bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with the local control of brain metastases: a systematic search and machine learning application
Authors: Kanakarajan Hemalatha , De Baene Wouter , Gehring Karin , Eekers Daniëlle B. P. , Hanssens Patrick , Sitskoorn Margriet 
Published: June 2024

Abstract
Background
Enhancing Local Control (LC) of brain metastases is pivotal for improving overall survival, which makes the prediction of local treatment failure a crucial aspect of treatment planning. Understanding the factors that influence LC of brain metastases is imperative for optimizing treatment strategies and subsequently extending overall survival. Machine learning algorithms may help to identify factors that predict outcomes.

Methods
This paper systematically reviews these factors associated with LC to select candidate predictor features for a practical application of predictive modeling. A systematic literature search was conducted to identify studies in which the LC of brain metastases is assessed for adult patients. EMBASE, PubMed, Web-of-Science, and the Cochrane Database were searched up to December 24, 2020. All studies investigating the LC of brain metastases as one of the endpoints were included, regardless of primary tumor type or treatment type. We first grouped studies based on primary tumor types resulting in lung, breast, and melanoma groups. Studies that did not focus on a specific primary cancer type were grouped based on treatment types resulting in surgery, SRT, and whole-brain radiotherapy groups. For each group, significant factors associated with LC were identified and discussed. As a second project, we assessed the practical importance of selected features in predicting LC after Stereotactic Radiotherapy (SRT) with a Random Forest machine learning model. Accuracy and Area Under the Curve (AUC) of the Random Forest model, trained with the list of factors that were found to be associated with LC for the SRT treatment group, were reported.

Results
The systematic literature search identified 6270 unique records. After screening titles and abstracts, 410 full texts were considered, and ultimately 159 studies were included for review. Most of the studies focused on the LC of the brain metastases for a specific primary tumor type or after a specific treatment type. Higher SRT radiation dose was found to be associated with better LC in lung cancer, breast cancer, and melanoma groups. Also, a higher dose was associated with better LC in the SRT group, while higher tumor volume was associated with worse LC in this group. The Random Forest model predicted the LC of brain metastases with an accuracy of 80% and an AUC of 0.84.

Conclusion
This paper thoroughly examines factors associated with LC in brain metastases and highlights the translational value of our findings for selecting variables to predict LC in a sample of patients who underwent SRT. The prediction model holds great promise for clinicians, offering a valuable tool to predict personalized treatment outcomes and foresee the impact of changes in treatment characteristics such as radiation dose.
Translation, cultural adaptation, and validation of the Nurse Self-Concept Questionnaire (NSCQ) for Portuguese nursing students
Authors: Almeida Inês F. , Bernardes Rafael A. , Sousa Liliana B. , Santos-Costa Paulo , Ventura Filipa , Rosa Amorim 
Published: June 2024

Abstract
Background
The professional self-concept of nursing students significantly influences their attitude and identity within the profession, ultimately impacting their mental health and overall well-being. Recent evidence underscores the importance of assessing students’ professional self-concept to prevent adverse outcomes such as burnout and stress. Since there are currently no validated instruments available in Portugal for this purpose, our objective was to translate, adapt, and validate the Nurse Self-Concept Questionnaire (NSCQ) with nursing students in Portugal.

Methods
A two-phase research study with a non-probabilistic sample of 216 undergraduate nursing students, using the QualtricsXM electronic platform for data collection. An exploratory factor analysis was performed to verify the validity of the theoretical construct and its internal consistency. Cronbach’s alpha was calculated, and a confirmatory factor analysis was performed to assess the model fit.

Results
The final instrument, designated as Questionário de Autoconceito dos/as Enfermeiros/as (Pt – NSCQ), is composed of 24 items distributed across five dimensions: “General self-concept”, “Staff relations”, “Leadership”, “Communication-care” and “Knowledge”, which explain 67.71% of the total variance. All dimensions and the global scale revealed good internal consistency values, ranging from 0.775 to 0.927. The resulting factorial structure is coherent with the theoretical framework.

Conclusion
The Pt – NSCQ proved to be a valid and reliable instrument to assess Portuguese nursing students’ professional self-concept. Future studies should be carried out on larger samples and different educational contexts, aligned with the importance to ensure the continuity of the psychometric analysis of the instrument.
Climate change worry among nurses and their hope levels for climate change prevention
Authors: Duran Songül , Kaynak Serap 
Published: June 2024

Abstract
Aim
This research aimed to determine nurses’ climate change worry, their level of hope for climate change prevention, and the relationship between climate change worry and hope for climate change.

