bluuebunny/crossref_metadata_2025_split huggingface dataset:
Soft Fuzzy Reinforcement Neural Network PD Controller
Authors: Han Qiang , Boussaid Farid , Bennamoun Mohammed 
Published: December 2024

Abstract

Fuzzy PD controllers are widely used in industry due to their excellent control performance and robustness. However, their performance heavily relies on manually designed fuzzy logic. Fuzzy neural networks (FNNs) combine neural networks and fuzzy logic, allowing them to utilize expert knowledge and possess self-learning capabilities. FNNs can be used to automatically tune PD parameters, resulting in a more robust fuzzy neural network PD (FNNPD) controller. Most current research on FNNPD controllers focuses on training using system mean square error, which can be inefficient and unstable, especially in complex systems. By integrating a critic in an actor-critic framework, learning efficiency improves as the critic provides direct feedback by evaluating actions, leading to faster and more stable training. This paper proposes an algorithm that applies the Soft Actor-Critic (SAC) framework to FNNPD controller, referred to as soft fuzzy reinforcement neural network PD (SFPD) controller. The SFPD algorithm can pre-set the parameters of FNNs using expert knowledge, ensuring good control performance from the beginning of training. By using reinforcement learning, the network parameters can be automatically adjusted. The use of a stochastic algorithm with entropy during the exploration process greatly accelerates exploration. Reported results demonstrate that the proposed method achieves rapid learning speed and superior control performance, and exhibits robustness to noise. The utilization of expert knowledge enables the proposed controller to exhibit good control performance from the start of training.
Heterogeneity of PD-L1 expression on tumor cells and tumor-infiltrating immune cells between the primary tumor and matched lymph node metastases in head and neck squamous cell carcinomas
Authors: Knebel Moritz , Klamminger Gilbert Georg , Kühn Jan Philipp , Körner Sandrina , Wemmert Silke , Brust Lukas Alexander , Braun Felix , Smola Sigrun , Wagner Mathias , Ertz Martin , Morris Luc G. T. , Schick Bernhard , Linxweiler Maximilian 
Published: December 2024

Abstract

Background: The role of immune checkpoint inhibition in treating head and neck squamous cell carcinoma (HNSCC) is expanding, yet response rates to PD-L1 therapy remain inconsistent and generally poor. Although several studies have examined heterogeneous intratumoral PD-L1 expression, the disparity in response to PD-L1 therapy between primary tumors and their associated lymph node metastases remains unclear.
Methods: Primary tumor samples and two matching lymph node metastases were obtained from a cohort of 50 patients and immunohistochemically stained with a PD-L1 antibody. PD-L1 expression, assessed using the combined positive score (CPS) and tumor proportion score (TPS), and immune infiltration, measured with an immunoreactive score (IRS), were compared between the primary tumor and lymph node metastases. These measures were then correlated with other histopathological and clinical features.
Results: PD-L1 expression, evaluated by CPS and TPS, showed no significant differences between the primary tumor and matched lymph node metastases. However, 18% (CPS) respectively 4% (TPS) of patients exhibited clinically relevant discordant CPS and TPS values between their primary tumor and lymph node metastases with respect to the cutoff level for FDA and EMA approval. CPS and TPS values were not influenced by primary tumor subsite or HPV status. Conversely, immune infiltration measured by IRS was significantly affected by primary tumor subsite location. Both HPV tumor status and primary tumor subsite were statistically significantly associated with overall survival.
Conclusion: Our study emphasizes the heterogeneity in PD-L1 expression in HNSCC patients and provides potential explanations for the heterogeneous response of primary tumors and lymph node metastases to immune checkpoint therapy as observed in recent clinical trials. These findings underscore the need for a more comprehensive understanding of PD-L1 expression in head and neck cancer and delineate a rational for re-biopsies including lymph node metastases if therapeutic cut-offs for Anti-PD-1 therapy are initially not met.
The Joint Effects of Sleep Duration and Exercise Habit on All-cause Mortality among Chinese Elderly: A National Community-Based Cohort Study
Authors: LI Na , REN Kexin , TAO Yuan 
Published: December 2024

