bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lymphovascular invasion is a significant risk factor for non-sentinel nodal metastasis in breast cancer patients with sentinel lymph node (SLN)-positive breast cancer: a cross-sectional study
Authors: Wei Chunyu , Deng Yongqing , Wei Suosu , Huang Zhen , Xie Yujie , Xu Jinan , Dong Lingguang , Zou Quanqing , Yang Jianrong 
Published: December 2023

Abstract
Background
A connection between lymphovascular invasion and axillary lymph node metastases in breast cancer has been observed, but the findings are inconsistent and primarily based on research in Western populations. We investigated the association between lymphovascular invasion and non-sentinel lymph node (non-SLN) metastasis in breast cancer patients with sentinel lymph node (SLN) metastasis in western China.

Methods
This study comprised 280 breast cancer patients who tested positive for SLN through biopsy and subsequently underwent axillary lymph node dissection (ALND) at The People’s Hospital of Guangxi Zhuang Autonomous Region between March 2013 and July 2022. We used multivariate logistic regression analyses to assess the association between clinicopathological characteristics and non-SLN metastasis. Additionally, we conducted further stratified analysis. Results: Among the 280 patients with positive SLN, only 126 (45%) exhibited non-SLN metastasis. Multivariate logistic regression demonstrated that lymphovascular invasion was an independent risk factor for non-SLN in breast cancer patients with SLN metastasis (OR = 6.11; 95% CI, 3.62–10.32, p < 0.05). The stratified analysis yielded similar results.

Conclusions
In individuals with invasive breast cancer and 1–2 positive sentinel lymph nodes, lymphovascular invasion is the sole risk factor for non-SLN metastases. This finding aids surgeons and oncologists in devising a plan for local axillary treatment, preventing both over- and undertreatment.
Comparing breath hold versus free breathing irradiation for left-sided breast radiotherapy by PlanIQ™
Authors: Yuan Ke , Yao Xinghong , Liao Xiongfei , Diao Pen , Xin Xin , Ma Jiabao , Li Jie , Orlandini Lucia Clara 
Published: December 2023

Abstract
Background
Breast cancer is the most widespread cancer in women and young women worldwide. Moving towards customised radiotherapy, balancing the use of the available technology with the best treatment modality may not be an easy task in the daily routine. This study aims to evaluate the effectiveness of introducing IQ-feasibility into clinical practice to support the decision of free-breathing (FB) versus breath-hold (BH) left-sided breast irradiations, in order to optimise the technology available and the effectiveness of the treatment.

Methods
Thirty-five patients who received 3D radiotherapy treatment of the left breast in deep-inspiration BH were included in this retrospective study. Computed tomography scans in FB and BH were acquired for each patient; targets contoured in both imaging datasets by an experienced radiation oncologist, and organs at risk delineated using automatic segmentation software were exported to PlanIQ™ (Sun Nuclear Corp.) to generate feasibility dose volume histogram (FDVHs). The dosimetric parameter of BH versus FB FDVH, and BH clinical dataset versus BH FDVH were compared.

Results
A total of 30 patients out of 35 patients analysed, presented for the BH treatments a significant reduction (p < 0.05) in the heart mean dose ($${{\text{D}}}_{{\text{m}}}$$

D
m

), volume receiving 5 Gy ($${{\text{V}}}_{5{\text{Gy}}}$$

V

5
Gy

) and 20 Gy ($${{\text{V}}}_{20{\text{Gy}}}$$

V

20
Gy

), of 35.7%, 54.5%, and 2.1%, respectively; for the left lung, a lower reduction was registered and significant only for $${{\text{V}}}_{5{\text{Gy}}}$$

V

5
Gy

(21.4%, p = 0.046). For the remaining five patients, the FDVH cut-off points of heart and lung were superimposable with differences of less than 1%. Heart and left lung dosimetric parameters of the BH clinical plans are located in the difficult zone of the FDVH and differ significantly (p < 0.05) from the corresponding parameters of the FDVH curves delimiting this buffer area between the impossible and feasible zones, respectively.

