bluuebunny/crossref_metadata_2025_split huggingface dataset:
AI-generated feedback on writing: insights into efficacy and ENL student preference
Authors: Escalante Juan , Pack Austin , Barrett Alex 
Published: October 2023

AbstractThe question of how generative AI tools, such as large language models and chatbots, can be leveraged ethically and effectively in education is ongoing. Given the critical role that writing plays in learning and assessment within educational institutions, it is of growing importance for educators to make thoughtful and informed decisions as to how and in what capacity generative AI tools should be leveraged to assist in the development of students’ writing skills. This paper reports on two longitudinal studies. Study 1 examined learning outcomes of 48 university English as a new language (ENL) learners in a six-week long repeated measures quasi experimental design where the experimental group received writing feedback generated from ChatGPT (GPT-4) and the control group received feedback from their human tutor. Study 2 analyzed the perceptions of a different group of 43 ENLs who received feedback from both ChatGPT and their tutor. Results of study 1 showed no difference in learning outcomes between the two groups. Study 2 results revealed a near even split in preference for AI-generated or human-generated feedback, with clear advantages to both forms of feedback apparent from the data. The main implication of these studies is that the use of AI-generated feedback can likely be incorporated into ENL essay evaluation without affecting learning outcomes, although we recommend a blended approach that utilizes the strengths of both forms of feedback. The main contribution of this paper is in addressing generative AI as an automatic essay evaluator while incorporating learner perspectives.
Comparative study on regression time of block and adverse effects of nalbuphine and fentanyl as an adjuvant to intrathecal bupivacaine: a prospective randomized double-blind study
Authors: Deori Kamal Chandra , Taye Mrinal Kanti , Lahkar Babita 
Published: October 2023

Abstract
Background
The study was done to observe the effectiveness of nalbuphine as an adjuvant to intrathecal bupivacaine heavy, and hence, it was compared in terms of regression time of sensory and motor block and adverse effects with that of fentanyl as an adjuvant. The study design was a prospective randomized double-blind study. Total number of patients were 100. They were randomly allocated into two groups. Group N (n = 50) received 3.2 ml of 0.5% heavy bupivacaine and 0.5 ml (0.8 mg) of nalbuphine, a total of 3.7 ml. Group F (n = 50) received 3.2 ml of 0.5% heavy bupivacaine and 0.5 ml (25 µg) of fentanyl, a total of 3.7 ml. Assessment of sensory and motor blockade and analgesia was done by visual analogue scale and modified Bromage scale.

Results
On comparing the spinal block characteristics among two groups to reach, Bromage-3 motor block was found to be significantly shorter in group F (p = 0.03777). The regression time of both sensory and motor block was significantly prolonged in group N (P < 0.0001). No patients required additional analgesic intraoperatively, and intraoperative VAS scores and adverse effects were comparable in the two groups.

Conclusions
On comparing nalbuphine 0.8 mg and fentanyl 25 µg as an adjuvant to intrathecal bupivacaine, it has been observed that nalbuphine significantly prolongs regression time of sensory and motor block indicating the effectiveness of nalbuphine as an alternative to fentanyl and for prolong surgeries. The incidence of adverse effects was similar in both groups.
Protrieve sheath utilization for capturing supra-filter thrombus during a retrieval of thrombosed and embedded IVC filter
Authors: Shewarega Annabella , Powell Taylor M. , Silin Douglas 
Published: October 2023

Abstract
Background
Inferior vena cava (IVC) filters, while effective in preventing pulmonary embolism, can increase the risk of IVC thrombosis. IVC filter (IVCF) thrombosis can result from emboli getting trapped within the filter, extension of deep vein thrombosis (DVT), or the device’s inherent thrombogenicity causing in situ thrombosis. This condition can cause noticeable clinical symptoms and complicate the removal of the filter due to the potential for thromboembolism, often resulting in temporary filters remaining unextracted. This case report highlights a novel approach employed to mitigate the risk of thromboembolism during the procedure by capturing mobilized thrombus proximally to the entrapped IVCF.

