bluuebunny/crossref_metadata_2025_split huggingface dataset:
How fragile the positive results of Chinese herbal medicine randomized controlled trials on irritable bowel syndrome are?
Authors: Luo Minjing , Huang Jinghan , Wang Yingqiao , Li Yilin , Liu Zhihan , Liu Meijun , Tao Yunci , Cao Rui , Chai Qianyun , Liu Jianping , Fei Yutong 
Published: August 2024

Abstract
Objective
The fragility index (FI), which is the minimum number of changes in status from “event” to “non-event” resulting in a loss of statistical significance, serves as a significant supplementary indicator for clinical physicians in interpreting clinical trial results and aids in understanding the outcomes of randomized controlled trials (RCTs). In this systematic literature survey, we evaluated the FI for RCTs evaluating Chinese herbal medicine (CHM) for irritable bowel syndrome (IBS), and explored potential associations between study characteristics and the robustness of RCTs.

Methods
A comprehensive search was conducted in four databases in Chinese and four databases in English from their inception to January 1, 2023. RCTs encompassed 1:1 ratio into two parallel arms and reported at least one binary outcome that demonstrated statistical significance were included. FI was calculated by the iterative reduction of a target outcome event in the treatment group and concomitant subtraction of a non-target event from that group, until positive significance (defined as P < 0.05 by Fisher’s exact test) is lost. The lower the FI (minimum 1) of a trial outcome, the more fragile the positive result of the outcome was. Linear regression models were adopted to explore influence factors of the value of FI.

Results
A total of 30 trials from 2 4118 potentially relevant citations were finally included. The median FI of total trials included was 1.5 (interquartile range [IQR], 1–5), and half of the trials (n = 15) had a FI equal to 1. In 12 trials (40%), the total number of participants lost to follow-up surpassed the respective FI. The study also identified that increased FI was significantly associated with no TCM syndrome differentiation for inclusion criteria of the patients, larger total sample size, low risk of bias, and larger numbers of events.

Conclusions
The majority of CHM IBS RCTs with positive results were found to be fragile. Ensuring adequate sample size, scientifically rigorous study design, proper control of confounding factors, and a quality control calibration for consistency of TCM diagnostic results among clinicians should be addressed to increase the robustness of the RCTs. We recommend reporting the FI as one of the components of sensitivity analysis in future RCTs to facilitate the assessment of the fragility of trials.
The prevalence of herbal medicine among Sudanese adults: a cross-sectional study 2021
Authors: Mohamed Raheeg , Mohamed Reham , Dafalla Rana , Ahmed Aya , Abdeldaim Abdulrahman 
Published: August 2024

Abstract
Background
The use of herbal medicine has a long history in Sudan and is widely practiced among the general population. However, there is a lack of studies examining the prevalence, patterns, and predictors of herbal medicine usage in Sudan. Thus, this study was conducted to bridge this gap.

Methods
This descriptive cross-sectional study was conducted between January and February 2021. It included Sudanese adults residing in Omdurman, Sudan, using systematic and simple random sampling methods. Data were collected using a structured, adapted questionnaire comprising: the socio-demographic characteristics and the knowledge of herbal medicine and its usage. Moreover, it investigated the commonly used herbal remedies and the participants’ sources of information and procurement of such products. Additionally, we examined the correlation between socio-demographic factors, cultural beliefs, and the use of herbal medicine. Data were analyzed using SPSS, and categorical data were presented as frequencies and percentages. Associations were assessed using chi-square, Fisher’s exact tests, and binary logistic regression (p < 0.05).

Results
This study included 381 participants, of which 48.1% were females and 31.4% were aged 20-30. The majority of participants were aware of the practice of herbal medicine and the prevalence of its usage was 85.9%. Peppermint, acacia, hibiscus, ginger, and fenugreek were the most commonly used remedies. Chi-square and Fisher’s exact testing revealed that the participants’ gender and beliefs in the safety and effectiveness of herbal medicines were significantly associated with herbal medicine usage (p < 0.05). Binary logistic regression analysis showed that only the perception of herbal medicine’s safety was an independent predictor of its usage (p-value 0.038).

