bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying clusters of raters with a common notion of diagnosing erosive tooth wear: a step towards improving the accuracy of diagnostic procedures
Authors: Vach Kirstin , Ganss Carolina , Schlueter Nadine , Vach Werner 
Published: January 2025

Abstract
Background
Heterogeneous results are to be expected when multiple raters diagnose whether the dentine of a tooth with erosive tooth wear (ETW) is exposed or not. Identification of notions (fundamental concepts and understanding) about the diagnostic problem shared by groups of raters can be helpful to develop guidelines and to optimize teaching and calibration procedures. We aim to illustrate how clusters of raters with a common notion can be identified and how first insights about the notions can be obtained.

Methods
This investigation is based on a former study in which 49 tooth surfaces affected by ETW were rated visually by 61 raters (23 scientists, 18 university dentists, 20 dental students) in terms of dentine exposed or not. The true status was determined histologically. Gender, age, professional experience, and specialization of the raters were documented. An algorithm was used to search for clusters of raters with high agreement in their ratings suggesting a common notion. The clusters identified were examined with respect to various aspects.

Results
Four clusters of raters with high agreement could be found. The ratings of the raters in the cluster with the lowest diagnostic accuracy showed the highest correlation with the degree of tissue loss and the background tooth color, whereas the correlation with tissue loss was least in the cluster with highest diagnostic accuracy. The 15 raters of the latter cluster covered both students and dentists with or without specialization in erosion/cariology and/or long experience. This suggests that similar conceptual understanding of ETW can exist independent of professional experience.

Conclusions
The described methodology is useful to identify clusters of raters with a common notion about a specific diagnostic problem. The cluster-specific notions can be further examined based on existing study data or by group-based interviews of the raters of a cluster. This methodology allows investigators to learn more about useful or useless cues in diagnostic decision-making. This information can facilitate development or enhancement of guidelines on diagnostic decision-making.
Implementation of carceral medicaid suspension and enrollment programs: perspectives of carceral and medicaid leaders
Authors: Bandara Sachini , Saloner Brendan , Maniates Hannah , Song Minna , Krawczyk Noa 
Published: January 2025

Abstract
Background
Medicaid expansion via the Affordable Care Act, more recent legislation and Medicaid 1115 waivers offer opportunity to increase health care access among individuals involved in the carceral system. Effective enrollment of new beneficiaries and temporary suspension and reactivation of existing Medicaid benefits upon release is key to the success of these efforts. This study aims to characterize how jails, prisons and Medicaid agencies are implementing Medicaid suspension and enrollment programs and identifies barriers and facilitators to implementation.

Methods
We conducted 19 semi-structured interviews with 36 multi-state leaders in carceral facilities, Medicaid agencies, local health departments and national policy experts from 2020 to 2021. Interviews covered 4 domains: (1) the role of policy in influencing carceral and reentry Medicaid practices, (2) implementation strategies to suspend and enroll incarcerated individuals into Medicaid, (3) barriers and facilitators to successful implementation, and (4) variation in implementation between jails and prisons.

Results
Participants identified logistical challenges with suspension and enrollment, including limited infrastructure for data sharing between carceral facilities and Medicaid agencies, burdensome bureaucratic requirements, and challenges with Medicaid renewal, particularly in the jail environment. They offered opportunities to overcome barriers, such as the creation of specialized incarcerated Medicaid benefit categories and provision of in-reach services via managed care organizations. Participants also called for improvements to Medicaid reactivation processes, as even when facilities successfully suspended benefits, individuals faced significant challenges and delays reactivating benefits upon release. Participants also called for further loosening of the Medicaid Inmate Exclusion Policy.

Discussion
Findings highlight the need to update data sharing infrastructure, which will be critical to the implementation of the 1115 waivers, as carceral facilities will be subject to Medicaid billing and reporting requirements. In addition to investing in the ability to newly enroll and suspend Medicaid benefits, attention towards improving timely reactivation practices is needed, particularly given the highly elevated risk of mortality immediately after release. Participants calls for further reforms to the Medicaid Inmate Exclusion Policy are consistent with proposed legislation.

