bluuebunny/crossref_metadata_2025_split huggingface dataset:
Informing the ethical review of human subjects research utilizing artificial intelligence
Authors: Makridis Christos Andreas , Boese Anthony , Fricks Rafael , Workman Don , Klote Molly , Mueller Joshua , Hildebrandt Isabel J. , Kim Michael , Alterovitz Gil 
Published: September 2023

IntroductionThe rapid expansion of artificial intelligence (AI) has produced many opportunities, but also new risks that must be actively managed, particularly in the health care sector with clinical practice to avoid unintended health, economic, and social consequences.MethodsGiven that much of the research and development (R&amp;D) involving human subjects is reviewed and rigorously monitored by institutional review boards (IRBs), we argue that supplemental questions added to the IRB process is an efficient risk mitigation technique available for immediate use. To facilitate this, we introduce AI supplemental questions that provide a feasible, low-disruption mechanism for IRBs to elicit information necessary to inform the review of AI proposals. These questions will also be relevant to review of research using AI that is exempt from the requirement of IRB review. We pilot the questions within the Department of Veterans Affairs–the nation's largest integrated healthcare system–and demonstrate its efficacy in risk mitigation through providing vital information in a way accessible to non-AI subject matter experts responsible for reviewing IRB proposals. We provide these questions for other organizations to adapt to fit their needs and are further developing these questions into an AI IRB module with an extended application, review checklist, informed consent, and other informational materials.ResultsWe find that the supplemental AI IRB module further streamlines and expedites the review of IRB projects. We also find that the module has a positive effect on reviewers' attitudes and ease of assessing the potential alignment and risks associated with proposed projects.DiscussionAs projects increasingly contain an AI component, streamlining their review and assessment is important to avoid posing too large of a burden on IRBs in their review of submissions. In addition, establishing a minimum standard that submissions must adhere to will help ensure that all projects are at least aware of potential risks unique to AI and dialogue with their local IRBs over them. Further work is needed to apply these concepts to other non-IRB pathways, like quality improvement projects.
Predictors and prognostic implications of hospital-acquired pneumonia in patients admitted for acute heart failure
Authors: Polovina Marija , Tomić Milenko , Viduljević Mihajlo , Zlatić Nataša , Stojićević Andrea , Civrić Danka , Milošević Aleksandra , Krljanac Gordana , Lasica Ratko , Ašanin Milika 
Published: September 2023

IntroductionData on predictors and prognosis of hospital acquired pneumonia (HAP) in patients admitted for acute heart failure (AHF) to intensive care units (ICU) are scarce. Better knowledge of these factors may inform management strategies. This study aimed to assess the incidence and predictors of HAP and its impact on management and outcomes in patients hospitalised for AHF in the ICU.Methodsthis was a retrospective single-centre observational study. Patient-level and outcome data were collected from an anonymized registry-based dataset. Primary outcome was in-hospital all-cause mortality and secondary outcomes included length of stay (LOS), requirement for inotropic/ventilatory support, and prescription patterns of heart failure (HF) drug classes at discharge.ResultsOf 638 patients with AHF (mean age, 71.6 ± 12.7 years, 61.9% male), HAP occurred in 137 (21.5%). In multivariable analysis, HAP was predicted by de novo AHF, higher NT proB-type natriuretic peptide levels, pleural effusion on chest x-ray, mitral regurgitation, and a history of stroke, diabetes, and chronic kidney disease. Patients with HAP had a longer LOS, and a greater likelihood of requiring inotropes (adjusted odds ratio, OR, 2.31, 95% confidence interval, CI, 2.16–2.81; p &lt; 0.001) or ventilatory support (adjusted OR 2.11, 95%CI, 1.76–2.79, p &lt; 0.001). After adjusting for age, sex and clinical covariates, all-cause in-hospital mortality was significantly higher in patients with HAP (hazard ratio, 2.10; 95%CI, 1.71–2.84; p &lt; 0.001). Patients recovering from HAP were less likely to receive HF medications at discharge.DiscussionHAP is frequent in AHF patients in the ICU setting and more prevalent in individuals with de novo AHF, mitral regurgitation, higher burden of comorbidities, and more severe congestion. HAP confers a greater risk of complications and in-hospital mortality, and a lower likelihood of receiving evidence-based HF medications at discharge.
Long-term adoption of bed planted conservation agriculture based maize/cotton-wheat system enhances soil organic carbon stabilization within aggregates in the indo-gangetic plains
Authors: Joseph Ann Maria , Bhattacharyya Ranjan , Biswas D. R. , Das T. K. , Bandyopadhyay K. K. , Dey Abir , Ghosh Avijit , Roy Plabani , Naresh Kumar Soora , Jat S. L. , Casini Ryan , Elansary Hosam O. , Bhatia Arti 
Published: September 2023

