bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acceptability, feasibility and fidelity of the culturally adapted version of Unplugged (“Yo Se Lo Que Quiero”), a substance use preventive program among adolescents in Chile: a pilot randomized controlled study
Authors: Salgado Gabriel , Gaete Jorge , Gana Sofía , Valenzuela Daniela , Araya Ricardo 
Published: July 2024

Abstract
Introduction
The consumption of alcohol, tobacco, and cannabis is a public health problem that impacts the cognitive, social, and emotional development of adolescents. Prevention strategies such as the “Unplugged” program are effective in delaying the progression of daily smoking and episodes of drunkenness among adolescents. “Yo Se Lo Que Quiero” (YSLQQ) corresponds to the adaptation of this program to the Chilean context. This study assesses the acceptability and feasibility of implementing this program to the local reality.

Material and methods
This was a cluster-randomized controlled pilot study conducted on six public schools. All consented students attending 6th, 7th, and 8th grades (n = 1,180) participated in the study. The schools were randomly assigned to one of two conditions in a 1:1 ratio: (1) the “YSLQQ” intervention group (n = 526), and (2) the Control group (n = 654). The program consisted of a 12-hour class-based curriculum based on a comprehensive social-influence approach delivered by a trained facilitator. The acceptability and feasibility were assessed in the intervention group at the end of the intervention using questionnaires answered by students and facilitators. The quality and fidelity of the program were evaluated during the implementation using self-ported surveys answered by the facilitators and the assessment of video-recorded sessions rated by external observers. Finally, a pre-test and a post-test survey assessing past and current substance use and risk and protective factors were conducted before and immediately after the program’s implementation.

Results
A high proportion of students (49.6%) liked the sessions. 79.2% reported that the YSLQQ helped them learn about the dangers of substances, while 65.8% reported having more skills to avoid substance use in the future. Regarding students’ satisfaction with YSLQQ, 62.9% reported being happy or very happy with the program. Facilitators reported implementing the intervention according to the manual in 73.9% of sessions. Regarding substance use, students who participated in the intervention groups reported a significant reduction in drunkenness in the last year and last 30-day prevalence and also a significant reduction in a lifetime and 30-day prevalence of cannabis use when compared with those students in the control group.

Conclusions
Our results suggest that YSLQQ has adequate acceptability and feasibility to be implemented in the Chilean context, and there were promising results in reducing drunkenness and cannabis use. Future research should confirm these results in a larger RCT study.

Trial registration
The trial was registered in ClinicalTrials.gov, NCT04566627; registration date: 01/03/2019
Predictive value of inflammatory factors and lymphocyte counts in tracheal intubation and death after infection with COVID-19
Authors: Xu Zhongying , Jin Guomin , Zhang Debao 
Published: July 2024

Abstract
Objective
This study aims to investigate the prognostic significance of inflammatory cytokines and lymphocyte levels in predicting disease progression among patients with COVID-19 infection.

Methods
Ninety-two hospitalized COVID-19 patients were retrospectively included as subjects for this study. General clinical information and various indicators, including lymphocyte count, interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), tumor necrosis factor (TNF), were collected. All patients received treatment according to the ninth edition of the guidelines for COVID-19. Incidences of endotracheal intubation and mortality within 28 days were observed.

Results
1.In the analysis of intubation impact, multivariate analysis identified age, immunoglobulins, lymphocytes, and IL-6 as independent risk factors. When analyzing the impact on patient mortality, multivariate analysis revealed age, prealbumin, and BNP as independent risk factors. 2. Lymphocyte count and inflammatory factors demonstrated predictive value for endotracheal intubation in COVID-19 patients. The critical lymphocyte count value was 0.91, with a sensitivity of 38.8%, specificity of 92.9%, and AUC of 0.687 (95% CI: 0.580–0.795). The critical IL-6 value was 38.21, with a sensitivity of 81%, specificity of 63.3%, and AUC of 0.771 (95% CI: 0.6670.872). The area under the ROC curve for IL-8, IL-10 and TNF is 0.665, 0.712 and 0.648, respectively. 3.Lymphocyte count and inflammatory factors also exhibited predictive value for death in COVID-19 patients. The critical lymphocyte count value was 0.56, with a sensitivity of 71.2%, specificity of 57.5%, and AUC of 0.641 (95% CI: 0.528–0.754). The critical IL-6 value was 53.05, with a sensitivity of 75%, specificity of 71.2%, and AUC of 0.770 (95% CI: 0.6690.870). The area under the ROC curve for IL-8, IL-10 and TNF is 0.687, 0.683 and 0.636, respectively.