Conclusion
The use of PlanIQTM as a decision-support tool for the FB versus BH treatment delivery modality allows customisation of the treatment technique using the most appropriate technology for each patient enabling accurate management of available technologies.
Optimizing age-related hearing risk predictions: an advanced machine learning integration with HHIE-S
Authors: Yang Tzong-Hann , Chen Yu-Fu , Cheng Yen-Fu , Huang Jue-Ni , Wu Chuan-Song , Chu Yuan-Chia 
Published: December 2023

Abstract
Objectives
The elderly are disproportionately affected by age-related hearing loss (ARHL). Despite being a well-known tool for ARHL evaluation, the Hearing Handicap Inventory for the Elderly Screening version (HHIE-S) has only traditionally been used for direct screening using self-reported outcomes. This work uses a novel integration of machine learning approaches to improve the predicted accuracy of the HHIE-S tool for ARHL in older adults.

Methods
We employed a dataset that was gathered between 2016 and 2018 and included 1,526 senior citizens from several Taipei City Hospital branches. 80% of the data were used for training (n = 1220) and 20% were used for testing (n = 356). XGBoost, Gradient Boosting, and LightGBM were among the machine learning models that were only used and assessed on the training set. In order to prevent data leakage and overfitting, the Light Gradient Boosting Machine (LGBM) model—which had the greatest AUC of 0.83 (95% CI 0.81–0.85)—was then only used on the holdout testing data.

Results
On the testing set, the LGBM model showed a strong AUC of 0.82 (95% CI 0.79–0.86), far outperforming conventional techniques. Notably, several HHIE-S items and age were found to be significant characteristics. In contrast to traditional HHIE research, which concentrates on the psychological effects of hearing loss, this study combines cutting-edge machine learning techniques—specifically, the LGBM classifier—with the HHIE-S tool. The incorporation of SHAP values enhances the interpretability of the model's predictions and provides a more comprehensive comprehension of the significance of various aspects.

Conclusions
Our methodology highlights the great potential that arises from combining machine learning with validated hearing evaluation instruments such as the HHIE-S. Healthcare practitioners can anticipate ARHL more accurately thanks to this integration, which makes it easier to intervene quickly and precisely.
Safety and antitumor activity of metformin plus lanreotide in patients with advanced gastro-intestinal or lung neuroendocrine tumors: the phase Ib trial MetNET2
Authors: Pusceddu Sara , Corti Francesca , Prinzi Natalie , Nichetti Federico , Ljevar Silva , Busico Adele , Cascella Tommaso , Leporati Rita , Oldani Simone , Pircher Chiara Carlotta , Coppa Jorgelina , Resi Veronica , Milione Massimo , Maccauro Marco , Miceli Rosalba , Tamborini Elena , Perrone Federica , Spreafico Carlo , Niger Monica , Morano Federica , Pietrantonio Filippo , Seregni Ettore , Mariani Luigi , Mazzaferro Vincenzo , Di Liberti Giorgia , Fucà Giovanni , de Braud Filippo , Vernieri Claudio 
Published: December 2023

AbstractIn retrospective studies, metformin use has been associated with better clinical outcomes in diabetic patients with advanced, well-differentiated neuroendocrine tumors (WDNETs). However, prospective evidence of metformin safety and activity is lacking. Here, we conducted the first-in-human phase Ib MetNET2 trial to investigate the safety and antitumor activity of metformin in combination with the somatostatin analog lanreotide autogel (ATG) in both diabetic and non-diabetic patients with advanced WDNETs of the gastrointestinal (GI) or thoracic tract. Enrolled patients received lanreotide ATG 120 mg plus oral metformin, up to a maximum dosage of 2550 mg/day. We enrolled 20 patients, of whom 18 (90%) and 2 (10%) had WDNETs of the GI and thoracic tract, respectively. Fourteen patients (70%) were non-diabetic. With a 5% incidence of SAEs, the study met its primary objective of demonstrating treatment safety. With a median follow-up of 39 months (95% CI 28-NE), median PFS was 24 months (95% CI 16-NE), with 12-month and 24-month PFS probability of 75% (95% CI 58–97) and 49% (95% CI 31–77), respectively. We found no statistically significant PFS differences between diabetic and non-diabetic patients. Among exploratory analyses, the presence of tumor genomic alterations in DNA damage pathways was associated with trend towards worse PFS, whereas a precocious reduction of HOMA-IR index and plasma cholesterol concentration showed a trend towards an association with better PFS. In conclusion, metformin plus lanreotide ATG is a safe and well tolerated combination treatment that is associated with promising antitumor activity in both non-diabetic and diabetic patients with WDNETs, and that warrants further investigation in larger clinical trials.
Physical activity status prevents symptoms of long covid: Sulcovid-19 survey
Authors: Rocha Juliana Quadros Santos , Caputo Eduardo Lucia , Vieira Yohana Pereira , Afonso Max dos Santos , Duro Suele Manjourany Silva , de Oliveira Saes Mirelle 
Published: December 2023

