bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decoding the NCCN Guidelines With AI: A Comparative Evaluation of ChatGPT-4.0 and Llama 2 in the Management of Thyroid Carcinoma
Authors: Pandya Shivam , Bresler Tamir E. , Wilson Tyler , Htway Zin , Fujita Manabu 
Published: August 2024

Introduction Artificial Intelligence (AI) has emerged as a promising tool in the delivery of health care. ChatGPT-4.0 (OpenAI, San Francisco, California) and Llama 2 (Meta, Menlo Park, CA) have each gained attention for their use in various medical applications. Objective This study aims to evaluate and compare the effectiveness of ChatGPT-4.0 and Llama 2 in assisting with complex clinical decision making in the diagnosis and treatment of thyroid carcinoma. Participants We reviewed the National Comprehensive Cancer Network® (NCCN) Clinical Practice Guidelines for the management of thyroid carcinoma and formulated up to 3 complex clinical questions for each decision-making page. ChatGPT-4.0 and Llama 2 were queried in a reproducible manner. The answers were scored on a Likert scale: 5) Correct; 4) correct, with missing information requiring clarification; 3) correct, but unable to complete answer; 2) partially incorrect; 1) absolutely incorrect. Score frequencies were compared, and subgroup analysis was conducted on Correctness (defined as scores 1-2 vs 3-5) and Accuracy (scores 1-3 vs 4-5). Results In total, 58 pages of the NCCN Guidelines® were analyzed, generating 167 unique questions. There was no statistically significant difference between ChatGPT-4.0 and Llama 2 in terms of overall score (Mann-Whitney U-test; Mean Rank = 160.53 vs 174.47, P = 0.123), Correctness ( P = 0.177), or Accuracy ( P = 0.891). [Formula: see text] Conclusion ChatGPT-4.0 and Llama 2 demonstrate a limited but substantial capacity to assist with complex clinical decision making relating to the management of thyroid carcinoma, with no significant difference in their effectiveness.
Numerical model and experimental validation of stress waves propagation in large composite panels
Authors: Bhandari Binayak , Maung Phyo Thu , Prusty Gangadhara B. 
Published: August 2024

This study investigates stress waves application for non-destructive inspection and structural health monitoring in large laminated composite panels. This study investigates Lamb wave dispersion under two boundary conditions: fixed support and simply support. Lamb wave propagation is examined under two conditions: one with a 100 kHz excitation frequency to simulate internal defects, and the other with a 30N impulse load to simulate external events. Both scenarios include cases with and without cutouts. Experimental and numerical analyses are conducted to examine stress wave propagation characteristics in these panels. The experimental phase focuses on discerning propagation time differences attributable to cutouts, while the three-dimensional (3-D) numerical model analyses propagation time, path, and frequencies. Results reveal a significant time discrepancy between panels with and without cutouts, indicating that cutouts introduce delays in wave propagation due to disruptions in the propagation path. Comparative analysis affirms the reliability and accuracy of the numerical approach, aligning with outcomes from the experimental approach. This research contributes insights into stress wave behaviour, demonstrating its potential for effective non-destructive inspection and structural health monitoring in laminated composites across diverse structural applications.
Prevalence of Obstructive Sleep Apnea Among Veterans and Nonveterans
Authors: Goldstein Lizabeth A. , Bernhard Paul A. , Hoffmire Claire A. , Schneiderman Aaron , Maguen Shira 
Published: August 2024

