bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of a machine learning model to predict the risk of lymph node metastasis in early-stage supraglottic laryngeal cancer
Authors: Wang Hongyu , He Zhiqiang , Xu Jiayang , Chen Ting , Huang Jingtian , Chen Lihong , Yue Xin 
Published: January 2025

BackgroundCervical lymph node metastasis (LNM) is a significant factor that leads to a poor prognosis in laryngeal cancer. Early-stage supraglottic laryngeal cancer (SGLC) is prone to LNM. However, research on risk factors for predicting cervical LNM in early-stage SGLC is limited. This study seeks to create and validate a predictive model through the application of machine learning (ML) algorithms.MethodsThe training set and internal validation set data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Data from 78 early-stage SGLC patients were collected from Fujian Provincial Hospital for independent external validation. We identified four variables associated with cervical LNM and developed six ML models based on these variables to predict LNM in early-stage SGLC patients.ResultsIn the two cohorts, 167 (47.44%) and 26 (33.33%) patients experienced LNM, respectively. Age, T stage, grade, and tumor size were identified as independent predictors of LNM. All six ML models performed well, and in both internal and independent external validations, the eXtreme Gradient Boosting (XGB) model outperformed the other models, with AUC values of 0.87 and 0.80, respectively. The decision curve analysis demonstrated that the ML models have excellent clinical applicability.ConclusionsOur study indicates that combining ML algorithms with clinical data can effectively predict LNM in patients diagnosed with early-stage SGLC. This is the first study to apply ML models in predicting LNM in early-stage SGLC patients.
Population dynamics analysis of the interaction between tacrolimus and voriconazole in renal transplant recipients
Authors: Sun Zhi-Hua , Zhao Yi-Chang , Li Jia-Kai , Peng Fenghua , Yu Feng , Zhang Bi-Kui , Yan Miao 
Published: January 2025

BackgroundThe concurrent administration of tacrolimus and voriconazole in kidney transplant recipients can lead to drug interactions, potentially resulting in severe adverse reactions. This study aimed to establish a robust population pharmacokinetic model to explore the interaction between tacrolimus and voriconazole in greater depth.MethodsTacrolimus blood samples and laboratory data were prospectively collected from eligible patients enrolled between April 2023 and April 2024, following predefined inclusion and exclusion criteria. Using Phoenix (version 8.1), a pharmacokinetic prediction model was developed. Model performance was assessed using model fitting plots, bootstrap analysis, and visual predictive checks (VPC).ResultsThis study ultimately included 51 eligible patients, with a total of 281 blood samples collected. Analysis revealed a significant negative correlation between voriconazole concentration (Cvrc) and tacrolimus volume of clearance rate (CL), a significant positive correlation between platelets (PLT) and tacrolimus clearance (CL), and a significant negative correlation between blood cells (RBC) and tacrolimus clearance (CL).ConclusionThis study successfully established a population pharmacokinetic model for renal transplant patients concurrently receiving tacrolimus and voriconazole. The model demonstrated good predictive performance and offers valuable insights to clinicians for optimizing tacrolimus dosing in this patient population.
Exploring the association between herbal medicine usage and drug-induced liver injury: insights from a nationwide population-based cohort study using SCCS in South Korea
Authors: Yang Taehyun , Ahn Juhee , Won Sungho , Lee Sanghun 
Published: January 2025