Conclusions
Findings can critically inform the successful implementation of Medicaid-based reforms to improve the health of incarcerated and formerly incarcerated people.
Intravenous branched-chain amino acid administration for the acute treatment of hepatic encephalopathy: a systematic review and meta-analysis
Authors: Yokobori Shoji , Yatabe Tomoaki , Kondo Yutaka , Ajimi Yasuhiko , Araki Manabu , Chihara Norio , Nagayama Masao , Samkamoto Tetsuya ,   the Japan Resuscitation Council (JRC) Neuroresuscitation Task Force and the Guidelines Editorial Committee, Kobata Hitoshi , Yoshimura Hajime , Kawamoto Michi , Wakasugi Masahiro , Yamagami Hiroshi , Nakamoto Hidetoshi , Hoshiyama Eisei , Todo Kenichi , Togawa Masaya , Kurihara Mana , Moriya Takashi , Nakae Ryuta , Uchida Hidetoshi , Yang Sunghoon , Iwase Masaaki 
Published: January 2025

Abstract
Background
Hepatic encephalopathy (HE) is a severe complication of acute hepatic failure requiring urgent critical care management. Branched-chain amino acids (BCAAs) such as leucine, isoleucine, and valine have been investigated as potential treatments to improve outcomes in patients with acute HE. However, the effectiveness of BCAA administration during the acute phase remains unclear. This study aimed to evaluate the effect of intravenous BCAA (IV-BCAA) treatment on clinical outcomes in patients with acute HE by systematically reviewing and analyzing randomized controlled trials (RCTs).

Methods
We conducted a comprehensive literature search of MEDLINE, the Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi (ICHUSHI), a Japanese database for medical literature. We included RCTs involving adult patients with acute HE who received IV-BCAA or placebo during the acute phase after admission (< 7 days). Two reviewers independently screened the citations and extracted data. The primary “critical” outcomes were mortality from any cause and improvement in disturbance of consciousness. The secondary “important” outcome included the incidence of complications such as nausea and diarrhea. Risk ratios (RRs) were calculated using random effects models with inverse variance weighting.

Results
Among the 2073 screened records, four met the criteria for quantitative analysis. The analysis included 219 patients: 109 received IV-BCAA, and 110 received placebo. Improvement in the disturbance of consciousness and mortality were not significantly different between the two groups (RR, 1.26; 95% confidence interval [CI], 0.96–1.66; RR, 0.90; 95% CI 0.70–1.16, respectively). Following IV-BCAA administration, the absolute differences of improvement in the disturbance of consciousness and mortality were 118 more per 1000 (95% CI 18 fewer–300 more) and 55 fewer per 1000 (95% CI 165 fewer–88 more), respectively. No significant differences were observed in the incidence of nausea or diarrhea between the two groups.

Conclusions
Our meta-analysis demonstrates that all outcomes were not significantly different between IV-BCAA treatment and placebo for acute HE. Further RCTs are required to better understand IV-BCAA treatment potential in patients with HE.
Umbilical outpouchings in pigs – an international survey on fitness for transport, welfare and management
Authors: Hansen Marie-Louise , Larsen Inge , Jensen Tina Birk , Kristensen Charlotte Sonne , Pedersen Ken Steen 
Published: January 2025

Abstract
Background
Umbilical outpouchings (UOs) in pigs are a multifactorial disease and little is known about effective prevention strategies and risk factors for UO development. UOs are common in Danish pigs and legislation complicates and increases the cost of keeping and raising pigs with UO. Recommendations for preventive measures exist but the scientific evidence behind the recommendations is often lacking. This study´s purpose was to investigate veterinarians’ perspectives on UO pigs´ fitness for transport, the welfare of UO pigs, the significance of UO, risk factors for the development of UO, and the management of pigs with UO. This study´s purpose was to investigate veterinarians’ perspectives on UO pigs´ fitness for transport, the welfare of UO pigs, the significance of UO, risk factors for the development of UO, and the management of pigs with UO.

Results
The survey received 93 complete responses from veterinarians working within porcine health management. Because of the large proportion of replies from Danish veterinarians, all reporting of results was divided among Danish and non-Danish veterinarians. There were no statistically significant differences between the two groups in the assessment of fitness for transport. Both groups mainly agreed to a series of statements regarding the significance of UO and risk factors for UO development. The management of UO was also similar across the groups except for the use of neonatal antibiotics which was used considerably more in Danish herds.

