bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating residual tumor after neoadjuvant chemotherapy for muscle-invasive urothelial bladder cancer: diagnostic performance and outcomes using biparametric vs. multiparametric MRI
Authors: Woo Sungmin , Becker Anton S. , Das Jeeban P. , Ghafoor Soleen , Arita Yuki , Benfante Nicole , Gangai Natalie , Teo Min Yuen , Goh Alvin C. , Vargas Hebert A. 
Published: November 2023

Abstract
Background
Neoadjuvant chemotherapy (NAC) before radical cystectomy is standard of care in patients with muscle-invasive bladder cancer (MIBC). Response assessment after NAC is important but suboptimal using CT. We assessed MRI without vs. with intravenous contrast (biparametric [BP] vs. multiparametric [MP]) for identifying residual disease on cystectomy and explored its prognostic role.

Methods
Consecutive MIBC patients that underwent NAC, MRI, and cystectomy between January 2000–November 2022 were identified. Two radiologists reviewed BP-MRI (T2 + DWI) and MP-MRI (T2 + DWI + DCE) for residual tumor. Diagnostic performances were compared using receiver operating characteristic curve analysis. Kaplan-Meier curves and Cox proportional-hazards models were used to evaluate association with disease-free survival (DFS).

Results
61 patients (36 men and 25 women; median age 65 years, interquartile range 59–72) were included. After NAC, no residual disease was detected on pathology in 19 (31.1%) patients. BP-MRI was more accurate than MP-MRI for detecting residual disease after NAC: area under the curve = 0.75 (95% confidence interval (CI), 0.62–0.85) vs. 0.58 (95% CI, 0.45–0.70; p = 0.043). Sensitivity were identical (65.1%; 95% CI, 49.1–79.0) but specificity was higher in BP-MRI compared with MP-MRI for determining residual disease: 77.8% (95% CI, 52.4–93.6) vs. 38.9% (95% CI, 17.3–64.3), respectively. Positive BP-MRI and residual disease on pathology were both associated with worse DFS: hazard ratio (HR) = 4.01 (95% CI, 1.70–9.46; p = 0.002) and HR = 5.13 (95% CI, 2.66–17.13; p = 0.008), respectively. Concordance between MRI and pathology results was significantly associated with DFS. Concordant positive (MRI+/pathology+) patients showed worse DFS than concordant negative (MRI-/pathology-) patients (HR = 8.75, 95% CI, 2.02–37.82; p = 0.004) and compared to the discordant group (MRI+/pathology- or MRI-/pathology+) with HR = 3.48 (95% CI, 1.39–8.71; p = 0.014).

Conclusion
BP-MRI was more accurate than MP-MRI for identifying residual disease after NAC. A negative BP-MRI was associated with better outcomes, providing complementary information to pathological assessment of cystectomy specimens.
Nitrogen allocation in PM2.5 smoke-exposed plants: implications for ecosystem nitrogen cycling and stress response
Authors: Lin Haichuan , Ma Yuanfan , Zhao Pingxin , Huang Ziyan , Zhan Xiaoyu , Tigabu Mulualem , Guo Futao 
Published: November 2023

Abstract
Background
With the increase in forest fire emissions, an increasing amount of nitrogen is released from combustibles and taken up by plant leaves in the form of PM2.5 smoke deposition. Concurrently, the stress from PM2.5 also disrupts the physiological processes of plants. This study aims to reveal the migration paths of N in combustibles in smoke and plants during forest fires and the stress response of plant leaves to smoke particle deposition. This study conducted a simulated smoke deposition treatment on Schima superba and Cunninghamia lanceolata, analyzing the changes in plant 15N content and stress-related products.

Results
The main findings include the following: (1) Nitrogen in combustibles can be transported to plant leaves via PM2.5 smoke during combustion and can be allocated and assimilated in various parts of the plant after being absorbed by the leaves. (2) The stress response of Schima superba to PM2.5 is less pronounced than that of Cunninghamia lanceolata. (3) Under PM2.5 stress, the correlation between nitrogen accumulation in the leaves of Schima superba and Cunninghamia lanceolata and their respective stress responses differs.

