bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impacts of COVID-19 crisis and some related factors on the mental health of 37150 Vietnamese students: a cross-sectional online study
Authors: Duong Chau Bao , Van Tran Nhi , Nguyen An Hoang , Le Thong Nhat , Ha Bien Huy , Do Chau Ngoc Phuc , Huynh Khon , Le Thong Minh , Nguyen Thao Phuong , Nguyen Hoai Thi Thu 
Published: April 2023

AbstractBackgroundUniversity students are vulnerable to changes due to COVID-19 pandemic. Although warning has been made about the impact of this crisis on students’ mental health, there are barely any sufficient study. This work investigated how the pandemic affected the mental health of students at the Vietnam National University of Ho Chi Minh City (VNU-HCMC) and efficiency of available mental health supportive methods.MethodsAn online survey was conducted among students at Vietnam National University of Ho Chi Minh City (VNU-HCMC) from October 18, 2021, to October 25, 2021. Microsoft Excel 16.51 (Microsoft, USA) and R language, Epi packages 2.44 and 4.1.1 (rdrr.io) were used for data analysis.ResultsThirty-seven thousand one hundred fifty students participated in the survey, including 48.4% female and 51.6% male. Online learning pressure was mainly recorded (65.1%). Many students suffered from sleeping disorders (56.2%). Some reported being victims of abuse (5.9%). Female students expressed a significantly higher level of distress than males, particularly the feeling of ambiguity about the purpose of life (p-value < 0.0001, OR: 0.94, 95% CI: [0.95–0.98]). Third-year students suffered higher stress levels than others, especially in online learning (68.8%,p-value < 0.05). Mental health statuses among students of different lockdown status regions were not significantly different. Therefore, lockdown status did not affect the stress levels of students which suggested that poor mental health outcomes seemed to root in the suspension of everyday university life rather than the prohibition of going out.ConclusionsDuring COVID-19, students experienced lots of stress and mental problems. These findings underscore the importance of academic and innovative activities, bringing attention to the needs of interactive study and extra-curricular activities.
Characteristics and treatment results of patients with gastroenteropancreatic neuroendocrine tumors in a tertiary care centre
Authors: Bazarbashi Shouki , Aseafan Mohamed , Elgazzar Tasnim , Alkhayat Maha , Alghabban Abdulrahman , Abdelgawad Marwa I. , Alshamsan Bader , Alshibany Aisha , Elhassan Tusneem , Aljubran Ali , Alzahrani Ahmed , Alhindi Hindi , Raef Hussein 
Published: April 2023

Abstract
Background
Gastroenteropancreatic Neuroendocrine tumors (GEP-NET) are rare neoplasms with limited reported data from the Middle East. Our study aims to report the clinicopathological feature, treatment patterns, and survival outcomes of patients with GEP-NET from our part of the world.

Methods
Medical records of patients diagnosed with GEP-NET between January 2011 and December 2016 at a single center in Saudi Arabia were reviewed retrospectively, and complete clinicopathological and treatment data were collected. Patients’ survival was estimated by the Kaplan–Meier method.

Results
A total of 72 patients were identified with a median age of 51 years (range 27–82) and male-to-female ratio of (1.1). The most common tumor location was the pancreas (29.1%), followed by small bowel (25%), stomach (12.5%), rectum (8.3%), colon (8.3%), and appendix (6.9%). Forty-one patients (57%) had well-differentiated grade (G)1, 21 (29%) had G2, and 4 (6%) had G3. In five patients, the pathology was neuroendocrine carcinoma and in one it could not be classified. 54.2% of the patients were metastatic at diagnosis. Forty-two patients underwent surgical resection as primary management while 26 underwent systemic therapy, three patients were put on active surveillance, and one was treated endoscopically with polypectomy. The 5-year overall survival and progression-free survivals were 77.2% and 49%, respectively, for the whole group. Patients with G1 and 2 disease, lower Ki-67 index, and surgically treated as primary management had significantly better survival outcomes.

Conclusion
Our study suggests that the most common tumor locations are similar to western reported data. However, there seems to be a higher incidence of metastatic disease at presentation than in the rest of the world.
Differential attitudes and outcomes of endodontics education between mainland and non-mainland chinese students during COVID-19 pandemic
Authors: Zhong Ting , Liao Chufang , Shi Haishan 
Published: April 2023

Abstract
Background
The COVID-19 pandemic has changed the learning style and campus life of dental students. This study aimed to evaluate the learning attitudes and outcomes of endodontics among mainland Chinese students and non-mainland Chinese students (students from Hong Kong, Macao, and Taiwan) during the pandemic.