Background
Nurses are healthcare professionals actively involved in the fight against climate change. However, their close involvement with the issue can also increase their own climate change worry. Therefore, it is important to maintain high levels of hope among nurses in preventing climate change.

Methods
This descriptive cross-sectional study was conducted with nurses working at a university hospital.

Results
The average score on the Climate Change Worry Scale for nurses was 29.22 ± 9.33, with sub-dimensions scores as follows: personal-sphere will and way 10.96 ± 2.09; collective sphere will 18.36 ± 3.39; lack of will and way dimensions 10.40 ± 2.48. The average score on the climate change hope scale was 39.73 ± 5.52. A statistically significant positive relationship was found between age and the climate change worry scale (r = 0.169, p = 0.020) as well as climate change hope (r = 0.148, p = 0.041).

Conclusion
The research findings indicate that nurses have a high level of climate change worry, but they also have a high level of hope in preventing climate change. It is considered essential to address the concerns of nurses who are actively combating the climate crisis.
Readiness levels of intern nursing students during the transition to professional practice within the Al Jouf Region in Saudi Arabia
Authors: Alruwaili Abeer N. , Alruwaili Majed M. , Colby Normajean 
Published: June 2024

Abstract
Background
The transition of newly graduated nurses into the workforce is recognized as a complex undertaking and has been examined extensively in the literature.

Objective
This study aimed to assess the readiness levels of intern nursing students and investigate the factors affecting their transition to professional practice within the Al Jouf region in Saudi Arabia.

Methods
The study employed a combination of descriptive, correlational, and qualitative methodologies to conduct its investigation. Data were acquired via an online questionnaire that included demographic information, the Nursing Practice Readiness Scale (NPRS), and two open-ended questions. A total of 135 nursing intern students were recruited to participate in the study. Benner’s “novice-to-expert” theory of clinical competence was utilized to guide the theoretical underpinning of the study.

Results
Findings revealed that most intern nursing students (63.7%) exhibited a moderate level of readiness. Furthermore, 70.4% and 55.6% of the students showed moderate readiness in terms of their professional attitudes and patient-centeredness, respectively. More than one-third of the students demonstrated a high level of readiness in the self-regulation domain (36.3%), while a similar proportion indicated a high level of readiness in the domain of collaborative interpersonal relationships (33.3%). The students underscored their reliance on the education system as pivotal in enhancing their preparedness for clinical practice.

Conclusion
Nursing internship programs contribute to a more comprehensive readiness of nurses for active participation in clinical practice as compared to traditional educational programs.
Comprehensive analysis of the expression, prognostic, and immune infiltration for COL4s in stomach adenocarcinoma
Authors: Xu Ying , Jin Hangbin , Chen Yan , Yang Zhen , Xu Dongchao , Zhang Xiaofeng , Yang Jianfeng , Wang Yu 
Published: June 2024

Abstract
Background
Collagen (COL) genes, play a key role in tumor invasion and metastasis, are involved in tumor extracellular matrix (ECM)-receptor interactions and focal adhesion pathways. However, studies focusing on the diagnostic value of the COL4 family in stomach adenocarcinoma (STAD) are currently lacking.

Methods
The TCGA database was employed to retrieve the clinical features and RNA sequencing expression profiles of patients with STAD. We conducted an investigation to examine the expression disparities between STAD and adjacent normal tissues. Kaplan-Meier survival analysis was utilized to assess their prognostic significance, while Spearman correlation analysis was employed to determine their association with immune checkpoint genes and immunomodulatory molecules. Furthermore, GO and KEGG analyses were performed on the COL4s-related genes, revealing potential biological pathways through gene set enrichment analysis (GSEA). Subsequently, we explored the extent of immune infiltration of the COL4 family in STAD using the TIMER database. Lastly, the expression levels of the COL4 family in STAD were further validated through quantitative PCR (qPCR) and western blot techniques.