IntroductionDrug-induced liver injury (DILI) is a significant health concern caused by exposure to pharmaceuticals, over-the-counter medications, herbal remedies, and dietary supplements. The contribution of prescribed herbal medicines to DILI risk remains unclear. This study aimed to evaluate the hepatotoxicity risk associated with traditional Korean medicines (TKMs) using nationwide health insurance claims data.MethodsA tailored cohort of patients diagnosed with DILI (ICD-10 code: K71) between January 2011 and December 2019 was obtained from the Health Insurance Review and Assessment Service. After applying inclusion and exclusion criteria, 672,411 patients were identified. Using a self-controlled case study (SCCS) design, exposures were defined as hospital/clinic visits or medication prescriptions within a 90-day window. Analyses were conducted across three groups: outpatients, inpatients, and patients with liver disease. Relative incidences of DILI were calculated for different exposure scenarios.ResultsOutpatients showed the highest relative incidences of DILI 3–15 days after visiting Western hospitals/clinics or being prescribed commercial drugs, with risk estimates of 1.55 (95% confidence interval [CI]: 1.55–1.56) and 2.44 (95% CI: 2.43–2.44), respectively. These risks gradually declined to baseline levels (1.0). All other groups exhibited similar patterns. In contrast, DILI risks associated with TKM hospital/clinic visits and herbal medicine prescriptions were minimal, with relative risks of 1.01 (95% CI: 1.00–1.01) and 0.99 (95% CI: 0.99–0.99), respectively. However, a mildly elevated risk was observed in patients with liver disease.ConclusionThis nationwide cohort study demonstrates that herbal medicines prescribed by TKM practitioners have minimal impact on DILI risk. Patients with pre-existing liver disease exhibit increased susceptibility to DILI. Differentiating between unregulated herbal products and those prescribed in medical institutions is essential for accurate assessment of hepatotoxicity risk.
Hemoglobin-to-red blood cell distribution width ratio as a protective factor against coronary artery disease: a cross-sectional analysis of NHANES (2011-2018)
Authors: Wang Xin-Da , Li Chaoya , Hu Jia , Cao Fen , Zhu Li , Zhu Yongzhi , Wen Zhongzheng , Liu Jun 
Published: January 2025

BackgroundCoronary artery disease (CAD) is the leading cause of death worldwide, and inflammation is a significant factor in its development. While the hemoglobin-to-red blood cell distribution width ratio (HRR), an indicator of inflammation, has been linked to various diseases, its association with CAD is not well established.MethodsWe conducted an analysis using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2011 to 2018. After excluding participants due to age, missing data, and potential confounding factors, 6,881 individuals were included in our study. CAD was identified through self-reported questionnaires, and HRR was determined from laboratory measurements. We controlled for factors such as hypertension, waist circumference, systolic blood pressure, fasting plasma glucose, and others in our logistic regression analysis to explore the relationship between HRR and CAD.ResultsWe found that higher HRR levels were associated with a lower risk of CAD. In our fully adjusted model, the odds ratios for CAD for the second, third, and fourth quartiles of HRR were 0.38, 0.42, and 0.51, respectively, compared to the first quartile (P &lt; 0.001). An increase in HRR by one unit was associated with a 49% decrease in the likelihood of CAD. Furthermore, linear regression models indicated a 74% reduction in CAD risk for each one-unit increase in HRR (P = 0.0002). There was a notable threshold at HRR 1.02; beyond this point, each unit increase in HRR was associated with a 91% decrease in CAD odds. This suggests that for individuals with an HRR above 1.02, strategies to increase body water content and reduce blood viscosity could potentially lower their risk of developing CAD.ConclusionOur study revealed an inverse linear relationship between HRR and CAD risk, indicating that HRR may serve as a protective factor against CAD.
Activation of KATP channels in pain modulation: a systematic review of preclinical studies
Authors: Beich Signe Schønning , Kokoti Lili , Al-Karagholi Mohammad Al-Mahdi 
Published: January 2025

ObjectiveTo systematically review the involvement of KATP channel activation in pain modulation in preclinical studies.BackgroundKATP channels are expressed at several levels in the spinal and trigeminal pain pathways, where they seem to modulate nociceptive transmission.MethodsPubMed and Embase databases were searched until 29 January 2024, using the following search string: [(pain) OR (nociception) OR (antinociception) AND (KATP channel) OR (ATP sensitive potassium channel)]. Non-English and unavailable records, as well as records with non-experimental methodology, were excluded. Inclusion criteria were preclinical studies measuring pain in vivo upon activation of the KATP channel by administering a stimulator or positive modulator. Records were screened based on title and abstract, and those that met the study inclusion criteria were reviewed based on study design, measurements, intervention, and outcomes.ResultsThe search resulted in 569 records. In total, 126 duplicates were detected. Subsequently, 438 records were screened by title and abstract, resulting in the exclusion of 396. Based on inclusion criteria, 42 studies were included. The main findings of the present systematic review were that KATP channel openers can attenuate induced pain in various animal models and potentiate the effects of analgesics.ConclusionLocal, systemic, spinal, and supraspinal activation of KATP channels can attenuate pain and potentiate the efficacy of analgesic drugs. One exception was levcromakalim, as the systemic levcromakalim administration, but not a local application, induced pain. This finding is consistent with those of recent human trials. Future studies should investigate the differences in KATP channel activation between rodents and humans, as well as the differences in activation sites between levcromakalim and other KATP channel openers.
Dispositional mindfulness profiles and psychological symptoms: a latent profile analysis
Authors: Mehrabi Fereshteh , Beshai Shadi 
Published: January 2025

