bluuebunny/crossref_metadata_2025_split huggingface dataset:
A rapidly evolving landscape: immune checkpoint inhibitors in pretreated metastatic endometrial cancer
Authors: Tinker Anna V. , Dhani Neesha C. , Ghatage Prafull , McLeod Deanna , Samouëlian Vanessa , Welch Stephen A. , Altman Alon D. 
Published: March 2023

Background and objectives: Endometrial cancer is a common malignancy and recurrences can be fatal. Although platinum-pretreated endometrial tumors are commonly treated with anthracyclines and taxanes, there is no current standard of care. Both immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) have been extensively assessed in this setting, including tumors selected for DNA mismatch repair (MMR)/microsatellite instability (MSI) and programmed death-ligand 1 expression status. This review will provide evidence-based guidance on use of ICIs alone or in combination with TKIs in patients with pretreated advanced, persistent, or recurrent metastatic endometrial cancer. Data sources and methods: Randomized phase II–III trials in unselected populations pretreated, recurrent, or metastatic endometrial cancer and phase I–II trials in biomarker selected populations were identified from PubMed as well as conference proceedings using the key search terms ‘immune checkpoint inhibitors’, ‘endometrial cancer’, and ‘advanced’. Results: A total of nine eligible studies were identified assessing ICI monotherapy for biomarker-selected or ICI plus TKI combinations and a dual ICI regimen for biomarker-unselected patients with pretreated recurrent or metastatic endometrial cancer. In MMR/MSI-selected tumors, five phase I/II studies evaluated ICI monotherapy indicating benefit in these patients. Only the phase III KEYNOTE-775 trial reported a statistically significant overall survival improvement for the combination of pembrolizumab plus lenvatinib compared with docetaxel or paclitaxel regardless of MMR/MSI status. Conclusions: Pembrolizumab plus lenvatinib is indicated for patients with unselected pretreated metastatic endometrial cancer and pembrolizumab monotherapy is a preferred option for patients with MMRd/MSI-H tumors.
Sexually Transmitted Infections and Health Literacy: A Community-Based Preventive Program
Authors: Sul Susana , Ferreira Liliana , Maia Ana Catarina , Coelho Anabela , Costa Andreia 
Published: March 2023

Background: Sexually transmitted infections (STIs) are a public health problem with a high risk of morbidity and community transmissibility. Evidence points to their continuous increase. This study describes the design, development, and implementation of a community-based STI prevention program for community healthcare users. Methods: Based on the Health Planning Process design method, a structured, community-based intervention program on STI counseling and detection was conducted in a primary health care unit in Lisbon. Two data collection instruments were applied in the diagnosis of the situation, namely the Health Literacy Survey Portugal (ILS-PT) and the STD Attitude Scale, to 47 patients who attended the health consultation on STI counseling and detection in a primary care unit in Lisbon. Two interventions were implemented, the health education session and the provision of an educational poster. In the evaluation of the project, the acceptance and satisfaction of the patients with the implemented interventions were considered as outcome indicators. A descriptive statistical analysis of the data was performed. Results: The participants shows considerably low levels of health literacy and high-risk behaviors for acquiring STIs. After an intervention, a high percentage of the participants point out the project as exciting and valuable and reveal having acquired knowledge that allowed them to improve their health. Furthermore, the patients were very satisfied with the implemented health education session and the educational poster. Conclusion: This project revealed the urgent and important need to implement community intervention projects to prevent STIs and promote health literacy among the most vulnerable groups.
Can a Novel Natural Language Processing Model and Artificial Intelligence Automatically Generate Billing Codes From Spine Surgical Operative Notes?
Authors: Zaidat Bashar , Tang Justin , Arvind Varun , Geng Eric A. , Cho Brian , Duey Akiro H. , Dominy Calista , Riew Kiehyun D. , Cho Samuel K. , Kim Jun S. 
Published: March 2023

