bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic Cranial Irradiation (PCI) and Brain MRI Surveillance versus Brain MRISurveillance Alone in Patients with Limited-Stage Small Cell Lung Cancer Achieving Complete Remission (CR) of tumor after Chemoradiotherapy: a Multicenter Prospective Randomized Study
Authors: Chen Mengyuan , Li Runhua , Kong Yue , Shi Lei , Wang Jing , Wang Yuezhen , Xu Yujin , Ji Yongling , Hu Xiao 
Published: October 2023

Abstract
Background
Prophylactic cranial irradiation (PCI) is part of standard care in limited-stage small cell lung cancer (SCLC) at present. As evidence from retrospective studies increases, the benefits of PCI for limited-stage SCLC are being challenged.
Methods
A multicenter, prospective, randomized controlled study was designed. The key inclusion criteria were: histologically or cytologically confirmed small cell carcinoma, age ≥ 18 years, KPS ≥ 80, limited stage defined as tumor confined to one side of the chest including ipsilateral hilar, bilateral mediastinum, bilateral supraclavicular lymph nodes, patients have received definitive thoracic radiotherapy (regardless of the dose-fractionation of radiotherapy used) and chemotherapy, evaluated as complete remission (CR) of tumor 4–6 weeks after the completion of chemo-radiotherapy. Eligible patients will be randomly assigned to two arms: (1) PCI and brain MRI follow-up arm, receiving PCI (2.5Gy qd to a total dose of 25Gy in two weeks) followed by brain MRI follow-up once every three months for two years; (2) brain MRI surveillance alone arm, undergoing brain MRI surveillance once every three months for two years. The primary objective was to compare the 2-year brain metastasis-free survival (BMFS) rates between the two arms. Secondary objectives included 2-year overall survival (OS) rates, intra-cranial failure patterns, 2-year progression-free survival rates and neurotoxicity. In case of brain metastasis (BM) detected during follow-up, patients meeting the eligibility criteria will receive stereotactic radiosurgery (SRS).
Discussion
Based on our post hoc analysis of a prospective study, we hypothesize that in limited-stage SCLC patients with CR after definitive chemoradiotherapy, and ruling out of BM by MRI, it would be feasible to use brain MRI surveillance and omit PCI in these patients. If BM is detected during follow-up, treatment with SRS or whole brain radiotherapy (WBRT) does not appear to have a detrimental effect on OS. Additionally, this approach may reduce potential neurotoxicity associated with PCI.
The effect of physical exercise during radiotherapy on physical functioning in patients with head and neck cancer: a trial within cohorts, the VITAL study
Authors: Kriellaars Yvette , Vermaire Jorine Ariane , Beugeling Maaike , Poorter Robert , Drijvers Janneke , Speksnijder Caroline Margina 
Published: October 2023

Abstract
Background
During the last ten years, twelve studies are published investigating physical exercise interventions (PEIs) for patients with head and neck cancer (HNC) during or after radiotherapy (RT), chemoradiation (CRT) or bioradiation (BRT). The overall conclusion is clear, PEIs for patients with HNC are safe and feasible. PEIs during or after RT, CRT or BRT ((C/B)RT) may maintain or improve physical function and quality of life (QoL). It is, however, necessary to do more research to underpin these effects. Besides, a cost-effectiveness analysis is missing. The aim of this study is to determine and compare physical performance, muscle strength, fatigue, QoL, body composition, nutritional status, physical activity, treatment tolerability of (C/B)RT, and healthcare related costs in patients with HNC with and without a 10 week exercise intervention during (C/B)RT.
Methods
This study based on a trial within cohorts (TwiCs) design will contain a prospective cohort with 112 patients. Half of the 112 patients will randomly be invited for an experimental 10 week PEI. Measurements are at baseline (M0), after 12 weeks (M1), 6 months (M2) and 12 months (M3). Statistical analyses will be performed for intention-to-treat and instrumental variable analysis using SPSS.
Discussion
This study is the first randomized study investigating the effect of PEI in a Dutch HNC population and it is the first study investigating the cost-effectiveness of PEI in HNC patients. A TwiCs design will be used. However, with this design, effect estimation can be more challenging.
Trial Registration
protocol is registered at clinicaltrials.gov with number NCT05988060.
Ectopic pregnancy following in vitro fertilization-embryo transfer: A retrospective diagnostic study to develop a predictive nomogram
Authors: He Sang , Xie Bing , Cao ShengHui , Luo Chen , Lin Jiao , Zhou ShunQiang , Chen XiaoYan , Huang XiangHong , Tan XiaoJun 
Published: October 2023