Conclusions
In forest fires involving different tree species, there are variations in the migration pathways of nitrogen and the stress effects of PM2.5 on leaves, with a significant correlation observed between leaf nitrogen accumulation and stress response.

Graphical Abstract
Downregulation of RNA binding protein 47 predicts low survival in patients and promotes the development of renal cell malignancies through RNA stability modification
Authors: Wang Cheng , Li Weiquan , Meng Xiangui , Yuan Hongwei , Yu Tiexi , Yang Wei , Ni Dong , Liu Lei , Xiao Wen 
Published: November 2023

AbstractRNA binding proteins (RBPs) are crucial for cell function, tissue growth, and disease development in disease or normal physiological processes. RNA binding motif protein 47 (RBM47) has been proven to have anti-tumor effects on many cancers, but its effect is not yet clear in renal cancer. Here, we demonstrated the expression and the prognostic role of RBM47 in public databases and clinical samples of clear cell renal carcinoma (ccRCC) with bioinformatics analysis. The possible mechanism of RBM47 in renal cancer was verified by gene function prediction and in vitro experiments. The results showed that RBM47 was downregulated in renal cancers when compared with control groups. Low RBM47 expression indicated poor prognosis in ccRCC. RBM47 expression in renal cancer cell lines was reduced significantly when compared to normal renal tubular epithelial cells. Epithelial-mesenchymal transition (EMT) and transforming growth factor-β signaling pathway was associated with RBM47 in ccRCC by Gene set enrichment analysis. RBM47 expression had a positive correlation with e-cadherin, but a negative correlation with snail and vimentin. RBM47 overexpression could repress the migration, invasion activity, and proliferation capacity of renal cancer cells, while RBM47 inhibition could promote the development of the malignant features through EMT signaling by RNA stability modification. Therefore, our results suggest that RBM47, as a new molecular biomarker, may play a key role in the cancer development of ccRCC.
Building an enhanced case-based reasoning and rule-based systems for medical diagnosis
Authors: Mustafa Eslam M. , Saad Mahmoud M. , Rizkallah Lydia Wahid 
Published: November 2023

AbstractExpert systems are computer programs that use knowledge and reasoning to solve problems typically solved by human experts. Expert systems have been used in medicine to diagnose diseases, recommend treatments, and plan surgeries. Interpretability of the results in medical applications is crucial since the decision that will be taken based on the system’s output has a direct effect on people’s health and lives which makes expert systems ideal choices when dealing with these applications in contrast to other machine learning approaches. An expert system has the ability to explain its own line of reasoning providing a robust way of diagnosis. This paper presents two types of expert systems for medical diagnosis. The first system is a case-based reasoning system using a database of previously diagnosed cases to diagnose a new case. The second system is a rule-based expert system that uses a set of if–then rules extracted from a decision tree classifier to make diagnoses. In this paper, machine learning-based similarity functions are proposed and compared with other traditional similarity functions. The results of this study suggest that expert systems can be a valuable tool for medical diagnosis. The two systems presented in this paper achieved competitive results, and they provide diagnoses similar to those made by human experts.
Responsiveness of Patient-Reported and Device-based Physical Activity Measures: Secondary Analysis of Four Randomised Trials
Authors: Baldwin Jennifer N. , He Jialan , Oliveira Juliana S. , Bates Amanda , Tiedemann Anne , Hassett Leanne , Sherrington Catherine , Pinheiro Marina B. 
Published: November 2023

ABSTRACT

Purpose
This study aimed to compare the responsiveness of patient-reported and device-based instruments within four physical activity trials.

Methods
This was a secondary analysis of four randomised trials that used both a patient-reported outcome measure (the Incidental and Planned Exercise Questionnaire, IPEQ) and a device-based instrument (ActiGraph or ActivPAL) to measure physical activity. The four trials included were (i) Activity and MObility UsiNg Technology (AMOUNT): digitally-enabled exercises in those undertaking aged care and neurological rehabilitation; (ii) Balance Exercise Strength Training (BEST) at Home: home-based balance and strength exercises in community-dwelling people aged ≥65 years; (iii) Coaching for Healthy AGEing (CHAnGE): physical activity coaching and fall prevention intervention in community-dwelling people aged ≥60 years; and (iv) Fitbit trial: fall prevention and physical activity promotion with health coaching and activity monitor in community-dwelling people aged ≥60 years. We estimated treatment effects for all variables within each physical activity instrument using regression analyses and expressed results as effect sizes (ES).

