bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of YouTube® videos on knowledge on tracheal intubation for anesthesiologist trainees: a prospective observational study
Authors: Marra Annachiara , de Siena Andrea Uriel , Iacovazzo Carmine , Vargas Maria , Cesarano Nicola , Collà Ruvolo Claudia , Celentano Giuseppe , Buonanno Pasquale 
Published: February 2025

Abstract

Background
Social media platforms, initially developed for recreational use, have evolved into major sources for disseminating information, including medical information for patients and healthcare providers in many disciplines. This study aimed to evaluate the educational potential of YouTube® videos in teaching tracheal intubation to first-year anesthesiology residents.

Methods
This study was approved by the Ethical Committee of “University Federico II-AORN A. Cardarelli” (protocol no. 00010735). We analyzed the first 10 YouTube videos identified via the search term “tracheal intubation.” Each video was evaluated for misinformation and informational completeness via a 5-item Likert scale. After providing written consent, fifty-seven first-year anesthesiology residents watched these videos and completed a 22-item questionnaire before and after viewing. Each correct answer received one point, whereas incorrect answers received 0 points, allowing for comparisons of knowledge acquisition.

Results
The videos exhibited moderate quality (median score, 3; range, 1–5) and low informational completeness (median score, 1.432; range, 1.000–2.046). Residents’ scores increased modestly by one point after viewing (from 13 to 14; p < 0.001). Misinformation was positively correlated with the number of followers (beta coefficient: 0.00002, p < 0.001), video duration (beta coefficient: 0.0042, p < 0.05), and linking ratio (beta coefficient: 0.242, p < 0.05). Conversely, informational completeness was inversely correlated with video duration (beta coefficient: − 0.001121, p < 0.05) and the thumbs-up/view ratio (beta coefficient: − 67.4697, p < 0.05).

Conclusions
While YouTube® has potential as an accessible educational tool, current video selection offers limited improvement in residents’ understanding of tracheal intubation. Our findings highlight the need for greater curation and better-quality control of medical educational content on YouTube® to optimize its effectiveness and provide accurate information. Institutions could play a key role in producing reliable, guideline-based videos that better support learning objectives in anesthesiology training.
Dynamical homogenization in effective loop quantum cosmology
Authors: Wilson-Ewing Edward 
Published: February 2025

Abstract
The effective dynamics of loop quantum gravity for marginally bound Lemaître-Tolman-Bondi spacetimes predict that the big-bang singularity is resolved and replaced by a cosmic bounce. Numerics show that these effective dynamics also homogenize small regions soon after the bounce when inhomogeneities before the bounce are sufficiently large. These homogeneous regions typically have a width of a few Planck lengths where relative perturbations in the energy density remain less than 15%. If the bounce is followed by an inflationary period, the homogeneous region can reach cosmic scales and the amplitude of relative perturbations can be suppressed to a value compatible with observations.
The Role of Specialty Palliative Care in Elective Surgical Oncology: A Systematic Review
Authors: Walsh Amanda K. , Guo Marissa Z. , Leuschner Thomas , Ejaz Aslam , Pawlik Timothy M. , Wells-Di Gregorio Sharla , Waterman Brittany , Cloyd Jordan M. 
Published: February 2025

Abstract

Background
Unlike advanced cancer populations, for whom early and routine specialty palliative care (PC) referral has demonstrated clear benefits for quality of life and symptom control, evidence supporting PC for patients undergoing curative-intent cancer surgery has been inconclusive.

Method
A systematic review of the PubMed, Embase, Cochrane Library, and MEDLINE databases was performed to identify all studies evaluating the role of PC for patients undergoing curative-intent surgery for cancer.

Results
Among the 12,886 publications initially retrieved, 14 met all inclusion criteria: two cross-sectional studies comprised of physician surveys, four cohort studies, five qualitative studies, one prospective trial, and two randomized controlled trials (RCTs). In non-randomized studies, PC was associated with increased advanced care planning and symptom control; however, both the PERIOP-PC and SCOPE RCTs found no significant improvement in quality of life with routine perioperative PC among patients undergoing major abdominal cancer surgery. Qualitative studies characterized patient experiences and physician perspectives of PC.

