bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glypican-3 targeted positron emission tomography detects sub-centimeter tumors in a xenograft model of hepatocellular carcinoma
Authors: Labadie Kevin P. , Lehnert Adrienne L , Kenoyer Aimee L , Hamlin Donald K , Ludwig Andrew D. , Utria Alan F. , Daniel Sara K. , Mihailovic Tara N. , Prossnitz Alexander , Orozco Johnnie J. , Li Yawen , Wilbur D. Scott , Miyaoka Robert S. , Park James O. 
Published: February 2023

Abstract
BACKGROUND
Early intrahepatic recurrence is common after surgical resection of hepatocellular carcinoma (HCC) and leads to increased morbidity and mortality. Insensitive and nonspecific diagnostic imaging contributes to EIR and results in missed treatment opportunities. In addition, novel modalities are needed to identify targets amenable for targeted molecular therapy. In this study, we evaluated a zirconium-89 radiolabeled glypican-3 (GPC3) targeting antibody conjugate (89Zr-αGPC3) for use in positron emission tomography (PET) for detection of small, GPC3+ HCC in an orthotopic murine model.
Athymic nu/J mice received hepG2, a GPC3+ human HCC cell line, into the hepatic subcapsular space. Tumor-bearing mice were imaged by PET/computerized tomography (CT) 4 days after tail vein injection of 89Zr-αGPC3. Livers were then excised for the tumors to be identified, measured, bisected, and then serially sectioned at 500mm increments. Sensitivity and specificity of PET/CT for 89Zr-αGPC3-avid tumors was assessed using tumor confirmation on histologic sections as the gold standard.
RESULTS
In tumor-bearing mice, 89Zr-αGPC3 avidly accumulated in the tumor within four hours of injection with ongoing accumulation over time. There was minimal off-target deposition and rapid bloodstream clearance. Thirty eight of 43 animals had identifiable tumor on histologic analysis. 89Zr-αGPC3 immuno-PET detected all 38 histologically confirmed tumors with a sensitivity of 100%, with the smallest tumor detected measuring 330mm in diameter. Tumor-to-liver ratios of 89Zr-αGPC3 uptake were high, creating excellent spatial resolution for ease of tumor detection on PET/CT. Two of five tumors that were observed on PET/CT were not identified on histologic analysis, yielding a specificity of 60%.
CONCLUSIONS
89Zr-αGPC3 avidly accumulated in GPC3+ tumors with minimal off-target sequestration. 89Zr-αGPC3 immuno-PET yielded a sensitivity of 100% and detected sub-millimeter tumors. This technology may improve diagnostic sensitivity of small HCC and select GPC3+ tumors for targeted therapy. Human trials are warranted to assess its impact.
Activation of ET/ETR axis in myocardial tissue characterizes heart failure induced by experimental autoimmune myocarditis
Authors: Yang Peng , Wu Yujing , Tian Qingshan , Li Fangfei , Tang Jiangfeng , Zheng Zhenzhong 
Published: February 2023

Abstract
Background: Endothelial dysfunction is characterized by an imbalance between endothelium-derived vasodilatory and vasoconstrictive effects and may play an important role in the development of heart failure. More and more studies have shown that endothelial-derived NO-mediated vasodilation is attenuated in heart failure patients. However, the role of ET-1 and its receptors in heart failure remains controversial. The aim of this study is to determine whether ET-1 and its receptor are activated in myocarditis and heart failure, and to explore the role of ET-1/ETR in heart failure.
Methods: HE staining was used to detect myocardial inflammatory infiltration and myocarditis score, echocardiography to evaluate cardiac function, ELISA to detect serum ET-1 level, and immunohistochemistry and western blot to detect ETAR and ETBR expression in myocardial tissue of rats with myocarditis heart failure.
Results: PCM-induced EAM rats tended to reach peak inflammation after 3 weeks of immunization and develop stable chronic HF at week 8 of immunization. Echocardiography was performed on day 21 and 56 of PCM-immunized rats, LVEDd and LVEDs were significantly increased in the EAM group compared to the control group at 3 weeks and 8 weeks while EF and FS were significantly reduced. Therefore, autoimmune myocarditis can induce both acute and chronic heart failure through a PCM-induced autoimmune myocarditis model. Moreover, HE staining revealed that inflammation persisted in EAM-induced acute and chronic heart failure. Serum ET-1 level detected by ELISA method was significantly increased. And immunohistochemistry and western blot indicated that ETAR, and ETBR protein expression in myocardial tissue were significantly elevated in acute heart failure and chronic heart failure.
Conclusions: The ET-1/ETR axis were activated in both EAM-induced acute heart failure and chronic heart failure. The ET-1/ETR axis were positively correlated with heart failure and can be used as biomarkers to characterize heart failure.
Multi-clade neutralizing antibodies against H1 influenza A viruses of swine and humans by sequential vaccinations with divergent H1N1 strains
Authors: Reeth Kristien Van , Parys Anna , Gracia Jose Carlos Mancera , Trus Ivan , Chiers Koen , Mead Philip , Liu Sean , Palese Peter , Krammer Florian , Vandoorn Elien 
Published: February 2023