Results
Overall, device-based instruments were more responsive among healthy older adults (ES range: 0.01 to 0.32), whereas the IPEQ was more responsive among adults requiring rehabilitation (ES range: -0.06 to 0.35). Both the IPEQ and device-based instruments were more responsive in trials that promoted walking via coaching participants to increase their daily steps (AMOUNT [ES range: -0.06 to 0.35], CHAnGE [ES range: -0.24 to 0.22] and Fitbit trial [ES range: -0.23 to 0.32]). Individual variables within the IPEQ and device-based instruments varied in their responsiveness (ES range: -0.13 to 0.20).

Conclusions
Both the IPEQ and device-based instruments are able to detect small changes in physical activity levels. However, responsiveness varies across different interventions and populations. Our findings provide guidance for researchers and clinicians in selecting an appropriate instrument to measure changes in physical activity.
Complete blood count, lipid profiles, and inflammatory markers associated with atherosclerotic cardiovascular disease in patients with diabetes
Authors: Amalia Muttia , Saputri Fadlina Chany , Sauriasari Rani , Widyantoro Bambang 
Published: November 2023

Background: Complete blood count (CBC) and inflammatory markers derived from hematology parameters, as well as lipid profiles, have emerged as novel biomarkers that aid in predicting the progression of atherosclerotic cardiovascular disease (ASCVD) in people with diabetes. This study aimed to evaluate the alterations in CBC, lipid profiles, and inflammatory markers derived from CBC in Type 2 diabetes mellitus (T2DM)-associated ASCVD and the associations between glycated hemoglobin and hematology, lipid profiles, and inflammatory markers. Methods: Overall, 75 patients with T2DM ASCVD from the National Cardiovascular Center Harapan Kita were investigated. Patients with diabetes were classified into high-risk (HR), very high-risk (VHR), and acute coronary syndrome (ACS) groups. VHR-ASCVD was defined as having ≥2 major ASCVD events, or one major ASCVD event and ≥2 high-risk conditions. HR-ASCVD were patients with >3 major risk factors, diabetes, chronic kidney disease stage 3B or 4, and a very high LDL-C level. ECG and cardiac biomarker tests ensured an ACS diagnosis. CBC, lipid profiles, and IL-6 were estimated in all groups. Results: Patients with T2DM ACS demonstrated significantly different levels of red blood cell distribution width (RDW), leucocytes, basophils, eosinophils, lymphocytes, monocytes, segmented neutrophils, absolute lymphocytes, absolute monocytes, neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), total cholesterol, LDL, HDL/total cholesterol ratio, hemoglobin A1c (HbA1c), and IL-6. HbA1c was significantly correlated with leucocytes (p<0.05), segmented neutrophils (p<0.001), NLR (p<0.05), PLR (p<0,05), total cholesterol (p<0.05), LDL (p<0.05), total cholesterol/ HDL ratio (p<0.05), and IL-6 (p<0.001), eosinophils (p<0.05), lymphocytes (p<0.05), monocytes (p<0.05), and absolute lymphocytes (p<0.05). Logistic regression analysis showed that monocytes, MLR, leucocytes, eosinophils, and absolute monocytes were found to be valuable predictors for T2DM ACS (p<0.05). Conclusions: CBC, inflammatory biomarkers derived from CBC, and lipid ratios were inexpensive parameters that could serve as inflammatory biomarkers of increased risks and complications in T2DM ASCVD.
Spatial mobility as a carrier of cultural capital: an analysis based on a longitudinal study of generations
Authors: Szafraniec Krystyna 
Published: November 2023