Case presentation
A 54-year-old woman with a complex medical history including cerebral palsy, Crohn’s disease, and transfusion-dependent iron-deficiency anemia experienced a pulmonary embolism. Due to failed anticoagulation therapy resulting in gastrointestinal bleeding and high transfusion requirements, she underwent placement of an IVCF as a preventive measure against recurrent pulmonary embolism. Three years later, the patient presented with lower extremity swelling and a sudden decline in hemoglobin levels. Diagnostic imaging revealed adherent nonocclusive thrombus within and above the indwelling IVCF. Utilizing the novel Protrieve sheath with the self-expandable Nitinol funnel, successful endovascular removal of the embedded IVCF and adherent thrombus was performed, while mitigating the risk of intraprocedural pulmonary embolism.

Conclusions
The successful intraprocedural trapping and removal of mobilized thrombus from the IVCF removal was achieved using the Protrieve sheath and Nitinol funnel. This approach provides a promising solution to reduce the risk of embolization during the removal of thrombosed IVCFs, potentially outweighing the complications associated with filter removal.
Maternal immunoglobulin treatment can reduce severity of fetal acetylcholine receptor antibody-associated disorders (FARAD)
Authors: Wassenberg Matthias , Hahn Andreas , Mück Anna , Krämer Heidrun H. 
Published: October 2023

Abstract
Background
Fetal acetylcholine receptor antibody-associated disorders (FARAD), caused by in utero exposure to maternal antibodies directed against the fetal acetylcholine receptor (AChR), is a rare condition occurring in newborns of myasthenic mothers. Only two cases of FARAD children born to asymptomatic mothers are published.

Case
We report a completely asymptomatic mother of two FARAD children presenting exclusively with positive AChR antibodies. After birth, the first child needed intensive care therapy due to generalized hypotonia, respiratory problems, dysphagia, necessitating tube feeding and gastrostomy. FARAD was suspected because of ptosis, a hypomimic face, and confirmed by increased AChR antibodies in the mother. The mother became pregnant again 2 years later. Since FARAD is likely to reoccur and it is known that intensity of maternal myasthenia gravis treatment determines postnatal outcome, monthly intravenous immunoglobulin (IVIG) therapy was started at 12 weeks gestational age. The second child needed a short mask ventilation for initial stabilization at birth, but her muscle weakness improved rapidly and tube feeding was not necessary. Similar to her sister a tent-shaped mouth and a somewhat myopathic face persisted, but motor milestones were reached in time.

Conclusions
These observations highlight that FARAD is an important differential diagnosis of genetically determined congenital neuromuscular disorders even in asymptomatic mothers, and that IVIG therapy during the pregnancy has the potential to improve the outcome of the children.
Regulation of epithelial-mesenchymal transition in retinal pigment epithelium and its associated cellular signaling cascades: an updated review
Authors: Gelat Brijesh , Malaviya Pooja , Rathaur Pooja , Trivedi Krupali , Chaudhary Priya , Patel Binita , Johar Kaid , Gelat Rahul 
Published: October 2023

Abstract
Background
The epithelial-mesenchymal transition (EMT) affects the retinal pigment epithelium's natural homeostasis. According to observations from around the world, numerous oculopathies, including proliferative vitreoretinopathy (PVR), diabetic retinopathy (DR), and other macular degenerative illnesses such as age-related macular degeneration (AMD), have been linked to the epithelial-mesenchymal transition of retinal pigment epithelium (EMT of RPE). Retinopathy is referred to as an impairment in the retina, where AMD is characterized as an alteration in the macula region, DR as an impairment in the microvascular system, and PVR as an alteration in the subretinal bands, fibrovascular membranes, and fibrotic alteration in the detached retina. To find molecular targets and therapeutic drugs to protect and restore RPE function, a connection between EMT-related signaling pathways and RPE degeneration must be established.