Conclusions
Umbilical outpouchings seem to be perceived as a challenge across pork production; affecting the welfare of the individual pig as well as the management of the entire production. There were no significant differences between Danish and non-Danish veterinarians’ assessments of fitness for transport, and almost all the veterinarians agreed that some UO pigs might need special attention and care. Most would also recommend preventive measures. Despite most respondents in this survey working under the laws of the European Union, some were unaware of legislation regarding UO pigs.
Machine learning algorithms for predictive modeling of dyslipidemia-associated cardiovascular disease risk in pregnancy: a comparison of boosting, random forest, and decision tree regression
Authors: Sadiq Idris Zubairu , Abubakar Fatima Sadiq , Saliu Muhammad Auwal , katsayal Babangida Sanusi , Salihu Aliyu , Muhammad Aliyu 
Published: January 2025

Abstract
Background
Cardiovascular diseases (CVD) are major contributors to maternal mortality and morbidity during pregnancy and increased atherogenic index of plasma levels is associated with a higher risk of CVD and obesity.

Methods
In this study, we utilized three different machine learning algorithms (boosting, random forest, and decision tree regression) to predict dyslipidemia-associated cardiovascular disease using atherogenic index and lipid profile parameters based on a cross-sectional study datasets of 112 pregnant women aged between 15 and 49 conducted at Aminu Kano Teaching Hospital.

Results
The results showed that random forest regression outperformed both boosting and decision tree regression, recording the lowest error criteria (MSE = 0.071 and RMSE = 0.266) for evaluating the model. These findings indicated that all the three algorithms have the potential to effectively model the data from atherogenic indices and lipid profile parameters but random forest and boosting were found to outperform decision tree models with respective R2 values of 0.95 and 0.92.

Conclusions
Overall, the study highlights the accuracy of machine learning models (random forest, boosting, and decision trees) in predicting dyslipidemia-associated cardiovascular diseases and the findings could contribute to the development of effective strategies for the prevention and treatment of dyslipidemia-associated cardiovascular diseases.
Prosthetic articulating spacers as a preferred option for two-stage revision arthroplasty in chronic periprosthetic joint infection
Authors: Lin Jiamin , Li Hongyan , Chen Yang , Ding Haiqi , Wang Qijin , Lv Jianhua , Li Wenbo , Zhang Wenming , Fang Xinyu 
Published: January 2025

Abstract
Purpose
The study aimed to compare the infection control rates, mechanical complications, and functional outcomes between prosthetic and cement spacers in two-stage revision arthroplasty for chronic periprosthetic joint infection (PJI).

Patients and methods
Data from patients treated for chronic PJI in our center from 2014 to 2023 were retrospectively collected and the patients were divided into the prosthetic spacer (PS) and cement spacer (CS) groups based on the type of spacer used for the first-stage surgeries. Data on patients’ demographics and clinical scores were harvested. Infection control rates and mechanical complications were compared between the two groups by using chi-square tests and log-rank analysis.

Results
The study involved 113 cases, with a mean age of 64 ± 11.45 years (range, 31–88 years), with 48 cases in the PS group, 65 in the CS group, and all patients were followed up for at least 1 year (average 52.68 ± 26.07 months). Five patients in the PS group (10.42%) and six in the CS group (9.23%) developed recurrent infections, with no significant difference found in infection control rates (P = 0.833). The joint function score after the first-stage surgeries was higher in the PS group than in the CS group (P = 0.021). The incidence of mechanical complications, including dislocation, spacer fracture, and periprosthetic fracture, was significantly lower in the PS group than in the CS group (P = 0.024). The proportion of patients who underwent second-stage surgeries was lower in the PS group than in the CS group (58.3% vs 70.77%, P = 0.169).

Conclusion
For most patients with chronic PJI, PS can be used as the preferred option for two-stage revision arthroplasty.
ImpACT Project: Improving Access to Clinical Trials in Victoria, an Artificial Intelligence–Based Approach
Authors: Bechelli Maria L. , Ivanova Kris , Tan Suan Siang , Kumar Beena , Swiatek Dayna , Arulananda Surein , Evans Sue M. 
Published: January 2025

PURPOSE
Enhancing the speed and efficiency of clinical trial recruitment is a key objective across international health systems. This study aimed to use artificial intelligence (AI) applied in the Victorian Cancer Registry (VCR), a population-based cancer registry, to assess (1) if VCR received all relevant pathology reports for three clinical trials, (2) AI accuracy in auto-extracting information from pathology reports for recruitment, and (3) the number of participants approached for trial enrollment using the AI approach compared with standard hospital-based recruitment.

