bluuebunny/crossref_metadata_2025_split huggingface dataset:
A phase II study of gemcitabine and docetaxel combination in relapsed metastatic or unresectable locally advanced synovial sarcoma
Authors: Tansir Ghazal , Rastogi Sameer , Kumar Akash , Barwad Adarsh , Mridha Asit R. , Dhamija Ekta , Shamim Shamim A. , Bhatnagar Sushma , Bhoriwal Sandeep 
Published: July 2023

AbstractSynovial sarcoma (SS) is one of the commonest non-rhabdomyosarcoma soft tissue sarcoma with limited treatment options in the relapsed and advanced settings. The combination of gemcitabine and docetaxel has demonstrated its role predominantly in leiomyosarcoma and pleomorphic sarcomas but has not been prospectively studied in SS. This trial assesses the efficacy, tolerability and quality of life (QoL) with this regimen in metastatic/unresectable locally advanced relapsed SS.Patients and methods This was a single-arm, two-stage, phase II, investigator-initiated interventional study among patients with metastatic or unresectable locally advanced SS who had progressed after at least one line of chemotherapy. Gemcitabine 900 mg/m2 on days 1 and 8 and docetaxel 75 mg/m2 on day 8 were administered intravenously every 21 days. The primary endpoint was 3-month progression-free rate (PFR); overall survival (OS), progression-free survival (PFS), overall response rate (ORR), safety and quality of life (QoL) constituted the secondary endpoints.Results Twenty-two patients were enrolled between March 2020 and September 2021 and the study had to be closed early due to slow accrual. The study population comprised of 18 (81.8%) patients with metastatic disease and 4 (18.2%) patients with locally advanced, unresectable disease. The most common primary sites of disease were extremity in 15 (68%) and the median number of lines of prior therapies received was 1 (range 1–4). 3-month PFR was 45.4% (95% CI 24.8–66.1) and ORR was 4.5%. Median progression-free survival (PFS) was 3 months (95% CI 2.3–3.6) and median OS was 14 months (95% CI 8.9–19.0). 7 (31.8%) patients experienced grade 3 or worse toxicities, including anemia (18%), neutropenia (9%) and mucositis (9%). QoL analysis demonstrated significant decline in certain functional and symptom scales, while financial and global health scales remained stable.Conclusion This is the first prospective study on the combination of gemcitabine and docetaxel performed specifically in patients with advanced, relapsed SS. Although the accrual of patients could not be completed as planned, the therapy did produce clinically meaningful outcomes and met its primary endpoint of 3-month PFR. This result, along with the manageable toxicity profile and stable global health status on QoL analysis, should encourage further studies.Trial registration This trial was prospectively registered under the Clinical Trials Registry of India on 26/02/2020 (Registration number: CTRI/2020/02/023612).
Deep learning–based radiomic nomograms for predicting Ki67 expression in prostate cancer
Authors: Deng Shuitang , Ding Jingfeng , Wang Hui , Mao Guoqun , Sun Jing , Hu Jinwen , Zhu Xiandi , Cheng Yougen , Ni Genghuan , Ao Weiqun 
Published: July 2023

Abstract
Background
To explore the value of a multiparametric magnetic resonance imaging (MRI)-based deep learning model for the preoperative prediction of Ki67 expression in prostate cancer (PCa).

Materials
The data of 229 patients with PCa from two centers were retrospectively analyzed and divided into training, internal validation, and external validation sets. Deep learning features were extracted and selected from each patient’s prostate multiparametric MRI (diffusion-weighted imaging, T2-weighted imaging, and contrast-enhanced T1-weighted imaging sequences) data to establish a deep radiomic signature and construct models for the preoperative prediction of Ki67 expression. Independent predictive risk factors were identified and incorporated into a clinical model, and the clinical and deep learning models were combined to obtain a joint model. The predictive performance of multiple deep-learning models was then evaluated.