Study Design Retrospective cohort. Objective Billing and coding-related administrative tasks are a major source of healthcare expenditure in the United States. We aim to show that a second-iteration Natural Language Processing (NLP) machine learning algorithm, XLNet, can automate the generation of CPT codes from operative notes in ACDF, PCDF, and CDA procedures. Methods We collected 922 operative notes from patients who underwent ACDF, PCDF, or CDA from 2015 to 2020 and included CPT codes generated by the billing code department. We trained XLNet, a generalized autoregressive pretraining method, on this dataset and tested its performance by calculating AUROC and AUPRC. Results The performance of the model approached human accuracy. Trial 1 (ACDF) achieved an AUROC of .82 (range: .48-.93), an AUPRC of .81 (range: .45-.97), and class-by-class accuracy of 77% (range: 34%-91%); trial 2 (PCDF) achieved an AUROC of .83 (.44-.94), an AUPRC of .70 (.45-.96), and class-by-class accuracy of 71% (42%-93%); trial 3 (ACDF and CDA) achieved an AUROC of .95 (.68-.99), an AUPRC of .91 (.56-.98), and class-by-class accuracy of 87% (63%-99%); trial 4 (ACDF, PCDF, CDA) achieved an AUROC of .95 (.76-.99), an AUPRC of .84 (.49-.99), and class-by-class accuracy of 88% (70%-99%). Conclusions We show that the XLNet model can be successfully applied to orthopedic surgeon’s operative notes to generate CPT billing codes. As NLP models as a whole continue to improve, billing can be greatly augmented with artificial intelligence assisted generation of CPT billing codes which will help minimize error and promote standardization in the process.
Genetic liability to migraine and functional outcome after ischemic stroke
Authors: Wang Mengmeng , Daghlas Iyas , Zhang Zhizhong , Ye Dan , Li Shun , Liu Dandan 
Published: March 2023

Background and purpose: To evaluate the association of genetic liability to migraine with functional outcome after ischemic stroke using Mendelian randomization. Methods: Genetic proxies for migraine were obtained from the largest genome-wide association study meta-analysis of 102,084 migraine cases and 771,257 controls. Genetic associations with functional outcome after ischemic stroke were obtained from the Genetics of Ischemic Stroke Functional Outcome network study ( N = 6021). Poor functional outcome after ischemic stroke was defined as a score of 3–6 on the modified Rankin scale at 3 months ( N = 2280). The inverse-variance weighted method was used to estimate the association of genetic liability to migraine with functional outcome, and we performed sensitivity analyses to assess the robustness of results. Results: Genetic liability to migraine was associated with poor functional outcome after ischemic stroke (odds ratio of poor functional outcome per doubling in migraine odds 1.22, 95% confidence interval 1.02–1.45, p = 0.031). This association remained directionally consistent across sensitivity analyses. Conclusions: This study provides genetic support that migraine is associated with poor functional outcome after ischemic stroke. These findings warrant further follow-up and, if replicated, may have clinical implications for post-stroke recovery.
Role of the human solute carrier family 14 member 1 gene in hypoxia-induced renal cell carcinoma occurrence and its enlightenment to cancer nursing
Authors: Shi Jing , Sha Ruili , Yang Xilan 
Published: March 2023

Abstract
Background
Hypoxia is considered a critical contributor to renal cell carcinoma progression, including invasion and metastasis. However, the potential mechanisms by which it promotes invasion and metastasis have not yet been clarified. The purpose of this study was to investigate the role and mechanism of hypoxia-induced renal cell carcinoma and provide evidence-based medical proof for improvements to postoperative nursing of renal cell carcinoma patients. A total of 64 patients with renal cell carcinoma were divided into the observation group (nursing based on oxygen administration) and the control group (conventional nursing). Renal function indexes, serum inflammatory factors, and tumor markers were evaluated. The human renal cell carcinoma cell line A498 under hypoxia/normoxia was used as an experimental model in vitro and the biological characteristics and mitochondrial function of the cells were assessed.

Results
Nursing based on oxygen administration decreased the value of renal function indexes, serum inflammatory factors, and tumor markers in renal cell carcinoma patients. Hypoxia was found to induce A498 cell invasion, migration, and the release of inflammatory cytokines, while repressing human solute carrier family 14 member 1 gene expression. Elevated levels of solute carrier family 14 member 1 expression induced mitochondrial reactive oxygen species accumulation, diminished the intracellular adenosine triphosphate level, and destroyed both mitochondrial membrane potential integrity and mitochondrial morphology. Overexpression of the solute carrier family 14 member 1 gene could abolish hypoxia-induced invasion, reduce the migration of A498 cells, inhibit the hypoxia-induced release of inflammatory cytokines, and arrest the cell cycle at the G1/S checkpoint.

