bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the Landscape of Role‐Playing Game Research Through Bibliometric Analysis From 1986 to 2023 Using Scopus Database
Authors: Nguyen Long Thanh , Pham Hiep-Hung , May Amy Yeo Chu , Chin Tay Lee 
Published: February 2025

Background: Role‐playing games (RPGs) have long attracted scholars because of their interactive and immersive attributes. The areas of studies on RPGs are various, from computer science to sociology and psychology. Nevertheless, there is a notable absence of comprehensive systematic literature that traces the trends, changes, and developments in RPG research.Purpose: This paper is aimed at undertaking a systematic review of RPG research by analyzing the Scopus database, covering the period from 1986 to 2023.Method: The analyzed dataset comprises 1152 documents, filtered through the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) screening method from an initial pool of 2908 data points. This data was subjected to analysis using descriptive statistics and bibliometric techniques to discern trends in RPG research and identify influential documents shaping studies in this domain.Findings: This research systematically analyzes RPG research, providing insights into growth patterns, global interest, and influential contributors. By synthesizing diverse research strands, the study contributes valuable knowledge for scholars, practitioners, and policymakers as well as guiding future research in RPGs.Contribution: This research provides valuable insights into the evolving RPG landscape, offering guidance for future research.
Gli2 Facilitates Tumor Immune Evasion and Immunotherapeutic Resistance by Coordinating Wnt Ligand and Prostaglandin Signaling
Authors: DeVito Nicholas C. , Nguyen Y-Van , Sturdivant Michael , Plebanek Michael P. , Villarreal Kaylee A. , Yarla Nagendra , Jain Vaibhav , Aksu Michael , Beasley Georgia M. , Theivanthiran Balamayooran , Hanks Brent A. 
Published: February 2025

Abstract
Therapeutic resistance to immune checkpoint blockade has been commonly linked to the process of mesenchymal transformation (MT) and remains a prevalent obstacle across many cancer types. An improved mechanistic understanding for MT-mediated immune evasion promises to lead to more effective combination therapeutic regimens. Herein, we identified the Hedgehog transcription factor, GLI2, as a key node of tumor-mediated immune evasion and immunotherapy resistance during MT. GLI2 generated an immunotolerant tumor microenvironment through the upregulation of WNT ligand production and increased prostaglandin synthesis. This pathway drove the recruitment, viability, and function of granulocytic myeloid-derived suppressor cells while also impairing type I conventional dendritic cell, CD8+ T cell, and natural killer cell functionality. Pharmacologic inhibition of EP2/EP4 prostaglandin receptor signaling or WNT ligand secretion each reversed a subset of the immunomodulatory effects of GLI2 and prevented primary and adaptive resistance to anti-PD-1 immunotherapy, respectively. A transcriptional GLI2 signature correlated with resistance to anti-PD-1 immunotherapy in stage IV melanoma patients. Together, these findings provide a translational roadmap to direct combination immunotherapies in the clinic.
Spatially resolved, multi-region proteomics for prediction of immunotherapy outcome in deficient mismatch repair metastatic colorectal cancer
Authors: Saberzadeh-Ardestani Bahar , Liu Zhenglong , Stein Mariam I. , Sherman Will A. , Trussoni Christy E. , Abbott Charles W. , Yan Dongyao , Smith Skyler , Shanmugam Kandavel , Graham Rondell P. , Diallo Alos , Levy Joshua J. , Ordog Tamas , Sinicrope Frank A. 
Published: February 2025