Abstract
Vaccines that protect against any H1N1 influenza A virus strain would be advantageous for use in pigs and humans. Here, we try to induce a pan-H1N1 antibody response in pigs by sequential vaccination with antigenically divergent H1N1 strains. Adjuvanted whole inactivated vaccines are given intramuscularly in various two- and three-dose regimens. Three doses of heterologous monovalent H1N1 vaccine result in seroprotective neutralizing antibodies against 71% of a diverse panel of human and swine H1 strains, detectable antibodies against 88% of strains, and sterile cross-clade immunity against two heterologous challenge strains. This strategy outperforms any two-dose regimen and is as good or better than giving three doses of matched trivalent vaccine. Neutralizing antibodies are H1-specific, and the second heterologous booster enhances reactivity with conserved epitopes in the HA head. We show that even the most traditional influenza vaccines can offer surprisingly broad protection, if they are administered in an alternative way.
Having trust in the PrEP provider is crucial to more accurate self-reported adherence among South African and Zimbabwean adolescent girls and young women in the open- label HPTN 082 study
Authors: Beauchamp Geetha , Donnell Deborah , Hosek Sybil , Anderson Peter L , Chan Kwun C. G. , Dye Bonnie J. , Mgodi Nyaradzo , Bekker Linda-Gail , Delany-Moretlwe Sinead , Celum Connie 
Published: February 2023

Abstract
Background

Trust is an important cornerstone of patient-provider communication. Accurate reporting of pre-exposure prophylaxis (PrEP) adherence is vital for providers to determine who needs adherence support, especially adolescent girls, and young women (AGYW) who are disproportionately affected by newly diagnosed HIV infections.

Methods

We examined if trust in the PrEP provider was associated with concordance between patient-reported adherence and intracellular tenofovir-diphosphate (TFV-DP) in dried blood spots. The patient-reported adherence response ‘In the past month, how often did you take the tablet?’ was dichotomized as ‘high’ if the response was every day or most days, and ‘low’ if some days or not many days or never. The biomarker marker evidence of adherence was defined as ‘high’ if TFV-DP ≥ 700, and ‘low’ if < 350 fmol/punch.

Results

The HPTN 082, an open-label PrEP demonstration study enrolled 451 AGYW (ages16-25 years) from 2016–2018 in Cape Town and Johannesburg, South Africa, and Harare, Zimbabwe. Of the 427 AGYW who initiated PrEP in the HPTN-082 open-label PrEP demonstration study, 354 (83%) had month three patient-reported adherence responses and TFV-DP measurement. AGYW who reported trust in their providers were almost four-fold (aOR 3.72, 95% CI 1.20-11.51) more likely to have high self-reported adherence and high TFV-DP concentrations (concordant adherent) compared to those who reported high adherence but had low TFV-DP concentrations (discordant non-adherent).

Conclusion

Education and training to build trusting relationships between providers and AGYW may lead to more accurate reporting of PrEP adherence. With accurate reporting, adequate support can be provided to bolster adherence.
Trial Registration: ClinicalTrials.gov Identifier: NCT02732730 (11/04/2016)
Measures of multiple deprivation and visual field loss in glaucoma clinics in England: lessons from big data
Authors: Rathore Mehal , Shweikh Yusrah , Kelly Stephen , Crabb David P 
Published: February 2023

