bluuebunny/crossref_metadata_2025_split huggingface dataset:
How often do medical students change career preferences over the course of medical school?
Authors: Rachoin Jean-Sebastien , Vilceanu M. Olguta , Franzblau Natali , Gordon Sabrina , Cerceo Elizabeth 
Published: February 2023

Abstract
Introduction

During the preclinical years, students typically do not have extensive exposure to clinical medicine. When they begin their clinical rotations, usually in the third year, the majority of the time is spent on core rotations with limited experience in other fields of medicine. Students then have to decide on their future careers early in their fourth year. We hypothesized that limited exposure to certain fields may prompt students to switch career preferences.

Methods

We conducted a retrospective, cohort study using the American Association of Medical Colleges Year 2 Questionnaire (Y2Q) and Graduating Questionnaire (GQ) from 2016–2020.

Results

20,408 students answered both surveys, but 2,165 had missing values on the career choice question and were excluded. Of the remaining students, 10,233 (56%) changed their career choice between the Y2 and GQ surveys. Fields into which students preferentially switched by the GQ survey included anesthesia, dermatology, ENT, family medicine, OB/GYN, pathology, PM&R, psychiatry, radiology, urology, and vascular surgery. Many characteristics, including future salary, the competitiveness of the field, and the importance of work-life balance, we significantly associated with a higher likelihood of changing career choice. On the other hand, having a mentor and the specialty content were associated with a lower likelihood of change.

Conclusion

A majority of students switched their career preference from the Y2Q to the GQ. Curricula focused on early integration of a variety of specialties should be designed with a goal of aligning with student interests and needs.
A novel bronchoscopic guided non-invasive treatment for lung nodule
Authors: Kim June-Hong , Shah Izaz Ali , Seol Hee Yun , Cho Youngdae , Ji Wonjun , Seo Jaeyoung , Lee Cheolmin , Chon Min-ku , Shin Dong Hoon , Kim Justin H. , Choo Ki-seok , Park Junhui , Yoo Hyoungsuk 
Published: February 2023

Abstract
Radiofrequencyablation (RFA) is one of the treatment options for lung nodules; however, the need for exact delivery of the rigid metal electrode into the center of the target mass often leads to complications or suboptimal results. To overcome these limitations, we report a novel bronchoscopy-guided atraumatic no-touch RFA procedure that uses a specially designed radiofrequency (RF) conductor balloon catheter (CAROL catheter) and an injectable bronchial electrode based on a medical grade liquid metal (E-GaIn) in porcine lungs. The bronchial electrode injected from the CAROL catheter was able to turn the target-site bronchial air pipe into a temporally multi-tined RF electrode. The mean volume of E-GaIn (bronchial electrode) for each effective CAROL was 0.46 ± 0.47 ml. The ablation results showed highly efficacious and consistent results especially in the peripheral lung. Most bronchial electrodes were also retrieved by either bronchoscopic suction immediately after the procedure or by natural expectoration thereafter. The residual bronchial electrode did not cause any significant safety issues. Our computer simulation model also supported preclinical data.
Exploring the use of cluster analysis to assess antibiotic stewardship in critically-ill neonates in a low resource setting
Authors: Benoni Roberto , Balestri Eleonora , Endrias Tariqua , Tolera Jiksa , Borellini Martina , Calia Margherita , Biasci Filippo , Pisani Luigi 
Published: February 2023

