bluuebunny/crossref_metadata_2025_split huggingface dataset:
A single-center prospective study evaluating the usefulness of artificial intelligence for the diagnosis of esophageal squamous cell carcinoma in a real-time setting
Authors: Tani Yasuhiro , Ishihara Ryu , Inoue Takahiro , Okubo Yuki , Kawakami Yushi , Matsueda Katsunori , Miyake Muneaki , Yoshii Shunsuke , Shichijo Satoki , Kanesaka Takashi , Yamamoto Sachiko , Takeuchi Yoji , Higashino Koji , Uedo Noriya , Michida Tomoki , Kato Yusuke , Tada Tomohiro 
Published: May 2023

Abstract
Background
Several pre-clinical studies have reported the usefulness of artificial intelligence (AI) systems in the diagnosis of esophageal squamous cell carcinoma (ESCC). We conducted this study to evaluate the usefulness of an AI system for real-time diagnosis of ESCC in a clinical setting.

Methods
This study followed a single-center prospective single-arm non-inferiority design. Patients at high risk for ESCC were recruited and real-time diagnosis by the AI system was compared with that of endoscopists for lesions suspected to be ESCC. The primary outcomes were the diagnostic accuracy of the AI system and endoscopists. The secondary outcomes were sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and adverse events.

Results
A total of 237 lesions were evaluated. The accuracy, sensitivity, and specificity of the AI system were 80.6%, 68.2%, and 83.4%, respectively. The accuracy, sensitivity, and specificity of endoscopists were 85.7%, 61.4%, and 91.2%, respectively. The difference between the accuracy of the AI system and that of the endoscopists was − 5.1%, and the lower limit of the 90% confidence interval was less than the non-inferiority margin.

Conclusions
The non-inferiority of the AI system in comparison with endoscopists in the real-time diagnosis of ESCC in a clinical setting was not proven.

Trial registration
Japan Registry of Clinical Trials (jRCTs052200015, 18/05/2020).
Impact of anti-VEGF therapy on distinctive retina layers in patients with macular edema secondary to branch retinal vein occlusion
Authors: Wang Hui , Wang Chanjuan , Zhang Shaochi , Liu Jun , Bi Xiaojun 
Published: May 2023

Abstract
Background
To explore the impact of anti-vascular epithelial growth factor (ant-VEGF) on the thickness of each retinal layer in patients with macular edema (ME) secondary to the branch retinal vein occlusion (BRVO).

Methods
This retrospective study included patients with ME secondary to monocular BRVO who received anti-VEGF therapy in Ningxia Eye Hospital between January-December 2020.

Results
Forty-three patients (25 males) were included, with 31 showed > 25% reduction in central retinal thickness (CRT) after anti-VEGF therapy (response group), and the others showed a ≤25% reduction in CRT (no-response group). The response group showed significantly smaller mean changes in the ganglion cell layer (GCL) (after 2 months) and inner plexiform layer (IPL) (after 1, 2, and 3 months) and significantly greater mean changes in the inner nuclear layer (INL) (after 2 and 3 months), outer plexiform layer (OPL) (after 3 months), outer nuclear layer (ONL) (after 2 and 3 months), and CRT (after 1 and 2 months) (all P < 0.05) as compared to the no-response group. The mean change in the thickness of each retinal layer IPL (P = 0.006) between the two groups was significantly different after controlling for a time and with a significant time trend (P < 0.001). Additionally, patients in the response group were more likely to have an improvement in IPL (43.68 ± 6.01 at 1 month and 41.52 ± 5.45 at 2 months vs. 39.9 ± 6.86 at baseline) after anti-VEGF therapy, while those in no response group might show improvement in GCL (45.75 ± 8.24 at 1 month, 40.00 ± 8.92 at 2 months, and 38.83 ± 9.93 at 3 months vs. 49.67 ± 6.83 at baseline).

