bluuebunny/crossref_metadata_2025_split huggingface dataset:
An interpretable clinical ultrasound-radiomics combined model for diagnosis of stage I cervical cancer
Authors: Yang Xianyue , Gao Chuanfen , Sun Nian , Qin Xiachuan , Liu Xiaoling , Zhang Chaoxue 
Published: May 2024

ObjectiveThe purpose of this retrospective study was to establish a combined model based on ultrasound (US)-radiomics and clinical factors to predict patients with stage I cervical cancer (CC) before surgery.Materials and methodsA total of 209 CC patients who had cervical lesions found by transvaginal sonography (TVS) from the First Affiliated Hospital of Anhui Medical University were retrospectively reviewed, patients were divided into the training set (n = 146) and internal validation set (n = 63), and 52 CC patients from Anhui Provincial Maternity and Child Health Hospital and Nanchong Central Hospital were taken as the external validation set. The clinical independent predictors were selected by univariate and multivariate logistic regression analyses. US-radiomics features were extracted from US images. After selecting the most significant features by univariate analysis, Spearman’s correlation analysis, and the least absolute shrinkage and selection operator (LASSO) algorithm, six machine learning (ML) algorithms were used to build the radiomics model. Next, the ability of the clinical, US-radiomics, and clinical US-radiomics combined model was compared to diagnose stage I CC. Finally, the Shapley additive explanations (SHAP) method was used to explain the contribution of each feature.ResultsLong diameter of the cervical lesion (L) and squamous cell carcinoma-associated antigen (SCCa) were independent clinical predictors of stage I CC. The eXtreme Gradient Boosting (Xgboost) model performed the best among the six ML radiomics models, with area under the curve (AUC) values in the training, internal validation, and external validation sets being 0.778, 0.751, and 0.751, respectively. In the final three models, the combined model based on clinical features and rad-score showed good discriminative power, with AUC values in the training, internal validation, and external validation sets being 0.837, 0.828, and 0.839, respectively. The decision curve analysis validated the clinical utility of the combined nomogram. The SHAP algorithm illustrates the contribution of each feature in the combined model.ConclusionWe established an interpretable combined model to predict stage I CC. This non-invasive prediction method may be used for the preoperative identification of patients with stage I CC.
Efficacy of anti-PD-1 monotherapy for recurrent or metastatic olfactory neuroblastoma
Authors: Hoshi Yuta , Enokida Tomohiro , Tamura Shingo , Nakashima Torahiko , Okano Susumu , Fujisawa Takao , Sato Masanobu , Wada Akihisa , Tanaka Hideki , Takeshita Naohiro , Tanaka Nobukazu , Onaga Ryutaro , Kishida Takuma , Uryu Hideoki , Sakashita Shingo , Asakage Takahiro , Tahara Makoto 
Published: May 2024

BackgroundOlfactory neuroblastoma (ONB) is a rare malignant tumor of the head and neck. Due to its rarity, standard systemic therapy for this condition has yet to be established. In particular, the use of immune checkpoint inhibitors (ICIs) for the recurrent or metastatic (R/M) ONB population remains unclear.MethodsWe retrospectively evaluated 11 patients with R/M ONB who received any systemic chemotherapy at two Japanese institutions (National Cancer Center Hospital East and Kyushu Medical Center) between January 2002 and March 2022 and analyzed outcomes by use of anti-PD-1 antibody (nivolumab or pembrolizumab) monotherapy.ResultsOf the 11 patients, 6 received ICI (ICI-containing treatment group) and the remaining 5 were treated with systemic therapy but not including ICI (ICI-non-containing treatment group). Overall survival (OS) was significantly longer in the ICI-containing group (median OS: not reached vs. 6.4 months, log-rank p-value: 0.035). The fraction of ICI systemic therapy in the entire treatment period of this group reached 85.9%. Four patients (66.7%) in the ICI-containing treatment group experienced immune-related adverse events (irAE), with grades of 1/2. No irAE of grade 3 or more was seen, and no patient required interruption or discontinuation of treatment due to toxicity.ConclusionICI monotherapy appears to be effective and to contribute to prolonged survival in R/M ONB.
Case report: Isolated immunoglobulin G4-related sclerosing cholangitis misdiagnosed as hilar cholangiocarcinoma
Authors: Li Hui , Wang Ran , Wang Dongyang , Tang Yufu , Liu Xuantong , Li Hongyu , Qi Xingshun 
Published: May 2024