Purpose Understanding disease prevalence can inform treatment and resource needs across populations. This study aimed to identify the prevalence of sleep apnea (OSA) among veterans and nonveterans. Design The national Comparative Health Assessment Interview Study, cross-sectional survey using probability-based sampling frames. Setting Surveys completed by Internet or phone. Subjects 15,166 veterans (40% response rate) and 4,654 nonveterans (57% response rate). Measures Self-report of healthcare provider-based diagnosis of OSA. Analysis Calculation of prevalence of OSA using statistical weighting to allow for direct comparison between veterans and nonveterans. Secondary analyses evaluated OSA by deployment status among veterans and compared average age of OSA diagnosis and differences in OSA prevalence among veterans and nonveterans stratified by gender, marital status, race/ethnicity, and posttraumatic stress disorder diagnosis. Results OSA diagnosis was more than twice as prevalent among veterans (21%, 95% CI 20%-22%) than nonveterans (9%, 95% CI 8%-10%; aOR: 2.56, 95% CI 2.22-2.95, P < .001). Deployment was associated with higher odds of OSA among veterans (aOR: 1.64, 95% CI 1.43-18.7, P < 001.) Veterans were diagnosed with OSA on average 5 years earlier than nonveterans. Conclusion Veterans have a high prevalence rate of OSA, highlighting the importance of veterans’ access to treatment. OSA is likely underdiagnosed in nonveterans, particularly among racial/ethnic minoritized groups. Future research should investigate disparities in access to diagnostic testing for racial/ethnic minority nonveterans and/or risk factors for OSA among racial/ethnic minority veterans. The increased odds of OSA among those with PTSD highlights in the importance of early referral for OSA testing by providers as well as development of trauma-informed strategies to promote OSA treatment adherence. Limitations include a bias toward underestimation of true disease prevalence due to self-report of diagnosis.
Assessment of Online Arabic Patient-Centered Knowledge About Orthognathic Surgery: An Infodemiologic Study
Authors: Alassaf Muath Saad , Sharbib Shadan H. , Alhammad Reem H. , Alabdali Faisal Hussain , Habib Osama A. , Abdelfattah Ashraf , Aboalkhair Ayoub , Albeshir Hasan , Samman Mahmood 
Published: August 2024

Background Orthognathic surgery, addressing skeletal and dental irregularities, is pivotal for patients suffering from malocclusion, facial asymmetry, and related disorders. With the internet becoming a primary source of health information, the accuracy, quality, and reliability of online Arabic-language patient-centered information on orthognathic surgery necessitate thorough evaluation. This study aimed to assess the quality, reliability, and readability of Arabic online resources about orthognathic surgery to ascertain their potential as reliable patient education tools. Methods An infodemiological approach was employed, analyzing the top 100 websites from Google, Yahoo, and Bing based on specific Arabic search terms related to orthognathic surgery. Websites were evaluated for affiliation, content specialization, and presentation and excluded based on predetermined criteria to ensure relevance and focus. Quality assessment was conducted using the DISCERN instrument, Journal of the American Medical Association (JAMA) benchmarks, and Health On the Net code evaluation. Readability was assessed using the Flesch-Kincaid Grade Level, Simplified Measure of Gobbledygook, and Flesch Reading Ease scales. Results Of 600 initial websites, 96 met the inclusion criteria. Most were affiliated with universities or medical centers (53.1%), followed by commercial (28.1%), and non-profit organizations (16.7%). The majority of websites (96.9%) were only partially related to orthognathic surgery. Content analysis revealed a moderate quality of information, with a median overall DISCERN quality rating of 3 out of 5. The JAMA benchmarks showed a lack of comprehensive adherence, with currency being the most achieved criterion. Readability assessments indicated the content was generally accessible yet highlighted the need for Arabic-specific readability evaluation tools. Conclusion The study reveals a critical need for enhancing Arabic online resources on orthognathic surgery. Despite the available content's moderate quality and acceptable readability, there is a substantial gap in providing comprehensive, patient-centered, and easily understandable information. Future efforts should focus on developing high-quality, reliable, and readable online resources to aid Arabic-speaking patients in making informed decisions about orthognathic surgery.
Relationship of the modified Glasgow Prognostic Score with peripheral artery disease severity and procedure success in patients who had undergone endovascular treatment
Authors: Karaduman Ahmet , Balaban İsmail , Biyiklı Kadir , Keten Mustafa Ferhat , Kalkan Semih , Kahyaoglu Muzaffer , Celik Mehmet , Gecmen Çetin 
Published: August 2024