Main body of abstract
Studies conducted in vivo and in vitro indicate that several signaling pathways, including the Rho pathway, the transforming growth factor-β (TGFβ) pathway, the Jagged/Notch pathway, mitogen-activated protein kinase (MAPK)-dependent pathway, and Wnt/β-catenin pathway, are activated in RPE cells during PVR and AMD. In order to discover the most suitable candidate for retinopathy therapies, it is necessary to determine the relationship between the regulators of the EMT and the degeneration of the RPE. To treat retinopathies, particularly those that are brought on by the EMT of retinal pigment epithelial cells, it is necessary to investigate prospective pharmaceutical candidates.

Conclusion
TGFβ's intracellular cascade, which comprises both canonical (SMAD-associated) and non-canonical (SMAD-nonassociated) pathways, is shown to be the most active signaling pathway in the degeneration of the RPE caused by EMT.
Therapeutic benefits of gossypin as an emerging phytoconstituents of Hibiscus spp.: a critical review
Authors: Jejurkar Gayatri , Chavan Machindra 
Published: October 2023

Abstract
Background
Flavonoids are one of the crucial secondary metabolites as several functions are carried out by flavonoids, including regulating cell growth, luring insects and pollinators, and defending against biotic and abiotic stressors. They are found in fruits, whole grains, vegetables, spices, tea, wine, herbs, and seeds. More than 4000 flavonoid compounds have been discovered and extracted through different techniques. Most flavonoids are frequently utilized in pharmaceuticals, nutraceuticals, cosmetics, and other products. A flavonol glucoside called gossypin is the primary phytochemical of herbs that comes under the "Malvaceae" family and can be found in many species, including Hibiscus esculentus, Gossypium indicum, and Hibiscus vitifolius, all have it in their flowers. Gossypin shows not only significant pharmacological activities but also a defence mechanism and protects against pathogens, UV radiation, etc. It has drawn much interest from researchers and scholars due to its benefits of few adverse effects, high efficacy, and simple preparation. Thus, the current review focuses primarily on the pharmacological accounts of gossypin in various acute and chronic diseases. The various assays and animal studies conducted in the past supported gossypin effects as supporting the concept of the objective of the title. The review also highlights various patents filled on gossypin’s importance and current market scenario.

Conclusion
Therefore, the technical contents based on pharmacological activities, patents and current market scenario provided in this paper for the improvement of research in numerous scientific fields will be helpful to researchers for suitable alternative designs of gossypin in various disorders.

Graphical abstract
Chinese herbal extracts with antiviral activity: evaluation, mechanisms, and potential for preventing PRV, PEDV and PRRSV infections
Authors: Sun Yumei , Li Chang , Liu Zhongzhu , Zeng Wei , Ahmad Muhammad Jamil , Zhang Mengjia , Liu Lina , Zhang Shujun , Li Wentao , He Qigai 
Published: October 2023

AbstractThe rapid expansion of large-scale pig farming has brought about a surge in viral diseases with high morbidity rates and diverse manifestations. This widespread occurrence of multiple viral diseases in pig farms has inflicted severe economic losses on the global swine industry. Consequently, there is an urgent need for eco-friendly and efficient antiviral drugs that can effectively combat viruses and prevent diseases such as PEDV, PRRSV, PRV, and other viral infections. To this end, we conducted a study on the antiviral activity and cytotoxicity of eleven different Chinese herbal extracts (CHE) against PRV. In vitro testing of several extracts, namely, Echinacea, Ilex purpurea Hassk, Ganoderma lucidum Kars, Taraxacum mongolicum, and Ilex rotunda Thunb, exhibited remarkable inhibition of PRV infection without causing any cytotoxic effects. Specifically, their antiviral selectivity indexes were significantly higher, with values ranging from 6- to 144-fold. The antiviral efficacy of five CHEs was evaluated against other RNA viruses, including PRRSV and PEDV. The extracts showed substantial inhibition of PEDV and PRRSV proliferation. Echinacea and Ilex purpurea Hassk extracts exhibited the highest virus inhibitory effects. To understand the antiviral mechanisms underlying their potent activity, a time-of-addition experiment was conducted. The results indicated that these extracts effectively targeted the early infection and postinfection stages of PRV, PEDV, and PRRSV. The study found that the Chinese herbal extracts, Echinacea and Ilex purpurea Hassk, had both direct and indirect effects on virus particles and cellular targets, demonstrating broad-spectrum antiviral activity against multiple clinical strains of PRV and PEDV. These findings provide a strong foundation for the development of herbal medicines to prevent and treat infections caused by PRV, PEDV and PRRSV in the swine industry. The identified extracts show great promise for the formulation of effective and environmentally friendly antiviral interventions.
Graphical Abstract
Artificial intelligence and increasing misinformation
Authors: Monteith Scott , Glenn Tasha , Geddes John R. , Whybrow Peter C. , Achtyes Eric , Bauer Michael 
Published: October 2023