Conclusions
These data reveal that nursing based on oxygen administration can improve the clinical efficacy of renal cell carcinoma therapies, being safe and effective. The results elucidate a mechanism wherein the solute carrier family 14 member 1 gene participates in the occurrence and development of hypoxia-induced renal cell carcinoma in a mitochondria-dependent manner.
A novel clinical prediction model of severity based on red cell distribution width, neutrophil-lymphocyte ratio and intra-abdominal pressure in acute pancreatitis in pregnancy
Authors: Liao Wenyan , Tao Guangwei , Chen Guodong , He Jun , Yang Chunfen , Lei Xiaohua , Qi Shuo , Hou Jiafeng , Xie Yi , Feng Can , Jiang Xinmiao , Deng Xin , Ding Chengming 
Published: March 2023

Abstract
Background
Acute pancreatitis in pregnancy (APIP) with a high risk of death is extremely harmful to mother and fetus. There are few models specifically designed to assess the severity of APIP. Our study aimed to establish a clinical model for early prediction of severity of APIP.

Methods
A retrospective study in a total of 188 patients with APIP was enrolled. The hematological indicators, IAP (intra-abdominal pressure) and clinical data were obtained for statistical analysis and prediction model construction.

Results
According to univariate and multivariate logistic regression analysis, we found that red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR) and Intra-abdominal pressure (IAP) are prediction indexes of the severity in APIP (p-value < 0.05). Our novel clinical prediction model was created by based on the above three risk factors and showed superior predictive power in primary cohort (AUC = 0.895) and validation cohort (AUC = 0.863). A nomogram for severe acute pancreatitis in pregnancy (SAPIP) was created based on the three indicators. The nomogram was well-calibrated.

Conclusion
RDW, NLR and IAP were the independent risk factors of APIP. Our clinical prediction model of severity in APIP based on RDW, NLR and IAP with predictive evaluation is accurate and effective.
Effects of maternal pre-pregnancy body mass index and gestational weight gain on antenatal mental disorders in China: a prospective study
Authors: Zhou Xuan , Rao Lin , Yang Dongjian , Wang Tong , Li Hong , Liu Zhiwei 
Published: March 2023

AbstractBackgroundMaternal obesity is the most common medical condition among women of reproductive age worldwide. The pre-pregnancy body mass index and gestational weight gain have been suggested to be associated with maternal mental disorders. This study aimed to investigate the effects of the pre-pregnancy body mass index and gestational weight gain on antenatal depression, stress, and anxiety.MethodsIn total, 4,890 pregnant women were enrolled in the present study, which is based on an ongoing prospective cohort study. We used self-reported pre-pregnancy weights and the last weights measured prior to delivery (using professional instruments) to calculate the pre-pregnancy body mass index and gestational weight gain. The questionnaires used included the Center for Epidemiologic Studies Depression Scale (CES-D), Self-Rating Anxiety Scale (SAS), and 10-item version of the Perceived Stress Scale (PSS-10). We used Pearson product-moment correlation and multivariable logistic regression models to examine the impact of the pre-pregnancy body mass index and gestational weight gain on different maternal mental disorders.ResultsAfter adjusting for conception, annual household income, occupation, education, smoking status, and drinking status, excessive gestational weight gain during pregnancy was associated with a greater chance of anxiety symptoms in the entire sample (adjusted model: odds ratio = 1.479, 95% confidence interval = 1.128, 1.938) and especially in women with a normal body mass index (adjusted model: odds ratio = 1.668, 95% confidence interval = 1.209, 2.302). However, the relationship between the maternal pre-pregnancy body mass index and mental health was not significant.ConclusionPregnant women with a normal pre-pregnancy body mass index had a greater chance of experiencing anxiety symptoms before delivery if gestational weight gain was excessive; however, its effects on depression or stress symptoms were not observed. The maternal pre-pregnancy body mass index may not be independently associated with maternal mental disorders.
Analysis of the clinical outcomes of microbial contamination caused by environmental contamination of the embryology laboratory during IVF-ET treatment cycles
Authors: Zheng Tingting , Li Qinhua , Chen Ningjing , Du Peiyao , Ye Hong 
Published: March 2023

Abstract
Background
Bacterial contamination may cause loss of or damage to cultured oocytes or embryos, resulting in the lack of transplantable embryos during IVF embryo culture. However, there are few reports about IVF embryo contamination caused by embryology laboratories. In this work, we evaluated clinical pregnancy outcomes and the risk of maternal and infant complications after embryo contamination caused by environmental pollution during IVF.

Methods
The authors retrospectively analyzed 2490 IVF-ET ovulation induction therapy cycles in the Reproductive Center of Yichang Central People's Hospital from January 2015 to May 2022. According to the presence or absence of embryo culture medium contamination, the two groups were divided into an embryo contamination cycle and a nonembryo contamination cycle. The primary outcome parameters were the characteristics and progress of embryo culture medium contamination. Embryo laboratory outcomes, pregnancy outcomes, and maternal and infant complications were secondary outcome parameters.