Conclusion
Elevated inflammatory factors and decreased lymphocyte levels have prognostic value for predicting endotracheal intubation and mortality in COVID-19 patients, providing valuable insights for clinicians in anticipating disease progression.
Systematic review and meta-analysis of percutaneous nephrolithotomy in flank versus prone position
Authors: He Qing , Xiong Liqiang , Wei Renbo , Fu Lei , Zhou Liang , Yuan Renbin , Zhuo Hui 
Published: July 2024

Abstract
Background
This systematic review and meta-analysis aimed to evaluate the efficiency and safety of percutaneous nephrolithotomy (PCNL) between flank position and prone position for the treatment of renal stones.

Methods
PubMed, Embase, OVID, and Cochrane Library were comprehensively searched from their inception to Jul 2024. Randomized and nonrandomized trials evaluating renal calculi patients who underwent PCNL via flank position or prone position were included. Data extraction and quality assessment were conducted by two independent reviewers. The outcomes and complications of both groups were compared in this meta-analysis.

Results
This review involved five articles (554 patients). Specifically, four articles were randomized controlled trials, and the remaining publication was prospective cohort study. No significant difference was found in stone-free rate between the flank group and prone group after the PCNL procedure. Similarly, the percutaneous access time, operative time, and hospital stay of flank position had no significant difference compared with the prone group. There was no significant difference in the comparison of complication rates between the flank group and the prone group. Although further analysis indicated that patients in the prone position suffered more hemoglobin drop than the flank group, no significant difference was found in the hemorrhage and blood transfusion rates.

Conclusions
Both surgical positions were appropriate for most PCNL procedures and had shown similar efficacy and safety. In practice, the optimal choice should be made according to the patients’ conditions and urologists’ acquaintance.
Advance directives in amyotrophic lateral sclerosis – a systematic review and meta-analysis
Authors: Mangal Anne Lisa , Mücke Martin , Rolke Roman , Appelmann Iris 
Published: July 2024

Abstract
Background
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease of the upper and lower motoneuron. It is associated with a life expectancy of 2–4 years after diagnosis. Individuals experience paralysis, dysphagia, respiratory failure and loss of communicative function, rendering advance care planning (ACP) critically important. This systematic review primarily aimed to internationally compare the application of advance directives (AD) and ACP in ALS. Its secondary aim was to identify ACP preferences, identify fields for future research and to generate recommendations for improving patient care through ACP.

Methods
We conducted a systematic literature review and meta-analysis. Five electronic databases (Embase, Medline, Scopus, PsycInfo and CENTRAL) were searched for qualitative and quantitative primary literature from 1999 to 2024. Cross-references were used to identify additional publications. Study selection was performed based on inclusion criteria. Number and content of AD were extracted systematically. After statistical analysis consecutive meta-analysis was performed for international differences and changes over time. Quality assessment of studies was performed using the MMAT (Mixed Methods Appraisal Tool). PROSPERO Registration (June 07, 2021) : CRD42021248040.

Results
A total of 998 records was screened of which 26 were included in the synthesis. An increase in publication numbers of 88.9% was observed from 1999 to 2024. Results regarding use and content of AD were heterogeneous and international differences were detected. AD were signed in 60.4% of records (1,629 / 2,696 patients). The number of AD decreased over time when separating the review period in two decades (1st 1999–2011: 78% vs. 2nd 2012–2024: 42%). Study quality was superior in qualitative and mixed method designs compared to quantitative studies.

Conclusion
Further prospective studies should include detailed analyses on preferences regarding ventilation and artificial nutrition in ALS and should encompass countries of the global south. Despite the complexity of ACP with regard to individual patient needs, ACP should be part of each individual support plan for ALS patients and should specifically comprise a discussion on the preferred place of death. The available disease-specific AD documents should be preferred.
Association of caesarean scar defect with risk of abnormal uterine bleeding: results from meta-analysis
Authors: Xu Xiao-Jing , Jia Jing-Xing , Sang Zi-Qiong , Li Li 
Published: July 2024

Abstract
Objective
To investigate the association between caesarean scar defects and abnormal uterine bleeding through systematic literature review.

Methods
PubMed, Web of Science, Cochrane Library and Embase databases were searched based on PRISMA 2020 to include studies exploring abnormal uterine bleeding in women with caesarean scar defects. The combined relative risk (RR) of uterine bleeding, combined prevalence of abnormal uterine bleeding and combined RR of intermenstrual uterine bleeding were calculated using a fixed- or random-effects model.

Results
Ten studies involving 1,183 women with caesarean scar defects met the inclusion criteria for this study. Compared with women without caesarean scar defects, those with caesarean scar defects had a higher risk of abnormal uterine bleeding (RR: 3.22, 95% CI: 1.83–5.66) and intermenstrual bleeding (RR: 2.93, 95% CI: 1.91–4.50). The prevalence of abnormal uterine bleeding was approximately 0.46 (95% CI: 0.27–0.64), and across populations, women with a previous caesarean section who had undergone imaging specifically for gynaecological disease had a significantly higher prevalence of abnormal uterine bleeding (0.77, 95% CI: 0.65–0.89) than those with at least one caesarean Sect. (0.25, 95% CI: 0.10–0.39).

