bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient engagement in radiation oncology: a large retrospective study of survey response dynamics
Authors: Loving Bailey A. , Ye Hong , Rutka Elizabeth , Robertson John M. 
Published: January 2025

PurposePatient satisfaction surveys are pivotal in evaluating healthcare quality and enhancing patient care. Understanding the factors influencing patient engagement with these surveys in radiation oncology can guide improvements in patient-centered care.MethodsThis retrospective study analyzed data from radiation oncology patients at a large multi-site single-institution center from May 2021 to January 2024. We assessed the influence of demographic, clinical, and socioeconomic factors on the likelihood of survey participation using univariate (UVA) and multivariable (MVA) logistic regression analyses. Factors included age, gender, race, socioeconomic status (SES) via Area Deprivation Index (ADI), language, marital status, smoking, employment, insurance type, mental health disorders (MHD), comorbidity index (CCI), and cancer type.ResultsIn a comprehensive analysis of 11,859 patients, most were female (57.2%), over 65 years old (60.7%), and primarily insured by Medicare (45.9%). MVA showed that higher socioeconomic disadvantage significantly decreased survey participation (ADI third tertile vs. first tertile OR=0.708, p&lt;0.001), with each unit increase in ADI reducing the odds of completion by 1% (p&lt;0.001). Older adults, and patients with head and neck or genitourinary cancers were significantly more likely to participate, while those with higher comorbidities, MHD, or other minority status were less engaged (p&lt;0.001). Telemedicine encounters also significantly increased participation compared to in-person visits (OR=1.149, p=0.006).ConclusionsMultiple factors including age, race, SES, insurance type, cancer type, health conditions, and modality of healthcare delivery influence patient engagement with satisfaction surveys in radiation oncology. Strategies to enhance patient engagement must consider these diverse influences to ensure comprehensive and inclusive feedback mechanisms in healthcare settings. Tailored interventions to mitigate barriers specific to underrepresented groups are crucial for capturing a broad spectrum of patient experiences and improving the overall quality of patient care.
Major and minor perineural invasion in salivary gland cancer
Authors: Liu Fei , Chu Yinglin , Zheng Qizhe , Hu Yunshuang , Wang Yiyi , Qin Lu , Fu Shuaikun , Wang Suping 
Published: January 2025

ObjectiveTo delineate the distribution of perineural invasion (PNI), evaluate its impact on patient survival, and identify optimal criteria for initiating adjuvant radiation therapy (RT) in cases of PNI associated with salivary gland cancer (SGC).MethodsThis retrospective study categorized enrolled patients into three groups based on PNI status (none, minor, or major), defined by the extent of nerve involvement. The influence of PNI on overall survival and locoregional control was assessed using a Cox proportional hazards model.ResultsA total of 555 patients were incorporated into the study. Logistic regression analysis indicated that tumor stage, neck stage, histological grade, and pathological type were independently linked to the occurrence of PNI. In the Cox model assessing overall survival, patients exhibiting minor nerve PNI demonstrated a hazard ratio (HR) of 1.78 [95% CI: 1.14-2.47] in comparison to those without PNI, a difference that was statistically significant (p&lt;0.001). Conversely, the variation in HR between patients with major nerve PNI and those with minor nerve PNI was not statistically significant (p=0.673). In the Cox model for locoregional control, patients with minor and major nerve PNI exhibited HRs of 1.64 [95% CI: 1.17-2.78] and 1.65 [95% CI: 1.03-2.90], respectively, when compared to those without PNI. Subgroup analyses revealed that the incorporation of chemotherapy into radiotherapy did not significantly modify the risk of mortality or locoregional recurrence in comparison to patients treated with radiotherapy alone, irrespective of PNI classification.ConclusionBoth minor and major nerve PNI exerting comparable influences on prognosis, the adjunctive use of chemotherapy in combination with RT did not yield improvements in overall survival or locoregional control, irrespective of PNI status.
Transarterial radioembolization versus chemoembolization for hepatocellular carcinoma: a meta-analysis
Authors: Lu Wenxiao , Zhang Tongsheng , Xia Fengfei , Huang Xiangzhong , Gao Fulei 
Published: January 2025