Abstract

This study investigates the combined impact of sleep duration and exercise habits on all-cause mortality among the elderly population in China, utilizing data from 7,231 residents aged 60 and above from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Participants were categorized based on their exercise habits and sleep duration, which were analyzed over three follow-ups (2011, 2014, and 2018). The findings revealed that normal sleep (6-8 hours) correlated with a 20% reduction in mortality risk compared to short sleepers, while long sleep (over 8 hours) was linked to a 29% increase in mortality risk. Exercise significantly affected mortality; active individuals had a reduced risk, and those transitioning from inactivity to activity saw a 12% reduction in mortality. Notably, among short sleepers, exercise habits did not significantly impact mortality for either sex. However, for those with normal or long sleep, both men and women experienced significant mortality benefits from regular exercise. Additionally, older women moving from a sedentary lifestyle to physical activity during periods of long sleep demonstrated lower mortality rates. This research highlights the importance of both sleep and exercise in influencing health outcomes, with notable gender differences in their combined effects on mortality risk.
Analysis of the Quality of Septoplasty Videos on YouTube and Validation of the IVORY-Grading-System Quality of Septoplasty Videos
Authors: Mayer Marcel , Isik Tarik Bugra , Ev Ina , Kurnaz Yigit , Kirca Numan , Wahl Albert , Kourou Sofia , Hansen Kevin Karl , Nachtsheim Lisa , Wolber Philipp , Klussmann Jens Peter , Shabli Sami 
Published: December 2024

Abstract

Objective
This study aimed to analyze the educational quality of septoplasty videos on YouTube and validate the “Instructional Videos in Otorhinolaryngology by YO-IFOS-Grading-System” (IVORY-GS), the first otorhinolaryngology-specific video scoring system based on the IVORY Guidelines.
Methods
A search for “septoplasty,” “closed septoplasty,” and “deviated nasal septum surgery” was performed on YouTube in March 2023. Videos of surgeries on patients and cadaver dissections were included. The IVORY-GS was adjusted for septoplasty and applied to rate video quality based on criteria related to ethics, technical aspects, case presentation, surgical procedure, and organ-specific elements. Descriptive data on video characteristics was collected, including views, likes, video length, and time since publication. Statistical analyses were conducted to identify associations between video features and the IVORY-GS total score.
Results
Overall, 105 septoplasty videos were included. Among these, 40% demonstrated Cottle’s, while 53% followed Killian’s technique. Mean IVORY-GS total score for septoplasty videos was 25.3 (maximum 48). Video education quality was rated as moderate/high in 10%. Endoscopic versus macroscopic videos (p < 0.01) and videos published within the last 50 months versus those published earlier (p < 0.01) received significantly higher total scores. A significant correlation was found between the total score and number of likes (p = 0.02). A higher total score was a significant predictor for more likes (p = 0.02).
Conclusion
The analysis revealed only a small proportion of septoplasty videos available on YouTube being suitable for surgical training. The IVORY-GS has proven useful in assessing the educational value of otolaryngology-specific videos and can be beneficial for establishing a dedicated online platform for high-quality otorhinolaryngology surgery videos.
Impact of transition to Dolutegravir-based antiretroviral therapy on virological suppression among children living with HIV in Southern Nigeria: A before and after analysis of program data
Authors: Ani Izuchukwu , Iyamu Ihoghosa , Akpan Uduak , Nwanja Esther , Onwah Ogheneuzuazo , Toyo Otoyo , Gana Bala , Joseph Umana , Okolo Chukwuemeka , Usang Sifon , Egbe Emmanuel , Isang Etiemana , Unimuike Maria , Katbi Moses , Idemudia Augustine , Oyawola Babatunde , Onimode Bayo Mohammed , Asaolu Olugbenga , Ogundehin Dolapo , Igboelina Onyeka , Gado Pamela , Obiora-Okafo Chika , Omo-Emmanuel Ughweroghene , James Ezekiel , Pius Jemeh , Oyelaran Omosalewa , Onyedinachi Okezie , Adegboye Adeoye , Eyo Andy 
Published: December 2024

