bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of a nomogram for predicting overall survival in patients with sinonasal mucosal melanoma
Authors: Zhu Zhenzhen , Wang Weiqing , Zha Yang , Wang Xiaowei , Aodeng Surita , Wang Lei , Liu Yuzhuo , Lv Wei 
Published: February 2024

Abstract
Background
Sinonasal mucosal melanoma (SNMM) is a relatively rare malignant tumour with a poor prognosis. This study was designed to identify prognostic factors and establish a nomogram model to predict the overall survival (OS) of patients with SNMM.

Methods
A total of 459 patients with SNMM were selected from the Surveillance, Epidemiology, and End Results (SEER) database as the training cohort. Univariate and multivariate Cox regression analyses were used to screen for independent factors associated with patient prognosis and develop the nomogram model. In addition, external validation was performed to evaluate the effectiveness of the nomogram with a cohort of 34 patients with SNMM from Peking Union Medical College Hospital.

Results
The median OS in the cohort from the SEER database was 28 months. The 1-year, 3-year and 5-year OS rates were 69.8%, 40.4%, and 30.0%, respectively. Multivariate Cox regression analysis indicated that age, T stage, N stage, surgery and radiotherapy were independent variables associated with OS. The areas under the receiver operating characteristic curves (AUCs) of the nomograms for predicting 1-, 3- and 5-year OS were 0.78, 0.71 and 0.71, respectively, in the training cohort. In the validation cohort, the area under the curve (AUC) of the nomogram for predicting 1-, 3- and 5-year OS were 0.90, 0.75 and 0.78, respectively. Patients were classified into low- and high-risk groups based on the total score of the nomogram. Patients in the low-risk group had a significantly better survival prognosis than patients in the high-risk group in both the training cohort (P < 0.0001) and the validation cohort (P = 0.0016).

Conclusion
We established and validated a novel nomogram model to predict the OS of SNMM patients stratified by age, T stage, N stage, surgery and radiotherapy. This predictive tool is of potential importance in the realms of patient counselling and clinical decision-making.
Does interferential current provide additional benefit to orthopedic rehabilitation for the patients with proximal humeral fractures? A randomized controlled study
Authors: Duran Emine , Durmaz Berrin , Atamaz Funda Çalış , Kadı Mehmet Resul , Küçük Levent 
Published: February 2024

Abstract
Background
Approximately 80% of all proximal humeral fractures (PHFs) are non-displaced or minimally displaced fractures, which can be treated with conservative treatment. This study investigated the effect of interferential current (IFC) added to orthopedic rehabilitation on shoulder function, pain, and disability in patients with PHF.

Methods
This study was a prospective, double-blind, randomized, placebo-controlled conducted in physical medicine and rehabilitation outpatient clinic. Thirty-five patients were randomly separated into the IFC group (n = 18) and the sham group (n = 17). The orthopedic rehabilitation program was applied to all patients by the same physiotherapist three times a week for four weeks. Patients in the IFC group received the intervention for 20 minutes 3 times a week before the exercise. The same pads were performed for the sham group, but no electrical stimulation was applied. Constant-Murley score (CMS) for shoulder function, visual analog scale (VAS) activity pain, disabilities of the arm, shoulder, and hand (DASH) score, and paracetamol intake were recorded post-treatment, at 6 weeks and 18 weeks post-treatment.

Results
The demographic and fracture characteristics were not different between the groups. Significant differences were observed in the IFC and sham group in intragroup comparisons of total CMS, VAS activity pain, DASH score, and paracetamol intake over time (p < 0.001). Significant improvement over time was valid for all pairwise comparisons in both groups. However, no significant differences were detected between the IFC and sham group.

Conclusion
IFC added to orthopedic rehabilitation could not appear to be an electrotherapy modality that could potentially benefit shoulder function and disability in patients with PHF.
The transcultural adaptation and validation of the Chinese version of the Oral Health Literacy Scale for Diabetic Patients
Authors: Zhao Ying , Zhao Hang , Yu Hongyu 
Published: February 2024

Abstract
Background
Diabetic patients’ oral health concerns are a reality for every diabetic patient in China. The attitudes of diabetic patients toward early identification of oral literacy influence oral literacy in diabetes patients. Diabetes patients' oral health literacy is critical for providing focused education and therapies. However, no instrument exists to measure oral health literacy in Chinese diabetic patients. In this study, the English version of the oral health literacy among people living with diabetes (OHLD) scale was cross-culturally validated to provide a reliable tool for assessing the oral health literacy of diabetic patients in China.