BackgroundCurrently, inoperable hepatocellular carcinoma (HCC) is treated by both transarterial radioembolization (TARE) and transarterial chemoembolization (TACE). However, their relative efficacy and outcomes remain unclear. This meta-analysis aimed to compare TARE and TACE to evaluate their safety and efficacy in treating inoperable HCC patients.MethodsRelevant studies were identified by searching the Web of Science, PubMed, and Wanfang databases. Pooled analyses were used to compare treatment response rates, complications, and overall survival (OS) outcomes between the TARE and TACE groups.ResultsThis analysis selected 8 studies comprising 1026 and 358 patients that respectively underwent TACE and TARE treatment. The results revealed that the TARE group had significantly higher pooled total response, disease control, and 1-year OS rates compared to the TACE group (P = 0.04, 0.003, and 0.02, respectively), with a corresponding increase in OS (P = 0.0002). Furthermore, rates of complications including fever and abdominal pain were also reduced in the TARE group (P = 0.006 and 0.02, respectively). Moreover, there were no significant differences in the pooled analyses of complete response rates, fatigue, nausea/vomiting, 3-year OS, or 5-year OS between these groups (P = 0.24, 0.69, 0.15, 0.73, and 0.38, respectively). Significant heterogeneity was detected for endpoints including fatigue, nausea/vomiting, fever, abdominal pain, OS duration, and 3-year OS (I2 = 89%, 82%, 72%, 90%, 96%, and 66%, respectively). All endpoints exhibited no significant risk of publication bias.ConclusionsThis study revealed that relative to TACE, TARE performed using 90Y can yield significantly higher treatment response rates and prolong HCC patient survival with fewer treatment-related side effects.The PRISMA guidelines were used to guide the execution and publication of this meta-analysis. The study is registered at INPLASY.COM (No. INPLASY202380017).Systematic review registrationINPLASY.COM, identifier INPLASY202380017.
Needle tracking and segmentation in breast ultrasound imaging based on spatio-temporal memory network
Authors: Zhang Qiyun , Chen Jiawei , Wang Jinhong , Wang Haolin , He Yi , Li Bin , Zhuang Zhemin , Zeng Huancheng 
Published: January 2025

IntroductionUltrasound-guided needle biopsy is a commonly employed technique in modern medicine for obtaining tissue samples, such as those from breast tumors, for pathological analysis. However, it is limited by the low signal-to-noise ratio and the complex background of breast ultrasound imaging. In order to assist physicians in accurately performing needle biopsies on pathological tissues, minimize complications, and avoid damage to surrounding tissues, computer-aided needle segmentation and tracking has garnered increasing attention, with notable progress made in recent years. Nevertheless, challenges remain, including poor ultrasound image quality, high computational resource requirements, and various needle shape.MethodsThis study introduces a novel Spatio-Temporal Memory Network designed for ultrasound-guided breast tumor biopsy. The proposed network integrates a hybrid encoder that employs CNN-Transformer architectures, along with an optical flow estimation method. From the Ultrasound Imaging Department at the First Affiliated Hospital of Shantou University, we developed a real-time segmentation dataset specifically designed for ultrasound-guided needle puncture procedures in breast tumors, which includes ultrasound biopsy video data collected from 11 patients.ResultsExperimental results demonstrate that this model significantly outperforms existing methods in improving the positioning accuracy of needle and enhancing the tracking stability. Specifically, the performance metrics of the proposed model is as follows: IoU is 0.731, Dice is 0.817, Precision is 0.863, Recall is 0.803, and F1 score is 0.832. By advancing the precision of needle localization, this model contributes to enhanced reliability in ultrasound-guided breast tumor biopsy, ultimately supporting safer and more effective clinical outcomes.DiscussionThe model proposed in this paper demonstrates robust performance in the computer-aided tracking and segmentation of biopsy needles in ultrasound imaging, specifically for ultrasound-guided breast tumor biopsy, offering dependable technical support for clinical procedures.
Non-melanoma skin cancer treated with hypofractionated 192—Ir contact brachitherapy: a single institution series
Authors: Ciurlia Elisa , Santo Bianca , Barba Maria Cristina , Cavalera Elisa , De Franco Paola , De Matteis Sara , Di Paola Giuseppe , Leone Angela , Papaleo Antonella , Rubini Dino , Russo Donatella , Rubini Giuseppe , Sardaro Angela 
Published: January 2025