Results
The expression levels of COL4A1/2 were significantly upregulated, while COL4A5/6 were conspicuously downregulated in STAD. The survival analysis revealed that the upregulated COL4s indicated poorer overall survival, first progression and post-progression survival outcomes. Additionally, our findings demonstrated a positive correlation between the expressions of COL4A1/2/3/4 and the infiltration of immune cells, including CD8 + T cells, dendritic cells, macrophages, neutrophils and CD4 + T cells. Further correlation analysis uncovered a favorable association between the expression of COL4A1/2/3/4 and various crucial immunomodulatory molecules, immunological checkpoint molecules, and chemokines. Quantitative PCR analysis confirmed that the expression patterns of COL4A1/3/4/6 genes aligned with the finding from the TCGA database. However, gastric cancer cells exhibited downregulation of COL4A2. Consistently, the protein level of COL4A1 was elevated, whereas the protein level of COL4A2 was reduced in the gastric cancer cell lines.

Conclusion
COL4s could potentially serve as biomarkers for diagnosing and predicting the prognosis of STAD.
Laser-activated perfluorocarbon nanodroplets for intracerebral delivery and imaging via blood–brain barrier opening and contrast-enhanced imaging
Authors: Hallam Kristina A. , Nikolai Robert J. , Jhunjhunwala Anamik , Emelianov Stanislav Y. 
Published: June 2024

Abstract
Background
Ultrasound and photoacoustic (US/PA) imaging is a promising tool for in vivo visualization and assessment of drug delivery. However, the acoustic properties of the skull limit the practical application of US/PA imaging in the brain. To address the challenges in targeted drug delivery to the brain and transcranial US/PA imaging, we introduce and evaluate an intracerebral delivery and imaging strategy based on the use of laser-activated perfluorocarbon nanodroplets (PFCnDs).

Methods
Two specialized PFCnDs were developed to facilitate blood‒brain barrier (BBB) opening and contrast-enhanced US/PA imaging. In mice, PFCnDs were delivered to brain tissue via PFCnD-induced BBB opening to the right side of the brain. In vivo, transcranial US/PA imaging was performed to evaluate the utility of PFCnDs for contrast-enhanced imaging through the skull. Ex vivo, volumetric US/PA imaging was used to characterize the spatial distribution of PFCnDs that entered brain tissue. Immunohistochemical analysis was performed to confirm the spatial extent of BBB opening and the accuracy of the imaging results.

Results
In vivo, transcranial US/PA imaging revealed localized photoacoustic (PA) contrast associated with delivered PFCnDs. In addition, contrast-enhanced ultrasound (CEUS) imaging confirmed the presence of nanodroplets within the same area. Ex vivo, volumetric US/PA imaging revealed PA contrast localized to the area of the brain where PFCnD-induced BBB opening had been performed. Immunohistochemical analysis revealed that the spatial distribution of immunoglobulin (IgG) extravasation into the brain closely matched the imaging results.

Conclusions
Using our intracerebral delivery and imaging strategy, PFCnDs were successfully delivered to a targeted area of the brain, and they enabled contrast-enhanced US/PA imaging through the skull. Ex vivo imaging, and immunohistochemistry confirmed the accuracy and precision of the approach.

Graphical Abstract
Risk factors analysis of lateral cervical lymph node metastasis in papillary thyroid carcinoma: a retrospective study of 830 patients
Authors: Zhong Haifeng , Zeng Qingxin , Long Xi , Lai Yeqian , Chen Jiwei , Wang Yuedong 
Published: June 2024

Abstract
Objective
The aim of this study is to investigate the risk factors for lateral cervical lymph node metastasis in papillary thyroid carcinoma (PTC).

Methods
Clinicopathological data (age, gender, Hashimoto’s thyroiditis, preoperative circulating tumor cells (CTCs), multifocal, maximum lesion diameter, invaded capsule, T stage, and lymph node metastasis) of 830 PTC patients diagnosed and treated in Meizhou People’s Hospital from June 2021 to April 2023 were collected. The related factors of lateral cervical lymph node metastasis were analyzed.

Results
There were 334 (40.2%), and 103 (12.4%) PTC patients with central lymph node metastasis, and lateral cervical lymph node metastasis, respectively. Compared with patients without lateral cervical lymph node metastasis, PTC patients with lateral cervical lymph node metastasis had a higher proportion of multifocal, maximum lesion diameter > 1 cm, invaded capsule, T3-T4 stage. Regression logistic analysis showed that male (odds ratio (OR): 2.196, 95% confidence interval (CI): 1.279–3.769, p = 0.004), age < 55 years old (OR: 2.057, 95% CI: 1.062–3.988, p = 0.033), multifocal (OR: 2.759, 95% CI: 1.708–4.458, p < 0.001), maximum lesion diameter > 1 cm (OR: 5.408, 95% CI: 3.233–9.046, p < 0.001), T3-T4 stage (OR: 2.396, 95% CI: 1.241–4.626, p = 0.009), and invaded capsule (OR: 2.051, 95% CI: 1.208–3.480, p = 0.008) were associated with lateral cervical lymph node metastasis.

