bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modified protocol for pterygium surgery without blades and electrocoagulation
Authors: Ge Huimin , Cao Guofan , Wang Jian , Zhang Shu 
Published: February 2025

PurposeTo evaluate the efficacy, safety, and outcomes of a blade- and cautery-free surgical protocol for pterygium removal.MethodsPterygium removal surgery was done in 69 eyes (67 patients; 24 males and 43 females) who were followed up for at least 6 months. The surgery was characterized by blunt separation of the pterygium from the head to the limbal arc using the tip of Vannas scissors and modified procedures, such as transpositional flapping and suture closure. Neither a blade nor a cautery was used.ResultsThe reported subjects were 60.7 years old on average, and most of them had primary pterygium (66 out of 69). The proposed surgical protocol was simple to perform, requiring an average operation time of 18.7 min which was shorter than that of the suture and fibrin glue groups mentioned in relevant reports. Post-anesthesia pain was relieved quickly 1 day after surgery without the use of pain killers. During the follow-up period of 11.3 ± 3.1 months, recurrence of pterygium requiring additional surgery was seen in only three eyes (4.3%).ConclusionThe potential of the examined protocol as an easy, efficient, and reliable approach was demonstrated.
Evaluating the predictive value of clinical models for HBV-related hepatocellular carcinoma: A meta-analysis
Authors: Huang Long , Feng Luhuai , Lu Yang , Hu Bobin , Liang Hongqian , Ren Aoli , Wang Hang , He Wenming , Deng Caifang , Su Minghua , Jiang Jianning 
Published: February 2025

ObjectivesChronic viral hepatitis B (CHB) is a prevalent liver disease with primary hepatic carcinoma (HCC) as a severe complication. Clinical prediction models have gained attention for predicting HBV-related HCC (HBV-HCC). This study aimed to evaluate the predictive value of existing models for HBV-HCC through meta-analysis.DesignMeta-analysis.Data sourcesEmbase, PubMed, the Chinese Biomedical Literature Service System, and the Cochrane database were used for searches between 1970 and 2022.MethodsA meta-analysis was conducted to assess original studies on HBV-HCC prediction models. The REACH-B, GAGHCC, and CUHCC models were externally validated in a Guangxi cohort. The C-index and calibration curve evaluated 5 years predictive performance, with subgroup analysis by region and risk bias.ResultsAfter screening, 27 research articles were included, covering the GAGHCC, REACH-B, PAGE-B, CU-HCC, CAMD, and mPAGE-B models. The meta-analysis indicated that these models had moderate discrimination in predicting HCC risk in HBV-infected patients, with C-index values from 0.75 to 0.82. The mPAGE-B (0.79, 95% CI: 0.79–0.80), GAG-HCC (0.80, 95% CI: 0.78–0.82), and CAMD (0.80, 95% CI: 0.78–0.81) models demonstrated better discrimination than others (P &lt; 0.05), but most studies did not report model calibration. Subgroup analysis suggested that ethnicity and research bias might contribute to differences in model discrimination. Sensitivity analysis indicated stable meta-analysis results. The REACH-B, GAGHCC, CUHCC, PAGE-B, and mPAGE-B models had average predictive performance in Guangxi, with medium to low 3 and 5 years HCC risk prediction discrimination.ConclusionExisting models have predictive value for HBV-infected patients but show geographical limitations and reduced effectiveness in Guangxi.
Association between the p53 polymorphisms and cervical cancer risk: an updated meta-analysis
Authors: Zhang Xi-Qin , Bai Xiao-Hui , Zhang Hui-Zhen , He Xiao-Feng 
Published: February 2025

