bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cluster analysis of clinical, angiographic, and laboratory parameters in patients with ST-segment elevation myocardial infarction
Authors: Birdal Oğuzhan , İpek Emrah , Saygı Mehmet , Doğan Remziye , Pay Levent , Tanboğa Ibrahim Halil 
Published: June 2024

Abstract
Introduction
ST-segment elevation myocardial infarction (STEMI) represents the most harmful clinical manifestation of coronary artery disease. Risk assessment plays a beneficial role in determining both the treatment approach and the appropriate time for discharge. Hierarchical agglomerative clustering (HAC), a machine learning algorithm, is an innovative approach employed for the categorization of patients with comparable clinical and laboratory features. The aim of the present study was to investigate the role of HAC in categorizing STEMI patients and to compare the results of these patients.

Methods
A total of 3205 patients who were diagnosed with STEMI at the university hospital emergency clinic between 2015 and 2023 were included in the study. The patients were divided into 2 different phenotypic disease clusters using the HAC method, and their outcomes were compared.

Results
In the present study, a total of 3205 STEMI patients were included; 2731 patients were in cluster 1, and 474 patients were in cluster 2. Mortality was observed in 147 (5.4%) patients in cluster 1 and 108 (23%) patients in cluster 2 (chi-square P value < 0.01). Survival analysis revealed that patients in cluster 2 had a significantly greater risk of death than patients in cluster 1 did (log-rank P < 0.001). After adjustment for age and sex in the Cox proportional hazards model, cluster 2 exhibited a notably greater risk of death than did cluster 1 (HR = 3.51, 95% CI = 2.71–4.54; P < 0.001).

Conclusion
Our study showed that the HAC method may be a potential tool for predicting one-month mortality in STEMI patients.
Mutual recognition of qualifications, health workforce migration, and graduate outcomes: a comparative mapping study of undergraduate dental education in Europe
Authors: Bryce Marie , Hanks Sally , Burns Lorna , Zahra Daniel , Gale Thomas 
Published: June 2024

Abstract
Background
The resource needs of health services are served by the recognition of qualifications across borders which allows professionals to migrate between countries. The movement of dentists across the European Union (EU), especially into the United Kingdom (UK), has provided a valuable boost to workforce supply. Recent changes to policy recognising overseas qualifications have brought attention to the equivalence of qualifications awarded in EU countries. Professional regulators need to be confident that dentists who qualified elsewhere have the appropriate knowledge, skills and experience to practise safely and effectively. The aim of this study was to compare UK and EU dental curricula, identify any differences, and compare the extent of pre-qualification clinical experience.

Methods
This was a mixed methods study comprising a questionnaire and website searches to identify information about curricula, competences, and quality assurance arrangements in each country. The questionnaire was sent to organisations responsible for regulating dental education or dental practice in EU member states. This was supplemented with information obtained from website searches of stakeholder organisations for each country including regulators, professional associations, ministries, and providers of dental education. A map of dental training across the EU was created.

Results
National learning outcomes for dental education were identified for seven countries. No national outcomes were identified 13 countries; therefore, learning outcomes were mapped at institution level only. No information about learning outcomes was available for six countries. In one country, there is no basic dental training. Clinical skills and communication were generally well represented. Management and leadership were less represented. Only eight countries referenced a need for graduates to be aware of their own limitations. In most countries, quality assurance of dental education is not undertaken by dental organisations, but by national quality assurance agencies for higher education. In many cases, it was not possible to ascertain the extent of graduates’ direct clinical experience with patients.