Methods
A cross-sectional survey was conducted in November 2022 at the School of Stomatology, Jinan University, utilizing a self-report online questionnaire, including demographic characteristics and attitudes toward the endodontic course and the COVID-19 pandemic. The endodontics scores were collected from recruited students for further analysis. The collected data were analyzed using SPSS 22.0 software, with independent two-sample t-tests to compare continuous variables and chi-square tests for categorical variables.

Results
A total of 215 dental students completed the survey, with 126 (58.6%) of them being non-mainland Chinese students. Compared to mainland Chinese students, non-mainland Chinese students had lower scores in both theoretical (63.6 ± 13.5 vs. 83.2 ± 8.00) and skill (88.4 ± 5.38 vs. 90.0 ± 4.91) endodontic assessments. Non-mainland Chinese students reported significantly greater impacts of the COVID-19 pandemic on their learning emotions, personal hygiene, and future career choices compared to mainland Chinese students.

Conclusions
Non-mainland Chinese students had poorer academic performance in endodontics and experienced a greater impact from the COVID-19 pandemic in terms of their studies and lives. Dental educators should consider the diversity of students and take necessary measures to support their mental health and enhance learning outcomes in the post-COVID-19 era.
Adjuvant music therapy for patients with hypertension: a meta-analysis and systematic review
Authors: Cao Min , Zhang Zhiyuan 
Published: April 2023

Abstract
Background
High blood pressure, anxiety, depression and sleep disorder is very common in patients with hypertension. We aimed to perform a meta-analysis to evaluate the effects of adjuvant music therapy for patients with hypertension, to provide insights to the clinical management of hypertension.

Methods
Two authors searched PubMed, Embase, Web of Science, the Cochrane Library, Chinese National Knowledge Infrastructure, China Biomedical Literature Database, Wanfang Databases for randomized controlled trials (RCTs) on the role of music therapy in hypertension up to Oct 15, 2022. RevMan 5.3 software was used for meta-analysis.

Results
A total of 20 RCTs including 2306 patients were finally included. 1154 patients received music therapy. Meta-analysis showed that music therapy can effectively reduce the systolic blood pressure(MD = − 9.00, 95%CI: − 11.99~- 6.00), diastolic blood pressure(MD = -6.53, 95%CI: -9.12~- 3.93), heart rate (MD = -3.76, 95%CI: -7.32~- 0.20), self-rating anxiety scale (SAS) score(MD =-8.55, 95%CI: -12.04~-4.12), self-rating depression scale (SDS) score(MD = -9.17, 95%CI: -13.85~-5.18), Hamilton anxiety scale (HAMA), score(MD = -3.37, 95%CI: − 5.38~- 1.36), PSQI score(MD =-1.61, 95%CI:-2.30~- 0.93) compared with routine therapy in patients with hypertension(all P < 0.05). No publication bias in the synthesized outcomes were found (all P > 0.05).

Conclusion
Music therapy can effectively control blood pressure and heart rate, reduce anxiety and depression levels, and improve sleep quality in hypertensive patients. Limited by the quantity and quality of included studies, the above conclusions need to be verified by more high-quality studies.
Similarity matching of medical question based on Siamese network
Authors: Li Qing , He Song 
Published: April 2023

AbstractBackgroundWith the rapid development of the medical industry and the gradual increase in people’s awareness of their health, the use of the Internet for medical question and answer, to obtain more accurate medical answers. It is necessary to first calculate the similarity of the questions asked by users, which further matches professional medical answers. Improving the efficiency of online medical question and answer sessions will not only reduce the burden on doctors, but also enhance the patient’s experience of online medical diagnosis.MethodThis paper focuses on building a bidirectional gated recurrent unit(BiGRU) deep learning model based on Siamese network for medical interrogative similarity matching, using Word2Vec word embedding tool for word vector processing of ethnic-medical corpus, and introducing an attention mechanism and convolutional neural network. Bidirectional gated recurrent unit extracts contextual semantic information and long-distance dependency features of interrogative sentences; Similar ethnic medicine interrogatives vary in length and structure, and the key information in the interrogative is crucial to similarity identification. By introducing an attention mechanism higher weight can be given to the keywords in the question, further improving the recognition of similar words in the question. Convolutional neural network takes into account the local information of interrogative sentences and can capture local position invariance, allowing feature extraction for words of different granularity through convolutional operations; By comparing the Euclidean distance, cosine distance and Manhattan distance to calculate the spatial distance of medical interrogatives, the Manhattan distance produced the best similarity result.ResultBased on the ethnic medical question dataset constructed in this paper, the accuracy and F1-score reached 97.24% and 97.98%, which is a significant improvement compared to several other models.ConclusionBy comparing with other models, the model proposed in this paper has better performance and achieve accurate matching of similar semantic question data of ethnic medicine.
Communication competence, self-efficacy, and spiritual intelligence: evidence from nurses
Authors: Mehralian Gholamhossein , Yusefi Ali Reza , Dastyar Neda , Bordbar Shima 
Published: April 2023