BackgroundThe association of the p53 rs1042522 and rs17878362 polymorphisms with cervical cancer risk has been reported in several published original studies and meta-analyses. However, the conclusions of these studies were contradictory. Consequently, we conducted an updated meta-analysis to further validate these debates.ObjectiveTo evaluate the association between the p53 rs1042522 and rs17878362 polymorphisms and cervical cancer risk.Materials and MethodsPubMed, Medline, Ovid, Embase, CNKI, and China Wanfang databases were searched. Association was assessed using odds ratio (OR) with 95% confidence interval (CI). Moreover, the false-positive reporting probability (FPRP), Bayesian false-finding probability (BFDP), and Venice criteria were used to assess the credibility of statistically significant association.ResultsA significantly decreased cervical cancer risk was revealed for the p53 rs1042522 polymorphism (Pro/Pro +Arg/Pro vs. Arg/Arg: OR = 0.79, 95% CI = 0.71-0.87; Pro/Pro vs. Arg/Arg: OR = 0.80, 95% CI = 0.70-0.91; Arg/Pro vs. Arg/Arg: OR = 0.78, 95% CI = 0.71-0.86; Pro vs. Arg: OR = 0.87, 95% CI = 0.81-0.93) in overall analysis and several subgroup analyses, such as in Caucasians, Asians, Indians, and so on. However, no significant association was found between the p53 rs17878362 polymorphism and cervical cancer risk. Despite these statistically significant results, reliability analysis using FPRP, BFDP, and Venice criteria deemed all associations “unreliable”.ConclusionsAfter considering the reliability of the results, this study indicates that the p53 rs1042522 polymorphism is not associated with the cervical cancer risk.
Updated review on novel therapies and ongoing clinical trials for high-risk non-muscle invasive bladder cancer
Authors: Wiesen Brett , Hargis Paige , Flores Hunter , Kukreja Janet 
Published: February 2025

Purpose of reviewThe treatment options for high-risk non-muscle invasive bladder cancer (NMIBC), particularly in the setting of BCG-unresponsive disease, remain limited. We provide updates on recent, promising trials for high-risk NMIBC and newly FDA approved therapies.Recent findingsSeveral therapies with diverse mechanisms of action have shown favorable results in both BCG-naïve and BCG-unresponsive settings for NMIBC. These treatments include intravenous and intravesical immunotherapies, viral- and bacterial-based intravesical therapies, combination intravesical chemotherapy regimens, and novel methods of intravesical chemotherapy administration. Overall, the efficacy and tolerability of these emerging treatments for NMIBC appear promising, offering potential alternatives to radical cystectomy. There have also been recent FDA approvals for novel combination therapy for NMIBC which have been detailed below.SummaryAs the landscape of managing BCG-unresponsive disease evolves, clinical trials will continue to expand the treatment options available for NMIBC.
Prognostic significance of the inhibitory-to-stimulatory immune checkpoint ratio in patients with breast cancer
Authors: Tang Chuangang , Hu Xiang , Hao Dawei , Chen Tao , Wang Pei , Li Changwen , Chen Chengling , Li Yongcheng , Hao Xiaowen , Yuan Zeng 
Published: February 2025

BackgroundAccumulating evidences suggested that immune checkpoints (ICPs) played an important role in malignancies including breast cancer (BRCA). We aimed to investigate whether inhibitory-to-stimulatory immune checkpoint ratio (ISICPR) could be used as a prognostic marker for BRCA.MethodsBRCA patients were enrolled from The Cancer Genome Atlas (TCGA). Survival analysis was performed with Kaplan-Meier (KM) methods. X-tile was used to calculate the optimal cut-off values of ISICPRs. Univariate and multivariate Cox regression analysis were carried out to identify prognostic factors for BRCA patients. Tissue microarray was used to validate our findings.ResultsIn total, 586 BRCA patients were collected, including 104 cases of stage I, 330 of stage II, 139 of stage III, and 13 of stage IV. Univariate analysis showed that four ISICPRs (PDCD1/CD27 ratio, PDCD1/TNFSF4 ratio, IDO1/TMIGD2 ratio, and IDO1/TNFSF4 ratio) were significantly associated with the survival of BRCA patients. After adjusting for confounders, multivariate analysis indicated that only the IDO1/TMIGD2 ratio was an independent prognostic factor. The optimal cut-off values for the IDO1/TMIGD2 ratio were set at 4.4 and 6.3. Survival analysis indicated that the high-ratio group (ratio &gt; 6.3) had a worse prognosis than both the low-ratio (ratio &lt; 4.4) and medium-ratio group (4.4 &lt; ratio &lt; 6.3) (P &lt; 0.001), which was further validated by BRCA tissue microarray.ConclusionsWe found that IDO1/TMIGD2 ratio was an independent prognostic factor for BRCA. On one hand, dual targeting of IDO1 and TMIGD2 may be a more effective therapeutic strategy for patients with a high IDO1/TMIGD2 ratio. On the other hand, ISICPR was a promising indicator with high clinical values and worthy of further promotion in other cancers.
Ubiquitin specific protease 7 is a potential therapeutic target for gastric cancer
Authors: Wang Zhi-Ru , Kang Wen-Ting , Yu Rui-Li 
Published: February 2025