ObjectivesIn this study, we aimed to (1) examine profiles of mindfulness using the short form of the FFMQ (FFMQ-SF), (2) identify the demographic predictor (i.e., sex) of mindfulness profile membership, and (3) examine associations of mindfulness profiles with psychological outcomes (i.e., anxiety and depressive symptoms).MethodsThis cross-sectional study included 604 individuals recruited from Amazon’s Mechanical Turk platform (MTurk). We performed latent profile analyses (LPA) to explore the individual profiles based on scores on dispositional mindfulness facets. Dispositional mindfulness was measured using the Five-Facet Mindfulness Questionnaire-Short Form (FFMQ-SF). Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Anxiety symptoms were measured by the Generalized Anxiety Disorder Scale (GAD-7).ResultsWe identified three mindfulness profiles including, Judgmentally Describing, Low Mindfulness, and Non-Judgmentally Describing. Participants in the Low Mindfulness group were more likely to be women compared to the other two profiles (Judgmentally Describing and Non-Judgmentally Describing groups). Participants in the Low Mindfulness group had the highest levels of anxiety and depressive symptoms, whereas individuals in the Non-Judgementally Describing group had the lowest levels of depression and anxiety.ConclusionIn the present study, we demonstrated three profiles of the FFMQ-SF, which had differential relationships with anxiety and depressive symptoms. Consideration of such profiles may help clinicians to develop more fine-tuned mindfulness-based psychological interventions.
An expert perspective on diversity-oriented standards for assessing sex and gender in clinical research
Authors: Hambruch Hannah R. , Laskowski Nora M. , Juster Robert-Paul , Halbeisen Georg , Paslakis Georgios 
Published: January 2025

IntroductionRandomized controlled trials require diverse patient groups to ensure broad applicability of results. However, gender minorities are often not included, which affects the generalizability and equity of healthcare outcomes. Inclusive research must consider the diversity of sex and gender to eliminate inequalities and improve health outcomes.MethodsA two-stage expert survey was conducted using a self-developed questionnaire in which the constructs of sex, gender, and gender expression were considered. Experts rated the importance and practicality of assessing these concepts in clinical trials and evaluated terms for suitability and comprehension. In addition, existing definitions were refined. Consensus was defined as 70% agreement or disagreement.Results14 out of 17 participating experts agreed on the importance to independently assess sex assigned at birth, and 9 out of 16 emphasized this for gender identity in clinical trials. Sex should be assessed with “Please specify your sex assigned at birth” and the answer categories “female”, “male”, “intersex”. Gender identity should be assessed with “I identify as…” and the answer categories “woman”, “man”, “nonbinary”, “trans woman”, “trans man”, “genderqueer”, “genderfluid”, “agender”, “two spirit”. Assessment of gender expression depends on the research question and may not be relevant for every study.DiscussionOur findings emphasize inclusivity by providing multiple gender options and improve data accuracy by allowing individuals to accurately report their gender identity. The results emphasize the importance of distinguishing between sex assigned at birth, gender identity, and gender expression in research. This ensures that gender diversity is accurately represented and considered, improving the relevance and inclusivity of clinical trials.
Occupational risk factors for sleep quality among Serbian airline pilots
Authors: Stojanović Marko , Nesic Dejan , Maksimović Miloš , Terzić-Šupić Zorica , Todorović Jovana , Topalović Ivana , Vlaisavljević Željko , Ilić Živojinović Jelena 
Published: January 2025