BackgroundImmunoglobulin G4-related sclerosing cholangitis (IgG4-SC) is frequently accompanied with type 1 autoimmune pancreatitis (AIP). Isolated IgG4-SC which is not accompanied with AIP is uncommon in clinical practice, and its manifestations are similar to those of hilar cholangiocarcinoma.Case presentationA 55-year-old male presented with persistent aggravation of icteric sclera and skin. He was initially diagnosed with hilar cholangiocarcinoma and underwent surgery. However, positive IgG4 plasma cells were found in the surgical specimens. Thus, a pathological diagnosis of IgG4-SC was established. After that, steroid therapy was given and initially effective. But he was steroid dependent, and then received rituximab therapy twice. Unfortunately, the response to rituximab therapy was poor.ConclusionIt is crucial to differentiate isolated IgG4-SC from hilar cholangiocarcinoma to avoid unnecessary surgery. Future studies should further explore effective treatment strategy in patients who do not respond to steroids therapy. It is also required to develop novel and accurate diagnostic approaches to avoid unnecessary surgical procedures.
Epidemiological and clinical characteristics of hospitalized unintentional injuries among children in central China from 2017–2023
Authors: Wang Meng , Cheng Yibing , Wang Haijun , Lin Li , Shen Yuelin 
Published: May 2024

ObjectivesTo examine the epidemiological and clinical characteristics of hospitalized unintentional injuries among children in Central China and theoretically propose preventive and control measures.MethodsWe conducted a retrospective study of children aged 0–18 years with unintentional injuries who were admitted to a tertiary hospital in Central China from January 2017 to December 2023. We examined various aspects of the unintentional injuries, including age, gender, urban-rural distribution, external causes, trends, location of injury, cost, and length of stay.ResultsA total of 20,166 children with hospitalized unintentional injuries were enrolled. The median age with IQR was 2.8 (1.6, 5.1) years, with majority of the patients (57.0%) were aged 1–3 years, while the fewest were aged 11–18 years. The male-to-female ratio was 1.8:1, and the urban-to-rural ratio was 1.1:1. The most common external causes were foreign bodies (41.7%), exposure to inanimate mechanical forces (25.1%), and falls (22.1%). The most frequently injured body parts were head (72.5%). The total number of unintentional injuries exhibited an increasing trend from 2017–2022, and a decreasing trend from 2022–2023. The urban-rural distribution reversed after 2020. The overall hospitalization cost was 20,810,870.4 USD, with an median cost of 758.7 (556.4, 1,186.2) USD per person.ConclusionUnintentional injuries imposed a heavy burden on society and families. However, the number of cases and the urban-rural distribution showed significant trend changes from 2017–2023. The external causes varied by age group, gender, and region, while prevention and control measures should be developed accordingly.
Mortality prediction and influencing factors for intensive care unit patients with acute tubular necrosis: random survival forest and cox regression analysis
Authors: Zeng Jinping , Zhang Min , Du Jiaolan , Han Junde , Song Qin , Duan Ting , Yang Jun , Wu Yinyin 
Published: May 2024

