bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dissemination feature based on PET/CT is a risk factor for diffuse large B cell lymphoma patients outcome
Authors: Wang Fei , Cui Silu , Lu Luo , Shao Xiaoliang , Yan Feng , Liu Yaqi , He Bai , Wang Jianfeng , Cao Yang , Yue Yanhua , Wang Yuetao , Gu Weiying 
Published: November 2023

Abstract
Background
18F-FDG PET/CT provides precise information about dissemination of lymphoma lesions. Dmax, defined as distance between the two lesions that were farthest apart by PET/CT, was found to be a promising predictor of Diffuse large B-cell lymphoma (DLBCL) outcome in a small size of clinical trial data. We analyzed the impact of Dmax on the outcome of a large real-world DLBCL cohort.

Methods
Data of newly diagnosed DLBCL at the Third Affiliated Hospital of Soochow University were retrospectively collected. Baseline Dmax, clinical data and survival information were recorded. A metabolic parameter, metabolic bulk volume (MBV), was also measured to verify the independent impact of Dmax.

Results
Optimal cut-off values for Dmax and MBV were 45.34 cm and 21.65 cm3. With a median follow-up of 32 months, Dmax significantly impacted progression-free survival (PFS) and overall survival (OS) in 253 DLBCL patients. For Dmaxlow and Dmaxhigh groups, estimated 3-year OS were 87.0% and 53.8% (p < 0.001), while 3-year PFS were 77.3% and 37.3% (p < 0.001). And for MBVlow and MBVhighgroups, 3-year OS were 84.5% and 58.8% (p < 0.001), and 3-year PFS were 68.7% and 50.4% (p = 0.003). Multivariate analysis identified Dmax and Eastern Cooperative Oncology Group performance status (ECOG PS) independently associated with PFS and OS, while MBV only independently associated with OS. A Dmax revised prognostic index (DRPI) combining Dmax and ECOG PS identified an ultra-risk DLBCL population with 3-year PFS of 31.7% and 3-year OS of 38.5%. The area under the curve (AUC) showed that this model performed better than International prognostic Index (IPI).

Conclusion
Dmax is a new and promising indicator to investigate dissemination of lymphoma lesions associated with the outcome of DLBCL. It significantly contributes to stratification of patients with disparate outcomes.

Trial registration
This research has been retrospectively registered in the Ethics Committee institutional of the Third Affiliated Hospital of Soochow University, and the registration number was approval No. 155 (approved date: 31 May 2022).
PD-1/PD-L1 inhibitors plus carboplatin and paclitaxel compared with carboplatin and paclitaxel in primary advanced or recurrent endometrial cancer: a systematic review and meta-analysis of randomized clinical trials
Authors: de Moraes Francisco Cezar Aquino , Pasqualotto Eric , Lopes Lucca Moreira , Cavalcanti Souza Maria Eduarda , de Oliveira Rodrigues Anna Luíza Soares , de Almeida Artur Menegaz , Stecca Carlos , Fernandes Marianne Rodrigues , dos Santos Ney Pereira Carneiro 
Published: November 2023

Abstract
Background
Paclitaxel and carboplatin is the standard chemotherapy for the treatment of advanced or recurrent endometrial cancer. However, the benefit of adding programmed cell death 1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors to chemotherapy is still unclear.

Method
We searched PubMed, Scopus, Cochrane, and Web of Science databases for randomized controlled trials that investigated PD-1/PD-L1 inhibitors plus carboplatin and paclitaxel compared with carboplatin and paclitaxel in primary advanced or recurrent endometrial cancer. We computed hazard ratios (HRs) or risk ratios (RRs) for binary endpoints, with 95% confidence intervals (CIs). We used DerSimonian and Laird random-effect models for all endpoints. Heterogeneity was assessed using I2 statistics. R, version 4.2.3, was used for statistical analyses.

Results
A total of three studies and 1,431 patients were included. Compared with carboplatin plus paclitaxel-based chemotherapy, progression-free survival (PFS) rate (HR 0.32; 95% CI 0.23–0.44; p < 0.001) and overall survival (OS) at 30 months (RR 3.13; 95% CI 1.26–7.78; p = 0.01) were significant in favor of the PD-1/PD-L1 inhibitors plus carboplatin and paclitaxel group in the mismatch repair–deficient subgroup. However, there were no significant differences in the mismatch repair–proficient subgroup for PFS (HR 0.74; 95% CI 0.50–1.08; p = 0.117) or OS at 30 months (RR 2.24; 95% CI 0.79–6.39; p = 0.13).

