bluuebunny/crossref_metadata_2025_split huggingface dataset:
Future of myocardial infarction mortality in Iran: a scenario-based study
Authors: Alizadeh Gisoo , Gholipour Kamal , Kazemi Shishavan Maryam , Dehnavieh Reza , Goharinejad Salime , Arab-Zozani Morteza , Khosravi Mohammad Farough , Khodayari-Zarnaq Rahim 
Published: March 2023

AbstractThis study defines futures myocardial infarction landscapes and proposes a few policy options to reduce the burden of cardiovascular diseases using the scenario development method. We identified the effective drivers of myocardial infarction by reviewing the literature and completed the returned list with “experts” opinions. The results were classified using the STEEP (Social, Technological, Environmental, Economic, and Political) framework. We plotted the critical uncertainties in a two-dimensional ranking of “effect” and “uncertainty” levels. Eleven drivers with uncertainty and high potential impact were selected and categorized into three groups: Political Development, Access to health services, and Self-Care. Scenarios were developed, and 3 scenarios (optimistic, pessimistic, and possible) were selected based on scoring. For each scenario, policy options were formulated. Utilizing the capacity of Non-Governmental Organizations and charities and strengthening restrictive and punitive legislation was chosen as policy options for addressing possible scenarios. Building infrastructure and improving prevention services, designing and regenerating curative infrastructure were selected as optimal strategies for addressing issues related to the optimistic scenario. Strengthening restrictive and punitive legislation related to community health and population empowerment were proposed as critical policy options for health improvement regarding the pessimistic scenario. Increasing people’s participation, strengthening infrastructure and punitive policies can be effective in Myocardial infarction mortality prevention policies in Iran.
RETRACTED ARTICLE: Sexual reproductive health service utilization and associated factors among undergraduate students of Addis Ababa University in Ethiopia
Authors: Mekbib Bethel , Demissei Dereje Bayissa 
Published: March 2023

Abstract
Background
Making clinical services attractive to the younger generation has remained a challenge. Students in higher education continue to underutilize sexual and reproductive health services. This group is exposed to a very hostile environment and has a highly mobile and unprotected lifestyle, often resulting in an early sexual debut, physical and drug abuse, and sexually transmitted infections.

Objective
The aim of this study was to assess sexual reproductive health services and associated factors among undergraduate students of Addis Ababa University 2022.

Method
An Institution-based cross-sectional study was been conducted among 419 randomly selected students and data were collected by using semi-structured and pre-tested questionnaire. Data were entered to Epi info data 7.0 and exported to SPSS version 21.0 for further analysis. Both binary and multiple logistic regression analysis was used to identify factors at P < 0.05 with 95% CI and AOR.

Results
When queried, all 419 youths agreed to participate in the study, for a response rate of 100%. The mean age of the respondents was 22 years. The majority of respondents (371, 88.5%) were between the ages of 19 and 24, and 221 (52.7%) were female. More than half of those polled (273, or 65.2%) were third-year students, while 59, or 14.1%, were first-year students. About 206 (49.2%) of participants lived with their father and mother, but 138 (32.9%) had never discussed sexual and reproductive health. Finally, 205 respondents (or 48.9%) had ever used the Sexual and Reproductive Health Services. College of business (AOR (95% CI) 3.546 (1.62–7.79), respondents who live with only their mother (AOR (95% CI) 9.37 (2.78–31.51) and who live alone (AOR (95% CI) 5.75 (2.40–13.79), positive attitude toward SRHS (AOR (95% CI) 3.15 (1.71–5.80), good knowledge (AOR (95% CI) 4.16 (2.27–7.64), frequency of discussing SRHS(AOR (95% CI) 1.93 (1.12–3.346), Convenient location of youth RHs (AOR (95% CI) 8.31 (1.61–42.93), Fee of RH services (AOR (95% CI) 12.34 (6.48–23.49) and Satisfied to received RH services (AOR (95% CI) 4.59 (2.54–8.33) were independent predictors of utilized SRHS among undergraduate students.