Objective
The oral literacy among people living with diabetes (OHLD) scale was Chineseized and its reliability and validity tested, and the OHLD scale was revised to test the reliability and validity of the Chinese version of the OHLD scale and to provide a tool for assessing the oral health literacy of diabetic patients in China.

Methods
A modified version of the Brislin translation model was used, cross-cultural adaptation was performed through expert consultation and pre-survey, and expert opinion was used to assess content validity to form the Chinese version of the Oral Health Literacy Scale for Diabetic Patients, which was administered to 420 diabetic patients in two tertiary hospitals in Liaoning Province from March to August 2023. The reliability of the scale was tested. SPSS 25.0 and AMOS 23.0 were used to analyze the data.

Results
The Chinese version of the OHLD scale consisted of three dimensions and 10 entries. Structure of the validity analysis: three factors were extracted from the exploratory factors with a cumulative variance contribution of 79.794%; Content validity results:An item’s content validity index (I-CVI) was 0.857 to 1 at the entry level, and the content validity index of the scale (S-CVI) was 0.928 at the scale level. The results of the reliability analyses were: the Cronbach's alpha coefficient for the total scale was 0.908; the Cronbach's alpha coefficients for the factors and dimensions were 0.853 to 0.922; the split-half reliability was 0.827; and the test–retest reliability was 0.848. The results of the validation factor analysis showed that (χ2/df) was 1.430, the root mean square of the error of approximation (RMSEA) was 0.045, the comparative fit index (CFI) was 0.989, and the Tucker Lewis index (TLI) was 0.985, which showed that the model had an overall good fit.

Conclusion
The Chinese version of the OHLD scale has good reliability and validity and can be used as a valid tool for assessing diabetes mellitus patients in China.
Disparities in treatment modalities and survival among older patients with high-grade serous ovarian cancer
Authors: Cai Yan , Shu Tong , Zheng Hong 
Published: February 2024

Abstract
Background
Undertreatment of ovarian cancer is common among older women. We aimed to evaluate the treatment modalities offered to older patients and their impact on overall survival (OS).

Methods
The study identified 5,055 patients with high-grade serous ovarian cancer and 3584 patients with advanced stage (IIIC + IV) disease from the Surveillance, Epidemiology, and End Results (SEER) database from January 1, 2010, to December 31, 2017. We performed comparisons of OS and ovarian cancer-specific survival (OCSS) across age groups using a Cox proportional hazards model.

Results
Very elderly patients (≥ 75 years old) received treatment with significantly less surgical complexity, such as no lymphadenectomy (59.7% vs. 48.6%; p < 0.001) and a lower rate of optimal debulking surgery (44.0% vs. 52.7%; p < 0.001), as well as lower rates of chemotherapy (78.2% vs. 89.4%; P<0.001) and standard treatment (70.6% vs. 85%; p < 0.001). High proportions of both very elderly and elderly patients received neoadjuvant chemotherapy (NACT), with no significant difference (38.7% vs. 36.2%; P = 0.212). Patients aged ≥ 75 years had significantly worse OS and OCSS.

Conclusion
With increasing age, the survival rate of women with ovarian cancer decreases significantly. Noticeably fewer ovarian cancer patients aged over 75 years receive standard treatments, and more very elderly patients are treated with NACT.
Teaching airway teachers: a post-course quantitative and qualitative survey
Authors: Steinberg Irene , Nabecker Sabine , Greif Robert , Cortese Gerardo 
Published: February 2024

Abstract
Background
Airway management is a crucial skill for many clinicians. Besides mastering the technical skills of establishing a patent airway, human factors including leadership and team collaboration are essential. Teaching these human factors is often challenging for instructors who lack dedicated training. Therefore, the European Airway Management Society (EAMS) developed the Teach-the-Airway-Teacher (TAT) course.