AbstractFor many years international migrations have been the primary focus of spatial mobility research, whereas internal migrations – occurring within one state – have aroused significantly less interest. However, the latter are not only an important complement to the former, but they also seem to have a much greater impact on the domestic affairs of the state. For example, internal migrations engage the resources (intellectual, cultural, social) of much wider cohorts of people who therefore become, with varying degrees of significance, agents of social changes. This article presents an analysis of the spatial mobility of two generations monitored during a 45-year-long longitudinal research project. Its broad time perspective makes it possible to analyse not only the net changes with regard to the place of residence, a typical focus of migration studies, but also gross changes (migration flows). The aim of this article is to determine the scale and the social embeddedness of the migration flows in both generations.It is assumed that, due to differences in generational biographies and resources, as well as changes in the quality of life in rural areas compared to urban areas, migrations in both generations, even though occurring at the same stages of life, are different. As a result, the resources contributed by migrants to their new places of residence also carry a different quality.
Disrupted Market Relations in Agriculture in North Macedonia: the COVID-19 Crisis
Authors: Stojcheska Aleksandra Martinovska , Nacka Marina , Tuna Emelj 
Published: November 2023

Abstract
The COVID-19 crisis has stressed the importance of, and need for, a stable and functional food system, able to provide consumers with a continuous supply of quality food at affordable prices. The pandemic has also highlighted the role of agricultural producers in the food supply chain, with small farmers being the most vulnerable category. This global crisis has actually deepened the problems faced by farmers, especially those on the verge of sustainability. The purpose of this analysis was to provide an overview of the disrupted links in agriculture, as a result of the initial COVID-19 crisis. A survey was carried out with 91 farmers in North Macedonia. Moreover, in-depth interviews were conducted with selected traders and processors. In general, farmers assessed that the crisis negatively affected their economic operations. The critical parts of the supply chain derive from the disrupted link between farmers and traders/processors, lack of field technical support resulting from the mobility restrictions, uncertainty in cooperation, lower production quantities, and varying quality of the agricultural products. Availability and cost of seasonal workforce was also pronounced as an issue. The dominant family farms small-scale structure and lack of aggregation in the sector challenged the resilience and effective response to the crisis. From buyers’ and processors’ perspective, the crisis effect was marked through the disrupted communication with farmers, low awareness of the need for change, and drastic decline in the HORECA channel sales. The agricultural and rural policy is designed to address measures adjusted to the needs of the key actors in the sector. The priority set of measures should support the food supply chain, enhancing farmers’ networking and aggregation, and on-farm and off-farm diversification, along with improved communication, information systems and digitalisation. Improving productivity and competitiveness remains an effective strategy for sustainable operations, greater resilience and risk adaptation in crises such as the pandemic.
Techniques for the restorative management of localized and generalized tooth wear
Authors: Milosevic Alex 
Published: November 2023

This narrative review describes techniques and materials available to restore the worn dentition. Emphasis is given to application of composite resin as this material can be bonded to worn surfaces and is easily adjusted either within an existing or at an increased vertical dimension. The relevance of the differences in the composition of glass ceramics and polycrystalline ceramics for restoration in various wear scenarios are discussed. Removable dentures are still appropriate in certain circumstances, but require an understanding of their limitations. CPD/Clinical Relevance: Young and old patients with a range of aetiologies and presentations expect dentists to know how best to restore their disordered, worn dentition.
Tooth wear in children: prevalence, presentation and prevention
Authors: O'Sullivan Elizabeth 
Published: November 2023

Tooth wear in children is a multifactorial process that can be due to either physiological or pathological processes. The most frequent type of tooth wear in children is erosion, and its contribution to overall tooth wear is explained. The prevalence, aetiology, presentation and management of tooth wear, especially erosion, are discussed in this article, with practical clinical advice for the treating clinician and families. The challenges to giving practical preventive advice, and the complexities involved in overcoming dietary and lifestyle changes in an environment of powerful advertising, peer pressure and social media influencers are discussed in detail.CPD/Clinical Relevance: Erosive tooth wear is common in children, so understanding the aetiology and giving families practical and relevant preventive advice is important.
Factors associated with use of community-based, peer-led sexual and reproductive health services by adolescent boys and young men aged 18–24 in Lusaka, Zambia: A case control study nested in the Yathu Yathu trial
Authors: Phiri Mwelwa M. , Hensen Bernadette , Sigande Lucheka M. , Floyd Sian , Schaap Albertus J. , Simuyaba Melvin , Mwenge Lawrence , Zulu-Phiri Rosemary , Mwape Louis , Fidler Sarah , Simwinga Musonda , Hayes Richard , Ayles Helen M. 
Published: November 2023