SummaryWith the recent advances in artificial intelligence (AI), patients are increasingly exposed to misleading medical information. Generative AI models, including large language models such as ChatGPT, create and modify text, images, audio and video information based on training data. Commercial use of generative AI is expanding rapidly and the public will routinely receive messages created by generative AI. However, generative AI models may be unreliable, routinely make errors and widely spread misinformation. Misinformation created by generative AI about mental illness may include factual errors, nonsense, fabricated sources and dangerous advice. Psychiatrists need to recognise that patients may receive misinformation online, including about medicine and psychiatry.
Why Am I Ill? Beliefs in Supernatural and Natural Causes of Ill Health at the Time of Diagnostic Workup of Patients With Esophageal Cancer in Tanzania
Authors: Simba Hannah , Mmbaga Blandina T. , Serventi Furaha , Mremi Alex , Motlhale Melitah , Espina Carolina , Mwasamwaja Amos , Schuz Joachim , McCormack Valerie , Prah Efua 
Published: October 2023

PURPOSEAn understanding of the cultural and context-specific perceptions of the causes of cancer is an important prerequisite for designing effective primary health prevention and early detection strategies. We aimed to use the Murdock Ill Health Theoretical Model to conceptualize views on illness causation among dysphagia-suffering patients undergoing diagnostic workup for esophageal cancer (EC) in Tanzania.METHODSAt the end of a structured interview on lifestyle habits, patients with suspected EC were asked about beliefs on the reasons behind their illness through (1) a set of questions with fixed binary answers, whose determinants were analyzed using logistic regression, and (2) a single question with free-text answers. Responses were coded using a hierarchy of natural and supernatural (godly and social constructs) causes.RESULTSAmong 322 patients interviewed between November 2015 and December 2019, we found complex and varied views about the origins of their illness. Overall, 49% of patients attributed illness to natural causes and 39% to supernatural causes. Natural causes ranged from infection, use of alcohol and tobacco, other ailments, and the environment. The supernatural causes included attributing illness to God, curses, and spells from personal acquaintances. Belief in supernatural causes was more common in the less educated and those who sought help first via a traditional healer.CONCLUSIONThe results underscore the need for increased community awareness of biomedical causes of ill health and patient-based participatory research to inform prevention programs. The results also highlight the importance of building health systems that support a series of health-seeking behaviors that acknowledge both biomedical and local traditional healing belief systems.
Long-Term Follow-Up of the Response-Adjusted Therapy for Advanced Hodgkin Lymphoma Trial
Authors: Luminari Stefano , Fossa Alexander , Trotman Judith , Molin Daniel , d'Amore Francesco , Enblad Gunilla , Berkahn Leanne , Barrington Sally F. , Radford John , Federico Massimo , Kirkwood Amy A. , Johnson Peter W.M. 
Published: October 2023

