude and practice scores were evaluated by Pearson correlation analysis. Factors associated with knowledge, attitude and practice scores were identified by multivariable linear regression. Based on a cross-sectional questionnaire survey, this study designed a questionnaire according to the Guidelines for Diagnosis and Treatment of Dementia in China, and randomly selected nurses from Peking Union Medical College Hospital to fill in the questions through the Wen-Juan-Xing online platform from September 2022 to October 2022.

Results
The analysis included 210 nurses (202 females). The average knowledge, attitude and practice scores were 11.06±2.61 (total score: 18), 53.51±5.81 (total score: 60) and 64.66 ± 10.35 (total score: 80) points, respectively. Knowledge score was positively correlated with attitude score (r = 0.416, P < 0.001) and practice score (r = 0.389, P < 0.001); attitude and practice scores were also positively correlated (r = 0.627, P < 0.001). Multivariable analysis demonstrated that age ≥ 40 years-old (vs. ≤30 years-old) was associated with higher knowledge score (β = 1.48, 95% confidence interval [95%CI] = 0.42–2.54, P = 0.006). Age ≥ 40 years-old (β = 1.43, 95%CI = 0.35–2.51, P = 0.010 vs. ≤30 years-old) and bachelor’s degree or higher (β = 1.11, 95%CI = 0.12–2.10, P = 0.028 vs. college degree or lower) were associated with higher practice score.

Conclusions
Older age and higher education level were associated with higher knowledge, attitude and/or practice scores. The findings of this study may help guide the development and implementation of education and training programs to improve the management of BPSD by nurses in China.
Unveiling the hidden pathologies: preoperative endoscopic findings in patients with obesity undergoing bariatric surgery
Authors: Tian Peirong , Fu Jing , Liu Yang , Li Mengyi , Liu Jia , Liu Jingli , Zhang Zhongtao , Zhang Peng 
Published: July 2024

Abstract
Background
Obesity is closely associated with upper gastrointestinal disorders. The recommendations for routine preoperative esophagogastroduodenoscopy (EGD) before bariatric surgery remains a topic of debate. This study aimed to describe the pathological endoscopic findings in individuals qualified for bariatric surgery.

Methods
Retrospective analysis was conducted on preoperative gastroscopy reports of patients who underwent bariatric surgery at our hospital between October 2022 and October 2023.

Results
A total of 405 patients were included in the study. The two most prevalent endoscopic findings during EGD in this patient cohort were chronic superficial gastritis (326/405, 80.5%) and reflux esophagitis (82/405, 20.2%). Some patients exhibited two or more abnormalities. Patients with reflux esophagitis were older, had a higher proportion of men, higher BMI, higher rates of smoking and drinking compared to those without it (P = 0.033, P < 0.001, P = 0.003, P = 0.001, and P = 0.003, respectively). Morbid obesity (P = 0.037), smoking habits (P = 0.012), and H. pylori infection (P = 0.023) were significant risk factors for reflux esophagitis in male patients, while age (P = 0.007) was the sole risk factor in female patients. No statistically significant differences were observed in surgical procedures between LA-A and B groups (P = 0.382), but statistically significant differences were noted between the nondiabetic and diabetic groups (P < 0.001).

Conclusions
Preoperative EGD can unveil a broad spectrum of pathologies in patients with obesity, suggesting the need for routine examination before bariatric surgery. The findings of this study can guide bariatric surgeons in developing tailored treatments and procedures, thus significantly enhancing prognosis. Gastroscopy should be performed routinely in Chinese patients planning to undergo bariatric surgery.
Efficacy and safety of oral semaglutide in older patients with type 2 diabetes: a retrospective observational study (the OTARU-SEMA study)
Authors: Oe Yuki , Nomoto Hiroshi , Cho Kyu Yong , Yokozeki Kei , Ono Tsubasa , Miya Aika , Kameda Hiraku , Nakamura Akinobu , Arimura Yoshiaki , Atsumi Tatsuya 
Published: July 2024

Abstract
Background
Oral semaglutide in older subjects with type 2 diabetes was as effective as in younger subjects, according to phase 3 clinical trials. However, its efficacy can be limited in very aged population, due to the presence of impaired cognitive function and the complex instructions for its use. Here, we investigated its efficacy and safety by further age bracket in older subjects in real-world.