Abstract
Background
Physical activity is indicated as a treatment for Long COVID, but prevention is unknown. This study aimed to investigate the relationship between physical activity (PA) before and after acute SARS-Cov-2 infection and the presence of Long COVID symptoms in adults.

Methods
We used data from the Sulcovid-19, a longitudinal study carried out with individuals who were infected by SARS-Cov-2 between December/2020 and March/2021. Participants were asked about 19 symptoms commonly associated with long COVID. Three PA variables were built, as follows: (1) remained inactive; (2) became inactive; (3) remained active.

Results
2.919 people were interviewed. The prevalence of individuals who had at least one symptom of Long COVID is 48.3% (95%CI 46.5–51.1). Our results showed that 71.8% (95%CI 70.1–73.4) of the individuals remained inactive, 14.9% (95%CI 13.6–16.2) became inactive and 13.3% (95% CI 12.1–14.6) remained active. The likelihood of experiencing long COVID symptoms was reduced in the musculoskeletal (PR 0.70; 95%CI 0.49–0.99), neurological (PR 0.61; 95%CI 0.43–0.88), and respiratory (PR 0.58; 95%CI 0.35–0.96) systems in those who remained active. In addition, the likelihood of experiencing Long COVID symptoms was 7% less in those who remained active.

Conclusions
Continuous PA practice showed important protection effect for Long COVID symptoms in adults.
Splenogonadal fusion: a case report
Authors: Oshiba Ahmed , Abdallah Dina , Abdelaziz Marwa , Ibrahim Amir , Kotb Mostafa , Eshiba Samar , Rizvi Maryam 
Published: December 2023

Abstract
Background
Accessory splenic tissue is a commonly encountered phenomenon in medical literature. Typically, these accessory spleens are found in close proximity to the main spleen, either in the hilum or within the surrounding ligaments. Nevertheless, it is noteworthy that they can also be located in unusual sites such as the jejunum wall, mesentery, pelvis, and, exceptionally rarely, the scrotum. The first documented case of accessory splenic tissue in the scrotum was reported by Sneath in 1913 and is associated with a rare congenital anomaly called splenogonadal fusion. This report describes an infant who presented with a scrotal mass noted by his mother and after examination, investigations, and surgical exploration, it was revealed to be splenogonadal fusion.

Case description
An 8-month-old Caucasian male patient presented with a mass in the left testicle and bluish discoloration of the scrotum, which had been incidentally noticed in the previous 2 months. The general physical examination was unremarkable. Other than a palpable scrotal mass that was related to the upper pole of the testis, the rest of examination was unremarkable. Imaging revealed that this mass originated from the tail of the epididymis without infiltrating the testis and tumor markers were normal. On inguinal exploration, a reddish brown 2 × 2 cm mass was found attached to the upper pole and was completely excised without causing any harm to the testis, vessels, or epididymis. Histopathological evaluation confirmed the presence of intratesticular ectopic splenic tissue.

Conclusion
Although uncommon, splenogonadal fusion can be included in the differential diagnosis of a testicular swelling. Accurate diagnosis allows for appropriate treatment planning which helps to avoid unnecessary radical orchiectomy, which can have a significant impact on the patient’s reproductive and psychological wellbeing.
Emotional dysmetria after cerebellar-pontine stroke: a case report
Authors: Long Rebecca M. , DuVal Michèle , Mulvany-Robbins Bridget , Wagner Amanda N. , Jickling Glen C. 
Published: December 2023

Abstract
Introduction
Pseudobulbar affect, or emotional dysregulation, commonly occurs following stroke. However, it is frequently missed in cases involving the cerebellum, resulting in a lack of treatment, which can directly impact stroke rehabilitation.