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported. We analyzed long-term results of the response-adapted trial for adult patients with advanced-stage Hodgkin lymphoma. The aim was to confirm noninferiority of treatment de-escalation by omission of bleomycin from doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) for interim fluorodeoxyglucose positron emission tomography (iPET)–negative patients and assess efficacy and long-term safety for iPET-positive patients who underwent treatment intensification with escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisolone (BEACOPP/BEACOPP14). The median follow-up is 7.3 years. For all patients, the 7-year progression-free survival (PFS) and overall survival (OS) are 78.2% (95% CI, 75.6 to 80.5) and 91.6% (95% CI, 89.7 to 93.2), respectively. The 1.3% difference in 3-year PFS (95% CI, –3.0 to 4.7) between ABVD and doxorubicin, vinblastine, and dacarbazine (AVD) now falls within the predefined noninferiority margin. Among 172 patients with positive iPET, the 7-year PFS was 65.9% (95% CI, 58.1 to 72.6) and the 7-year OS was 83.2% (95% CI, 76.2 to 88.3). The cumulative incidence of second malignancies at 7 years was 5.5% (95% CI, 4.0 to 7.5) for those receiving ABVD/AVD and 2.5% (95% CI, 0.8 to 7.7) for those escalated to BEACOPP. With extended follow-up, these results confirm noninferiority of treatment de-escalation after a negative iPET. Escalation with BEACOPP for iPET-positive patients is effective and safe, with no increase in second malignancies.
Association between pre-diagnosis financial strain and later stage cancer presentation.
Authors: Khor Sara , Yu Kaiyue , Fedorenko Catherine R. , Rivers Zachary , Kestner Shannon , Shankaran Veena 
Published: October 2023

127 Background: Poverty and community-level deprivation have been shown to be associated with later stage cancer diagnosis. However, few studies have used objective financial data to study the link between individual financial strain and cancer stage at diagnosis. Our goal was to assess the associations between pre-diagnosis financial strain (FS) as measured by credit reports and later stage cancer diagnosis. Methods: Records from cancer patients diagnosed with solid tumors between 2014 and 2018 from the Western Washington SEER cancer registry and quarterly credit report data from a large credit-reporting agency TransUnion were linked and deidentified. Patients diagnosed with late-stage cancer (stages III and IV) were matched 1:1 to patients diagnosed with early-stage cancer (stages I and II) by age, year of diagnosis, cancer type, and insurance status. We assessed the association between FS (defined as any records of third-party collections, charge-offs, delinquent mortgage payments, tax liens, foreclosures, repossessions, and bankruptcies within 2 years prior to diagnosis) and late-stage diagnosis using conditional logistic regression to account for matching, adjusting for race, sex, marital status, area deprivation, and rurality. We performed stratified analyses by insurance enrollment. Separately, among a subset of unmatched insured breast cancer patients eligible for cancer screening (ages 50-74), we used multivariable logistic regressions to exam how the nonreceipt of screening mammography within 2 years of diagnosis mediated the relationship between FS and late-stage diagnosis. Results: After matching, 27916 patients were included in the analysis (mean age 66, 47% female, 84% White race, 7% Asian or Pacific Islander, 4% Black, and 3% Hispanic). Almost one in three patients (32%) had experienced FS before diagnosis. FS was associated with higher odds of late-stage cancer diagnosis (adjusted OR, aOR 1.18, 95%CI 1.1-1.3), and this association remained significant among insured patients (aOR 1.13, 95%CI 1.03-1.2). Among a subset of insured breast cancer patients (n=6934), FS was associated with nonreceipt of mammography (aOR 1.88, 95%CI 1.5-2.4). The association between FS and late-stage diagnosis became insignificant after we accounted for nonreceipt of mammography (aOR reduced from 1.65 (95%CI 1.4-1.9) to 1.04 (95%CI 0.8-1.4)). Conclusions: FS is associated with a later stage cancer diagnosis, which could in turn lead to adverse cancer outcomes. Among breast cancer patients, this association can be largely explained by nonreceipt of mammography. Our findings suggest that even with insurance coverage, individual’s financial stress may create an additional barrier to timely medical attention for suspicious cancer symptoms or routine screening, further exacerbating cancer disparities. This research highlights the need to develop strategies to improve access to care for these individuals.