Conclusion
Immunotherapy plus carboplatin-paclitaxel increased significantly PFS and OS among patients with advanced or recurrent endometrial cancer, with a significant benefit in the mismatch repair–deficient and high microsatellite instability population.
Assessment of nutrient adequacy in undergraduate students during the undertaking shipboard internship: using 12-day dietary recall through smartphone photography
Authors: Chun Hyejin , Ha Jung-Heun , Im Hyohyeon , Jung Cho Young , Doo Miae 
Published: November 2023

Abstract
Background
This study aimed to investigated nutritional status and estimated the adequacy of dietary intake of university students during shipboard internships.

Methods
In this cross- sectional study, data were collected from 25 students out of 42 participants who attended in the research information session in the department of maritime at a university located in Jeonbook, South Korea. The dietary intake data was obtained using the 12-day dietary recall through smartphone photography during the shipboard internships. The data on dietary intake were used to calculate acceptable macronutrient distribution ranges (AMDRs), frequency of inappropriate intake of the 2020 Dietary Reference Intakes for Koreans (KDRIs) as a reference, intake ratio to the nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ).

Results
The average age of subjects was 21.68 years and average BMIs in men and women were 25.67 kg/m2 and 23.44kg/m2, respectively. The average energy of men and women was 2018.66 kcal and 1727.87 kcal, respectively. More than half of the subjects did not meet the inappropriate range of the AMDRs for carbohydrates and fat. The NAR of vitamin A, vitamin C, and calcium among all 10 nutrients tended to be lower in both men and women. The MAR were 0.71 and 0.769. On the other hand, in both men and women, vitamin C had the lowest INQ (0.5 and 0.39). For men, grains and potatoes were the major contributors to energy and carbohydrates, and calcium contributed in the order of meat, fish and eggs and vegetables and fruits. Although the highest contributors to energy and carbohydrates for women were grains and potatoes, the contributions from meat, fish, and eggs were similar, and the major contributors to calcium were vegetables and fruits.

Conclusions
To improve the inadequate nutritional status of university students engaged in shipboard internships with the aim of pursuing careers as seafarers, there is a need to provide additional nutritional education tailored to their specific circumstances. Additionally, professional health guidance should be provided to maintain optimal nutritional status.
Impact of spontaneous abortion history and induced abortion history on perinatal outcomes of singleton pregnancies
Authors: Sun Hanxiang , Mao Jing , Su Xiujuan , Du Qiaoling 
Published: November 2023

Abstract
Background
At present, there are several studies on abortion history and perinatal outcomes, but there is no unified conclusion whether the history of abortion and different types of abortion are related to perinatal complications of subsequent pregnancy. We aim to study the impact of different types of abortion history on perinatal outcomes of singleton pregnancies.

Methods
This was a retrospective study from a maternity and infant hospital in Shanghai, China from 2016 to 2020. Pregnant women who gave birth to live singleton infant were included (n = 75,773). We classified abortion into spontaneous abortion (SAB) and induced abortion (IA). We compared the perinatal outcomes of singleton pregnancies with different abortion histories and used Logistic regression analysis to evaluate the associations between pre-pregnancy abortion history with perinatal outcomes.

Results
We observed that pregnant women with a history of abortion were more likely to have a premature delivery (0.99% VS 0.45%), gestational diabetes mellitus (GDM) (13.40% VS 10.29%), placenta abnormality (8.16% VS 5.06%), placenta previa (5.65% VS 3.75%), placenta accreta (0.18% VS 0.04%), and placenta adhesion (2.79% VS 1.03%) than those who obtained singleton pregnancies without a history of abortion. When confounding factors were adjusted, differences in placenta abnormality still existed (excluding placenta abruption). The odds ratios and 95% confidence interval of placenta previa, placenta accreta, and placenta adhesion in pregnant women with only SAB history, only IA history, and both abortion history were 1.294(1.174–1.427), 1.272(1.159–1.396), and 1.390(1.188–1.625), 2.688(1.344–5.374), 2.549(1.268–5.125), and 5.041(2.232–11.386), 2.170(1.872–2.515), 2.028(1.738–2.366), and 3.580(2.917–4.395), respectively.