Conclusion and recommendation
The prevalence of utilization of sexual and reproductive health services was determined to be low in this study, with identified factors increasing the likelihood of utilization being attitude, knowledge, satisfaction, discussion, fee for RH services, and location, in that order. On the other hand, poor knowledge and a negative attitude toward SRHS posed risks that contributed to reproductive health issues, so we worked on advocating for services that were available in a nearby location and raising awareness. Therefore, policymakers and health planners would be better off strengthening the urgent need to ensure adequate SRHS, knowledge, and attitude building among undergraduate students in higher education in Ethiopia.
Synthesis of [18F]FMISO, a hypoxia-specific imaging probe for PET, an overview from a radiochemist’s perspective
Authors: Kniess Torsten , Zessin Jörg , Mäding Peter , Kuchar Manuela , Kiss Oliver , Kopka Klaus 
Published: March 2023

Abstract
Background
[18F]fluoromisonidazole ([18F]FMISO, 1H-1-(3-[18F]fluoro-2-hydroxypropyl)-2-nitroimidazole) is a commonly used radiotracer for imaging hypoxic conditions in cells. Since hypoxia is prevalent in solid tumors, [18F]FMISO is in clinical application for decades to explore oxygen demand in cancer cells and the resulting impact on radiotherapy and chemotherapy.

Results
Since the introduction of [18F]FMISO as positron emission tomography imaging agent in 1986, a variety of radiosynthesis procedures for the production of this hypoxia tracer has been developed. This paper gives a brief overview on [18F]FMISO radiosyntheses published so far from its introduction until now. From a radiopharmaceutical chemist’s perspective, different precursors, radiolabeling approaches and purification methods are discussed as well as used automated radiosynthesizers, including cassette-based and microfluidic systems.

Conclusion
In a GMP compliant radiosynthesis using original cassettes for FASTlab we produced [18F]FMISO in 49% radiochemical yield within 48 min with radiochemical purities > 99% and molar activities > 500 GBq/µmol. In addition, we report an easy and efficient radiosynthesis of [18F]FMISO, based on in-house prepared FASTlab cassettes, providing the radiotracer for research and preclinical purposes in good radiochemical yields (39%), high radiochemical purities (> 99%) and high molar activity (> 500 GBq/µmol) in a well-priced option.
Restricting the distribution of visual attention reduces cybersickness
Authors: Yip Sai Ho , Saunders Jeffrey Allen 
Published: March 2023

AbstractThis study investigated whether increased attention to the central or peripheral visual field can reduce motion sickness in virtual reality (VR). A recent study found that increased attention to the periphery during vection was correlated with lower self-reported motion sickness susceptibility, which suggests that peripheral attention might be beneficial for avoiding cybersickness. We tested this experimentally by manipulating visual attention to central vs. peripheral fields during VR exposure. We also measured attention to the periphery during vection and motion sickness susceptibility to attempt to replicate the previous results. In Experiment 1, task-relevant cues to target locations were provided in the central or peripheral field during navigation in VR, and we found no differences in motion sickness. In Experiment 2, attention to the center or periphery was manipulated with a dot-probe task during passive VR exposure, and we found that motion sickness was greater in the condition that required attention to the periphery. In both experiments, there was no correlation between baseline attentional allocation and self-reported motion sickness susceptibility. Our results demonstrate that restricting attention to the central visual field can decrease cybersickness, which is consistent with previous findings that cybersickness is greater with large FOV.
Exploring the relationships between interaction measures and learning outcomes through social network analysis: the mediating role of social presence
Authors: Lim Jieun 
Published: March 2023

AbstractThis research aimed to explore (1) the characteristics and patterns of student interactions on online discussion boards throughout a course using social network analysis (SNA) and (2) the mediating effect of social presence, as the underlying mechanism, on the relationship between these interactions and students' learning outcomes. Eighty-four college students from four classes of a single course responded to an online survey asking about their perceptions of social presence, perceived learning achievement, and course satisfaction. Students’ discussion threads were analyzed using SNA. The results confirmed that social presence mediates relationships between interaction measures and learning outcomes. This research also found that SNA can be a useful tool to monitor the dynamic characteristics and patterns of online discussion interactions among students and support instructors to implement immediate and relevant instruction.
Development and validation of a physical frailty phenotype index-based model to estimate the frailty index
Authors: Pua Yong-Hao , Tay Laura , Clark Ross Allan , Thumboo Julian , Tay Ee-Ling , Mah Shi-Min , Lee Pei-Yueng , Ng Yee-Sien 
Published: March 2023

Abstract
Background
The conventional count-based physical frailty phenotype (PFP) dichotomizes its criterion predictors—an approach that creates information loss and depends on the availability of population-derived cut-points. This study proposes an alternative approach to computing the PFP by developing and validating a model that uses PFP components to predict the frailty index (FI) in community-dwelling older adults, without the need for predictor dichotomization.