Conclusion
This study reported a very high prevalence of herbal medicine usage, highlighting the acceptability of Sudanese adults towards herbal medicine usage. This prompts further studies to explore their safety, efficacy, and the possibility of their integration into mainstream healthcare practices and policies.
Knowledge, attitude, and practice of Egyptian medical students towards healthcare workers’ recommended vaccines: a nationwide cross-sectional survey
Authors: Mohamed Shawqi Mohamed , El-Said Yara Mohamed , Behery Mostafa B. , Abdelaziz Ali , Ibrahem Esraa Shawky , ElBoraie Aly , Khattab Mohamed Ayman , Ghattas Ahmad S. , Naeem Ahmed , Madany Maysa , Elboraay Toka , Naguib Mostafa Mahmoud , Allam Abdallah R. , Allam Ahmed Hafez , Bahbah Ammar Ayman , Ewis Marwa Ibrahim , Elsayed Mostafa Ahmed , Sherief Leenah , KhallafAllah Mahmoud Tawfik , Gouda Mohamed Alaa , Aboshady Omar Ali 
Published: August 2024

Abstract
Background
Vaccination of healthcare workers (HCWs) is pivotal in decreasing the incidence of contagious infections in hospital settings. In this study, we assessed the knowledge, attitude, and practice regarding HCWs’ recommended vaccines among medical students and interns in Egypt.

Methods
A multicenter, cross-sectional study was conducted using a structured, pilot-tested, and self-administered questionnaire among Egyptian medical students and interns. We invited 1332 participants to our survey using a systematic random sampling that included participants across nine medical schools in Egypt during the 2021–2022 academic year.

Results
Out of 1332 participants, 1141 completed our questionnaire with a response rate of 85.7%. Overall, 43% of the participants had intermediate knowledge (knew 2–3 HCWs’ recommended vaccines). Furthermore, 36.7% had received a booster dose of at least one of the HCWs’ recommended vaccines over the last 10 years, with only 6.1% having received all recommended vaccines. Hepatitis B vaccine was the most widely known (71%) and received (66.7%). Interns were more likely to know, receive, and recommend HCWs’ recommended vaccines. The majority (> 90%) agreed that vaccination is beneficial and safe, with a median score of eight (interquartile range [IQR: Q25-Q75]: 7–9) out of ten for vaccine efficacy and eight (IQR: 7–8) for safety. However, the median score for hesitancy was five (IQR: 2–7). The most common influential and limiting factors for vaccination were scientific facts (60.1%) and fear of vaccine side effects (44.9%).

Conclusion
Although medical students in Egypt have good knowledge of and attitudes towards vaccination, there is a gap in their practices. Interventions are needed to improve vaccination uptake among medical students in Egypt.
Qualitative studies involving users of clinical neurotechnology: a scoping review
Authors: Starke Georg , Akmazoglu Tugba Basaran , Colucci Annalisa , Vermehren Mareike , van Beinum Amanda , Buthut Maria , Soekadar Surjo R. , Bublitz Christoph , Chandler Jennifer A. , Ienca Marcello 
Published: August 2024

Abstract
Background
The rise of a new generation of intelligent neuroprostheses, brain-computer interfaces (BCI) and adaptive closed-loop brain stimulation devices hastens the clinical deployment of neurotechnologies to treat neurological and neuropsychiatric disorders. However, it remains unclear how these nascent technologies may impact the subjective experience of their users. To inform this debate, it is crucial to have a solid understanding how more established current technologies already affect their users. In recent years, researchers have used qualitative research methods to explore the subjective experience of individuals who become users of clinical neurotechnology. Yet, a synthesis of these more recent findings focusing on qualitative methods is still lacking.

Methods
To address this gap in the literature, we systematically searched five databases for original research articles that investigated subjective experiences of persons using or receiving neuroprosthetics, BCIs or neuromodulation with qualitative interviews and raised normative questions.

Results
36 research articles were included and analysed using qualitative content analysis. Our findings synthesise the current scientific literature and reveal a pronounced focus on usability and other technical aspects of user experience. In parallel, they highlight a relative neglect of considerations regarding agency, self-perception, personal identity and subjective experience.