Results
Seven prediction models were constructed: one clinical model, three deep learning models (the DLRS-Resnet, DLRS-Inception, and DLRS-Densenet models), and three joint models (the Nomogram-Resnet, Nomogram-Inception, and Nomogram-Densenet models). The areas under the curve (AUCs) of the clinical model in the testing, internal validation, and external validation sets were 0.794, 0.711, and 0.75, respectively. The AUCs of the deep models and joint models ranged from 0.939 to 0.993. The DeLong test revealed that the predictive performance of the deep learning models and the joint models was superior to that of the clinical model (p < 0.01). The predictive performance of the DLRS-Resnet model was inferior to that of the Nomogram-Resnet model (p < 0.01), whereas the predictive performance of the remaining deep learning models and joint models did not differ significantly.

Conclusion
The multiple easy-to-use deep learning–based models for predicting Ki67 expression in PCa developed in this study can help physicians obtain more detailed prognostic data before a patient undergoes surgery.
Cardiovascular fitness is associated with child adiposity at 5 years of age: findings from the ROLO longitudinal birth cohort study
Authors: Geraghty Aisling A. , O’Brien Eileen C. , Callanan Sophie , Mehegan John , McAuliffe Fionnuala M. 
Published: July 2023

Abstract
Background
Cardiovascular fitness is strongly linked with metabolic risk; however, research is limited in preschool children. Although there is currently no simple validated measure of fitness in preschool children, heart rate recovery has been highlighted as an easily accessible and non-invasive predictor of cardiovascular risk in school-aged children and adolescents. We aimed to investigate whether heart rate recovery was associated with adiposity and blood pressure in 5-year-olds.

Study design
This is a secondary analysis of 272 5-year-olds from the ROLO (Randomised cOntrol trial of LOw glycaemic index diet in pregnancy to prevent recurrence of macrosomia) Kids study. Three-minute step tests were completed by 272 participants to determine heart rate recovery duration. Body mass index (BMI), circumferences, skinfold thickness, heart rate, and blood pressure were collected. Independent t-tests, Mann-Whitney U, and Chi-square tests were used to compare participants. Linear regression models examined associations between heart rate recovery and child adiposity. Confounders included child sex, age at study visit, breastfeeding, and perceived effort in the step test.

Results
The median (IQR) age at the study visit was 5.13 (0.16) years. 16.2% (n = 44) had overweight and 4.4% (n = 12) had obesity based on their BMI centile. Boys had a quicker mean (SD) heart rate recovery after the step test than girls (112.5 (47.7) seconds vs. 128.8 (62.5) seconds, p = 0.02). Participants with a slower recovery time (> 105 s) had higher median (IQR) sum of skinfolds (35.5 (11.8) mm vs. 34.0 (10.0) mm, p = 0.02) and median (IQR) sum of subscapular and triceps skinfold (15.6 (4.4) mm vs. 14.4 (4.0) mm, p = 0.02) compared to participants with a quicker recovery time. After adjusting for confounders (child sex, age at study visit, breastfeeding, effort in the step test), linear regression analyses revealed heart rate recovery time after stepping was positively associated with sum of skinfolds (B = 0.034, 95% CI: 0.01, 0.06, p = 0.007).

Conclusion
Child adiposity was positively associated with heart rate recovery time after the step test. A simple stepping test could be used as a non-invasive and inexpensive fitness tool in 5-year-olds. Additional research is needed to validate the ROLO Kids step test in preschool children.
Tools for measuring individual self-care capability: a scoping review
Authors: El-Osta Austen , Sasco Eva Riboli , Barbanti Evelina , Webber Iman , Alaa Aos , Karki Manisha , Asmar Marie line El , Idriss Haitham , Almadi Mashael , Massoud Farah , Alboksmaty Ahmed , Majeed Azeem 
Published: July 2023

Abstract
Background
Our ability to self-care can play a crucial role in the prevention, management and rehabilitation of diverse conditions, including chronic non-communicable diseases. Various tools have been developed to support the measurement of self-care capabilities of healthy individuals, those experiencing everyday self-limiting conditions, or one or more multiple long-term conditions. We sought to characterise the various non-mono-disease specific self-care measurement tools for adults as such a review was lacking.

Objective
The aim of the review was to identify and characterise the various non-mono-disease specific self-care measurement tools for adults. Secondary objectives were to characterise these tools in terms of their content, structure and psychometric properties.