Introduction
Adolescents and young people (AYP) aged 15–24 years have the least access to facility-based sexual and reproductive health (SRH) services, including HIV services. The Yathu-Yathu cluster-randomized trial (CRT) in Zambia tested whether a novel peer-led community-based approach increased knowledge of HIV status amongst AYP. In this nested case-control study, we aimed to identify factors associated with non-attendance to the Yathu Yathu hubs by adolescent boys and young men (ABYM) aged 18-24-years.

Methods
Yathu Yathu was a CRT conducted in two communities in Lusaka, Zambia, with 10 intervention and 10 control zones. AYP in all zones were offered prevention points cards (PPC), which incentivized and tracked service use at the hubs and health facility. In intervention zones, services were provided to AYP through community-based spaces (hubs) led by peer support workers. In these zones, cases were defined as those not having accessed any service at a hub and controls as those that accessed at least one service. Data were collected from October 2020 to January 2021 and analysed using methods appropriate for unmatched case-control studies.

Results
161 cases and 160 controls consented to participate in the study. Participants aged 20–24 years (adjOR 1.99, 95%CI 1.26–3.12, p = 0.003), who were educated up to college level (adjOR 8.47,95%CI 2.08–34.53, p = 0.001) or who reported being employed in the last 12 months (adjOR 2.15, 95%CI 1.31–3.53, p = 0.002) were more likely to not attend the hubs. ABYM who had a friend with a PPC were more likely to attend the hubs (adjOR 0.18 95%CI 0.09–0.35, p<0.001). Most cases reported having their last HIV test at the local government health facility (58%) while most controls reported HIV-testing at a Yathu Yathu hub (82%). Among the controls, 84% (134/160) rated the hub experience as excellent. Among cases, 65% (104/161) stated they didn’t visit the hubs “due to employment”.

Conclusions
Despite Yathu Yathu services being community-based and more accessible compared to health facilities, we found age, education and employment were associated with not attending hubs. Strategies are needed to reach employed young men who may not have access to SRH/HIV services during conventional working hours and to better utilise peer networks to increase service use.
Descriptive regression tree analysis of intersecting predictors of adult self-rated health: Does gender matter? A cross-sectional study of Canadian adults
Authors: Vafaei Afshin , Stewart Jocelyn M. , Phillips Susan P. 
Published: November 2023

Background
While self-rated health (SRH) is a well-validated indicator, its alignment with objective health is inconsistent, particularly among women and older adults. This may reflect group-based differences in characteristics considered when rating health. Using a combination of SRH and satisfaction with health (SH) could capture lived realities for all, thus enabling a more accurate search for predictors of subjective health. With the combined measure of SRH and SH as the outcome we explore a range of characteristics that predict high SRH/SH compared with predictors of a low rating for either SRH or SH.

Methods
Data were from the Canadian General Social Survey 2016 which includes participants 15 years of age and older. We performed classification and regression tree (CRT) analyses to identify the best combination of socioeconomic, behavioural, and mental health predictors of good SRH and health satisfaction.

Results
Almost 85% of the population rated their health as good; however, 19% of those had low SH. Conversely, about 20% of those reporting poor SRH were, none-the-less, satisfied. CRT identified healthy eating, absence of a psychological disability, no work disability from long-term illness, and high resilience as the main predictors of good SRH/SH. Living with a spouse or children, higher social class and healthy behaviours also aligned with high scores in both self-perceived health measures. Sex was not a predictor.

Conclusions
Combining SRH and SH eliminated sex as a predictor of subjective health, and identified characteristics, particularly resilience, that align with high health and well-being and that are malleable.