bluuebunny/crossref_metadata_2025_split huggingface dataset:
A novel nomogram to predict lymph node metastasis in cT1 non-small-cell lung cancer based on PET/CT and peripheral blood cell parameters
Authors: Wei Bohua , Jin Xin , Lu Gaojun , Zhao Teng , Xue Hanjiang , Zhang Yi 
Published: January 2023

Abstract
Background
Accurately evaluating the lymph node status preoperatively is critical in determining the appropriate treatment plan for non-small-cell lung cancer (NSCLC) patients. This study aimed to construct a novel nomogram to predict the probability of lymph node metastasis in clinical T1 stage patients based on non-invasive and easily accessible indicators.

Methods
From October 2019 to June 2022, the data of 84 consecutive cT1 NSCLC patients who had undergone PET/CT examination within 30 days before surgery were retrospectively collected. Univariate and multivariate logistic regression analyses were performed to identify the risk factors of lymph node metastasis. A nomogram based on these predictors was constructed. The area under the receiver operating characteristic (ROC) curve and the calibration curve was used for assessment. Besides, the model was confirmed by bootstrap resampling.

Results
Four predictors (tumor SUVmax value, lymph node SUVmax value, consolidation tumor ratio and platelet to lymphocyte ratio) were identified and entered into the nomogram. The model indicated certain discrimination, with an area under ROC curve of 0.921(95%CI 0.866–0.977). The calibration curve showed good concordance between the predicted and actual possibility of lymph node metastasis.

Conclusions
This nomogram was practical and effective in predicting lymph node metastasis for patients with cT1 NSCLC. It could provide treatment recommendations to clinicians.
Utilization of dental care service and associated factors among pre-school children in northwest China over the past decade
Authors: Hu Xiao , Fan Xiaoyu , Tian Jiangang , Zhang Bin , Huang Ruizhe 
Published: January 2023

Abstract
Objective
The purpose of this study was to analyze the factors influencing the utilization of oral health care among 5 years old children.

Methods
We conducted two observational cross-sectional studies. The studies were conducted in 2005 and 2015 and included 5-year-old children who underwent dental examination by trained dentists and the caregivers of the children were requested to answer the questionnaire. Multi-level stratified sampling method was used. Chi-square tests were used to analyze the utilization of dental care and other socio-economic variables. Logistic regression models were employed to explore the primary factors influencing the use of dental care among pre-school children.

Results
In 2005, a total of 399 and in 2015, 492 child-caregiver pairs were included. The majority of the caregivers in both surveys were females, comprising 68.2% and 74.8% of the caregivers in 2005 and 2015, respectively. 75.2% and 87.0% (p < 0.05) of the respondents had an education level of lesser than 9 years. The prevalence of caries was higher in 2015 (63.2%) (p < 0.05) than in 2005 (53.4%). In 2005 and 2015, the utilization of dental care services was 20.8% and 20.0%, respectively. A statistically significant association was observed between caries and dental care use in 5-year-olds over the past decade. After adjusting for confounders, dental service usage among children in urban areas was 1.62 times higher than that of rural areas in 2005 (95% CI 0.069–0.571), and the self-assessment of caregivers regarding their child’s oral health significantly improved oral health use in 2015.

Conclusion
The utilization of dental care services over the past decade is insufficient among pre-school children in northwest China. Hence, with the decreasing gap about economic and health service resources, policymakers should place greater emphasis on raising awareness among caregivers about the oral health status of their children.
Evaluating the usability of a cancer registry system using Cognitive Walkthrough, and assessing user agreement with its problems
Authors: Bagheri Fatemeh , Abbasi Faezeh , Sadeghi Mojtaba , Khajouei Reza 
Published: January 2023

Abstract
Objective/aim
Good design of cancer registry systems makes them easy to use, while poor design of their user interfaces leads to user dissatisfaction and resistance. The objective of this study was to evaluate the usability of a cancer registry system using Cognitive Walkthrough (CW) and to assess users' agreement with its usability problems.