Conclusions
Anti-VEGF therapy might help restore the retinal structure and function in patients with ME secondary to BRVO, and those who have a response after anti-VEGF therapy are more likely to improve IPL, while those having no response might show improvement in GCL.
Therapeutic outcome and long-term naturalistic follow-up of female adolescent outpatients with AN: clinical, personality and psychopathology evolution, process indicators and outcome predictors
Authors: Amianto Federico , Arletti Luca , Vesco Serena , Davico Chiara , Vitiello Benedetto 
Published: May 2023

AbstractBackgroundAnorexia nervosa (AN) is a serious mental illness of growing prevalence in childhood and adolescence. Despite its severity, there are still no completely satisfactory evidence-based treatments. Follow-up studies represent the most effective attempt to enlighten treatment effectiveness, outcome predictors and process indicators.MethodsSeventy-three female participants affected with AN were assessed at intake (T0) and at 6 (T1) and 12 (T2) months of an outpatient multimodal treatment program. Nineteen participants were assessed 15 years after discharge (T3). Changes in diagnostic criteria were compared with the chi-square test. Clinical, personality and psychopathology evolution were tested with ANOVA for repeated measures, using the t-test or Wilcoxon test as post-hoc. T0 features among dropout, stable and healed participants were compared. Healed and unhealed groups at long-term follow-up were compared using Mann-Whitney U test. Treatment changes were correlated to each other and with intake features using multivariate regression.ResultsThe rate of complete remission was 64.4% at T2, and 73.7% at T3. 22% of participants maintained a full diagnosis at T2, and only 15.8% at T3. BMI significantly increased at each time-point. A significant decrease of persistence and increase in self-directedness were evidenced between T0 and T2. Interoceptive awareness, drive to thinness, impulsivity, parent-rated, and adolescent-rated general psychopathology significantly decreased after treatment. Lower reward dependence and lower cooperativeness characterized the dropout group. The healed group displayed lower adolescent-rated aggressive and externalizing symptoms, and lower parent-rated delinquent behaviors. BMI, personality and psychopathology changes were related with each other and with BMI, personality and psychopathology at intake.ConclusionA 12-months outpatient multimodal treatment encompassing psychiatric, nutritional and psychological approaches is an effective approach for the treatment of mild to moderate AN in adolescence. Treatment was associated not only with increased BMI but also with positive personality development, and changes in both eating and general psychopathology. Lower relational abilities may be an obstacle to healing. Approaches to treatment resistance should be personalized according to these finding.
Co-creation of health-enabling initiatives in food retail: academic perspectives
Authors: Vargas Carmen , Brimblecombe Julie , Allender Steven , Whelan Jillian 
Published: May 2023

Abstract
Introduction
Co-creation of healthy food retail comprises the systematic collaboration between retailers, academics and other stakeholders to improve the healthiness of food retail environments. Research into the co-creation of healthy food retail is in its early stages. Knowledge of the roles and motivations of stakeholders in intervention design, implementation and evaluation can inform successful co-creation initiatives. This study presents academic experiences of stakeholder roles and motivations in the co-creation of healthy food retail environments.

Methods
Purposive sampling of academics with research experience in the co-creation of healthy food retail initiatives. Semi-structured interviews conducted between October and December 2021 gathered participants’ experiences of multi-stakeholder collaborative research. Thematic analysis identified enablers, barriers, motivations, lessons and considerations for future co-creation of healthy food retail.

Results
Nine interviewees provided diverse views and applications of co-creation research in food retail environments. Ten themes were grouped into three overarching areas: (i) identification of stakeholders required for changes to healthier food retail; (ii) motivations and interactions, which included the intrinsic desire to build healthier communities along with recognition of their work; and (iii) barriers and enablers included adequate resourcing, effective and trusting working relationships and open communications.

