bluuebunny/crossref_metadata_2025_split huggingface dataset:
Construction and validation of a prognostic nutritional index-based nomogram for predicting pathological complete response in breast cancer: a two-center study of 1,170 patients
Authors: Qu Fanli , Luo Yaxi , Peng Yang , Yu Haochen , Sun Lu , Liu Shengchun , Zeng Xiaohua 
Published: January 2024

BackgroundPathological complete response (pCR) after neoadjuvant chemotherapy (NAC) is associated with favorable outcomes in breast cancer patients. Identifying reliable predictors for pCR can assist in selecting patients who will derive the most benefit from NAC. The prognostic nutritional index (PNI) serves as an indicator of nutritional status and systemic immune competence. It has emerged as a prognostic biomarker in several malignancies; however, its predictive value for pCR in breast cancer remains uncertain. The objective of this study is to assess the predictive value of pretreatment PNI for pCR in breast cancer patients.MethodsA total of 1170 patients who received NAC in two centers were retrospectively analyzed. The patients were divided into three cohorts: a training cohort (n=545), an internal validation cohort (n=233), and an external validation cohort (n=392). Univariate and multivariate analyses were performed to assess the predictive value of PNI and other clinicopathological factors. A stepwise logistic regression model for pCR based on the smallest Akaike information criterion was utilized to develop a nomogram. The C-index, calibration plots and decision curve analysis (DCA) were used to evaluate the discrimination, calibration and clinical value of the model.ResultsPatients with a high PNI (≥53) had a significantly increased pCR rate (OR 2.217, 95% CI 1.215-4.043, p=0.009). Tumor size, clinical nodal status, histological grade, ER, Ki67 and PNI were identified as independent predictors and included in the final model. A nomogram was developed as a graphical representation of the model, which incorporated the PNI and five other factors (AIC=356.13). The nomogram demonstrated satisfactory calibration and discrimination in the training cohort (C-index: 0.816, 95% CI 0.765-0.866), the internal validation cohort (C-index: 0.780, 95% CI 0.697-0.864) and external validation cohort (C-index: 0.714, 95% CI 0.660-0.769). Furthermore, DCA indicated a clinical net benefit from the nomogram.ConclusionThe pretreatment PNI is a reliable predictor for pCR in breast cancer patients. The PNI-based nomogram is a low-cost, noninvasive tool with favorable predictive accuracy for pCR, which can assist in determining individualized treatment strategies for breast cancer patients.
Drug survival of IL-12/23, IL-17 and IL-23 inhibitors for moderate-to-severe plaque psoriasis: a retrospective multicenter real-world experience on 5932 treatment courses – IL PSO (Italian landscape psoriasis)
Authors: Gargiulo Luigi , Ibba Luciano , Malagoli Piergiorgio , Balato Anna , Bardazzi Federico , Burlando Martina , Carrera Carlo G. , Damiani Giovanni , Dapavo Paolo , Dini Valentina , Gaiani Francesca M. , Girolomoni Giampiero , Guarneri Claudio , Lasagni Claudia , Loconsole Francesco , Marzano Angelo V. , Megna Matteo , Mercuri Santo R. , Travaglini Massimo , Costanzo Antonio , Narcisi Alessandra 
Published: January 2024

IntroductionThe development of several effective biological drugs for moderate-to-severe plaque psoriasis has dramatically changed the lives of patients. Despite the wide use of interleukin (IL) inhibitors, limited data are available to date regarding long-term treatment persistence.MethodThis multicenter retrospective real-world study evaluated 5932 treatment courses across 5300 patients, all treated with interleukin inhibitors. Drug survival was expressed by using the Kaplan-Meier estimator for each biological drug at 6, 12, 24, 36 and 48 months. We also stratified by discontinuation associated with primary or secondary ineffectiveness.ResultsIn our study, the most prescribed drugs were secukinumab (1412), ixekizumab (1183), and risankizumab (977). After four years of follow-up, risankizumab emerged as the treatment with the highest drug survival overall, as 91.6% of patients were still on treatment. The overall probability of drug survival at four years was comparable for tildrakizumab (83.5%), ixekizumab (82.6%), guselkumab (82.4%) and brodalumab (81.8%). When evaluating only patients who discontinued the treatment because of ineffectiveness, once again risankizumab was the molecule with the highest drug survival at 4 years (93.4%), this time followed by ixekizumab (87%). Our study, in which all IL inhibitors were adequately represented, confirmed a slightly better treatment persistence for IL-23 inhibitors, consistent with other real-world studies.ConclusionOur experience showed that IL-23 inhibitors, and risankizumab in particular, had a higher probability of drug survival overall during a 4-year follow-up. Risankizumab and ixekizumab were less likely to be discontinued because of ineffectiveness after four years.
Failure modes and mechanical properties of double-layer rock-like composite specimens with a single fissure under triaxial compression
Authors: Xiao Taoli , Xu Ke , Lu Yifan , She Haicheng 
Published: January 2024