Conclusion
This systematic review summarizes the existing literature on the role of PC in surgical oncology, highlighting the unique considerations and unmet needs of surgical patients that differ from those with advanced cancer. While the routine use of perioperative PC for patients undergoing cancer surgery is not supported, future research should focus on identifying high-risk patients who would most benefit from specialty PC and innovative methods of delivering supportive care in surgical oncology.
Global Algorithms for Mean-Variance Optimization in Markov Decision Processes
Authors: Xia Li , Ma Shuai 
Published: February 2025

Dynamic optimization of mean and variance in Markov decision processes (MDPs) is a long-standing challenge caused by the failure of dynamic programming. In this paper, we propose a new approach to finding the globally optimal policy for combined metrics of steady-state mean and variance in an infinite-horizon undiscounted MDP. By introducing the concepts of pseudo mean and pseudo variance, we convert the original problem to a bilevel MDP problem, where the inner one is a standard MDP optimizing pseudo mean-variance, and the outer one is a single-parameter selection problem optimizing pseudo mean. We use the sensitivity analysis of MDPs to derive the properties of this bilevel problem. By solving inner standard MDPs for pseudo mean-variance optimization, we can identify worse policy spaces dominated by optimal policies of the pseudo problems. We propose an optimization algorithm that can find the globally optimal policy by repeatedly removing worse policy spaces. The convergence and complexity of the algorithm are studied. Another policy dominance property is also proposed to further improve the algorithm efficiency. Numerical experiments demonstrate the performance and efficiency of our algorithms. To the best of our knowledge, our algorithm is the first that efficiently finds the globally optimal policy of mean-variance optimization in MDPs. Our results are also valid for solely minimizing the variance metrics and can shed light on solving other varied forms of mean-variance MDPs. Funding: This research was supported in part by the National Key Research and Development Program of China [Grant 2022YFA1004600], the National Natural Science Foundation of China [Grants 72342006 and 72371253], the Guangdong Basic and Applied Basic Research Foundation [Grants 2023A1515012492 and 2023B1515040001], the Regional Joint Foundation of Guangdong [Grant 2022A1515110725], and the Guangdong Province Key Laboratory of Computational Science at the Sun Yat-sen University. The work described in this paper was also partially supported by the InnoHK Initiative, the Government of the HKSAR, and the Laboratory for AI-Powered Financial Technologies.
“ABRAM AS PORTAS PARA O CINEMA POPULAR”:
Authors: Rodrigues Maciel Rodrigo José , Oliveira Melo Eduardo , Da Silva Rocha Kátia Carvalho 
Published: February 2025

O presente estudo expõe os resultados de um Projeto de Extensão, intitulado: “Cinema e Ensino de História: O Audiovisual Brasileiro na Sala de Aula”, sendo financiado pela Universidade Estadual da Região Tocantina do Maranhão (UEMASUL). Esta investida teve como finalidade utilizar-se da sétima arte como espaço de problematização dentro do ambiente escolar, oferecendo o Letramento Cinematográfico aos alunos da rede pública do ensino básico, apresentando, por uma perspectiva lúdica e interdisciplinar, questões relacionadas ao conhecimento histórico e ao que diz respeito a tópicos transversais fundamentais para a formação da consciência histórica (RÜSEN,2007). Diante disso, justifica-se esta iniciativa por sua perspectiva interdisciplinar diante o processo de ensino-aprendizagem, propondo transpor a barreira entre os saberes produzidos pela universidade e o espaço escolar. Nesse sentido, cabe ressaltar a importância de trabalhos de campos e projetos de extensão das ciências humanas que tem como público-alvo a rede pública de ensino médio, visto que a flexibilização curricular promulgada pela lei nº 13.415 acabou por minimizar a carga horária das matérias ligadas às ciências humanas, esvaziando o debate crítico dentro da escola pública, os principais afetados pela lei. Dito isso, o projeto “Cine História” foi desenvolvido no Centro Educacional Graça Aranha, localizado em Imperatriz-MA, tendo como público alvo alunos do ensino médio. A partir desta iniciativa propaga-se o ideal de Cinema Popular, de Gutiérrez Alea (1984), tornando o espetáculo sensível-artístico cinematográfico em uma oportunidade de desenvolvimento da criticidade e um veículo para formação de uma consciência histórica.
Efficacy of Dapagliflozin in the Treatment of Type 2 Diabetes Mellitus Complicated by Coronary Heart Disease: A Meta-Analysis
Authors: Ma Wenchao , Wang Kun , Sun Leina , Su Fangcheng 
Published: February 2025