Methods
This online post-course survey of TAT-course participants 2013–2021 investigated the impact of the TAT-course and the status of airway management teaching in Europe. Twenty-eight questions e-mailed to participants (using SurveyMonkey) assessed the courses’ strengths and possible improvements. It covered participants’ and workplace details; after TAT-course considerations; and specifics of local airway teaching. Data were assessed using Excel and R.

Results
Fifty-six percent (119/213) of TAT-participants answered the survey. Most were anaesthetists (84%), working in university level hospitals (76%). Seventy-five percent changed their airway teaching in some way, but 20% changed it entirely. The major identified limitation to airway teaching in their departments was “lack of dedicated resources” (63%), and the most important educational topic was “Teaching non-technical skills” (70%). “Lecturing “ was considered less important (37%). Most surveyed anaesthesia departments lack a standardized airway teaching rotation. Twenty-one percent of TAT-participants rated their departmental level of airway teaching overall as inadequate.

Conclusions
This survey shows that the TAT-course purpose was successfully fulfilled, as most TAT-course participants changed their airway teaching approach and did obtain the EAMS-certificate. The feedback provided will guide future TAT-course improvements to advance and promote a comprehensive approach to teaching airway management.
Exploring value creation in a virtual community of practice: a framework analysis for knowledge and skills development among primary care professionals
Authors: Koatz Débora , Torres-Castaño Alezandra , Salrach-Arnau Cristina , Perestelo-Pérez Lilisbeth , Ramos-García Vanesa , González-González Ana Isabel , Pacheco-Huergo Valeria , Toledo-Chávarri Ana , González-Pacheco Himar , Orrego Carola 
Published: February 2024

Abstract
Background
Healthcare professionals traditional education reflects constraints to face the complex needs of people with chronic diseases in primary care settings. Since more innovative and practical solutions are required, Virtual Community of Practices (vCoP) seem to better respond to learning updates, improving professional and organizational knowledge. However, little is known about the value created in vCoPs as social learning environments. The objective of this project was to explore the value creation process of a gamified vCoP (“e-mpodera vCoP”) aimed at improving the knowledge and attitudes of primary healthcare professionals (PCPs) (nurses and general practitioners) to the empowerment of people with chronic conditions.

Methods
A framework analysis assessed the value creation process using a mixed methods approach. The framework provided awareness about knowledge and usefulness in a learning community through five cycles: (1) immediate value, (2) potential value, (3) applied value, (4) realized value, and (5) reframing value. Quantitative data included vCoP analytics such as logins, contributions, points, badges, and performance metrics. Qualitative data consisted of PCPs’ forum contributions from Madrid, Catalonia, and Canary Islands over 14 months.

Results
A total of 185 PCPs had access to the e-mpodera vCoPs. The vCoP showed the dynamic participation of 146 PCPs, along 63 content activities posted, including a total of 3,571 contributions (including text, images, links to webpages, and other files). Regarding the value creation process, the e-mpodera vCoP seems to encompass a broad spectrum of value cycles, with indicators mostly related to cycle 1 (immediate value – activities and interactions) and cycle 2 (potential value – knowledge capital); and to a lesser extent for cycle 3 (applied value – changes in practice) and for cycle 4 (realized value – performance improvement). The presence of indicators related to cycle 5 (reframing value), was minimal, due to few individual redefinitions of success.

Conclusion
To reach a wider range of value possibilities, a combination of learning objectives, competence framework, challenged-based gamified platform, and pathway model of skill development seems crucial. However, additional research is required to gain clearer insights into organizational values, professionals’ lifelong educational needs in healthcare, and the long-term sustainability of performance improvement.

Trial registration
ClinicalTrials.gov, NCT02757781. Registered on 02/05/2016.
Demanded interdisciplinary subjects for integration in medical education program from the point of view of graduated medical physicians and senior medical students: a nationwide mixed qualitative-quantitative study from Iran
Authors: Lankarani Kamran Bagheri , Honarvar Behnam , Faghihi Seyed Aliakbar , Haghighi Mohammad Reza Rahmanian , Sadati Ahmad Kalateh , Rafiei Fatemeh , Hosseini Sayyed Amirreza , Bordbari Amir-Hassan , Ziaee Arash , Pooriesa Mohammad Jafar 
Published: February 2024

Abstract
Introduction
This study aimed to detect interdisciplinary subjects for integration into the medical education program of Iran.