Conclusions
Our research showed that pregnant women who have a history of abortion before pregnancy were more likely to have premature birth, GDM, placenta previa, placenta accreta, and placenta adhesion. After adjusting for confounding factors, we found that the history of SAB, IA, and both SAB and IA history were related to the increased risk of placenta previa, placenta accreta, and placenta adhesion.
How dentists in Egypt perceive their knowledge, attitudes, and barriers they face in providing oral healthcare to geriatric patients: a cross-sectional study
Authors: Hall Mohamed Ashraf , Ashmawy Rasha , Karawia Inas , Ghazy Ramy Mohamed 
Published: November 2023

Abstract
Background
Geriatric dentistry is an understudied area in dental schools in Egypt. Our study aimed to assess the knowledge and attitudes of Egyptian dentists regarding geriatric oral health and identify barriers to delivering dental care to geriatric patients.

Methods
We conducted an anonymous online cross-sectional study in November and December 2022, targeting dentists with varying levels of experience working in different Egyptian institutions. A 30-item questionnaire assessed the respondent’s views on geriatric oral health, perceived knowledge, attitudes, and barriers. The Google form was distributed through emails and commonly used social media platforms.

Results
A total of 421 dentists responded to this online questionnaire. Of the respondents, 44.9% were male, 45.0% were between 20 and 29 years old, and 31.5% worked in more than one dental setting. Multivariate analysis revealed that female sex negatively affected attitude β = -1.72 [95%CI,-2.43 – -1.11]. The proportion of older patients who visited the respondents’ clinics per day (11–30%) and more than 30% increased perceived knowledge [β = 1.01 (95%CI, 0.41 –1.62), β = 1.50 (95%CI, 0.71–2.22)] and attitude [β = 0.70 (95%CI, 0.06–1.40), β = 0.73 (95%, 0.13–1.61)] while decreased the perceived barriers [β = -1.10 (95%CI, -1.91 – -0.32)] respectively. On the other hand, years of experience increased perceived knowledge only after 5–10 years [β = 1.02 (95%CI, 0.04–2.10)] and after more than 10 years [β = 1.30 (95%CI, 0.21–2.70)]. Governmental work only increased perceived barriers [β = 1.33 (95%CI, 0.10–2.54)], while living in the middle and west delta decreased perceived barriers [β = -0.91 (95%CI, -2.12 – -0.01 and β = -1.33, (95%CI, -2.22 – -0.40) respectively].

Conclusions
Our study highlights the need to improve the knowledge and attitudes of young dentists towards geriatric dentistry. Furthermore, working conditions in dental facilities, particularly in the government sector and Upper Egypt, need to be improved to reduce barriers to delivering dental care to geriatric patients.
Integrated investigation and discovery of therapeutic targets for 3-hydroxybakuchiol against diabetes based on molecular docking studies and cell experiments
Authors: Liu Min , Wang Xinyu , Yang Junsong , Qin Dan 
Published: November 2023

Abstract
Background
Diabetes mellitus is a prevalent endocrine condition. We aimed to investigate the anti-diabetic effects of 3-hydroxybakuchiol (HYD) by exploring its potential targets and molecular mechanisms through bioinformatics analysis and cell experiments.

Methods
We performed an extensive search and screening of HYD and its potential targets for diabetes mellitus across various databases. Enrichment analyses were conducted using the ClusterProfiler package. PPI networks of the identified genes were constructed using STRING, and topological analysis was performed to identify core targets. The results were further confirmed through molecular docking. To validate the findings of our bioinformatics analysis, we conducted cell experiments using insulin resistance-induced HepG2 cells and C2C12 cells.

Results
We discovered 260 common targets of HYD and diabetes mellitus, which were primarily related to the MAPK signaling pathway, PI3K-Akt signaling pathway, and endocrine resistance. A topological analysis of the PPI network identified four core targets (HSP90AA1, AKT1, SRC, and MAPK1). Molecular docking studies further confirmed the strong binding ability between HYD and these core targets. In cell experiments, we observed that HYD enhanced glucose uptake and suppressed gluconeogenesis in HepG2 cells and C2C12 cells. This resulted in an improvement in glucose metabolism, potentially through the regulation of the PI3K-Akt pathway.