Sustainability of contemporary crop establishment and management practices is questioned due to soil degradation, higher carbon emission and declining soil productivity. Hence, this study was conducted to address the impacts of conservation agriculture (CA) practices like permanent broad beds (PBB), permanent narrow beds (PNB) and zero tilled flat beds (ZT) with residue retention on soil organic carbon (SOC) protection within aggregates in the Indo-Gangetic Plains (IGP). Compared to conventionally tilled (CT) plots, the total SOC content was ∼27%–33% higher in the CA plots on equivalent mass basis. The soil physical properties, such as soil aggregation and mean weight diameter were considerably improved under the CA practices. The macroaggregates were ∼41, 37% and 27% higher in the PBB with residue (PBB + R), PNB with residue (PNB + R) and ZT with residue (ZT + R) plots (CA plots), respectively, than the CT plots in the surface soil (0–15 cm). The plots under PBB + R had ∼31% higher microaggregates within macroaggregates than the CT plots (24.4 g 100 g−1) soil. An increase in SOC content by ∼72, 55% and 69% was observed in the PBB + R, PNB + R and ZT + R plots over the CT plots in microaggregates within macroaggregates (3.02 Mg ha−1). However, plots under PBB + R, PNB + R and ZT + R had only ∼11, 3% and 23% more SOC within silt + clay fraction, respectively, than CT plots (5.85 Mg ha−1). Thus, SOC stabilization within microaggregates inside macroaggregates was the major mechanism, and not the chemical stabilization within silt + clay, of C sequestration under CA. As aggregate-associated carbon is an ecosystem property that strongly affects organic carbon stabilization, water holding capacity and resistance to erosion, growing maize/cotton–wheat system under PBB + R practice is a viable option for carbon sequestration in the IGP and similar agro-ecologies.
Vaccine hesitancy and knowledge regarding maternal immunization among reproductive age women in central Italy: a cross sectional study
Authors: Moschese Viviana , De Angelis Luigi , Capogna Maria Vittoria , Graziani Simona , Baglivo Francesco , Pietropolli Adalgisa , Miraglia Del Giudice Michele , Rizzo Caterina ,   the Italian Society of Pediatric Allergology and Immunology (SIAIP) Vaccine Committee
Published: September 2023

BackgroundVaccination in pregnancy offers protection to the mother and the newborn. In Italy, influenza, pertussis, and COVID-19 vaccinations are recommended in pregnancy, but vaccination coverage is still far from the National Immunization Plan goals. We aimed to assess knowledge and attitude on maternal immunization in two groups of Italian women, in pregnancy and in reproductive age (non pregnant).MethodsA cross sectional study on Italian childbearing age women gathering information on their knowledge on maternal immunization and attitudes to receiving influenza and pertussis vaccines in pregnancy was carried out at the University of Rome Tor Vergata, between September 2019 and February 2020. Logistic and multinomial regressions were chosen as statistical tests for our analysis.Results1,031 women participated in the survey by answering the questionnaire. Out of these, 553 (53.6%) women were pregnant, and 478 (46.4%) were in the reproductive age. 37% (204/553) of pregnant women and 41% (198/476) of non pregnant women are aware of the existence of an immunization plan for pregnant women in Italy. The group with age between 20 and 30, for both pregnant women and women in the reproductive age, has a better knowledge of vaccination in pregnancy. Working status is a variable associated with more awareness about vaccination during pregnancy only for pregnant women (OR = 2.34, p &lt; 0.00001). Educational status, trimester of pregnancy and knowledge on the topic are associated with vaccine hesitancy in our multivariate analysis for pregnant women. In the reproductive age group women who had a previous pregnancy are more likely to be hesitant towards vaccination in pregnancy, on the other hand the one with a higher knowledge and educational status are more likely to get vaccinated.ConclusionsThe study highlights the persistent vaccine hesitancy among Italian women of reproductive age and pregnant women. Despite healthcare providers being identified as a reliable source of information, their recommendations alone are insufficient to overcome vaccine hesitancy. Factors such as employment status, educational level, pregnancy trimester, and knowledge about vaccinations during pregnancy influence vaccine hesitancy. Tailored educational interventions and communication campaigns targeting these areas can help reduce vaccine hesitancy and promote maternal immunization.
High CD8+tumor-infiltrating lymphocytes indicate severe exhaustion and poor prognosis in angioimmunoblastic T-cell lymphoma
Authors: Zhu Qiqi , Yang Yiming , Deng Xueqin , Chao Ningning , Chen Zihang , Ye Yunxia , Zhang Wenyan , Liu Weiping , Zhao Sha 
Published: September 2023