BackgroundNon-melanoma skin carcinoma (NMSC) is the most common malignant tumor in the population, with a steadily increasing incidence due to an aging population and sun exposure. The two main subtypes of NMSC are basal cell carcinoma(BCC) and squamous cell carcinoma(SCC). Therapeutic management of NMSC includes a variety of options, such as surgery, radiotherapy, and topical or systemic treatments. High-dose fractionated contact brachytherapy (c-HDR-BRT) is a viable therapeutic option for treating NMSCs.MethodsAt our center, we treated 39 patients with BCC or SCC, with a total of 46 lesions, treated with c-HDR-BRT. The patients underwent two different radiotherapy schedules: 40 Gy in four fractions and 30 Gy in three fractions.ResultsTwo-year results showed 100% local control (LC) and 100% disease-specific survival (DSS), indicating high efficacy of c-HDR-BRT in terms of tumor control. Furthermore, the observed toxicity profile was favorable with no significant late toxicity.ConclusionsThese results suggest that c-HDR-BRT represents a viable therapeutic alternative for NMSC, combining high oncological efficacy with an acceptable safety profile, while minimizing the aesthetic and functional impact of therapy. Finally, the study emphasizes the importance of personalization of treatment and careful evaluation of individual cases to optimize the treatment approach in NMSC.
Evaluating ChatGPT-4o as a decision support tool in multidisciplinary sarcoma tumor boards: heterogeneous performance across various specialties
Authors: Ammo Tekoshin , Guillaume Vincent G. J. , Hofmann Ulf Krister , Ulmer Norma M. , Buenting Nina , Laenger Florian , Beier Justus P. , Leypold Tim 
Published: January 2025

Background and objectivesSince the launch of ChatGPT in 2023, large language models have attracted substantial interest to be deployed in the health care sector. This study evaluates the performance of ChatGPT-4o as a support tool for decision-making in multidisciplinary sarcoma tumor boards.MethodsWe created five sarcoma patient cases mimicking real-world scenarios and prompted ChatGPT-4o to issue tumor board decisions. These recommendations were independently assessed by a multidisciplinary panel, consisting of an orthopedic surgeon, plastic surgeon, radiation oncologist, radiologist, and pathologist. Assessments were graded on a Likert scale from 1 (completely disagree) to 5 (completely agree) across five categories: understanding, therapy/diagnostic recommendation, aftercare recommendation, summarization, and support tool effectiveness.ResultsThe mean score for ChatGPT-4o performance was 3.76, indicating moderate effectiveness. Surgical specialties received the highest score, with a mean score of 4.48, while diagnostic specialties (radiology/pathology) performed considerably better than the radiation oncology specialty, which performed poorly.ConclusionsThis study provides initial insights into the use of prompt-engineered large language models as decision support tools in sarcoma tumor boards. ChatGPT-4o recommendations regarding surgical specialties performed best while ChatGPT-4o struggled to give valuable advice in the other tested specialties. Clinicians should understand both the advantages and limitations of this technology for effective integration into clinical practice.
Pharmacodynamic characteristics and influencing factors of tapentadol for chronic pain relief under dose titration
Authors: Xin Liang , Zhu Haoxiang , Niu Suping , Han Xie , Pang Hongxian , Li Jiangfan , Hu Ye , Wang Xuhong , Li Lujin , Fang Yi 
Published: January 2025

ObjectiveThe aim of this study was to establish a pharmacodynamic model of tapentadol analgesia under dose titration conditions, to quantitatively analyze the time-effect relationship of the drug, and to identify relevant influencing factors. This model is intended to provide a pharmacodynamic reference for designing rational tapentadol dose titration schemes in clinical research.MethodsRandomized controlled trials assessing the efficacy of tapentadol in the management of chronic pain were retrieved from public databases (PubMed and EMBASE). A time-effect relationship model of the percent change in Numerical Rating Scale (NRS) scores post-tapentadol intervention from baseline was constructed, along with a covariate model to identify factors significantly impacting the analgesic effects of tapentadol. Potential influencing factors that were clinically significant but not included in the final covariate model were examined for their impact trends on tapentadol analgesia through subgroup analysis.ResultsA total of 16 studies involving 4,508 participants were included in the analysis. Covariate analysis indicated that age significantly affected the maximum reduction in NRS scores following tapentadol treatment, with the reduction rate being 40.9% for patients aged 45 and 60.7% for those aged 65, suggesting that older patients have a higher demand for pain relief. Furthermore, studies published after 2014 and placebo-controlled trials showed a slower rate of NRS reduction, indicating a more cautious approach to tapentadol dosing titration post the U.S. opioid crisis and in placebo-controlled contexts. Additionally, subgroup analysis suggested that higher titration doses, higher baseline NRS levels, the use of extended-release tapentadol, and a smaller proportion of male participants were trends associated with better analgesic effects, although the differences were not statistically significant. Moreover, the study found that tapentadol was significantly more effective in treating lower back pain compared to non-lower back pain.ConclusionThis research successfully developed a pharmacodynamic model for dose-titrated tapentadol administration, which can simulate the temporal changes in analgesic effects of tapentadol across different clinical scenarios. This model can guide the formulation of dosing titration protocols for tapentadol in clinical research.Systematic Review Registrationhttps://inplasy.com/inplasy-2024-5-0014/
Feasibility of trancutaneous auricular vagus nerve stimulation in Black and Hispanic/Latino people with peripheral neuropathy
Authors: Wong Marlon L. , Widerström-Noga Eva , Bolanos Jessica L. , Gonzalez Gabriel , Penedo Frank J. , Hosein Peter J. , Tovin Melissa M. , Gonzalez Juan P. , McTeague Lisa M. 
Published: January 2025