Abstract
BACKGROUND/OBJECTIVES:
To examine the association between multiple deprivation with late diagnosis and rapid worsening of glaucoma in patients in English hospital eye services (HES).
METHODS:
602 439 visual fields (VFs) were extracted from five regionally different glaucoma clinics in England. Mean Deviation (MD) worse than −12 dB was used as a surrogate definition for advanced VF loss at diagnosis in patients with ≥2 reliable VF records. MD loss worse than -1 dB per year was used to define rapid VF progression in patients with ≥6 VFs. Patient data were stratified into deciles of the Index of Multiple Deprivation (IMD) from residential postcodes.
RESULTS:
There was an association between IMD and advanced VF loss at diagnosis in 44 956 patients with 18% (293/1608) and 11% (771/6929) in the most and least deprived IMD decile respectively. Age-corrected odds ratio (OR) for having advanced VF loss at entry into HES was 1.42 (95% confidence interval [CI] 1.21-1.67) and 0.75 (95% CI: 0.66-0.85) in the most and least deprived IMD decile respectively (reference=fifth decile). In 15 094 patients with follow up data (median [interquartile range] of 6.9 [4.5,10.0] years) the proportion having rapid VF progression did not differ across the IMD spectrum.
CONCLUSION:
Large-scale VF data from clinics indicates that glaucoma severity at presentation to English HES is associated with levels of multiple deprivation. We found no evidence to suggest likelihood of having rapid VF progression during follow-up is associated with IMD; this hints at equity of glaucoma care and outcomes once patients are in English HES.
Implementation Evaluation of a Teledermatology Virtual Clinic at an Academic Medical Center
Authors: Kheterpal Meenal , Borre Ethan D. , Nicholas Matilda W. , Cooner Edward W. , Phinney Donna , Gagnon Kelly , Zullig Leah L. , King Heather A. , Malcolm Elizabeth J. , Chen Suephy C. 
Published: February 2023

Abstract
Background
Teledermatology (TD) is an evidence-based practice that may increase access to dermatologic care. We sought to evaluate implementation of TD at four Duke primary care practices.
Methods
We implemented a hybrid TD program where trained primary care providers (PCPs) sent referrals with clinical and dermatoscopic images to dermatology. Patients were seen by dermatologists over video visit within days, and dermatologists managed the patient plan. We evaluated implementation using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework using electronic health record data. Implementation barriers and facilitators were collected through surveys (n = 24 PCPs, n = 10 dermatologists, n = 10 dermatology residents).
Results
At four PCP clinics throughout 9/1/2021-4/30/2022 there were 218 TD referrals. Video visits occurred on average 7.5 days after referral and 18/18 patients completing the post-visit survey were satisfied. Adoption varied between clinics, with one placing 22% of all dermatology referrals as TD and another placing 2%. The primary PCP barriers to TD were time burdens, lack of fit in clinic flow, and discomfort with image taking. Top-endorsed potential facilitating interventions included allowing for rash referrals without dermoscopy and assurance for clinical evaluation within 3 days.
Conclusions
Addressing TD process fit into PCP clinic flow and reducing time burdens may increase PCP uptake of TD.
Individual identification of endangered amphibians using deep learning and smartphone images: case study of the Japanese giant salamander (Andrias japonicus)
Authors: Takaya Kosuke , Taguchi Yuki , Ise Takeshi 
Published: February 2023

Abstract
Information obtained via individual identification is invaluable for ecology and conservation. Physical tags, such as PIT tags and GPS, have been used for individual identification; however, their impact on animal behavior and survival rates is unclear and the tags may become lost. Although non-invasive methods that do not affect the target species (such as manual photoidentification) are available, these techniques utilize stripes and spots that are unique to the individual, which requires training, and applying them to large datasets is challenging. Many studies that have applied deep learning for identification have focused on species-level identification; however, few have addressed individual-level identification. In this study, we developed an image-based identification method with deep learning using the head spot of the Japanese giant salamander (Andrias japonicus), an endemic and endangered species in Japan. We trained and evaluated the dataset collected over two days from 11 individuals in captivity, including 7,075 images from the smartphone camera. Photographing was conducted three times a day at approximately 11:00 (morning), 15:00 (evening), and 18:00 (afternoon). As a result, individual identification by EfficientNet-V2 achieved 99.86% accuracy, 0.99 Kappa coefficient, and 0.99 F1 score. Performance was lower in the evening than in the morning or afternoon when trained and evaluated at each photographing time. This method does not require direct contact with the target species, and the effect on the animals is minimal; moreover, individual-level information can be obtained under natural conditions. In the future, smartphone images can be applied to citizen science surveys and individual-level big data collection, which is difficult to perform using current methods.
Early Use of Low-dose Ticagrelor-based Dual Antiplatelet Therapy and Clinical Outcomes in Patients Undergoing Percutaneous Coronary Interventions for Complex Lesions
Authors: Lee Yonggu , Shin Jeong-Hun , Seo Suk Min , Choi Ik Jun , Lee Jong-Young , Lee Jun-Won , Park Mahn-Won , Kang Tae Soo , Choi Woong Gil , Jeon Ki-Hyun , Lim Hong-Seok , Joo Hyung Joon , Rhee Sang Jae , Seo Jae-Bin , Park Myung Soo , Park Sang-Ho , Lim Young-Hyo 
Published: February 2023