Abstract
Objective
This study aimed to investigate the risk factors associated with ectopic pregnancy (EP) following in vitro fertilization-embryo transfer (IVF-ET) to establish a model to predict the risk of EP.
Methods
This retrospective cohort study was conducted in our hospital between January 2010 and December 2020. The enrolled dataset was randomly divided into two: a training cohort (65%, N = 603) and validation cohort (35%, N = 331). Clinical characteristics and laboratory indexes were associated with EP following IVF-ET based on univariate and multivariate analyses, and nomograms for predicting EP were established. Discrimination and calibration were assessed using the concordance (C)-index and a calibration curve.
Results
Multivariate logistic regression analysis showed that female factors, previous ectopic pregnancy, high estrogen levels, frozen-thawed embryo transfer, and low human chorionic gonadotropin levels at 14 days post embryo transfer were risk factors for EP. Multivariate logistic regression analysis was used to develop the nomogram. A C-index of 0.819 and 0.882 in the training and validation cohorts respectively, indicated the model had reliable discrimination, and the calibration plot overlapped the diagonal reference line of perfect calibration, indicating effective calibration.
Conclusions
We developed and validated a nomogram for predicting the probability of EP that provides clinicians with a quantitative tool.
The causal association between inflammatory bowel disease and pancreatitis: a two-sample Mendelian randomization study
Authors: Gao Zetian , Zhang Xie , Cai Dihui , Song Yufei , Kang Jingyu , Zhang Qiubo 
Published: October 2023

Abstract
Background
Clinical studies showed a relationship between inflammatory bowel disease (IBD) and pancreatitis. This study employed a Mendelian randomization (MR) approach to determine whether there is a causal association between IBD and pancreatitis.
Methods
Genome-wide association study data on IBD were acquired from the International Inflammatory Bowel Disease Genetics Consortium. Summary statistics for acute pancreatitis (AP), chronic pancreatitis (CP), alcohol-induced acute pancreatitis (AAP), and alcohol-induced chronic pancreatitis (ACP) were from the FinnGen database. Inverse-variance weighting (IVW) was used to perform a two-sample MR analysis. Heterogeneity tests, horizontal pleiotropy tests, and sensitivity analyses were used to ensure the consistency and accuracy of our results.
Results
The incidence of AP in IBD populations was 1.063 times higher than in the control population (95% confidence interval [CI]: 1.008–1.121, IVW p = 0.023). The CP incidence in IBD populations was 1.075 times higher than in the comparative population (95% CI: 1.004–1.153, IVW p = 0.039). AP incidence in Crohn’s disease (CD) populations was 1.056 times higher than in the comparative population (95% CI: 1.010–1.105, IVW p = 0.017). The CP incidence in CD populations was approximately 1.070 times higher than in the comparative population (95% CI: 1.009–1.135, IVW p = 0.024). AP incidence in ulcerative colitis (UC) populations was 1.070 folds higher than in the general population (95% CI: 1.007–1.137, IVW p = 0.030), AAP incidence in UC populations was 1.189 times higher than in the general population (95% CI: 1.009–1.135, IVW p = 0.024).
Conclusion
IBD increases the risk of AP and CP. CD was related to AP and CP. UC had a causality with AP and AAP. Our research verified that IBD increased the risk of pancreatitis.
Diagnostic Accuracy of Cognitive Screening Tools Validated for Older Adults in Iran: A Systematic Review and Meta-analysis
Authors: Kamalzadeh Leila , Tayyebi Gooya , Shariati Behnam , Shati Mohsen , Saeedi Vahid , Malakouti Seyed Kazem 
Published: October 2023