Case presentation
A 63-year-old Caucasian female with no history of mood disorders presented with gait instability, dysarthria, and right sided hemiplegia, secondary to cerebellar and pontine ischemic stroke from a basilar occlusion. She underwent endovascular therapy and her deficits gradually improved. However during recovery she began to develop uncontrollable tearfulness while retaining insight that her emotional expression was contextually inappropriate. She was treated with a selective serotonin reuptake inhibitor with reported improvements in her emotional regulation at one year follow up.

Conclusion
This case highlights cerebellar injury as a potential cause of poorly regulated emotions, or an emotional dysmetria. The recognition of this disorder in patients with cerebellar or pontine strokes is critical, as untreated pseudobulbar affect can impact future stroke rehabilitation.
Early detection of infectious bovine keratoconjunctivitis with artificial intelligence
Authors: Gupta Shekhar , Kuehn Larry A. , Clawson Michael L. 
Published: December 2023

AbstractArtificial intelligence (AI) was developed to distinguish cattle by their muzzle patterns and identify early cases of disease, including infectious bovine keratoconjunctivitis (IBK). It was tested on 870 cattle in four locations, with 170 developing IBK. The AI identified 169 of the 170 cases prior to their identification by veterinarians, and another 17 cases that remained free of IBK signs (sensitivity = 99.4%, specificity = 97.6%). These results indicate the AI can detect emerging IBK cases by muzzle images very early in the disease process and be used as an intervention tool in the prevention of IBK outbreaks.
Care intervention on psychological outcomes among patients admitted to intensive care unit: an umbrella review of systematic reviews and meta-analyses
Authors: Zheng Yafang , Zhang Lijuan , Ma Shihong , Wu Bian , Chen Peipei , Xu Yan , Tan Wenting , Li Hanzhan , Wu Qiaomei , Zheng Jingxia 
Published: December 2023

Abstract
Background
Numerous studies have explored care interventions to improve the psychological outcome of intensive care unit (ICU) patients, but inconclusive evidence makes it difficult for decision-makers, managers, and clinicians to get familiar with all available literature and find appropriate interventions. This umbrella review aimed to analyze the relationship between care intervention and psychological outcomes of ICU patients based on existing systematic reviews.

Methods
An umbrella review of evidence across systematic reviews and meta-analyses published between 1987 and 2023 was undertaken. We systematically searched reviews that examined the association between care intervention and the improvement of adverse psychological outcomes in ICU patients using PubMed, EMBASE, Web of Science, Cochrane Library, and manual reference screening. The measurement tool (AMSTAR 2) was applied to evaluate the methodological quality of included studies. The excess significance bias, between-study heterogeneity expressed by I2, small-study effect, and evidence class were estimated.

Results
A total of 5110 articles were initially identified from the search databases and nine of them were included in the analysis. By applying standardized criteria, only weak evidence was observed in 13 associations, even though most included reviews were of moderate to high methodological quality. These associations pertained to eight interventions (music therapy, early rehabilitation, post-ICU follow-up, ICU diary, information intervention, preoperative education, communication and psychological support, surrogate decision-making) and five psychological outcomes (post-intensive care syndrome, transfer anxiety, post-traumatic stress disorder, anxiety, and depression). Weak or null association was shown among the rest of the associations (e.g., weak association between music therapy and maternal anxiety or stress level).

Conclusions
The evidence of these eight supporting interventions to improve the adverse psychological outcomes of ICU patients and caregivers was weak. Data from more and better-designed studies with larger sample sizes are needed to establish robust evidence.
Enhancement of damaged-image prediction based on digital twin technology
Authors: Guo Jing , Qi Deyu 
Published: December 2023

AbstractDigital twins have revolutionized the field of image enhancement by applying their unique capabilities. A digital twin refers to a virtual replica of a physical object or system, which can be utilized to simulate and analyze real-world scenarios. In image enhancement, digital twins map entities to images, identify damaged areas, and restore them to their original state. This process involves utilizing the digital twin method to understand the underlying structure and characteristics of the image. The damaged areas can be accurately modeled and repaired using techniques like the Cahn-Hilliard equation. Additionally, neural network models are leveraged to measure the effectiveness of the image restoration process. Compared with the first-order numerical scheme, the second-order method can improve the prediction accuracy by more than 40% in some cases. Through these advancements, digital twins have significantly enhanced images’ quality, clarity, and visual appeal, contributing to various photography, healthcare, and remote sensing applications.
Synergistic impact of autocrine motility factor and curcumin on colorectal cancer cell proliferation
Authors: Kim Seok Joong , Kim Yangji , Van Duong Thanh , Park Hee Sung 
Published: December 2023