Abstract
Background: Sepsis is the third leading cause of neonatal death in low and middle-income countries, accounting for one third of all deaths in Ethiopia. A concerning issue is the increasing number of multidrug-resistant microorganisms facilitated by suboptimal antibiotic stewardship. The study aims to identify clusters of newborns switching antibiotic lines for sepsis in a neonatal intensive care unit (NICU) in Ethiopia, and to explore their potential association with sepsis outcomes.
Methods: A retrospective cohort study was conducted including all newborns discharged with a diagnosis of probable neonatal sepsis from the St. Luke Catholic Hospital NICU between April and July 2021. The antibiotic management protocol included two lines according to WHO guidelines and a third line based on internal hospital guidelines. In the cluster analysis, the Gower distance was estimated based on the antibiotics employed in the different lines and the duration of each line. Mortality and respiratory distress (RD) were the response variables.
Results: In the study period, 456 newborns were admitted to the NICU and 196 (42.8%) had probable neonatal sepsis. Four antibiotic management clusters were identified. Cluster 1 (n=145, 74.4%) had no antibiotic switches, using only the first line. Cluster 2 (n=26, 13.3%) had one switch from the first to the second line. Cluster 4 (n=9, 4.6%) had two switches: from first to second and then to third line. In cluster 3 (n=15, 7.7%), newborns were switched from ceftriaxone/cloxacillin as second line to off-protocol antibiotics. There were no differences in sex, age, weight on admission or crude mortality between clusters. Cluster 3 included a higher frequency of infants who did not breathe at birth (53.3%, p=0.011) and that necessitated bag ventilation (46.7%, p=0.039) compared to the other clusters. The RD odds ratio (OR) was higher in cluster 3 than in clusters 1 (OR=0.09[0.01-0.36] p=0.003) and 2 (OR=0.13[0.02-0.64] p=0.022).
Conclusions: The first antibiotic line failed one out of four newborns with sepsis while third-generation cephalosporins were insufficient in 12.3% of patients. Cluster analysis can be a useful tool for identifying patients who need antibiotic switches and their characteristics.
Food Amyloid Fibrils as Safe Nutrition Ingredients: In-vitro and In-vivo Assessment
Authors: Xu Dan , Zhou Jiangtao , Soon Wei Long , Kutzli Ines , Molière Adrian , Radiom Milad , Handschin Stephan , Li Bing , Li Lin , Ewald Collin , Mezzenga Raffaele 
Published: February 2023

Abstract
If safety concerns could be conclusively disproven, food protein amyloid fibrils would constitute superior ingredients compared to native monomers from a technological, nutritional, sensorial, and physical perspective. Here, we show, by combining SDS-PAGE, ELISA, fluorescence, AFM, TEM, MALDI-MS, CD, microfluidics, and SAXS techniques on β-lactoglobulin and lysozyme amyloid fibrils subjected to in-vitro gastrointestinal digestion, that either no noticeable differences exist between amyloid aggregates and their monomer counterparts after the gastrointestinal digestion process (as in β-lactoglobulin), or that amyloid fibrils are even digested significantly better than monomers (as in lysozyme). Both amyloid protein sources are digested down to unfolded oligopeptides well-below amyloid nuclei size and deprived of the β-sheet amyloids hallmark signature. We further conclude via in-vivo studies on both C. elegans and mice animal models that the digested fibrils present no observable toxicity to the investigated animal models. These results suggest that final peptides digested from food amyloids fibrils are at least equally safe than those obtained from the digested corresponding native monomers and feature no detectable toxicity in-vivo, pointing to food amyloid fibrils as potential ingredients for human nutrition.
The Influence of Nrf2 gene promoter methylation on gene expression and oxidative stress parameters in preeclampsia
Authors: Zakeri Saba , Rahimi Zohreh , Rezvani Nayebali , Vaisi-Raygani Asad , Alibakhshi Reza , Yari Kheirolah 
Published: February 2023

Abstract
Background and aims
Preeclampsia (PE) is a serious medical condition that usually causes high blood pressure and affects multiple organs. Considering the adverse effect of oxidative stress on the process of PE in pregnant women and regarding the role of the Nrf2 gene in placental oxidative pathways, this study was conducted to investigate the DNA methylation status of Nrf2 in PE and healthy pregnant women.
Materials and methods
The present case-control study consisted of 70 PE and 70 healthy pregnant women. Blood and placenta samples were taken from all subjects, and the percentage of the Nrf2 gene methylation in the samples was assessed by the Methyl Light PCR method. Also, the Nrf2 gene expression was evaluated by real-time PCR. The oxidative factors of total antioxidant capacity [1] and total oxidative status (TOS) were measured by the colorimetric method.
Results
In PE women, there was a significant increase in blood pressure, term of pregnancy, and BMI. In addition, there were enhanced Nrf2 DNA methylation percentages in placenta tissue and increased TOS levels in placenta tissue and blood compared to healthy pregnant women (P < 0.05). Also, in the PE group, there was a significant decrease in Nrf2 gene expression and TAC level in placenta tissue compared to the control group (P < 0.05).
Conclusion
The Nrf2 gene undergoes epigenetic modifications of DNA hypermethylation in the PE placenta. Also, decreased expression of this gene and the changes in the level of oxidative parameters (TAC, TOS) confirm it. It also confirms reduced expression of this gene and alterations in the level of oxidative parameters.
Associations between exposure to metal mixtures and insufficient bone strength: a cross-sectional study among children aged 2-6 years
Authors: Liu Yanli , Wang Yan , Fu Ye , Liu Yang , Li Mingzhu , Zhang Yao , Li Chen , Ding Hongcheng , Li Xiaowen , Ji Hongxian , Wang Jing 
Published: February 2023