BackgroundExhaustion of CD8+ tumor-infiltrating lymphocytes (TILs), characterized by the overexpression of immune checkpoints (IC), is a major impediment to anti-tumor immunity. However, the exhaustion status of CD8+TILs in angioimmunoblastic T cell lymphoma (AITL) remains unclear. Therefore, we aimed to elucidate the exhaustion status of CD8+TILs in AITL and its influence on prognosis.MethodsThe correlation between CD8+TILs and IC expression in AITL was analyzed using single-cell RNA sequencing (n = 2), flow cytometry (n = 20), and RNA sequencing (n = 20). Biological changes related to CD8+TILs exhaustion at different cytotoxic T lymphocyte (CTL) levels (mean expression levels of CD8A, CD8B, GZMA, GZMB, and PRF1) in AITL were evaluated using RNA sequencing (n = 20) and further validated using the GEO dataset (n = 51). The impact of CD8 protein expression and CTL levels on patient prognosis was analyzed using flow cytometry and RNA sequencing, respectively.ResultsOur findings demonstrated that the higher the infiltration of CD8+TILs, the higher was the proportion of exhausted CD8+TILs characterized by the overexpression of multiple IC. This was accompanied by extensive exhaustion-related biological changes, which suggested severe exhaustion in CD8+TILs and may be one of the main reasons for the poor prognosis of patients with high CD8+TILs and CTL.ConclusionOur study comprehensively reveals the exhaustion status of CD8+TILs and their potential negative impact on AITL prognosis, which facilitates further mechanistic studies and is valuable for guiding immunotherapy strategies.
Construction and validation of a predictive model for the risk of peritoneal dialysis-associated peritonitis after peritoneal dialysis catheterization
Authors: Dai Rong , Peng Chuyi , Sang Tian , Cheng Meng , Wang Yiping , Zhang Lei 
Published: September 2023

AimTo construct and validate a risk prediction model for the development of peritoneal dialysis-associated peritonitis (PDAP) in patients undergoing peritoneal dialysis (PD).MethodsThis retrospective analysis included patients undergoing PD at the Department of Nephrology, the First Affiliated Hospital of Anhui University of Chinese Medicine, between January 2016 and January 2021. Baseline data were collected. The primary study endpoint was PDAP occurrence. Patients were divided into a training cohort (n = 264) and a validation cohort (n = 112) for model building and validation. Least Absolute Shrinkage and Selection Operator (LASSO) regression was applied to optimize the screening variables. Predictive models were developed using multifactorial logistic regression analysis with column line plots. Receiver operating characteristic (ROC) curves, calibration curves, and Hosmer-Lemeshow goodness-of-fit tests were used to verify and evaluate the discrimination and calibration of the prediction models. Decision curve analysis (DCA) was used to assess the clinical validity of the prediction models.ResultsFive potential predictors of PDAP after PD catheterization were screened using LASSO regression analysis, including neutrophil-to-lymphocyte ratio (NLR), serum ALBumin (ALB), uric acid (UA), high sensitivity C-reactive protein (hsCRP), and diabetes mellitus (DM). Predictive models were developed by multi-factor logistic regression analysis and plotted in columns. The area under the ROC curve (AUC) values were 0.891 (95% confidence interval [CI]: 0.829–0.844) and 0.882 (95% CI: 0.722–0.957) for the training and validation cohorts, respectively. The Hosmer-Lemeshow test showed a good fit (p = 0.829 for the training cohort; p = 0.602 for the validation cohort). The DCA curves indicated that the threshold probabilities for the training and validation cohorts were 4–64% and 3–90%, respectively, predicting a good net gain for the clinical model.ConclusionNLR, ALB, UA, hsCRP, and DM are independent predictors of PDAP after PD catheterization. The column line graph model constructed based on the abovementioned factors has good discriminatory and calibrating ability and helps to predict the risk of PDAP after PD catheterization.
Combined early palliative care for non-small-cell lung cancer patients: a randomized controlled trial in Chongqing, China
Authors: Chen Mengting , Yu Huiqing , Yang Liejun , Yang Hong , Cao Haoyang , Lei Lei , Ma Liling , Liu Shihong , Tian Ling , Wang Sixiong 
Published: September 2023