IntroductionPeripheral neuropathy (PN) is the most common neurodegenerative disorder, and the primary causes are chemotherapy-induced peripheral neuropathy (CIPN) and diabetic neuropathy (DN). Transcutaneous auricular vagus nerve stimulation (taVNS) is a promising non-pharmacological and non-invasive intervention that targets key pathways involved with PN. However, research is needed to determine the feasibility, acceptability, and effects of taVNS in people with PN. It is also critical that this research on taVNS include the perspectives of Black and Hispanic/Latino patients, who are often underrepresented in research.MethodsThis research was comprised of two consecutive studies: a survey and a pilot randomized sham-controlled trial (RCT). The survey assessed symptom burden, management strategies, and interest in taVNS among CIPN patients. The pilot RCT evaluated the feasibility, acceptability, and preliminary effects of taVNS in Black and Hispanic/Latino patients with CIPN or diabetic neuropathy. Participants were recruited from the University of Miami medical system, with culturally sensitive approaches to enhance minority participation.ResultsThe survey included 62 respondents, 78% Black or Hispanic/Latino, revealing high symptom burden and significant interest in taVNS (82% expressed moderate to high interest). The pilot RCT enrolled 28 participants, achieving a 42% recruitment rate and 86% retention. taVNS was well tolerated, with no significant adverse effects. Preliminary data indicated a decrease in neuropathic symptoms and an increased heart rate variability (HRV) during active taVNS, suggesting autonomic modulation. Tingling sensation and pain decreased by median values of 2.0 and 1.5, respectively. Additionally, the median values for standard deviation of the RR interval increased from 34.9 (CI = 21.6–44.8) at baseline to 44.8 (CI = 26.5–50.3) during intervention. Exit interviews highlighted positive participant experiences and identified potential barriers, such as protocol length and distrust in medical research.ConclusionThe findings underscore the need for novel CIPN treatments and demonstrate the feasibility of conducting taVNS research in historically underrepresented populations. High interest in taVNS and successful recruitment and retention rates suggest that culturally sensitive approaches can enhance minority participation in clinical trials. These findings will be used to develop a large clinical trial to determine the efficacy of repeated taVNS in a diverse cohort.
Clinical Trial Registrationhttps://clinicaltrials.gov, identifier (NCT05896202).
Clinical features and outcomes of pseudolithiasis induced by ceftriaxone in Chinese children: a single-center observational study
Authors: Jin Chen , Xiu Wen-Li , Liu Yao , Hao Xi-Wei , Dong Qian 
Published: January 2025