Conclusions
Male, age < 55 years old, multifocal, maximum lesion diameter > 1 cm, T3-T4 stage, and invaded capsule were independent risk factors for lateral cervical lymph node metastasis in PTC.
Syndecan-1 as a prognostic biomarker in COVID-19 patients: a retrospective study of a Japanese cohort
Authors: Hayashi Kiyohito , Koyama Daisuke , Hamazaki Yoichi , Kamiyama Takamichi , Yamada Shingo , Furukawa Miki , Tanino Yoshinori , Shibata Yoko , Ikezoe Takayuki 
Published: June 2024

Abstract
Background
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a profound global impact, with millions of confirmed cases and deaths worldwide. While most cases are mild, a subset progresses to severe respiratory complications and death, with factors such as thromboembolism, age, and underlying health conditions increasing the risk. Vascular endothelial damage has been implicated in severe outcomes, but specific biomarkers remain elusive. This study investigated syndecan-1 (SDC-1), a marker of endothelial damage, as a potential prognostic factor for COVID-19, focusing on the Japanese population, which is known for its aging demographics and high prevalence of comorbidities.

Methods
A multicenter retrospective study of COVID-19 patients in Fukushima Prefecture in Japan who were admitted between February 2020 and August 2021 was conducted. SDC-1 levels were measured along with other clinical and laboratory parameters. Outcomes including thrombosis, 28-day survival, and disease severity were assessed, and disease severity was categorized according to established guidelines.

Results
SDC-1 levels were correlated with disease severity. Patients who died from COVID-19 had greater SDC-1 levels than survivors, and the area under the receiver operating characteristic curve (AUC) analysis suggested the potential of the SDC-1 level as a predictor of mortality (AUC 0.714). K‒M analysis also revealed a significant difference in survival based on an SDC-1 cutoff of 10.65 ng/mL.

Discussion
This study suggested that SDC-1 may serve as a valuable biomarker for assessing COVID-19 severity and predicting mortality within 28 days of hospitalization, particularly in the Japanese population. However, further investigations are required to assess longitudinal changes in SDC-1 levels, validate its predictive value for long-term survival, and consider its applicability to new viral variants.

Conclusions
SDC-1 is emerging as a potential biomarker for assessing the severity and life expectancy of COVID-19 in the Japanese population, offering promise for improved risk stratification and patient management in the ongoing fight against the virus.
Evaluation of OVOL1 and Filaggrin immunohistochemical expression and clinical relevance in psoriasis
Authors: Hemida Aiat Shaban , Hammam Mostafa Ahmed , Swilam Aya Ahmed , Shehata Wafaa Ahmed 
Published: June 2024

Abstract
Background
Psoriasis is a disease of overactive immune system. OVOL1 and Filaggrin have been associated with many inflammatory skin lesions. To the best of our knowledge, the correlation between OVOL1 and Filaggrin in psoriasis was not previously investigated. This work aims to search the immunohistochemical expression and correlation between OVOL1 and Filaggrin in psoriasis.

Materials and methods
Slides cut from paraffin blocks of 30 psoriasis cases and 30 control subjects were stained with OVOL1 and Filaggrin. Clinicopathological data were correlated with the results of staining.

Results
OVOL1 and Filaggrin expression in epidermis showed a significant gradual reduction from normal skin to peri-lesional and psoriasis biopsies (P < 0.001). In contrast, psoriasis dermis showed a significant overexpression of OVOL1 in inflammatory cells in relation to peri-lesional biopsies (P < 0.002). OVOL1 demonstrated a significant direct correlation with Filaggrin expression in psoriasis (r = 0.568, P < 0.004). OVOL1 and Filaggrin expression in psoriasis skin epidermis demonstrated a statistically significant negative correlation with PASI score.

