bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of inflammation in a rat model of radiation retinopathy
Authors: Lebon Cécile , Malaise Denis , Rimbert Nicolas , Billet Manon , Ramasamy Gabriel , Villaret Jérémie , Pouzoulet Frédéric , Matet Alexandre , Behar-Cohen Francine 
Published: June 2024

AbstractRadiation retinopathy (RR) is a major side effect of ocular tumor treatment by plaque brachytherapy or proton beam therapy. RR manifests as delayed and progressive microvasculopathy, ischemia and macular edema, ultimately leading to vision loss, neovascular glaucoma, and, in extreme cases, secondary enucleation. Intravitreal anti-VEGF agents, steroids and laser photocoagulation have limited effects on RR. The role of retinal inflammation and its contribution to the microvascular damage occurring in RR remain incompletely understood. To explore cellular and vascular events after irradiation, we analyzed their time course at 1 week, 1 month and 6 months after rat eyes received 45 Gy X-beam photons. Müller glial cells, astrocytes and microglia were rapidly activated, and these markers of retinal inflammation persisted for 6 months after irradiation. This was accompanied by early cell death in the outer retina, which persisted at later time points, leading to retinal thinning. A delayed loss of small retinal capillaries and retinal hypoxia were observed after 6 months, indicating inner blood‒retinal barrier (BRB) alteration but without cell death in the inner retina. Moreover, activated microglial cells invaded the entire retina and surrounded retinal vessels, suggesting the role of inflammation in vascular alteration and in retinal cell death. Radiation also triggered early and persistent invasion of the retinal pigment epithelium by microglia and macrophages, contributing to outer BRB disruption. This study highlights the role of progressive and long-lasting inflammatory mechanisms in RR development and demonstrates the relevance of this rat model to investigate human pathology.
The effect of hyperlipidemia on overall survival in patients with cancer was differentiated by BMI and hyperlipidemia type
Authors: Tian Hai-Ying , Yang Ming , Xie Hai-Lun , Ruan Guo-Tian , Ge Yi-Zhong , Zhang Xiao-Wei , Zhang He-Yang , Liu Chen-An , Liu Tong , Shi Han-Ping 
Published: June 2024

Abstract
Background and aims
The impact of lipids on the overall survival (OS) of patients with malignancy has not yet been clarified. This study aimed to evaluate the effect of hyperlipidemia on the OS among Chinese patients based on Body Mass Index (BMI) stratifications and hyperlipidemia types.

Method
The patients in this study were derived from the Investigation of the Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) trial. Kaplan–Meier was used to draw the survival curve, and the log-rank test was used to estimate the survival rates between each group. Cox proportional hazards regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI).

Results
A total of 9054 patients were included in the final study, with a median age of 59 years, and 55.3% (5004) of them were males. Regarding types of hyperlipidemia, only low high-density lipoprotein was an independent risk factor for the prognosis of all patients (HR = 1.35, 95% CI: 1.25–1.45, P < 0.001), while high total cholesterol (HR = 1.01, 95% CI: 0.90–1.15, P = 0.839) and high low-density lipoprotein (HR = 1.03, 95%CI: 0.91–1.16, P = 0.680) were not. In terms of BMI stratification, the effect of triglycerides on prognosis varied; high triglycerides were an independent risk factor for the prognosis of underweight patients (HR = 1.56, 95% CI:1.05–2.32, P = 0.027) and a protective factor for overweight patients (HR = 0.75, 95% CI: 0.63–0.89, P = 0.001). However, for normal-weight patients, there was no significant statistical difference (HR = 0.88, 95%CI: 0.75–1.03, P = 0.108).