Abstract
Introduction
Communication skills and acceptable levels of spiritual intelligence (SI) are the prerequisites of the nursing profession, which can significantly impact the individual and organizational performance of nurses. This study aimed to investigate the competency and self-efficacy of communication and its relationship with the SI of nurses.

Methods
This cross-sectional study was conducted in 2021 and included 312 nurses working in a COVID-19 hospital in the south of Iran. The data collection instruments were the Standard Communication Competence Scale, Communication Self-Efficacy, and SI Questionnaires. Data were analyzed with SPSS software version 23 using descriptive and inferential statistics, and t-test, ANOVA, Pearson’s correlation coefficient, and multiple linear regression were performed at 5% significance level.

Results
The mean scores of nurses’ communication competence, communication self-efficacy, and SI were 89.11 ± 7.32 out of 180, 64.45 ± 5.61 out of 120, and 147.13 ± 11.26 out of 210, respectively. A direct and significant correlation was observed between competence (r = 0.527, p<0.001) and communication self-efficacy (r = 0.556, p<0.001) with spiritual intelligence. The dimensions of spiritual intelligence, including the ability to deal with and interact with problems, self-awareness, love and affection, general thinking and doctrinal dimension, and dealing with moral issues, were identified as predictors of nurses’ communicative competence and self-efficacy (p<0.05). There was a positive and significant correlation between nurses’ competence and self-efficacy with their age (p<0.05). The nurses’ mean communication competence and self-efficacy score were different regarding their level of education and the number of shifts (p<0.05). The mean scores of self-efficacy revealed a statistically significant difference between the participants’ gender and the number of patients under observation (p<0.05). Moreover, the nurses’ SI significantly correlated with age, and the mean scores of this intelligence had statistically significant differences regarding gender (p<0.05).

Conclusion
The nurses’ communication competence and self-efficacy were at a moderate level. Considering the correlation and predictive role of SI and its dimensions, it is recommended to promote problem-solving skills, improve self-awareness, and pay attention to moral standards to nurture communication competence and self-efficacy among nurses.
Association between progression-free survival and overall survival in women receiving first-line treatment for metastatic breast cancer: evidence from the ESME real-world database
Authors: Courtinard Coralie , Gourgou Sophie , Jacot William , Carton Matthieu , Guérin Olivier , Vacher Laure , Bertaut Aurélie , Le Deley Marie-Cécile , Pérol David , Marino Patricia , Levy Christelle , Uwer Lionel , Perrocheau Geneviève , Schiappa Renaud , Bachelot Florence , Parent Damien , Breton Mathias , Petit Thierry , Filleron Thomas , Loeb Agnès , Mathoulin-Pélissier Simone , Robain Mathieu , Delaloge Suzette , Bellera Carine 
Published: April 2023

Abstract
Background
Overall survival (OS) is the gold standard endpoint to assess treatment efficacy in cancer clinical trials. In metastatic breast cancer (mBC), progression-free survival (PFS) is commonly used as an intermediate endpoint. Evidence remains scarce regarding the degree of association between PFS and OS. Our study aimed to describe the individual-level association between real-world PFS (rwPFS) and OS according to first-line treatment in female patients with mBC managed in real-world setting for each BC subtype (defined by status for both hormone-receptor [HR] expression and HER2 protein expression/gene amplification).

Methods
We extracted data from the ESME mBC database (NCT03275311) which gathers deidentified data from consecutive patients managed in 18 French Comprehensive Cancer Centers. Adult women diagnosed with mBC between 2008 and 2017 were included. Endpoints (PFS, OS) were described using the Kaplan–Meier method. Individual-level associations between rwPFS and OS were estimated using the Spearman’s correlation coefficient. Analyses were conducted by tumor subtype.