Abstract
Purpose. Digital proteomic profiling was performed to identify spatial context in relationship to patient response and survival after anti-PD-1 therapy in metastatic colorectal cancer (CRC). Experimental Design. Primary CRCs with deficient mismatch repair (d-MMR) from patients treated with anti-PD-1 antibodies were analyzed (N=30) using Digital Spatial Profiling (GeoMx® nCounter). At the invasive margin, 71 proteins were profiled in 10 regions of interest /slide that were segmented into 3 compartments labeled with pan-cytokeratin (PanCK; epithelia), CD45 (stromal cells) and SYTO13 (nuclei). In an independent cohort (n=13), DSP data and single cell transcriptomic data were analyzed. Differential protein abundance, after Benjamini-Hochberg correction, was examined by response and progression-free survival (PFS) using multivariable Cox regression. Results. Protein abundance varied significantly between epithelial and stromal compartments. Nonresponders (NR) to anti-PD-1 showed higher fibronectin and smooth muscle actin (SMA) abundance in the epithelial compartment that were associated with significantly shorter PFS (HRadj: 6.49 and 4.52, respectively; p &lt; 0.05). In CD45+ stroma, increased expression of proteins related to T-cells (CD3, CD4), NK cells (CD56), antigen presentation (CD40), immune activation (CD27, ICOS), and apoptosis (GZMA) were found in responders (vs NR) to anti-PD-1; each marker was significantly associated with longer patient PFS (0.02 &lt;HRadj &lt; 0.17; p &lt; 0.05). In a separate cohort, consistent results by compartment were found for fibronectin and CD56. Gene expression data revealed that fibronectin and SMA were primarily derived from cancer-associated fibroblasts. Conclusions. Spatially resolved protein profiles within microenvironments of d-MMR CRCs can influence patient response and survival after anti-PD-1 highlighting their potential clinical significance.
Valsartan to Prevent Acquired Pulmonary Vein Stenosis in Pediatric Patients After Total Anomalous Pulmonary Venous Connection Surgery
Authors: Shentu Jin , Zhang Mingjie , Xu Zhuoming , Wen Chen , Zhang Hao , Zhu Zhongqun , Chen Huiwen , Shi Guocheng 
Published: February 2025

Background
Recurrent pulmonary vein stenosis (PVS) following surgical repair of total anomalous pulmonary venous connection is associated with poor prognosis. Preclinical studies have shown that use of an angiotensin receptor blocker can attenuate intimal hyperplasia; notwithstanding, its clinical utility is of uncertain benefit.

Methods
This single‐center study included patients undergoing total anomalous pulmonary venous connection repair in 2020 to 2021. Since August 2020, patients have been considered for valsartan therapy early after operation. Contemporaneous participants were subcategorized into study versus control groups based on valsartan exposure. Patients in the control group were treated with the same protocolized algorithm except valsartan administration. The primary end point was postoperative PVS (PPVS) progression.

Results

Overall, 104 patients operated on at a median age of 1.3 months were included (valsartan group: 25 versus control group: 79). The baseline characteristics were similar between the 2 groups. Within a median follow‐up of 28.6 months, 27 patients developed PPVS noted by echocardiography and computed tomography angiography, among which 22 with clinical PPVS underwent reoperations. No between‐group difference was observed in the incidence of initial PPVS (
P
=0.80, Cohen's h=0.06 [95% CI, −0.38 to 0.50]) and reoperation (
P
=0.46, Cohen's h=−0.18[ 95% CI, −0.65 to 0.29]); however, patients in the valsartan group had a significantly lower risk of PPVS progression (
P
=0.019, Cohen's h=−1.12 [95% CI, −1.66 to −0.57]) and subsequent PPVS progression after reoperation (
P
=0.011, Cohen's h=−1.71 [95% CI, −2.61 to −0.82]) compared with the control group. PPVS‐related death was observed in 9 cases (11.4%) in the control group versus none (0%) in the valsartan group. No adverse event related to valsartan occurred in this series.

Conclusions
Early use of valsartan after total anomalous pulmonary venous connection surgery appears to potentially be a feasible and effective adjunct to reoperation in treating pediatric acquired PVS.
Artificial Intelligence ECG Diastolic Dysfunction and Survival in Cardiac Intensive Care Unit Patients
Authors: Jentzer Jacob C. , Lee Eunjung , Attia Zachi , Hillerson Dustin , Kane Garvan C. , Lopez‐Jimenez Francisco , Noseworthy Peter A. , Friedman Paul A. , Oh Jae K. 
Published: February 2025

Background
Left ventricular diastolic dysfunction (LVDD) predicts mortality in patients in cardiac intensive care units. An artificial intelligence enhanced ECG (AIECG) algorithm can predict LVDD and mortality in general populations but has not been examined in cardiac intensive care units.

Methods
This historical cohort study included consecutive adults admitted to Mayo Clinic cardiac intensive care unit from 2007 to 2018 with an admission AIECG. The AIECG assigned the LVDD grade (0–3). Medial mitral E/e' ratio >15 on transthoracic echocardiogram (TTE) defined elevated filling pressures. In‐hospital and 1‐year mortality was evaluated, before and after multivariable adjustment.