Objectives The modified Glasgow Prognostic Score (mGPS) is one type of inflammation-based index; it includes data on elevated C-reactive protein and reduced albumin content. The predictive value of mGPS for outcomes is investigated in various diseases such as cancer, heart failure, myocardial infarction, acute pulmonary embolism, and inflammatory bowel diseases. This study aimed to evaluate the link between mGPS and the severity and complexity of peripheral arterial disease (PAD) as determined by the Transatlantic Intercommunal Consensus Document (TASC-II) classification and the prediction value of mGPS for procedural success in patients undergoing endovascular treatment (EVT). Methods Our study included 203 consecutive patients receiving EVT for atherosclerotic obstruction of aortoiliac, femoro-popliteal, and below-knee arteries between January 2019 and February 2020. The lesion characteristics were determined according to categories in the TASC-II. Operational failure is the inability to position the guidewire through the occluded lesion following percutaneous intervention or achieve distal perfusion following EVT. Results In our study, we observed 136 patients (%6) with TASC A–B lesions and 67 patients (%33) with TASC C–D lesions. EVT was performed on the femoro-popliteal artery in 59.4% of the patients, on the aortoiliac artery in 30.7%, and on the below-the-knee artery in 9.9%. mGPS was an independent predictor of severe PAD (OR: 17.943, 95% CI: 5.120–62.882; p < .001) and procedural success (odds ratio: 0.004; 95% CI: 0.001–0.099; p < .001). Additionally, we identified age and the presence of a TASC D lesion as independent predictors of interventional success (OR: 0.938, 95% CI: 0.819–0.979; p: .034; OR: 0.104, 95% CI: 0.107–0.643; p: .015, respectively). Conclusion We determined that mGPS independently predicts PAD complexity and severity based on TASC-II classification; the EVT success rate is lower in patients with high mGPS.
Adolescents’ unhealthy snacking behaviour during the school journey and the association with transport modes and food outlets along the school route
Authors: Situmorang ML , Mandic S , Smith M , Keall M , Donnellan N , Coppell KJ 
Published: August 2024

Aims: Active transport to and from school provides an opportunity for adolescents to engage in physical activity, but travelling through an obesogenic environment may have unintended consequences on their snacking behaviour. This study aimed to: (1) identify whether adolescents’ unhealthy snacking behaviour was associated with school transport modes and food outlets on their estimated school route and (2) explore whether food outlet density on the school route differed between school transport modes. Methods: Adolescents ( n = 406; aged 15.1 ± 1.4 years; 50.7% boys; 63.5% New Zealand European) from all 12 secondary schools in Dunedin city, Aotearoa New Zealand, completed an online survey. School transport modes (active, motorised or mixed) and unhealthy snacking data were collected. Food outlet data were collected using Google Places Application Programming Interface (API). Home-to-school route and distance were estimated using geographical information system (GIS) analysis based on a walkable road network. Data were analysed using the chi-square test and logistic regression. Results: Overall, 26.4% of adolescents reported purchasing and consuming unhealthy snacks or soft drinks on the way to school and 41.4% from school. The odds of unhealthy snacking during the school journey was higher among mixed transport users than active transport users on the way to (odds ratio (OR) = 2.73, 95% confidence interval (CI) = 1.39–5.36) and from school (OR = 2.68, 95% CI = 1.40–5.13). No differences were observed by food outlet type. There were no food outlets on the estimated school route for 44.8% of adolescents. The presence of more than one food outlet per kilometre of the estimated school route differed between active (38.7%), motorised (42.6%) and mixed transport users (46.4%; p = 0.006). Conclusion: School transport modes were significantly associated with adolescents’ unhealthy snacking behaviour and food outlets on their school journey. Policy measures which minimise exposure to unhealthy food outlets may reduce unhealthy snacking among adolescents.
Bridge-Enhanced Anterior Cruciate Ligament Restoration: 6-Year Results From the First-in-Human Cohort Study
Authors: Fleming Braden C. , Baranker Ben , Badger Gary J. , Kiapour Ata M. , Ecklund Kirsten , Micheli Lyle J. , Murray Martha M. 
Published: August 2024