Methods
A sample of 998 community-dwelling older adults (mean [SD], 68 [7] years) participated in this prospective cohort study. Participants completed a multi-domain geriatric screen and a physical fitness assessment from which the count-based PFP and the 36-item FI were computed. One-year prospective falls and hospitalization rates were also measured. Bayesian beta regression analysis, allowing for nonlinear effects of the non-dichotomized PFP criterion predictors, was used to develop a model for FI (“model-based PFP”). Approximate leave-one-out (LOO) cross-validation was used to examine model overfitting.

Results
The model-based PFP showed good calibration with the FI, and it had better out-of-sample predictive performance than the count-based PFP (LOO-R2, 0.35 vs 0.22). In clinical terms, the improvement in prediction (i) translated to improved classification agreement with the FI (Cohen’s kw, 0.47 vs 0.36) and (ii) resulted primarily in a 23% (95%CI, 18–28%) net increase in FI-defined “prefrail/frail” participants correctly classified. The model-based PFP showed stronger prognostic performance for predicting falls and hospitalization than did the count-based PFP.

Conclusion
The developed model-based PFP predicted FI and clinical outcomes more strongly than did the count-based PFP in community-dwelling older adults. By not requiring predictor cut-points, the model-based PFP potentially facilitates usage and feasibility. Future validation studies should aim to obtain clear evidence on the benefits of this approach.
Routine patient assessment and the use of patient-reported outcomes in specialized palliative care in Japan
Authors: Ito Nao , Ishii Yoko , Aoyama Maho , Abo Hirofumi , Sakashita Akihiro , Matsumura Yuko , Miyashita Mitsunori 
Published: March 2023

Abstract
Background
Discrepancies in symptom assessment between providers and patients are reported in cancer care, and the use of patient-reported outcome measures (PROMs) has been recommended for patients receiving palliative care. However, the status of the routine use of PROMs in palliative care in Japan is presently unclear. Therefore, this study aimed to clarify this complex question. To this end, we administered a questionnaire survey either online or via telephone interviews (questionnaire: sent to 427 designated cancer hospitals, 423 palliative care units [PCUs], and 197 home hospices; interviews: conducted at 13 designated cancer hospitals, nine PCUs, and two home hospices).

Results
Questionnaires were returned from 458 institutions (44% response rate). We found that 35 palliative care teams (PCTs, 15%), 66 outpatient palliative care services (29%), 24 PCUs (11%) and one (5%) home hospice routinely used PROMs. The most frequently implemented instrument was the Comprehensive Care Needs Survey questionnaire. Moreover, 99 institutions (92%) that routinely used PROMs responded these instruments as useful in relieving patients’ symptoms; and moreover, the response rate in regard to usefulness in symptom management was higher than that of institutions that did not routinely use PROMs (p = 0.002); > 50% of the institutions that routinely used PROMs stated that use of these instruments was influenced by disease progression and patients’ cognitive function. Moreover, 24 institutions agreed to be interviewed, and interviews demonstrated the benefits of and the barriers to the implementation of PROMs. Effective methods used in the implementation of PROMs were introduced as efforts to reduce the burden placed on patients and to promote healthcare providers’ education in the use of PROMs.