Abstract
Background
This systematic review aims to comprehensively assess the diagnostic accuracy of cognitive screening tools validated for older adults in Iran, providing evidence-based recommendations for clinicians and researchers.
Methods
Multiple databases were searched for cross-sectional research published until March 2033. Inclusion criteria encompassed paper and pencil cognitive screening tools used in Iranian seniors. Data extraction involved evaluating diagnostic accuracy measures, cognitive domains, and strengths/weaknesses of each test. A bivariate random-effects meta-analysis generated summary estimates with 95% CIs, and forest plots visually represented the findings.
Results
The review included 17 studies investigating 14 cognitive screening instruments. Diagnostic accuracy data were extracted for the Clock Drawing Test (CDT), Mini-Cog, short portable mental status questionnaire (SPMSQ), A Quick Test of Cognitive Speed (AQT), Quick Mild Cognitive Impairment (Qmci) screen, Rowland Universal Dementia Assessment (RUDAS), Picture-Based Memory Impairment Screen (PMIS), Abbreviated Mental Test Score (AMTS), Mini–Mental State Examination (MMSE), Modified Mini-Mental State Examination (3MS), Montreal Cognitive Assessment (MoCA), Addenbrooke’s Cognitive Examination (ACE)-III, Persian test of Elderly for Assessment of Cognition and Executive function (PEACE), and Rey Auditory Verbal Learning Test (RAVLT). Pooled values from the bivariate effect model for the MMSE showed a sensitivity of 0.97, specificity of 0.87, DOR of 242, LR + of 7.69, and LR- of 0.03.
Conclusion
The results showed that the ACE-III demonstrated the highest accuracy for dementia and mild cognitive impairment (MCI) in specialized care settings. However, the high risk of bias in many studies emphasizes the need for more rigorous validations in diverse clinical contexts and populations.
Fabrication of O‑enriched macroporous polymer for the efficient adsorption organic acid from aqueous solution
Authors: Fu Yuli , Zhong shihua , Lei Ting , Gong Hui , Su Shengpei 
Published: October 2023

Abstract
Herein, an oxygen-rich polymer, namely, β-CD-PS was gained according to one-step nucleophilic substitution, and it was used to adsorb organic acids from aqueous solution. The nucleophilic substitution brought abundant functional -OH groups (the oxygen contents were 9.04 wt%,) to the polymer, and increased the hydrogen bonding between the polymer and the adsorbate. The adsorption results showed that the capacities of organic acids on β-CD-PS were much greater than chloromethylated polystyrene (CMPS). The maximum adsorption capacities of salicylic acid (SA), pyrogallic acid (PA), β-naphthol (NAP), 1,1'-bi-2-naphthol (BNAP) and gallic acid (GA) were 407.47 mg/g, 312.42 mg/g, 246.39 mg/g, 320.75 mg/g and 254.40mg/g, respectively. Langmuir model was more fit for the adsorption of BNAP, PA, and GA, and Freundlich model was more suited to the adsorption of PHE, NAP, and SA. Thermodynamic analysis showed that the adsorption is a spontaneous process, furthermore, the exothermic occurred between the adsorption site and SA, NAP, and phenol (PHE) and the endothermic occurred between the adsorption site and BNAP, PA and GA. The adsorption kinetics results indicated that the time for the equilibrium of SA, PA, GA, and NAP was about 100 min, while BNAP required more time. Moreover, the adsorption of SA on β-CD-PS could achieve most adsorption at high concentrations and complete removal at low concentrations. The organic acids adsorbed on the polymer could be eluted by anhydrous alcohol and 0.01 mol/L NaOH. The β-CD-PS exhibited superior adsorption efficiency, reproducibility, and reusability, demonstrating their excellent performance for the adsorption of organic acids, and analysis of the adsorption mechanism revealed that the -OH groups played a significant role due to the strong hydrogen bonding interaction.
Comparison of three-dimensional imaging of the nose using three different 3D- photography systems
Authors: Ritschl Lucas M. , Classen Carolina , Kilbertus Paul , Eufinger Julia , Storck Katharina , Fichter Andreas M. , Wolff Klaus-Dietrich , Grill Florian D. 
Published: October 2023

Abstract
Objectives
New 3D technologies for superficial soft tissue changes, especially in plastic and reconstructive surgical procedures, can improve the planning and documentation of facial surgeries. The purpose of this study was to compare and determine the applicability and feasibility of three different 3D-photography systems in clinical practice imaging the nose.
Methods and materials
A total of 16 healthy non-operated noses were included in this prospective study. A plaster model of each nose was produced, digitized, and converted to an .stl mesh (= ground truth model). Three-dimensional images of each nose were then taken using Artec Space Spider (gold standard), Planmeca ProFace®, and the Bellus3D Dental Pro application. All resulting .stl files were aligned to the ground truth model using MeshLab software, and the root mean square error (RMSE), mean surface distance (MSD), and Hausdorff distance (HD) were calculated.
Results
The Artec Space Spider 3D-photography system showed significantly better results compared to the two other systems in regard to RMSE, MSD, and HD (each p < 0.001). There was no significant difference between Planmeca ProFace® and Bellus3D Dental Pro in terms of RMSE, MSD, and HD. Overall, all three camera systems showed a clinically acceptable deviation to the reference model (range: -1.23–1.57 mm).
Conclusions
The three evaluated 3D-photography systems were suitable for nose imaging in the clinical routine. While Artec Space Spider showed the highest accuracy, the Bellus3D Dental Pro app may be the most feasible option for everyday clinical use due to its portability, ease of use, and low cost. This study presents three different systems, allowing readers to extrapolate to other systems when planning to introduce 3D photography in the clinical routine.
A complex systems perspective on chronic aggression and self-injury: Case study of a woman with mild intellectual disability and borderline personality disorder
Authors: Hulsmans Daan H. G. , Otten Roy , Poelen Evelien A. P. , Vonderen Annemarie van , Daalmans Serena , Hasselman Fred , Olthof Merlijn , Lichtwarck-Aschoff Anna 
Published: October 2023