Background: Bridge-enhanced anterior cruciate ligament restoration (BEAR) combines suture repair of the anterior cruciate ligament (ACL) with an extracellular matrix implant plus autologous blood to facilitate native ACL healing. Purpose/Hypothesis: The purpose of this study was to compare the 6-year follow-up outcomes of patients who underwent the BEAR procedure with those of a nonrandomized concurrent control group receiving autograft ACL reconstruction (ACLR) in the first-in-human safety study of the BEAR implant (BEAR I trial). Based on the 2-year results, it was hypothesized that isometric hamstring strength after the BEAR procedure would be greater than that after ACLR and that there would be no other differences in outcomes at 6 years. Study Design: Cohort study, Level of evidence, 2. Methods: Ten patients underwent BEAR and 10 received ACLR with a 4-stranded hamstring autograft. Outcomes assessed included the record of subsequent surgeries, the International Knee Documentation Committee (IKDC) Subjective Knee Score, IKDC physical examination grade, the Knee injury and Osteoarthritis Outcome Score, instrumented knee laxity, functional outcomes (ie, muscle strength assessments and hop testing), and qualitative magnetic resonance imaging assessment. Comparisons between treatments were based on computations of the mean differences and the associated 95% CIs. Results: One patient in the BEAR group and 3 patients in the ACLR group were lost to follow-up. In the period between 2 and 6 years, 1 patient in each group underwent revision surgery. There were no differences between groups at the 6-year follow-up in any of the outcome measures except for isometric hamstring strength, which was approximately equal to that of the contralateral knee in the BEAR group and <44% of that in the contralateral knee in the ACLR group ( P < .01). Conclusion: This preliminary study suggests that the outcomes of BEAR and ACLR with a hamstring tendon graft may be similar at the 6-year follow-up and warrants investigation of the BEAR procedure in a larger cohort of patients.
Impact of cerebral protection on observed versus predicted in-hospital stroke in a high stroke risk TAVR cohort
Authors: Marcusohn Erez , Manoragavan Ragavie , Fremes Stephen , Tarola Christopher , Sathananthan Janarthanan , Barabash Israel M. , Orbach Ady , Sachedina Ayaaz K. , Radhakrishnan Sam , Wijeysundera Harindra C. 
Published: August 2024

Abstract
Background
Despite impressive improvements in the safety profile of Transcatheter aortic valve replacement (TAVR), the risk for peri-procedural stroke after TAVR has not declined substantially. In an effort to reduce periprocedural stroke, cerebral embolic protection (CEP) devices have been utilized but have yet to demonstrate benefit in all-comers. There is a paucity of data supporting the utilization of CEP in TAVR patients with an anticipated high risk for peri-procedural stroke.

Methods
The Transcatheter Aortic Valve Replacement In-Hospital Stroke (TASK) score is a clinical risk tool for predicting the in-hospital stroke risk of patients undergoing transfemoral TAVR. This score was used to identify high-risk patients and calculate the expected in-hospital stroke risk. This was a single-centre cohort study in all consecutive TAVR patients who had placement of CEP. The observed versus expected ratio for peri-procedural stroke was calculated. To obtain 95% credible intervals, we used 1000 bootstrapped samples of the original cohort sample size without replacement and recalculated the TASK predicted scores.

Results
The study included 103 patients. The median age was 83 (IQR 78,89). 63 were male (61.1%) and 45 (43.69%) had a history of previous Stroke or TIA. Two patients had an in-hospital stroke after TAVR (1.94%). The expected risk of in-hospital stroke based on the TASK score was 3.39% (95% CI 3.07–3.73). The observed versus expected ratio was 0.57 (95% CI 0.52–0.64).

Conclusion
In this single-center study, we found that in patients undergoing TAVR with high stroke risk, CEP reduced the in-hospital stroke risk by 43% when compared with the risk-score predicted rate.

Clinical trial number
N/A.
Predictors of dementia among the oldest old: longitudinal findings from the representative “survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+)”
Authors: Hajek André , Kretzler Benedikt , Riedel-Heller Steffi G. , Gyasi Razak M. , König Hans-Helmut 
Published: August 2024

Abstract
Background/Aims
Our current study aimed to investigate the determinants of dementia among the oldest old using longitudinal data from a representative sample covering both community-dwelling and institutionalized individuals.

Methods/Design
Longitudinal representative data were taken from the “Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+)” that surveyed community-dwelling and institutionalized individuals aged 80 years and above (n = 1,296 observations in the analytic sample), living in North Rhine-Westphalia (most populous state of Germany). The established DemTect was used to measure cognitive impairment (i.e., probable dementia). A logistic random effects model was used to examine the determinants of probable dementia.