METHODS
To verify pathology report accessibility for VCR trial enrollment, reports from the laboratory were cross-referenced. To determine the accuracy of a Rapid Case Ascertainment (RCA) module of the AI software in extracting key clinical variables from the pathology report, data were compared with manually reviewed reports. To examine the effectiveness of the AI recruitment approach, the number of patients approached for recruitment was compared with standard practice.

RESULTS
Of the 195 reports provided by the pathology laboratory, 185 (94.9%) were received by VCR, 73 of 195 (37.4%) were eligible for the studies, and 5 of 73 (6.8%) eligible cases had not been received by the VCR. The RCA module demonstrated an accuracy of 93% and an F1 score of 0.94 in extracting key clinical variables. However, the RCA false-positive rate was 10% and the false-negative rate was 5%. The standard hospital approach selected fewer cases for approach to clinical trials compared with the RCA module approach, 8 of 336 (2.4%) versus 12 of 336 (3.6%), respectively.

CONCLUSION
Using AI to screen potentially eligible cases for recruitment to three clinical trials resulted in a 50% increase in eligible cases being approached for enrollment.
Observational Study of Best Supportive Care With or Without Oral Capecitabine in Patients With Metastatic Gallbladder Carcinoma at a Tertiary Center in India
Authors: Srivastava Abhinav , Misra Shagun , Rastogi Neeraj , Kapoor Vishwas , Kumar Shaleen 
Published: January 2025

PURPOSE
To compare overall survival (OS), toxicity, and quality of life (QOL) in patients with metastatic gallbladder cancer receiving oral capecitabine (X) with best supportive care (BSC) and BSC alone.

MATERIALS AND METHODS

Patients with metastatic gallbladder cancer and Karnofsky Performance Status (KPS) ≥70 were accrued and assigned to either arm A or B. Assignment to these two arms was based on physician/patient discretion. Arm A received oral capecitabine 825 mg/m
2
twice a day d1-14, repeated every 3 weeks for six cycles with BSC, and arm B received BSC alone. The Kaplan-Meier method computed OS and comparison was using a log-rank test. QOL was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 administered at baseline, 3 months, and 6 months. The linear mixed-effects model was used for the longitudinal analysis of QOL.

RESULTS

Between December 2020 and April 2022, 64 patients diagnosed with metastatic gallbladder carcinoma and KPS ≥70 were accrued in the study, and 32 patients were assigned to each arm. In arm A versus B, the median age was 52 versus 55 (
P
= .21); the median KPS was 80 versus 70 (
P
= .008). The median OS in arm A versus B was 3.4 versus 2 months (
P
= .001). Grade 1-2 vomiting and diarrhea were seen in 50% versus 78% (
P
= .041) and 59% versus 9.3% (
P
= .01) patients in arm A versus B, respectively. Grade 1-2 hand-foot syndrome was seen in 12 (37.5%) patients in arm A. Dynamic changes showed an improvement in pain in the linear mixed model with a significant difference between the arms (
P
= .011); arm A experienced a significant improvement in pain over time (arm × time
P
= .020). Global QOL improved over time (
P
= .038) with parallel improvement between arms (arm × time
P
= .490).

CONCLUSION
Compared with BSC alone, patients who receive X + BSC experience an OS improvement of 1.4 months and better pain control without grade 3 toxicities or negative impact on QOL.
Trastuzumab-Pertuzumab Plus Eribulin or Taxane as First-Line Chemotherapy for Human Epidermal Growth Factor 2–Positive Locally Advanced/Metastatic Breast Cancer: The Randomized Noninferiority Phase III EMERALD Trial
Authors: Yamashita Toshinari , Saji Shigehira , Takano Toshimi , Naito Yoichi , Tsuneizumi Michiko , Yoshimura Akiyo , Takahashi Masato , Tsurutani Junji , Iwatani Tsuguo , Kitada Masahiro , Tada Hiroshi , Mori Natsuko , Higuchi Toru , Iwasa Tsutomu , Araki Kazuhiro , Koizumi Kei , Hasegawa Hiroki , Uchida Yohei , Morita Satoshi , Masuda Norikazu 
Published: January 2025

PURPOSE
Trastuzumab-pertuzumab (HP) plus taxane is a current standard first-line therapy for recurrent or metastatic human epidermal growth factor 2 (HER2)+ breast cancer (BC). We investigated noninferiority of eribulin to a taxane when combined with dual HER2 blockade as first-line systemic treatment for locally advanced/metastatic HER2+ BC.