AbstractColorectal cancer (CRC) presents a formidable challenge, characterized by a steadily increasing incidence. Current approaches to manage CRC, including chemotherapy and targeted therapies, are burdened with significant limitations such as resistance development, adverse events, and high costs. Hence, there is an urgent demand for a more promising alternative. Autocrine motility factor (AMF), known for its role in promoting cancer cell motility, exhibits a unique ability to selectively impede the growth of cancer cells. In our study, we have elucidated the specific inhibitory effect of AMF derived from DU145 prostate cancer cells (D-AMF) on the proliferation of CRC cells. D-AMF effectively downregulated the expression of glucose-6-phosphate dehydrogenase (G6PD) at both the mRNA and protein levels, resulting in a concurrent increase in the generation of reactive oxygen species (ROS). Notably, the combination of D-AMF and curcumin proved highly effective in eliminating curcumin-resistant CRC cells. Therefore, the use of D-AMF in conjunction with curcumin holds promise as an alternative treatment approach for CRC.
Phylogenetic diversity of functional genes in deep-sea cold seeps: a novel perspective on metagenomics
Authors: Wang Danrui , Li Jiangtao , Su Lei , Shen Wenli , Feng Kai , Peng Xi , Wang Zhujun , Zhao Bo , Zhang Zheng , Zhang Zhaojing , Yergeau Étienne , Deng Ye 
Published: December 2023

Abstract
Background
Leakages of cold, methane-rich fluids from subsurface reservoirs to the sea floor are termed cold seeps. Recent exploration of the deep sea has shed new light on the microbial communities in cold seeps. However, conventional metagenomic methods largely rely on reference databases and neglect the phylogeny of functional genes.

Results
In this study, we developed the REMIRGE program to retrieve the full-length functional genes from shotgun metagenomic reads and fully explored the phylogenetic diversity in cold seep sediments. The abundance and diversity of functional genes involved in the methane, sulfur, and nitrogen cycles differed in the non-seep site and five cold seep sites. In one Haima cold seep site, the divergence of functional groups was observed at the centimeter scale of sediment depths, with the surface layer potentially acting as a reservoir of microbial species and functions. Additionally, positive correlations were found between specific gene sequence clusters of relevant genes, indicating coupling occurred within specific functional groups.

Conclusion
REMIRGE revealed divergent phylogenetic diversity of functional groups and functional pathway preferences in a deep-sea cold seep at finer scales, which could not be detected by conventional methods. Our work highlights that phylogenetic information is conducive to more comprehensive functional profiles, and REMIRGE has the potential to uncover more new insights from shotgun metagenomic data.
Body image perception, eating disorder behavior, self-esteem and quality of life: a cross-sectional study among female medical students
Authors: Mallaram Ganesh Kumar , Sharma Pragya , Kattula Dheeraj , Singh Swarndeep , Pavuluru Poojitha 
Published: December 2023

AbstractBackgroundEating disorders are strongly associated with body image concerns. Eating disorders tend to significantly impact the current and future health and quality of life of affected persons, their caregivers, and society. As body image is based on a social construct of ideal body image, it is essential to evaluate it in its cultural context.MethodsThe current study explored the relationship among body image perception, perceived stress, eating disorder behaviour and quality of life among female medical students (n = 777). Measurements included Body Shape Questionnaire, Body Image Quality of Life Inventory, Eating Attitudes Test-26 and Rosenberg Self-Esteem Scale. Multivariate analysis was conducted.ResultsThere was a significant correlation between eating disorder behaviour and perceived body shape, body image, quality of life and self-esteem among our study participants. We also found eating disorder status was significantly associated with BMI, perceived body shape, quality of life and self-esteem.ConclusionsThis is of clinical implication to female medical students and healthcare professionals to engage early in primary and secondary prevention of eating pathologies. Increasing awareness of these facts among female students can help identify at-risk students and help them seek timely medical help.