Conclusions
This survey quantified the status of the routine use of PROMs within specialized palliative care in Japan, revealed barriers to wider PROM use, and identified needed innovations. Only 108 institutions (24%) routinely used PROMs within specialized palliative care. Based on the results of the study, it is necessary to carefully consider the usefulness of PROs in clinical palliative care, perform careful selection of PROMs according to the patient's condition, and evaluate how specifically to introduce and operate PROMs.
Are deep models in radiomics performing better than generic models? A systematic review
Authors: Demircioğlu Aydin 
Published: March 2023

AbstractBackgroundApplication of radiomics proceeds by extracting and analysing imaging features based on generic morphological, textural, and statistical features defined by formulas. Recently, deep learning methods were applied. It is unclear whether deep models (DMs) can outperform generic models (GMs).MethodsWe identified publications on PubMed and Embase to determine differences between DMs and GMs in terms of receiver operating area under the curve (AUC).ResultsOf 1,229 records (between 2017 and 2021), 69 studies were included, 61 (88%) on tumours, 68 (99%) retrospective, and 39 (56%) single centre; 30 (43%) used an internal validation cohort; and 18 (26%) applied cross-validation. Studies with independent internal cohort had a median training sample of 196 (range 41–1,455); those with cross-validation had only 133 (43–1,426). Median size of validation cohorts was 73 (18–535) for internal and 94 (18–388) for external. Considering the internal validation, in 74% (49/66), the DMs performed better than the GMs, vice versa in 20% (13/66); no difference in 6% (4/66); and median difference inAUC0.045. On the external validation, DMs were better in 65% (13/20), GMs in 20% (4/20) cases; no difference in 3 (15%); and median difference inAUC0.025. On internal validation, fused models outperformed GMs and DMs in 72% (20/28), while they were worse in 14% (4/28) and equal in 14% (4/28); median gain in AUC was + 0.02. On external validation, fused model performed better in 63% (5/8), worse in 25% (2/8), and equal in 13% (1/8); median gain in AUC was + 0.025.ConclusionsOverall, DMs outperformed GMs but in 26% of the studies, DMs did not outperform GMs.
An information-oriented paradigm in evaluating accuracy and agreement in radiology
Authors: Casagrande Alberto , Fabris Francesco , Girometti Rossano 
Published: March 2023

AbstractThe goal of any radiological diagnostic process is to gain information about the patient’s status. However, the mathematical notion of information is usually not adopted to measure the performance of a diagnostic test or the agreement among readers in providing a certain diagnosis. Indeed, commonly used metrics for assessing diagnostic accuracy (e.g., sensitivity and specificity) or inter-reader agreement (Cohen $$\kappa$$
κ
statistics) use confusion matrices containing the number of true- and false positives/negatives results of a test, or the number of concordant/discordant categorizations, respectively, thus lacking proper information content. We present a methodological paradigm, based on Shannon’s information theory, aiming to measure both accuracy and agreement in diagnostic radiology. This approach models the information flow as a “diagnostic channel” connecting the state of the patient’s disease and the radiologist or, in the case of agreement analysis, as an “agreement channel” linking two or more radiologists evaluating the same set of images. For both cases, we proposed some measures, derived from Shannon’s mutual information, which can represent an alternative way to express diagnostic accuracy and agreement in radiology.Key points• Diagnostic processes can be modeled with information theory (IT).• IT metrics of diagnostic accuracy are independent from disease prevalence.• IT metrics of inter-reader agreements can overcome Cohen κ pitfalls.
Volumetric assessment of canines using post-mortem computed tomography (PMCT) for sexual dimorphism in a Malaysian population
Authors: Harudin Mohd Hafizal , Franco Ademir , Jaffar Norhayati , Noor Mohamad Helmee Mohamad , Ibrahim Mohamad Azaini , Manica Scheila 
Published: March 2023

Abstract
Background
Recent research has explored volumetric assessment in three-dimensional (3D) imaging procedures for sexual dimorphism. The 3D techniques have enabled a more realistic, accurate, and non-invasive visualization of sex-related anatomical parameters, such as the size and shape of human teeth.

Aim
To perform sexual dimorphism based on dental tissue volumes of permanent left maxillary and mandibular canines in a Malaysian population.

Methods
A cross-sectional study was carried out on 220 post-mortem computed tomography (PMCT) scans of Malaysian subjects (114 males and 106 females) aged between 18 and 40 years old. The permanent left maxillary and mandibular canines were analysed based on the volume of their (I) enamel cap, (II) coronal dentine, and (III) root, as well as the combination between the three dental tissue volumes (DTV). 3D Slicer version 4.10.2 computer software was used to perform a semi-automated segmentation of the anatomic regions of interest of each tooth.