Abstract

Background
In 2021, Nigeria introduced the 10mg paediatric dolutegravir (DTG) formulation for children living with HIV (CLHIV) aiming to improve virological outcomes, and immediately commenced transitioning children < 10 years old on first-line non-DTG-based regimen to DTG. We assessed the association between the transition to DTG-based ART and virological suppression among CLHIV.
Methods
We conducted a retrospective cohort study using routinely collected data from 121 PEPFAR-supported health facilities in Akwa Ibom and Cross River States. We included all ART-experienced CLHIV who were transitioned to DTG between July and December 2021, had a baseline viral load (VL) assessment before the transition and VL ≥ 6 months after transitioning. We defined VL as a three-level outcome (i.e., ≤ 50 copies/ml – undetectable, 51–999 copies/ml – low-level viremia and ≥ 1,000 copies/ml – unsuppressed). We assessed the association between the transition to DTG and VL using ordinal logistic regression with generalized estimating equations. We also conducted additional sensitivity analyses on a complete case dataset and assessed the impact of the transition on various definitions of virological suppression including undetectable (< 50 copies/ml) vs. detectable (≥ 50 copies/ml).
Results
Out of 1,951 CLHIV included in this analysis, 1,250 (64.1%) were between the ages of five and nine, 993 (50.9%) were male. Among these, 1,786 (91.5%) had undetectable VL levels, up from 1,611 (82.6%) at baseline, while 123 (6.3%) had low-level viraemia, down from 271 (13.9%) initially. The transition to DTG-based ART was associated with virological suppression (adjusted odds ratio [aOR]: 1.70, 95%CI: 1.20, 2.41) and undetectable VL (aOR: 2.56, 95%CI: 2.06, 3.19). Findings were consistent in sensitivity analyses.
Conclusions
CLHIV achieved favourable virological changes when transitioned to DTG-based ART, including undetectable viral load rates. Findings suggest DTG can improve overall program outcomes and reduce the risk for low-level viremia in CLHIV, emphasizing its role in achieving HIV epidemic control among CLHIV.
Challenges encountered in the implementation of art therapy as an intervention for college students with psychological problems in colleges in China
Authors: Guangli Luo 
Published: December 2024

Abstract

Numerous studies have explained the different healing benefits of art therapy to different people all over the world in recent times. However, irrespective of the outstanding benefits of art therapy to different people with mental disorders, psychological issues are still prevalent among college students all over the world, including China. This prevalence of psychological problems among college students is because art therapy is not implemented in most colleges and universities due to some challenges they face. This study specifically focuses on three main challenges encountered by colleges in applying art therapy. The study is anchored on Bronfenbrenner’s ecological systems theory, which describes the various complex systems that interact in individuals in influencing their development mentally, physically and socially. The research is a quantitative descriptive study aimed at determining the challenges facing colleges and universities in China in implementing art therapy for students with psychological problems. The study data were obtained via interview carried out online with the research participants. The research population included teachers and counselors from five schools (SCBC, GMU, BNU, CCOM and SHCM) selected in China. The responses from the participants were presented in tables and analyzed using descriptive analysis. The study results revealed that the challenges facing colleges in China in implementing art therapy for their students. The challenges are specifically insufficient funding for art therapy facilities and resources, lack of trained teachers and counselors and students’ attitude towards art therapy. This study aims to examine the challenges facing colleges and universities in China in implementing art therapy as an intervention for their students with psychological problems. This study proposed a sustainable art programme that can be applied to address these challenges, which would be of great benefit to students’ psychological development.
Mixotrophy in Pyrophacus horologium (thecate dinoflagellate): Predation on toxic and harmful dinoflagellates and molecular phylogenetics
Authors: Kim Mu-chan , Seong Min-Jun , Yun Kun-Woo , Son Hwa-Seong , Lee Seung-Min 
Published: December 2024