IntroductionAs a deubiquitinase, ubiquitin-specific protease 7 (USP7) plays a vital role in diverse cancers, nevertheless, its role in gastric cancer (GC), which is the fifth leading cause of death in diverse cancers worldwide, has rarely been reported.MethodsTo gain a comprehensive understanding about USP7 in the progression of GC, 287 paired GC tissues were collected and analyzed. ShRNA and small molecular inhibitor were used to investigate the impact of USP7 on cell proliferation. Additionally, xenograft proliferation was used to explore the effect of USP7 on tumor growth in animals.ResultsWe found that USP7 overexpression in GC tissues was correlated with several parameters of clinicopathology and poor disease-free survival rate. Meanwhile, the abrogation of USP7 suppressed GC cell proliferation by stabilizing p53 and promoting cell cycle arrest both in vitro and in vivo.DiscussionThese results indicate that USP7 may serve as a biomarker for predicting the outcomes of patients with GC. Therefore, USP7 could be a promising therapeutic target for GC treatment.
Impacts of Chinese national centralized volume-based procurement policy targeting meropenem on prescription of designated antimicrobials for inpatients: an interrupted time series analysis
Authors: Lin Zhi-Hang , Wang Can-Ming , Cai Li-Li 
Published: February 2025

ObjectivesA national centralized volume-based procurement policy (NCVBPP) targeting meropenem has been implemented in China since December 2022. Here, the effects of the meropenem NCVBPP upon the prescription of designated antimicrobials for inpatients were explored.MethodsThe impacts of the meropenem NCVBPP on the consumption of and expenditures for designated antimicrobials prescribed for inpatients were evaluated by means of an interrupted time series analysis (ITSA) using both an autoregressive integrated moving average (ARIMA) model and a segmented regression model. The designated antimicrobials consisted of carbapenem-type antimicrobials and carbapenem-replaced antimicrobials; the latter referred specifically to combinations of penicillins/cephalosporins with beta-lactamase inhibitors and cephamycins. Data on the consumption of and expenditures for designated antimicrobials used in the inpatient sector of our hospital during the period ranging from January 2020 to March 2024 were collected and subjected to an ITSA.ResultsThe meropenem NCVBPP boosted the consumption of meropenem (generic drug and original counterpart); however, neither the total consumption of carbapenem-type antimicrobials nor that of carbapenem-replaced antimicrobials was affected by the meropenem NCVBPP. On the other hand, the meropenem NCVBPP significantly decreased the expenditures on meropenem. Its impacts on the total expenditures for carbapenem-type antimicrobials were unknown. Although a transient increase in the expenditures for carbapenem-replaced antimicrobials and a reduction in the overall expenditures for carbapenem-type antimicrobials plus carbapenem-replaced antimicrobials were also observed following the meropenem NCVBPP, these results were not necessarily caused by the meropenem NCVBPP.ConclusionThe meropenem NCVBPP triggers increased consumption of but reduced expenditures for meropenem. It has no effects on either the overall consumption of carbapenems or carbapenem-replaced antimicrobials.
Characteristics and needs of physical and mental health among older adult individuals with disabilities under the background of smart healthcare: according to data from the China family panel studies
Authors: Zou Qianlingzi , Guan Xin , Cao Xiaojing , Gu Huangying , Wang Caimeng , Ming Xin , Li Rongyong 
Published: February 2025