Results
20,033 women were eligible. Median age was 60.0 years. Median follow-up duration was 62.3 months. Median rwPFS ranged from 6.0 months (95% CI 5.8–6.2) for HR-/HER2 − subtype to 13.3 months (36% CI 12.7–14.3) for HR + /HER2 + subtype. Correlation coefficients were highly variable across subtypes and first-line (L1) treatments. Among patients with HR − /HER2 − mBC, correlation coefficients ranged from 0.73 to 0.81, suggesting a strong rwPFS/OS association. For HR + /HER2 + mBC patients, the individual-level associations were weak to strong with coefficients ranging from 0.33 to 0.43 for monotherapy and from 0.67 to 0.78 for combined therapies.

Conclusions
Our study provides comprehensive information on individual-level association between rwPFS and OS for L1 treatments in mBC women managed in real-life practice. Our results could be used as a basis for future research dedicated to surrogate endpoint candidates.
Identification immune response genes in psoriasis after treatment with secukinumab
Authors: Wang Jing , Liu Yufang , Zhang Yuxin , Wang Shiyan , Kang Shaomei , Mi Ningyu , Li Ruxin , Zou Yulin 
Published: April 2023

Abstract
Background
Secukinumab is a fully human IgG1κ MoAb that selectively binds to IL-17A with high affinity, and it has been proven effective for the treatment of psoriasis. However, the immune response pathways and mechanisms during the treatment are still masked. Therefore, the current study was designed to investigate the potential immune response genes via bioinformatics approaches.

Methods
Gene expression data of severe plaque-type psoriasis was retrieved from the GEO database. Quantification of immune infiltration by ssGSEA and identification of differentially infiltrated immune cells were conducted to validate the treatment effect of secukinumab. After data processing, differentially expressed genes were identified between the treatment and untreated group. TC-seq was employed to analyze the trend of gene expression and clustering analysis. IL-17 therapeutic immune response genes were selected by taking the intersection of the genes inside the key cluster set and the MAD3-PSO geneset. Based on these therapeutic response genes, protein–protein interaction networks were built for key hub gene selection. These hub genes would work as potential immune response genes, and be validated via an external dataset.

Results
Enrichment scores calculated by ssGSEA illustrated that the immune infiltration level of T cells had a strong difference before and after medication, which validated the treatment effect of Secukinumab. 1525 genes that have significantly different expression patterns before and after treatment were extracted for further analysis, and the enrichment result shows that these genes have the function related to epidermal development, differentiation, and keratinocytes differentiation. After overlapping candidate genes with MAD3-PSO gene set, 695 genes were defined as anti-IL7A treatment immune response genes, which were mainly enriched in receptor signaling and IL-17 signaling pathways. Hub gene were pinpointed from the PPI network constructed by anti-IL7A treatment immune response genes, their expression pattern fits TC-seq gene expression pattern.

Conclusion
Our study revealed the potential anti-IL7A treatment immune response genes, and the central hub genes, which may act critical roles in Secukinumab, induced immune response. This would open up a novel and effective avenue for the treatment of psoriasis.
Myocardial fat accumulation is associated with cardiac dysfunction in patients with type 2 diabetes, especially in elderly or female patients: a retrospective observational study
Authors: Kashiwagi-Takayama Risa , Kozawa Junji , Hosokawa Yoshiya , Kato Sarasa , Kawata Satoshi , Ozawa Harutoshi , Mineo Ryohei , Ishibashi Chisaki , Baden Megu Y. , Iwamoto Ryuya , Saisho Kenji , Fujita Yukari , Tamba Sachiko , Sugiyama Takuya , Nishizawa Hitoshi , Maeda Norikazu , Yamamoto Koji , Higashi Masahiro , Yamada Yuya , Sakata Yasushi , Matsuzawa Yuji , Shimomura Iichiro 
Published: April 2023

Abstract
Background
Ectopic fat is fat that accumulates in or around specific organs or compartments of the body including myocardium. The clinical features of type 2 diabetes patients with high fat accumulation in the myocardium remain unknown. Moreover, little is known about the influence of myocardial fat accumulation in type 2 diabetes on coronary artery disease and cardiac dysfunction. We aimed to clarify the clinical features, including cardiac functions, of type 2 diabetes patients with myocardial fat accumulation.