Conclusions
The findings demonstrate considerable variation in learning outcomes for dental education between countries and institutions in Europe. This presents a challenge to decision-makers responsible for national recognition and accreditation of diverse qualifications across Europe to maintain a safe, capable, international workforce; but one that this comparison of programmes helps to address.
Prevotella copri transplantation promotes neurorehabilitation in a mouse model of traumatic brain injury
Authors: Gu Nina , Yan Jin , Tang Wei , Zhang Zhaosi , Wang Lin , Li Zhao , Wang Yingwen , Zhu Yajun , Tang Shuang , Zhong Jianjun , Cheng Chongjie , Sun Xiaochuan , Huang Zhijian 
Published: June 2024

AbstractBackgroundThe gut microbiota plays a critical role in regulating brain function through the microbiome-gut-brain axis (MGBA). Dysbiosis of the gut microbiota is associated with neurological impairment in Traumatic brain injury (TBI) patients. Our previous study found that TBI results in a decrease in the abundance ofPrevotella copri(P. copri).P. coprihas been shown to have antioxidant effects in various diseases. Meanwhile, guanosine (GUO) is a metabolite of intestinal microbiota that can alleviate oxidative stress after TBI by activating the PI3K/Akt pathway. In this study, we investigated the effect ofP. copritransplantation on TBI and its relationship with GUO-PI3K/Akt pathway.MethodsIn this study, a controlled cortical impact (CCI) model was used to induce TBI in adult male C57BL/6J mice. Subsequently,P. copriwas transplanted by intragastric gavage for 7 consecutive days. To investigate the effect of the GUO-PI3K/Akt pathway inP. copritransplantation therapy, guanosine (GUO) was administered 2 h after TBI for 7 consecutive days, and PI3K inhibitor (LY294002) was administered 30 min before TBI. Various techniques were used to assess the effects of these interventions, including quantitative PCR, neurological behavior tests, metabolite analysis, ELISA, Western blot analysis, immunofluorescence, Evans blue assays, transmission electron microscopy, FITC-dextran permeability assay, gastrointestinal transit assessment, and 16 S rDNA sequencing.ResultsP. copriabundance was significantly reduced after TBI.P. copritransplantation alleviated motor and cognitive deficits tested by the NSS, Morris’s water maze and open field test.P. copritransplantation attenuated oxidative stress and blood-brain barrier damage and reduced neuronal apoptosis after TBI. In addition,P. copritransplantation resulted in the reshaping of the intestinal flora, improved gastrointestinal motility and intestinal permeability. Metabolomics and ELISA analysis revealed a significant increase in GUO levels in feces, serum and injured brain afterP. copritransplantation. Furthermore, the expression of p-PI3K and p-Akt was found to be increased afterP. copritransplantation and GUO treatment. Notably, PI3K inhibitor LY294002 treatment attenuated the observed improvements.ConclusionsWe demonstrate for the first time thatP. copritransplantation can improve GI functions and alter gut microbiota dysbiosis after TBI. Additionally,P. copritransplantation can ameliorate neurological deficits, possibly via the GUO-PI3K/Akt signaling pathway after TBI.
Lower HBV DNA level is associated with more severe liver fibrosis in HBeAg-positive chronic hepatitis B with normal alanine transaminase
Authors: Wang Jian , Zhu Li , Zhang Zhiyi , Zhang Shaoqiu , Pan Yifan , Li Yuanyuan , Cao Fei , Jiang Chao , Fan Tao , Xiong Ye , Liu Jiacheng , Chen Yuxin , Yin Shengxia , Tong Xin , Zhu Chuanwu , Liu Xingxiang , Li Jie , Wu Chao , Huang Rui 
Published: June 2024

Abstract
Background
The association of hepatitis B virus (HBV) DNA levels and liver fibrosis in chronic hepatitis B (CHB) patients with immune-tolerant phase remains unclear. We explored the association between liver fibrosis and HBV DNA levels in HBeAg-positive CHB patients with normal alanine transaminase (ALT) with relatively high HBV DNA.

Methods
Six hundred and twenty-two HBeAg-positive CHB patients with normal ALT were included. Patients were divided into three categories: low (6 log10 IU/mL ≤ HBV DNA < 7 log10 IU/mL), moderate (7 log10 IU/mL ≤ HBV DNA < 8 log10 IU/mL), and high (HBV DNA ≥ 8 log10 IU/mL). APRI, FIB-4, transient elastography, or liver biopsy were used to assess liver fibrosis.