Aims/Background Dapagliflozin is a sodium-glucose cotransporter inhibitor that functions to lower blood sugar by promoting glucose excretion. We conducted a meta-analysis to assess the therapeutic efficacy of dapagliflozin in patients with type 2 diabetes mellitus complicated by coronary heart disease. The objective of this analysis is to provide additional clarity on dapagliflozin’s effectiveness in this specific patient population. Methods A systematic review of the literature was performed by searching China National Knowledge Infrastructure (CNKI), Wanfang, Wip Chinese Science, Technology Journals, China Biomedicine, Pubmed, Web of Science, and Cochrane Library. Related literature regarding the effectiveness of dapagliflozin, published since the inception of databases until October 2023, was searched and selected. Subsequent to the screening process, the Jadad scale was used to assess the quality of the gathered literature. The NoteExpress3.2 software (Beijing Aegean Music Technology Co., Ltd., Beijing, China) was utilized to manage the literature. Statistical analysis was conducted using RevMan5.4.1 software (The Cochrane Collaboration, London, UK). The p-value of the Q test determined the heterogeneity of the studies, guiding the choice between fixed or random effect models for establishing the combined effect. Forest plots were used to visualize dapagliflozin’s efficacy in treating patients with type 2 diabetes mellitus and coronary heart disease. A funnel plot was plotted to assess potential publication bias. Results Twenty-three studies were eligible for inclusion in this meta-analysis. The results revealed that dapagliflozin has better clinical efficacy (odds ratio [OR] = 3.88, 95% confidence interval [CI] 2.59 to 5.82), left ventricular ejection fraction (LVEF) (OR = 5.43, 95% CI 4.02 to 6.84). The values of left ventricular end-diastolic diameter (LVEDD) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were lower in the experimental group (OR: –4.03 and –84.65, 95% CI –5.08 to –2.98 and –127.05 to –42.25, respectively). In addition, further analysis showed that the experimental group experienced a lower incidence of adverse reactions (OR = 0.30, 95% CI 0.16 to 0.57). Conclusion Dapagliflozin is more effective in controlling type 2 diabetes mellitus complicated by coronary heart disease.
Impact of Nafamostat Mesylate Combined with Continuous Renal Replacement Therapy on Clinical Outcomes, Immune Function, and Oxidative Stress Markers in Patients with Sepsis-Associated Acute Kidney Injury
Authors: Miao Mengai , Chen Zhile 
Published: February 2025

Aims/Background Sepsis is a prevalent critical condition associated with acute kidney injury (AKI). Nafamostat mesylate (NM), a serine protease inhibitor, has anticoagulant and anti-inflammatory properties. This study aimed to investigate the effects of NM combined with continuous renal replacement therapy (CRRT) on clinical efficacy, immune function, and oxidative stress markers in patients with sepsis-associated acute kidney injury (SA-AKI). Methods A total of 98 patients diagnosed with SA-AKI and treated at The People’s Hospital of Pingyang between January 2022 and January 2024 were included. Patients were divided into two groups based on their treatment regimen: a CRRT group (n = 48) and a NM+CRRT group (n = 50). Clinical outcomes, including length of stay in the intensive care unit (ICU) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, were analyzed. Changes in clinical efficacy, immune function, renal function, and oxidative stress markers were assessed before and after treatment. Adverse reactions were also compared between the groups. Results The total effective rate in the NM+CRRT group was significantly higher than in the CRRT group (p < 0.05). Patients in the NM+CRRT group had significantly shorter ICU stays and lower APACHE II scores compared to those in the CRRT group (p < 0.05). Baseline levels of renal function markers, serum creatinine (SCr), and blood urea nitrogen (BUN) were similar between the groups (p > 0.05). SCr and BUN levels improved significantly in the two groups post-treatment, with significant reductions observed in the NM+CRRT group (p < 0.05). Immune function markers, immunoglobulin G (IgG), and immunoglobulin A (IgA) showed no significant differences between groups at baseline (p > 0.05), but were significantly higher in the NM+CRRT group after treatment (p < 0.05). Oxidative stress markers, glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) also showed no significant baseline differences (p > 0.05). After treatment, MDA levels decreased, and GSH-Px levels improved in the two groups, with more significant improvements in the NM+CRRT group. The incidence of adverse reactions was 26.00% in the NM+CRRT group and 16.67% in the CRRT group, with no statistically significant difference (p > 0.05). Conclusion NM combined with CRRT significantly enhances clinical efficacy, immune function, and renal function in patients with SA-AKI and reduces oxidative stress. The therapy demonstrates an acceptable safety profile and is suitable for clinical application.
Early Prediction of Death Risk in Progressive Nasopharyngeal Carcinoma Using Radiomics Nomogram Based on Clinical Semantic Multi-Parameter Magnetic Resonance Imaging
Authors: Xi Yuzhen , Ding Yuanhui , Zhang Yingjiao , Wang Mengze , Wu Chunying , Chen Xuan , Ruan Lei , Ding Zhongxiang , Jiang Feng , Liu Miao 
Published: February 2025