Methods
We retrospectively studied subjects > 65 years of age with type 2 diabetes who started oral semaglutide treatment. The primary outcome was the change in glycated hemoglobin (HbA1c) over 6 months. Adverse events and cognitive function were evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) and the Hasegawa Dementia Rating Scale-revised (HDS-R). The achievement rate of glycemic targets was evaluated based on the age, health status of subjects and their use of anti-diabetic agents which can cause hypoglycemia, with additional analysis between two subgroups; early (65–74) versus late (≥ 75) older. Furthermore, we evaluated the relationships between their improvements in HbA1c and the baseline characteristics of the subjects, including their cognitive function and insulin secretory capacity.

Results
We studied the efficacy of the drug in 24 subjects. Their HbA1c and body weight significantly decreased (− 13.1 ± 7.5 mmol/mol and − 3.0 ± 2.4 kg, respectively; P < 0.01). Although cognitive function was lower in the late older group (r = −0.57, P < 0.01), changes in HbA1c showed no difference between the two subgroups (P = 0.66) and it correlated with the insulin secretory capacity rather than cognitive function (r = −0.49, P < 0.05). Glycemic targets were more likely to be achieved (P < 0.01), but HbA1c excessively decreased in late older subjects who were also using insulin or an insulin secretagogue. The frequency of adverse events was similar to that in the clinical trial, whereas discontinuation of medication were more frequent among the late older subjects (Early; n = 2, Late; n = 4).

Conclusions
Oral semaglutide improves the glycemic control of older subjects, but it might be a risk for potential hypoglycemia and discontinuation because of adverse events in subjects of ≥ 75 years. Attention should be paid to insulin secretory capacity and concomitant medications rather than concern about adherence.
What do medical students think are characteristics of a good ultrasound tutor? A qualitative study
Authors: Walter Robin , Alt Leander , Hari Roman , Harris Michael 
Published: July 2024

Abstract
Purpose
This study was designed to elicit medical students’ opinions on the characteristics of a good ultrasound tutor. The results should help educators to create an optimal teaching environment and inform tutor training.

Materials and methods
The qualitative study recruited 15 participants from a larger mixed-methods study of 64 medical students who underwent a basic course on abdominal ultrasound taught by faculty and near-peer tutors. During semi-structured interviews, they were asked which characteristics make a good ultrasound tutor. We used inductive thematic analysis to identify the most important categories.

Results
Medical students identified teaching themes and subthemes relating to teaching skills (e.g., course structure, repetition, vocabulary, feedback, guidance of participants), tutors’ attitudes (e.g., atmosphere creation, empathy) and knowledge as the crucial components of being a good ultrasound tutor.

Conclusions
While some of the themes that students identified are generic to medical education, others are specific to ultrasound teaching. Tutors can use our results to assess their own teaching. They should aim to address learning needs, optimise understanding, give adequate feedback, and create a non-threatening atmosphere with empathic interactions. Accounting for the ultrasound-specific setting they should possess the necessary knowledge, provide verbal guidance to their students, and distribute examination time wisely.
MetSCORE: a molecular metric to evaluate the risk of metabolic syndrome based on serum NMR metabolomics
Authors: Gil-Redondo Rubén , Conde Ricardo , Bruzzone Chiara , Seco Maria Luisa , Bizkarguenaga Maider , González-Valle Beatriz , de Diego Angela , Laín Ana , Habisch Hansjörg , Haudum Christoph , Verheyen Nicolas , Obermayer-Pietsch Barbara , Margarita Sara , Pelusi Serena , Verde Ignacio , Oliveira Nádia , Sousa Adriana , Zabala-Letona Amaia , Santos-Martin Aida , Loizaga-Iriarte Ana , Unda-Urzaiz Miguel , Kazenwadel Jasmin , Berezhnoy Georgy , Geisler Tobias , Gawaz Meinrad , Cannet Claire , Schäfer Hartmut , Diercks Tammo , Trautwein Christoph , Carracedo Arkaitz , Madl Tobias , Valenti Luca , Spraul Manfred , Lu Shelly C. , Embade Nieves , Mato José M. , Millet Oscar 
Published: July 2024

Abstract
Background
Metabolic syndrome (MetS) is a cluster of medical conditions and risk factors correlating with insulin resistance that increase the risk of developing cardiometabolic health problems. The specific criteria for diagnosing MetS vary among different medical organizations but are typically based on the evaluation of abdominal obesity, high blood pressure, hyperglycemia, and dyslipidemia. A unique, quantitative and independent estimation of the risk of MetS based only on quantitative biomarkers is highly desirable for the comparison between patients and to study the individual progression of the disease in a quantitative manner.

Methods
We used NMR-based metabolomics on a large cohort of donors (n = 21,323; 37.5% female) to investigate the diagnostic value of serum or serum combined with urine to estimate the MetS risk. Specifically, we have determined 41 circulating metabolites and 112 lipoprotein classes and subclasses in serum samples and this information has been integrated with metabolic profiles extracted from urine samples.