Abstract

BackgroundChallenging behaviors like aggression and self-injury are dangerous for clients and staff in residential care. These behaviors are not well understood and therefore often labeled as “complex”. Yet it remains vague what this supposed complexity exactly entails at the individual level. The current case-study used a mixed-methods analytical strategy, inspired by complex systems theory, that consisted of three steps. First, we construed a holistic summary of the client’s relevant factors in her daily life. Second, we described her challenging behavioral trajectory by identifying stable phases. Third, instability and extraordinary events in her environment were evaluated as potential mechanisms for changes between different phases.Case presentationA woman, living at a residential facility, with mild intellectual disability and borderline personality disorder with a chronic pattern of aggressive and self-injurious incidents. She used ecological momentary assessments to daily self-rate challenging behaviors for 560 days.ConclusionsA qualitative summary of caretaker records revealed many internal and environmental factors relevant to her daily life. Her clinician narrowed these down to 11 staff hypothesized risk- and protective factors, such as reliving trauma, experiencing pain, receiving medical care, compliments or psychological therapy. The vast multitude of bivariate associations between these 11 factors and self-reported challenging behaviors were non-significant. These null-results indicate that challenging behaviors are not governed by mono-causal if-then relations, speaking to its complex nature. Despite this complexity there were patterns in the temporal ordering of incidents. Aggression and self-injury occurred on respectively 13% and 50% of the 560 days. On this timeline, we identified 11 distinct stable phases, that were alternating between four unique states: high levels of aggression and self-injury, average levels of aggression and self-injury, low levels of aggression and self-injury, and low aggression with high self-injury. Eight out of ten transitions between phases were either triggered by extraordinary events in her environment (event-induced) or preceded by increased fluctuations in her self-ratings (instability-induced), or a combination of these two. Desirable patterns emerged more often and were less easily malleable, indicating that when the participant experiences bad times, keeping in mind better times are ahead is as hopeful as it is realistic.
Single-cell RNA-seq Analysis Reveals the Wnt/Ca2+ Signaling Pathway with Inflammation, Apoptosis in Nucleus Pulposus Degeneration
Authors: Wang Peigeng , Li Zhencong , Ye Dongping 
Published: October 2023

Abstract

Background.Increasing studies have shown degeneration of nucleus pulposus cells (NPCs) as an critical part of the progression of intervertebral disc degeneration (IVDD). However, there are relatively few studies on single-cell transcriptome contrasts in human degenerated NPCs. Moreover, differences in Wnt/Ca2+signaling in human degenerated nucleus pulposus cells have not been elucidated. The aim of this study is to investigate the differential expression of Wnt/Ca2+signaling pathway between normal and degenerated nucleus pulposus cells in humans and try to investigate its mechanism.Methods.In this research, nucleus pulposus was isolated from normal and degenerated tissues for single-cell RNA sequencing (scRNA-seq). Cells were clustered unsupervised based on gene expression profiles and passed to tSNE/UMAP using the Seurat package for clustering and visualization to obtain the desired data.Results.The obtained cell data were clustered into five different chondrocytes clusters, which chondrocyte 4 and chondrocyte 5 mainly accounted for a high proportion in degenerated nucleus pulposus tissues, but rarely in normal nucleus pulposus tissues. Genes associated within the Wnt/Ca2+signaling pathway, such as Wnt5B, FZD1, PLC (PLCB1), CaN (PPP3CA) and NAFATC1 are mainly present in chondrocyte 3, chondrocyte 4 and chondrocyte 5 from degenerated nucleus pulposus tissues. In addition, as a receptor that activates Wnt signaling pathway, LRP5 is mainly highly expressed in chondrocyte 5 of degenerated nucleus pulposus cells. Six genes, ANGPTL4, PTGES, IGFBP3, GDF15, TRIB3 and TNFRSF10B, which are associated with apoptosis and inflammatory responses, and are widespread in chondrocyte 4 and chondrocyte 5, may be closely related to degenerative of nucleus pulposus cells.Conclusions.Single-cell RNA sequencing revealed differential expression of Wnt/Ca2+signaling in human normal and degenerated nucleus pulposus cells, and this differential expression may be closely related to the abundance of chondrocyte 4 and chondrocyte 5 in degenerated nucleus pulposus cells. In degenerated nucleus pulposus cells, LRP5 activate Wnt5B, which promotes nucleus pulposus cell apoptosis and inflammatory response by regulating the Wnt/Ca2+signaling pathway, thereby promoting disc degeneration. ANGPTL4, IGFBP3, PTGES in chondrocyte 4 and TRIB3, GDF15, TNFRSF10B in chondrocyte 5 may play an important role in this process．
Comparative Analysis of The Impact of Limitied Physical Activity on Lumbar Spinal Stenosis and Spondylolisthesis: A Retrospective Cohort Study between COVID-19 Pandemic Period and Control Period
Authors: Kim Jun-Hoe , Yebin Chegal , Kim Suhyun , Park Hangeul , Kim Young Rak , Kim Sum , Kim Kwangsoo , Lee Chang-Hyun , Kim Chi Heon , Chung Chun Kee 
Published: October 2023