Results
We included 11 868 patients (median age 69.5 years, 37.7% female); 48% had heart failure and 44% had acute coronary syndromes. AIECG LVDD grade was 0 (normal), 33%; 1, 7%; 2, 39%; and 3, 21%. In‐hospital and 1‐year mortality increased in each higher AIECG LVDD grade. After adjustment, each higher AIECG LVDD grade was associated with higher in‐hospital (adjusted odds ratio [OR], 1.22 [95% CI, 1.13–1.32]) and 1‐year mortality (adjusted hazard ratio [HR], 1.23 [95% CI, 1.19–1.29]); this persisted after adjustment for TTE measurements. Patients with grade 2 or 3 LVDD by AIECG and medial mitral E/e' ratio >15 by TTE had the highest in‐hospital (adjusted OR, 2.54 [95% CI, 1.69–3.88]) and 1‐year (adjusted HR, 2.03 [95% CI, 1.65–2.48]) mortality, whereas patients meeting either of these criteria had similar, elevated mortality.

Conclusions
The AIECG LVDD grade was strongly associated with in‐hospital and 1‐year mortality in patients in cardiac intensive care units, even after adjusting for clinical variables and TTE measurements. Patients with concordant AIECG and TTE for elevated filling pressures were at highest risk.
In‐Hospital or Out‐of‐Hospital Initiation of Sacubitril/Valsartan Versus Valsartan in Patients With Mildly Reduced or Preserved Ejection Fraction After A Worsening Heart Failure Event: The PARAGLIDE‐HF Trial
Authors: Nouhravesh Nina , Cyr Derek , Hernandez Adrian F. , Morrow David A. , Velazquez Eric J. , Ward Jonathan , Sarwat Samiha , Sharma Kavita , Williamson Kristin , Starling Randall C. , Lepage Serge , Zieroth Shelley , Solomon Scott D. , Mentz Robert J. 
Published: February 2025

Background
Efficacy and tolerability of sacubitril/valsartan (Sac/Val) is not well characterized in heart failure (HF) with ejection fraction >40% initiated in‐hospital. Thus, this prespecified PARAGLIDE‐HF (Prospective Comparison of ARNI With ARB Given Following Stabilization In Decompensated HFpEF) analysis assessed the effects of Sac/Val versus valsartan (Val) by location of initiation in HF with ejection fraction >40% and recent worsening HF.

Methods and Results

This analysis of the double‐blind, randomized controlled trial assessed patients by in‐hospital and out‐of‐hospital (≤30 days of worsening HF) initiation. The primary end point was time‐averaged proportional change in NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) from baseline through weeks 4 and 8. A secondary hierarchical outcome consisted of cardiovascular death, HF hospitalizations, urgent HF visits, and NT‐proBNP change. Safety end points were symptomatic hypotension, hyperkalemia, and worsening renal function. Overall, 324 (70%, 162 Sac/Val, 162 Val) were initiated in‐hospital and 142 (71 Sac/Val, 71 Val) out‐of‐hospital. There was no evidence of a statistically significant differential treatment benefit of Sac/Val versus Val on NT‐proBNP change by location of initiation (in‐hospital, 0.86 [95% CI, 0.70–1.05] and out‐of‐hospital, 0.87 [95% CI, 0.70–1.09];
P
interaction
=0.99). The win ratio for the hierarchical outcome was 1.09 (95% CI, 0.82–1.45;
P
=0.57) for in‐hospital and 1.43 (95% CI, 0.91–2.26;
P
=0.12) for out‐of‐hospital. For the safety end points of symptomatic hypotension, hyperkalemia, and worsening renal function, no statistically significant differences in tolerability were seen between in‐hospital and out‐hospital initiation (
P
interaction
>0.1).

Conclusions
Sac/Val provided consistent benefit compared with Val, whether initiated in‐hospital or out‐of‐hospital in HF with ejection fraction >40% with a recent worsening HF event, demonstrating an opportunity to improve postdischarge outcomes by initiating Sac/Val during hospitalization.
Investigating Sensitivity to Shared Information and Personal Experience in Children’s Use of Majority Information
Authors: Gelpí Rebekah A. , Otsubo Kay , Whalen Amy , Buchsbaum Daphna 
Published: February 2025