Conclusions
This study provides valuable insights into the pharmacological effects of HYD on diabetes mellitus, suggesting its potential as a promising treatment option for the disease.
Use of sentiment analysis for capturing hospitalized cancer patients' experience from free-text comments in the Persian language
Authors: Yazdani Azita , Shamloo Mohammad , Khaki Mina , Nahvijou Azin 
Published: November 2023

Abstract
Purpose
Today, the Internet provides access to many patients' experiences, which is crucial in assessing the quality of healthcare services. This paper introduces a model for detecting cancer patients' opinions about healthcare services in the Persian language, both positive and negative.

Method
To achieve the objectives of this study, a combination of sentiment analysis (SA) and topic modeling approaches was employed. All pertinent comments made by cancer patients were collected from the patient feedback form of the Tehran University of Medical Science (TUMS) Cancer Institute (CI) in Iran, from March to October 2021. Conventional evaluation metrics such as accuracy, precision, recall, and F-measure were utilized to assess the performance of the proposed model.

Result
The experimental findings revealed that the proposed SA model achieved accuracies of 89.3%, 92.6%, and 90.8% in detecting patients' sentiments towards general services, healthcare services, and life expectancy, respectively. Based on the topic modeling results, the topic "Metastasis" exhibited lower sentiment scores compared to other topics. Additionally, cancer patients expressed dissatisfaction with the current appointment booking service, while topics such as "Good experience," "Affable staff", and "Chemotherapy" garnered higher sentiment scores.

Conclusion
The combined use of SA and topic modeling offers valuable insights into healthcare services. Policymakers can utilize the knowledge obtained from these topics and associated sentiments to enhance patient satisfaction with cancer institution services.
Automatic deep learning-based pleural effusion segmentation in lung ultrasound images
Authors: Vukovic Damjan , Wang Andrew , Antico Maria , Steffens Marian , Ruvinov Igor , van Sloun Ruud JG , Canty David , Royse Alistair , Royse Colin , Haji Kavi , Dowling Jason , Chetty Girija , Fontanarosa Davide 
Published: November 2023

Abstract
Background
Point-of-care lung ultrasound (LUS) allows real-time patient scanning to help diagnose pleural effusion (PE) and plan further investigation and treatment. LUS typically requires training and experience from the clinician to accurately interpret the images. To address this limitation, we previously demonstrated a deep-learning model capable of detecting the presence of PE on LUS at an accuracy greater than 90%, when compared to an experienced LUS operator.

Methods
This follow-up study aimed to develop a deep-learning model to provide segmentations for PE in LUS. Three thousand and forty-one LUS images from twenty-four patients diagnosed with PE were selected for this study. Two LUS experts provided the ground truth for training by reviewing and segmenting the images. The algorithm was then trained using ten-fold cross-validation. Once training was completed, the algorithm segmented a separate subset of patients.

Results
Comparing the segmentations, we demonstrated an average Dice Similarity Coefficient (DSC) of 0.70 between the algorithm and experts. In contrast, an average DSC of 0.61 was observed between the experts.

Conclusion
In summary, we showed that the trained algorithm achieved a comparable average DSC at PE segmentation. This represents a promising step toward developing a computational tool for accurately augmenting PE diagnosis and treatment.
Health and economic impact associated with rheumatoid arthritis discharges: a cost analysis of a two-year cohort in Mexico
Authors: Mendoza-Gutierrez Carlos Fernando , Montiel-Ojeda Diana , Vargas-Chanes Delfino , Cisneros-González Nelly , Fernández-Gárate José Esteban , Godina-Ortiz Blanca , Clark Patricia 
Published: November 2023

Abstract
Background
Rheumatoid arthritis is a highly prevalent disease. Patients undergo various medical and pharmacological treatments, which have an economic impact on hospitals. The aim of this study was to estimate the direct economic costs of Mexican Social Security Institute (IMSS) resources used to provide healthcare to adult patients with rheumatoid arthritis in 2016–2017.

Methods
Data of patients aged > 18 years with Rheumatoid Arthritis (RA) were obtained from databases and public information sources to estimate the use of IMSS resources for the target population. Total costs were estimated by means of the macro-costing method, employing the diagnosis-related group (DRG). Each DRG of the IMSS was constructed with one of the diagnoses and the respective combination of clinical characteristics included in the ICD-9. This study was conducted from the national perspective of IMSS, the largest healthcare service administrator in the country. As such, it can be considered representative of the broader healthcare landscape in Mexico.