Results
The median age of patients was 33.0 years and 57.9% patients were male. 18.8%, 52.1%, and 29.1% of patients had low, moderate, and high HBV DNA levels, respectively. The APRI (0.33 vs. 0.26 vs. 0.26, P < 0.001), FIB-4 (1.03 vs. 0.71 vs. 0.68, P < 0.001), and LSM values (7.6 kPa vs. 5.6 kPa vs. 5.5 kPa, P = 0.086) were higher in low HBV DNA group than other two groups. Low HBV DNA group had higher proportions of significant fibrosis (24.8% vs. 9.9% vs. 3.3%, P < 0.001) and cirrhosis (7.7% vs. 2.5% vs. 1.1%, P = 0.004) than moderate and high HBV DNA groups. Moderate (OR 3.095, P = 0.023) and low (OR 4.968, P = 0.003) HBV DNA were independent risk factors of significant fibrosis.

Conclusion
Lower HBV DNA level was associated with more severe liver fibrosis in HBeAg-positive CHB patients with ALT.
Assessing the Impact of an Artificial Intelligence-Based Model for Intracranial Aneurysm Detection in CT Angiography on Patient Diagnosis and Outcomes (IDEAL Study)—a protocol for a multicenter, double-blinded randomized controlled trial
Authors: Shi Zhao , Hu Bin , Lu Mengjie , Chen Zijian , Zhang Manting , Yu Yizhou , Zhou Changsheng , Zhong Jian , Wu Bingqian , Zhang Xueming , Wei Yongyue , Zhang Long Jiang ,   on behalf of the China Aneurysm AI Project Group
Published: June 2024

Abstract
Background
This multicenter, double-blinded, randomized controlled trial (RCT) aims to assess the impact of an artificial intelligence (AI)-based model on the efficacy of intracranial aneurysm detection in CT angiography (CTA) and its influence on patients’ short-term and long-term outcomes.

Methods
Studydesign: Prospective, multicenter, double-blinded RCT.
Settings: The model was designed for the automatic detection of intracranial aneurysms from original CTA images.
Participants: Adult inpatients and outpatients who are scheduled for head CTA scanning.
Randomization groups:
(1) Experimental Group: Head CTA interpreted by radiologists with the assistance of the True-AI-integrated intracranial aneurysm diagnosis strategy (True-AI arm).
(2) Control Group: Head CTA interpreted by radiologists with the assistance of the Sham-AI-integrated intracranial aneurysm diagnosis strategy (Sham-AI arm).
Randomization: Block randomization, stratified by center, gender, and age group.
Primary outcomes: Coprimary outcomes of superiority in patient-level sensitivity and noninferiority in specificity for the True-AI arm to the Sham-AI arm in intracranial aneurysms.
Secondary outcomes: Diagnostic performance for other intracranial lesions, detection rates, workload of CTA interpretation, resource utilization, treatment-related clinical events, aneurysm-related events, quality of life, and cost-effectiveness analysis.
Blinding: Study participants and participating radiologists will be blinded to the intervention.
Sample size: Based on our pilot study, the patient-level sensitivity is assumed to be 0.65 for the Sham-AI arm and 0.75 for the True-AI arm, with specificities of 0.90 and 0.88, respectively. The prevalence of intracranial aneurysms for patients undergoing head CTA in the hospital is approximately 12%. To establish superiority in sensitivity and noninferiority in specificity with a margin of 5% using a one-sided α = 0.025 to ensure that the power of coprimary endpoint testing reached 0.80 and a 5% attrition rate, the sample size was determined to be 6450 in a 1:1 allocation to True-AI or Sham-AI arm.

Discussion
The study will determine the precise impact of the AI system on the detection performance for intracranial aneurysms in a double-blinded design and following the real-world effects on patients’ short-term and long-term outcomes.