Abstract

In June 2023, Pyrophacus horologium, known to be an autotrophic thecate dinoflagellate, was isolated from the Masan Bay, Korea. In this study, we investigated the morphology, novel molecular characteristics, and feeding characteristics of P. horologium in a successfully established clonal culture strain. Morphological analysis was conducted by capturing detailed images of living and fixed cells using an inverted light microscope and a scanning electron microscope. The morphological analysis confirmed the classification of P. horologium based on the following Kofoidian plate formula: Po, X, 5′, 0a, 9′′, 9c, Pc, 8s, 9′′′, 1p, and 3′′′′. We investigated the previously unreported molecular characteristics of P. horologium by examining interspecies differences using the small subunit, internal transcribed spacer, and large subunit ribosomal rDNA regions. A significant genetic difference was observed between P. horologium and Pyrophacus steinii, demonstrating that P. horologium is distinct from P. steinii. The feeding characteristics showed that P. horologium primarily preys on thecate dinoflagellates with an equivalent spherical diameter of 10.1–31.5 µm, including toxic species, i.e., Alexandrium tamarense, Alexandrium catenella, and Gonyaulax spinifera. Additionally, P. horologium strongly preferred G. spinifera and Heterocapsa niei as its prey. It brought the prey directly to its sulcal plates for ingestion or captured it using a tow filament before feeding and ingested its prey through direct engulfment. Thus, based on the results obtained in this study, we propose that P. horologium, earlier classified as an autotrophic dinoflagellate, is a mixotrophic dinoflagellate.
Response Evaluation to Oxaliplatin-Based Adjuvant Chemotherapy After Curative Resection Between Right and Left-Sided Stage II and III Colon Cancer: A Retrospective Survival Analysis.
Authors: NASR Cynthia , Nasr Cassandra , Hawat Stephanie El , Riachy Christelle El , Massoud Marcel 
Published: December 2024

Abstract

Background
Colon cancer is divided into Right and Left colon cancer. It manifests with distinct physiopathology, histology, presentation, and prognosis. The choice of treatment for stage IV disease is based on tumor sidedness. However, until now, stage II and III diseases are being treated with the same regimens regardless of the tumor location.
Methods
A retrospective survival analysis was performed between January 1, 2009 and December 31, 2019 on 57 Lebanese patients who were diagnosed with stage II or III colon cancer and who underwent curative surgical resection followed by Oxaliplatin-based adjuvant chemotherapy (XELOX or FOLFOX). Response to chemotherapy, as well as recurrence, were assessed with thoraco-abdominopelvic CT scan or Magnetic resonance imaging (MRI), scheduled regularly.
Results
Left-sided tumors were more common than right-sided ones, 57,9% vs. 42,1% (p = 0,483) .
Concerning the tumor size, right colon cancer (RCC) recorded larger sizes (5.53 cm vs. 4,89 cm) compared to the left colon cancer (LCC), but this difference is not statistically significant (p=0,252).
Despite cancer localization, FOLFOX was the main regimen used for stage III colon cancer, while XELOX was the main one for stage II.
Finally, the survival rate in the RCC group was 100% in the first year post-surgery (p=0,385), remained 100% in the second year and until the sixth year (p=0,214; p=0,005 respectively), then decreased to 95,65% in the seventh year (p = 0,021). However, the survival rate in the LCC group was 96,8 % in the first year post-surgery (p=0,385), then decreased gradually to 93,5% in the second year (p=0,214); it reached 71% in the fifth year (p = 0.005) and remained the same in the 3 years that followed.
Conclusion
Colon cancer is a type of malignancy that carries a good prognosis when discovered at the early stages.
A better prognosis was noted in RCC compared to LCC in early-stage disease (stage II-III), with a 5-year survival rate of 100% in RCC vs. 71% in left sided ones.
Unlocking Magnetic Resonance Images Potential: Innovative Brain Tumor Classification via Transfer Learning and Convolutional Neural Networks
Authors: Rad Mohammad Farhadi , Tahmasbi Marziyeh , Bagheri Hamed , Rezaee Seyed Parviz , Gerami Reza , Khah Ali Mosadegh , Sadeghi Shahriar 
Published: December 2024

Abstract

Background and Objectives:
Recent advancements in artificial intelligence (AI), particularly through convolutional neural networks (CNNs), have led to significant progress in tumor detection and classification systems. This study aims to train and evaluate the performance of four distinct CNN models for the 4-way classification of glioma, meningioma, pituitary tumors, and non-tumor magnetic resonance images (MRI).
Methods
Data augmentation techniques were applied to MRI slices from the Figshare, Br35H, and Brain Tumor Classification datasets to enhance the generalizability of the models and mitigate overfitting, effectively increasing the sample size. Four pre-trained CNN models including VGG-16, AlexNet, GoogleNet, and ResNet-50 were fine-tuned for brain tumor classification.
Results
Transfer learning proved highly effective for classifying tumor types and identifying non-tumor images. The performance metrics showed that AlexNet achieved an accuracy of 97.33%, ResNet-50 reached 98.03%, GoogLeNet attained 98.09%, and VGG-16 matched AlexNet with 97.33% accuracy on the test dataset. Among the models, GoogleNet achieved the highest accuracy with fewer parameters, while ResNet-50 demonstrated the highest sensitivity and F1-Score. All models performed exceptionally well, with sensitivity and precision exceeding 95%.
Conclusion
The research highlights the effectiveness of deep learning techniques, especially CNNs and transfer learning, in classifying brain tumor types using MR images. The study emphasizes that merely increasing model parameters does not guarantee better performance, underscoring the need for fine-tuning models originally trained on ImageNet for medical imaging tasks. These findings contribute to advancing automated medical image analysis, potentially leading to earlier brain tumor diagnosis and improved patient outcomes.
Design and Implementation of an AI-Powered Sapient System for Maximum Efficiency of Fractionation Operations
Authors: Amirsalari Behzad 
Published: December 2024