Conclusions
Our synthesis of the existing qualitative literature on clinical neurotechnology highlights the need to expand the current methodological focus as to investigate also non-technical aspects of user experience. Given the critical role considerations of agency, self-perception and personal identity play in assessing the ethical and legal significance of these technologies, our findings reveal a critical gap in the existing literature. This review provides a comprehensive synthesis of the current qualitative research landscape on neurotechnology and the limitations thereof. These findings can inform researchers on how to study the subjective experience of neurotechnology users more holistically and build patient-centred neurotechnology.
A new model to understand the complexity of inequalities in dementia
Authors: Giebel Clarissa 
Published: August 2024

AbstractMany people living with dementia and unpaid carers experience inequalities in care related to challenges in receiving a correct diagnosis, care and support. Whilst complexities of the evidence are well recognised including barriers in receiving a diagnosis or post-diagnostic care, no coherent model has captured the far-reaching types and levels of inequalities to date. Building on the established Dahlgren & Whitehead Rainbow model of health determinants, this paper introduces the new Dementia Inequalities model. The Dementia Inequalities model, similar to the original general rainbow model, categorises determinants of health and well-being in dementia into three layers: (1) Individual; (2) Social and community networks; and (3) Society and infrastructure. Each layer comprises of general determinants, which have been identified in the original model but also may be different in dementia, such as age (specifically referring to young- versus late-onset dementia) and ethnicity, as well as new dementia-specific determinants, such as rare dementia subtype, having an unpaid carer, and knowledge about dementia in the health and social care workforce. Each layer and its individual determinants are discussed referring to existing research and evidence syntheses in the field, arguing for the need of this new model. A total of 48 people with lived, caring, and professional experiences of dementia have been consulted in the process of the development of this model. The Dementia Inequalities model provides a coherent, evidence-based overview of inequalities in dementia diagnosis and care and can be used in health and social care, as well as in commissioning of care services, to support people living with dementia and their unpaid carers better and try and create more equity in diagnosis and care.
The CD47/TSP-1 axis: a promising avenue for ovarian cancer treatment and biomarker research
Authors: Moniot Aurélie , Schneider Christophe , Chardin Laure , Yaniz-Galende Elisa , Genestie Catherine , Etiennot Marion , Henry Aubéri , Drelon Coralie , Le Formal Audrey , Langlois Benoit , Venat Laurence , Louvet Christophe , Favier Laure , Lortholary Alain , Berton-Rigaud Dominique , Dohollou Nadine , Desauw Christophe , Fabbro Michel , Malaurie Emmanuelle , Dubot Coraline , Kurtz Jean Emmanuel , Bonichon Lamichhane Nathalie , Pujade-Lauraine Éric , Jeanne Albin , Leary Alexandra , Dedieu Stéphane 
Published: August 2024

Abstract
Background
Ovarian cancer (OC) remains one of the most challenging and deadly malignancies facing women today. While PARP inhibitors (PARPis) have transformed the treatment landscape for women with advanced OC, many patients will relapse and the PARPi-resistant setting is an area of unmet medical need. Traditional immunotherapies targeting PD-1/PD-L1 have failed to show any benefit in OC. The CD47/TSP-1 axis may be relevant in OC. We aimed to describe changes in CD47 expression with platinum therapy and their relationship with immune features and prognosis.

Methods
Tumor and blood samples collected from OC patients in the CHIVA trial were assessed for CD47 and TSP-1 before and after neoadjuvant chemotherapy (NACT) and multiplex analysis was used to investigate immune markers. Considering the therapeutic relevance of targeting the CD47/TSP-1 axis, we used the CD47-derived TAX2 peptide to selectively antagonize it in a preclinical model of aggressive ovarian carcinoma.