Conclusion
OVOL1 and Filaggrin might be involved in psoriasis-associated inflammation and skin hyperproliferation. OVOL1 might have a protective barrier function in the skin and could be used to stratify progressive disease. Filaggrin may play a role in progression of psoriasis. OVOL1 inhibition could be considered in suppression of Filaggrin function. OVOL1 agonists may be beneficial in psoriasis treatment.
Emerging human pulmonary dirofilariasis in Hungary: a single center experience
Authors: Kuthi Levente , Zombori Tamás , Tiszlavicz László , Hegedűs Fanni , Almási Szintia , Baráth Bence , Almakrami Mohammed , EJ Mohammad Jamal , Barta Nikolett , Ujfaludi Zsuzsanna , Pankotai Tibor , Hajdu Adrienn , Furák József , Sejben Anita 
Published: June 2024

Abstract
Background
Human pulmonary dirofilariasis (HPD) is rare in Hungary, and it stems from Dirofilaria immitis, mainly transmitted through mosquito bites, with dogs as primary hosts. Despite its prevalence in veterinary settings, human cases are infrequent. Historically, Mediterranean countries report most HPD cases, but sporadic cases occur in temperate European regions. Radiologically, HPD often manifests in a non-specific manner, resembling pulmonary neoplasms, leading to unnecessary surgery and patient distress.

Methods
This study presents a notable case series from Hungary, encompassing a 12-year period, documenting 5 instances of HPD with the aim to provide baseline estimate of occurrence for future comparison.

Results
Among the patients studied, all were of middle age (median: 52 years, range: 37–69) and exhibited tumor-like lesions, primarily localized to the right lung, necessitating lobectomy or wedge resection. Histological examination consistently revealed a necrotizing granulomatous response characterized by remnants of helminths, without the presence of ovules. Furthermore, rigorous diagnostic procedures excluded other potential infectious agents through specialized staining techniques. Polymerase chain reaction analysis definitively confirmed the diagnosis of HPD in each case.

Conclusions
This case series highlights HPD as a seldom zoonosis, with a probable escalation in its occurrence within temperate regions. Therefore, clinicians should maintain a heightened awareness of HPD in the differential diagnosis of pulmonary coin lesions. Early recognition and diagnosis are paramount for appropriate management and prevention of potential complications associated with this increasingly recognized infectious entity.
Rare histologic transformation of a CTNNB1 (β-catenin) mutated prostate cancer with aggressive clinical course
Authors: Akhoundova Dilara , Fischer Stefanie , Triscott Joanna , Lehner Marika , Thienger Phillip , Maletti Sina , Jacquet Muriel , Lubis Dinda S.H. , Bubendorf Lukas , Jochum Wolfram , Rubin Mark A. 
Published: June 2024

Abstract
Background
Catenin (Cadherin-Associated Protein), Beta 1 (CTNNB1) genomic alterations are rare in prostate cancer (PCa). Gain-of-function mutations lead to overexpression of β-catenin, with consequent hyperactivation of the Wnt/β-catenin signaling pathway, implicated in PCa progression and treatment resistance. To date, successful targeted treatment options for Wnt/β-catenin - driven PCa are lacking.

Methods
We report a rare histologic transformation of a CTNNB1 (β-catenin) mutated metastatic castration resistant prostate cancer (mCRPC), clinically characterized by highly aggressive disease course. We histologically and molecularly characterized the liver metastatic tumor samples, as well as successfully generated patient-derived organoids (PDOs) and patient-derived xenograft (PDX) from a liver metastasis. We used the generated cell models for further molecular characterization and drug response assays.

Results
Immunohistochemistry of liver metastatic biopsies and PDX tumor showed lack of expression of typical PCa (e.g., AR, PSA, PSAP, ERG) or neuroendocrine markers (synaptophysin), compatible with double-negative CRPC, but was positive for nuclear β-catenin expression, keratin 7 and 34βE12. ERG rearrangement was confirmed by fluorescent in situ hybridization (FISH). Drug response assays confirmed, in line with the clinical disease course, lack of sensitivity to common drugs used in mCRPC (e.g., enzalutamide, docetaxel). The casein kinase 1 (CK1) inhibitor IC261 and the tankyrase 1/2 inhibitor G700-LK showed modest activity. Moreover, despite harbouring a CTNNB1 mutation, PDOs were largely insensitive to SMARCA2/4- targeting PROTAC degraders and inhibitor.

Conclusions
The reported CTNNB1-mutated mCRPC case highlights the potential challenges of double-negative CRPC diagnosis and underlines the relevance of further translational research to enable successful targeted treatment of rare molecular subtypes of mCRPC.