Abstract
Heavy metal exposure has been widely recognized as a risk factor for human health. However, epidemiological studies of associations between exposure to metal mixtures with bone strength among preschoolers are limited. We estimated the associations of 23 urinary metals with the risk of insufficient bone strength (IBS) among 1399 children aged 2–6 years in China. Urine concentrations of 23 metals were measured using inductively coupled plasma mass spectrometer and bone strength was measured using the quantitative ultrasound instrument. The weighted quantile sum (WQS) and bayesian kernel machine regression (BKMR) models were conducted to investigate the associations between exposure to metal mixtures and IBS. In the single metal exposure model, urine cobalt and zinc were identified to be negatively associated with IBS, whereas urine lead was positively associated with IBS. Furthermore, WQS regression and BKMR analyses consistently showed that exposure to metal mixtures was inversely related to IBS, and cobalt was the main contributor to the combined effects. Such associations were more evident in children aged 2–4 years. These findings indicated that exposure to metal mixtures was associated with bone strength among children. These findings need further validation in prospective studies.
Psychological stress, cortisol, ACTH, and cortisol/ACTH ratio associated with burning mouth syndrome
Authors: Lee Yeon-Hee , Suk Chon 
Published: February 2023

Abstract
Objective
Clinical characteristics of patients with burning mouth syndrome (BMS) were compared in the presence or absence of psychological stress to investigate the clinical, psychological, and haematological indicators.
Methods
Among 141 BMS patients (117 females, 82.98%; 56.4 ± 12.89 years), inter- and intra-group statistical analyses were conducted according to the presence or absence of psychological stress; BMS patients were divided into psychological-stress (n = 68; 55 females, 56.39 ± 12.89 years) and non-psychological stress group (n = 73; 62 females, 56.03 ± 14.90 years).
Results
Prevalence of xerostomia was higher in the psychological-stress group than in the non-psychological-stress group (67.6% vs. 34.2%, p < 0.001), and the unstimulated salivary flow rate was respectively lower (1.97 ± 1.79 vs. 2.74 ± 1.59 mL/min, p < 0.01). The SCL-90R subscale values, including somatization, hostility, anxiety, and depression, were higher in the psychological- than in the non-psychological-stress group (all p < 0.05); the cortisol level, adrenocorticotropic hormone (ACTH) level, cortisol/ACTH ratio, and antidiuretic hormone (ADH) level were respectively higher (all p < 0.05). Above-mean values of cortisol (AUC = 0.980, 95%CI: 0.959–1.000) and cortisol/DHEA ratio (AUC = 0.779, 95%CI: 0.701–0.856) were excellent predictors of psychological stress. The strongest correlation was obtained for cortisol (r = 0.831, p < 0.01), while cortisol/DHEA ratio (r = 0.482, p < 0.01) showed substantial correlation.
Conclusion
In BMS patients, xerostomia, decreased salivary flow rate, and increased cortisol and cortisol/DHEA ratios were associated with psychological stress, highlighting psycho-neuro-endocrinological features.
Threshold growth has a limited role in differentiating HCC from other focal hepatic lesions
Authors: Lyu Rong , Wang Di , Hu Weijuan , Gao Zhongsong , Yu Changlu , Wang Jiao , Li Mingge , Jia Kefeng 
Published: February 2023