Conclusions
The impact of hyperlipidemia on the OS among patients with cancer varied by different BMI and hyperlipidemia types. BMI and hyperlipidemia type ought to be considered in combination to estimate the prognosis of patients with malignancy.
Development of a risk prediction model for radiation dermatitis following proton radiotherapy in head and neck cancer using ensemble machine learning
Authors: Lee Tsair-Fwu , Liu Yen-Hsien , Chang Chu-Ho , Chiu Chien-Liang , Lin Chih-Hsueh , Shao Jen-Chung , Yen Yu-Cheng , Lin Guang-Zhi , Yang Jack , Tseng Chin-Dar , Fang Fu-Min , Chao Pei-Ju , Lee Shen-Hao 
Published: June 2024

Abstract
Purpose
This study aims to develop an ensemble machine learning-based (EML-based) risk prediction model for radiation dermatitis (RD) in patients with head and neck cancer undergoing proton radiotherapy, with the goal of achieving superior predictive performance compared to traditional models.

Materials and methods
Data from 57 head and neck cancer patients treated with intensity-modulated proton therapy at Kaohsiung Chang Gung Memorial Hospital were analyzed. The study incorporated 11 clinical and 9 dosimetric parameters. Pearson’s correlation was used to eliminate highly correlated variables, followed by feature selection via LASSO to focus on potential RD predictors. Model training involved traditional logistic regression (LR) and advanced ensemble methods such as Random Forest and XGBoost, which were optimized through hyperparameter tuning.

Results
Feature selection identified six key predictors, including smoking history and specific dosimetric parameters. Ensemble machine learning models, particularly XGBoost, demonstrated superior performance, achieving the highest AUC of 0.890. Feature importance was assessed using SHAP (SHapley Additive exPlanations) values, which underscored the relevance of various clinical and dosimetric factors in predicting RD.

Conclusion
The study confirms that EML methods, especially XGBoost with its boosting algorithm, provide superior predictive accuracy, enhanced feature selection, and improved data handling compared to traditional LR. While LR offers greater interpretability, the precision and broader applicability of EML make it more suitable for complex medical prediction tasks, such as predicting radiation dermatitis. Given these advantages, EML is highly recommended for further research and application in clinical settings.
A novel nomogram model to predict in-hospital mortality in patients with acute type A aortic dissection after surgery
Authors: Zhou Yifei , Fan Rui , Jiang Hongwei , Liu Renjie , Huang Fuhua , Chen Xin 
Published: June 2024

Abstract
Background
Acute type A aortic dissection is a dangerous disease that threatens public health. In recent years, with the progress of medical technology, the mortality rate of patients after surgery has been gradually reduced, leading that previous prediction models may not be suitable for nowadays. Therefore, the present study aims to find new independent risk factors for predicting in-hospital mortality and construct a nomogram prediction model. Methods: The clinical data of 341 consecutive patients in our center from 2019 to 2023 were collected, and they were divided into two groups according to the death during hospitalization. The independent risk factors were analyzed by univariate and multivariate logistic regression, and the nomogram was constructed and verified based on these factors. Results: age, preoperative lower limb ischemia, preoperative activated partial thromboplastin time (APTT), preoperative platelet count, Cardiopulmonary bypass (CPB) time and postoperative acute kidney injury (AKI) independently predicted in-hospital mortality of patients with acute type A aortic dissection after surgery. The area under the receiver operating characteristic curve (AUC) for the nomogram was 0.844. The calibration curve and decision curve analysis verified that the model had good quality. Conclusion: The new nomogram model has a good ability to predict the in-hospital mortality of patients with acute type A aortic dissection after surgery.
Challenges for gene therapy in the financial sustainability of health systems: a scoping review
Authors: Ossandon Hugo , Armijo Nicolás , Vargas Constanza , Repetto Gabriela M. , Espinoza Manuel Antonio 
Published: June 2024

Abstract
Aim
To review the available evidence about the strategies implemented or proposed for coverage or reimbursement for currently approved gene therapies.

Methods
A scoping review was conducted to analyze the evidence published during the years 2016 to 2023. The main search criteria were coverage or reimbursement of gene therapy by healthcare systems. The eligible articles were those that described or proposed a financing model used to provide coverage in the various systems around the world.