Abstract
BACKGROUND
The primary treatment for lumbar spinal stenosis (LSS) and spondylolisthesis (SPL) is conservative care, including exercise. Regarding exercise, physical activity has a different therapeutic role in the two diseases. We investigated the effect of physical inactivity on LSS and SPL by analyzing changes in hospital visits and medical costs during the COVID-19 pandemic period.
METHODS
We included first-visit patients diagnosed exclusively with LSS and SPL in 2017 and followed them up for two years before and after implementation of social distancing (SoD) policy. As controls, patients who first visited in 2015 and were followed for four years without SoD were analyzed. The common data model was employed to analyze each patient’s diagnostic codes and treatments. Hospital visits and medical costs were analyzed by regression discontinuity in time (RDiT) to control for temporal effects on dependent variables.
RESULTS
Among 33,484 patients, 2,615 LSS and 446 SPL were included. A significant decrease in hospital visits was observed in both the LSS (difference,-3.94 times/month·100 patients; p = 0.023) and SPL (difference,-3.44 times/month·100 patients; p = 0.026) groups after the SoD. This decrement was not observed in the data from the control. Concerning the medical cost, the LSS group showed a statistically significant decrease in median copayment (difference,-$45/month·patient; p < 0.001) after the SoD, while a significant change was not observed in the SPL group (difference,-$19/month·patient; p = 0.160).
CONCLUSION
After the implementation of SoD, both hospital visits and medical costs were reduced in only the LSS group. Limited physical activity due to SOD may reduce the medical demand for patients with LSS.
Mild cognitive impairment, Spirituality, and All-cause Mortality Among Older Adults in Mainland China: A Prospective Cohort Study
Authors: Xiong Mengyun , Ma Wanrui , Hu Xue , Tong Yan , He Zhehao , Lei Qiuhui , Koenig Harold G. , Wang Zhizhong 
Published: October 2023

Abstract
Background:
The association between spirituality, cognitive function, and risk of mortality is still unknown among older adults in mainland China.
Methods:
Data from a prospective cohort study of 4,705 community-dwelling older adults, including 915 with MCI, were analyzed. Measures included the Duke University Religion Index (DUREL), which assessed the spirituality of the
participants from years 2012 to 2016 (baseline). All-cause mortality records were linked with the National Cause of Death Surveillance System in the years 2017, 2019, and 2021. Cox proportional hazards regression modeling was used to estimate hazard ratios (HR) and 95% confidence intervals to assess the effects of MCI and spirituality on all-cause mortality. In addition, the interaction between spirituality and MCI in predicting all-cause mortality was examined using moderation modeling.
Results:
A total of 387 deaths were identified during an average follow-up time of 87.3 months (SD=20.8). MCI was associated with an increased risk of all-cause mortality (HR=2.07, 95%CI: 1.58-2.72), while high spirituality was associated with decreased risk of all-cause mortality (HR=0.65, 95%CI: 0.49-0.86). Interaction effect of MCI and spirituality on all-cause mortality after adjusting for covariates (Relative Excess Risk of Interaction=0.82; Attributable Proportion =0.27; Synergy Index=1.67) was found, participants with low spirituality and MCI had the highest risk of mortality (HR=3.30, 95%CI: 2.40~4.52).
Conclusions:
MCI predicted an increased risk of all-cause mortality among Chinese older adults, and spirituality predicted a reduced risk. The findings suggest that a spiritually-integrated community intervention program may reduce the risk of mortality in older adults with cognitive impairment.