IntroductionThe ability of airline pilots to maintain a good level of sleep goes a long way in ensuring operational effectiveness with regard to safety as well as personal health. The study assesses the risk factors for sleep quality of airline pilots in Serbia with the objective of determining those factors, both occupational and lifestyle that are paramount in assisting with sleep health.MethodsA cross-sectional study was conducted on a total of 66 Serbian commercial pilots, and the Pittsburgh Sleep Quality Index (PSQI) was used to assess their sleep quality. Demographic, occupational, lifestyle, biological and psychological variables were obtained through validated questionnaires. Multivariate logistic regression was used to determine the predictors of poor sleep quality (PSQI ≥5).ResultsOverall sleep quality was poor in 65.2% of the participants. Significant factors associated with poor sleep quality included years of experience (OR = 1.17, p = 0.007) and levels of stress (OR = 2.87, p = 0.004). Particular lifestyle variables, including factors such as coffee intake, had initial relationships with sleep quality but were not significant in the multivariate models. With regard to age, a significant univariate association was also revealed but was dropped in the final model because of collinearity with years of experience.ConclusionSerbian commercial pilots have a relatively high risk of inadequate sleep associated with years of experience and levels of stress. There is a need to implement organization-wide changes such as stress management schemes in order to improve sleep quality among pilots, and foster prioritizing well-being.
Factors enhancing implementation of occupational safety and health management systems in manufacturing industry of Mutare, Zimbabwe
Authors: Mandowa Johanes , Matsa Mark , Jerie Steven 
Published: January 2025

IntroductionSeveral studies elucidating a plethora of factors that influence establishment of OSH management systems in many industrial sectors have been conducted worldwide. Very few studies have been conducted to explicate factors influencing OSHMS implementation in Southern African countries, particularly in Zimbabwe. The study evaluated factors enhancing implementation of OSH management systems in the manufacturing industry of Mutare.MethodsA descriptive cross-sectional research design was utilized in the study. Primary data sources were questionnaires and interviews, and secondary data sources were e-OSH databases and past OSH research papers among others.ResultsThe results revealed the primary factors that enhance OSHMSs implementation as strong senior management commitment, involvement and support, strong employee involvement and participation, good safety culture, provision of adequate resources among others. Strong senior management commitment, involvement and support was identified as a catalyst of all other factors enhancing implementation of OSHMSs, hence a recommendation is made for employers to invest in programmes aimed at bolstering management commitment, involvement and support to OSH management.DiscussionConsidering that lack of adequate resources emerged as a significant impediment to OSHMS implementation, the study challenges the Government to take a leading role in establishing policies that unlocks various funding mechanisms to support workplaces in overcoming financial barriers in the implementation of OSHMSs. It can be inferred from the study results that employee involvement is central to effective implementation of OSHMSs as it enables the generation of knowledge, ideas and deployment of abilities that are paramount in enhancing OSH management. Inferential statistics also revealed the existence of an association between factory size and implementation of OSHMS. Development of scaled down OSHMSs requirements for small to medium manufacturing companies (SMMCs) is recommended considering the unattractiveness of OSHMSs in SMMCs owing to sustainability challenges. This recommendation places a demand on researchers and OSH stakeholders globally to rethink the current global order for OSHMSs implementation in order to advance an approach to OSHMSs implementation in the SMMCs that is sensitive to contextual compounding factors. The study develops a framework that is key in creating a “preventive safety culture” at workplaces which is an epitome for sustainability in OSHMSs implementation.
Multi-Center Outcome Analysis of 16 Face Transplantations – A Retrospective OPTN Study
Authors: Knoedler Leonard , Schaschinger Thomas , Niederegger Tobias , Hundeshagen Gabriel , Panayi Adriana C. , Cetrulo Curtis L. , Jeljeli Maxime , Hofmann Elena , Heiland Max , Koerdt Steffen , Lellouch Alexandre G. 
Published: January 2025