Background: Patients with acute tubular necrosis (ATN) not only have severe renal failure, but also have many comorbidities, which can be life-threatening and require timely treatment. Identifying the influencing factors of ATN and taking appropriate interventions can effectively shorten the duration of the disease to reduce mortality and improve patient prognosis.Methods: Mortality prediction models were constructed by using the random survival forest (RSF) algorithm and the Cox regression. Next, the performance of both models was assessed by the out-of-bag (OOB) error rate, the integrated brier score, the prediction error curve, and area under the curve (AUC) at 30, 60 and 90 days. Finally, the optimal prediction model was selected and the decision curve analysis and nomogram were established.Results: RSF model was constructed under the optimal combination of parameters (mtry = 10, nodesize = 88). Vasopressors, international normalized ratio (INR)_min, chloride_max, base excess_min, bicarbonate_max, anion gap_min, and metastatic solid tumor were identified as risk factors that had strong influence on mortality in ATN patients. Uni-variate and multivariate regression analyses were used to establish the Cox regression model. Nor-epinephrine, vasopressors, INR_min, severe liver disease, and metastatic solid tumor were identified as important risk factors. The discrimination and calibration ability of both predictive models were demonstrated by the OOB error rate and the integrated brier score. However, the prediction error curve of Cox regression model was consistently lower than that of RSF model, indicating that Cox regression model was more stable and reliable. Then, Cox regression model was also more accurate in predicting mortality of ATN patients based on the AUC at different time points (30, 60 and 90 days). The analysis of decision curve analysis shows that the net benefit range of Cox regression model at different time points is large, indicating that the model has good clinical effectiveness. Finally, a nomogram predicting the risk of death was created based on Cox model.Conclusion: The Cox regression model is superior to the RSF algorithm model in predicting mortality of patients with ATN. Moreover, the model has certain clinical utility, which can provide clinicians with some reference basis in the treatment of ATN and contribute to improve patient prognosis.
Effects of long-term antipsychotic medication on brain instability in first-episode schizophrenia patients: a resting-state fMRI study
Authors: Zhong Maoxing , Liu Zhening , Wang Feiwen , Yang Jun , Chen Eric , Lee Edwin , Wu Guowei , Yang Jie 
Published: May 2024

Early initiation of antipsychotic treatment plays a crucial role in the management of first-episode schizophrenia (FES) patients, significantly improving their prognosis. However, limited attention has been given to the long-term effects of antipsychotic drug therapy on FES patients. In this research, we examined the changes in abnormal brain regions among FES patients undergoing long-term treatment using a dynamic perspective. A total of 98 participants were included in the data analysis, comprising 48 FES patients, 50 healthy controls, 22 patients completed a follow-up period of more than 6 months with qualified data. We processed resting-state fMRI data to calculate coefficient of variation of fractional amplitude of low-frequency fluctuations (CVfALFF), which reflects the brain regional activity stability. Data analysis was performed at baseline and after long-term treatment. We observed that compared with HCs, patients at baseline showed an elevated CVfALFF in the supramarginal gyrus (SMG), parahippocampal gyrus (PHG), caudate, orbital part of inferior frontal gyrus (IOG), insula, and inferior frontal gyrus (IFG). After long-term treatment, the instability in SMG, PHG, caudate, IOG, insula and inferior IFG have ameliorated. Additionally, there was a positive correlation between the decrease in dfALFF in the SMG and the reduction in the SANS total score following long-term treatment. In conclusion, FES patients exhibit unstable regional activity in widespread brain regions at baseline, which can be ameliorated with long-term treatment. Moreover, the extent of amelioration in SMG instability is associated with the amelioration of negative symptoms.
Authenticity identification method for calligraphy regular script based on improved YOLOv7 algorithm
Authors: Chen Jinyuan , Huang Zucheng , Jiang Xuyao , Yuan Hai , Wang Weijun , Wang Jian , Wang Xintong , Xu Zheng 
Published: May 2024

A regular calligraphy script of each calligrapher has unique strokes, and a script’s authenticity can be identified by comparing them. Hence, this study introduces a method for identifying the authenticity of regular script calligraphy works based on the improved YOLOv7 algorithm. The proposed method evaluates the authenticity of calligraphy works by detecting and comparing the number of single-character features in each regular script calligraphy work. Specifically, first, we collected regular script calligraphy works from a well-known domestic calligrapher and divided each work into a single-character dataset. Then, we introduced the PConv module in FasterNet, the DyHead dynamic detection header network, and the MPDiou bounding box loss function to optimize the accuracy of the YOLOv7 algorithm. Thus, we constructed an improved algorithm named YOLOv7-PDM, which is used for regular script calligraphy identification. The proposed YOLOv7-PDM model was trained and tested using a prepared regular script single-character dataset. Through experimental results, we confirmed the practicality and feasibility of the proposed method and demonstrated that the YOLOv7-PDM algorithm model achieves 94.19% accuracy (mAP50) in detecting regular script font features, with a single-image detection time of 3.1 m and 31.67M parameters. The improved YOLOv7 algorithm model offers greater advantages in detection speed, accuracy, and model complexity compared to current mainstream detection algorithms. This demonstrates that the developed approach effectively extracts stroke features of regular script calligraphy and provides guidance for future studies on authenticity identification.
Effects of rope skipping exercise on working memory and cardiorespiratory fitness in children with attention deficit hyperactivity disorder
Authors: Huang Ziyun , Li Liang , Lu Yijuan , Meng Jie , Wu Xueping 
Published: May 2024