Results
One case of embryo contamination originated from semen contamination. The remaining 15 cases involved environmental contamination outbreaks in embryo culture chambers, caused by Staphylococcus pasteuri. Compared with conventional uncontaminated IVF cycles, the 15 cases of contaminated embryo cycles showed no significant difference in embryo laboratory outcomes, pregnancy outcomes, or maternal and infant complications except for a slightly higher rate of fetal growth retardation. Ultimately, 11 live-born infants were successfully delivered, of which 2 were premature. The remaining 4 patients did not become pregnant after 1–2 transfers due to a lack of transferable embryos.

Conclusion
When the embryo culture medium is contaminated due to the environmental contamination of the IVF culture room, it is feasible to perform daily rapid rinsing of the culture medium and avoid blastocyst culture as remedial treatment. However, the long-term impact on offspring needs further prospective research.
DNMT3A low-expression is correlated to poor prognosis in childhood B-ALL and confers resistance to daunorubicin on leukemic cells
Authors: Li Weijing , Liu Shuguang , Wang Chanjuan , Cui Lei , Zhao Xiaoxi , Liu Wei , Zhang Ruidong , Li Zhigang 
Published: March 2023

Abstract
Background
Little is known about DNMT3A expression and its prognostic significance in childhood B cell acute lymphoblastic leukemia (B-ALL).

Methods
We determined DNMT3A mRNA expression in 102 children with B-ALL. Correlations with relapse-free survival (RFS) and common clinical characteristics were analyzed. DNMT3A was stably knocked out by CRISPR/Cas9 gene editing technology in Reh and 697 B-ALL cell lines. Cell proliferation activity after treated with daunorubicin (DNR) was determined by CCK8 assay in DNMT3A KO Reh and 697 cell lines.

Results
DNMT3A expression in B-ALL patients who were in continuous complete remission (CCR) was higher than in those who got relapse (P = 0.0111). Receiver operating characteristic curve showed prognostic significance of DNMT3A expression (P = 0.003). Low expression of DNMT3A (≤ 0.197) was significantly correlated with poor RFS (P < 0.001) in children with B-ALL. Knock-out of DNMT3A in Reh and 697 cell lines significantly increased IC50 of DNR (P = 0.0201 and 0.0022 respectively), indicating elevated resistance to DNR.

Conclusion
Low expression of DNMT3A associates with poor prognosis in children with B-ALL. Knock-out of DNMT3A confers resistance to DNR on leukemic cells.
Association between neonatal near miss and infant development: the Ribeirão Preto and São Luís birth cohorts (BRISA)
Authors: Aristizábal Liliana Yanet Gómez , Rocha Paulo Ricardo Higassiaraguti , Confortin Susana Cararo , Simões Vanda Maria Ferreira , Bettiol Heloisa , Barbieri Marco Antonio , da Silva Antônio Augusto Moura 
Published: March 2023

Abstract
Aim
To analyze the association between neonatal near miss and infant development at two years.

Methods
Data from two birth cohorts, one conducted in Ribeirão Preto (RP)/São Paulo and the other in São Luís (SL)/Maranhão, were used. The cognitive, motor and communication development of children was evaluated using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). The following criteria were used for the definition of NNM: birth weight < 1,500 g, 5-min Apgar score < 7, gestational age < 32 weeks, and report of congenital malformations. The relationship between neonatal near miss and development was assessed using the weighted propensity score from the Inverse Probability of Treatment Weighting (IPTW). A directed acyclic graph was built to select the adjustment variables.

Results
A total of 1,050 mother-newborn dyads were evaluated in SL and 1,840 in RP. Regarding outcomes in SL and RP, respectively, 2.4% and 17.3% of the children were not competent in the cognitive domain, 12.1% and 13.3% in the receptive communication domain, 39.2% and 47.1% in the expressive communication domain, 20.7% and 12.6% in the fine motor domain, and 14.3% and 13.8% in the gross motor domain. The prevalence of neonatal near miss was 5.4% in SL and 4.3% in RP. Unadjusted analysis showed an association of neonatal near miss with fine motor development in SL and RP and with the cognitive, receptive communication, expressive communication, and gross motor domains only in RP. These associations remained after adjusted analysis.