Methods
CW was used to evaluate the registry system. We developed a checklist to help evaluators speed up the evaluation process, a problems form to collect the usability issues identified by the evaluators, and a problems severity form to determine the severity of problems by the evaluators. The problems were classified into two categories according to the CW questions and the system tasks. The agreement of the users with the system problems was examined by an online questionnaire. Users' agreement with the problems was then analyzed using the Interclass Correlation Coefficient in the SPSS 22 (Statistical Package for Social Science).

Results
In this study, 114 problems were identified. In the categorization of problems based on the CW questions, 41% (n = 47) of the problems concerned the issue of “users do not know what to do at each stage of working with the system”, 24% (n = 27) were classified as “users cannot link what they intend to do with system controls”, and 22% (n = 25) were related to “user's lack of understanding of the system processes”. Based on user tasks, about 36% (n = 41) of the problems were related to “removing patient duplication” and 33% (n = 38) were related to “registration of patient identification information”. User agreement with the problems was high (CI 95% = 0.9 (0.96, 0.98)).

Conclusion
System problems often originate from user ignorance about what to do at each stage of using the system. Also, half of the system problems concern a mismatch between what users want to do and the system controls, or a lack of understanding about what the system does at different stages. Therefore, to avoid user confusion, designers should use clues and guides on the screen for users, design controls consistent with the user model of thinking, and provide appropriate feedback after each user action to help users understand what the system is doing. The high agreement of users with the problems showed that in the absence of users system designers can use CW to identify the problems that users face in the real environment.
COVID-19’s impact on care practice for alpha-1-antitrypsin deficiency patients
Authors: Calle Rubio Myriam , López-Campos José Luis , Miravitlles Marc , Michel de la Rosa Francisco Javier , Hernández Pérez José María , Montero Martínez Carmen , Montoro Ronsano José Bruno , Casas Maldonado Francisco , Rodríguez Hermosa Juan Luis , Tabernero Huguet Eva María , Martínez Sesmero José Manuel , Martínez Rivera Carlos , Callejas González Francisco Javier , Torres Durán María 
Published: January 2023

Abstract
Background
Patients with alpha-1 antitrypsin deficiency (AATD), commonly categorized as a rare disease, have been affected by the changes in healthcare management brought about by COVID-19. This study’s aim was to identify the changes that have taken place in AATD patient care as a result of the COVID-19 pandemic in Spain and to propose experts’ recommendations aimed at ensuring humanized and quality care for people with AATD in the post-pandemic situation.

Methods
A qualitative descriptive case study with a holistic single-case design was conducted, using focus groups with experts in AATD clinical management, including 15 health professionals with ties to the Spanish health system (12 pneumologists and 2 hospital pharmacists from 11 different hospitals in Spain) and 1 patient representative.

Results
COVID-19 has had a major impact on numerous aspects of AATD clinical patient management in Spain, including diagnostic, treatment, and follow-up phases. The experts concluded that there is a need to strengthen coordination between Primary Care and Hospital Care and improve the coordination processes across all the organizations and actors involved in the healthcare system. Regarding telemedicine and telecare, experts have concluded that it is necessary to promote this methodology and to develop protocols and training programs. Experts have recommended developing personalized and precision medicine, and patient participation in decision-making, promoting self-care and patient autonomy to optimize their healthcare and improve their quality of life. The possibility of monitoring and treating AATD patients from home has also been proposed by experts. Another result of the study was the recommendation of the need to ensure that plasma donations are made on a regular basis by a sufficient number of healthy individuals.