Results
The total cost per year of furnishing inpatient care to RA patients was found to be $170,099,794 MXN ($9,096,245.67 USD) for 2016 and $167,039,481 MXN ($8,932,592.57 USD) for 2017, implying an enormous economic impact on the government budget for Mexican public health services.

Conclusions
Our results demonstrate that the direct costs of musculoskeletal and cardiovascular surgery represented the highest costs of RA in-hospital care at IMSS (the largest health institution in Mexico) in 2016 and 2017. Further studies are needed that include the cost of drugs and other indirect costs in addition to our results to get the most accurate approximation of the cost of living with RA.
Fruit bats adjust their decision-making process according to environmental dynamics
Authors: Naamani Goni , Shahar Nitzan , Ger Yoav , Yovel Yossi 
Published: November 2023

AbstractOne of the main functions of behavioral plasticity lies in the ability to contend with dynamic environments. Indeed, while numerous studies have shown that animals adapt their behavior to the environment, how they adapt their latent learning and decision strategies to changes in the environment is less understood. Here, we used a controlled experiment to examine the bats’ ability to adjust their decision strategy according to the environmental dynamics. Twenty-five Egyptian fruit bats were placed individually in either a stable or a volatile environment for four consecutive nights. In the stable environment, two feeders offered food, each with a different reward probability (0.2 vs. 0.8) that remained fixed over two nights and were then switched, while in the volatile environment, the positions of the more and the less rewarding feeders were changed every hour. We then fit two alternative commonly used models namely, reinforcement learning and win-stay-lose-shift strategies to the bats' behavior. We found that while the bats adapted their decision-making strategy to the environmental dynamics, they seemed to be limited in their responses based on natural priors. Namely, when the environment had changed slowly, at a rate that is natural for these bats, they seemed to rely on reinforcement learning and their performance was nearly optimal, but when the experimental environment changed much faster than in the natural environment, the bats stopped learning and switched to a random decision-making strategy. Together, these findings exemplify both the bats’ decision-making plasticity as well as its natural limitations.
Dissemination of Registered COVID-19 Clinical Trials (DIRECCT): a cross-sectional study
Authors: Salholz-Hillel Maia , Pugh-Jones Molly , Hildebrand Nicole , Schult Tjada A. , Schwietering Johannes , Grabitz Peter , Carlisle Benjamin Gregory , Goldacre Ben , Strech Daniel , DeVito Nicholas J. 
Published: November 2023

Abstract
Background
The results of clinical trials should be completely and rapidly reported during public health emergencies such as COVID-19. This study aimed to examine when, and where, the results of COVID-19 clinical trials were disseminated throughout the first 18 months of the pandemic.

Methods
Clinical trials for COVID-19 treatment or prevention were identified from the WHO ICTRP database. All interventional trials with a registered completion date ≤ 30 June 2021 were included. Trial results, published as preprints, journal articles, or registry results, were located using automated and manual techniques across PubMed, Google Scholar, Google, EuropePMC, CORD-19, the Cochrane COVID-19 Study Register, and clinical trial registries. Our main analysis reports the rate of dissemination overall and per route, and the time from registered completion to results using Kaplan–Meier methods, with additional subgroup and sensitivity analyses reported.

Results
Overall, 1643 trials with completion dates ranging from 46 to 561 days prior to the start of results searches were included. The cumulative probability of reporting was 12.5% at 3 months from completion, 21.6% at 6 months, and 32.8% at 12 months. Trial results were most commonly disseminated in journals (n = 278 trials, 69.2%); preprints were available for 194 trials (48.3%), 86 (44.3%) of which converted to a full journal article. Trials completed earlier in the pandemic were reported more rapidly than those later in the pandemic, and those involving ivermectin were more rapidly reported than other common interventions. Results were robust to various sensitivity analyses except when considering only trials in a “completed” status on the registry, which substantially increased reporting rates. Poor trial registry data on completion status and dates limits the precision of estimates.

Conclusions
COVID-19 trials saw marginal increases in reporting rates compared to standard practice; most registered trials failed to meet even the 12-month non-pandemic standard. Preprints were common, complementing journal publication; however, registries were underutilized for rapid reporting. Maintaining registry data enables accurate representation of clinical research; failing to do so undermines these registries’ use for public accountability and analysis. Addressing rapid reporting and registry data quality must be emphasized at global, national, and institutional levels.