Trial registration
This trial has been registered with the NIH, U.S. National Library of Medicine at ClinicalTrials.gov, ID: NCT06118840. Registered 11 November 2023.
Sinonasal immunoglobulin G4-related disease: a case report of an atypical and rare entity
Authors: Gorial Faiq I. , Awadh Nabaa Ihsan , Ali Shahlaa B. , Mirza Sazan Abdulwahab , Abbas Murtadha Hussein 
Published: June 2024

Abstract
Background
Immunoglobulin G4-related disease is marked by extensive inflammation and fibrosis of an unknown autoimmune component, with an overall incidence ranging from 0.78 to 1.39 per 105 person-years. Sinonasal immunoglobulin G4-related disease is atypical and exceedingly uncommon in the existing literature, frequently manifesting clinically as chronic rhinosinusitis, epistaxis, and facial pain.

Case presentation
This report describes a 25-year-old Iraqi female who has been suffering from symptoms of chronic rhinosinusitis for 8 years. Despite undergoing several surgeries, there has been no improvement in her symptoms. A tissue biopsy that revealed dense lymphoplasmocytosis with noticeable plasma cell infiltration, storiform fibrosis, and obliterative angitis, along with positive immunohistochemical staining for Immunoglobulin G4 plasma cells, finally confirmed the diagnosis of sinonasal immunoglobulin G4-related disease. The patient responded well to oral prednisolone and methotrexate treatments.

Conclusions
The main objective of the current report is to raise awareness among physicians about the significance of promptly identifying and diagnosing this rarity, thus preventing the adverse consequences linked to delayed diagnosis and treatment initiation.
Executive function and spatial abilities in physically active children: an explorative study
Authors: Passarello Noemi , Turriziani Patrizia , Lucidi Fabio , Mandolesi Laura 
Published: June 2024

Abstract
Background
Regular physical activity has consistently shown promise in improving cognitive functioning among children. However, there is a shortage of comprehensive studies that delve into these benefits across various cognitive domains. This preliminary investigation aimed to discern potential disparities in cognitive performance between active and sedentary children, with a specific focus on inhibitory control, cognitive flexibility, and visuo-spatial working memory abilities.

Methods
The study employed a cross-sectional design encompassing 26 children (mean age 9.53 ± 2.20 years), categorized into two groups: Active and Sedentary. Executive functions were assessed using the NEPSY-II, while visuo-spatial working memory abilities were evaluated through the table version of the Radial Arm Maze (table-RAM) task. All outputs were analyzed with One-way ANOVAS or Kruskal–Wallis Tests to assess differences between Active and Sedentary children in both executive functioning and visuo-spatial working memory processes.

Results
The findings revealed that the Active group outperformed the sedentary group in inhibitory control (F1,23 = 4.99, p = 0.03*), cognitive flexibility (F1,23 = 5.77, p = 0.02*), spatial span (F1,23 = 4.40, p = 0.04*), and working memory errors (F1,23 = 8.59, p = 0.01**). Both spatial span and working memory errors are parameters closely associated with visuo-spatial working memory abilities.

Conclusions
Although preliminary, these results offer evidence of a positive link between physical activity and cognitive functioning in children. This indicates the importance of promoting active behaviors, especially within educational environments.
The way to relieve college students’ academic stress: the influence mechanism of sports interest and sports atmosphere
Authors: Liu Mengfan , Shi Bo , Gao Xu 
Published: June 2024

Abstract
Background and research objectives
Given the enduring popularity of higher education, there has been considerable attention on the correlation between college students’ engagement in sports and their academic stress levels. This study seeks to delve deeply into how university physical education fosters academic performance by influencing students’ sports interests, particularly in enhancing their psychological resilience to mitigate academic pressure. Through this investigation, the aim is to offer both theoretical underpinnings and empirical evidence to support the holistic enhancement of higher education.

Research methods
Initially, this study undertakes an analysis of the fundamental relationship between college students’ physical activities and their experience of academic stress. Subsequently, utilizing a structural equation model, specific research models and hypotheses are formulated. These are then examined in detail through the questionnaire method to elucidate the mechanism by which college sports interests alleviate academic stress.