PurposeMore effective approaches are needed to improve the prognosis of non-small-cell lung cancer (NSCLC) patients. Thus, we used the E-warm model to assess how early integration of interdisciplinary palliative care was related to the quality of life (QoL), psychological functioning, pain management, and nutrition factors of NSCLC patients.MethodsThis randomized controlled trial enrolled 280 newly diagnosed NSCLC patients, which were randomly divided (1:1) into combined early palliative care (CEPC) and standard oncological care (SC) groups. At baseline and after 24 weeks, the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale, Hospital Anxiety and Depression Scale (HADS), and the Patient Health Questionnaire-9 (PHQ-9) were used to assess QoL and psychological function, respectively. The Numerical Rating Scale (NRS) and Patient-Generated Subjective Global Assessment (PG-SGA) were used to assess cancer patients’ pain and nutrition levels. The primary outcome was overall survival (OS). Secondary outcomes comprised changes in the QoL, psychological functioning, pain, and nutrition state. The intention-to-treat method was applied for analysis. This study was registered at www.chictr.org.cn (ChiCTR2200062617).ResultsOf the 140 patients enrolled in the CEPC and SC groups, 102 and 82 completed the research. The CEPC group presented higher QoL than the SC group (p &lt; 0.05). Additionally, fewer patients presented depressive symptoms in the CEPC group than in the SC group (p &lt; 0.05), as well as better nutritional status (p = 0.007) and pain management (p = 0.003). Compared to the SC group, CEPC patients had significantly longer OS (20.4 vs. 24.6 months, p = 0.042; HR: 0.19; 95% CI: 0.04-0.85, p = 0.029).ConclusionWith combined early palliative care, NSCLC patients lived longer, had better QoL, were psychologically stable, were in less pain, and were more nutritionally satisfied.
Characteristics of second primary breast cancer after ovarian cancer: a Korea central cancer registry retrospective study
Authors: Lee Eun-Gyeong , Lim Jiwon , Ha Hyeong In , Lim Myong Cheol , Chang Yoon Jung , Won Young-Joo , Jung So-Youn 
Published: September 2023

BackgroundSecond primary cancer has become an important issue among cancer survivors. This study sought to determine the differences in clinicopathologic outcomes between second primary breast cancer (SPBC) after ovarian cancer and primary breast cancer (PBC) in the Republic of Korea.Methods and materialsWe searched the Korea Central Cancer Registry and identified 251,244 breast cancer cases that were diagnosed between 1999 and 2017. The incident rate and standardized incidence ratio (SIR) were calculated. Demographic and clinical characteristics and overall survival (OS) rates were estimated according to age, histological type, and cancer stage.ResultsAmong the 228,329 patients included, 228,148 were patients with PBC, and 181 patients had SPBC diagnosed after ovarian cancer (OC). The mean ages at diagnosis were 56.09 ± 10.81 years for SPBC and 50.65 ± 11.40 years for PBC. Patients with SPBC were significantly less likely than patients with PBC to receive adjuvant radiotherapy (14.92% vs. 21.92%, p = 0.02) or adjuvant chemotherapy (44.75% vs. 55.69%, p &lt; 0.01). Based on the age-standardized rate (ASR), the incidence of SPBC after OC was 293.58 per 100,000 ovarian cancer patients and the incidence of PBC was 39.13 per 100,000 women. The SIR for SPBC was 1.27 (1.09-1.46, 95% Confidence interval) in the patients overall. The 5-year OS rates were 72.88% and 89.37% for SPBC and PBC (p &lt; 0.01). The OS rate in SPBC decreased significantly with advanced stage and older age.ConclusionThe incidence of breast cancer is about 1.27 times higher in ovarian cancer patients than in healthy people. The survival outcomes were worse for SPBC than for PBC and were related to older age and advanced stage. Active screening for breast cancer is necessary in ovarian cancer patients.
Whether mindfulness-guided therapy can be a new direction for the rehabilitation of patients with Parkinson’s disease: a network meta-analysis of non-pharmacological alternative motor-/sensory-based interventions
Authors: He Shenglan , Fang Wanyi , Wu Jiaoyang , Lv Hang , Zhang Jueyu , Wang Tunyi , Huang Yingjie , Li Guangyao , Li Min 
Published: September 2023