Abstract
Children and adults alike rely on others to learn about the world, but also need to be able to determine the strength of both their own evidence as well as the evidence that other people provide, particularly when different sources of information disagree. For example, if two informants agree on a belief but share the same evidence, their testimony is statistically dependent on each other, and may be weaker evidence for that belief than two informants who draw on different pieces of evidence to support that belief. Across three experiments (total N = 492), we examine how 4- and 5-year-old children evaluate statistical dependency on a task where they must determine which of two jars that toys were drawn from. A majority of informants, whose testimony could draw from the same evidence or different evidence, always endorsed one jar. Then, children were presented with a dissenting informant or their own personal data that was consistent with the other jar. Children showed no sensitivity to statistical dependency, choosing the majority with equal probability regardless of the independence of their testimony, but also systematically overweighted their own personal data, endorsing the jar consistent with their own evidence more often than would be predicted by an optimal Bayesian model. In contrast, children made choices consistent with this model on a similar task in which the data was presented to children without testimony. Our findings suggest that young children treat majorities as broadly informative, but that the challenges of inferring others’ experiences may lead them to rely on concrete, visible evidence when it is available.
Exploring Completion Rates of the SNOT-22 Questionnaire
Authors: Amin Luv , Davis John , Thapa Mishek , Khalil Syeda L. , Wu Arthur W. , Higgins Thomas S. , Tang Dennis M. 
Published: February 2025

Background: The 22-item Sinonasal Outcome Test (SNOT-22) is a widely used patient-reported outcome measure (PROM) for assessing chronic rhinosinusitis (CRS). However, incomplete surveys may impact its predictive utility. Aims: This study explores SNOT-22 completion rates, response trends, and potential factors influencing survey omissions aiming to optimize its predictive utility and practical application. Methods: SNOT-22 surveys were retrospectively collected from patients at various time points throughout their CRS treatment. Surveys with at least one question unanswered were included in the study. Completely unanswered surveys were excluded. Survey response dynamics and trends were analyzed and reported. Results: 1,034 SNOT-22 surveys were collected, 18% of the surveys were incomplete. Questions on “Ear fullness” and “Embarrassed” were most unanswered, while “Need to blow nose” and “Nasal blockage” were least unanswered. Questions later in the survey showed a moderate positive correlation with missing responses. Mean scores per question were higher in incomplete than in complete surveys, though differences in SNOT-22 scores between partially and fully completed surveys weren’t significant. Conclusion: Our study found that a large number of SNOT-22 surveys were incomplete, higher than rates reported in similar PROMs. Mean scores did not differ significantly between partial and complete surveys, suggesting interpretation should prioritize individual responses over total scores. Potential barriers to survey completion include question wording, symptom relevance, and survey length. Future research should further investigate survey completion through qualitative methods and randomized question ordering to refine survey design.
Effects of Auditory Anticipatory Cues and Lead Time on Visually Induced Motion Sickness
Authors: Xin Xin , Chen Xinyuan , Liu Wei 
Published: February 2025

Objective This study aims to investigate the ability of auditory cues for predicting motion and lead times to mitigate visually induced motion sickness (VIMS). Background The vehicle information systems predominantly utilize visual displays, which can introduce conflicts between visual and vestibular motion cues, potentially resulting in VIMS. In these scenarios, auditory cues may provide a viable solution, especially when visual cues are diminished by fatigue or distractions. Methods In two distinct studies, a total of 180 participants were involved in investigating the impact of auditory cues on VIMS. In Study 1, participants were categorized based on the type of auditory cue they received (speech, nonspeech, or no-cue). Study 2 examined the effects of three different lead times (1 s, 2 s, and 3 s) between the activation of the auditory cue and the occurrence of car braking or turning in nonspeech conditions. VIMS severity was assessed with the Simulator Sickness Questionnaire (SSQ) before and after the simulation phase. Results Nonspeech cues significantly reduced VIMS compared to speech or no-cue. VIMS was notably lower with a 2 s lead time than with 1 s or 3 s lead times, and females reported higher levels of VIMS than males. Conclusion Results across two studies suggest using nonspeech cues with a 2-second lead time to reduce VIMS. It also recommends investigating the effects of duration, tone, and voice frequency. Furthermore, the study proposes extensive research into lead time settings for various scenarios such as driving fatigue, hillside roads, and traffic congestion. Application These findings offer potential value in designing auditory cues to reduce VIMS in autonomous driving, simulators, VR games, and films.
Production of polystyrene nanofibers for adsorption of mineral oils derived from petroleum
Authors: da Silveira Kelen Pagliarini , da Silva Crespo Janaina , Catafesta Jadna , Giovanela Marcelo , Takimi Antonio Shigueaki , Tubino Rejane Maria Candiota 
Published: February 2025