Introduction: Geotechnical engineering disasters often result from instability failures in layered and heterogeneous fissured rock masses. However, the key mechanisms governing mechanical properties and crack propagation in these rock masses remain unclear.Methods: This study presents triaxial compression tests on double-layer rock-like specimens composed of limestone and sandstone materials, containing a single fissure, to investigate the effects of fissure angles and positions on the strength and failure modes of these double-layer specimens under varying confining pressure.Results and Discussion: The experimental results reveal that the intact composite rock approaches the strength of sandstone but is deformation-limited by limestone. Under constant confining pressure (σ3 = 5 MPa), the fissure angle affects initial crack initiation, and fissure position dictates the failure mode and extent, while increased confining pressure induces overall shear failure in the composite rock, with the failure mode being predominantly influenced by confining pressure. Concerning mechanical deformation, augmenting the fissure angle and confining pressure substantially enhances the elasticity and ductility of the composite rock. Regarding volumetric deformation, the extent of volume shrinkage in the composite rock is influenced by both fissure angle and confining pressure, while volume expansion is influenced by fissure position. Under uniaxial compression, fissured composite rock exhibits the most unstable crack propagation, resulting in early failure. Triaxial compression shows that a higher fissure angle stabilizes crack propagation while confining pressure variation affects stability only when the fissure is in limestone. When the fissure is in sandstone, crack propagation stability remains at its highest. Furthermore, an increase in fissure angle, higher confining pressure, and changes in fissure position from sandstone through the contact interface to limestone contribute to an increasing trend in the peak strength and elastic modulus of the composite rock. Fissure-induced rock degradation is primarily influenced by the fissure angle. These findings are significant for guiding engineering construction and design, providing valuable insights to geotechnical engineers, and enhancing safety in rock engineering projects.
Obstetric Medicine: the protocol for a prospective three-dimensional cohort study to assess maternity care for women with pre-existing conditions (ForMaT)
Authors: Jost Elena , Kosian Philipp , Greiner Gregory Gordon , Icks Andrea , Schmitz Marie-Therese , Schmid Matthias , Merz Waltraut M. 
Published: January 2024

BackgroundPregnancies in women with pre-existing medical conditions are on the rise. These pregnancies are characterized by an increased rate of maternal and perinatal complications, which can result in higher health care expenditures and altered pregnancy experiences. The purpose of this study is to integrally analyze maternity care for women with pre-existing conditions in the framework of a risk-adapted, interdisciplinary care by recording three substantial parts of maternity care: (1) maternal and perinatal outcome; (2) hospital costs and reimbursements covering the period from preconception counseling or initial antenatal visit to discharge after birth; and (3) women’s experience of reproductive choice and becoming a mother in the presence of a pre-existing condition.MethodsIn this observational, prospective, longitudinal, and monocentric cohort study, we aim to include a total of 1,500 women over a recruitment period of 15 months. Women registering for care at the Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Germany, are allocated to three groups based on their health and risk status: women with pre-existing conditions, as well as healthy women with obstetric risk factor and healthy women with a low-risk pregnancy. Participants are observed from time of initial consultation until discharge after birth. Analysis focuses on (1) maternal and perinatal outcome, especially rate of severe maternal and neonatal morbidity; (2) costs and reimbursements; and (3) surveys to capture of women’s experience and health-related quality of life during the time of reproductive choice, pregnancy, and childbirth in the presence of pre-existing medical conditions.DiscussionWith its complex three-dimensional design, the ForMaT-Trial is aiming to provide a comprehensive analysis of pregnancy and childbirth in women with pre-existing conditions. The results may serve as a basis for counseling and care of these women. By analyzing costs of specialized care, data for discussing reimbursement are generated. Lastly, our results may increase awareness for the perception of reproductive choice, pregnancy and motherhood in this continuously rising population.Clinical trial registration: German Clinical Trials Register, DRKS00030061, October 28, 2022.
A multi-institute, follow-up, observational study measuring nursing students’ adherence to infection prevention and control protocols in Saudi Arabia
Authors: Albarmawi Marwa , Al Hadid Lourance , Alnjadat Rafi , Aljabery Ahmad 
Published: January 2024