Abstract
Background
The role of threshold growth, as one of the major features (MFs) of HCC in the Liver Imaging Reporting and Data System (LI-RADS) is inconsistent. This study evaluated the LI-RADS diagnostic performance for HCC when threshold growth was removed or replaced by highly frequent ancillary features (AFs).
Methods
This was a retrospective institutional review board-approved study including patients with a high HCC risk with gadoxetic acid-enhanced MRI findings consistent with pathologically proven focal hepatic observations. With pathological results used as the gold standard reference, the observations were divided into three groups: HCC, non-HCC malignancy and benign lesion. The sizes of the lesions with and without threshold growth were compared. The MFs and AFs of each observation were evaluated and compared among the three groups to select the most highly frequent AFs of HCC and was used to replace threshold growth. The LI-RADS categories of observations were categorized as follows: Scheme A, using all MFs and AFs according to LI-RADS v2018; scheme B, using all MFs except threshold growth, with threshold growth treated as an AF favouring malignancy; and scheme C, using the highly frequent AFs inplace of threshold growth as new MFs. The LR-5 (the category of definitely HCC) diagnostic performance for HCC among the 3 schemes was compared.
Results
A total of 379 patients and 426 observations were included. There was no statistically significant difference in the frequency of threshold growth between HCCs and non-HCC malignancies (p = 0.560). Whether HCCs, non-HCC malignancies, or benign lesions, the mean size with threshold growth was smaller than that without threshold growth (all p < 0.05). The nodule-in-nodule feature was a highly frequent AF (p < 0.05) and was used to replace threshold growth as a new MF in scheme C. The LR-5 diagnostic performance values for HCC with schemes A, B, and C were respectively as follows: a sensitivity of 74.4%, 74.0% and 75.6%; specificity of 88.6%, 88.6% and 88.6%; and accuracy of 80.3%, 80.0% and 81.0%. There was no statistically significant difference in diagnostic performance between schemes A and B or between schemes A and C (all p > 0.05).
Conclusion
The threshold growth is removed or replaced by the nodule-in-nodule feature
Portal vein tumor thrombus radiotherapy improves the outcomes of immunotherapy plus bevacizumab in hepatocellular carcinoma: A multicenter real-world research of southwest China
Authors: TANG Cuiping , HE Qin , FENG Jian , LIAO Ziyue , PENG Yunli , GAO Jian 
Published: February 2023

Abstract
Background: The aim of this study was to investigate the changes in some immune-related indicators after radiotherapy for portal vein tumor thrombosis (PVTT) in patients with hepatocellular carcinoma (HCC), to evaluate the efficacy and safety of sequential immune checkpoint inhibitors (ICIs) plus bevacizumab therapy after radiotherapy for PVTT, and to preliminarily explore the factors affecting the efficacy of patients.
Methods: Retrospective data were collected from three hospitals in southwestern China, patients of HCC complicated with PVTT were analyzed, patients were divided into the PVTT radiotherapy combined with ICIs plus bevacizumab group (PVTT radiotherapy group) and ICIs plus bevacizumab group (control group). The difference of progression-free survival (PFS), objective response rate (ORR) and disease control rate (DCR) of the two groups were analyzed, and the potential factors affecting PFS were analyzed. The adverse events (AEs) were compared between the two groups.
Results: A total of 113 patients were treated with ICIs plus bevacizumab as a first line treatment, of whom 55 patients had been treated with PVTT radiotherapy before first treatment. There were significant differences in some immune-related indicators before and after radiotherapy for PVTT. The patients in PVTT radiotherapy group had a longer PFS (median, 10.1 vs. 5.8 months, P < 0.05), and the PFS rates of 3 months, 6 months, 9 months and 12 months were 98.18% vs. 93.10%, 83.64% vs. 44.83%, 58.18% vs. 6.90% and 23.64% vs. 1.72%, respectively, with statistical differences (P < 0.05). There were no significant difference in ORR (41.82% vs.37.93%, P = 0.704) and DCR (87.27% vs.82.61%, P = 1.000) between the two groups, but the ORR and DCR of the PVTT radiotherapy group were showed a higher results, and no serious AEs were observed. Multivariate Cox analysis showed that the expression of AFP, the gross classification of HCC, PVTT type, extrahepatic metastasis, and PVTT radiotherapy were independent influencing factors of PFS (P < 0.05).
Conclusions: Sequential ICIs plus bevacizumab therapy after radiotherapy for PVTT of HCC patients is safe and feasible, which may further prolong the PFS of patients.
Urea Free Screen Printing of Cotton Fabric Via Newly Synthesized Reactive Dyes and Impact of Functional Group Chemistry on Printing Properties
Authors: Siddiqua Umme Habibah , Ali Shaukat 
Published: February 2023