BackgroundThe treatment for Parkinson’s disease (PD) consumes a lot of manpower and financial resources. Non-pharmacological alternative motor-/sensory-based interventions are optimized for the rehabilitation of PD patients. Mindfulness-based therapy shows ideal efficacy, but the diversity of the therapy brings difficulties to the selection of clinicians and patients.MethodsNetwork meta-analysis in the Bayesian framework was used to evaluate the efficacy of non-pharmacological alternative motor-/sensory-based interventions in improving motor and non-motor symptoms in PD patients.ResultsA total of 58 studies (2,227 patients) were included. Compared with the non-intervention group, qigong was associated with improved outcomes in the Timed Up and Go (TUG) test (mean difference (MD) −5.54, 95% confidence interval (CI) −8.28 to −2.77), and UPDRS-I (MD −15.50, 95% CI −19.93 to −7.63). Differences between non-pharmacological alternative motor-/sensory-based interventions were not significant for PDQ-39, UPDRS-I, or UPDRS-II; however, qigong was superior to dance (MD −3.91, 95% CI −6.90 to −0.95), Tai Chi (MD −3.54, 95% CI −6.53 to −0.69), acupuncture (MD −6.75, 95% CI −10.86 to −2.70), music (MD -3.91, 95% CI −7.49 to −0.48), and exercise (MD −3.91, 95% CI −6.49 to −1.33) in the TUG test.ConclusionThis network meta-analysis supports mindfulness-based therapy (e.g., qigong, yoga, and Tai Chi) as a preferred non-pharmacological alternative motor-/sensory-based intervention for PD rehabilitation.Systematic review registrationhttps://inplasy.com/inplasy-2022-10-0109/, INPLASY2022100109.
Decision making influences movement variability and performance of high-level female football players in an elastic resistance task
Authors: Tuyà Viñas Sílvia , Fernández-Valdés Villa Bruno , Pérez-Chirinos Buxadé Carla , González Jacob , Moras Feliu Gerard 
Published: September 2023

IntroductionThe inclusion of sport-specific constraints in resistance training promotes the development of player abilities in an integrated way, which maximises the effectiveness of player adaptations induced by training. Considering that perceptual-cognitive abilities play a fundamental role in football, decision making could be introduced to enhance the cognitive similarity of resistance tasks to sport actions. However, it is unknown how decision making as a constraint could affect the player during an elastic resistance task. Therefore, the aim of this study was to investigate the effects of decision making of high-level female football players on movement variability and performance during an elastic band resistance task.MethodsTwenty-three high-level female football players performed the elastic resistance task with a ball, both as attackers and as defenders without decision making (NDM) and with decision making (DM). The movement variability was quantified using the sample entropy derived from the acceleration recorded with an accelerometer placed at the lower back of each player. The passing accuracy of the attacker was quantified using a scoring scale.ResultsResults revealed that adding decision making to an elastic resistance task increased the movement variability of the defender but did not affect the movement variability of the attacker. In contrast, the passing accuracy of the attacker was reduced. Overall, the attacker had a higher movement variability compared to the defender.DiscussionThese findings suggest that decision making, as a football-specific constraint, can enhance the potential of an elastic resistance task in training. This is due to the fact that it reduces control and regularity of movement for the defensive role player and increases technical difficulty for the attacking role player. Furthermore, these effects are beneficial, as they can promote the adaptive processes necessary to optimise the performance of the players.