Conclusion
This study provides insights that could help future co-creation in healthy food retail environments. Trusting and respectful relationships and reciprocal acknowledgement between stakeholders are key practices in the co-creation process. These constructs should be considered in developing and testing a model that helps to systematically co-create healthy food retail initiatives that ensure all parties meet their needs while also delivering research outcomes.
Feasibility evaluation of the induced membrane technique with structural autologous strip bone graft management of phalangeal and metacarpal segmental defects using radiography
Authors: Fang Jie , Shi Rongjian , Qi Weiya , Zheng Dawei , Zhu Hui 
Published: May 2023

Abstract
Purpose
The purpose of this study was to explore the feasibility and evaluate the clinical outcomes of treatment for phalangeal and metacarpal segmental defects with the induced membrane technique and autologous structural bone grafting.

Methods
Sixteen patients who sustained phalangeal or metacarpal bone segmental defects were treated by the induced membrane technique and autologous structural bone grafting from June 2020 to June 2021 at our center.

Results
The average follow-up was 24 weeks (range, 12–40 weeks). Radiography demonstrated union of all bone grafts after an average of 8.6 weeks (range, 8–12 weeks). All incisions at donor and recipient sites demonstrated primary heal without infection complications. The mean visual analog scale score of the donor site was 1.8 (range, 0–5), with a good score in 13 cases and a fair score in 3. The mean total active motion of the fingers was 179.9°.

Conclusions
The feasibility of the induced membrane technique and structural treatment with a cylindrical bone graft for segmental bone defects of the metacarpal or phalanx is demonstrated by follow-up radiography results. The bone graft provided much more stability and structural support in the bone defects, and the bone healing time and bone union rate were ideal.
Effects of tracer position on screw placement technique in robot-assisted posterior spine surgery: a case–control study
Authors: Yi Meng , Song Jipeng , Zhang Yao , Lin Wancheng , Yao Mingtao , Fan Yuyu , Ding Lixiang 
Published: May 2023

Abstract
Introduction
Robot-assisted spine surgery is increasingly used in clinical work, and the installation of tracers as a key step in robotic surgery has rarely been studied.

Objective
To explore the potential effects of tracers on surgical outcomes in robot-assisted posterior spine surgery.

Methods
We reviewed all patients who underwent robotic-assisted posterior spine surgery at Beijing Shijitan Hospital over a 2-year period from September 2020 to September 2022. Patients were divided into two groups based on the location of the tracer (iliac spine or vertebral spinous process) during robotic surgery and a case–control study was conducted to determine the potential impact of tracer location on the surgical procedure. Data analysis was performed using SPSS.25 statistical software (SPSS Inc., Chicago, Illinois).

Results
A total of 525 pedicle screws placed in 92 robot-assisted surgeries were analyzed. The rate of perfect screw positioning was 94.9% in all patients who underwent robot-assisted spine surgery (498/525). After grouping studies based on the location of tracers, we found there was no significant difference in age, sex, height and body weight between the two groups. The screw accuracy (p < 0.01)was significantly higher in the spinous process group compared to the iliac group (97.5% versus 92.6%), but the operation time (p = 0.09) was longer in comparison.

Conclusion
Placing the tracer on the spinous process as opposed to the iliac spine may result in longer procedure duration or increased bleeding, but enhanced satisfaction of screw placement.
Angulation error assessment for the trajectory in the anteroposterior and lateral fluoroscopic views during percutaneous endoscopic transforaminal lumbar discectomy
Authors: Huang Xin , Hou Xiangyu , Li Shuiqing , Zhu Bin , Li Yan , Liu Kaixi , Liu Xiaoguang 
Published: May 2023

Abstract
Background
Anteroposterior (AP) and lateral fluoroscopies are often used to evaluate the intraoperative location and angulation of the trajectory in percutaneous endoscopic transforaminal lumbar discectomy (PETLD). Although the location of the trajectory shown in fluoroscopy is absolutely accurate, the angulation is not always reliable. This study aimed to evaluate the accuracy of the angle shown in the AP and lateral fluoroscopic views.