Methods
A qualitative-quantitative method was used. Firstly, interdisciplinary subjects demanded by medical graduates and senior medical students were defined by qualitative study. In the second stage, questionnaire was developed which based on the findings of qualitative stage, experts’ opinion and reviewing of the national general guide of professional ethics for medical practitioners. Questionnaire consisted of demographic, occupational and thirteen interdisciplinary items. These items consisted of social determinants of health, social and economic consequences of disease, social prescribing, physicians’ social responsibility, role of gender, racial, ethnic, social and economic issues in approach to patients, role of logic and mathematics in clinical decision-making, philosophy of medicine, maintaining work-life balance, self-anger management, national laws of medicine, religious law in medical practice, health system structure, and teamwork principles. Level and importance of knowledge and self-assessed educational needs were asked about each item. In the third stage, a national online survey was conducted. SPSS 25 was used for statistics.

Results
By content analysis of data in qualitative stage, 36 sub-themes and 7 themes were extracted. In the quantitative part, 3580 subjects from 41 medical universities across Iran participated in this study. 2896 (80.9%) were medical graduates and 684 (19.1%) were senior medical students. Overall, knowledge about interdisciplinary items was low to intermediate, while high to very high knowledge ranged from maximally 38.7% about socioeconomic consequences of disease to minimally 17.2% about social prescribing. Participants gave the most importance to the having knowledge about self-anger management (88.3%), maintaining work-life balance (87.2%) and social determinants of health (85.8%), respectively. However, national laws of medicine (77.6%), maintaining work-life balance (75.4%) and self-anger management (74%) were the first top three educational demands by participants.

Conclusion
This study revealed a low to moderate level of knowledge about interdisciplinary topics among both graduated medical physicians and senior medical students. These groups showed a strong demand and tendency to know and to be educated about these topics. These findings underscore the urgency for educational reforms to meet the interdisciplinary needs of medical professionals in Iran.
Evaluating MedDRA-to-ICD terminology mappings
Authors: Zhang Xinyuan , Feng Yixue , Li Fang , Ding Jin , Tahseen Danyal , Hinojosa Ezekiel , Chen Yong , Tao Cui 
Published: February 2024

AbstractBackgroundIn this era of big data, data harmonization is an important step to ensure reproducible, scalable, and collaborative research. Thus, terminology mapping is a necessary step to harmonize heterogeneous data. Take the Medical Dictionary for Regulatory Activities (MedDRA) and International Classification of Diseases (ICD) for example, the mapping between them is essential for drug safety and pharmacovigilance research. Our main objective is to provide a quantitative and qualitative analysis of the mapping status between MedDRA and ICD.We focus on evaluating the current mapping status between MedDRA and ICD through the Unified Medical Language System (UMLS) and Observational Medical Outcomes Partnership Common Data Model (OMOP CDM). We summarized the current mapping statistics and evaluated the quality of the current MedDRA-ICD mapping; for unmapped terms, we used our self-developed algorithm to rank the best possible mapping candidates for additional mapping coverage.ResultsThe identified MedDRA-ICD mapped pairs cover 27.23% of the overall MedDRA preferred terms (PT). The systematic quality analysis demonstrated that, among the mapped pairs provided by UMLS, only 51.44% are considered an exact match. For the 2400 sampled unmapped terms, 56 of the 2400 MedDRA Preferred Terms (PT) could have exact match terms from ICD.ConclusionSome of the mapped pairs between MedDRA and ICD are not exact matches due to differences in granularity and focus. For 72% of the unmapped PT terms, the identified exact match pairs illustrate the possibility of identifying additional mapped pairs. Referring to its own mapping standard, some of the unmapped terms should qualify for the expansion of MedDRA to ICD mapping in UMLS.
Examining the effect of training with a teaching for understanding framework on intravenous therapy administration’s knowledge, performance, and satisfaction of nursing students: a non-randomized controlled study
Authors: Huang Jing , Liu Xiaoyan , Xu Jing , Ren Li , Liu Lihui , Jiang Ting , Huang Menglu , Wu Zhoupeng 
Published: February 2024

Abstract
Background
Nursing students require improvement in their intravenous infusion therapy management skills, yet traditional training models possess deficiencies. The Teaching for Understanding (TfU) Framework can enhance the teaching-learning process and support quality education. Therefore, utilizing TfU framework for training may promote the performance of nurses.