Technological innovations can offer a multitude of benefits to modern society; however, they often fail to fully address the desired requirements for the specific applications, particularly when considering environmental impacts of solid waste. Expanded polystyrene (EPS) waste exemplifies this challenge, highlighting the urgent need for innovative and effective solutions to address the existing gaps in conventional technologies. In this regard, chemical dissolution methods using organic solvents emerge as a viable approach for polymer recovery and impurity removal. This study focused on the preparation of EPS nanofibers from polymeric solutions with concentrations of 10% (EPS_10) and 15% (w/w) (EPS_15) in chloroform, employing the solution blow spinning technique. The resulting nanofibers were then characterized morphologically through scanning electron microscopy and evaluated for their oil adsorption efficiency. Overall, the EPS_10 and EPS_15 nanofibers displayed average diameters of 149.7 and 330.5 nm, respectively, and achieved maximum adsorption capacities of 37.0 and 70.1 g/g for petroleum jelly, and 33.3 and 48.9 g/g for lubricating oil. These results emphasize the transformative potential of EPS nanofibers as high-performance sorbent materials, offering promising opportunities for their application in oil spill remediation and wastewater treatment. By addressing a critical environmental issue, this work contributes to developing a solution for managing solid waste and mitigating its ecological impact.
Impact of Sepsis Onset Timing on All-Cause Mortality in Acute Pancreatitis: A Multicenter Retrospective Cohort Study
Authors: Huang Xiaodong , Liu Siyao , Xu Zhihong , Liu Xiong , Hu Jun , Pan Mandong , Yang Chengbin , Lin Jiyan , Huang Xianwei 
Published: February 2025

Background Sepsis complicates acute pancreatitis (AP), increasing mortality risk. Few studies have examined how sepsis and its onset timing affect mortality in AP. This study evaluates the association between sepsis occurrence and all-cause mortality in AP, focusing specifically on the impact of sepsis onset timing. Methods This multicenter retrospective cohort study included 494 ICU-admitted AP patients from the MIMIC-IV database and 91 from our center. Patients were grouped by sepsis occurrence and onset timing. Clinical outcomes were in-hospital and 90-day all-cause mortality. Machine learning identified key variables associated with mortality. Multivariable regression analyzed the impact of sepsis and its onset timing on mortality. To reduce baseline differences, propensity score matching (PSM) based on time to sepsis was conducted. After PSM, Kaplan-Meier survival analyses incorporated data from our center for validation. Restricted cubic spline analysis examined any nonlinear relationship between sepsis onset timing and mortality. Results Patients with sepsis had significantly higher in-hospital and 90-day mortality rates than those without sepsis ( p < 0.05). Sepsis was identified as a significant risk factor for in-hospital mortality and remained significantly associated after adjusting for key variables ( p < 0.05). However, sepsis onset timing did not significantly impact in-hospital or 90-day mortality. These findings were validated after PSM and with our center's data. No nonlinear relationship between sepsis onset timing and mortality was found. Conclusion Sepsis significantly increases all-cause mortality in AP patients, but the timing of its onset has limited impact. Continuous monitoring and intervention for sepsis during hospitalization are recommended to improve prognosis.
A deep learning detection method for pancreatic cystic neoplasm based on Mamba architecture
Authors: Dai Junlong , He Cong , Jin Liang , Chen Chengwei , Wu Jie , Bian Yun 
Published: February 2025

Objective: Early diagnosis of pancreatic cystic neoplasm (PCN) is crucial for patient survival. This study proposes M-YOLO, a novel model combining Mamba architecture and YOLO, to enhance the detection of pancreatic cystic tumors. The model addresses the technical challenge posed by the tumors’ complex morphological features in medical images. Methods: This study develops an innovative deep learning network architecture, M-YOLO (Mamba YOLOv10), which combines the advantages of Mamba and YOLOv10 and aims to improve the accuracy and efficiency of pancreatic cystic neoplasm(PCN) detection. The Mamba architecture, with its superior sequence modeling capabilities, is ideally suited for processing the rich contextual information contained in medical images. At the same time, YOLOv10's fast object detection feature ensures the system's viability for application in clinical practice. Results: M-YOLO has a high sensitivity of 0.98, a specificity of 0.92, a precision of 0.96, an F1 value of 0.97, an accuracy of 0.93, as well as a mean average precision (mAP) of 0.96 at 50% intersection-to-union (IoU) threshold on the dataset provided by Changhai Hospital. Conclusions: M-YOLO(Mamba YOLOv10) enhances the identification performance of PCN by integrating the deep feature extraction capability of Mamba and the fast localization technique of YOLOv10.