Conclusion
The study advances knowledge by highlighting the challenges faced by health professionals and changes in AATD patient management in the context of the COVID-19 pandemic. It also proposes experts’ recommendations aimed at ensuring humanized and quality care for people with AATD in the post-pandemic situation. This work could serve as a reference study for physicians on their daily clinical practice with AATD patients and may also provide guidance on the changes to be put in place for the post-pandemic situation.
Relationship between drug targets and drug-signature networks: a network-based genome-wide landscape
Authors: Lee Chae Won , Kim Sung Min , Sa Soonok , Hong Myunghee , Nam Sang-Min , Han Hyun Wook 
Published: January 2023

AbstractDrugs produce pharmaceutical and adverse effects that arise from the complex relationship between drug targets and signatures; by considering such relationships, we can begin to understand the cellular mechanisms of drugs. In this study, we selected 463 genes from the DSigDB database corresponding to targets and signatures for 382 FDA-approved drugs with both protein binding information for a drug-target score (KDTN, i.e., the degree to which the protein encoded by the gene binds to a number of drugs) and microarray signature information for a drug-sensitive score (KDSN, i.e., the degree to which gene expression is stimulated by the drug). Accordingly, we constructed two drug–gene bipartite network models, a drug-target network and drug-signature network, which were merged into a multidimensional model. Analysis revealed that the KDTN and KDSN were in mutually exclusive and reciprocal relationships in terms of their biological network structure and gene function. A symmetric balance between the KDTN and KDSN of genes facilitates the possibility of therapeutic drug effects in whole genome. These results provide new insights into the relationship between drugs and genes, specifically drug targets and drug signatures.
Low dose ultra-slow infusion thrombolytic therapy (LDUSITT) as an alternative option in a COVID-19 patient with free-floating right atrial thrombus: a case report and review of literature
Authors: Mahjani Mahsa , Gohari Sepehr , Ahangar Hassan 
Published: January 2023

AbstractThe hyper-coagulopathy nature of COVID-19 is a prevalent consequence among patients. Free-floating right atrial thrombi are a relatively rare finding and the optimal therapy is a therapeutic dilemma.We present a 37-year-old woman with acute dyspnea and fatigue. Several ground glass opacities were shown on computed tomography of chest that further proved to be associated with severe COVID-19 disease. A transthoracic echocardiography revealed a mobile right atrial mass with bilateral pulmonary embolism. She was considered high risk for surgical therapy by cardiovascular surgeons. She was then started on anticoagulation therapy for 5 days however the size regression of the thrombus remained unchanged. A regimen of low dose (24 mg) ultra-slow (24 h) intravenous infusion of alteplase, without bolus was initiated. Following the third day of thrombolytic therapy, the control echocardiography demonstrated complete resolution of the thrombus.Prolonged infusion of low dose fibrinolytics can be an alternative treatment to surgery for right heart thrombi.
Description of recurrent headaches in 7–14-year-old children: Baseline data from a randomized clinical trial on effectiveness of chiropractic spinal manipulation in children with recurrent headaches
Authors: Dissing Kristina Boe , Vach Werner , Lynge Susanne , Christensen Henrik Wulff , Hestbaek Lise 
Published: January 2023

Abstract
Background
Headaches in children are poorly described and diagnosing can be challenging. Objectives are: (1) to describe headache characteristics and child characteristics, (2) to explore whether data can suggest a more diverse way to categorize headaches than traditionally.

Methods
Baseline data for a clinical trial included a questionnaire and a physical screening. Children's characteristics and detailed description of headache symptoms were provided. Children were classified for migraine or tension-type-headache based on questionnaire data reported by children and parents. This required to apply slightly modified classification criteria and a “non-classifiable” group was added. Severity and symptoms, related to the migraine versus tension type distinction, were investigated to define a migraine-tension-type-index.

Results
253 children were included. Mean pain intensity was 5.9/10. Over 2/3 of the children had headache for > 1 year, and > 50% for several days/week. Half of the children were non-classifiable, 22% were classified as migraine and 23% as tension-type headache. A migraine-tension-type-index was constructed and describes a continuous spectrum rather than two distinct groups.