Methods
A technical study was performed to assess the angulation errors of PETLD trajectories shown in AP and lateral fluoroscopic views. After reconstructing a lumbar CT image, a virtual trajectory was placed into the intervertebral foramen with gradient-changing coronal angulations of the cephalad angle plane (CACAP). For each angulation, virtual AP and lateral fluoroscopies were taken, and the cephalad angles (CA) of the trajectory shown in the AP and lateral fluoroscopic views, which indicated the coronal CA and the sagittal CA, respectively, were measured. The angular relationships among the real CA, CACAP, coronal CA, and sagittal CA were further demonstrated with formulae.

Results
In PETLD, the coronal CA is approximately equal to the real CA, with a small angle difference and percentage error, whereas the sagittal CA shows a rather large angle difference and percentage error.

Conclusion
The AP view is more reliable than the lateral view in determining the CA of the PETLD trajectory.
Detecting representative characteristics of different genders using intraoral photographs: a deep learning model with interpretation of gradient-weighted class activation mapping
Authors: Zhou Yimei , Jiang Fulin , Cheng Fangyuan , Li Juan 
Published: May 2023

AbstractBackgroundSexual dimorphism is obvious not only in the overall architecture of human body, but also in intraoral details. Many studies have found a correlation between gender and morphometric features of teeth, such as mesio-distal diameter, buccal-lingual diameter and height. However, it’s still difficult to detect gender through the observation of intraoral photographs, with accuracy around 50%. The purpose of this study was to explore the possibility of automatically telling gender from intraoral photographs by deep neural network, and to provide a novel angle for individual oral treatment.MethodsA deep learning model based on R-net was proposed, using the largest dataset (10,000 intraoral images) to support the automatic detection of gender. In order to reverse analyze the classification basis of neural network, Gradient-weighted Class Activation Mapping (Grad-CAM) was used in the second step, exploring anatomical factors associated with gender recognizability. The simulated modification of images based on features suggested was then conducted to verify the importance of characteristics between two genders. Precision (specificity), recall (sensitivity) and receiver operating characteristic (ROC) curves were used to evaluate the performance of our network. Chi-square test was used to evaluate intergroup difference. A value of p < 0.05 was considered statistically significant.ResultsThe deep learning model showed a strong ability to learn features from intraoral images compared with human experts, with an accuracy of 86.5% and 82.5% in uncropped image data group and cropped image data group respectively. Compared with hard tissue exposed in the mouth, gender difference in areas covered by soft tissue was easier to identify, and more significant in mandibular region than in maxillary region. For photographs with simulated removal of lips and basal bone along with overlapping gingiva, mandibular anterior teeth had similar importance for sex determination as maxillary anterior teeth.ConclusionsDeep learning method could detect gender from intraoral photographs with high efficiency and accuracy. With assistance of Grad-CAM, the classification basis of neural network was deciphered, which provided a more precise entry point for individualization of prosthodontic, periodontal and orthodontic treatments.
Relationship between dental anxiety levels and oral health among dental patients in Turkey: a cross-sectional study
Authors: Saba Zafer , Katirci Gunseli 
Published: May 2023

Abstract
Background
This study aimed to determine the relationship between dental anxiety and oral health in adult patients who applied to the Department of Restorative Dentistry at the Faculty of Dentistry at Suleyman Demirel University.

Methods
The study included 500 subjects. The dental anxiety levels of the patients were determined using a modified dental anxiety scale (MDAS). Information on sociodemographic details, oral hygiene and nutritional habits were recorded. Intraoral examinations of the subjects were performed. Caries prevalence of individuals was determined using the decayed, missing or filled teeth (DMFT) and decayed, missing, or filled surfaces (DMFS) indices. Gingival health was evaluated using the gingival index (GI). Statistical analyses were performed using the Mann–Whitney U, Kruskal–Wallis and Chi-square tests and Spearman correlation analysis.