Abstract
Ticagrelor-based dual antiplatelet therapy (TDAPT) provides potent antiplatelet inhibition but may increase the bleeding risk in Asian populations. We investigated the impact of the early use of low-dose TDAPT (l-TDAPT; 120 mg) on clinical outcomes in Korean patients undergoing percutaneous coronary intervention (PCI). A multicenter prospective clinical cohort study was conducted with patients on standard-dose TDAPT (s-TDAPT; 180 mg) after PCI for complex lesions. A major adverse cardiovascular event (MACE) was defined as a composite of cardiovascular death, myocardial infarction, stroke, and repeat revascularization. A net clinical event (NCE) was defined as a composite of bleeding events and MACEs. Among the 772 patients on s-TDAPT, 115 (14.8%) switched to l-TDAPT within 6 months. Common reasons for the regimen changes were switching as planned (38.8%), dyspnea (25.5%), and bleeding (23.6%). A multivariate Cox proportional hazard model (CPH) showed that the risks of MACE, bleeding events, and NCE were not different between the l-TDAPT and s-TDAPT groups during the entire follow-up period and beyond 6 months after PCI. Multivariate time-varying CPH also showed similar results. De-escalation with low-dose ticagrelor within 6 months after PCI is feasible and safe even in patients with complex lesions harboring a high ischemic event risk.
Relationship between self-reported chewing ability and incidents of stroke in Japanese community-dwelling older adults
Authors: Katayose Ryo , Okura Mika , Kinoshita Ayae , Arai Hidenori , Ogita Mihoko 
Published: February 2023

Abstract
Purpose: This 4-year prospective observational study aimed to examine the relationship between self-reported chewing ability and incidents of stroke in community-dwelling older adults in Japan.
Methods: A total of 5,093 adults aged 65 years and older who were neither disabled nor living in long-term care facilities completed the baseline survey in April 2013. In February 2017, a follow-up survey was conducted for 3,606 older adults who were not disabled and had not died. All data were obtained from self-reported questionnaires. Participants were classified into a normal or an impaired chewing ability group. Using multivariable logistic regression analysis, odds ratios and 95% confidential intervals were calculated for the risk of stroke, adjusting for sex, age, physical activities, BMI, medications, and wearing a denture.
Results: The final analysis included 2,099 participants with no history of cardiovascular disease or severe hypertension in 2013, excluding those with missing main data. During the 4-year follow-up period, the incidence of stroke was 2.8% and 3.6% for the normal chewing ability group and 5.9% and 4.7% for the impaired chewing ability group in participants 65–74 years old and 75 years old or older, respectively. The adjusted ORs were 2.29 for chewing ability impairment, 8.57 with mobility impairment, and 4.09 with cognitive impairment; however, there were no significant differences in participants 75 years old or older, except for those with a physical impairment.
Conclusion: Our results suggested that impaired chewing ability independently predicted stroke, especially for those with physical or cognitive frailty in a community.
Does patient and public involvement impact public health decision-making? A 10-year retrospective analysis of public consultation in Brazil
Authors: Lopes Ana Carolina de Freitas , NOVAES HILLEGONDA MARIA DUTILH , DE SOÁREZ PATRÍCIA COELHO 
Published: February 2023