Conclusions
Children with recurrent headaches are often severely affected. A questionnaire-based classification appeared feasible to distinguish between migraine and tension-type headaches in children but leaving many children unclassified. A migraine-tension-type-index can be generated allowing to regard the traditional distinction as a continuum (including mixed headache), and potentially serving as an instrument to improve headache management.
Trial registration ClinicalTrials.gov, identifier NCT02684916.
Screening of Q-markers for the wine-steamed Schisandra chinensis decoction pieces in improving allergic asthma
Authors: Qu Zhongyuan , Bing Yifan , Zhang Tianlei , Zheng Yan , Wu Shuang , Ji Chenfeng , Li Wenlan , Zou Xiang 
Published: January 2023

Abstract
Background
Traditional Chinese medicine (TCM) posits that Chinese medicinal materials can only be clinically used after being processed and prepared into decoction pieces. Schisandra Chinensis Fructus (derived from the dried and mature fruits of Schisandra chinensis (Turcz.) Baill.) has been used as a traditional antiasthmatic, kidney strengthening, and hepatoprotective agent for 2000 years. The results of previous research show that decoction pieces of wine-steamed Schisandra chinensis (WSC) are more effective than raw decoction pieces of Schisandra chinensis (RSC) for treating cough and asthma. Steaming with wine was demonstrated to promote the dissolution of ingredients. However, the relationship between the changes in the components of the decoction pieces of WSC and the therapeutic effect remains unclear.

Methods
The efficacies of decoctions of RSC and WSC were compared using allergic asthma rats. The potential bioactive components in the serum of the WSC treatment group and the changes in the chemical composition of the RSC decoction pieces before and after wine steaming were determined by ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS/MS) and ultra-high-performance liquid chromatography tandem mass spectrometry (UPLC H-CLASS XEVO TQD) to speculate quality markers (Q-markers) related to the efficacy of WSC, which were subsequently verified based on a zebrafish inflammation model.

Results
Steaming RSC decoction pieces with wine was found to promote improvement of allergic asthma. Reverse tracing of 22 components detected in the serum of the high dose group of WSC (WSC-H) resulted in 12 ingredients being finally designated as potential effective components. Among these ingredients, 5 components, Schisandrin, Schisandrol B, Schisandrin A, Schisandrin B, and Gomisin D, had higher dissolution rates than RSC after steaming with wine. Validation by an inflammatory zebrafish model showed that these 5 ingredients had a dose-dependent effect and were therefore Q-markers for WSC in the treatment of allergic asthma.

Conclusion
In this study, changes in the components of decoction pieces of RSC and WSC and Q-markers related to WSC efficacy were identified, providing valuable information for expanding the application of WSC and establishing a specific quality standard for WSC.
Changes in the tumor oxygenation but not in the tumor volume and tumor vascularization reflect early response of breast cancer to neoadjuvant chemotherapy
Authors: Pavlov Mikhail V. , Bavrina Anna P. , Plekhanov Vladimir I. , Golubyatnikov German Yu. , Orlova Anna G. , Subochev Pavel V. , Davydova Diana A. , Turchin Ilya V. , Maslennikova Anna V. 
Published: January 2023

Abstract
Background
Breast cancer neoadjuvant chemotherapy (NACT) allows for assessing tumor sensitivity to systemic treatment, planning adjuvant treatment and follow-up. However, a sufficiently large number of patients fail to achieve the desired level of pathological tumor response while optimal early response assessment methods have not been established now. In our study, we simultaneously assessed the early chemotherapy-induced changes in the tumor volume by ultrasound (US), the tumor oxygenation by diffuse optical spectroscopy imaging (DOSI), and the state of the tumor vascular bed by Doppler US to elaborate the predictive criteria of breast tumor response to treatment.

Methods
A total of 133 patients with a confirmed diagnosis of invasive breast cancer stage II to III admitted to NACT following definitive breast surgery were enrolled, of those 103 were included in the final analysis. Tumor oxygenation by DOSI, tumor volume by US, and tumor vascularization by Doppler US were determined before the first and second cycle of NACT. After NACT completion, patients underwent surgery followed by pathological examination and assessment of the pathological tumor response. On the basis of these, data regression predictive models were created.