Research findings
The study reveals a significant positive correlation between psychological resilience and academic stress, indicating that a robust psychological resilience can effectively diminish academic pressure. Furthermore, both the sports atmosphere and sports interest are found to exert a notable positive impact on academic stress, mediated by the variable of psychological toughness. This underscores the pivotal role of physical education in fostering positive psychological traits and enhancing academic achievement.

Conclusion
This study underscores the central importance of cultivating and nurturing college students’ sports interests, as well as fostering a conducive sports atmosphere, in fortifying psychological resilience and mitigating academic pressure. By offering novel perspectives and strategies for alleviating the academic stress faced by college students, this study contributes valuable theoretical insights and practical experiences to the broader development of higher education.
A case of surgical treatment for recurrence of right ventricular metastasis due to renal cell carcinoma after molecular targeted therapy
Authors: Sasaki Keita , Nishioka Naritomo , Yamamoto Mika , Kato Kenichi , Matsumoto Ryo , Masuda Takahiko , Maruyama Ryushi , Kurimoto Yoshihiko , Yamada Akira , Naraoka Shuichi 
Published: June 2024

Abstract
Background
Cardiac metastasis including the right ventricle from renal cell carcinoma is rare. No standard treatment for cardiac metastasis and recurrence in renal cell carcinoma has been established.

Case presentation
We present the case of a 61-year-old man who underwent the resection of recurrent right ventricular metastasis caused by renal cell carcinoma following molecular targeted therapy. The first cardiac operation was performed for right ventricular metastasis due to renal cell carcinoma. The patient had a good postoperative course. Two years after the first operation, however, follow-up computed tomography revealed the recurrence of the right ventricular tumor and metastases in both lungs. Molecular targeted therapy was carried out and effectively controlled the lung metastasis but the right ventricular lesion remained unchanged, leading to reoperation. The recurrent right ventricular tumor was completely resected through a redo median sternotomy assisted by cardiopulmonary bypass. The patient had an uneventful postoperative course and was discharged on the 13th postoperative day. Follow-ups at 2 years showed no cardiac recurrence.

Conclusion
Surgical intervention was considered useful in managing the recurrence of right ventricular metastasis from renal cell carcinoma after molecular targeted therapy.
National Implementation of an Artificial Intelligence–Based Virtual Dietitian for Patients With Cancer
Authors: Buchan Marissa L. , Goel Keshav , Schneider Chelsey K. , Steullet Vera , Bratton Susan , Basch Ethan 
Published: June 2024

PURPOSE Nutritional status is an established driver of cancer outcomes, but there is an insufficient workforce of registered dietitians to meet patient needs for nutritional counseling. Artificial intelligence (AI) and machine learning (ML) afford the opportunity to expand access to guideline-based nutritional support. METHODS An AI-based nutrition assistant called Ina was developed on the basis of a learning data set of >100,000 expert-curated interventions, peer-reviewed literature, and clinical guidelines, and provides a conversational text message-based patient interface to guide dietary habits and answer questions. Ina was implemented nationally in partnership with 25 advocacy organizations. Data on demographics, patient-reported outcomes, and utilization were systematically collected. RESULTS Between July 2019 and August 2023, 3,310 users from all 50 states registered to use Ina. Users were 73% female; median age was 57 (range, 18-91) years; most common cancer types were genitourinary (22%), breast (21%), gynecologic (19%), GI (14%), and lung (12%). Users were medically complex, with 50% reporting Stage III to IV disease, 37% with metastases, and 50% with 2+ chronic conditions. Nutritional challenges were highly prevalent: 58% had overweight/obese BMIs, 83% reported barriers to good nutrition, and 42% had food allergies/intolerances. Levels of engagement were high: 68% texted questions to Ina; 79% completed surveys; median user retention was 8.8 months; 94% were satisfied with the platform; and 98% found the guidance helpful. In an evaluation of outcomes, 84% used the advice to guide diet; 47% used recommended recipes, 82% felt the program improved quality of life (QoL), and 88% reported improved symptom management. CONCLUSION Implementation of an evidence-based AI virtual dietitian is feasible and is reported by patients to be beneficial on diet, QoL, and symptom management. Ongoing evaluations are assessing impact on other outcomes.