Methods
Utilizing a non-synchronized design, 102 nurses were recruited using a convenience sampling method. Fifty-one student nurses from August 2019 to January 2021 were designated as the control group, and 51 student nurses from February 2021 to July 2022 were included as the intervention group. The control group received traditional teaching methods, while the intervention group was trained based on TfU framework. The impact was gauged through medical education environment perception, theory and practice assessments, and learning satisfaction surveys.

Results
After the training, there was no significant difference between the control group and the intervention group in the theory assessment. However, the practice assessment scores of the intervention group were significantly higher than those of the control group. Compared with the control group, the learning satisfaction scores of the trained nurses in the intervention group were significantly higher, exhibiting significant differences, particularly in communication ability, teamwork cooperation, summing up capability, and interest in learning improvement. Furthermore, the scores of the learning perceptions, atmosphere, social self-perceptions, and total scores of the intervention group were significantly higher.

Conclusion
Training using TfU framework can heighten students’ understanding and command over knowledge and skills, fuel their learning fervor, and enhance their communication and collaboration abilities. TfU framework should be disseminated in medical education to improve the quality of education.
Rab37 mediates trafficking and membrane presentation of PD-1 to sustain T cell exhaustion in lung cancer
Authors: Kuo Wan-Ting , Kuo I-Ying , Hsieh Hung-Chia , Wu Ssu-Ting , Su Wu-Chou , Wang Yi-Ching 
Published: February 2024

Abstract
Background
Programmed cell death protein 1 (PD-1) is an immune checkpoint receptor expressed on the surface of T cells. High expression of PD-1 leads to T-cell dysfunction in the tumor microenvironment (TME). However, the mechanism of intracellular trafficking and plasma membrane presentation of PD-1 remains unclear.

Methods
Multiple databases of lung cancer patients were integratively analyzed to screen Rab proteins and potential immune-related signaling pathways. Imaging and various biochemical assays were performed in Jurkat T cells, splenocytes, and human peripheral blood mononuclear cells (PBMCs). Rab37 knockout mice and specimens of lung cancer patients were used to validate the concept.

Results
Here, we identify novel mechanisms of intracellular trafficking and plasma membrane presentation of PD-1 mediated by Rab37 small GTPase to sustain T cell exhaustion, thereby leading to poor patient outcome. PD-1 colocalized with Rab37-specific vesicles of T cells in a GTP-dependent manner whereby Rab37 mediated dynamic trafficking and membrane presentation of PD-1. However, glycosylation mutant PD-1 delayed cargo recruitment to the Rab37 vesicles, thus stalling membrane presentation. Notably, T cell proliferation and activity were upregulated in tumor-infiltrating T cells from the tumor-bearing Rab37 knockout mice compared to those from wild type. Clinically, the multiplex immunofluorescence-immunohistochemical assay indicated that patients with high Rab37+/PD-1+/TIM3+/CD8+ tumor infiltrating T cell profile correlated with advanced tumor stages and poor overall survival. Moreover, human PBMCs from patients demonstrated high expression of Rab37, which positively correlated with elevated levels of PD-1+ and TIM3+ in CD8+ T cells exhibiting reduced tumoricidal activity.

Conclusions
Our results provide the first evidence that Rab37 small GTPase mediates trafficking and membrane presentation of PD-1 to sustain T cell exhaustion, and the tumor promoting function of Rab37/PD-1 axis in T cells of TME in lung cancer. The expression profile of Rab37high/PD-1high/TIM3high in tumor-infiltrating CD8+ T cells is a biomarker for poor prognosis in lung cancer patients.