Results
The mean age was 86.3 years (SD: 4.2 years). Multiple logistic regressions revealed that a higher likelihood of probable dementia was positively associated with lower education (e.g., low education compared to medium education: OR: 3.31 [95% CI: 1.10–9.98]), a smaller network size (OR: 0.87 [95% CI: 0.79–0.96]), lower health literacy (OR: 0.29 [95% CI: 0.14–0.60]), and higher functional impairment (OR: 13.45 [3.86–46.92]), whereas it was not significantly associated with sex, age, marital status, loneliness, and depressive symptoms in the total sample. Regressions stratified by sex were also reported.

Discussion
Our study identified factors associated with dementia among the oldest old. This study extends current knowledge by using data from the oldest old; and by presenting findings based on longitudinal, representative data (also including individuals residing in institutionalized settings).

Conclusions
Efforts to increase, among other things, formal education, network size, and health literacy may be fruitful in postponing dementia, particularly among older women. Developing health literacy programs, for example, may be beneficial to reduce the burden associated with dementia.
Antibiotic prescribing practices and antibiotic use quality indicators in Luang Prabang, Lao PDR: a point prevalence survey in a tertiary care hospital
Authors: Elias Christelle , Ha Nay Thi , Sengvilaipaserth Onanong , Phaychith Athip , Chansamouth Vilada , Phongsavath Valy , Keohavong Bounxou , Detleuxay Khamsay , Maniphonh Phaylinh , Soukhaseum Thongphout , Vanhems Philippe , Babin François-Xavier 
Published: August 2024

Abstract
Context
The increase and global dissemination of antibiotic resistance limit the use of antibiotics to prevent and treat infections. Implementing antibiotic stewardship programs guided by local data on prescription profiles is a useful strategy to reduce the burden of antibiotic resistance. The aim was to determine the prevalence of antibiotic use and guideline compliance at Luang Prabang provincial hospital, Lao PDR.

Methods
A point prevalence survey of antibiotics was conducted among hospitalized patients admitted to Luang Prabang hospital (204 beds) in Lao PDR on May 25, 2023. All patients presenting at 8:00 AM were eligible. Sociodemographic data, indications for antibiotic use, and antibiotic prescriptions were collected from medical records using a paper-based questionnaire and entered into an electronic platform following WHO methodology. The prevalence of antibiotic use was determined.

Results
Out of the 102 patients included, 60(58.8%) were undergoing antibiotic treatment, of which 33(55.0%) received combination therapy, and 7(10.5%) had two indications for antibiotic use. The highest prevalence was in the surgical ward (14/15, 93%) followed by general paediatrics (18/27, 67%). Out of the 100 antibiotic prescriptions, 47(47%) were for community-acquired infections, 26(26%) for surgical prophylaxis, 13(13%) for hospital-acquired infections and 5(5%) for medical prophylaxis. Twenty(20%) antibiotics were prescribed for obstetrics and gynaecology prophylaxis, 17(17%) for intra-abdominal infections, and 10(10.0%) for pneumonia treatment as well as bone, and joint infections. The main antibiotics prescribed were ceftriaxone 36(34.6%), metronidazole 18(17.3%), ampicillin 8(7.7%), and gentamicin 8(7.7%). Only 2(3%) samples were sent to the laboratory, one of which showed a positive culture for Escherichia coli Extended Spectrum β-Lactamase. According to the WHO Access Watch and Reserve classification, 55(52.9%) molecules belonged to the Access category, 47(49.1%) to the Watch category, and none to the Reserve category. Only 14.9% of antibiotic prescriptions were fully compliant with current guidelines.

Conclusion
This study indicated a significant prevalence of antibiotic use and a very low compliance with guidelines at Luang Prabang provincial hospital, Lao PDR. This highlights an urgent need for comprehensive strategies at all levels to optimize antibiotic use in hospitals, emphasizing diagnostic improvements, and continued research to address the factors driving this excessive antibiotic usage and improve adherence to guidelines.