Aims/Background Patients with recurrent or/and metastatic nasopharyngeal carcinoma (NPC) have a notably low survival rate. Our primary objective in this study is to establish a comprehensive nomogram model based on clinical factors, semantic features, and multi-parameter magnetic resonance imaging (MRI) radiomic features, and to predict the risk of mortality in patients with progressive NPC following intensity-modulated radiation therapy. Methods A retrospective study, including 110 patients with recurrent or/and metastatic NPC who underwent treatment at the Zhejiang Cancer Hospital between June 2012 and December 2016, was conducted. Comprehensive reviews of clinical and pre-treatment MRI data were undertaken. Patients were categorized into two groups based on their mortality status within a 5 year-frame: the non-death group (54 cases) and the death group (56 cases). Radiomic features were extracted from patients’ MRIs and the best feature set was selected. Each patient was assigned a radiomic score (Rad-Score). A combined model was constructed using multivariate binary logistic regression, incorporating Rad-Score, semantic features, and clinical data. Receiver operating characteristic (ROC) curves and calibration plots were generated to evaluate the predictive performance of the radiomic feature model, the clinical-semantic feature model, and the combined model for predicting death risk in patients with progressive NPC. A nomogram based on the combined model was constructed. Results Gender, invasion of the carotid sheath by the primary tumour, tumour volume, and progression time showed statistically significant differences between the two groups (p < 0.05). There were statistically significant differences between the three models in the death and non-death groups (p < 0.001). The area under the curve (AUC) value for the radiomic feature model was 0.861 (95% confidence interval [CI]: 0.783–0.920), while the AUC value for the clinical-semantic feature model was 0.797 (95% CI: 0.709–0.868). The combined model demonstrated the highest efficacy for predicting death risk in NPC patients, with an AUC value of 0.904 (95% CI: 0.832–0.952), accuracy of 0.818, sensitivity of 0.857, specificity of 0.870, negative predictive value of 0.778, and positive predictive value of 0.857. Conclusion The combined model incorporating clinical features, semantic features and multi-parameter MRI radiomic features is a highly valuable tool for predicting death risk in patients with progressive NPC, providing a quantitative approach to aiding in early clinical intervention and treatment.
Causal Relationship between Branched-Chain Amino Acids and Inflammatory Bowel Disease: A Bidirectional and Multivariable Mendelian Randomization Study
Authors: Zhou Jiaying , Zhu Fengting , Sun Leimin 
Published: February 2025

Aims/Background The relationship between dysregulated branched-chain amino acid (BCAA) and inflammatory bowel disease (IBD) is not fully understood. This study applied a bidirectional, two-sample Mendelian randomization (MR) approach to explore the potential causal relationship between circulating BCAA levels and IBD. Methods Genome-wide association studies (GWAS) data on total BCAA levels, comprising leucine, valine, and isoleucine, were utilized. Data on IBD and its subtypes were sourced from the FinnGen study. The primary analytical method was the inverse-variance weighted (IVW) MR. To determine the direct causal effect of BCAA levels on IBD risk while accounting for confounders, we employed multivariable Mendelian randomization (MVMR). Results IVW analysis revealed a positive correlation between circulating total BCAA levels, including valine, leucine, and isoleucine, and an increased risk of Crohn’s disease (CD). No causal link was detected between BCAA levels and overall IBD or ulcerative colitis (UC). In the MVMR analysis, adjusting for common risk factors further validated a direct causal effect of elevated BCAA levels on CD risk. Conclusion Our findings suggest that elevated circulating BCAA levels are associated with an increased risk of CD. Further research is warranted to explore the potential implications of these findings for CD risk management.
Development and Validation of a Preoperative Prediction Model for Neoplastic Gallbladder Polyps
Authors: Zhang Yanning , Hao Jinyong , Wang Pengfei , Xu Shaoce , Zhou Xiong , Wang Jingzhe , Huang Xiaojun 
Published: February 2025