Design
Scoping review with content assessment.

Methods
The search was conducted in Embase, PubMed, PsycINFO and CINAHL databases using a variety of MeSH terms and keywords covering 1 January 1950 to 30 November 2022. Inclusion criteria included tools assessing health literacy, capability and/or performance of general health self-care practices and targeting adults. We excluded tools targeting self-care in the context of disease management only or indicated to a specific medical setting or theme. We used the Seven Pillars of Self-Care framework to inform the qualitative content assessment of each tool.

Results
We screened 26,304 reports to identify 38 relevant tools which were described in 42 primary reference studies. Descriptive analysis highlighted a temporal shift in the overall emphasis from rehabilitation-focused to prevention-focused tools. The intended method of administration also transitioned from observe-and-interview style methods to the utilisation of self-reporting tools. Only five tools incorporated questions relevant to the seven pillars of self-care.

Conclusions
Various tools exist to measure individual self-care capability, but few consider assessing capability against all seven pillars of self-care. There is a need to develop a comprehensive, validated tool and easily accessible tool to measure individual self-care capability including the assessment of a wide range of self-care practices. Such a tool could be used to inform targeted health and social care interventions.
Epidemiological differences between the sexes in adolescent patients with lumbar spondylolysis: a single-institution experience in Japan
Authors: Asai Reo , Tatsumura Masaki , Gamada Hisanori , Okuwaki Shun , Eto Fumihiko , Nagashima Katsuya , Takeuchi Yousuke , Funayama Toru , Mammoto Takeo , Hirano Atsushi , Yamazaki Masashi 
Published: July 2023

Abstract
Background
Lumbar spondylolysis, a common identifiable cause of low back pain in young athletes, reportedly has a higher incidence rate in males. However, the reason for its higher incidence in males is not clear. This study aimed to investigate the epidemiological differences between the sexes in adolescent patients with lumbar spondylolysis.

Methods
A retrospective study was conducted in 197 males and 64 females diagnosed with lumbar spondylolysis. These patients visited our institution from April 2014 to March 2020 with their main complaint being low back pain, and they were followed-up until the end of their treatment. We investigated associations between lumbar spondylosis, their background factors, and characteristics of the lesions and analyzed their treatment results.

Results
Males had a higher prevalence of spina bifida occulta (SBO) (p = 0.0026), more lesions with bone marrow edema (p = 0.0097), and more lesions in the L5 vertebrae (p = 0.021) than females. The popular sports disciplines were baseball, soccer, and track and field in males, and volleyball, basketball, softball in females. The dropout rate, age at diagnosis, bone union rate, and treatment period did not differ between the sexes.

Conclusion
Lumbar spondylolysis was more common in males than in females. SBO, bone marrow edema, and L5 lesions were more frequent in males, and sports discipline varied between the sexes.
The feasibility of a new self-guided pedicle tap for pedicle screw placement: an anatomical study
Authors: Liu Yongtao , Zhou Xiaoji , Li Yuan , Wang Peng 
Published: July 2023

Abstract
Purpose
To investigate the safety and accuracy of applying a new self-guided pedicle tap to assist pedicle screw placement.

Methods
A new self-guided pedicle tap was developed based on the anatomical and biomechanical characteristics of the pedicle. Eight adult spine specimens, four males and four females, were selected and tapped on the left and right sides of each pair of T1-L5 segments using conventional taps (control group) and new self-guided pedicle taps (experimental group), respectively, and pedicle screws were inserted. The screw placement time of the two groups were recorded and compared using a stopwatch. The safety and accuracy of screw placement were observed by CT scanning of the spine specimens and their imaging results were graded according to the Heary grading criteria.

Results
Screw placement time of the experimental group were (5. 73 ± 1. 18) min in thoracic vertebrae and (5. 09 ± 1. 31) min in lumbar vertebrae respectively. Screw placement time of the control group were respectively (6. 02 ± 1. 54) min in thoracic vertebrae and (5.51 ± 1.42) min in lumbar vertebrae. The difference between the two groups was not statistically significant (P > 0. 05). The Heary grading of pedicle screws showed 112 (82.35%) Heary grade I screws and 126 (92.65%) Heary grade I + II screws in the experimental group, while 96 (70.59%) Heary grade I screws and 112 (82.35%) Heary grade I + II screws in the control group.The difference between the two groups was statistically significant (P < 0.05).