Results
The ages of the 276 female and 224 male participants ranged from 18–84 years. The median MDAS value was 9.00. The median DMFT and DMFS values were 10.00 and 23.00, respectively. The median MDAS values ​​of women were higher than those of men. Individuals who postponed their appointment had a higher MDAS median value than those who did not (Mann–Whitney U test, p < 0.05). No statistically significant correlation was found between dental anxiety level (MDAS) and GI, DMFT and DMFS index scores (Spearman correlation analysis, p > 0.05).

Conclusion
The MDAS values of individuals who did not remember the reason for their dental visit were higher than those who visited the dentist for routine control. Based on the findings of this study, further research on the relationship between dental anxiety and oral health is necessary to determine the factors that pose a risk for dental anxiety and to ensure the regular benefits of dental services.
Awareness and perceptions of Filipino obstetrician-gynecologists on fertility preservation: a cross-sectional survey
Authors: de Guzman Glaiza S. , Manalo Eileen M. , Banal-Silao Maria Jesusa B. 
Published: May 2023

Abstract
Background
The demand for fertility preservation has increased substantially over the past decade as more women wish to delay childbearing and with improved survival outcomes of various medical conditions. This study evaluated the awareness and perceptions of Filipino obstetrician-gynecologists on fertility preservation.

Methods
A cross-sectional survey was conducted among diplomates and fellows of the Philippine Obstetrical and Gynecological Society from September to December 2021. A self-administered questionnaire with 24 items was distributed online. Univariate descriptive statistics were reported as means for continuous variables and frequencies with percentage for categorical variables. Differences in responses were tested using the chi-square test.

Results
A total of 215 respondents completed the survey. Majority of the respondents were female, general obstetrician-gynecologists practicing in the National Capital Region. There was an overall positive perception of fertility preservation, with 98.60% agreeing that discussions about childbearing intentions should be initiated. Most participants (98.60%) were aware of fertility preservation but had varying levels of awareness of the different techniques. Fifty-nine percent of the respondents were unaware of regulations on fertility preservation. Setting up dedicated centers for fertility preservation and offering it as a public service were viewed as necessary by the respondents.

Conclusions
This study underscored the need to increase awareness of fertility preservation techniques among Filipino obstetrician-gynecologists. Meeting the need for comprehensive guidelines and centers is essential to promote fertility preservation in the country. Efficient referral systems and multidisciplinary approaches should be established for holistic care.
Psychometric properties of the Arabic version of the Fertility Quality of Life (FertiQoL) questionnaire tested on infertile couples in Jordan
Authors: Al Obeisat Salwa , Hayajneh Audai , Hweidi Issa , Abujilban Sanaa , Mrayan Lina , Alfar Rana , Nashwan Abdulqadir , Hweidi Lama I. 
Published: May 2023

Abstract
Background
The Fertility Quality of Life (FertiQoL) questionnaire assesses the quality of life of people with fertility problems. The present study aimed to assess the psychometric properties of the Arabic version of the FertiQoL in infertile couples in Jordan.

Methods
This study used a cross-sectional design among 212 participants with infertility problems. An exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) were conducted to investigate the underlying structure of the novel Arabic version of the FertiQoL tool.

Results
The Cronbach’s alpha values for the FertiQoL core domain, the FertiQoL treatment domain, and the total FertiQoL scale were 0.93, 0.74, and 0.92, respectively. The EFA indicated a two-domain model, with the first factor having 24 items and measuring "Core QoL". The second factor has 10 items and measures "Treatment QoL" in the context of infertility. The EFA and the CFA supported a two-factor model whereby the two factors explained 48% of the shared covariance between the analyzed quality of life indicators. The indices of goodness-of-fit of the model showed acceptable fit as follows: the chi-squared test (χ2) = 7.943, the comparative fit index (CFI) = 0.999, the root mean square error of approximation (RMSEA) = 0.001, and the Tucker-Lewis index (TLI) = 0.989.

Conclusion
The study's findings demonstrated the reliability and validity of the Arabic version of the FertiQoL for assessing the quality of life of infertile couples or those in Jordan with no pregnancy or childlessness.