Results
We observed changes in all three parameters 3 weeks after the start of the treatment. However, a high predictive potential for early assessment of tumor sensitivity to NACT demonstrated only the level of oxygenation, ΔStO2, (ρ = 0.802, p ≤ 0.01). The regression model predicts the tumor response with a high probability of a correct conclusion (89.3%). The “Tumor volume” model and the “Vascularization index” model did not accurately predict the absence of a pathological tumor response to treatment (60.9% and 58.7%, respectively), while predicting a positive response to treatment was relatively better (78.9% and 75.4%, respectively).

Conclusions
Diffuse optical spectroscopy imaging appeared to be a robust tool for early predicting breast cancer response to chemotherapy. It may help identify patients who need additional molecular genetic study of the tumor in order to find the source of resistance to treatment, as well as to correct the treatment regimen.
Non-linear dose response effect of cathodal transcranial direct current stimulation on muscle strength in young healthy adults: a randomized controlled study
Authors: Vimolratana Oranich , Lackmy-Vallee Alexandra , Aneksan Benchaporn , Hiengkaew Vimonwan , Klomjai Wanalee 
Published: January 2023

Abstract
Background
Transcranial direct current stimulation (tDCS) is a technique that modulates brain excitability in humans. Increasing the stimulation intensity or duration within certain limits could enhance tDCS efficacy with a polarity-dependent effect; anodal stimulation increases cortical excitability, whereas cathodal stimulation decreases excitability. However, recent studies have reported a non-linear effect of cathodal tDCS on neuronal excitability in humans, and there is no conclusive result regarding the effect of cathodal tDCS on muscle performance.

Methods
Our study aimed to investigate the immediate effects of different intensities (i.e., 1, 1.5, and 2 mA and sham tDCS) of cathodal tDCS on muscle strength in healthy participants. All participants [mean age 23.17 (3.90) years] were recruited and randomly allocated into four groups (1, 1.5, and 2 mA cathodal tDCS and sham tDCS). Muscle strength in bilateral upper and lower extremities was measured before and immediately after tDCS using a handheld dynamometer.

Results
Our results showed that cathodal tDCS at 1 and 1.5 mA reduced muscle strength bilaterally in upper and lower extremity muscles, whereas stimulation at 2 mA tended to increase muscle strength on the dominant limb.

Conclusion
These findings support the non-linear effects of cathodal tDCS on muscle strength, which should be considered for the clinical use of tDCS in motor rehabilitation.
Trial registration: NCT04672122, date of first registration 17/12/2020.
Resilience in the face of adversity: classes of positive adaptation in trauma-exposed children and adolescents in residential care
Authors: Sölva Katharina , Haselgruber Alexander , Lueger-Schuster Brigitte 
Published: January 2023

AbstractChildren and adolescents in residential care often face multiple traumatic experiences. However, some individuals show resilient adaptation. To depict this heterogeneity, the person-centered examination of different classes of adaptation is a powerful tool. Up to date, resilience was insufficiently addressed in this population. Data from 141 children and adolescents in residential care institutions in Austria regarding trauma history, psychopathology, behavioral adjustment, and protective factors were assessed with standardized self-report questionnaires. Distinct classes of adaptation after traumatic experiences were examined with Latent Class Analysis. Class differences regarding traumatic experiences and protective factors were analyzed with χ2 testing. Three classes were identified [resilience (66.18%), mixed psychopathology (13.97%, mixed), high psychopathology (19.85%, high)]. Only males were classified into the resilient class and only females into the high class. The high class differed significantly from the resilient class regarding cumulative trauma history and protective factors. The mixed class did not differ from the resilient class regarding trauma history, however, they differed significantly regarding protective factors. The resilient class was associated with protective factors. Strong gender differences show the relevance of a differentiated evaluation of gender-specific protective factors and resilience indicators. Fostering protective factors may be a suitable approach for tailored intervention measures.