Results
Significant reductions in CD47 expression were observed post NACT. Tumor patients having the highest CD47 expression profile at baseline showed the greatest CD4+ and CD8+ T-cell influx post NACT and displayed a better prognosis. In addition, TSP-1 plasma levels decreased significantly under NACT, and high TSP-1 was associated with a worse prognosis. We demonstrated that TAX2 exhibited a selective and favorable biodistribution profile in mice, localizing at the tumor sites. Using a relevant peritoneal carcinomatosis model displaying PARPi resistance, we demonstrated that post-olaparib (post-PARPi) administration of TAX2 significantly reduced tumor burden and prolonged survival. Remarkably, TAX2 used sequentially was also able to increase animal survival even under treatment conditions allowing olaparib efficacy.

Conclusions
Our study thus (1) proposes a CD47-based stratification of patients who may be most likely to benefit from postoperative immunotherapy, and (2) suggests that TAX2 is a potential alternative therapy for patients relapsing on PARP inhibitors.
The analysis of the medical tourism expansion policy in Taiwan: a policy analysis using Kingdon’s multiple streams
Authors: Yu Ying-Ju , Huang Nicole , Kuo Hsu-Sung 
Published: August 2024

Abstract
Background
Since 2006, Taiwan has actively pursued the development of its medical tourism industry. In 2013, the government sought to bolster this sector by integrating medical tourism into the Free Economic Pilot Zones. Despite narrowly missing the mark, the initiative failed to materialize into law. This qualitative study endeavors to discern the pertinent factors influencing the agenda-setting process for incorporating medical tourism into the Free Economic Pilot Zones in Taiwan.

Methods
A comprehensive examination of policies concerning the legitimation of medical tourism within the Free Economic Pilot Zones was undertaken through semi-structured interviews and a thorough review of policy documents. Key informants were strategically selected using purposive and snowball sampling techniques. Thematic analysis was applied to scrutinize the amassed data and organize it within the framework of Kingdon's multiple streams.

Results
In the problem stream, increasing financial strains and cost containment pressures under the National Health Insurance program have long driven health care providers to seek further opportunities in medical tourism. The existing barriers to expanding medical tourism in Taiwan included diplomatic tensions (specifically cross-strait relations), public concerns about commercialization of medical care and reduced their access to care, and legal and language barriers. Within the policy stream, factors such as franchise fees to support national health insurance, limited number of demonstration medical tourism sites and services allowed, the allowance of foreign medical personnel, regulations governing domestic physicians, the importance of demonstration, regulation, and accreditation, as well as restrictions on investment from China, were emphasized. The politics stream highlights factors such as governmental support, opposition from opposing parties, public concerns and critics from academia and non-governmental organizations, and skepticism from medical faculties.

Conclusion
Acknowledging the recognized challenges in enacting the medical tourism provision of the Free Economic Pilot Zones Special Act and emphasizing the political will of leadership, a viable policy solution remained elusive. Although a window of opportunity existed for the passage of the bill, it waned as public concerns sidelined the issue from the national agenda. The Taiwan case underscores the necessity for meticulous consideration of issues, proposed solutions, and political dynamics to achieve successful policy enactment.
Fairy: fast approximate coverage for multi-sample metagenomic binning
Authors: Shaw Jim , Yu Yun William 
Published: August 2024

Abstract
Background
Metagenomic binning, the clustering of assembled contigs that belong to the same genome, is a crucial step for recovering metagenome-assembled genomes (MAGs). Contigs are linked by exploiting consistent signatures along a genome, such as read coverage patterns. Using coverage from multiple samples leads to higher-quality MAGs; however, standard pipelines require all-to-all read alignments for multiple samples to compute coverage, becoming a key computational bottleneck.

Results
We present fairy (https://github.com/bluenote-1577/fairy), an approximate coverage calculation method for metagenomic binning. Fairy is a fast k-mer-based alignment-free method. For multi-sample binning, fairy can be $$> 250 \times$$

>
250
×

faster than read alignment and accurate enough for binning. Fairy is compatible with several existing binners on host and non-host-associated datasets. Using MetaBAT2, fairy recovers $$98.5\%$$

98.5
%

of MAGs with $$> 50\%$$

>
50
%

completeness and $$< 5\%$$

<
5
%

contamination relative to alignment with BWA. Notably, multi-sample binning with fairy is always better than single-sample binning using BWA ($$> 1.5\times$$

>
1.5
×

more $$>50\%$$

>
50
%

complete MAGs on average) while still being faster. For a public sediment metagenome project, we demonstrate that multi-sample binning recovers higher quality Asgard archaea MAGs than single-sample binning and that fairy’s results are indistinguishable from read alignment.