Aims/Background The primary goal in evaluating gallbladder polypoid lesions (GPLs) is to identify neoplastic polyps (NP). Numerous studies have investigated risk factors for NP. This study aimed to develop a practical preoperative prediction model for NP using simple and easily accessible clinical variables. Methods We retrospectively analyzed clinical data from patients with GPLs who underwent cholecystectomy at Lanzhou University Second Hospital between January 2018 and September 2022. A total of 621 cases were included and randomly assigned into a training set (70%) and an internal validation set (30%). An external validation set was established using data from 117 patients treated at other centers between January and December 2023. Univariate logistic analyses were performed, followed by backward stepwise multivariate logistic regression analysis for variables with p< 0.2 to identify significant variables associated with NP. These predictors were included in the final logistic regression model and visualized as a nomogram model. The discrimination, calibration, and clinical utility of the model were evaluated. Results Age (odd ratio (OR) = 1.06, 95% CI = 1.03–1.09, p= 0.0001), polyp size (OR = 19.01, 95% CI = 6.48–55.79, p < 0.0001), polyp number (OR = 0.25, 95% CI = 0.12–0.56, p = 0.0006), gallbladder wall thickness (OR = 1.57, 95% CI = 1.02–2.41, p= 0.0385), and polyp echo characteristics (OR = 0.41, 95% CI = 0.19–0.85, p = 0.0169) were identified as independent influencing factors for NP. The area under the curve (AUC) of the nomogram model in the training, internal validation, and external validation sets were 0.886 (95% CI, 0.841–0.930), 0.836 (95% CI, 0.753–0.919), and 0.867 (95% CI, 0.743–0.978), respectively. Calibration curves for the three datasets showed Brier scores of 0.079, 0.092, and 0.070, all below 0.25, indicating good calibration. Decision curve analysis (DCA) and clinical impact curve (CIC) analysis suggested that a threshold probability of 0.6 provided the most significant clinical benefit. Conclusion This prediction model, incorporating easily accessible variables, demonstrated excellent performance in the identification of NP and contributed to clinical decision-making in GPL management.
Facilitators and barriers for healthcare workers’ adherence to the national nutritional guidelines for people living with HIV in Dar-es-Salaam: A mixed-method study
Authors: Mwakasungura Felistar , Mkumbwa Rebecca , Sunguya Bruno 
Published: February 2025

The dual burden of HIV and malnutrition is a significant public health challenge in high burden Sub-Saharan African countries. Tanzania is no exception. Care and treatment of HIV has been strengthened in these countries, however integration with nutrition care and support remains poor. This study evaluated adherence to nutritional guidelines for people living with HIV (PLHIV) in Dar es Salaam Tanzania and identified its influencing factors. A mixed method study was conducted among PLHIV, health facility administrators, and healthcare providers from April 29 to May 27, 2024. Data were collected through observation checklists, structured questionnaires, and in-depth interviews. Statistical and qualitative analyses were performed to assess adherence and determinants. Among 478 participants who received care, only 19.5% were managed while adhering to the national nutritional guidelines. Universally, anthropometric assessments were taken, however, only 1% received micronutrient supplements. Higher education (AOR = 5.08, p = 0.019) and attendance at referral hospitals (AOR = 8.23, p = 0.032) positively influenced adherence. Conversely, nurse attendance (AOR = 0.34, p = 0.038), adequate staffing (AOR = 0.31, p = 0.010), and urban residence (AOR = 0.47, p = 0.009) negatively influenced adherence. Key facilitators included consistent training and supportive leadership while financial constraints and high staff turnover remained important barriers. There is a significant gap in adherence to nutritional guidelines among PLHIV in Dar es Salaam, Tanzania. This highlights the need for improved resource distribution, staff training, and clients education in Tanzania and countries with similar contexts.