Abstract
Urea free screen printing of cotton fabric using newly synthesized azo reactive dyes was carried out in the present study. Functional group chemistry and its effect on the printing properties of cotton fabric by varying the nature, number and position of reactive groups of synthesized azo reactive dyes (D1-D6) was studied. Different printing parameters (Temperature, alkali and urea) and their effect was explored on the physicochemical printing properties e.g., fixation, color yield, and penetration of the dyed cotton fabric. Data revealed that dyes with more reactive groups and having linear and planar structures (D-6) showed enhanced printing properties. Spectraflash spectrophotometer was used to evaluate the colorimetric properties of screen-printed cotton fabric and results showed superb color buildup. Printed cotton samples displayed excellent to very good ultraviolet protection factor (UPF). Presence of sulphonate groups and excellent fastness properties may entitle these reactive dyes as commercially viable for urea free printing of cotton fabric.
Small-scale genetic structure of the bulb mite Rhizoglyphus robini populations
Authors: Przesmycka Karolina , Radwan Jacek 
Published: February 2023

Abstract
Bulb mites are an economically significant pest of subterranean parts of plants and a versatile laboratory animal. However, genetic structure of their populations remains unknown. To fill this gap in our knowledge of their biology, we set-up field experiment in which we allowed mites to colonize onion bulbs, and then determined genetic structure of colonisers based on a panel of microsatellite loci. We found moderate but significant population structure among sites separated by ca. 20m (FST range 0.03–0.21), with 7% of genetic variance distributed among sites. Allelic richness within some bulbs was nearly as high as that in the total population, suggesting that colonisation of bulbs was not associated with strong population bottlenecks. The significant genetic structure we observed over small spatial scales seems to reflect limited dispersal of mites in soil.
Transcranial photobiomodulation improves insulin therapy in diabetic mice: modulation of microglia and the brain drainage system
Authors: Liu Shaojun , Li Dongyu , Yu Tingting , Zhu Jingtan , Semyachkina-Glushkovskaya Oxana , Zhu Dan 
Published: February 2023

Abstract
Background: The chronic hyperglycemia of diabetes mellitus (DM) leads to the dysfunction of microglia, which is associated with the occurrence of diabetic cerebrovascular injuries (DCIs) and various complications, the main reasons of death in patients with DM. Although long term insulin therapy can effectively control blood glucose levels, it is not sufficient to rapidly restore the function of microglia. Therefore, the search for new alternative methods of treating diabetes-related dysfunction of microglia is urgently needed to improve the survival and quality of life of patients with DM.
Methods: We evaluated the therapeutic effects of transcranial photobiomodulation (tPBM) at near infrared-Ⅱ wavelengths (1267 nm) with high tissue penetration depth on microglial function in diabetic mice. Afterwards, we investigated the mechanisms of tPBM in terms of changes in blood-brain barrier permeability and meningeal lymphatic vessels function.
Results: The treatment of tPBM significantly improved insulin therapy via modulation of microglial morphology and reactivity to cerebrovascular injury. We also demonstrated that tPBM stimulated the brain drainage system through activation of the meningeal lymphatics contributing the removal of inflammatory factor, such as the interferon gamma (IFN-γ) from the brain parenchyma. These therapeutic effects of tPBM contribute the repair of microglial reactivity to the cerebrovascular injury via an increase in the expression of microglial chemokine receptor P2RY12.
Conclusions: Our results demonstrate that tPBM can be an efficient innovative method for the treatment of microglial dysfunction caused by diabetes to prevent diabetic brain disorders and has the potential to be quickly introduced in clinical practice since tPBM is widely used for the therapy of brain diseases.
Screening for EGFR and AKT dual-target inhibitors
Authors: Yang Han-Yu , Zhang Zhi-Wei , Yu Jie , Liu Cong-Jin , Lu Wen-Cai 
Published: February 2023

Abstract
Epidermal growth factor EGFR is an important target for non-small cell lung (NSCL) cancer, and inhibitors of AKT protein has been used in many cancer treatments including NSCL cancer. Therefore, screening small molecular inhibitors targeting both EGFR and AKT can help for cancer treatment. In this study, we screened Traditional Chinese Medicine on Immune-Oncology (TCMIO) database for potential natural product inhibitors that can target both EGFR and AKT using ligand-based pharmacophore model, molecular docking, and MD simulations methods. The human endogenous database HMDB was also screened. It was found that TCMIO89212, TCMIO90156 and TCMIO98874 from the TCMIO database had large binding free energies with EGFR and AKT. In the HMDB database, kinetin-7-N-glucoside was found to have ability to bind to EGFR and AKT. These results may provide valuable information for further experimental studies.