Conclusions
Fairy is a new tool for approximately and quickly calculating multi-sample coverage for binning, resolving a computational bottleneck for metagenomics.
Smartphone-sensor-based human activities classification for forensics: a machine learning approach
Authors: Moubarak Nchouwat Ndumgouo Ibrahim , Omar Njutapmvoui Mbah Mohamed , Youssef Vepouyoum Njouokouo 
Published: August 2024

AbstractThe accurate classification of human activities in crime scenes during forensics (criminalistics) is of utmost importance in classifying suspicious and unlawful activities, easing their acceptability and interpretability by judges during legal procedures in courts or by other non-experts in the field of forensics. This paper implements machine learning (ML) algorithms: support vector machine (SVM) and decision tree (DT), to demonstrate with a high accuracy, how data emanating from smartphones’ sensors reveal and isolate relevant information about static and dynamic human activities in criminalistics. Smartphones’ data from five different sensors (accelerometer, gravity, orientation, Gyroscope and light), related to ten recurrent crime scenes activities, grouped into three classes of events (normal, felony and none-felony events) are classified by the proposed algorithms, with novelty being the classification decisions based on the entire period of the events and not instantaneous decision makings. Three independent data-subsets were made, with permutations done between them and at each time, two sets used for training and the third set used for testing. Time- and frequency-domain features were initially used separately and then combined for the model training and testing. The best average training accuracies of 100% and 97.8% were obtained for the DT and SVM, respectively, and the testing accuracies of 89.1% were obtained for both algorithms. We therefore believe that these results will serve as a solid persuasive and convincing argument to judges and non-experts of the field of forensics to accept and easily interpret computer-aided classification of suspicious activities emanating from criminalistic studies.
Design and optimization of DPC-crosslinked HPβCD nanosponges for entrectinib oral delivery: formulation, characterization, and pharmacokinetic studies
Authors: Reddy Konda Sri Chaya , Bhikshapathi Darna 
Published: August 2024

Abstract
Background
In advanced or metastatic cancers characterized by specific genetic alterations, heightened growth and resistance to conventional therapies are common. Targeted treatments like entrectinib (ENT) precisely inhibit aberrant signaling pathways, potentially enhancing outcomes. The objective of this research is to develop and enhance the effectiveness of entrectinib-loaded nanosponge formulations by utilizing hydroxypropyl-β-cyclodextrin (HPβCD) to improve its oral bioavailability.

Results
The study employed surface response methodology and Design-Expert® software to optimize key formulation variables such as the molar concentration ratio of the polymer and cross-linker, as well as process variables such as stirring speed and duration. Optimization focused on particle size, polydispersity index, and percentage entrapment efficiency. Validation methods encompassed Fourier transform spectroscopy (FTIR), differential scanning calorimetry (DSC), scanning electron microscopy (SEM), in vitro release studies, and in vivo studies.
After optimization, ENT-loaded HPβCD NSPs were formulated with a molar ratio (P:CL) of 0.800 mg, stirred at 3000 rpm for 420 min, achieving a desirability of 0.926. Predicted values for PS (particle size), PdI (polydispersity index), and EE % (entrapment efficiency) were 146.98 nm, 0.263, and 88.29%, respectively. The optimized formulation showed a mean size of 151.8 ± 5.6 nm, PDI of 0.233 ± 0.049, and EE of 87.36 ± 1.61%. Further validation through various analyses confirmed the optimization's efficacy, with notable improvements demonstrated in AUC0-t (6.30-fold) and Cmax (4.10 times) compared to the free drug.

Conclusion
The findings of the study indicated that nanosponges exhibit promise as an effective carrier for delivering entrectinib, addressing for advance tumor effectively by enhancing release and bioavailability in the treatment of cancer.