BackgroundNursing students learn principles of infection prevention and control (IPC) and hand hygiene (HH) in clinical courses, and their learning is reflected in their practice.ObjectivesThe knowledge, attitude, and practice of principles of IPC and HH of the students were measured prior to and after attending an educational workshop. The adherence of the students to the IPC and HH protocols at the hospital was also observed.MethodsThis study included a pretest-posttest time series follow-up and an observational part. During the first part of the study, students attended a workshop, which was preceded by a pretest. It was then followed by a posttest directly after finishing the workshop and in 12 weeks. Participants were submitted to an observational part by a trained observer to document certain skills taught earlier during the workshop.SettingsStudents from three nursing schools in Saudi Arabia participated in the study.ParticipantsA total number of 130 completed the study protocol, and 100 completed the observation part.ResultsStudents were found to experience an improvement in their knowledge, beliefs, and commitment scales after the workshop. The attitude scale remained relatively unchanged over different tests. Most students performed the skills properly and adequately, but some failed to perform certain skills, like hand rub, and the proper use of disinfectants.
Chronic post-surgical pain after knee arthroplasty: a role of peripheral nerve blocks
Authors: Sreckovic Svetlana , Ladjevic Nebojsa , Milicic Biljana , Tulic Goran , Milovanovic Darko , Djukanovic Marija , Kadija Marko 
Published: January 2024

IntroductionPeripheral nerve blocks are an efficient method of pain control after total knee arthroplasty (TKA), but there is no report of their impact on chronic post-surgical pain (CPSP).MethodsThis prospective observational study aimed to assess adductor canal block (ACB) and IPACK block (blocks vs. no blocks) on opioid consumption, postoperative pain score, chronic post-surgical pain 2 years after TKA.Results166 patients (82 vs. 84) were analyzed. Opioid consumption was less in the group with blocks (9.74 ± 3.87 mg vs. 30.63 ± 11.52 mg) (p &lt; 0.001). CPSP was present in 20.24% of patients in the group without blocks and 6.1% of patients with blocks (p = 0.011). Predictor variables of CPSP included pain before surgery (cut-off of 5.5), pain at rest (cut-off of 2.35), pain during active movement (cut-off: 2.5), and opioid consumption (cut-off: 8 mg).ConclusionPeripheral nerve blocks provide adequate analgesia, significantly decrease opioid consumption, improve functional outcomes, and reduce CPSP 2 years after surgery.
Development and usability testing of a patient digital twin for critical care education: a mixed methods study
Authors: Rovati Lucrezia , Gary Phillip J. , Cubro Edin , Dong Yue , Kilickaya Oguz , Schulte Phillip J. , Zhong Xiang , Wörster Malin , Kelm Diana J. , Gajic Ognjen , Niven Alexander S. , Lal Amos 
Published: January 2024