Methods
We retrospectively enrolled type 2 diabetes patients who underwent ECG-gated coronary computed tomography angiography (CCTA) and abdominal computed tomography (CT) scan examinations within 1 year of CCTA from January 2000 to March 2021. High fat accumulation in the myocardium was defined as the low mean myocardial CT value of three regions of interest, and the associations between CT values and clinical characteristics or cardiac functions were assessed.

Results
In total, 124 patients were enrolled (72 males and 52 females). The mean age was 66.6 years, the mean BMI was 26.2 kg/m2, the mean ejection fraction (EF) was 67.6%, and the mean myocardial CT value was 47.7 Hounsfield unit. A significant positive correlation was found between myocardial CT value and EF (r = 0.3644, p = 0.0004). The multiple regression analyses also showed that myocardial CT value was independently associated with EF (estimate, 0.304; 95% confidence interval (CI) 0.092 to 0.517; p = 0.0056). Myocardial CT value showed significant negative correlations with BMI, visceral fat area and subcutaneous fat area (r = − 0.1923, − 0.2654, and -0.3569, respectively, p < 0.05). In patients who were ≥ 65 years or female, myocardial CT value showed significant positive correlations with not only EF (r = 0.3542 and 0.4085, respectively, p < 0.01) but also early lateral annular tissue Doppler velocity (Lat e’) (r = 0.5148 and 0.5361, respectively, p < 0.05). The multiple regression analyses showed that myocardial CT value was independently associated with EF and Lat e’ in these subgroups (p < 0.05).

Conclusions
Patients with type 2 diabetes, especially in elderly or female patients, who had more myocardial fat had more severe left ventricular systolic and diastolic dysfunctions. Reducing myocardial fat accumulation may be a therapeutic target for type 2 diabetes patients.
Cardiovascular risk of metabolically healthy obesity in two european populations: Prevention potential from a metabolomic study
Authors: Wei Dongmei , González-Marrachelli Vannina , Melgarejo Jesus D , Liao Chia-Te , Hu Angie , Janssens Stefan , Verhamme Peter , Van Aelst Lucas , Vanassche Thomas , Redon Josep , Tellez-Plaza Maria , Martin-Escudero Juan C , Monleon Daniel , Zhang Zhen-Yu 
Published: April 2023

Abstract
Background
A new definition of metabolically healthy obesity (MHO) has recently been proposed to stratify the heterogeneous mortality risk of obesity. Metabolomic profiling provides clues to metabolic alterations beyond clinical definition. We aimed to evaluate the association between MHO and cardiovascular events and assess its metabolomic pattern.

Methods
This prospective study included Europeans from two population-based studies, the FLEMENGHO and the Hortega study. A total of 2339 participants with follow-up were analyzed, including 2218 with metabolomic profiling. Metabolic health was developed from the third National Health and Nutrition Examination Survey and the UK biobank cohorts and defined as systolic blood pressure < 130 mmHg, no antihypertensive drugs, waist-to-hip ratio < 0.95 for women or 1.03 for men, and the absence of diabetes. BMI categories included normal weight, overweight, and obesity (BMI < 25, 25–30, ≥ 30 kg/m2). Participants were classified into six subgroups according to BMI category and metabolic healthy status. Outcomes were fatal and nonfatal composited cardiovascular events.

Results
Of 2339 participants, the mean age was 51 years, 1161 (49.6%) were women, 434 (18.6%) had obesity, 117 (5.0%) were classified as MHO, and both cohorts had similar characteristics. Over a median of 9.2-year (3.7–13.0) follow-up, 245 cardiovascular events occurred. Compared to those with metabolically healthy normal weight, individuals with metabolic unhealthy status had a higher risk of cardiovascular events, regardless of BMI category (adjusted HR: 3.30 [95% CI: 1.73–6.28] for normal weight, 2.50 [95% CI: 1.34–4.66] for overweight, and 3.42 [95% CI: 1.81–6.44] for obesity), whereas those with MHO were not at increased risk of cardiovascular events (HR: 1.11 [95% CI: 0.36–3.45]). Factor analysis identified a metabolomic factor mainly associated with glucose regulation, which was associated with cardiovascular events (HR: 1.22 [95% CI: 1.10–1.36]). Individuals with MHO tended to present a higher metabolomic factor score than those with metabolically healthy normal weight (0.175 vs. -0.057, P = 0.019), and the score was comparable to metabolically unhealthy obesity (0.175 vs. -0.080, P = 0.91).

Conclusions
Individuals with MHO may not present higher short-term cardiovascular risk but tend to have a metabolomic pattern associated with higher cardiovascular risk, emphasizing a need for early intervention.