METHODS

In the phase III EMERALD trial (target sample size, 480; ClinicalTrials.gov identifier:
NCT03264547
/UMIN000027938), patients were randomly assigned (1:1) to receive eribulin 1.4 mg/m
2
once daily on days 1 and 8 (eribulin group) or a taxane (docetaxel 75 mg/m
2
once on day 1 or paclitaxel 80 mg/m
2
once daily on days 1, 8, and 15; taxane group) intravenously in a 21-day cycle, each with HP on day 1. The primary end point was progression-free survival (PFS; intention-to-treat population). Secondary end points included objective response rate, overall survival (OS), patient-reported quality of life (QoL), and safety. Noninferiority was tested using the stratified Cox proportional hazards model to estimate hazard ratios (HRs) for PFS events, with a noninferiority HR margin of 1.33.

RESULTS
Between August 2017 and June 2021, 446 patients (median age, 56.0 years) were enrolled. The median PFS was 14.0 and 12.9 months in the eribulin group (n = 224) and taxane group (n = 222 [docetaxel/paclitaxel, n = 186/36]), respectively (HR, 0.95 [95% CI, 0.76 to 1.19]), which confirmed the noninferiority of the study regimen. The median OS was 65.3 months in the taxane group but has not been reached in the eribulin group. Median time to QoL deterioration was numerically longer with eribulin than with taxane. Adverse event (AE) rates were similar, despite the longer duration of eribulin use. Infusion reaction, skin-related AEs, diarrhea, and edema were more common with taxane, whereas neutropenia was more common with eribulin.

CONCLUSION
The results suggested that eribulin + HP is an option for first-line treatment of locally advanced/metastatic HER2+ BC.
Targeted Next-Generation Sequencing in Succinate Dehydrogenase–Deficient GI Stromal Tumor Identifies Actionable Alterations in the PI3K/mTOR Pathway
Authors: Cicala Carlo María , Matito Judit , Quindos María , Gómez-Peregrina David , Romero-Lozano Paula , Fernández-Suárez Paula , Valverde Claudia , González Macarena , Landolfi Stefania , Pérez-Albert Paula , Gros Luis , Vivancos Ana , Serrano César 
Published: January 2025

PURPOSE
Less than 5% of GI stromal tumors (GISTs) are driven by the loss of the succinate dehydrogenase (SDH) complex, resulting in a pervasive DNA hypermethylation pattern that leads to unique clinical features. Advanced SDH-deficient GISTs are usually treated with the same therapies targeting KIT and PDGFRA receptors as those used in metastatic GIST. However, these treatments display less activity in the absence of alternative therapeutic options. Therefore, it is critical to identify novel actionable alterations in SDH-deficient GIST.

PATIENTS AND METHODS
We performed a single-center, retrospective analysis of patients with SDH-deficient GIST together with next-generation sequencing (NGS) analysis from their respective tumor samples to identify mutations and copy number alterations and chromosomal alterations. NGS-tailored treatment was implemented whenever possible.

RESULTS
Seventeen tumor samples from 14 patients with SDH-deficient GIST underwent NGS. Mutational load was low, although three patients (21%) displayed molecular events in relapse samples leading to PI3K/mTOR pathway hyperactivation. mTOR inhibition with everolimus obtained a sustained tumor response in a heavily pretreated patient. Other alterations, largely present in late-stage patients, uncovered genes involved in cell cycle regulation, telomere maintenance, and DNA damage repair. Chromosomal arm-level alterations differed from the canonical cytogenetic progression in KIT/PDGFRA-mutant GIST.

CONCLUSION
This molecular landscape of SDH-deficient GIST uncovers novel molecular alterations, mostly in relapse and/or previously pretreated patients. The identification of genetic events leading to PI3K/mTOR dysregulation together with the remarkable activity of everolimus in one patient showcases the clinical relevance of this pathway, validates the utility of NGS in this population, and poses everolimus as a novel therapeutic alternative. Several other alterations were found at the genetic and genomic levels, underscoring novel biological processes likely involved during tumor evolution.