Results
We have developed MetSCORE, a metabolic model of MetS that combines serum lipoprotein and metabolite information. MetSCORE discriminate patients with MetS (independently identified using the WHO criterium) from general population, with an AUROC of 0.94 (95% CI 0.920–0.952, p < 0.001). MetSCORE is also able to discriminate the intermediate phenotypes, identifying the early risk of MetS in a quantitative way and ranking individuals according to their risk of undergoing MetS (for general population) or according to the severity of the syndrome (for MetS patients).

Conclusions
We believe that MetSCORE may be an insightful tool for early intervention and lifestyle modifications, potentially preventing the aggravation of metabolic syndrome.
EBV-positive small cell neuroendocrine carcinoma of nasopharynx as a probably unique subtype of neuroendocrine carcinoma: a clinicopathologic study of three cases and literature review
Authors: Chen Ying , Zhou Ning , Huang Caijun , He Xin , Wang Xiaodong , Tang Hao , Wang Wenyan , Wang Jiashuang , Li Tao , Guo Deyu 
Published: July 2024

Abstract
Background
There is currently scarcity of information on small cell neuroendocrine carcinoma of the nasopharynx (SCNEC-nasopharynx). It is believed that this type of cancer is not associated with Epstein-Barr virus (EBV) infection and is indistinguishable from classic SCNEC occurring in other organs.

Materials and methods
Herein we provided 3 cases of nasopharyngeal mass in our hospital, two males and one female. On admission, these patients were considered nasopharyngeal carcinoma with lymph node metastasis, and one of them had liver metastasis. The nasopharyngeal mucosal tissues were biopsied for pathological examination including immunohistochemistry and in situ hybridization. PubMed database was searched for articles about SCNEC-nasopharynx published up to April 2024 in any language.

Result
The 3 cases had similar histological features of SCNEC in other organs but differed in rich- tumor-infiltrating lymphocytes (TILs). All of them stained for pancytokeratin (panCK) and epidermal growth factor receptor (EGFR). Case 1 and Case 2 diffusely expressed insulinoma-associated protein 1(INSM-1) and synaptophysin (Syn), Case 3 strongly stained for CD56 and Syn. Immunostaining of all 3 cases for p40, p63, TTF-1, CK20, S-100 and NUT showed negative. BRG-1, INI-1 and Rb were retained. And p53 all showed wild-type expression. The Ki-67 labeling indiced of case 1, 2, and 3 were 80%, 90%, and 80%, respectively. In situ hybridization showed strong and uniform nuclear positivity of EBV-encoded small RNAs (EBER) in the neoplastic cells of 3 cases.

Conclusion
EBV-positive SCNEC-nasopharynx was exactly rare. The origin of this tumor is still controversial. It may originate from EBV-infected mucosal epithelium like nasopharyngeal carcinoma. Based on our cases and relevant literature, we found EBV-positive SCNEC-nasopharynx as a probably site-specific subtype of SCNEC with differing pathogenetic mechanism. The subtype not only virus positivity but also that it was associated with TILs and did not show p53 or Rb alterations by immunohistochemistry. It may be more responsive to treatment and have a better prognosis than classic SCNEC. We will continue to follow-up these patients and collect additional cases to further understand the unique biology of this rare solid tumor.
Biosynthesis and signal transduction of plant growth regulators and their effects on bioactive compound production in Salvia miltiorrhiza (Danshen)
Authors: Li Heqin , Jiang Xuwen , Mashiguchi Kiyoshi , Yamaguchi Shinjiro , Lu Shanfa 
Published: July 2024

AbstractPlant growth regulators (PGRs) are involved in multiple aspects of plant life, including plant growth, development, and response to environmental stimuli. They are also vital for the formation of secondary metabolites in various plants. Salvia miltiorrhiza is a famous herbal medicine and has been used commonly for > 2000 years in China, as well as widely used in many other countries. S. miltiorrhiza is extensively used to treat cardiovascular and cerebrovascular diseases in clinical practices and has specific merit against various diseases. Owing to its outstanding medicinal and commercial potential, S. miltiorrhiza has been extensively investigated as an ideal model system for medicinal plant biology. Tanshinones and phenolic acids are primary pharmacological constituents of S. miltiorrhiza. As the growing market for S. miltiorrhiza, the enhancement of its bioactive compounds has become a research hotspot. S. miltiorrhiza exhibits a significant response to various PGRs in the production of phenolic acids and tanshinones. Here, we briefly review the biosynthesis and signal transduction of PGRs in plants. The effects and mechanisms of PGRs on bioactive compound production in S. miltiorrhiza are systematically summarized and future research is discussed. This article provides a scientific basis for further research, cultivation, and metabolic engineering in S. miltiorrhiza.
Sound as a bell: a deep learning approach for health status classification through speech acoustic biomarkers
Authors: Wang Yanbing , Wang Haiyan , Li Zhuoxuan , Zhang Haoran , Yang Liwen , Li Jiarui , Tang Zixiang , Hou Shujuan , Wang Qi 
Published: July 2024