Abstract

This paper introduces a multi-step and comprehensive data-intensive structure to optimize the control of petrochemical fractionation columns using big-data analysis. The case study involved 11 parameters categorized into five control (adjustable) inputs, four imposed (non-adjustable) inputs, and two target outputs. The results from a factorial-designed set of experiments on a simulated model of a functional de-Ethanizer distillation unit constructed the initial database, consisting of 5620 vectors. The generated big dataset then trained a feed-forward artificial neural network (FF-ANN) that predicts the characteristics of the produced Ethane in response to ten input parameters. Subsequently, this trained model provided the feasible region for a multi-objective particle swarm optimization (PSO) algorithm to predict 625 individual optimum control points in response to different combinations of the imposed parameters. Finally, these optimum operation conditions trained five dedicated individual ANNs to predict a continuous optimum operation log according to the imposed parameters. This multi-step architecture of optimization and ANNs forms a flexible data-driven sapient system for the optimum control of distillation columns.
Addressing digital exclusion to improve access to HIV and viral hepatitis care for people who experience criminalization: A mixed methods evaluation of a quality improvement project
Authors: Tiwana Amrit , Gale Nicola , Mahay Mike , Barker Tiffany , Hasdell Rebecca , Young Pam , Korchinski Mo , Schmitz Deb , Luster Daryl , Ramji Alnoor , MacIsaac Julia , Conway Brian , Fraser Chris , Bartlett Sofia 
Published: December 2024

Abstract

Background
People who experience criminalization, such as those who use drugs, are incarcerated, and are affected by homelessness, have a high prevalence of HIV and/or hepatitis C virus (HCV) infection and low treatment uptake in British Columbia. Barriers to care include unreliable means of maintaining contact with healthcare providers. To reduce these barriers, the Test, Link, Call (TLC) Project provides cell phones and peer health mentors to support access to HIV and/or HCV care. This study aims to determine the outcomes and acceptability of TLC and its impact on care engagement.
Methods
A mixed-methods evaluation was conducted over the first 29 months (October 2021–March 2024) of the TLC Project. Data were collected concurrently in two rounds: the first after one year and the second two years after launch. Qualitative data were collected using semi-structured interviews conducted with healthcare providers (n = 8), peer health mentors (n = 6), and program participants (n = 20). Quantitative data, including demographic and clinical information, were gathered through program records and cross-sectional clinical chart reviews. Factors associated with HCV treatment uptake were assessed among HCV RNA positive participants (n = 245) using multivariate logistic regression. Data from both rounds were integrated for comprehensive analysis.
Results
273 participants were enrolled in HCV care, and 26 in HIV care. Interviewees found TLC highly acceptable and effective. Positive outcomes included increased access to health and social services, connection to loved ones, independence, and safety. Challenges included phone theft and digital literacy issues. Overall, 57% of TLC participants enrolled for HCV care initiated curative treatment, compared to 40% among people who currently inject drugs in the provincial administrative database in 2020. The multivariate logistic regression analysis suggested that gender, housing stability, safer supply prescriptions, and length of involvement in the TLC program are predictive factors influencing treatment initiation.
Conclusions
The provision of cell phones and peer health mentors effectively increased engagement in HIV and HCV care, demonstrating substantial benefits despite some challenges. This cost-effective intervention could be expanded to support people who experience criminalization in other geographic locations and addressing other health conditions, such as syphilis and substance use disorder.