BackgroundDigital twins are computerized patient replicas that allow clinical interventions testing in silico to minimize preventable patient harm. Our group has developed a novel application software utilizing a digital twin patient model based on electronic health record (EHR) variables to simulate clinical trajectories during the initial 6 h of critical illness. This study aimed to assess the usability, workload, and acceptance of the digital twin application as an educational tool in critical care.MethodsA mixed methods study was conducted during seven user testing sessions of the digital twin application with thirty-five first-year internal medicine residents. Qualitative data were collected using a think-aloud and semi-structured interview format, while quantitative measurements included the System Usability Scale (SUS), NASA Task Load Index (NASA-TLX), and a short survey.ResultsMedian SUS scores and NASA-TLX were 70 (IQR 62.5–82.5) and 29.2 (IQR 22.5–34.2), consistent with good software usability and low to moderate workload, respectively. Residents expressed interest in using the digital twin application for ICU rotations and identified five themes for software improvement: clinical fidelity, interface organization, learning experience, serious gaming, and implementation strategies.ConclusionA digital twin application based on EHR clinical variables showed good usability and high acceptance for critical care education.
Abdominal venous thromboses: detection of the JAK2 p.V617F mutation by next-generation ultradeep sequencing—A prevalence study of patients in Mecklenburg-West Pomerania (2017–2021)
Authors: Henze Larissa , Grunwald Luise , Felser Sabine , Witte Maria , Grosse-Thie Christina , Roolf Catrin , Murua Escobar Hugo , Junghanss Christian 
Published: January 2024

BackgroundAbdominal venous thromboses are rare thrombotic events with heterogeneous etiologies. They are related to myeloproliferative neoplasms (MPNs) in some patients and can occur as first signs of the disease. MPNs are characterized by mutations in the genes of Janus kinase 2 (JAK2), myeloproliferative leukemia virus oncogene (MPL), and calreticulin (CALR).MethodsWithin the prospective trial “Prevalence of JAK2 mutations in patients with abdominal venous thromboses” (JAK2 MV study; German Clinical Trials Register: DRKS00026943), the peripheral blood of patients with abdominal venous thromboses in Mecklenburg-West Pomerania, a federal state located in north-east Germany, was analyzed by next-generation ultradeep sequencing for MPN-associated mutations. Clinical characteristics and blood cell counts were also of interest. The primary endpoint was the detection of the mutation JAK2 p.V617F. Secondary endpoints were the detection of other acquired variants of JAK2, as well as MPL and CALR.ResultsA total of 68 patients with abdominal venous thromboses were included from February 2017 to January 2021, with splanchnic veins affected in 65 patients. The mutation JAK2 p.V617F was present in 13 patients (19%), with four patients showing low variant allele frequencies (VAF 0.1% to 1.9%). The time interval from the thrombotic event to analysis was longer for patients with the mutation. The mutation MPL p.W515R was detected in three cases, all of them with low VAF. One patient among them had a concurrent mutation of JAK2 p.V617F. The mutations CALR type I or type II were not found.DiscussionBy analyzing peripheral blood for the mutation JAK2 p.V617F, an important cause of these rare thrombotic events can be identified. The development of a diagnostic workup with next-generation ultradeep sequencing for the analysis of the JAK2 p.V617F mutation and further mutations has the potential to better understand the etiology of abdominal venous thromboses in individual patients in regional clinical care, as abdominal venous thromboses are diagnosed by various medical disciplines.
Antimicrobial resistance and genetic diversity of Klebsiella pneumoniae strains from different clinical sources in horses
Authors: Gravey Francois , Sévin Corinne , Castagnet Sophie , Foucher Nathalie , Maillard Karine , Tapprest Jackie , Léon Albertine , Langlois Bénédicte , Le Hello Simon , Petry Sandrine 
Published: January 2024