IntroductionChildren with Attention Deficit Hyperactivity Disorder (ADHD) exhibit deficits in working memory (WM) and cardiorespiratory fitness (CRF), both of which are closely associated with the core symptoms of ADHD. This study aimed to investigate the effects of rope skipping exercise (RSE) on the WM and CRF of children with ADHD, to provide a theoretical foundation for the optimization of exercise intervention programs tailored to children with ADHD.MethodsThis study recruited 55 children (age range 6–12 years) and randomly assigned them into three groups: the ADHD with RSE (AWRSE, n=22, mean age: 10.18 ± 1.10 years), the ADHD with sports game (SG) (AWSG, n=16, mean age: 9.38 ± 0.96 years), and the typically developing (TD) control group (CG, n=17, mean age: 8.94 ± 0.56 years). The AWRSE underwent a RSE intervention, while the other two groups participated in SG. The exercise intervention lasted for 8 weeks, with sessions held twice a week for 60 minutes each, at a moderate-to-vigorous-intensity (64–95% HRmax). All children in each group underwent pre-test and post-test, including height, weight, BMI, n-back, and 20mSRT. One-way analysis of variance (Ony-way ANOVA) and paired sample t-test were used to analyze inter- and intra-group differences respectively.ResultsBefore the intervention, children with ADHD exhibited a significantly lower VO2max compared to the TD children (p&lt;0.05), and there was no significant difference in the other indicators between the groups (p&gt;0.05). After the intervention, no significant inter-group differences were found across all indices for the three groups of children (p &gt; 0.05). The AWRSE had significant improvements in the accuracy of 1-back task, Pacer (laps), and VO2max (p&lt;0.05), with the level of CRF approaching that of TD children. A significant decrease in response time for the 1-back task was observed in the CG.ConclusionAn 8-week RSE intervention is an effective therapeutic approach for children with ADHD, significantly enhancing their WM and CRF.
Assessing the impact of annual health screenings in identifying noncommunicable disease risk factors within Qatar’s primary health care corporation Qatari registered population
Authors: Al-Abdulla Samya Ahmad , Haj Bakri Ahmad , Mansaray Mariama Aminata , Al-Kuwari Mohamed Ghaith 
Published: May 2024

BackgroundNoncommunicable diseases (NCDs) are a significant global health burden, including in Qatar, where cardiovascular diseases cause mortality. This study examines the outcomes of the annual health checkup implemented by the Primary Health Care Corporation (PHCC) in Qatar in detecting NCDs risk factors among Qataris aged 18+ years.MethodsA cross-sectional study design was implemented to calculate the prevalence of behavioural and metabolic NCDs risk factors among Qataris who underwent annual health checkups between 2017 and 2019. Data on age, gender, tobacco consumption, height, weight, blood pressure, glycated haemoglobin (HbA1c), and cholesterol levels were extracted from electronic medical records.ResultsIn 2019, Qatar experienced an 80% rise in Annual Health checkups attendance compared to 2017. Tobacco use fluctuated between 11.79 and 12.91%, peaking at 35.67% among males in 2018. Qataris with elevated blood pressure dropped from 29.44% in 2017 to 18.52% in 2019. Obesity decreased from 48.32 to 42.29%, more prevalent in females. High HbA1c levels reduced from 13.33 to 8.52%, while pre-diabetic levels rose from 21.1 to 25.52%. High cholesterol ranged from 7.31 to 9.47%. In a regression analysis, males had 2.28 times higher odds of elevated blood pressure and 1.54 times higher odds of high HbA1c, with a 0.68 lower odds of obesity compared to females. Ages 36 and above had 2.61 times higher odds of high cholesterol compared to younger age groups.ConclusionThe annual health screening has shown promising results in detecting and addressing NCDs risk factors among Qataris. The attendance rate has increased over the three-year period, and there has been a decrease in the prevalence of elevated blood pressure, obesity, and high HbA1c levels. However, tobacco consumption and pre-diabetic levels remain significant concerns. These findings can guide the implementation of tailored preventative and curative services to improve the health and well-being of the Qatari population.
Epidemiological characteristics and factors affecting healing in unintentional pediatric wounds
Authors: Gao Hua , Li Yang , Jin Shaobin , Zhai Wenli , Gao Yanhua , Pu Linzhe 
Published: May 2024