Conclusion
A significant association was observed between caesarean scar defects and abnormal uterine bleeding, with the former being a risk factor for the latter. However, previous studies have differed in the definition of caesarean scar defects and abnormal uterine bleeding, and more high-quality studies are needed to further investigate the relevant definitions and study results in the future.
The perceived relevance, utility and retention of basic sciences in general practice
Authors: Alele Faith O. , Albert Francis A. , Anderson Emma , Seidu Abdul-Aziz , Mason Hannah , Heggarty Paula , Hollins Aaron , Sen Gupta Tarun , McArthur Lawrie , Hays Richard B. , Malau-Aduli Bunmi S. 
Published: July 2024

AbstractBackgroundBasic sciences are crucial for clinical medicine, yet studies focusing on their perceived utility among general practitioners (GPs) are sparse. Considering the broad scope of GPs’ practice, an in-depth understanding of basic sciences is fundamental for making informed clinical decisions. This study evaluated GP registrars’ retention and perceptions of the utility of basic sciences in clinical practice.MethodsUsing sequential explanatory mixed methods study design, knowledge retention was assessed by a multiple-choice question (MCQ) examination followed by interviews on the perception of the relevance and utility of basic sciences among GP registrars at James Cook University's (JCU) General Practice Training (GPT) program. Descriptive and inferential statistical analyses were conducted on the MCQ exam data, while thematic analysis was employed for the qualitative interview data.ResultsSixty-one GP registrars participated in the MCQ exam, while 11 of them were involved in the interviews. The highest mean score was obtained in biochemistry (75.1 ± 2.23) while the lowest mean score was in anatomy (56.07 ± 3.16). Key performance predictors included the formative clinical examination scores (β = 0.83, 95% CI: 0.45 to 1.2,p < 0.001) and gender (β = -9.7, 95% CI: -17 to -2.3,p = 0.011). The qualitative data analysis revealed five themes, including the backbone of clinical medicine, varying utility over time and by specialty, clinical synthesis integrates encapsulated knowledge, professional pressures hinder revisitation of knowledge and knowledge renewal enhances updates.ConclusionBasic sciences were considered relevant in clinical practice. Development of continuing professional development (CPDs) sessions and clinically relevant online resources were measures proposed to enhance the retention of knowledge. Future research could focus on innovative educational strategies for GPs.
Knowledge and attitudes of medical and pharmacy university students regarding monkeypox: a multicenter, cross-sectional study in Vietnam
Authors: Doan Dung Anh , Nguyen Thuy Thi Xuan , Le Giang Ba , Phuong Trinh Lan , Nguyen Phuong Lan , Dinh Dai Xuan 
Published: July 2024

Abstract
Background
In May 2022, monkeypox (mpox) suddenly reappeared and rapidly spread worldwide. This global outbreak was a public health emergency of international concern. This study investigated Vietnamese medical and pharmacy university students’ knowledge and attitudes towards mpox.

Methods
This online cross-section survey was administered among students in four universities using a convenience sampling method. A semi-structured questionnaire was shared among students via a Google Forms link (quick-response code) in university amphitheaters at recess. Frequency (percentage) and mean (standard division) were used for descriptive statistics. Univariate and multivariate linear regression analyses were conducted to identify factors associated with students’ mpox knowledge and attitudes. A p-value < 0.001 was considered statistical significance.

Results
A total of 1,848 students participated in this study (including 1,030 medical students and 818 pharmacy students). Their common sources for seeking mpox/health information included the Internet (89.7%) and mass media (64.2%). Students’ average knowledge and attitude scores were 11.542 ± 3.910 (range: 0–23) and 30.301 ± 3.738 (range: 9–45), respectively. The average knowledge score of pharmacy students (12.139 ± 3.545) was significantly higher than that of medical students (11.067 ± 4.118) (p < 0.001). The average attitude score of the former (30.454 ± 3.787) was comparatively higher than that of the latter (30.181 ± 3.696), but this difference was insignificant (p = 0.111). Factors significantly associated with students’ mpox knowledge and/or attitudes were their sex, age, year of study, residence, major, grade point average, type of university, seeking mpox information in the past, and using reliable sources to seek health information (p < 0.001). A positive correlation existed between students’ knowledge and attitude scores (p < 0.001).