Conclusion
The new self-guided pedicle tap can safely and accurately place thoracic and lumbar pedicle screws with low-cost and convenient procedure,which indicates a good clinical application value.
Identification and characterization of sugar-regulated promoters in Chaetomium thermophilum
Authors: Reislöhner Sven , Schermann Geza , Kilian Max , Santamaría-Muñoz Daniela , Zimmerli Christian , Kellner Nikola , Baßler Jochen , Brunner Michael , Hurt Ed 
Published: July 2023

AbstractThe thermophilic fungus Chaetomium thermophilum has been used extensively for biochemical and high-resolution structural studies of protein complexes. However, subsequent functional analyses of these assemblies have been hindered owing to the lack of genetic tools compatible with this thermophile, which are typically suited to other mesophilic eukaryotic model organisms, in particular the yeast Saccharomyces cerevisiae. Hence, we aimed to find genes from C. thermophilum that are expressed under the control of different sugars and examine their associated 5’ untranslated regions as promoters responsible for sugar-regulated gene expression. To identify sugar-regulated promoters in C. thermophilum, we performed comparative xylose- versus glucose-dependent gene expression studies, which uncovered a number of enzymes with induced expression in the presence of xylose but repressed expression in glucose-supplemented media. Subsequently, we cloned the promoters of the two most stringently regulated genes, the xylosidase-like gene (XYL) and xylitol dehydrogenase (XDH), obtained from this genome-wide analysis in front of a thermostable yellow fluorescent protein (YFP) reporter. With this, we demonstrated xylose-dependent YFP expression by both Western blotting and live-cell imaging fluorescence microscopy. Prompted by these results, we expressed the C. thermophilum orthologue of a well-characterized dominant-negative ribosome assembly factor mutant, under the control of the XDH promoter, which allowed us to induce a nuclear export defect on the pre-60S subunit when C. thermophilum cells were grown in xylose- but not glucose-containing medium. Altogether, our study identified xylose-regulatable promoters in C. thermophilum, which might facilitate functional studies of genes of interest in this thermophilic eukaryotic model organism.
Orthodontic treatment of traumatically avulsed maxillary central incisors with bimaxillary dentoalveolar protrusion in an adult female: a case report
Authors: Yu Xiaotong , Duan Xiaoni , Zhi Cheng , Jiang Yilin , Chen Ziyi , Zhang Chunxiang 
Published: July 2023

Abstract
Background
Clinicians agree that obtaining and retaining good treatment results for missing maxillary central incisors owing to trauma is not easy. Management of adult patients with permanent maxillary central incisor loss who visit the clinic with high expectations for aesthetics and function pose a significant diagnostic dilemma. Therefore, esthetic and functional outcomes should be taken into consideration when deciding the proper treatment method. The treatment described in this study aimed to reestablish smile esthetics by proposing an effective multidisciplinary clinical approach that includes orthodontic-prosthetic-periodontal procedures, optimally reduced lip protrusion, center dental midlines, and establishment of stable occlusion.

Case presentation
The patient was a 19-year-old adult female with bimaxillary arch protrusion who had been wearing removable dentures for several years since the loss of her maxillary central permanent incisors. A multidisciplinary treatment including the extraction of two mandibular primary premolars was adopted. The treatment plan consisted of orthodontic space closure by shifting the adjacent teeth towards the central incisor spaces combined with appropriate morphologic remodeling and gingival reshaping to obtain good aesthetic and functional results. The duration to complete the orthodontic treatment was 35 months. Clinical and radiographic results after treatment suggested smile harmony with an improvement in the facial profile, good function of the occlusion, and a positive effect on bone remodeling in the area of the missing incisors during orthodontic tooth movement.