Results
The study identified 279 publications, and after removing duplicates and screening for eligibility, 10 were included in the study. The results show that various financing models have been proposed, including subscription-based payment models, outcome-based payment models, and amortization strategies. However, several barriers to implementing these models were identified, such as deficiencies in informatics systems for data collection, changes in laws or regulations, the lack of accessible clinical endpoints and administrative costs.

Conclusion
This scoping review provides an overview of financing strategies for gene therapies. Gene therapies can cure rare or previously intractable diseases, but their high cost can make access difficult. Publishing experiences with these models can help evaluate their use and gather more evidence for their effectiveness.
Synthesis of metformin-derived fluorescent quantum dots: uptake, cytotoxicity, and inhibition in human breast cancer cells through autophagy pathway
Authors: Akbari Ali , Nemati Mohadeseh , Lighvan Zohreh Mehri , Khanamiri Fereshteh Nazari , Rezaie Jafar , Rasmi Yousef 
Published: June 2024

Abstract
Background
Breast cancer remains a challenge for physicians. Metformin, an antidiabetic drug, show promising anticancer properties against cancers. An emerging quantum dot (QD) material improves therapeutic agents’ anticancer and imaging properties. QD are nano-sized particles with extreme application in nanotechnology captured by cells and accumulated inside cells, suggesting bioimaging and effective anticancer outcomes. In this study, a simple one-pot hydrothermal method was used to synthesize fluorescent metformin-derived carbon dots (M-CDs) and then investigated the cytotoxic effects and imaging features on two human breast cancer cell lines including, MCF-7 and MDA-MB-231 cells.

Results
Results showed that M-CDs profoundly decreased the viability of both cancer cells. IC50 values showed that M-CDs were more cytotoxic than metformin either 24–48 h post-treatment. Cancer cells uptake M-CDs successfully, which causes morphological changes in cells and increased levels of intracellular ROS. The number of Oil Red O-positive cells and the expression of caspase-3 protein were increased in M-CDs treated cells. Authophagic factors including, AMPK, mTOR, and P62 were down-regulated, while p-AMPK, Becline-1, LC3 I, and LC3 II were up-regulated in M-CDs treated cells. Finally, M-CDs caused a decrease in the wound healing rate of cells.

Conclusions
For the first, M-CDs were synthesized by simple one-pot hydrothermal treatment without further purification. M-CDs inhibited both breast cancer cells through modulating autophagy signalling.

Graphical Abstract
Epigenetic regulation of major histocompatibility complexes in gastrointestinal malignancies and the potential for clinical interception
Authors: Tovar Perez Jorge Enrique , Zhang Shilan , Hodgeman William , Kapoor Sabeeta , Rajendran Praveen , Kobayashi Koichi S. , Dashwood Roderick H. 
Published: June 2024

Abstract
Background
Gastrointestinal malignancies encompass a diverse group of cancers that pose significant challenges to global health. The major histocompatibility complex (MHC) plays a pivotal role in immune surveillance, orchestrating the recognition and elimination of tumor cells by the immune system. However, the intricate regulation of MHC gene expression is susceptible to dynamic epigenetic modification, which can influence functionality and pathological outcomes.

Main body
By understanding the epigenetic alterations that drive MHC downregulation, insights are gained into the molecular mechanisms underlying immune escape, tumor progression, and immunotherapy resistance. This systematic review examines the current literature on epigenetic mechanisms that contribute to MHC deregulation in esophageal, gastric, pancreatic, hepatic and colorectal malignancies. Potential clinical implications are discussed of targeting aberrant epigenetic modifications to restore MHC expression and 0 the effectiveness of immunotherapeutic interventions.

Conclusion
The integration of epigenetic-targeted therapies with immunotherapies holds great potential for improving clinical outcomes in patients with gastrointestinal malignancies and represents a compelling avenue for future research and therapeutic development.
Impact of sex and socioeconomic status on the likelihood of surgery, hospitalization, and use of medications in inflammatory bowel disease: a systematic review and meta-analysis
Authors: Rasmussen Nathalie Fogh , Moos Caroline , Gregersen Laura Helene Keiding , Hikmat Zainab , Andersen Vibeke , Green Anders , Jess Tine , Madsen Gunvor Iben , Pedersen Andreas Kristian , Petersen Sofie Ronja , Kjeldsen Lene Juel 
Published: June 2024

Abstract
Background
Inflammatory bowel diseases (IBDs) are associated with high healthcare utilization. This systematic review aimed to summarize what is known about the impact of sex, income, and education on the likelihood of bowel surgery, hospitalization, and use of corticosteroids and biologics among patients with IBD.