Conclusions
Students’ knowledge about mpox was relatively poor, while their attitudes were comparatively positive. Universities and relevant authorities should focus on the above factors and use multiple platforms and channels of communication to guarantee that trustworthy information about mpox can reach as many students as possible.
Transformer models in biomedicine
Authors: Madan Sumit , Lentzen Manuel , Brandt Johannes , Rueckert Daniel , Hofmann-Apitius Martin , Fröhlich Holger 
Published: July 2024

AbstractDeep neural networks (DNN) have fundamentally revolutionized the artificial intelligence (AI) field. The transformer model is a type of DNN that was originally used for the natural language processing tasks and has since gained more and more attention for processing various kinds of sequential data, including biological sequences and structured electronic health records. Along with this development, transformer-based models such as BioBERT, MedBERT, and MassGenie have been trained and deployed by researchers to answer various scientific questions originating in the biomedical domain. In this paper, we review the development and application of transformer models for analyzing various biomedical-related datasets such as biomedical textual data, protein sequences, medical structured-longitudinal data, and biomedical images as well as graphs. Also, we look at explainable AI strategies that help to comprehend the predictions of transformer-based models. Finally, we discuss the limitations and challenges of current models, and point out emerging novel research directions.
From pre-test and post-test probabilities to medical decision making
Authors: Nixon Michelle Pistner , Momotaz Farhani , Smith Claire , Smith Jeffrey S. , Sendak Mark , Polage Christopher , Silverman Justin D. 
Published: July 2024

Abstract
Background
A central goal of modern evidence-based medicine is the development of simple and easy to use tools that help clinicians integrate quantitative information into medical decision-making. The Bayesian Pre-test/Post-test Probability (BPP) framework is arguably the most well known of such tools and provides a formal approach to quantify diagnostic uncertainty given the result of a medical test or the presence of a clinical sign. Yet, clinical decision-making goes beyond quantifying diagnostic uncertainty and requires that that uncertainty be balanced against the various costs and benefits associated with each possible decision. Despite increasing attention in recent years, simple and flexible approaches to quantitative clinical decision-making have remained elusive.

Methods
We extend the BPP framework using concepts of Bayesian Decision Theory. By integrating cost, we can expand the BPP framework to allow for clinical decision-making.

Results
We develop a simple quantitative framework for binary clinical decisions (e.g., action/inaction, treat/no-treat, test/no-test). Let p be the pre-test or post-test probability that a patient has disease. We show that $$r^{*}=(1-p)/p$$

r

∗

=

(
1
-
p
)

/
p

represents a critical value called a decision boundary. In terms of the relative cost of under- to over-acting, $$r^{*}$$

r

∗

represents the critical value at which action and inaction are equally optimal. We demonstrate how this decision boundary can be used at the bedside through case studies and as a research tool through a reanalysis of a recent study which found widespread misestimation of pre-test and post-test probabilities among clinicians.

Conclusions
Our approach is so simple that it should be thought of as a core, yet previously overlooked, part of the BPP framework. Unlike prior approaches to quantitative clinical decision-making, our approach requires little more than a hand-held calculator, is applicable in almost any setting where the BPP framework can be used, and excels in situations where the costs and benefits associated with a particular decision are patient-specific and difficult to quantify.
Long-term prediction of Iranian blood product supply using LSTM: a 5-year forecast
Authors: Miri-Moghaddam Ebrahim , Bizhaem Saeede Khosravi , Moezzifar Zohre , Salmani Fatemeh 
Published: July 2024

Abstract
Background
This study aims to predict the trend of procurement and storage of various blood products, as well as planning and monitoring the consumption of blood products in different centers across Iran based on artificial intelligence until the year 2027.

Methods
This research constitutes a time-series investigation within the realm of longitudinal studies. In this study, information on the number of packed red blood cells (RBC), leukoreduced red blood cells (LR-RBC), and platelets (PLT), PLT-Apheresis, and fresh frozen plasma (FFP) was requested from all blood transfusion centers in the country and extracted using a unified protocol. After the initial examination of the information and addressing data issues and inconsistencies, the corrected data were analyzed. Both conventional and artificial intelligence approaches were used to predict each product in this study. The best model was selected based on goodness-of-fit indicators RMSE and MAPE.

Results
Based on the obtained results, the FFP product will follow a relatively consistent process similar to previous years in the next five years. The PLT product is predicted to have a growing trend over the next 5 years, which applies to both the demand and supply of the product. The PLT-Apheresis product also shows a similar upward trend, albeit with a lower growth rate. The RBC product will have a constant trend over a 5-year period (long-term) according to both models, taking into account short-term changes. Similarly, there is a similar trend in LR-RBC, with the expectation that short-term pattern repetition will continue over a 5-year period (long-term). Comparing the goodness-of-fit results, the LSTM model proved to be better for predicting the dominant blood products.

Conclusions
The growth of the elderly population and diseases related to old age, and on the other hand, the trend of increasing the consumption of the product with a short lifespan (PLT) requires the activation of the management of the patient’s blood, especially in relation to this product in medical centers. The trend for other products in the next five years is similar to previous years, and no growth in demand is observed. The LSTM method, considering periodic and cyclical events, has performed the prediction.