IntroductionCeftriaxone (CTX) is widely used in pediatric infectious disease treatment, although the diagnostic and therapeutic management of CTX-induced gallbladder pseudolithiasis (PL) remains challenging. In this study, we investigated the occurrence, clinical features, and management of CTX-induced PL in children.MethodsA retrospective case-control study was conducted on 185 pediatric patients receiving CTX at a single center. Data on treatment regimens, gallbladder imaging findings, and serum biochemical parameters post-CTX therapy were analyzed. Patients were classified into PL (n = 34) and non-PL (n = 151) groups based on imaging findings.ResultsPL was diagnosed in 18.4% of patients treated with CTX, primarily through ultrasound, which revealed hyperechoic material within the gallbladder. Compared with the non-PL group, patients with PL were older and taller, with no significant differences in CTX dosage (p = 0.915). Patients with PL also had higher rates of digestive and neurological infections (both p &lt; 0.001). Serum analysis revealed distinct liver and kidney function markers in the PL group, including lower levels of total bile acids, adenosine deaminase, and lactate dehydrogenase, and higher creatinine levels (all p &lt; 0.05). Discontinuation of CTX led to symptom resolution in most cases, and all cases of PL resolved within three months.ConclusionsThe occurrence of PL is not significantly related to CTX dosage. Furthermore, the rate of CTX metabolism and excretion may play a key role in PL development. Overall, the findings demonstrate that ultrasound is an effective tool for monitoring the development of PL in children receiving CTX and that discontinuation of CTX could be an effective treatment for PL.
Effects of oral Lcarnitine supplementation on liver enzymes in pediatric acute lymphoblastic leukemia patients in the maintenance phase of treatment: a randomized clinical trial study
Authors: Eghbali Aziz , Eghbali Aygin , Ashayeri Neda , Fadayi Fatemeh , Ghaffari Kazem , Ghasemi Ali 
Published: January 2025

BackgroundGiven that liver diseases and subsequent increases in liver enzymes are among the most frequent complications observed in leukemia patients treated with chemotherapeutic drugs, this study aimed to assess the impact of oral Lcarnitine supplementation on liver enzyme levels the maintenance phase of treatment for pediatric acute lymphoblastic leukemia (ALL) patients.MethodsIn this clinical trial, 100 pediatric patients aged &gt;5 years were divided into two groups after obtaining informed consent. The participants were randomly divided into the Lcarnitine and placebo groups. In the Lcarnitine group, patients received 50 mg/kg of Lcarnitine syrup three times a day (every 8 h). Patients were examined for 2 months to receive Lcarnitine syrup and to measure the levels of alanine aminotransferase (ALT), aspartate transferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), direct bilirubin, total bilirubin, prothrombin time (PT), and partial thromboplastin time (PTT).ResultsThe mean changes in AST, ALT, total bilirubin, and GGT during the study period were significant in the group treated with Lcarnitine (P &lt; 0.05), although they were not significant in the placebo group (P &gt; 0.05). Also, the levels of ALP, direct bilirubin, PT, and PTT were not significantly different between the two groups. The incidence of side effects was significantly higher in the Lcarnitine group than in the placebo group (18% vs 4%, P = 0.025).ConclusionThe results of this study suggested that a 60-day Lcarnitine treatment can improve liver enzyme levels and thus prevent the extent of liver damage during the treatment of ALL. Based on the results of our study, Lcarnitine supplementation may have a beneficial effect on liver enzyme levels in pediatric ALL patients during the maintenance phase of treatment.Clinical Trial Registration:https://irct.behdasht.gov.ir/search/result?query=IRCT20201107049296N2, identifier IRCT20201107049296N2
A cross-sectional study to explore the relationship between the technology acceptance model and burnout and depression among pharmacists working with a pharmacy robotic dispensing system
Authors: Alshamsi Amna Ibrahim , AlHarthi Mariam , AbdulQader Hessa , Chhabrani Pramod , Ahmed Safa , Almansoori Muna 
Published: January 2025

ObjectivesThis study compares hospitals using a pharmacy robotic dispensing system (RPDS) with those using manual dispensing systems regarding burnout and depression among pharmacists in Emirates Health Services (EHS) hospitals. Furthermore, this study aims to bridge the gap in the literature concerning the relationship between burnout and the technology acceptance model (TAM).MethodsA cross-sectional survey was conducted to determine whether burnout and TAM differed between hospitals with RPDS and those with manual dispensing system. The study was carried out in ten hospitals governed by the EHS.ResultsA total of 256 respondents completed the survey. Burnout and depression levels among pharmacists working with RPDS did not differ significantly from those using manual dispensing systems. However, the median of personal burnout levels in female pharmacists (Mdn = 50) differed significantly from those using manual dispensing systems (Mdn = 25; U = 3497.5, z = −7.8, p &lt; 0.001, r = −0.49). In contrast, male pharmacists exhibited higher levels of technology acceptance (U = 11,357, z = 5.58, p &lt; 0.001, r = 0.35; U = 10,391, z = 4.0, p &lt; 0.001, r = 0.25).ConclusionThis study explored the differences in burnout, depression levels, and TAM among employees working in public hospitals in the United Arab of Emirates. Overall, automation had both positive and negative effects on workplace stressors experienced by pharmacy staff.