Methods
We used EMBASE, MEDLINE, CINAHL, and Web of Science to perform a systematic literature search. Pooled hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random effects meta-analysis for the impact of sex on the likelihood of surgery and hospitalization. In addition, we performed subgroup analyses of the effect of IBD type (Crohn’s disease or ulcerative colitis) and age. Finally, meta-regression was undertaken for the year of publication.

Results
In total, 67 studies were included, of which 23 studies were eligible for meta-analysis. In the main meta-analysis, male sex was associated with an increased likelihood of bowel surgery (HR 1.42 (95% CI 1.13;1.78), which was consistent with the subgroup analysis for UC only (HR 1.78, 95% CI 1.16; 2.72). Sex did not impact the likelihood of hospitalization (OR 1.05 (95% CI 0.86;1.30), although the subgroup analysis revealed an increased likelihood of hospitalization in CD patients (OR 1.42, 95% CI 1.28;1.58). In 9 of 10 studies, no significant sex-based differences in the use of biologics were reported, although in 6 of 6 studies, female patients had lower adherence to biologics. In 11 of 13 studies, no significant sex-based difference in the use of corticosteroids was reported. The evidence of the impact of income and education on healthcare utilization was sparse and pointed in different directions. The substantial heterogeneity between studies was explained, in part, by differences in IBD type and age.

Conclusions
The results of this systematic review indicate that male patients with IBD are significantly more likely to have surgery than female patients with IBD but are not, overall, more likely to be hospitalized, whereas female patients appear to have statistically significantly lower adherence to biologics compared to male patients. Thus, clinicians should not underestimate the impact of sex on healthcare utilization. Evidence for income- and education-based differences remains sparse.

Systematic review registration
PROSPERO CRD42022315788.
Non-invasive brain stimulation for treatment-resistant schizophrenia: protocol of a systematic review and network meta-analysis
Authors: Siafis Spyridon , Lorenz Carolin , Wu Hui , Zhu Yikang , Schneider-Thoma Johannes , Bighelli Irene , Li Chunbo , Hansen Wulf-Peter , Padberg Frank , Salanti Georgia , Leucht Stefan 
Published: June 2024

Abstract
Background
Non-invasive brain stimulation (NIBS) is a promising intervention for treatment-resistant schizophrenia. However, there are multiple available techniques and a comprehensive synthesis of evidence is lacking. Thus, we will conduct a systematic review and network meta-analysis to investigate the comparative efficacy and safety of NIBS techniques as an add-on to antipsychotics for treatment-resistant schizophrenia.

Methods
We will include single- and double-blind randomized-controlled trials (RCT) comparing any NIBS technique with each other or with a control intervention as an add-on to antipsychotics in adult patients with treatment-resistant schizophrenia. We will exclude studies focusing on predominant negative symptoms, maintenance treatment, and single sessions. The primary outcome will be a change in overall symptoms, and secondary outcomes will be a change in symptom domains, cognitive performance, quality of life, functioning, response, dropouts, and side effects. We will search for eligible studies in previous reviews, multiple electronic databases and clinical trial registries from inception onwards. At least two independent reviewers will perform the study selection, data extraction, and risk of bias assessment. We will measure the treatment differences using standardized mean difference (SMD) and odds ratio (OR) for continuous and dichotomous outcomes, respectively. We will conduct pairwise and network meta-analysis within a frequentist framework using a random-effects model, except for rare event outcomes where we will use a fixed-effects Mantel–Haenszel method. We will investigate potential sources of heterogeneity in subgroup analyses. Reporting bias will be assessed with funnel plots and the Risk of Bias due to Missing Evidence in Network meta-analysis (ROB-MEN) tool. The certainty in the evidence will be evaluated using the Confidence in Network Meta-analysis (CINeMA) approach.