ObjectiveThis study aimed to utilize data from the China family panel studies (CFPS) to systematically analyze the physical and mental health characteristics and needs of older adult individuals with disabilities under the context of smart healthcare, aiming to provide scientific evidence for relevant policy formulation.MethodsData were derived from the CFPS surveys conducted by Peking University’s China Social Sciences between 2021 and 2022. Older adult individuals aged 65 and above requiring assistance in activities of daily living (ADL) or instrumental activities of daily living (IADL) were included. Descriptive statistics, univariate analysis, and multivariate analysis were employed to analyze the basic characteristics, physical and mental health status, influencing factors, and corresponding needs of older adult individuals with disabilities.ResultsSamples aged between 65 and 80, widowed or divorced, demonstrated higher physical health scores (p &lt; 0.05); samples with education at college level or above, residing in urban areas, free from chronic diseases, with annual income exceeding 100,000 RMB, receiving daily family support, frequently accessing community services, and regularly using smart medical devices exhibited greatly higher levels of physical health, mental health, and overall scores on the short form health survey (SF-36) (p &lt; 0.05). Factors such as younger age, absence of chronic diseases, higher economic status, daily family support, frequent access to community services, and regular use of smart medical devices exerted favorable effects on the physical health status of older adult individuals with disabilities (p &lt; 0.05); absence of chronic diseases, urban residence, higher economic status, daily family support, and frequent access to community services were found to positively influence the mental health status of older adult individuals with disabilities (p &lt; 0.05).ConclusionThe physical and mental health status of older adult individuals with disabilities is influenced by various factors, including social support, economic conditions, and utilization of medical resources. These factors constitute significant determinants in improving the physical and mental health of older adult individuals with disabilities and represent key needs for their betterment.
Associations between blood ethylene oxide levels and serum neurofilament light chain concentrations in adults: evidence from the NHANES
Authors: Li Shikun , Li Wenchen , Liu Jis Huang , Ma Jing , Juan Yan , Chen Bo 
Published: February 2025

BackgroundEthylene oxide (EO) is a widely used industrial chemical recognized for its health risks, potentially posing threats to human health, including neurotoxicity, cardiovascular damage, and carcinogenic effects. Neurofilament light chain (NfL) is a protein released into the blood following axonal damage. To date, no studies have investigated the relationship between EO exposure and NfL levels. Therefore, we selected 5,902,013–2014 National Health and Nutrition Examination Survey (NHANES) participants to examine the relationship between blood EO levels and serum NfL concentrations.MethodsAccording to the data from NHANES, this cross-sectional study used multiple regression analysis, subgroup analysis, and smooth curve fitting to explore the relationship between Ethylene oxide and Neurofilament light chain.ResultsThe results of the present study indicate a positive association between EO exposure and NfL concentrations. Greater EO exposure was correlated with increased serum NfL concentrations in the fully adjusted model [β = 0.28, 95% CI (0.16, 0.40)]. Each additional unit of EO exposure was linked to a 0.28-unit increase in the serum NfL level. Additionally, IN sensitivity analysis by changing EO exposure from a continuous variable to a categorical variable. The serum NfL concentrations increased with increasing tertiles of EO levels. Compared with the lowest tertile, the highest EO exposure tertile was associated with a 0.28-unit increase in serum NfL concentrations (β = 0.28, 95% CI 0.16, 0.40; P for trend = 0.0138).ConclusionOur results indicate a link between increased EO levels and higher serum NfL concentrations in a sample of US adults aged 20 years and older. Although the directionality and clinical significance of this observation remain uncertain, our results emphasize the importance of conducting additional studies to investigate the possible causes and neurological effects of exposure to EO in adults.
Global health inequities in retinoblastoma: a 1990–2021 analysis across socio-demographic index regions
Authors: Li Xi , Chang Ying , Zhao Xiaoyu , Liu Xi , Zhang Ying , Wang Xuan , Li Junhong 
Published: February 2025