Abstract

Background: The aim of this work is to characterize the processes associated with patient and public involvement (PPI) in the form of public consultations (PC) during the first 10 years of operation of the National Committee for Health Technology Incorporation in the Unified Health System (Conitec) of Brazil and to identify factors associated with changes in Conitec’s recommendations following these PC.
Methods: This cross-sectional study analysed all processes related to the adoption of technology that took place in Brazil between 2012 and 2021 based on technical reports and self-reported information collected from PC participants. A multiple logistic regression model identified factors associated with changes in Conitec’s recommendations following PC.
Results: A total of 479 technical reports were published, of which 83% (n=400) were submitted to PC. Demands were made mainly by applicants from the state (n=262; 55%), regarding the adoption of medicines (n=367; 77%), in which context neoplasms and infectious diseases were the most frequent indications (n=66; 14% for each). A total of 264 (55%) processes resulted in a final recommendation in favour of introducing the technology. Over the period of 10 years, 196,483 contributions were received in response to PC. The largest volume of contributions was made by patients and their families or representatives (n=99,082; 50.4%), females (122,895; 67%), white individuals (129,165; 70.8%) and individuals between the ages of 25 and 59 years (145,364; 79.9%). Alteration of the preliminary recommendation occurred in 13% (n=53) of the PC, with a higher proportion of recommendations being altered from 2017 onwards. Increased participation by patients had a significant impact on the alteration of the preliminary recommendation (Odds Ratio 3.87, 95% CI 1.33-13.35, p=0.02).
Conclusions: It is necessary to develop PPI mechanisms that are more dialogical and less vulnerable to political contexts with the aim of establishing a more equitable and accountable health system.
Soft Labeling and Expectation-Maximization Algorithm to the Learning Problem of Uncertain Labeling in Vehicular Networks
Authors: ALAYA Bechir , Sellami Lamaa 
Published: February 2023

Abstract
The supervised and semi-supervised learning framework does not always correspond to the situations encountered in vehicular networks. The labeling work is therefore often laborious and expensive. This is why the development of solutions to deal with imperfect labels was of particular interest to us during this research article. We introduce in this paper the formulation of the classification problem when the information available on the labels of the examples used for learning is imperfect. We also present an efficient way to solve classification problems, even when some of the labels provided to learn the classification function are wrong. Furthermore, we present our work on the extension of statistical learning methods in the environment of vehicular networks. To build an expectation-maximization (EM) algorithm capable of optimizing the marginal log-likelihood of the observed data, the path we will take follows the classic approach encountered in the probabilistic framework. Different experiments were carried out to analyze the behavior of our algorithm when “soft” labels in vehicles are used. These experiences have allowed us in particular to highlight the contribution of "soft" labels in this context to represent information on the reliability of the labels and thus significantly improve the performance of vehicular networks.
Assessing the Accuracy and Reliability of AI-Generated Medical Responses: An Evaluation of the Chat-GPT Model
Authors: Johnson Douglas , Goodman Rachel , Patrinely J , Stone Cosby , Zimmerman Eli , Donald Rebecca , Chang Sam , Berkowitz Sean , Finn Avni , Jahangir Eiman , Scoville Elizabeth , Reese Tyler , Friedman Debra , Bastarache Julie , Heijden Yuri van der , Wright Jordan , Carter Nicholas , Alexander Matthew , Choe Jennifer , Chastain Cody , Zic John , Horst Sara , Turker Isik , Agarwal Rajiv , Osmundson Evan , Idrees Kamran , Kiernan Colleen , Padmanabhan Chandrasekhar , Bailey Christina , Schlegel Cameron , Chambless Lola , Gibson Mike , Osterman Travis , Wheless Lee 
Published: February 2023

Abstract
Background: Natural language processing models such as ChatGPT can generate text-based content and are poised to become a major information source in medicine and beyond. The accuracy and completeness of ChatGPT for medical queries is not known.
Methods: Thirty-three physicians across 17 specialties generated 284 medical questions that they subjectively classified as easy, medium, or hard with either binary (yes/no) or descriptive answers. The physicians then graded ChatGPT-generated answers to these questions for accuracy (6-point Likert scale; range 1 – completely incorrect to 6 – completely correct) and completeness (3-point Likert scale; range 1 – incomplete to 3 - complete plus additional context). Scores were summarized with descriptive statistics and compared using Mann-Whitney U or Kruskal-Wallis testing.
Results: Across all questions (n=284), median accuracy score was 5.5 (between almost completely and completely correct) with mean score of 4.8 (between mostly and almost completely correct). Median completeness score was 3 (complete and comprehensive) with mean score of 2.5. For questions rated easy, medium, and hard, median accuracy scores were 6, 5.5, and 5 (mean 5.0, 4.7, and 4.6; p=0.05). Accuracy scores for binary and descriptive questions were similar (median 6 vs. 5; mean 4.9 vs. 4.7; p=0.07). Of 36 questions with scores of 1-2, 34 were re-queried/re-graded 8-17 days later with substantial improvement (median 2 vs. 4; p<0.01).
Conclusions: ChatGPT generated largely accurate information to diverse medical queries as judged by academic physician specialists although with important limitations. Further research and model development are needed to correct inaccuracies and for validation.