Results
The DTV of the permanent left maxillary and mandibular canines showed sexual dimorphism as the males presented larger DTV than females (p < 0.05). After binary logistic regression, the DTV revealed an overall sex classification rate of 60 to 74.1%. The DTV of the permanent left mandibular canine had more discriminant power to correctly classify males and females compared to the left maxillary canine.

Conclusions
The volumetric assessment of the dental tissues of the permanent left maxillary and mandibular canines could discriminate sex in the Malaysian population. Given the limited classification rate, this approach could act solely as a supplementary tool to existing sex estimation methods.
Role of DSM5 anxious distress specifier interview in acute manic episode: sociodemographic characteristics, clinical presentation and quality of life
Authors: El Sayed Samir , Gomaa Sarah , Al Hazmi Alaa , Sonbol Hassan , ElKalla Ibrahem 
Published: March 2023

Abstract
Background
DSM 5 anxious distress specifier is one of the newly added specifiers for bipolar and related disorders. It may have impacts on the symptoms severity, insight, impulsivity, and different domains of quality of life of acute manic episodes of bipolar disorders. The current study aimed to study the effects of DSM 5 anxious distress specifier in acute manic episodes and its relation to sociodemographic data, clinical characteristics, and quality of life. 380 patients with the diagnosis of acute manic episode were recruited in the study, sociodemographic data, clinical features, DSM 5 anxious distress specifier interview, attitude and insight of the disorder, impulsivity and different aspects of quality of life were also evaluated in those patients.

Results
The studied patients were divided into 2 subgroups according to the presence of high DSM5 anxious distress specifier interview score. The duration of a manic episode (P < 0.001), the severity of the manic episode (P < 0.001), and the presence of psychotic features (P = 0.002) were more common in the subgroup with high DSM 5 anxious distress. DSM 5 anxious distress specifier was severe (P < 0.001) and more frequent (P < 0.001) in the 1st subgroup than the 2nd one. There was a statistically significant difference regarding the attentional facet of the Barratt impulsiveness scale between the studied groups (P = 0.002). In addition, there was a statistically significant difference regarding the mean score (P < 0.001) and severe impairment (P < 0.001) domains of work and social adjustment scale between the 2 subgroups.

Conclusions
DSM 5 anxious distress specifier interview is a very crucial parameter of evaluation the patients with acute manic episodes which may have implications on the clinical presentations, symptoms severity, impulsivity, and variable aspects of quality of life in those patients. All these implications might change the course, prognosis, and outcomes of an acute manic episode of bipolar disorder.
Myasthenia gravis with achalasia secondary to thymoma: a case report and literature review
Authors: Haridy Nourelhoda A. , Khedr Eman M. , Hasan Asmaa M. , Maghraby Ahmed A. , Abdelmohsen Essam , Aly AbdelHamid M. 
Published: March 2023

Abstract
Background
Myasthenia gravis is an autoimmune neuromuscular junction disorder characterized by fatigable muscle weakness and autoantibodies. Frequent associations exist between myasthenia gravis and thymic abnormalities, including hyperplasia and thymoma. Several autoimmune illnesses have been identified to be associated with thymoma; however, a few case reports have linked thymoma and achalasia, and the underlying mechanism is unknown.

Case report
A 43-year-old man with thymoma-associated myasthenia gravis presented with dysphagia that was refractory to conventional treatment of myasthenia gravis. This dysphagia was challenging to diagnose even after multiple gastroenterology consults and upper endoscopy. The diagnosis of achalasia type II was established after a comprehensive evaluation, including upper endoscopy, barium swallow, and high-resolution esophageal manometry. The patient underwent elective pneumatic balloon dilatation, which successfully alleviated his dysphagia.

Conclusion
This case confirmed the association between myasthenia gravis secondary to thymoma and achalasia and showed how the diagnosis of achalasia was challenging. Awareness of this association is crucial for early diagnosis and treatment, improving affected patients’ quality of life.