ObjectiveTo assess health inequities associated with retinoblastoma across various Socio-Demographic Index (SDI) regions and evaluate whether these inequities have decreased from 1990 to 2021, with the aim of enhancing awareness and guiding government policies.DesignPopulation-based demographic analysis.ParticipantsChildren diagnosed with retinoblastoma from 204 countries and territories.MethodsThe estimates and their 95% uncertainty interval (UI) for disability-adjusted life-years (DALYs) of retinoblastoma were extracted from Global Burden of Disease study (GBD) 2021. The age-standardized DALYs and the average annual percentage change (AAPC) were evaluated.Main measuresThe Slope Index of Inequality (SII) and concentration index were computed to quantify the absolute and relative cross-national health inequality.ResultsAll SDI regions and the majority of countries experienced a significant decline in age-standardized DALYs from 1990 to 2021. The decrease was more rapid in middle to high SDI regions than in low to low-middle SDI regions. Globally, the 2–4 years age group had the highest DALYs rate, consistent with trends in low to middle SDI regions. In contrast, the highest DALYs rate in high and high-middle SDI regions was found in the 12–23 months age group. The SII was −40.81 (95% CI −36.04 to −45.58) DALYs per 100,000 population in 1990 and − 30.32 (95% CI −27.18 to −33.47) DALYs per 100,000 population in 2021. The concentration index increased from −0.37 (95% CI −0.46 to −0.28) in 1990 to −0.45 (95% CI −0.53 to −0.36) in 2021, although this increase did not reach statistical significance (p = 0.256).ConclusionDespite advancements in retinoblastoma management, the overall burden of the disease-related DALY remains disproportionately concentrated in poorer populations. The health inequalities are persisting and widening. This underscores the limitations of current efforts. Until progress benefits everyone, the vision of equitable healthcare remains imperfect.
Impact of action observation therapy on motor and cognitive outcomes in older adults with mild cognitive impairment: a randomized controlled study
Authors: Martin-Blazquez Miriam , Sosa-Reina M. Dolores , Andrade-Granda Angye Micaela , Sanz-Esteban Ismael , López-Ruiz Javier , Estrada Barranco Cecilia 
Published: February 2025

BackgroundMild Cognitive Impairment (MCI) affects both cognitive and motor function, increasing the risk of immobility, falls, and compromising independence. The aim of this study is to determine whether implementing Action Observation Therapy (AOT) in a population with MCI would yield positive outcomes in cognitive status, in activities of daily living (ADLs), upper limb (UL) functionality, gait and balance, and if these results differ based on the observation modality employed.MethodsThirty participants, aged 65 and above with MCI, were assigned to three groups: therapist observation group (TOG), peer observation group (POG), and control group (CG). The intervention comprised physical and cognitive exercises over 5 weeks, with assessments before and after.Resultssignificant differences in post-intervention improvement were found between the groups, excluding the Box and block test. No significant differences were found between the TOG and POG in any improvement variable. Significant differences were found between the CG and the observation groups.ConclusionsThe intervention with AOT proved beneficial for individuals with MCI, yielding significant results both when observing the therapist and when observing a peer compared to the CG, in the domains: cognition, ADLs, gait and balance.
Optimizing DSA parameters for enhanced radiation safety in interventional surgery
Authors: Zeng XunJin , Wang Hao , Chen Guang 
Published: February 2025

ObjectiveThe study aims to establish a reliable method for reducing radiation dose by analyzing variations in radiation dose from digital subtraction machines (DSA).MethodsThe study investigates changes in bed plate height (80–110 cm), detection height (0–30 cm), visual field size (6 × 6 inches and 12 × 12 inches), and radiation doses affecting various body parts, including the lens, thyroid, chest, gonads, and lower limbs. Radiation doses were measured using Raysafe X2 dosimetry for patients and AT1123 meter for operators.ResultsCompared to ordinary fluoroscopy, the low-dose fluoroscopy mode reduced the patient's radiation dose by 50.8% (from 13.2 to 6.5 mGy/min) and the operator's scattered radiation dose by 25–34% (lens dose reduced from 0.72 to 0.47 mGy). In photographic mode, the radiation dose was 3–4 times higher than in ordinary fluoroscopy (e.g., 53.9 vs. 13.2 mGy/min). Raising the bed plate height from 80 to 110 cm reduced the patient's direct radiation dose by 45.5% (from 24.2 to 13.2 mGy/min). The correct application of protective devices reduced the operator's scattering radiation by more than 10 times (e.g., gonads dose reduced from 4.07 to 0.41 mGy).ConclusionSelecting the appropriate bed plate (90–100 cm) and detector height (10–20 cm), along with an optimal visual field (6 × 6 inches), can effectively reduce radiation doses for both patients and operators. The proper use of protective devices in peripheral interventional surgery is crucial for reducing scatter radiation, with reductions exceeding 90% in some cases.