ObjectiveTo analyze the epidemiological characteristics and wound healing conditions of common unintentional skin lacerations in children.MethodsA retrospective analysis was conducted on data from 1,107 children, aged 0–12 years, with skin lacerations who received emergency treatment at Qilu Hospital of Shandong University from January 1, 2019, to December 30, 2022. Data on age, injury site, time from injury to suturing, and wound healing conditions were statistically analyzed.ResultsAmong the 1,107 cases, 714 (64.5%) were male and 393 (35.5%) were female, with a male-to-female ratio of 1.8:1; median age was 5 years (IQR, 3–7). Infants and toddlers (0–3 years old) constituted the highest proportion, accounting for 36.3% (402 cases). The number of children aged over 3 years gradually decreased with increasing age. In younger children, the most common injuries were to the forehead, scalp, and lower jaw; in school-aged children, the proportion of limb and trunk injuries significantly increased. Age (OR, 1.34; 95% CI, 1.23–1.46), outdoor injuries (OR, 2.21; 95% CI, 1.18–4.16), lower limb injuries (OR, 5.35; 95% CI, 2.86–10.00), and wound length greater than 3 cm (OR, 10.65; 95% CI, 5.02–22.60) were significant risk factors for poor wound healing. The risk of poor wound healing increased by 34% for each additional year of age.ConclusionIn children, the common sites of unintentional skin lacerations show distinct age and gender distribution characteristics. Older age, outdoor injuries, longer wound lengths, and lower limb injuries are independent risk factors for poor wound healing.
Association between urinary metals and prostate-specific antigen in aging population with depression: a cross-sectional study
Authors: Ren Liquan , Zhang Yue , Wu Jinyi 
Published: May 2024

ObjectiveThis study aims to investigate the impact of depression and urinary metals on Prostate-Specific Antigen (PSA).MethodsAnalysis was conducted on 1901 samples collected from the National Health and Nutrition Examination Survey (NHANES) database between 2001 and 2010. Analytical methods included stepwise multiple linear regression (MLR) analysis of the overall population’s urinary metals and PSA relationship, analysis of urinary metals and PSA relationship in older adults and BMI subgroups, analysis of urinary metals and PSA relationship in the depressed population, and restricted cubic spline (RCS) analysis. A significance level of p &lt; 0.05 was considered statistically significant.ResultsIn the stepwise multiple linear regression, beryllium (Be) showed a dose–response association with PSA (third quartile: β = 0.05, 95%CI (0.02, 0.09); fourth quartile: β = 0.07, 95%CI (0.02, 0.12), p trend = 0.048). Subgroup analysis indicated that in individuals aged &gt;60, Be at Q4 level [β = 0.09, 95%CI (0.05, 0.21)] exhibited a dose–response correlation with PSA. In the population with 25 ≤ BMI &lt; 30, Be might more significantly elevate PSA, with Q4 level having a pronounced impact on PSA levels [β = 0.03, 95%CI (0.02, 1.27)]. In the depressed population, urinary cadmium (Cd) levels showed a significant positive dose–response relationship, with Q4 level of Cd having the maximum impact on PSA [β = 0.3, 95%CI (0.09, 0.49)].ConclusionIndividuals exposed to beryllium (Be), especially the older adults and overweight, should monitor their PSA levels. In depressed patients, cadmium (Cd) levels may further elevate PSA levels, necessitating increased monitoring of PSA levels among males.