Discussion
Our network meta-analysis would provide an up-to-date synthesis of the evidence from all available RCTs on the comparative efficacy and safety of NIBS for treatment-resistant schizophrenia. This information could guide evidence-based clinical practice and improve the outcomes of patients.

Systematic review registration
PROSPERO-ID CRD42023410645.
Body image and social appearance anxiety in patients with cancer undergoing radiotherapy: a cross-sectional study
Authors: Arıkan Fatma , Kartöz Funda , Karakuş Zeynep , Altınışık Müge , Özer Zeynep , Korcum Şahin Aylin Fidan 
Published: June 2024

Abstract
Background
The body image of patients with cancer can be negatively affected due to treatment toxicities. Changes in body image may cause patients to experience social appearance anxiety. This study aimed to evaluate the body image and social appearance anxiety of patients with cancer undergoing radiotherapy.

Methods
The cross-sectional study was conducted with 153 patients with cancer undergoing radiotherapy in a university hospital. The data were collected with a Patient Information Form, the Body Image Scale, and the Social Appearance Anxiety Scale and the Radiation Therapy Oncology Group Skin Toxicity Criteria.

Results
Patients’ mean body image score was 15.18 ± 8.26 (min = 0, max = 30), mean social appearance anxiety score was 45.29 ± 14.50 (min = 16, max = 80). Patients with low education levels and low-income levels had higher body image and social appearance anxiety scores (p < 0.01). Body image and social appearance anxiety scores were found to be higher in patients with advanced cancer, grade III-IV skin toxicity, pain, fatigue, and constipation (p < 0.05).

Conclusions
Radiotherapy may negatively affect body image and social appearance anxiety. Assessments of body image and social appearance anxiety regularly before, during, and after treatment are essential. Psychosocial support should be provided to patients to reduce body image and social appearance anxiety and increase their well-being. Patients with cancer especially those who have low income and education levels, advanced cancer stage and skin toxicity, and suffer from pain, fatigue, constipation, etc. should be supported by methods such as counseling and social support groups.
Artistic heritage conservation: the relevance and cultural value of Guangzhou clan building paintings to traditional rituals from a kinship perspective through perceptual assessment and data mining
Authors: Li Weicong , Ma Shangbing , Shi Wenwen , Lin Haopai , Liu Yueling , Cui Yitong , Ao Jinghui 
Published: June 2024

Abstract
The study of clan paintings reveals a shift in perspective from art aesthetics to cultural connotations to cultural identity, yet literature seldom discusses the relationship between art and kinship culture. Taking the murals of ancestral hall architecture in Guangzhou as an example, this paper utilizes text mining to identify factors influencing its decorative art. It reveals the traditional rites' artistic expression through dimensions of characters' demeanor and the transmission of content values, offering a fresh perspective for heritage value research. Findings: (1) themes and implications are mostly oriented towards positive value transmission, transitioning from idealistic layman life to the realism of lower-class existence, emphasizing humanization; (2) the extroverted portrayal of characters contrasts with the dignified, restrained etiquette of traditional rites, with some characters' portrayal and facial expressions exuding approachability; (3) murals conveying positive emotions are mostly related to longevity, auspiciousness, fortune, and heroic deeds, while those conveying negative emotions mainly involve elderly male figures, reflecting a content bias related to characters; (4) historical allusion murals with complex content reduce the emotional resonance and arousal efficiency of the viewer; (5) incomplete mural content increases negative emotions in perceivers, highlighting the impact of mural preservation on emotional resonance. To delve into the formation of clan painting art, it is essential not only to interpret the diversity of its patterns but also to demonstrate the representation of its social attributes in decorative art. The formation of clan painting decorative art exhibits kinship cultural attributes, epitomizing the essence of traditional ceremonial thought.