Conclusion
Neonatal near miss is a risk factor for developmental delays.
Premature infants receiving delayed cord clamping with and without cord milking: a randomized control trial
Authors: Prachukthum Sariya , Tanprasertkul Chamnan , Somprasit Charintip 
Published: March 2023

Abstract
Background
Preterm infants often have long hospital stays and frequent blood tests; they often develop anemia requiring multiple blood transfusions. Placental transfusion via delayed cord clamping (DCC) or umbilical cord milking (UCM) helps increase blood volume. We hypothesized umbilical cord milking (UCM), together with DCC, would be superior in reducing blood transfusions.

Objectives
To compare the effects of DCC and DCC combined with UCM on hematologic outcomes among preterm infants.

Methods
One hundred twenty singleton preterm infants born at 280/7- 336/7 weeks of gestation at Thammasat University Hospital were enrolled in an open-label, randomized, controlled trial. They were placed into three groups (1:1:1) by a block-of-three randomization: DCC for 45 s, DCC with UCM performed before clamping (DCM-B), and DCC with UCM performed after clamping (DCM-A). The primary outcomes were hematocrit levels and number of infants receiving blood transfusions during the first 28 days of life. Intraventricular hemorrhage (IVH) and necrotizing enterocolitis (NEC) were secondary outcomes. Analyses were performed with an intent-to-treat approach.

Results
One hundred twenty preterm infants were randomized. There was no statistically significant difference in neonatal outcomes; hematocrit on admission 54.0 ± 5.5, 53.3 ± 6.0, and 54.3 ± 5.8 (p = 0.88), receiving blood transfusions 25%, 20%, and 12.5% (p = 0.24), incidence of NEC 7.5, 0 and 10% (p = 0.78) in the DCC, DCM-B and DCM-A groups, respectively. There were no preterm infants with severe IVH, polycythemia, maternal or neonatal death.

Conclusion
The placental transfusion techniques utilized, DCC and DCC combined with UCM, provided the same benefits for preterm infants born at GA 28 and 33 weeks in terms of reducing the need for RBC transfusions, severities of IVH and incidence of NEC without increasing comorbidity.

Trial registration
TCTR20190131002. Registered 31 January 2019—Retrospectively registered.
Antibiotic associated diarrhea in outpatient pediatric antibiotic therapy
Authors: Tanır Basaranoğlu Sevgen , Karaaslan Ayşe , Salı Enes , Çiftçi Ergin , Gayretli Aydın Zeynep Gökçe , Aldemir Kocabaş Bilge , Kaya Cemil , Şen Bayturan Semra , Kara Soner Sertan , Yılmaz Çiftdoğan Dilek , Çay Ümmühan , Gundogdu Aktürk Hacer , Çelik Melda , Ozdemir Halil , Somer Ayper , Diri Tijen , Yazar Ahmet Sami , Sütçü Murat , Tezer Hasan , Karadag Oncel Eda , Kara Manolya , Çelebi Solmaz , Özkaya Parlakay Aslınur , Karakaşlılar Sabahat , Arısoy Emin Sami , Tanır Gönül , Tural Kara Tuğçe , Devrim İlker , Erat Tuğba , Aykaç Kübra , Kaba Özge , Güven Şirin , Yeşil Edanur , Tekin Yılmaz Ayşe , Yaşar Durmuş Sevgi , Çağlar İlknur , Günay Fatih , Özen Metehan , Dinleyici Ener Çağrı , Kara Ateş 
Published: March 2023

Abstract
Background
Antibiotic-associated diarrhea is one of the most frequent side effects of antimicrobial therapy. We assessed the epidemiological data of antibiotic-associated diarrhea in pediatric patients in our region.

Methods
The prospective multi-center study included pediatric patients who were initiated an oral antibiotic course in outpatient clinics and followed in a well-established surveillance system. This follow-up system constituded inclusion of patient by the primary physician, supply of family follow-up charts to the family, passing the demographics and clinical information of patient to the Primary Investigator Centre, and a close telephone follow-up of patients for a period of eight weeks by the Primary Investigator Centre.

Results
A result of 758 cases were recruited in the analysis which had a frequency of 10.4% antibiotic-associated diarrhea. Among the cases treated with amoxicillin-clavulanate 10.4%, and cephalosporins 14.4% presented with antibiotic-associated diarrhea. In the analysis of antibiotic-associated diarrhea occurrence according to different geographical regions of Turkey, antibiotic-associated diarrhea episodes differed significantly (p = 0.014), particularly higher in The Eastern Anatolia and Southeastern Anatolia. Though most commonly encountered with cephalosporin use, antibiotic-associated diarrhea is not a frequent side effect.

Conclusion
This study on pediatric antibiotic-associated diarrhea displayed epidemiological data and the differences geographically in our region.