Abstract
Background
Human health is a complex, dynamic concept encompassing a spectrum of states influenced by genetic, environmental, physiological, and psychological factors. Traditional Chinese Medicine categorizes health into nine body constitutional types, each reflecting unique balances or imbalances in vital energies, influencing physical, mental, and emotional states. Advances in machine learning models offer promising avenues for diagnosing conditions like Alzheimer's, dementia, and respiratory diseases by analyzing speech patterns, enabling complementary non-invasive disease diagnosis. The study aims to use speech audio to identify subhealth populations characterized by unbalanced constitution types.

Methods
Participants, aged 18–45, were selected from the Acoustic Study of Health. Audio recordings were collected using ATR2500X-USB microphones and Praat software. Exclusion criteria included recent illness, dental issues, and specific medical histories. The audio data were preprocessed to Mel-frequency cepstral coefficients (MFCCs) for model training. Three deep learning models—1-Dimensional Convolution Network (Conv1D), 2-Dimensional Convolution Network (Conv2D), and Long Short-Term Memory (LSTM)—were implemented using Python to classify health status. Saliency maps were generated to provide model explainability.

Results
The study used 1,378 recordings from balanced (healthy) and 1,413 from unbalanced (subhealth) types. The Conv1D model achieved a training accuracy of 91.91% and validation accuracy of 84.19%. The Conv2D model had 96.19% training accuracy and 84.93% validation accuracy. The LSTM model showed 92.79% training accuracy and 87.13% validation accuracy, with early signs of overfitting. AUC scores were 0.92 and 0.94 (Conv1D), 0.99 (Conv2D), and 0.97 (LSTM). All models demonstrated robust performance, with Conv2D excelling in discrimination accuracy.

Conclusions
The deep learning classification of human speech audio for health status using body constitution types showed promising results with Conv1D, Conv2D, and LSTM models. Analysis of ROC curves, training accuracy, and validation accuracy showed all models robustly distinguished between balanced and unbalanced constitution types. Conv2D excelled with good accuracy, while Conv1D and LSTM also performed well, affirming their reliability. The study integrates constitution theory and deep learning technologies to classify subhealth populations using noninvasive approach, thereby promoting personalized medicine and early intervention strategies.
Enhancing molecular property prediction with auxiliary learning and task-specific adaptation
Authors: Dey Vishal , Ning Xia 
Published: July 2024

AbstractPretrained Graph Neural Networks have been widely adopted for various molecular property prediction tasks. Despite their ability to encode structural and relational features of molecules, traditional fine-tuning of such pretrained GNNs on the target task can lead to poor generalization. To address this, we explore the adaptation of pretrained GNNs to the target task by jointly training them with multiple auxiliary tasks. This could enable the GNNs to learn both general and task-specific features, which may benefit the target task. However, a major challenge is to determine the relatedness of auxiliary tasks with the target task. To address this, we investigate multiple strategies to measure the relevance of auxiliary tasks and integrate such tasks by adaptively combining task gradients or by learning task weights via bi-level optimization. Additionally, we propose a novel gradient surgery-based approach, Rotation of Conflicting Gradients ($$\mathop {\texttt{RCGrad}}\limits$$
RCGrad
), that learns to align conflicting auxiliary task gradients through rotation. Our experiments with state-of-the-art pretrained GNNs demonstrate the efficacy of our proposed methods, with improvements of up to 7.7% over fine-tuning. This suggests that incorporating auxiliary tasks along with target task fine-tuning can be an effective way to improve the generalizability of pretrained GNNs for molecular property prediction.Scientific contributionWe introduce a novel framework for adapting pretrained GNNs to molecular tasks using auxiliary learning to address the critical issue of negative transfer. Leveraging novel gradient surgery techniques such as $$\mathop {\texttt{RCGrad}}\limits$$
RCGrad
, the proposed adaptation framework represents a significant departure from the dominant pretraining fine-tuning approach for molecular GNNs. Our contributions are significant for drug discovery research, especially for tasks with limited data, filling a notable gap in the efficient adaptation of pretrained models for molecular GNNs.