IntroductionKlebsiella pneumoniae is a major cause of infections and reproductive disorders among horses, ranked in recent French studies as the sixth most frequently isolated bacterial pathogen in equine clinical samples. The proportion of multidrug-resistant (MDR) K. pneumoniae is therefore significant in a context where MDR K. pneumoniae strains are considered a major global concern by the World Health Organization.MethodsIn this study, we used a genomic approach to characterize a population of 119 equine K. pneumoniae strains collected by two laboratories specialized in animal health in Normandy (France). We describe the main antibiotic resistance profiles and acquired resistance genes, and specify the proportion of virulence-encoding genes carried by these strains. The originality of our panel of strains lies in the broad collection period covered, ranging from 1996 to 2020, and the variety of sample sources: necropsies, suspected bacterial infections (e.g., genital, wound, allantochorion, and umbilical artery samples), and contagious equine metritis analyses.ResultsOur results reveal a remarkable level of genomic diversity among the strains studied and we report the presence of 39% MDR and 9% hypervirulent strains (including 5% that are both MDR and hypervirulent).DiscussionThese findings clearly emphasize the importance of improving the surveillance of K. pneumoniae in routine equine diagnostic tests to detect high-risk MDR-hypervirulent Klebsiella pneumoniae strains. The circulation of these worrisome strains reveals that they are not being detected by the simple K1, K2, and K5 serotype approach currently implemented in the French horse-breeding sector.
Oral administration of resveratrol reduces oxidative stress generated in the hippocampus of Wistar rats in response to consumption of ethanol
Authors: Navarro-Cruz Addí Rhode , Juárez-Serrano Daniel , Cesar-Arteaga Ivan , Kammar-García Ashuin , Guevara-Díaz Jorge Alberto , Vera-López Obdulia , Lazcano-Hernández Martin , Pérez-Xochipa Ivonne , Segura-Badilla Orietta 
Published: January 2024

IntroductionChronic ethanol intake has been found to favor hippocampal deterioration and alter neuronal morphological maturation; resveratrol has been suggested as an antioxidant that may counteract these effects. The objective of this study was to analyze the effect of resveratrol on oxidative stress markers, endogenous antioxidant system in the hippocampus, and the behavior of male Wistar rats administered different concentrations of ethanol.MethodsThe animals, at 3 months old, were randomly distributed into 11 study groups (n = 6/group), orally administered (5 days on, 2 days off) with water (control), ethanol (10, 20, 30, 40 or 50%), or ethanol (10, 20, 30, 40 or 50%) plus resveratrol (10 mg/Kg/day) for 2 months. Subsequently, the production of nitrites, malondialdehyde, and 4-hydroxy-alkenal (HNE) and the enzymatic activity of catalase and superoxide dismutase (SOD) were quantified.ResultsThe levels of nitric oxide and lipid peroxidation products were significantly increased in each ethanol concentration and were statistically different compared to the control group; however, resveratrol significantly reduced oxidative stress caused by high ethanol concentration. The SOD and CAT did not present significant changes with respect to the controls in any of the study groups. In the different concentrations of ethanol used, GR increases significantly in the groups administered with resveratrol but not GPx. Resveratrol was shown to maintain the results similar to the control at most ethanol concentrations.DiscussionOur results suggest that resveratrol prevents oxidative stress induced by ethanol in the hippocampus by decreasing cellular lipid peroxidation, but does not prevent the activation of catalase or SOD enzymes; however, allows glutathione to be kept active and in adequate concentrations in its reduced form and avoids alterations in the locomotor system.
Beyond correlation: optimal transport metrics for characterizing representational stability and remapping in neurons encoding spatial memory
Authors: Aoun Andrew , Shetler Oliver , Raghuraman Radha , Rodriguez Gustavo A. , Hussaini S. Abid 
Published: January 2024

IntroductionSpatial representations in the entorhinal cortex (EC) and hippocampus (HPC) are fundamental to cognitive functions like navigation and memory. These representations, embodied in spatial field maps, dynamically remap in response to environmental changes. However, current methods, such as Pearson's correlation coefficient, struggle to capture the complexity of these remapping events, especially when fields do not overlap, or transformations are non-linear. This limitation hinders our understanding and quantification of remapping, a key aspect of spatial memory function.MethodsWe propose a family of metrics based on the Earth Mover's Distance (EMD) as a versatile framework for characterizing remapping.ResultsThe EMD provides a granular, noise-resistant, and rate-robust description of remapping. This approach enables the identification of specific cell types and the characterization of remapping in various scenarios, including disease models. Furthermore, the EMD's properties can be manipulated to identify spatially tuned cell types and to explore remapping as it relates to alternate information forms such as spatiotemporal coding.DiscussionWe present a feasible, lightweight approach that complements traditional methods. Our findings underscore the potential of the EMD as a powerful tool for enhancing our understanding of remapping in the brain and its implications for spatial navigation, memory studies and beyond.