Facial Vascularized Composite Allotransplantation (fVCA) restores form and function for patients with severe facial disfigurements, yet multi-center outcome data remain scarce. We accessed the Organ Procurement and Transplantation Network (OPTN) database from 2008 to 2024 to identify all full- or partial-face fVCA recipients, excluding patients under 18 years and those with physiologically impossible BMIs. Of 25 identified patients, 16 (64%) met inclusion criteria (69% male; mean age 43 ± 14 years). Recipients experienced a median of 5 [IQR 0.0–10] acute rejection episodes, which correlated with inotrope use during donor procurement (p = 0.033). On average, patients were hospitalized 2.4 ± 1.8 times, with arginine vasopressin (AVP) administration linked to fewer hospitalizations (p = 0.035). Seven recipients (44%) experienced complications, and extended-criteria donor (ECD) status was associated with higher complication rates (p = 0.049). These findings underscore the promise of fVCA to address complex facial defects while identifying key risk factors—particularly inotrope use and ECD status, while AVP administration may mitigate hospital stays. Further studies with larger cohorts are warranted to refine perioperative strategies, improve outcomes, and expand the clinical utility of fVCA.
Aortic Stenosis Prevention: Is a New Cardiovascular Disease Paradigm Coming of Age?
Authors: Halapas Antonios , Cokkinos Dennis V. 
Published: January 2025

Calcific aortic stenosis (CAS) is currently recognized as the third most frequent cardiovascular disorder in persons aged above 60 years, after atherosclerotic disease and hypertension, and together with its precursor aortic sclerosis it has been found in more than 30% of elderly individuals. CAS is an active multifactorial process characterized by a progressive fibro-calcific remodeling and thickening of the AV leaflets caused by hemodynamic flow factors, genetic factors, lipoprotein deposition, oxidation, chronic inflammation, immunomodulators, and finally osteoblastic transformation of cardiac. Herein a comprehensive state-of-the-art paper is presented regarding the underlying pathophysiological mechanisms of CAS and the potential preventive strategies as an alternative to surgical and interventional treatment.
The Relevance of Trust in the Implementation of AI-Driven Clinical Decision Support Systems by Healthcare Professionals: An Extended UTAUT Model
Authors: Ratta Rajni , Sodhi J , Saxana Utkarsh 
Published: January 2025

Background. In the healthcare sector clinical decision support powered by artificial intelligence is rapidly expanding. It can help medical personnel make better-informed decisions while saving time. The opposition of healthcare professionals to AI initiatives in the healthcare industry might prove to be a significant barrier, due to the combination of optimism and fear related to the technology. Professionals in the sector may be apprehensive about AI due to job security worries and the general public's lack of faith in the technology. Objective. A primary objective of this study is to examine how trust influences healthcare professionals' willingness to use AI-driven CDSS, particularly at well-known tertiary hospitals in Delhi-NCR region India, as well as to expand the Unified theory of acceptance and use of technology (UTAUT) by including constructs such as perceived risk and self-efficacy. Method. The UTAUT model provided the basis for the construction of a new model, which was developed by integrating the variables of perceived risk and self-efficacy. The model had eight components which were assessed using 31 survey questions. Two hundred and twenty participants filled out the surveys for the study. Results. The findings indicate that there are significant relationships between (PE) and (AI), (EE) and(AI), (PR) and (AI) and (SE) and (AI). This study reveals that trust fully mediates the relationship between AI which means that fostering trust in AI technology is essential for the successful adoption and implementation of AI-CDSS technology. There was no significant relationship between social influence and adoption of AI-powered CDSS nor between intention to adopt and actual use. Conclusion. The result of this study shed light on the factors influencing healthcare professionals to adopt AI-CDSS. The outcomes of this study provide insight into how individuals' performance expectancy, effort expectancy, social influence, perceived risk, and self-efficacy determine whether they embrace AI-CDSS. This study highlights the importance of trust in the deployment of these technologies in the healthcare sector. Furthermore, it highlights the significance of addressing perceived risk and self-efficacy. Although social influence plays a crucial role in technology adoption its impact may be limited in the case of AI-CDSS deployment in India. This could be due to the complexities of AI-CDSS implementation, the requirement for training, or the fact that healthcare personnel are unaware of the benefits of AI-CDSS or have limited exposure to it.