Conclusions
This clinical case illustrated the necessity for using multidisciplinary methods involving orthodontic, prosthodontic, and periodontic procedures to treat an adult female patient with bimaxillary arch protrusion and long-term absence of anterior teeth due to severe trauma.
Is automatic cephalometric software using artificial intelligence better than orthodontist experts in landmark identification?
Authors: Ye Huayu , Cheng Zixuan , Ungvijanpunya Nicha , Chen Wenjing , Cao Li , Gou Yongchao 
Published: July 2023

Abstract
Background
To evaluate the techniques used for the automatic digitization of cephalograms using artificial intelligence algorithms, highlighting the strengths and weaknesses of each one and reviewing the percentage of success in localizing each cephalometric point.

Methods
Lateral cephalograms were digitized and traced by three calibrated senior orthodontic residents with or without artificial intelligence (AI) assistance. The same radiographs of 43 patients were uploaded to AI-based machine learning programs MyOrthoX, Angelalign, and Digident. Image J was used to extract x- and y-coordinates for 32 cephalometric points: 11 soft tissue landmarks and 21 hard tissue landmarks. The mean radical errors (MRE) were assessed radical to the threshold of 1.0 mm,1.5 mm, and 2 mm to compare the successful detection rate (SDR). One-way ANOVA analysis at a significance level of P < .05 was used to compare MRE and SDR. The SPSS (IBM-vs. 27.0) and PRISM (GraphPad-vs.8.0.2) software were used for the data analysis.

Results
Experimental results showed that three methods were able to achieve detection rates greater than 85% using the 2 mm precision threshold, which is the acceptable range in clinical practice. The Angelalign group even achieved a detection rate greater than 78.08% using the 1.0 mm threshold. A marked difference in time was found between the AI-assisted group and the manual group due to heterogeneity in the performance of techniques to detect the same landmark.

Conclusions
AI assistance may increase efficiency without compromising accuracy with cephalometric tracings in routine clinical practice and research settings.
Factors associated with uptake of human papilloma virus vaccine among school girls aged 9–14 years in Lira City northern Uganda: a cross-sectional study
Authors: Nakayita Renniter Mirembe , Benyumiza Deo , Nekesa Catherine , Misuk Ivan , Kyeswa Julius , Nalubuuka Aisha , Murungi Tom , Udho Samson , Kumakech Edward 
Published: July 2023

Abstract
Background
Cervical cancer is the most common Human Papilloma Virus (HPV)-related disease among women. Since 2008, HPV vaccination has been routinely recommended for pre-adolescent and adolescent girls in Uganda as the primary preventive measure for cervical cancer. However, in Uganda, most especially in Lira district, there is limited literature on HPV vaccination uptake and associated factors among girls aged 9-14years. This study assessed the uptake of HPV vaccine and associated factors among in-school girls aged 9–14 years in Lira City, northern Uganda.

Methods
A cross-sectional study was conducted among 245 primary school girls aged 9–14 years in Lira City, northern Uganda. Multistage sampling technique was used to sample eligible participants and data was collected using interviewer administered questionnaire. Data was analysed using SPSS version 23.0. Descriptive statistics and multivariate logistic regression at 95% level of significance were used to identify the level of HPV vaccine uptake and predictors respectively.

Results
HPV vaccination uptake was at 19.6% (95% CI,14.8–25.1) among the school girls aged 9–14 years in Lira City, northern Uganda. The mean age of the girls was 12.11 (± 1.651) years. Predictors that were independently associated with HPV vaccine uptake included; recommendation from health worker [aOR 9.09, 95% CI (3.19–25.88), P ≤ 0.001], taught about cervical cancer at school [aOR,12.56, 95% CI (4.60–34.28), P ≤ 0.001], and exposure to outreach clinics [aOR, 4.41, 95% CI (1.37–14.19), P = 0.013].

Conclusion
The study found that one in five of the school girls in Lira City, northern Uganda. received HPV vaccine. Girls who were taught about cervical cancer at school, exposure to outreach clinics and received health worker recommendation had more odds of receiving HPV vaccine than their counter parts. The Ministry of Health should strengthen school based cervical cancer education, awareness raising about HPV vaccination and health worker recommendations to improve HPV vaccine uptake among school girls in Uganda.